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This study aimed to assess antihyperlipidemic, cardiac and antioxidant effects as well as mode of actions of Musa paradisiaca (M. paradisiaca) leaf and fruit peel hydroethanolic extracts in nicotinamide (NA)/streptozotocin (STZ)‐induced diabetic rats. Experimental diabetes mellitus was induced by a single intraperitoneal injection of STZ (60 mg/kg body weight), 15 min after intraperitoneal injection of NA (120 mg/kg body weight). NA/STZ‐induced diabetic rats were orally supplemented with M. paradisiaca leaf and fruit peel hydroethanolic extracts in a dose of 100 mg/kg body weight/day for 28 days. The treatment of NA/STZ‐induced diabetic rats with M. paradisiaca leaf and fruit peel extracts significantly decreased the elevated fasting and post‐prandial serum glucose, total cholesterol, triglycerides, LDL‐cholesterol and vLDL‐cholesterol levels and significantly increased the lowered serum insulin level, liver glycogen content, serum HDL‐cholesterol level, homeostasis model assessment‐insulin resistance (HOMA‐IS) and HOMA‐β cell function. The elevated cardiovascular risk indices in diabetic rats were significantly improved due to treatment with M. paradisiaca extracts. Concomitant with the increase in liver glycogen content, the glucose‐6‐phosphatase activity significantly decreased reflecting the decrease in hepatic glucose output. The heart function was potentially ameliorated as manifested by decrease in the elevated serum creatine kinase‐MB, lactate dehydrogenase and aspartate aminotransferase activities after treatments of diabetic rats with M. paradisiaca extracts. The elevated liver lipid peroxidation and the decline in liver glutathione content and superoxide dismutase, glutathione peroxidase and glutathione‐S‐transferase activities were significantly reversed by treatments. Thus, it can be concluded that M. paradisiaca leaf and fruit peel hydroethanolic extracts may have antihyperlipidemic and cardioprotective potentials in NA/STZ‐induced diabetic rats. These effects may be mediated via improvements in the glycemic state, β‐cell function, tissue insulin sensitivity, and antioxidant defense mechanism.

2-Amino-4,5,6,7-tetrahydrobenzo[b]thiophene-3-carboxamide (1) condensed with carbaldehydes 2a,b to give the respective thienopyrimidines (3a,b), which reacted with phosphoryl chloride and hydrazine hydrate to afford the respective pyrimidinohydrazines (4a,b). Compound 4a condensed with acetophenone under Vilsmeier conditions to afford the formylated pyrazolopyrimidine 6. Condensation of 4a with active methylenes produced the respective pyrazolopyrimidines (7-11). Besides, 4a condensed with succinic anhydride and with phthalic anhydride, yielding the pyrrolidine-2,5-dione 12 and the isoindoline-1,3-dione 13, respectively. Moreover, 4a reacted with isatin to afford the hydrazono-indolin-2-one 14. Structural elucidations for the new thienopyrimidines were based upon compatible analytical and spectroscopic results. Eleven of the new compounds were tested and found active against influenza A neuraminidase virus (H3N2). Compounds 12 and 13 were the most potent.

Summary Background Quantitative hepatitis C (HCV) polymerase chain reaction (qtHCV-PCR), the gold standard for monitoring HCV therapy, is an expensive, time-consuming procedure that requires equipped laboratories and trained personnel. Aims To assess the accuracy and cost-effectiveness of the automated Abbott ARCHITECT HCV Ag assay (Wiesbaden, Germany) in monitoring response to pagylated interferon (PEG-IFN) and ribavirin therapy for chronic HCV genotype 4 (G4). Methods This longitudinal, non-inferiority study compared the efficacy and cost benefit of an All-HCV core antigen assay protocol and a hybrid qtHCV RNA PCR and HCV core Ag assay protocol to the standard All-qtHCV-PCR protocol in chronic HCV G4 patients treated with pegylated interferon (PEG IFN) and ribavirin. Results Four hundred and ten patients with chronic hepatitis C genotype 4 met inclusion criteria and were enrolled in the study. The sustained virological response rate (SVR) was 66.34%. The All-HCV core antigen and hybrid monitoring assays resulted in the significant cost savings without compromising performance. A good correlation existed between HCV viral load and HCV core antigen levels (r = 0.944; P

