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Rheumatoid arthritis (RA) is a progressive and chronic systemic autoimmune disease. However, currently treatment is often carried out using NSAIDs and corticosteroids. Although it reduces symptoms, this treatment has a high rate of side effects. This study aims to determine the anti-inflammatory property of Curcuma heyneana so that it can be used as an alternative treatment for RA. Based on author knowledge, this study on C. heyneana from the Indonesian region for the treatment of RA is still limited. C. heyneana’s rhizome was extracted by maceration with ethanol followed by fractionation process using n-hexane, ethyl acetate, and n-butanol. The anti-inflammatory invitro activities were determined by heat-induced hemolysis, effect on protein denaturation, and cyclooxygenases (COX) inhibition assay. Molecular docking of major predictive compounds was performed by AutoDock Vina. The results showed that some fractions of C. heyneana contained terpenoids, flavonoids, and alkaloids. The ethyl acetate fraction exhibited the highest anti-inflammatory activity, which was attributed to the presence of curcuminoids. Molecular docking studies further confirmed the potential of demethoxycurcumin, a curcuminoid identified in the ethyl acetate fraction, to inhibit COX-2. These findings suggest that C. heyneana, particularly its previously unreported curcuminoid-rich fractions, holds promise as a natural anti-inflammatory agent. Further research is warranted to explore the therapeutic potential of this plant in the management of RA and other inflammatory disorders.

Abstract This article presents a Z source (ZS) based switched capacitor multilevel inverter (SC-MLI) with low capacitors charging inrush currents utilizing a modified modulation strategy. The topology generates nine output voltage levels with quadruple voltage gain utilizing eight power switches, five capacitors, two inductors, four discrete diodes, and a single DC source. The voltage gain can be further increased by applying shoot through (ST) states to the frontend ZS-network. Owing to its high voltage gain, the topology is suitable for low voltage renewable energy sources such as photovoltaics (PV), and fuel cells (FC). A modified modulation strategy is presented based on the conventional level shifted sinusoidal pulse width modulation (LS-SPWM). The proposed modulation strategy improves the dc-link utilization at higher modulation index. A detailed mathematical analysis is provided for the gain calculation based on the modified modulation strategy. A comparative study is implemented to verify the merits of the proposed topology. A simulation model is implemented utilizing MATLAB / Simulink to verify the topology characteristics. The power losses and efficiency calculations are presented using Altair PSIM. Furthermore, an experimental prototype is constructed to verify the simulation findings. The topology is tested with different loading conditions at numerous modulation index values and ST duty ratios. Furthermore, step change conditions are implemented to test the topology response. The effect of the ZS network on the switched capacitors charging inrush currents is validated. The proposed topology shows an overall advantage in terms of the output characteristics as well as the hardware requirements.

Abstract Lightweight concrete, particularly polystyrene concrete, has been extensively utilized in civil engineering for decades. The incorporation of waste expanded polystyrene (EPS) as a filler material in the production of lightweight concrete presents significant advantages from a circular economy perspective. Prior research indicates that increasing the proportion of lightweight aggregates, such as EPS, typically results in reductions in strength and bulk density. The utilization of substantial amounts of EPS waste in the formulation of structural polystyrene concrete is crucial for advancing sustainable construction practices. This study investigates the effects of varying nano-silica content on the bulk density, compressive strength, flexural strength, splitting tensile strength, and water penetration depth of structural polystyrene concrete. Concrete specimens were prepared by substituting 25%, 50%, 75%, and 100% of sand with EPS waste, while evaluating nano-silica contents of 0.75%, 1%, and 1.25%. The findings reveal that increasing the volume fraction of EPS corresponds to a decrease in the concrete’s bulk density. This research provides critical insights into optimizing structural lightweight concrete, thereby promoting advancements in sustainable construction applications.

