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Background: Respiratory distress syndrome [RDS] is among the most common diseases in preterm infants. Numerous causes of RDS have been recently diagnosed and researchers have identified the presence of low serum carnitine in preterm infants with RDS.The aim of this study: to evaluate serum carnitine levels in preterm infants with RDS.Patients and methods: Eighty preterm infants were divided into two groups; group 1 consisted of 50 preterm with RDS in the first 6h of life constituted Group [A] as they were preterm infants with RDS with normal serum carnitine levels while Group [B] represented infants with carnitine deficiency. Control group 2 consisted of 30 preterm infants without RDS in the first 6 h of life. All cases and their mothers included in the study were subjected to a thorough history taking, thorough clinical examination and measurement of serum carnitine.Results: The cases groups had significantly lower serum L-carnitine than the controls group [25.56 ± 11.14 vs. 34.53 ± 2.54], and carnitine deficiency in RDS cases [32%]. Concerning weight, cases with carnitine deficiency had higher weight than cases with normal carnitine and control. With regard to clinical manifestations, there was a statistically significant difference between the cases subgroups in Down score indicting severe RDS in cases with carnitine deficiency. There was a statistically significant difference among cases subgroups regarding radiological findings. The cases with carnitine deficiency had worse X-ray, more need for surfactant therapy and MV than the cases with normal carnitine.Conclusion: Preterm neonates with RDS were demonstrated to be associated with a significant reduction in carnitine level compared to RDS- free preterm ones.

Background: Febrile seizures are non-epileptic types of seizure that occur frequently during early childhood. Multiple factors are implicated in the pathogenesis of these types of seizures. Iron deficiency might play as an etiological or, at least, augmenting factor in the development of febrile seizures. Objective: To study iron status among children with simple febrile seizures, and to estimate the prevalence of iron deficiency between them. Patients and methods: A case-control study included 100 febrile children aged 6 months to 60 months, and were ascribed to 2 groups; 50 children with simple febrile seizures [case group], and 50 children who had febrile disease without occurrence of seizures [control group]. Venous samples were obtained for the analysis of complete blood count, and iron indices [serum ferritin, serum iron and total iron binding capacity]. Results: The peak temperature was significantly elevated among the case group [P=0.03]. Regarding iron profile, compared to controls, the case group had significantly lower iron [54.24±16.04 vs. 62.6±16.02; P=0.011], and lower ferritin [37.612±19.85 vs. 80.624±31.57; P

This work aimed to measure serum vascular endothelial growth factor (VEGF) levels before and after Conventional transarterial chemoembolization (cTACE) versus drug-eluting beads (DEB)-TACE and evaluate its efficacy in predicting response to therapy and tumor recurrence.114 patients with unresectable hepatocellular carcinoma complicating hepatitis C virus-related cirrhosis were included. They underwent cTACE (58) or DEB-TACE (56). VEGF serum levels were measured before and on days 1 and 30 after TACE. Patients with complete response (CR) after TACE were followed-up for one year. Statistical analysis was done.VEGF level was higher than baseline after cTACE (VEGF serum levels may predict response to therapy in patients treated by DEB-TACE or cTACE but it has no relation to tumor recurrence.

The current study aimed to investigate the diagnostic value of glycated albumin (GA), glycated hemoglobin (HbA1c), and a number of routine biomarkers as noninvasive indicators of liver fibrosis in patients with chronic hepatitis C (CHC). One hundred patients with CHC were subjected to full medical history and examination, in addition to ultrasound-guided liver biopsy and histopathological examination for assessment of liver fibrosis stage. GA and HbA1c values, GA/HbA1c ratio, liver function tests, complete blood count, and alpha fetoprotein (AFP) were determined. A novel noninvasive index, dubbed Fibrosis Prediction Score (FPS), was selected for predicting significant liver fibrosis based on total bilirubin, glycated albumin, platelet count, age, and AFP. A validation study for FPS was applied on archival data which include 66 diabetics' patients. The FPS had area under the curve (AUC) of 0.92 for classification of patients with significant fibrosis with 81% sensitivity and 95% specificity. The AUCs of FPS in predicting advanced fibrosis and cirrhosis were 0.86 and 0.82, respectively. Comparison of AST-to-platelet ratio index (APRI) and FIB-4 with FPS indicated increased sensitivity and specificity of FPS over APRI and FIB4 in both significant and advanced fibrosis. FPS has a good sensitivity and specificity for prediction of significant and advanced liver fibrosis in patients with CHC.

Background and Aim: Alzheimer’s disease (AD) is the most common cause of dementia. 80% of all dementia is due to AD. Diagnosis of AD is a difficult task, as the accurate diagnosis requires post-mortem examination of brain autopsy samples. Diagnosis of AD in living individuals can be aided by the establishment of the clinical criteria, positron emission tomography (PET) examination, and biomarkers. The study of biomarkers for diagnosis of AD could help clinicians to evaluate individuals at risk, and confirm the occurrence as well as the progression of AD in a non-invasive manner. High sensitivity and high specificity of the used markers are mandatory criteria for these biomarkers to trusted for AD diagnosis and prognosis. So, this review article aims to focus on the potential use of body fluids as a source of the biomarkers that are used for investigating patients with AD. Methodology: In the current study, we reviewed scientific articles that discuss AD pathogenesis and diagnosis of Google Scholar database, Pubmed, Pubmed Central, Cochrane Database of Systematic Reviews (CDSR), MEDLINE, and MedlinePlus with no time limitation. Moreover, we discussed the use of recently discovered biomarkers that are detected in blood, CSF, saliva, and urine. Conclusion: In the current review, it could be concluded that in addition to the blood and cerebrospinal fluid as common biological samples for the diagnosis of AD, saliva and urine are useful potential biological samples. Moreover, both are noninvasive samples that give them priority to be used.

