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Osteomyelitis is a rare infectious disease in children, predominantly affecting long bones; however, its clinical presentation can be ambiguous if the location is atypical. Costal osteomyelitis is very rare in children and can mimic other pathologies. We present a case of a seven-month-old infant diagnosed with costal osteomyelitis complicated by rupture of a subperiosteal abscess into the pleura. His clinical condition improved with conservative treatment, which included chest drain insertion and intravenous antibiotic therapy without the need for surgical debridement. Rib osteomyelitis represents a potentially severe condition. Early detection is imperative to prevent the necessity for invasive therapies and mitigate long-term complications.

Objective. The hormonal balance is dependent on the internal and external stimuli. The baseline cortisol (BC) and thyroid stimulating hormone (TSH) levels have been observed to vary and have a predictive value in critical illness settings. Few reports have studied their variation in non-severe acute illness. The present study aims to describe the variation of BC and TSH levels and to determine the factors influencing BC and TSH levels in patients admitted with non-severe acute illness.

Abstract The use of nanotechnology has the potential to revolutionize the detection and treatment of cancer. Developments in protein engineering and materials science have led to the emergence of new nanoscale targeting techniques, which offer renewed hope for cancer patients. While several nanocarriers for medicinal purposes have been approved for human trials, only a few have been authorized for clinical use in targeting cancer cells. In this review, we analyze some of the authorized formulations and discuss the challenges of translating findings from the lab to the clinic. This study highlights the various nanocarriers and compounds that can be used for selective tumor targeting and the inherent difficulties in cancer therapy. Nanotechnology provides a promising platform for improving cancer detection and treatment in the future, but further research is needed to overcome the current limitations in clinical translation. Graphical Abstract

Orbital plasmacytoma is rare and has only been reported in the context of the initial diagnosis of multiple myeloma. Moreover, isolated orbital plasmacytoma without any signs of multiple myeloma is extremely rare.We report the case of a 59-year-old female patient diagnosed with IgA Kappa multiple myeloma. It was stage I ISS (International Staging System) and stage I R-ISS (Revised ISS). According to the Tunisian national protocol, the patient was included in the standard-risk group and was eligible for four cycles of CTD (Cyclophosphamide, Thalidomide, Dexamethasone) followed by autologous stem cell transplantation. Taking into account the partial response after the CTD cycles, the patient has benefited from two VTD cycles (Bortezomib, Thalidomide, Dexamethasone). Thus, complete remission was obtained. The patient refused autologous stem cell transplantation. Therefore, maintenance treatment based on Thalidomide only was started and received over a twelve-month period.Five months after the end of maintenance treatment, she reported frontal headaches that were resistant to symptomatic treatment, with ptosis in the right eye in physical examination. Brain MRI revealed the presence of a right cranio-orbital tissue mass with intra-orbital and extra-axial cerebral components. The mass measured 32/36 mm on axial sections and 47 mm in height. The patient underwent a complete resection of the cranio-orbital mass with cranioplasty. The histopathological examination of the mass with Immunohistochemistry staining confirmed the diagnosis of orbital plasmocytoma.An update of the multiple myeloma assessment did not reveal any biological, cytological or radiological signs in favor of multiple myeloma. Therefore the diagnosis of isolated orbital plasmacytoma without signs of multiple myeloma was made.Post-operative brain MRI showed complete disappearance of the right cranio-orbital tissue lesion. There was only a persistent meningeal enhancement of the dura mater at the surgical site, suggestive of post-operative changes. The patient was then referred for cranio-orbital radiotherapy.