Complete heart block in women of childbearing age is rare, and incidental diagnosis during pregnancy is more uncommon. Hence, there remain no well-established guidelines on the management of patients with complete heart block presenting in labor. Here, we present a 26-year-old full-term primigravida, with no known previous cardiac history, in active labor with asymptomatic bradycardia in the 30–40s unresponsive to atropine augmentation. After multidisciplinary consultation, the decision was to proceed with delivery as planned without indication for a temporary pacemaker. The patient successfully delivered a full-term infant via operative vaginal delivery, with an ensuing cardiac workup completed postpartum.

Mohsen Salama,&ast; Nehad Darwesh,&ast; Maha Mohammad Elsabaawy,&ast; Eman Abdelsameea,&ast; Asmaa Gomaa,&ast; Aliaa Sabry&ast; Department of Hepatology and Gastroenterology, National Liver Institute, Menofia University, Shebeen El-Kom, Menofia, Egypt&ast;These authors contributed equally to this workCorrespondence: Asmaa Gomaa, National Liver Institute, Menofia University, Shebeen El-Kom, Menofia, Egypt, Tel +20-1006157160, Email aibrahim@liver-eg.orgPurpose: This research was designed to determine the long-term outcomes in patients with liver cirrhosis who achieved sustained virological response (SVR) after direct-acting anti-viral drugs (DAAs) based regimens.Patients and Methods: This study involved 193 patients with HCV-related cirrhosis who had previously completed DAAs regimens and accomplished SVR. Clinical, laboratory, and radiological features at the first and 3rd-year follow-up after the end of treatment were analyzed. Overall survival (OS) and incidence of liver decompensation or hepatocellular carcinoma (HCC) were determined at the 5-year follow-up.Results: About 68.4% of our patients with HCV-related cirrhosis were males and their mean age was 54.8 ± 7.7 years. Follow-up at the first and the 3rd-year showed significant improvements in albumin (P = 0.001), liver enzymes (P = 0.001), alpha-fetoprotein (AFP) (P < 0.001), platelet count (P = 0.001), the model for end-stage liver disease (MELD) score (P = 0.001 and 0.01), FIB4 and Aspartate Aminotransferase-to-Platelet Ratio Index (APRI) scores (p < 0.001). The liver stiffness (LS) also significantly improved (p = 0.001). At the 5th year, the mean OS was 58.3 months, with 14.5% and 17.6% of patients developing de-novo HCC and decompensation, respectively. The mean OS at the 5th-year follow-up was shorter in patients who developed HCC and those with liver decompensation (p = 0.001). Alfa-fetoprotein and LS are predictive factors for HCC development.Conclusion: Despite achieving SVR, continuous surveillance for HCC and new-onset decompensation is mandatory in patients with liver cirrhosis.Keywords: long-term outcomes, cirrhotic patients, sustained virological response, DAAs

Physical characteristics of ternary glasses based on sulphur, are the main topic of the investigation. Cu2xGe40−xS60−x (0 ≤ x ≤ 8 at. %) chalcogenides was fabricated using the conventional melt-quench method. With an increase in Cu-concentration, the glass's density (ρ) increased but the molar volume (Vm) decreased. Transmittance and reflection measurements of the films were made over 0.35–2.5 µm spectral-range. The estimated envelopes (RM, Rm) of the reflection spectrum might be used to determine the complex refractive index and the film thickness. With increasing Cu-concentrations, the refractive index (n) increased while the optical gap (Eg) decreased. Cu-concentrations affects the film's nonlinear refractive index (n2), 3ed-susceptibility (χ(3)) and nonlinear absorption coefficient (χa) were investigated. In Cu2xGe40−xS60−x system, the n2, χ(3), and χa values increase with the Cu-additions. Finally, the films analyzed here exhibit interesting properties for application in various optical devices.