Endoplasmic reticulum (ER) stress could participate in high-fat diet (HFD)-induced hepatic steatosis. The current study aims to investigate the role of ER stress as well as inflammation as possible pathophysiologic mechanisms of HFD-induced hepatic steatosis at ultrastructure and molecular levels. Fifteen control rats on ordinary diet and 30 HFD-fed rats were enrolled in the study. Histological and EM examinations of rats' liver were carried out. Molecular study of TNF-α, CRP, and HNF4α by RT qPCR as well as biochemical investigation of liver function and lipids profile were done. Hepatic steatosis was induced with lipid droplets accumulation at histological level and mega-mitochondria with reduced ER-mitochondrial distance at EM level. Increased gene expression of TNF-α and CRP was significantly correlated with the reduced HNF4α expression and with other ER stress markers. In conclusion, endoplasmic reticulum stress, confirmed at ultrastructure level, plays an important role in pathogenesis of HFD-induced hepatic steatosis. HNF4α downregulation as well as increased expression of hs-CRP and TNF-α enforce the concept of interplay between ER stress, hepatic subclinical inflammation, and disturbed gene expression regulation in the pathogenesis of HFD-induced hepatic steatosis.

Hepatitis C virus (HCV) related liver cirrhosis occurs in about 20% of chronically infected patients over a duration of 10-20 years, and within 5 years approximately 10-20% of these cirrhotic patients will develop hepatocellular carcinoma (HCC). Previous studies report that the X-ray repair cross-complementing group1 gene (XRCC1) is important in the risk of HCC development; however, results obtained from these studies are conflicting rather than conclusive. We hypothesised an association between single nucleotide polymorphisms (SNPs) in XRCC1 with the HCC risk on a background of chronic hepatitis C.We recruited 210 subjects, 70 with HCC, 70 with cirrhosis and 70 healthy controls. Two SNPs [c.1254CT(rs2293035) and c.1517GC(rs139599857)] in XRCC1 were genotyped using created restriction site-polymerase chain reaction (CRS-PCR) and PCR-restriction fragment length polymorphism (PCR-RFLP) methods.The TT genotype, CT genotype and T-allele in c.1254CT (rs2293035) were linked to risk of HCC compared to the CC genotype: OR 3.58 [confidence interval (CI) 95%: 1.19-10.7] p = 0.019; OR 2.16 (CI 95%: 1.04-4.47) p = 0.037 and OR 2.10 (CI 95%: 1.2-3.3) p = 0.006, respectively. Regarding c.1517GC (rs139599857), the CC genotype, GC genotype and C-allele were linked with higher risk of developing HCC compared to GG genotype: OR 4.77 (CI 95%: 1.3-16.9), p = 0.016; OR 3.02 (CI 95%: 1.46-6.2), p = 0.002 and OR 2.4 (CI 95%: 1.4-4.0), p = 0.001, respectively.We conclude that the T-allele of c.1254CT (rs2293035) and the C allele of c.1517GC (rs139599857) genetic variants may be associated with increased HCC risk among chronic hepatitis C patients.

Background: IVF is becoming now the gold standard for solving the problem of infertility, nearly million IVF babies were born. The time of embryo transfer still rises a big question and is still a field of great debate whether to transfer it early as day 3 or wait till day 5 or day 6 to give a good chance for embryo selection. Aim of the work: to determine whether embryo transfer on day 3 versus day 5 versus day 6 shows a significant difference in implantation, clinical pregnancy, live birth, miscarriage and multiple pregnancy rates among women undergoing intracytoplasmic sperm injection. Results: Concerning multiple pregnancy rates day 3 embryo transfer was 7 (14%) in compared to 31 (31%) in day 5 embryo transfer in compared to 13 (26%) in day 6 embryo transfer which still shows significant difference between three groups. There was only slight difference between live birth in three groups, for day 3 we had (14%) 19 (5 twins and 9 single) living babies while for day 5 we had (44%) 70 (26 twins and 18 single) while for day 6 we had (20%) 31 (11 twins and 9 single). Using Pearson Chi-Square there was significant difference between the three groups regarding live birth. There was great difference in success rates and outcome of embryo transfer between three groups.Conclusion: From this study we can conclude that there is significant difference in either pregnancy or delivery rates between day 3 and day 5 and day 6 when patients are appropriately randomized. Delaying embryo transfer to day 5 or day 6 offers advantage to patients undergoing ICSI. Embryos that develop to the expanded blastocyst stage and are transferred on day 5 after retrieval are approximately as likely to implant compared to those for which expansion and transfer are delayed until day 6.

The exact link between obesity, vitamin D deficiency, and their relation to cellular senescence in the pathogenesis of subclinical atherosclerosis is still under debate. Therefore, the current study aims to verify the possible role of vitamin D deficiency and cellular senescence in the pathogenesis of obesity-related subclinical atherosclerosis. Moreover, it aims to investigate the possible protective role of vitamin D supplementation. Fifty-seven male albino rats were enrolled in the study and classified into four groups: negative (10) and positive control groups (10), an obese model group (24), and a vitamin-D-supplemented obese group (13). Aortic tissue samples and fasting blood samples were collected. The following biochemical investigations were performed: serum cholesterol, triglycerides, HDL-C, LDL-C, ALT, AST, CPK, CK-MB, and hs-cTnt. HOMA-IR was calculated. Moreover, serum SMP-30, 25 (OH)Vitamin D3, and eNOS were determined by the ELISA technique. Aortic gene expression of eNOS, SMP-30, and P53 was estimated by real-time qRT-PCR. Serum 25(OH) D3 and SMP-30 were lower in the obese group. In addition, the obese group showed higher serum lipid profile, HOMA-IR, eNOS, ALT, AST, CPK, CK-MB, and hs-cTnt than the control groups, while decreased levels were found in the vitamin-D-treated obese group. Gene expression of eNOS and SMP-30 were in accordance with their serum levels. A positive correlation was found between vitamin D level and SMP-30. In conclusion, obesity is associated with vitamin D deficiency and enhanced cellular senescence. They could play a role in the pathogenesis of obesity-associated subclinical atherosclerosis and endothelial dysfunction. Vitamin D supplements could play a protective role against such obesity-related comorbidity.