Aim: The therapy of chronic hepatitis C genotype 4 (HCV-4) has not been optimized yet. This randomized, prospective, parallel-group clinical trial compared the efficacy and safety of pegylated interferon α-2a (PEG-IFN α-2a) plus ribavirin and PEG-IFN α-2b plus ribavirin and assessed the health-related quality of life (HRQOL) in patients with chronic HCV-4. Methods: Eligible patients with proven chronic HCV-4 were randomized to receive either a weekly dose of PEG-IFN α-2a (180 μg) or PEG-IFN α-2b (1.5 μg/kg) and a daily dose of ribavirin (1000–1200 mg) for 48 weeks with 24 weeks post-treatment follow-up. The primary end point was sustained virological response (SVR) defined by undetectable HCV RNA 24 weeks after treatment. The Short form-36 Health Survey version 2 (SF-36v2) and the Chronic Liver Disease questionnaires (CLDQ) were assessed before, during and after therapy. Results: The overall SVR rate of the entire cohort was 59.9%. The SVR rates were significantly higher in patients treated with PEG-IFN α-2a and ribavirin (Group A; n=109) compared with those treated with PEG-IFN α-2b and ribavirin (Group B; n=108, 70.6 vs. 54.6%, respectively; P=0.017). The relapse rates were 5.1% for PEG-IFN α-2a and 15.7% for PEG-IFN α-2b (P=0.0019). The SF-36v2 and CLDQ were low during therapy and improved significantly after therapy successful therapy. Conclusion: Pegylated interferon α-2a plus ribavirin was significantly more effective than PEG-IFN α-2b and ribavirin therapy in the treatment of chronic HCV-4 patients. The tolerability and adverse events were comparable between the two regimens. The HRQOL improved significantly after successful PEG-IFN α-2a plus ribavirin therapy.

The hepatitis C virus genotype 4 (HCV-4) is prevalent in Egypt, the Middle East and Africa. Recently, the epidemiology of HCV-4 has changed and this genotype has begun to cross borders and spread to several regions in Europe through immigration and injection drug use. HCV-4 has been considered a difficult-to-treat genotype based on the low sustained virological response (SVR) rates obtained with conventional interferon (IFN)-based regimens. Pegylated interferons (PEG-IFN) plus ribavirin therapy for chronic HCV-4 has been associated with increased SVR rates of more than 60%. Shorter treatment of chronic HCV-4 patients with rapid and early virological responses has been associated with high SVR rates, better compliance, fewer adverse events and lower costs. Despite this progress, the treatment of HCV-4 non-responders, injection drug users, patients coinfected with human immunodeficiency virus, thalassaemic patients, patients on haemodialysis and patients with HCV-4 recurrence after liver transplantation still represents a significant therapeutic challenge. Treatment of HCV-4 has markedly improved, with higher sustained response rates and the possibility of shorter regimens. Despite the recent progress in the treatment of HCV-4, more research is required to optimize current therapy and include genotype 4 patients in clinical trials on emerging therapies such as specifically targeted antiviral therapy for HCV with protease and/or polymerase inhibitors.