Abstract Background Despite the increasing incidence of colorectal cancer (CRC) in the Egyptian population, it still seems that there is a significant lack of awareness regarding the disease. This study aimed to assess the Egyptian population's awareness of CRC regarding its risk factors, the screening procedures, and the appropriate responses to its diagnosis. Method A cross-sectional study was conducted in Egypt between July 2022 and March 2023 and recruited a convenient sample of adults from seven governorates representing different geographic areas, and socioeconomic and educational backgrounds with the help of the validated Bowel Cancer Awareness Measure (CAM) version 2.1. The modified Arabic questionnaire was validated through a pilot study including 30 patients. Then it was presented through a Google form before being shared via online methods and face-to-face interviews. The questionnaire provided both numerical and categorical data, which were analyzed accordingly. The Chi-square, the Fisher exact, and the Man-Whitney test were used to compare colorectal cancer poor and good knowledge groups. Logistic regression analysis was conducted to predict the factors that affected the awareness level of the study population. Results Nine hundred forty individuals participated in the survey. Their ages ranged from 18 to 86 years old, with an average of 37.38 ± 12.22 years. The mean Knowledge score was 14.29 ± 7.05 out of 37 with most of our participants (71%) having poor knowledge about CRC. Most of the participants (64.1%) chose colonoscopy as the best screening modality, followed by an abdominal CT (27.8%), and fecal occult blood (15.5%). The study revealed significant differences between participants with good and poor knowledge of colorectal cancer. (78.5%) of participants with good CRC knowledge lived in cities, (85.4%) attained university or higher educational level, and (87.2%) of them were nonsmokers (p

Abstract Background Diffuse large B-cell lymphoma (DLBCL) is the most common aggressive non-Hodgkin lymphoma (NHL), constituting 31% of all NHL. Malignancy and inflammation are closely linked. Inflammatory processes have been identified to play an important role in the pathogenesis of lymphoma. Obesity is a well-known risk factor not only for the development of cardiovascular disease and diabetes but also for the development of several types of cancer, including lymphomas. Objective To find out the association of pan-immune-inflammation value (PIV) and body mass index (BMI) with survival in adults with diffuse large B-cell lymphoma. Patients and methods We conducted an observational retrospective study on 110 patients to unravel the association of PIV and BMI with survival outcome in a cohort of adults diagnosed as de novo DLBCL (NOS) and treated at the hematology units of International Medical Center, Helwan and Menoufia University Hospitals, in the period from 2014 to 2018. Results The mean age of the studied patients was 54.27 years, the mean BMI was 28.91, and the median and IQR for PIV were 195.84 (96.20–498.52). The cutoff value for detecting mortality in BMI was 29.74 kg/m2 with poor sensitivity (44.4%) and poor specificity (67.2%). The cutoff value for detecting mortality in PIV was 250.49 with poor sensitivity (50.0%) and poor specificity (67.2%). The mean duration of overall survival was 21.596 months. There was nonsignificant difference regarding 2-year overall survival according to BMI grouping (p-value = 0.195) and PIV grouping (p-value = 0.275). Conclusion Neither PIV nor BMI were associated with 2-year overall survival in patients with DLBCL.

Abstract Drought has a significant impact on rice yield by restricting the crop's ability to grow and develop. Producing rice cultivars adapted to water deficit conditions is still the main interest of rice breeders and geneticists. To address this challenge, a set of 413 highly diverse rice populations were evaluated under normal and water deficit conditions for two growing seasons of 2021 and 2022. High genetic variation was found among genotypes for all studied traits. The heritability estimates ranged from 0.82 (panicle length) to 0.95 (plant height). Sterility percentage (SET%) was the most trait affected by water deficit in two growing seasons. 22 Rice genotypes were classified as drought tolerant in both years. Genome-wide association mapping was performed for all traits in the two growing seasons under both conditions using a total of 700,000 SNPs. The GWAS results revealed important and major SNPs associated with all traits. 26 Significant SNPs with stable allele effects were found to be associated with yield traits under water deficit conditions in both years. The results of this study provided rice genotypes that can be adapted under water deficit conditions and important stable SNP markers that can be used for marker-assisted selection after validation in different genetic backgrounds.