Objective: Many studies have detailed the mechanisms of infection and quantitative peripheral blood findings reported in severe acute respiratory syndrome virus 2 (SARS-CoV-2) patients during the severity of infection since the start of the coronavirus disease 2019 (COVID-19) pandemic. Though, only a few studies have described blood morphologic abnormalities. We report peripheral blood cells morphologic changes in convalescent patient. Design: We performed complete blood counts (CBC), and blood smear of 52-year-old patient who were COVID-19 positive test by (RT-PCR), from May 20, 2021, through June 15, 2021. The peripheral blood smears of a convalescent patient were collected the morphological structures of Leukocytes, red blood cells (RBCs) and platelets were examined and documented, after 3 weeks from infection with COVID-19 RT-PCR was negative to look for viral changes on blood cells morphology. Results: On a complete blood count (CBC), the most common quantitative hematologic abnormalities were mild anemia with RBCs showed no abnormality followed by WBCs normal in count, and relative lymphopenia. Neutrophils showed the most substantial morphologic alterations with C-shaped bi-lobulated nuclei, coarse toxic granulations and cytoplasmic vacuolization. Activated neutrophil granulocytes with elongated cell membrane, pseudo Pelger–Huët anomaly-like nuclei, ring form nuclei and pyknotic nucleus. Lymphocytes were atypical reactive lymphocytes with cytoplasmic pseudopod formation. Plasmacytoid lymphocytes with an eccentric nucleus and deeply basophilic cytoplasm are frequently seen. Monocytes seen in active form with cytoplasmic vacuolization and cytoplasm contain granules, with pseudopod formation. Platelets were adequate in number with giant platelets are occasionally seen. Smudge cell is also seen. RBCs were normocytic; normochromic. Conclusion: Our work identifies and characterizes significant morphologic abnormalities in recovered COVID-19 patients' peripheral blood cells. Understanding these morphologic changes, in addition to established hematologic parameters, can help follow with COVID-19 patient during recovery through serial CBC and peripheral smear examination. Serial complete blood count and blood film review may become an essential tool to help physicians allocate patients to risk categories based on morphological findings if these proposals are supported by large-scale investigations of convalescent patients.

Abstract Background The sinonasal inverted papilloma is a rare benign tumor, characterized by local aggressiveness, a high rate of recurrence after surgical resection, and the possibility of malignant transformation. The aims of this study are to analyze diagnostic strategy and therapeutic modalities and to evaluate results after surgery. Methods We report a retrospective study, including patients operated for inverted sinonasal papilloma in our department. Preoperatively, all patients were assessed by CT scan (computed tomography), 9 of them by MRI (magnetic resonance imaging). Results The average age of our patients was 52 years with a male predominance. The most common symptom was unilateral nasal obstruction. The endoscopic appearance was suggestive of inverted papilloma (IP) in 75% of cases. Thirty-two patients underwent an exclusive endonasal endoscopic surgery; one patient was operated with a combined approach. Two patients underwent external approaches. A recurrence was observed in 4 patients (11%). Conclusion Preoperative investigation for IP is essentially based on MRI, also required in case of recurrence. Histological examination of the entire tumor is crucial to rule out an associated carcinoma. The “all endoscopic” management is not always achievable for these tumors.

Abstract Background Non-pharmacological exposure or pharmacological drug-induced hepatic injury is the most common cause of hepatotoxicity. This study was conducted to evaluate the effect of Moringa oleifera leaf extract against bisphenol-A (BPA)-induced hepatic toxicity in rats. Methods Rats (n=56) were randomized into 7 groups (8 rats/each). Control groups: rats received olive oil or Moringa oleifera (400mg/kg) orally for 42 days. Hepatotoxicity groups: rats received BPA (50mg/kg BW) orally in a 1-ml olive oil for 42 days. Reversal groups: rats received Moringa oleifera (200 or 400mg/kg) and BPA (50mg/kg BW) for 42 days. Preventive groups: rats received Moringa oleifera (200 or 400mg/kg) for 30 days followed by BPA (50mg/kg BW) for 14 days. At the end of the experiments, blood samples were collected for glucose and liver function assay, while the liver tissue samples were collected and homogenated for measuring the inflammatory/oxidant and antioxidant markers. Results Rats with BPA-induced hepatotoxicity have significantly increased serum aspartate transaminase (AST), alanine transaminase (ALT), and glucose; liver lysate malondialdehyde (MDA); tumor necrosis factor (TNF-α); and macrophage migrating inhibitory factor (MIF) but significantly decreased levels of liver lysate reduced glutathione (GSH) and total antioxidant capacity (TAC) levels. The administration of Moringa oleifera (especially 400mg/kg BW) in both reversal and preventive groups ameliorate the toxic effects of BPA in rats, as it decreased the activities of AST, ALT, glucose, MDA, TNF-α, and MIF levels and increased the antioxidant levels of GSH and TAC. Conclusion Moringa oleifera has hepatoprotective effects against BPA-induced liver damage through the regulation of antioxidants and inflammatory biomarkers.