Hepatitis C virus (HCV) genotypes 4, 5 and 6 represent20% of all HCV cases worldwide. HCV-4 is mainly seen in Egypt, where it represents 90% of all HCV cases. Antischistosomal therapy was the main cause of contamination there, followed by procedures performed by informal providers and traditional healers such as dental care, wound treatment, circumcision, deliveries, excision and scarification. It is also highly prevalent in sub-Saharan Africa and in the Middle East. In Europe, its prevalence has recently increased particularly among intravenous drug users and in immigrants. HCV-5 is mainly found in South Africa, where it represents 40% of all HCV genotypes, but four pockets of HCV-5 were found in France, Spain, Syria and Belgium and sporadic cases were found elsewhere. The mode of transmission is mainly iatrogenic and transfusion. HCV-6 is found in Hong Kong, Vietnam, Thailand and Myanmar and also in American and Australian from Asian origin. The response to treatment in HCV-4 is intermediate between HCV-1 and HCV-2 and HCV-3. A sustained viral response is achieved in 43-70% with pegylated interferon and ribavirin. It is higher in Egyptians than Europeans and Africans and is negatively related to insulin resistance and to the severity of fibrosis. It increases to80% with 24 weeks of therapy only if a rapid virological response is achieved. In HCV-5, a sustained virological response is achieved in60% with 48 weeks of therapy. HCV-6 is also considered an easy-to-treat genotype, leading to a response in 60-85% of cases.

Objective: Recent Sudanese studies have focused on depression and anxiety in women treated for breast cancer (BrCa). Less is known about whether such women suffer from sexual disturbances due to different cancer treatments. This study compares BrCa patients with a healthy control group and assessed the impact of cancer treatment types. Methods: The BrCa group included women treated for BrCa with mastectomies, chemotherapy and radiotherapy (N=100). Some received hormonal therapy (N=60) and others had not yet received it (N=40). The control group comprised women who had never had BrCa, non-BrCa (N=100). Outcomes were assessed using the Watts Sexual Function Questionnaire. Results: It was found that many women treated for BrCa suffered from sexual disturbances before hormonal treatment while some regained sexual activity during hormonal treatment. Demographic data show negative correlation (P=0.03) between sexual function and age of the patients, positive correlation (P=0.002) between sexual function and educational level and positive correlation (P=0.031) as well between sexual function and the patient's length of marriage. Conclusion: This study helps to fill the gap in the literature about Sudanese women's sexuality, as many studies indicate the effect of some psychological disturbance (depression and anxiety) and ignoring the effect of sexual function in enhancing patient's quality of life. Copyright © 2008 John Wiley & Sons, Ltd.

SUMMARY Helminthic infections occur worldwide, especially in developing countries. About one-quarter of the world's population, 1·5 billion, are infected with one or more of the major soil-transmitted helminths, including hookworms, ascarids, and whipworms. Schistosomes infect more than 200 million people worldwide with 600 million at risk in 74 countries. The interaction between helminths and the host's immune system provokes particular immunomodulatory and immunoregulatory mechanisms that ensure their survival in the host for years. However, these changes might impair the immunological response to bystander bacterial, viral, and protozoal pathogens and to vaccination. Modulation of the immune system by infection with helminthic parasites is proposed to reduce the levels of allergic responses and to protect against inflammatory bowel disease. In this review, we summarize the immunological milieu associated with helminthic infections and its impact on viral infections, mainly hepatitis B virus, hepatitis C virus, and human immunodeficiency virus in humans and experimental animals.

3-Diazotized aminopyrazolo[3,4-b]pyridines 2a,b used as good synthons for the synthesis of 3-thiadiazolinylpyrazolo[3,4-b]pyridines 8a,b through their reactions with thiocyanatoacetophenone (6) and pyrido[2,3:3',4']pyrazolo[5,1-c][1,2,4]]triazines 5a-d via their reactions with several active methylene containing reagents: 3a,b, 12, 16, 20, 23a-d and 26a-c. All the structures of the newly synthesized heterocyclic compounds were established by considering the data of IR, 1 H NMR and mass spectra in addition to the synthesis of most newly synthesized heterocyclic compounds via other routes.