Background: Favism means a hemolytic response to the ingesting of fava beans, also identified as broad beans. Aim: Assess effect of health education program for mothers their children diagnosed with favism. Research design: A quasi-experimental design. Setting: Pediatric Outpatient Clinic in Al-Azhar University Hospital (New Damietta City), Damietta Governorate, Egypt. Sample: A convenient sample (72) of mothers their children diagnosed with favism. Tool: An interviewing questionnaire used divided to five parts: Part (1):Demographic characteristics for mothers' and their children. Part (2): Children medical history. Part (3): Mothers' knowledge regarding favism; Part (4): Mothers' attitude regarding favism; Part (5): Mothers' reported practice regarding favism. Results: present study cleared, highly statistically significant enhancement of mothers' knowledge, attitude and reported practice post health education program than pre (5.874±2.341, 4.16±2.26 and 2.324±2.410),( 25.742±2.845, 23.63±2.53and 6.945± 2.748)respectively .Conclusion: The health education program was effective in enhancement mothers' knowledge, attitude and practices regarding favism .Recommendations: Further researches and health education program are needed in other settings to outreach mothers for the promotion of favism knowledge, attitude and consequently practice to prevent favism complications for their children.

Background. Oral mucositis is the most debilitating and troublesome adverse effect of irinotecan (CPT-11) treatment. It adversely affects the patient quality of life. The aim of this work was to study the histological, immunohistochemical, and molecular changes in the oral mucosa by CPT-11 and the possible alleviated role of atorvastatin. Methods. Rats were randomly divided into control, CPT-11-treated group, and CPT-11+ atorvastatin-treated group. At the end of the experiment, the anterior two-thirds of the tongue was dissected out and divided into two parts: one part for light microscopic examination and the second for molecular study. Results. CPT-11-treated group revealed loss of normal mucosal organization, areas of ulceration and inflammation, and loss of architecture of lingual papillae. A significant decrease in immunohistochemical and molecular gene expression of Ki-67 and antiapoptotic Bcl-2 levels was observed. A significant increase in NF-κB immunohistochemical and mRNA gene expression level and a nonsignificant increase in Nrf2 gene expression were detected. Coadministration of atorvastatin showed remarkable improvement in the histopathological picture with a significant increase in Ki-67 and Bcl-2, a significant decrease in NF-κB protein and gene expression, and a significant increase in Nrf2 gene expression. Conclusion. Atorvastatin substantially attenuates CPT-11-induced oral mucositis through the initiation of the antiapoptotic gene, modulation of the inflammatory, and antioxidant gene expression.

Background Nonalcoholic fatty liver disease (NAFLD) is a pathological process characterized by excessive hepatic fatty deposition with possible involvement of vitamin D deficiency and cellular senescence. The aim of this study is to investigate the pathophysiologic role of vitamin D deficiency and cellular senescence in NAFLD development. Moreover, it aims to investigate the potential protective role of vitamin D supplementation. Methods This is an experimental Case/Control study. Forty-five male albino rats were enrolled in this study. Animals were divided into four groups: negative and positive control groups (10 for each group), a model of NAFLD (11) and vitamin D–treated NAFLD groups (14). At the end of the experiment, all rats were subjected to the following investigation; biochemical estimation of serum 25 hydroxycholecalciferol, senescence marker protein–30 (SMP-30), lipid profile and calculation of homeostatic model of insulin resistance (HOMA-IR). Results NAFLD group shows a significant increase in glucose, insulin levels, and HOMA- IR compared with both normal controls. This finding indicates the intimate association between insulin resistance and NAFLD pathogenesis. Moreover, it was found that NAFLD group shows a significant decrease in SMP-30 level compared with normal controls. While vitamin D–treated NAFLD group shows significant increased SMP-30 and decrease in HOMA-IR in comparison with nontreated NAFLD group. Conclusion Vitamin D deficiency and increased cellular senescence are key features of NAFLD. Vitamin D supplementation could play a protective role, which needs further investigation including clinical human study.

Background Androgenetic alopecia (AGA) is associated with a risk of coronary heart disease (CHD), although the causes underlying this association are not clear. Serum homocysteine (SH) is a known risk factor for CHD, and methylene tetrahydrofolate reductase enzyme (MTHFR) plays a crucial role in the remethylation of homocysteine to methionine. The polymorphism C677T that affects the catalytic domain of the MTHFR protein leads to a high levels of SH. Our hypothesis was that this polymorphism and SH level are risk factors for CHD in patients with AGA. Materials and methods A total of 106 patients with AGA and 100 well-matched healthy controls were enrolled in the study. SH levels were estimated. DNA was extracted and polymerase chain reaction amplification, followed by restriction enzyme digestion for MTHFR (C677T) gene, was conducted. Results SH levels were significantly higher in the patient group and highest in those with the TT genotype. The mutant T allele was associated with hyperhomocysteinemia and an increased risk of CHD in patients with AGA. Conclusions AGA is associated with a higher risk of developing CHD due to the associated higher level of SH that, in turn, depends on and is correlated with mutant MTHFR genotypes. Cardiac evaluation and follow-up of patients with AGA is recommended for early detection and treatment of CHD to avoid an overall detrimental course.