Ninety, one-day-old Cobb chicks were randomly divided into 3 groups, each with 3 replicates. A control group was fed a standard diet, whereas the other two treatment groups received a diet with 0.2 or 0.3 mL thyme essential oil (TEO) per kg of the diet for 21 days. The 0.3 group had more meat protein (P ≤ 0.048) than the control group, while the other meat constituents have not changed. Meat sensory parameters (external aspect, odour, colour, and elasticity) declined (P < 0.001), while meat quality parameters (pH, total volatile nitrogen TVN, thiobarbituric acid number TBA, peroxide value PV, and free fatty acids FFA) increased (P < 0.001), through storage of the groups. In TEO groups, improved (P < 0.001) meat overall scores, external aspect and muscular elasticity was observed compared to control. Quality parameters were improved (P < 0.001) including pH, TVN, TBA, PV, and FFA, compared to control during storage. TEO had no effect on heavy metal concentrations while reducing bacterial contamination in meat. TEO 0.2 samples were positive for Salmonella Kentuckey and Staphylococcus aureus, while TEO 0.3 group were free from pathogenic bacteria. Thyme essential oil can enhance quality, and safety of the chilled broiler’s breast meat.

Liver hydatid cyst fistulized in the abdominal wall is rare. The clinical symptoms were often misleading. It often poses a problem of seat diagnosis rather than a problem of its hydatid nature despite the great contribution of modern imagery. We reported this uncommon case to highlight the difficulties of preoperative diagnosis and a better operative approach. 46-year-old men consulted for right flank pain. The clinical exam revealed a right flank subcutaneous mass. An abdominal CT scan showed multicystic lesions on the right flank. The MRI showed multiple cystic lesions on the right flank with several endophytic and exophytic daughter cysts. The patient was operated on. A wide excision was adopted to remove all the cystic lesions. The postoperative follow-up was uneventful. Abdominal subcutaneous hydatid cysts cause a diagnostic problem and the treatment is controversial. Surgery remains the only curative treatment. It avoids the risk of complications such the fistula, infection, and rupture.

The current study evaluated the cytotoxic activity of 11-(1,4-bisaminopropylpiperazinyl)5-methyl-5H-indolo[2,3-b]quinoline (BAPPN), a novel derivative of 5-methyl-5H-indolo[2,3-b]quinoline, against hepatocellular carcinoma (HepG2), colon carcinoma (HCT-116), breast (MCF-7), and lung (A549) cancer cell lines and the possible molecular mechanism through which it exerts its cytotoxic activity. BAPPN was synthesized and characterized with FT-IR and NMR spectroscopy. The binding affinity scores of BAPPN for caspase-3 PDB: 7JL7 was −7.836, with an RMSD of 1.483° A. In silico screening of ADME properties indicated that BAPPN showed promising oral bioavailability records in addition to their high gastrointestinal absorption and blood–brain barrier penetrability. BAPPN induced cytotoxicity, with IC50 values of 3.3, 23, 3.1, and 9.96 μg/mL against cancer cells HepG2, HCT-116, MCF-7, and A549, respectively. In addition, it induced cell injury and morphological changes in ultracellular structure, including cellular delayed activity, vanishing of membrane blebbing, microvilli, cytoplasmic condensation, and shrunken nucleus with more condensed chromatin autophagosomes. Furthermore, BAPPN significantly increased the protein expression of caspase-3 and tumor suppressor protein (P53). However, it significantly reduced the secretion of vascular endothelial growth factor (VEGF) protein into the medium and decreased the protein expression of proliferation cellular nuclear antigen (PCNA) and Ki67 in HepG2, HCT-116, MCF-7, and A549 cells. This study indicates that BAPPN has cytotoxic action against liver, colon, breast, and lung cancer cell lines via the up-regulation of apoptotic proteins, caspase-3 and P53, and the downregulation of proliferative proteins, VEGF, PCNA, and Ki67.