Different catalyst samples of nickel(II) and copper(II) phthalocyanines supported over bentonite clay (Indian type) were prepared with complex loadings ranging between 0.2 and 2.2 wt.-%. Catalyst activities were investigated in the bulk polymerization of methyl methacrylate (MMA) at 80°C in the absence and in the presence of sodium bisulfite as a cocatalyst. In all cases, the catalyst efficiency was evaluated in terms of conversion yield (%), polydispersity index (M w /M n ) was determined via GPC analysis in toluene. The stereotacticity was determined from 1 H NMR spectra. Optimum polymerization conditions were determined for both catalyst systems. Samples with metal phthalocyanines loadings of 1.8% were the most active ones. The polymers produced have controlled molecular weights, which are nearly proportional to conversion, show narrow molecular weight distributions and syndiotactic-rich steric structures. Nickel phthalocyanine seemed to have more stereoregulating effect while copper phthalocyanine had a more enhancing effect for the living polymerization process. The microstructure of solid catalysts was investigated by means of scanning electron microscopy and were correlated with activity data.

Background/ Aims: Infection with Schistosoma mansoni is endemic in Egypt leading to hepatic schistosomiasis and eventually portal hypertension. The prevalence of antibodies against hepatitis virus C among Egyptians is 14-51%. The aim of the present study was to investigate the influence of schistosomiasis on chronic hepatitis C with respect to the natural course of the disease, immunology, virology and histology. Patients and Methods: One hundred and twenty-six Egyptian patients classified into three groups: group A: chronic hepatitis C (n=33); group B: chronic schistosomiasis (n=30) and group C: chronic hepatitis C and chronic schistosomiasis (n=63) were enrolled and prospectively followed for 62.7±22 months. Patients infected with other hepatic viruses and/or parasites were excluded. Detailed history, clinical examination, CD4 + and CD8 + lymphocyte counts in blood, hematological and blood chemical values, abdominal ultrasonography, upper endoscopy, HCV RNA titer by RT/PCR, genotype and histological activity index in the liver biopsy were determined. Results: Thirty patients (48%) with HCV and schistosomiasis had liver cirrhosis and Child-Pugh class C vs. five (15%) in HCV patients and none in the schistosomal group. HCV RNA levels ranged between 0.07 and 13×10 5 copies/ml in group A, and between 1 and 25×10 5 copies/ml in group C. HCV genotype 4 was detected in 58 patients with co-infection (92%) and 21 patients with HCV alone (64%). Patients with coinfection showed higher grading and staging scores in their liver biopsies. Hepatocellular carcinoma was detected only in patients with coinfection. During follow-up, the mortality rate was 12%, 3% and 48% in group A, B and C, respectively. Conclusions: Patients with concomitant HCV and schistosomiasis infection were characterized by more advanced liver disease, higher HCV RNA titers, predominance of HCV genotype 4, higher histologic activity, higher incidence of cirrhosis and hepatocellular carcinoma as well as a much higher mortality rate.

Several pyrido[2,1-b]thiazines and thiazolo[2,3-a]pyridines were synthesized by reactions of cinnamonitriles with appropriate halocarbonyl compounds. Hydrazones of 3-diazotized aminopyrazolo[3,4-b]pyridinones were synthesized by coupling of their corresponding diazonium salts with several active methylene reagents. The obtained hydrazones were cyclized in refluxing ethanol containing a catalytic amount of triethylamine to afford the corresponding pyrazolopyridotriazines. All structures were established by considering the data of elemental analyses, IR, 1H-NMR, and mass spectra. © 1998 John Wiley & Sons, Inc. Heteroatom Chem 9: 571–579, 1998