Background: The most common cause of hospital admission in the first month of life is the neonatal jaundice. Some factors [e.g., prenatal, neonatal factors, maternal factors, and environmental factors (such as zinc) influence the frequency of neonatal jaundice. In terms of neonates, it is proposed that there is a correlation between serum zinc quality and hyperbilirubinemia. Aim of the work: To evaluate the level of serum zinc in term neonates with indirect hyperbilirubinemia. Patients and Methods: A case control study carried out at the neonatal intensive care unit (NICU) and pediatric outpatient clinic of New Damietta, Al-Azhar University Hospital, from June 2018 to February 2019. It included 75 neonates with neonatal jaundice as cases group and 75 healthy neonates of matched age and sex as a control group. All were assessed clinically and serum zinc levels were determined and documented. Results: Level of serum zinc in neonates with non-hemolytic hyperbilirubinemia (103.3±36.56 ug/dl) was significantly lower than healthy neonates without jaundice (128.62 ± 40.83 ug/dl) and zinc deficiency in jaundiced neonates (25.3%) was statistically significant more than healthy neonates) 6.7%). There was no significant relation between the level of serum zinc and other factors like the maternal age, parity, pattern of feeding, gender and weight, but there was significant correlation with maternal zinc intake during pregnancy. Conclusion: We concluded that serum zinc level in term neonates with neonatal jaundice was statistically significant decreased than healthy term neonates.

Non-alcoholic fatty liver disease (NAFLD) is a public health burden associated with significant liver-related and unrelated morbidity and mortality [1]. Results of epidemiological studies suggest t...

Background: Sodium valproate (VPA) is an antiepileptic drug (AED) licensed for epilepsy and used during pregnancy in various indications. Alpha-lipoic acid (ALA) is a natural compound inducing endogenous antioxidant production. Our study aimed to investigate the effect of prenatal administration of VPA on the pancreas of rat offspring and assess the potential protective role of ALA co-administration during pregnancy. Methods: Twenty-eight pregnant female albino rats were divided into four groups: group I (negative control), group II (positive control, ALA treated), group III (VPA-treated), and group IV (VPA-ALA-treated). The pancreases of the rat offspring were removed at the fourth week postpartum and prepared for histological, immune-histochemical, morphometric, molecular, and oxidative stress marker studies. Results: In group III, there were pyknotic nuclei, vacuolated cytoplasm with ballooning of acinar, &alpha, and &beta, cells of the pancreas. Ultrastructural degeneration of cytoplasmic organelles was detected. Additionally, there was a significant increase in oxidative stress, a decrease in insulin-positive cell percentage, and an increase in glucagon positive cells in comparison to control groups. Moreover, VPA increased the gene expression of an apoptotic marker, caspase-3, with a decrease in anti-apoptotic Bcl2 and nuclear factor erythroid 2-related factor 2 (Nrf2) transcriptional factor. Conversely, ALA improved oxidative stress and apoptosis in group VI, and a consequent improvement of the histological and ultrastructure picture was detected. Conclusion: ALA co-administration with VPA significantly improved the oxidative stress condition, histological and morphometric picture of the pancreas, and restored normal expression of related genes, including Nrf2, caspase-3, and Bcl-2. Administration of &alpha, lipoic acid has a protective effect against VPA-induced pancreatic oxidative damage via its cytoprotective antioxidant effect.

BACKGROUND The first-line treatment option for intermediate-stage hepatocellular carcinoma is trans-arterial chemoembolization (TACE). Blood indices, such as lymphocyte/monocyte ratio (LMR), lymphocyte count, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), monocyte-granulocyte/lymphocyte ratio (MGLR) and red blood cell distribution width (RDW), are prognostic biomarkers in certain diseases. The model for end-stage liver disease (MELD) and Child-Turcotte-Pugh (CTP) scores have been designed for patients with cirrhosis waiting for liver transplantation and in patients with hepatocellular carcinoma. We hypothesized possible roles for these blood indices, and the MELD and CTP scores as predictors for early recurrence of hepatocellular carcinoma after TACE. METHODS Routine laboratory indices determined the NLR, LMR, MGLR, RDW, PLR, as well as MELD and CTP scores in 147 patients. Sensitivity and specificity of the indices for hepatocellular carcinoma recurrence 36 months after TACE were estimated by receiver operator characteristic curve. RESULTS In multivariate regression analysis, only male sex, the lymphocyte count, CTP, the MGLR and the MELD score significantly (P

Background Many oral presentations of osteoporosis-a bone metabolic disease-were recorded. Thus, we aimed to assess panoramic radiomorphometric indices with bone mineral density (BMD) values among Saudi postmenopausal women and its importance in the prediction of osteoporosis. Methods A total of 431 Saudi women were enrolled in this study. Panoramic radiographs were obtained at the time of BMD measurement. Subjects were fatherly classified into; normal BMD, osteopenia, and osteoporosis groups. Serum follicle-stimulating hormone, luteinizing hormone (LH), estradiol (E2), 25-hydroxy-vitamin D (25[OH]D) and intact-parathyroid hormone were measured. Moreover, serum creatinine, calcium, and phosphate, together with serum osteocalcin (s-OC), procollagen type I N-terminal propeptide (s-PINP) and cross-linked C-terminal telopeptide of type 1 collagen (s-CTX) were measured. Receiver-operator curve (ROC) curve analysis for use of mandibular cortical width (MCW), panoramic mandibular index (PMI), and maxillary-mandibular ratio (M/M ratio) to differentiate women with osteoporosis or osteopenia from normal subjects was calculated. Cut off values of 4.6 at T score

BackgroundSystemic sclerosis (SSc) is an autoimmune disorder of unknown origin, characterized by excess accumulation of the extracellular matrix in the skin and other internal organs.Aim of the workThe current study was designed to establish an animal model of SSc in order to analyze the histologica