Background The growing concern of antibiotic-resistant microbial strains worldwide has prompted the need for alternative methods to combat microbial resistance. Biofilm formation poses a significant challenge to antibiotic efficiency due to the difficulty of penetrating antibiotics through the sticky microbial aggregates. Drug repurposing is an innovative technique that aims to expand the use of non-antibiotic medications to address this issue. The primary objective of this study was to evaluate the antimicrobial properties of Diltiazem HCl, a 1,5-benzothiazepine Ca2+ channel blocker commonly used as an antihypertensive agent, against four pathogenic bacteria and three pathogenic yeasts, as well as its antiviral activity against the Coxsackie B4 virus (CoxB4). Methods To assess the antifungal and antibacterial activities of Diltiazem HCl, the well diffusion method was employed, while crystal violet staining was used to determine the anti-biofilm activity. The MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) colorimetric assay was utilized to evaluate the antiviral activity of Diltiazem HCl against the CoxB4 virus. Results This study revealed that Diltiazem HCl exhibited noticeable antimicrobial properties against Gram-positive bacteria, demonstrating the highest inhibition of Staphylococcus epidermidis, followed by Staphylococcus aureus. It effectively reduced the formation of biofilms by 95.1% and 90.7% for S. epidermidis, and S. aureus, respectively. Additionally, the antiviral activity of Diltiazem HCl was found to be potent against the CoxB4 virus, with an IC50 of 35.8 ± 0.54 μg mL−1 compared to the reference antiviral Acyclovir (IC50 42.71 ± 0.43 μg mL−1). Conclusion This study suggests that Diltiazem HCl, in addition to its antihypertensive effect, may also be a potential treatment option for infections caused by Gram-positive bacteria and the CoxB4 viruses, providing an additional off-target effect for Diltiazem HCl.

Abstract Secondary metabolites (SMs) are the primary source of therapeutics and lead chemicals in medicine. They have been especially important in the creation of effective cures for conditions such as cancer, malaria, bacterial and fungal infections, neurological and cardiovascular problems, and autoimmune illnesses. In the present study, Aspergillus pseudodeflectus AUMC 15761 was demonstrated to use wheat bran in solid state fermentation (SSF) at optimum conditions (pH 7.0 at 30 °C after 10 days of incubation and using sodium nitrate as a nitrogen source) to produce methyl ferulate and oleic acid with significant antioxidant and antibacterial properties. Gas chromatography-mass spectrometry (GC–MS) analysis of the crude methanol extract revealed eleven peaks that indicated the most common chemical components. Purification of methyl ferulate and oleic acid was carried out by column chromatography, and both compounds were identified by in-depth spectroscopic analysis, including 1D and 2D NMR and HR-ESI–MS. DPPH activity increased as the sample concentration increased. IC50 values of both compounds obtained were 73.213 ± 11.20 and 104.178 ± 9.53 µM, respectively. Also, the MIC value for methyl ferulate against Bacillus subtilis and Staphylococcus aureus was 0.31 mg/mL, while the corresponding MIC values for oleic acid were 1.25 mg/mL and 0.62 mg/mL for both bacterial strains, respectively. Molecular modeling calculations were carried out to reveal the binding mode of methyl ferulate and oleic acid within the binding site of the crucial proteins of Staphylococcus aureus. The docking results were found to be well correlated with the experimental data.