BackgroundSevere acute respiratory syndrome coronavirus 2 (SARS-CoV 2) may cause damage to the cardiovascular system during the acute phase of the infection. However, recent studies reported mid- to long-term subtle cardiac injuries after recovering from acute coronavirus disease 2019 (COVID-19). This study aimed to determine the relationship between the severity of chest computed tomography (CT) lesions and the persistence of subtle myocardial injuries at mid-term follow-up of patients who recovered from COVID-19 infection.MethodsAll patients with COVID-19 were enrolled prospectively in this study. Sensitive troponin T (hsTnT) and chest CT scans were performed on all patients during the acute phase of COVID-19 infection. At the mid-term follow-up, conventional transthoracic echocardiograph and global longitudinal strain (GLS) of the left and right ventricles (LV and RV) were determined and compared between patients with chest CT scan lesions of < 50% (Group 1) and those with severe chest CT scan lesions of greater or equal to 50% (Group 2).ResultsThe mean age was 55 ± 14 years. Both LV GLS and RV GLS values were significantly decreased in group 2 (p = 0.013 and p = 0.011, respectively). LV GLS value of more than −18 was noted in 43% of all the patients, and an RV GLS value of more than −20 was observed in 48% of them. The group with severe chest CT scan lesions included more patients with reduced LV GLS and reduced RV GLS than the group with mild chest CT scan lesions [(G1:29 vs. G2:57%, p = 0.002) and (G1:36 vs. G2:60 %, p = 0.009), respectively].ConclusionPatients with severe chest CT scan lesions are more likely to develop subclinical myocardial damage. Transthoracic echocardiography (TTE) could be recommended in patients recovering from COVID-19 to detect subtle LV and RV lesions.

Abstract Background Intrathoracic rupture of hepatic hydatid cyst is a rare but dangerous complication. Its occurrence in children is exceptional as diagnosis and management constitute real challenges. We report two cases of intrathoracic rupture of hepatic hydatid cyst in children. Case presentation Our patients were respectively 12-year-old boy and 9-year-old girl, known cases of respiratory symptoms, diagnosed initially for pleuropneumonia. The CT scan established the diagnosis of intrathoracic rupture of hepatic hydatid cyst in the pleural cavity for the first patient and in the bronchial tree for the second. An emergency surgery was performed for both. The second patient developed broncho-biliary fistulas during the post-operative course which necessitated a re-intervention. A recurrence was noted at follow-up for the second patient. Conclusion Intrathoracic rupture of hepatic hydatid cyst is a serious complication which can occur even in children. Its diagnosis needs a high index of suspicion. The surgical approach remains controversial and there is a lack of consensus about the best way of management. Recurrence may occur despite appropriate treatment.

This study was implemented to assess the mechanism by which Moringa oleifera leaf extract (MOLE) improves the quality and prolongs shelf-life of the broilers’ breast meat. Ninety Cobb chicks were randomly allocated to 3 groups. A control group received the standard diet, whereas the other two groups received diets containing MOLE at the doses of 250 and 500 mg/kg for 21 days. Inclusion of MOLE in broilers diet significantly reduced the detrimental changes in the overall sensory attribute scores, characteristic color and odor, and the loss of breast muscle elasticity during storage. Furthermore, it significantly reduced concentrations of thiobarbituric acid, total volatile nitrogen, non-esterified fatty acids, and peroxide, during storage compared to the control samples. No effect on the concentrations of heavy metals, such as copper, cadmium, and lead, was observed. Decomposition of samples was delayed as indicated by lower pH values and higher sensory scores at 4 and 6 days of storage in the MOLE groups. Reduced contamination with E. coli and Salmonella species indicated an antibacterial effect of MOLE. Finally, the present study highlights that MOLE supplementation may play a role in improving quality and shelf-life of the chilled breast meat in broilers.

Background: The rapid and extensive spread of the COVID-19 pandemic has become a major cause of concern for both general public and healthcare profession. Objective: The aim of this study is to analyze and evaluate the awareness of both the general public and healthcare providers in Qassim region in Saudi Arabia. Method: A cross-sectional study was conducted randomly in different shopping malls in Qassim region from 10th of February to 10th of March 2020. All participants have answered the designed questionnaire. The structured questionnaire recorded demographics and awareness of both public participants as well as health care providers. Result: A total of 130 participants have answered the designed questionnaire, out of which 67participants were males (58.5%) and 54 were females (41.5%). Overall, 129 (99%) out of the 130 participants are aware of COVID-19, and 116 (90%) have recognize it as a respiratory disease and 100% of the participants have recognized it as a contagious disease. Around 94% of the participants were able to recognize the correct incubation period of the virus. Participants of the age group 20–40 showed higher awareness level than other age groups (P value = 0.005). In addition, government employees showed higher awareness level than other profession groups (P = 0.039). Results showed significant positive correlation between the recognition of high-risk groups, reliable source of information, infection symptoms, disease prevention and available treatments. Conclusion: General public and health care professionals from Qassim Region showed adequate awareness of COVID-19. However, there is a strong need to implement periodic educational interventions and training programs on infection control practices for COVID-19 across all healthcare professions.