To evaluate the effect of immediate postpartum curettage on rapid resolution of clinical and laboratory indices in pre-eclampsia and eclampsia women. A randomized controlled study, comprised of 420 pre-eclamptic or eclamptic women with singleton pregnancy 24 weeks gestation and more. Patients were divided into two groups: 220 patients underwent immediate postpartum curettage and 200 patients as a control group. The clinical and laboratory prenatal parameters showed no statistical significant differences between both groups. The follow-up for the postnatal clinical and laboratory data showed significant improvement for the mean arterial blood pressure in the curettage group over 6, 12, and 24 h after delivery and significant improvement in the platelet count as well. The average time required for MAP to reach 105 mmHg or less was significantly shorter (P

Background and aim: Loss of p53 function has been suggested to be a critical step inmultistage hepatocarcinogenesis. So, we aimed to investigate the frequency of P53codon 72 gene polymorphism and its relation to plasma P53 levels in Egyptianpatients with hepatocellular carcinoma (HCC) on top of viral and nonviral etiologies.Methods: This is a hospital-based case-control study which included 159 HCCpatients in addition to 83 healthy volunteers as controls. Patients were classified into:63 patients with HCC complicating cirrhosis due to HCV; 55 patients with HCCcomplicating cirrhosis due to HBV and 41 patients with HCC complicating cirrhosisdue to nonviral causes. Quantitative determination of plasma P53 levels wasperformed by ELISA. P53 Arg 72 Pro gene polymorphism was carried out byconventional PCR followed by restriction enzyme digestion (PCR-RFLP). Results:There were significant increases in α.fetoprotein and plasma P53 levels in all studiedgroups in relation to the control group. AA genotype and A allele were more in thecontrol group, PP genotype and P allele were more frequent in HCV related HCCgroup & HCC with non viral causes. AP genotype and P allele were more frequent inHBV related HCC group. P 53 plasma level showed significant increase in all groupsin relation to the control group in AA genotype, AP genotype and PP genotype. Therewere significant increases in AP and PP genotype in all studied groups in comparisonto AA genotype. Plasma P53 level showed significant increase in all groups in bothallele A and allele P when compared with the control group. Also, it showedsignificant increase in their levels in P allele when compared with that of A allele inall studied groups. Conclusion: plasma p53 protein level could be considered as anadditional tumor marker to AFP to increase the diagnostic potential of AFP in HCCpatients. Therefore, P53codon 72 gene polymorphism could be used as an indicatorof the genetic susceptibility for future development of HCC in Egyptian cirrhoticpatients.

Background This is the first study to investigate spermatozoal cell death-inducing DNA fragmentation factor-α-like effector A (CIDEA) gene expression and DNA fragmentations in the spermatozoa of men diagnosed with metabolic syndrome (MS) who have normal seminograms with unexplained infertility, and to correlate these parameters with seminal glucose concentration. Methods This study included 120 participants: 75 male subjects with MS (38 fertile and 37 infertile), and a control group of 45 fertile males without MS. HOMA-IR, semen analysis, and biochemical measurement of seminal plasma insulin and glucose levels were carried out. Spermatozoal insulin gene and CIDEA gene expressions were performed by the RT-PCR method. The percentage of spermatozoal DNA fragmentation was also estimated. Results The spermatozoal insulin and CIDEA gene expression, as well as the DNA fragmentation, were significantly higher in the infertile MS group than in the fertile MS group, and significantly higher in both the MS groups than in the control group. Seminal glucose concentration showed significant positive correlations with seminal insulin level, spermatozoa insulin, CIDEA gene expression, and DNA fragmentation. Moreover, there was a positive correlation between spermatozoa CIDEA gene expression and DNA fragmentation. Conclusions It can be concluded that MS may affect male fertility at the molecular level, through its possible inducing effect of spermatozoa CIDEA and insulin gene expression, DNA fragmentation, and increased seminal glucose.

To build a diagnostic non-invasive model for screening of large varices in cirrhotic hepatitis C virus (HCV) patients.This study was conducted on 124 post-HCV cirrhotic patients presenting to the clinics of the Endemic Medicine Department at Mansoura University Hospital for evaluation before HCV antiviral therapy: 78 were Child A and 46 were Child B (score ≤ 8). Inclusion criteria for patients enrolled in this study was presence of cirrhotic HCV (diagnosed by either biopsy or fulfillment of clinical basis). Exclusion criteria consisted of patients with other etiologies of liver cirrhosis, e.g., hepatitis B virus and patients with high MELD score on transplant list. All patients were subjected to full medical record, full basic investigations, endoscopy, and computed tomography (CT), and then divided into groups with no varices, small varices, or large risky varices. In addition, values of Fibrosis-4 score (FIB-4), aminotransferase-to-platelet ratio index (APRI), and platelet count/splenic diameter ratio (PC/SD) were also calculated.Detection of large varies is a multi-factorial process, affected by many variables. Choosing binary logistic regression, dependent factors were either large or small varices while independent factors included CT variables such coronary vein diameter, portal vein (PV) diameter, lieno-renal shunt and other laboratory non-invasive variables namely FIB-4, APRI, and platelet count/splenic diameter. Receiver operating characteristic (ROC) curve was plotted to determine the accuracy of non-invasive parameters for predicting the presence of large esophageal varices and the area under the ROC curve for each one of these parameters was obtained. A model was established and the best model for prediction of large risky esophageal varices used both PC/SD and PV diameter (75% accuracy), while the logistic model equation was shown to be (PV diameter × -0.256) plus (PC/SD × -0.006) plus (8.155). Values nearing 2 or more denote large varices.This model equation has 86.9% sensitivity and 57.1% specificity, and would be of clinical applicability with 75% accuracy.