Background: The use of traditional medicine against viral disease in animal production has been practiced worldwide. Herbal extracts possess organic substances would improve chicken body performance. Aim: The current study was designed to evaluate the effect of either thyme or ginseng oil in regard to their immune-modulatory, antiviral, and growth promoter properties. Methods: Two hundred and forty- one -day- old broiler chicks were allocated into eight equal groups as the following: group 1; non-vaccinated and non-treated and group 2; NDV vaccinated and non-treated. Birds of groups 3 and 4 were treated with thyme oil (200mg/L of drinking water for 12 hrs/day) without or with NDV vaccination. Birds of groups 5 and 6 were treated with ginseng oil (200mg/L of drinking water for 12 hrs/day) without or with NDV vaccination. Birds of groups 7 and 8 were treated with a combination of ginseng oil (100mg/L of drinking water) and thyme oil (100mg/L of drinking water) for 12 hrs/day. On the 35th day of life, birds in all the experimental groups were given 0.1 mL of a virulent genotype VIId NDV strain suspension containing 106.3 EID50/mL intramuscularly (IM). Results: Administration of ginseng and thyme oils each alone or simultaneously to birds either vaccinated or non-vaccinated elicited a significant improvement in body performance parameters. Administration of thyme and ginseng each alone or concurrently to vaccinated birds (Gp 4, 6 and 8) induced a higher HI titer of 6, 7.3 and 6.3 log2 at 21 days of age, 6.7, 7.6 and 7 log2, at 28 days of age and 7, 8 and 6.8 log2 at 35 days of age, respectively. Challenge with vNDV genotype VII led to an increase in the NDV-specific HI-Ab titers ten days post-challenge in all the experimental groups. In addition, thyme, ginseng oils or a combination of them improved the protection from mortality in vaccinated birds; 100%, 100% and 90% respectively, compared with 80% protection from mortality in vaccinated-only birds post-NDV challenge. Moreover, NDV-vaccinated birds treated either with thyme; ginseng or their combination showed negative detection of the virus in both tracheal and cloacal swabs and non-vaccinated groups that received oils showed improvement in vNDV shedding in tracheal and cloacal swabs. Conclusion: It could be concluded that administration of thyme and ginseng essential oils to broilers can improve productive performance parameters, stimulate humoral immunity against, and protect from vNDV infection. [Open Vet J 2024; 14(1.000): 398-406]

Abstract Background Water deficit is one of the most significant abiotic factors affecting rice and agricultural production worldwide. In hybrid rice, cytoplasmic male sterility (CMS) is an important technique for creating high-yielding crop based on heterosis. The phytohormone kinetin (Kin) regulates cell division in plant during the early stages of grain formation, as well as flow assimilation and osmotic regulation under water stress. The present study performed to estimate the effects of irrigation intervals (irrigation each six days (I6), nine days (I9), twelve days (I12) and fifteen days (I15) against continuous flooding (CF, each three days)) and kinetin exogenously application (control, 15 mg L−1 and 30 mg L−1) on hybrid rice (L1, IR69625A; L2, G46A and R, Giza 178 R) seed production. Results Leaves traits (Chlorophyll content (CHC), relative water content (RWC), stomatal conductance (SC), Leaf temperature (LT) and transpiration rate (TR)), floral traits such as style length (SL) and total stigma length (TSL), in addition to root traits (i.e., root length (RL), root volume (RV), root: shoot ratio (RSR), root thickness (RT), root xylem vessels number (RXVN) and root xylem vessel area (RXVA) were evaluated and a significant enhancement in most traits was observed. Applying 30 mg L−1 kinetin significantly and positively enhanced all growth, floral and roots traits (RV and RXVA recorded the most increased values by 14.8% and 23.9%, respectively) under prolonging irrigation intervals, in comparison to non-treated plants. Conclusions Subsequently, spraying kinetin exogenously on foliar could be an alternative method to reduce the harmful influences of water deficiency during seed production in hybrid rice.