This study evaluated the impacts of inclusion of Moringa Oleifera leaves extract (MOLE) in semen extender on rams cryopreserved semen quality and fertilization potential. Forty ejaculates were collected from eight fertile Barki rams, pooled and divided into five groups. The semen extender of the control group was without additives. The semen extender of the second and third groups was supplemented with MOLE at doses of 300 and 600 µg/mL, respectively. The semen extender of the fourth and fifth groups was supplemented with a combination of vitamin E and selenium at doses of 2.5 and 5 µg/mL, respectively. One hundred ten multiparous Barki ewes were artificially inseminated with the semen supplemented without or with MOLE or vitamin E and selenium combination. Inclusion of MOLE in semen extender significantly elevated the motility, viability index, membrane integrity and fertilization capacity of the post-thawed spermatozoa, as well as the activities of semen catalase, total antioxidant capacity, superoxide dismutase, glutathione peroxidase, and glutathione reductase. However, it significantly decreased acrosomal defects and DNA fragmentation of spermatozoa, the activities of semen alkaline and acid phosphatase and the concentration of malondialdehyde compared with the other groups. Similarly, vitamin E and selenium significantly improved the above-mentioned parameters compared to those of the control group. This study indicated that inclusion of MOLE to semen extender improved the quality and fertility of the post-thawed rams’ semen through enhancing the activities of the antioxidant enzyme system and decreasing the spermatozoa DNA fragmentation and lipid peroxidation.Highlights Moringa Oleifera leaves extract (MOLE) protected spermatozoa against cryopreservation induced oxidative stress. MOLE enhanced cryopreserved semen quality. MOLE enhanced post-thawed spermatozoa fertilization capacity.

In this work, performance analysis and comparison of eight photovoltaic (PV) technologies were carried out under the local harsh climate conditions of Kuwait. The test facility is elevated 3 metres​ above ground level on top of carports at the Kuwait Institute for Scientific Research (KISR), alongside the seashore. The test was carried out for two modules each of eight commercially available PV technologies, at total of 16 specimens. The eight technologies employed in this work are, Monocrystalline (m-Si), Polycrystalline (p-Si), Heterojunction (HIT), and thin film; Cadmium Telluride (CdTe), Copper Indium Gallium Diselenide (CIGS), and Amorphous Silicon (a-Si). The set of data analysed in this paper was systematically acquired during a period of 12 months. Special attention is given to the influence of temperature and dust on the performance of the PV modules. The results show that m-Si, p-Si and HIT modules performed better in high irradiance levels while decreasing rapidly at lower irradiance levels. However, in the case of the cylindrical CIGS module, good performance in low irradiance level was observed Two technologies in the study (a-Si and CdTe) performed significantly lower than the other technologies mainly due to capture losses. The performance analysis show that the HIT technology performed better than m-Si and p-Si technologies. Moreover the module’s geometry and construction materials had significant impact on module temperature, soiling loss, and subsequently module performance. Modules packaged with epoxy degraded faster than other modules with glass encapsulation under the same soiling rate due to dust fallout.

The cracks caused by desiccation induce rapid failures as rapid shallow landslides in stiff and fragile clayey soils. Several environmental structures such as landfill liners and road embankments are often constructed by compaction of a series of soil layers. These works suffered in many cases of disorders due to desiccation. One of the potential valuable techniques to reduce these disorders is the short fibers reinforcement. Fibers reduce the cracks propagation and the geometric cracks characteristics such as the length, depth and opening. The paper presents an experimental characterization of the crack pattern observed in compacted samples at optimum water content (OMC) with and without fibers reinforcement. 2D Image Analysis has been used to investigate the characteristics of the geometric cracks. Alfa natural short fibers used to assure the reinforcement, reduced the carks' propagation by stopping the propagation and reducing their 3D opening (surface opening and depth growth). The role of fibers to improve the tensile strength and reduce the growth of the crack has been well-highlighted. At this stage, a simple model was calibrated to predict the tensile strength for reinforced soil specimens with short fibers considering various fibers contents and fiber's geometrical characteristics.