The clinical application of doxorubicin is limited by its cardiotoxicity. The present study investigated the effect of valsartan on doxorubicin-induced cardiotoxicity in rats. Rats were divided into 6 groups: control, control + valsartan (10 mg/kg, for 14 days, orally), doxorubicin-treated (2.5 mg/kg, 3 times/week for 2 weeks, intraperitoneally), valsartan then doxorubicin, valsartan + doxorubicin, and doxorubicin then valsartan. ECG, isolated heart, lipid peroxidation (thiobaribituric acid reactive substances (TBARS)), total antioxidant capacity (TAC), and Bax, Bcl-2, and senescence marker protein 30 (SMP30) gene expression were measured in cardiac tissue. Blood samples were collected to measure lactate dehydrogenase (LDH) and creatine kinase MB (CK-MB). Doxorubicin significantly increased LDH, CK-MB, TBARS, heart rate (HR), Bax gene expression, and −dP/dtmax and decreased TAC, Bcl-2 and SMP30 gene expression, left ventricular developed pressure (LVDP), and +dP/dtmax. Also, doxorubicin lengthened ST, QT, and QTc intervals. Concurrent or post- but not pre-treatment of doxorubicin-treated rats with valsartan reduced LDH, CK-MB, TBARS, HR, Bax gene expression, −dP/dtmax, and ST, QT, and QTc intervals and increased TAC, Bcl-2 and SMP30 gene expression, LVDP, and +dP/dtmax. Therefore, we conclude that concurrent or post- but not pre-treatment of doxorubicin-induced rats with valsartan attenuated doxorubicin-induced cardiotoxicity through inhibiting oxidative stress, apoptosis, and senescence.

Introduction: Weight loss amongst women with polycystic ovary syndrome (PCOS) is crucial to reduce the risk of endocrine, reproductive and metabolic complications including hirsutism, menstrual disturbances and cardiovascular disease. With approximately 50% of women with PCOS being overweight or obese, effective dietary management of weight in PCOS is essential. However, there is inconsistent evidence as to whether specifically modified diets (e.g. reduced carbohydrate diets) are more effective at achieving weight loss amongst women with PCOS than are conventional healthy hypocaloric diets. Material and Methods: A systematic review and meta-analysis of randomized controlled trials that had compared weight and BMI between women with PCOS who had undergone either a specifically modified diet or a conventional healthy hypocaloric diet were performed. Six electronic databases were searched, a manual search of the reference lists of the included studies was carried out and authors were contacted for additional information. Nine studies with a total of 395 participants (all with a body mass index [BMI] ≥30) were included in the meta-analysis. The effect size used was the mean difference in post-intervention weight and BMI between participants who had undergone a specifically modified diet and participants who had undergone a conventional healthy hypocaloric diet. Results: There were no differences between groups in post-intervention weight (mean difference 1.26, 95% confidence interval (CI) -0.92 to 3.43, p = .26; heterogeneity I2 = 50%, p = .04) or BMI (mean difference 0.15, 95% CI -0.93 to 1.23, p = 0.79; heterogeneity I2 = 44%, p = 0.10). Subgroup analyses according to the presence of a dietary run-in period (a period at the start of the study during which all participants are placed on an identical diet in order to equalize them on variables influenced by diet), intervention duration and type of diet and a sensitivity analysis according to study quality were not significant. Conclusions: Whilst the results should be interpreted in light of the moderate heterogeneity observed, they suggest that specifically modified diets offer no added benefit for weight loss in women with PCOS over conventional healthy hypocaloric diets. The findings of this meta-analysis may promote the unification of guidelines for the dietary management of PCOS and allow clinicians to be confident in prescribing conventional healthy hypocaloric diets for weight loss amongst their PCOS patients.

The objective of this study was to investigate the modulation of metabolic dysfunctions, adiponectin levels, and cardiac dysfunctions of type 2 diabetes mellitus (T2DM) by a combination of the insulin sensitizer rosiglitazone and angiotensin receptor blocker telmisartan in an experimental rat model. Fifty male adult Sprague–Dawley rats were divided equally into 5 groups. Group I: fed normal chow; served as normal control group. Groups II–V: fed a high-fat diet (HFD) for 2 weeks, followed by injection of streptozotocin (STZ; 35 mg/kg) to create a model of T2DM. Group II: treated with vehicle. Group III: treated with rosiglitazone (4 mg/kg). Group IV: treated with telmisartan (5 mg/kg). Group V: treated with both agents. Untreated HFD-STZ rats showed elevated fasting blood glucose, insulin, homeostasis model assessment (HOMA) index, triglycerides (TGs), low-density lipoprotein cholesterol (LDL), and total serum cholesterol (TC), with a decrease in high-density lipoprotein cholesterol (HDL) and adiponectin levels (p < 0.001). Rosiglitazone exerted more improvement in all parameters than telmisartan did, and a combination of both did not augment the improvement further, except for TGs and adiponectin. For the isolated atrial study, a combination of rosiglitazone and telmisartan corrected the responses of the atria of HFD-STZ rats to the negative inotropic effect induced by adenosine better than either one did alone, whereas this combination, surprisingly, significantly attenuated the positive inotropic response to β-adrenoreceptor and α-adrenoreceptor agonists. In conclusion, rosiglitazone significantly improved the metabolic and cardiac dysfunctions in T2DM. Moreover, a combination of rosiglitazone and telmisartan offered more improvement in serum TGs and adiponectin, and restored the atrial inotropic response to adenosine. Surprisingly, this combination significantly attenuates the positive inotropic response to α1-adrenoreceptor and β-adrenoreceptor agonists.

Objective To investigate the combined effect of both pioglitazone and methotrexate on disease activity of rheumatoid arthritis in a biphasic study; experimental and clinical. Methods Experimentally: 50 rats were divided into 5 equal groups; controls, experimental arthritis, methorexate treated (0.1 mg/Kg daily), pioglitazone-treated (10 mg/kg daily), and methotrexate and pioglitazone treated. Clinically: forty-nine diabetic rheumatoid arthritis patients were included. Patients group consisted of 28 patients and they received pioglitazone 30 mg orally beside their usual treatment. Control group consisted of 21 patients and they continued their usual treatment plus placebo. Disease activity was assessed using DAS28 score. Patients were followed up for 3 months. Results Pioglitazone produced a significant improvement of serum oxidative stress parameters ( P < 0.05), and inflammatory cytokines in the treated arthritic group ( P < 0.05). Clinically, the pioglitazone treated group showed significant improvement in DAS28 ( P = 0.001) and C-reactive protein ( P < 0.0001) compared to placebo group. Conclusion The concomitant use of the PPAR γ agonist pioglitazone and methotrexate appears to be promising therapeutic strategy for rheumatoid arthritis patients.