Background and aim: Advanced liver fibrosis is a major risk for developing hepatocellular carcinoma (HCC) in chronic hepatitis C virus (HCV) patients. Direct-acting antivirals (DAAs) which are used for treating HCV infection, produce more than 90% cure rate but do not seem to diminish the rate of occurrence or recurrence of HCC. This study aimed to investigate the effect of DAAs sofosbuvir (SOF) and daclatasvir (DAC) on carbon tetrachloride (CCl4)-induced fibrotic changes in mice. Methods: Eighty adult male Swiss albino mice were randomly allocated into 8 groups (10 mice/group): normal control group, SOF group (receiving SOF 80 mg/kg body weight (BW), oral gavage, daily), DAC group (receiving DAC 30 mg/kg BW, oral gavage, daily), SOF + DAC group (receiving a combination of both, daily), CCl4 model group (receiving CCl4 2 mL/kg BW, intraperitoneal twice weekly) and three CCl4-intoxicated groups receiving either SOF or DAC or their combination. All CCl4 groups received CCl4 for 12 weeks followed by DAAs for another 12 weeks. Results: CCl4-induced a significant elevation of alanine aminotransferase (ALT) and aspartate aminotransferase (AST), and produced histopathological evidence of fibrosis and liver degeneration along with a significant increase (P ≤ 0.001) of the proliferation markers (proliferating cell nuclear antigen (PCNA) and Ki-67), hepatic stellate cells (HSCs) activation markers (alpha-smooth muscle actin (α-SMA) and glial fibrillary acidic protein (GFAP)), fibrosis marker (matrix metalloproteinase-9 (MMP-9)) and pro-inflammatory cytokine (tumor necrosis factor-alpha (TNF-α)). CCl4-intoxicated mice treated with SOF, DAC, or their combination revealed a significant amelioration (P ≤ 0.001) of CCl4-induced elevation of liver enzymes, fibrotic changes, and liver degeneration along with a significant attenuation (P ≤ 0.001) of CCl4-induced upregulation of all tested markers. The effects of SOF, DAC, and their combination on liver enzymes were comparable while the effect of SOF + DAC combination on mitigating CCl4-induced upregulation of the proliferation and HSCs activation markers was significantly stronger than either SOF or DAC alone. As for MMP-9 and TNF-α, the effects of DAC and SOF + DAC combination were comparable and both were more significant than that of SOF alone. Conclusions: SOF and DAC may possess an antifibrotic effect that is independent of their role as antiviral agents against CCl4-induced liver injury. This might exclude the role of DAAs in early occurrence or accelerated recurrence of HCC through the progression of the HCV patients' pre-existing fibrosis. However, HCC patients treated with DAAs should be closely monitored with continuous HCC surveillance during and post-therapy.

Background: Oxidative stress and its end products, such as malondialdehyde (MDA) play a leading role in the pathogenesis of hepatitis C. Melatonin is a hormone that helps regulate circadian rhythms, which likely play a role in infectious diseases in terms of susceptibility, clinical expression, and outcome.Objective: The present study was conducted to assess serum malondialdehyde and melatonin levels in patients with chronic hepatitis C infection before and after the intake of direct-acting antivirals.Method: Forty hepatitis C patients were the subjects of this study. While ten healthy volunteers who matched in age and socioeconomic status served as the control subjects. Malondialdehyde and melatonin were assayed in the serum of the three groups, and the results were statistically analyzed.Results: Hepatitis C patients had significantly higher malondialdehyde (p < 0.001) but significantly lower melatonin (p < 0.001) as compared to the healthy controls. After 12 weeks of treatment with direct-acting antivirals, the malondialdehyde level decreased significantly (p < 0.001) and the melatonin level increased significantly (p < 0.001). A significant negative correlation between malondialdehyde and melatonin was observed.Conclusion: The present findings suggest that treatment of hepatitis C patients with Direct-acting antivirals improves liver function parameters and antioxidant profiles.

The present study was planned to evaluate the clinical, hematological, biochemical, ultrasonographic, and histopathological alterations in kidneys and other organs in dogs injected with gentamicin. Six mongrel dogs were experimentally injected I/M with gentamicin by 20 mg/kg BW daily till the appearance of renal failure signs. Blood samples were collected before and after induction (on day 9 and day 12). Hematological results revealed a non-significant decrease in hemoglobin and RBC’s, a significant decrease in hematocrit values on both days, a non-significant increase in TLC at day 12 but a non-significant decrease at day 9, a significant increase in non-segmented neutrophil at day 9 but non-significant decrease at day 12, non-significant decrease in lymphocyte at day 9 but non-significant increase at day 12, a significant increase in monocyte at day 9 but non-significant decrease at day 12. Biochemical results revealed a significant increase in urea and creatinine on day 12 and a non-significant increase on day 9. Urinalysis results indicated an increase in leukocyte, albumin, glucose, pus cells, and RBCs. Urine culture revealed isolates of E.coli, Proteus, and Staphylococcus bacteria. Ultrasonographic results showed increased echogenicity of renal cortex with loss of corticomedullary junction on day 9. On day 12 ultrasonographic results revealed intensive hyper-echogenicity of the renal cortex, increased echogenicity of the right renal cortex as compared with the spleen, and the renal cortex of the right kidney appeared more hyperechoic when compared with the liver. Histopathological examination of kidneys showed different degenerative changes, hemorrhages, nephritis, and other organs revealed degeneration, inflammation, and hemorrhages. The findings indicated that despite the therapeutic effect of gentamicin in treating kidney infection, it may have an adverse effect on kidneys and other organs, especially with massive doses.