The standard treatment for superficial vesical tumors is transurethral resection (TUR) followed by intravesical instillation of Bacillus Calmette and Guérin (BCG). Pulmonary complications of BCG-therapy are rare but could be life threatening. We report the case of a 54-year-old patient who received BCG-therapy after TUR. After the sixth session of BCG instillations, the patient was diagnosed with a miliary tuberculosis secondary to BCG-therapy. We observed a progressive clinical and radiological improvement under specific tuberculosis treatment. Early diagnosis of pulmonary side effects of BCG-therapy and prompt treatment are the keys to complete recovery and survival.

Abstract Primary central nervous system neuroblastoma (PCNS‐NBL) is a rare and aggressive malignant tumour. Pleural metastases of PCNS‐NBL have not been documented before. We report a case of a 30‐year‐old male patient, with a history of PCNS‐NBL treated with surgery, radiation and chemotherapy. Three years later, he presented an aggravated dyspnoea with impaired general condition. The different investigations confirmed that his PCNS‐NBL has relapsed with bone, lymph nodes and bilateral pleural metastases. Because of the disseminated disease and the poor general condition of the patient, only symptomatic treatment measures were preconized. The patient died 3 months later following cardiorespiratory arrest. To the best of our knowledge, this is the first case reporting bilateral pleural metastases of a PCNS‐NBL in a young adult.

Abstract High‐dose short‐term corticosteroid therapy is effective and produces favorable clinical outcome in patients with severe 2019‐nCoV infection who are candidates for mechanical ventilation with close monitor/ing for the adverse effect of corticosteroids.

Introduction Several techniques have been reported for mid-penile hypospadias repair, including Snodgrass tubularized incised plate (TIP) and onlay island flap (OIF) procedures, which are two popular procedures. Aim of the work To compare the outcomes and complication rates for both TIP and OIF techniques. Patients and methods A prospective randomized study was conducted on 140 boys (age range, 1–6 years) with primary mid-penile hypospadias who underwent repair from June 2011 to December 2016 at our university hospitals. The patients were prospectively randomly divided into two equal groups: group A (n=70), underwent Snodgrass TIP urethroplasty, and group B (n=70), underwent OIF. Inclusion criteria only males with fresh mid penile hypospadias without ventral chordee from 1 to 6years old. Exclusion criteria were recurrent cases, presence of ventral chordee, parental refusal or children more than 6years of age. Outcomes were assessed in terms of success rates, operative time complication rates, and cosmetic appearance during follow-up. All children were subjected to full history taking, thorough clinical examination, and routine laboratory investigations (CBC, BT, CT, FBS, urinalysis, liver and renal profile), results were compiled and compared statistically. Results There were statistically significant differences between the two techniques regarding success rate, operative time incidence of complications and cosmetic results. Conclusion Both techniques are reliable and feasible for treatment of mid-penile hypospadias, but there was a statistically significant difference regarding operative time, complications, and cosmetic outcome with TIP procedure. So, the authors preferred it if suitable urethral plate is present.

The small bowel is the least common site for diverticula in the entire gastro-intestinal tract. Chronic upper intestinal obstruction due to diverticula is very rare. We report a case of multiple small bowel diverticula causing mechanical obstruction of the duodenojejunal flexure.

This study evaluates the antitumor efficacy of hesperidin (Hesp) versus cisplatin (Cis) in Ehrlich ascites carcinoma (EAC)-bearing mice, as well as its protective effect against Cis-triggered nephrotoxicity. Seventy female mice were allocated into control, Hesp, EAC, Hesp-protected, Hesp-treated, Cis-treated, and Cis+Hesp-treated groups. The inoculation of mice with EAC cells significantly reduced the mean survival time, while significantly increased the body weight, abdominal circumference, ascitic fluid volume, viable tumor cell count, and serum carcinoembryonic antigen, urea and creatinine levels, besides various hematological changes. Additionally, kidney tissue of EAC-bearing mice showed a significant increase in the malondialdehyde level, significant decreases in the reduced glutathione content and catalase activity, marked pathological alterations, and a strong Ki-67 expression with a weak caspase-3 expression in neoplastic cells infiltrating the renal capsule. Conversely, the administration of Hesp and/or Cis to the EAC-bearing mice induced, to various degrees, antitumor responses and alleviated the cytotoxic effects of EAC. In addition to the potent antitumor effect of the concomitant administration of Hesp and Cis, Hesp minimized the renal adverse side effects of Cis. In conclusion, Hesp may open new avenues for safe and effective cancer therapy and could be valuable for enhancing the antitumor potency and minimizing the renal adverse side effects of chemotherapeutic drugs.