Problem statement: We aim to evaluate the effects of acute and chroni c inhibition of Neutral EndoPeptidase (NEP), by ONO-9902, on plasma and renal NEP gene expression, hemodynamic and renal parameters in rats with Chronic Heart Failure (CHF) following left Coronary Artery Ligation (CAL). Approach: Forty eight male Sprague-Dawley rats (220-240 g) were divided into sham and CAL groups. Myocardial infarction was induced by left CAL. All rats were further subdivided into untreated and orally treated with O NO-9902 (300 mg kg -1 day -1 ) from the 1st to 6th weeks after the operation. At the 1st and 6th weeks after the operation, gene expression of plasma and renal NEP, plasma ANP, cGMP and aldosterone concentrations, urine volume, Na and ANP excretion, creatinine clearance and renal cGMP generation were measured. Results: CAL leads to sodium and water retention, increased renal NEP gene expressio n, plasma ANP and aldosterone and decreased renal cGMP generation and plasma NEP gene expression. Acute treatment of CAL rats by ONO-9902, at the 1st week after the operation, inhibited plas ma and renal NEP gene expression with increased plasma ANP, which caused diuresis, natriuresis and increased renal cGMP generation. Moreover, chronic treatment of those rats by ONO-9902 decreased plasma and renal NEP gene expression, plasma aldosterone, increased plasma ANP but non significantly, and caused diuresis, natriuresis with increased renal cGMP generation. GFR was not significantly changed before or after treatment. Conclusion: Chronic treatment with NEP inhibitor decreases Na and water retention in rats with CHF by enhancing ANP action and suppressing aldosterone secretion. So, ONO-9902 may offer a new therapeutic approach in patients with CHF.

Background and aim of work: The aim of the current study was to investigate theeffects of long term excessive iodine intake on gene expression of thyroidal sodiumiodide symporter (NIS), D1 deiodinase and thyroid peroxidase (TPO), thyroidhormones, oxidative injury and anti-oxidative ability of euthyroid and hypothyroidSprague Dawley rats. Materials and Methods: Ninety rats were divided intoeuthyroid and hypothyroid (thiocyanate induced) groups with or withoutadministration of excess iodine (3000 or 6000 μg/l) for 4 weeks. Serum thyroxine (T4),triiodothyronine (T3), TSH, thyroid antioxidants ((glutathione S transferase, catalase,superoxide dismutase enzymes, nitric oxide and total antioxidants), lipid peroxide(malondialdehyde, MDA) were measured. RT-PCR gene expression for thyroidal NIS,D1 deiodinase and TPO were performed. Results: Thiocyanate significantlydecreased thyroid hormones (T3, T4), increased lipid peroxides and antioxidants,increased gene expression of NIS, D1 deiodinase, TPO. High iodine intake tohypothyroid rats significantly decreased NIS, D1 deiodinase and TPO genesexpression. Excess iodine significantly increased MDA and antioxidants in euthyroidand hypothyroid rats. Despite the increase in T4 in euthyroid rats administered excessiodine, T3 decreased whereas in hypothyroid rats, both of them were increased. NIS,and D1 deiodinase genes expression in euthyroid rats administered excess iodinewere decreased but TPO was non-significantly increased. Conclusion:Hypothyroidism increased gene expression of NIS, TPO, and induces an oxidativestress. High iodine intake decreased NIS and D1 deiodinase gene expression ineuthyroid and hypothyroid rats. Moreover, excess iodine increase thyroid hormones,lipid peroxides and antioxidants in cases of euthyroid and hypothyroid rats.Therefore, screening of thyroid function and assessment of prooxidant/antioxidantstatus in subjects treated with drugs containing iodine and after investigations withcontrast media are recommended.

Problem statement: To assess the plasma concentrations and placental gene expression of soluble fms like tyrosine kinase (sFlt-1), Vascular Endothelial Growth Factor (VEGF), visfatin and Tumour Necrosis Factor α (TNF α) in a rat model of preeclampsia, induced by chroni c Reduction of Uterine Perfusion Pressure (RUPP) and to investigat e the involvement of Insulin Resistance (IR) in the pathophysiology of preeclampsia and the possible re lation of visfatin and TNF α to IR in preclampsia. Approach: Twenty female Sprague-Dawley rats weighing 220-250 g were divided into either RUPP (n = 10) or Normal Pregnant (NP; n = 10) (control) groups. Plasma levels and placental gene expression of sFlt-1, VEGF, visfatin, TNF α, plasma endothelin (ET-1), glucose, serum insulin, creatinine, HOMA-IR and placental Malondialdehyde (MDA) and total antioxidants were measured. Also, Mean Arterial Pressure (MAP), fetal number and weight were determined. Results: In RUPP rats, MAP increased, plasma level and placental gen e expression of sFlt-1, visfatin and TNF α increased while those of VEGF decreased. Moreover, plasma ET-1, glucose, insulin, HOMA-IR increased while GFR, fetal weight and number decreased. There is a significant positive correlation between TNF α, ET-1, sFlt-1 and MAP, between plasma visfatin or TNF α levels and both serum insulin and HOMA-IR, between visfatin and TNF α, between TNF α and ET-1 and between placental MDA and either sFlt-1 or ET-1. Furthermore, a negative correlation was reported between VEGF and MAP. Conclusion: RUPP increased sFlt-1, TNF α and decreased VEGF resulting in endothelial dysfunction which is manifested by increased MDA and ET-1. This results in altered renal function and hypertension. Moreover, IR may be involved in the p athophysiology of preeclampsia. Visfatin and TNF α, may have a role in IR during preclampsia.