Although colorectal cancer is not a common cancer in Egypt, the age distribution of the disease shows that a high proportion occurs in children and adults under 40 years of age. We reviewed the records of 1,608 colorectal cancer patients treated in 4 cancer hospitals in Egypt during a period of 3 to 10 years. The hospitals in which about 85% of all colorectal cancer cases in Egypt were seen included Egypt's 2 major cancer centers, The National Cancer Institute (NCI) in Cairo and Tanta Cancer Center (TCC) in the mid-Nile Delta region, and 2 major university hospitals, Assiut University in South Egypt and Ain Shams University in Cairo. Our review showed that patients younger than 40 years represented 35.6% of all patients in the 4 cancer hospitals, and that these rates were similar among the hospitals and for the years reviewed. The male-to-female ratio increased from 1.0 to 1.7 for the age groups ranging from 0-9 and 30-39 years, and increased from 1.0 to 1.5 for the age groups ranging from 40-49 to over 60 years. More than half of all the patients had rectal tumors, and about 90% of the cancers were adenocarcinomas; 30.6% of patients younger than 40 years, compared with 13.8% of older patients, had mucin-producing tumors. This study confirmed the occurrence of a high colorectal cancer rate in young Egyptians, and it opens the door to future epidemiologic studies to identify causes and risk factors of this disease pattern in Egypt.

Simple and efficient approaches for the synthesis of new sulfur-, selenium-, iron-, and nitrogen-containing benzofuran and furochromone derivatives starting from visnaginone (VIIIa), khellinone (VIIIb) or enaminoketones (I) are developed.

2-Amino-1.1.3-tricyanoprop-l-ene (1) reacted with thioglycollic acid to afford the key compound for this study namely: 2-amino-I,I-dicyano-3(2-thiazolin-4-on-2-yl)prop-1-ene 2. 2 reacted with hydrazines to afford the thiazolylmethylaminopyrazole derivatives 3 and 4. The reaction of 2 with diazotised primary aromatic amines afforded coupling products which were cyclised to the hydrazothiazolonylpyridazine derivatives 7. The reaction with aromatic aldehydes gave the his-ylidene derivatives 8. Structures are assigned based on elemental and spectroscopic analysis.

The ylidene derivatives of cyanothioacetamide 1a–d reacted with ethyl acetoacetate to give the pyridinethiol derivatives 2a–d. Compounds 2a–d were used as starting material for the synthesis of several heterocyclic compounds. Reactions with hydrazine hydrate, ethyl iodide, methyl chloroacetate and α-chloro ethyl acetoacetate gave the pyridine and annelated pyridine derivatives 5a–d, 6a–d, 7a, 8b–d, and 12a–d, respectively. Compounds 7a, 8b–d and 12a–d reacted with hydrazine hydrate to yield the annelated pyridines 10a–d and 15a–d, respectively.

Several new hydrazidoyl halides containing the 2-thiazolin-4-one moiety were synthesised and reacted with several reagents to yield several additional heterocyclics. Structures were based on both elemental analysis and spectral data.

The resonance-stabilized Wittig reagent 2 adds to the exocyclic ethylenic linkage of the arylidene malononitriles 1a–g to yield the new complex ylidenetriphenylphosphoranes 4a–g. The reaction is regiospecific which yields the E conformers of structure “4c”. Possible reaction mechanisms are considered and structures of the new products were confirmed on the basis of elemental analyses and spectral studies.

Several 5-hydrazono-4a,7-dihydrodipyrazolo[3,4-b;4,3-e]pyridin-3(2H)-ones and triazines derived thereform were synthesized via the reaction of diazotized dipyrazolopyridines with active-methylene-containing reagents.

Several new pyridine and thieno[2,3-b]pyridine derivatives were synthesized via the reactions of some pyridinethiones, obtained by the action of acetylacetone on some thiocarboxamidocinnamonitriles, with halogenated esters and ketones. Structures were established based on elemental and spectral data. All the synthesized compounds were tested for their biological activity.

Cyanothioacetamide (f 1) reacted with α,β -unsaturated carbonyl compounds 2a–d to afford thioxohydropyridine-3-carbonitriles 5a–d, which were used as the starting materials for the preparation of several thienopyridines via their reactions with active halogen-containing compounds, e.g., 2-bromo-1-phenylethanone (7a), 2-bromo-1-p-tolyl-ethanone (7b), chloroacetone (10a), α -chloroacetylacetone (10b), and chloroacetic acid ethyl ester (13). The structure of the newly synthesized heterocyclic compounds were established based on the data of elemental analyses, IR, 1 H NMR, and mass spectra.