Background Higher sphingosine 1-phosphate (S1P) plasma levels are associated with decreased bone mineral density (BMD), and increased risk of prevalent vertebral fracture. So, we hypothesized that postmenopausal women with increased baseline plasma S1P levels have a greater risk for future incident fracture (osteoporosis-related fractures [ORFs]). Methods This study was conducted in a prospective longitudinal cohort of 707 women recruited in 2004 and followed up annually for a mean period of 5.2±1.3 years. They were postmenopausal (aged ≥50 years). The primary outcome measure was the time to the first confirmed ORF event using radiographs and/or a surgical report. Results The plasma S1P levels (µmol/L) were significantly higher in the women with incident fracture (7.23±0.79) than in those without ORFs (5.02±0.51; P

Matrix metalloproteinase-9 is closely associated with the invasive and metastatic potential of most types of solid cancers. Our objective was to investigate the MMP-9 expression in lung cancer and to evaluate their relations to histopathologic types and prognosis.Bronchoscopic samples were obtained from tumor and normal bronchial mucosa in 25 patients with lung cancer. Total RNA was isolated from the tissues, and the relative expression as well as the activity of MMP-9 was evaluated.Non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) showed significantly higher MMP-9 expression (P0.0001) compared with normal tissues. MMP-9 activity in tissue and serum samples from both cancer groups were significantly higher than normal tissue and serum controls (P0.0001). Also, MMP-9 expression and tissue and serum activity were significantly higher in NSCLC than in SCLC (P=0.0167, 0.0454, and 0.004, respectively). As regards the pathologic types of NSCLC, similar results were found for the adenocarcinoma subgroup versus squamous cell lung cancer (P=0.0015, 0.0052, and 0.0011, respectively). MMP-9 expression and tissue activity were higher in stage III-IV NSCLC cases compared with early tumor stages (P=0.0120 and 0.0271, respectively).The expression and activity of MMP-9 are upregulated in NSCLC and are related to the pathologic type and clinical stage of NSCLC. Significantly higher expression and activity of MMP-9 in tumor tissue than in the surrounding tissue supports the important role of this metalloproteinase in the growth of lung cancer, and it could be used as a suggested therapeutic target.

CLU is a disulfide linked, heterodimeric protein associated with the clearance of cellular debris and apoptosis. We assessed the association of seminal CLU gene expression with seminal variables in fertile and infertile men.A total of 124 men were divided into healthy, fertile men with normozoospermia, and men with asthenozoospermia, asthenoteratozoospermia and oligoasthenoteratozoospermia. History was obtained, and clinical examination and semen analysis were done. In semen we assessed sperm acrosin activity, sperm DNA fragmentation and seminal CLU gene expression.CLU RNA and CLU protein gene expression were significantly increased in semen samples of infertile men with oligoasthenoteratozoospermiaasthenoteratozoospermiaasthenozoospermia compared with healthy, fertile controls. CLU gene expression significantly correlated negatively with sperm count, motility, acrosin activity index, linearity index and linear velocity, and significantly correlated positively with the percent of sperm abnormal forms and DNA fragmentation.CLU gene expression was significantly increased in the semen samples of infertile men. It correlated negatively with sperm count, motility, acrosin activity, linearity index and linear velocity, and positively with the percent of sperm abnormal forms and DNA fragmentation.

The prevalence of insulin resistance syndrome increases during menopause with the overproduction of reactive oxygen species and impairment of the free radical scavenger function. Therefore, we investigated the effects of 17β-estradiol (E2) and vitamin E, as an antioxidant, on lipid peroxidation and antioxidant levels in the brain cortex and liver of ovariectomized rats as well as on insulin resistance in those rats. Forty female Sprague–Dawley rats, 3 months of age and weighing 231.5 ± 9.4 g, were divided into 4 groups: sham, ovariectomized (OVX), OVX treated with E2 (40 µg/kg subcutaneously), and OVX treated with E2 and vitamin E (100 mg/kg intraperitoneally). The 4 groups received the appropriate treatment every day for 8 weeks. Levels of glutathione, glutathione peroxidase, superoxide dismutase , catalase, and malondialdehyde in the brain cortex and liver of ovariectomized rats were measured. Also, fasting plasma insulin, glucose, and homeostatis model assessment of insulin resistance (HOMA-IR) were determined. Malondialdehyde increased and antioxidants (glutathione, glutathione peroxidase, catalase, superoxide dismutase) decreased in the brain cortex and liver of OVX rats. Also, fasting glucose, insulin, and HOMA-IR increased in OVX rats. E2 and E2 plus vitamin E decreased malondialdehyde and increased antioxidants in the brain cortex and liver of OVX rats. Moreover, they decreased fasting glucose, insulin, and HOMA-IR in ovariectomized rats. This study demonstrates that E2 and E2 plus vitamin E supplementation to OVX rats may improve insulin resistance, strengthen the antioxidant system, and reduce lipid peroxidation.

To evaluate the effect of immediate postpartum curettage on rapid resolution of clinical and laboratory indices in pre-eclampsia and eclampsia women. A randomized controlled study, comprised of 420 pre-eclamptic or eclamptic women with singleton pregnancy 24 weeks gestation and more. Patients were divided into two groups: 220 patients underwent immediate postpartum curettage and 200 patients as a control group. The clinical and laboratory prenatal parameters showed no statistical significant differences between both groups. The follow-up for the postnatal clinical and laboratory data showed significant improvement for the mean arterial blood pressure in the curettage group over 6, 12, and 24 h after delivery and significant improvement in the platelet count as well. The average time required for MAP to reach 105 mmHg or less was significantly shorter (P