Abstract Objectives: To study serum growth differentiation factor‐15 (GDF‐15) serum level in β‐thalassemia patients and its relation to carotid intima‐media thickness. Background: Thalassemia is a common genetic disease resulting in decreased beta‐chains, leading to manifested anemia. It may be subsequently complicated by iron overload, which induces numerous morbidities and even death. Growth differentiation factor‐15 (GDF‐15) is a strong and independent predictor of mortality and disease progression in patients with atherosclerosis alongside with carotid‐intimal media thickness (CIMT). Patients and methods: This monocentric case‐control study was done on 90 subjects in the period from January 2020 to March 2021. Sixty transfusion‐dependent beta‐thalassemia (TDβT) cases (≥18 years) were selected from the thalassemia clinic of Hematology division at Menoufia University hospitals. We included also 30 sex and age matched healthy as the controls. Routine investigations were done beside. Serum GDF‐15 was measured by ELISA. CIMT was measured by Doppler Ultrasonography. Results: CIMT on both sides was statistically significant higher in cases (median of 0.08 cm) than in the controls (median of 0.04). GDF‐15 was also significantly higher in cases (median of 1839.89 pg/dl) than in controls (median of 256.14 pg/dl). So, we found that GDF‐15 is a predictor of and associated with atherosclerosis in thalassemic adults (OR = 39.198, p value 0.008, 95% CI: 2.576–596.5). Conclusion: GDF‐ 15 is increased in TDβT. CIMT (as a marker of subclinical atherosclerosis) is increased in these patients alongside with GDF‐15, is a predictor, and associated with atherosclerosis in thalassemic adults.

Abstract The burden of cancer diseases is increasing every year, therefore, the demands to figure out novel drugs that can retain antitumor properties have been raised. This study aimed to investigate the anti-tumor properties of amygdalin (Amy) against Ehrlich ascites carcinoma (EAC) bearing mice and its protective properties against liver damage. Amy and the standard anticancer drug Sorafenib (Sor) were given alone or in combination to Swiss albino female mice that had been injected with EAC cells. Biochemical parameters of liver function (AST, ALT, GGT, total protein, albumin), tumor volume, oxidative stress [malondialdehyde, (MDA)] and antioxidative [superoxide dismutase (SOD), and reduced glutathione (GSH)] markers were measured. The hepatic expression of the antioxidant-related gene [nuclear factor erythroid-2-related factor 2 (Nrf2)], the migration-related gene [matrix metalloprotease 9 (MMP9)], and the angiogenesis-related gene [vascular endothelial growth factor (VEGF)] were evaluated by qPCR. The results revealed that EAC-bearing mice treated with Amy and/or Sor showed a decrease in the tumor burden and hepatic damage as evidenced by (1) decreased tumor volume, number of viable tumor cells; (2) increased number of dead tumor cells; (3) restored the liver function parameters; (4) reduced hepatic MDA levels; (5) enhanced hepatic GSH and SOD levels; (6) upregulated expression of Nrf2; (7) downregulated expression of MMP9 and VEGF, and (8) improved hepatic structure. Among all treatments, mice co-treated with Amy (orally) and Sor (intraperitoneally) showed the best effect. With these results, we concluded that the Amy improved the antitumor effect of Sor and had a protective role on liver damage induced by EAC in mice.

Rice production faces challenges related to diverse climate change processes. Heat stress combined with low humidity, water scarcity, and salinity are the foremost threats in its cultivation. The present investigation aimed at identifying the most resilient rice genotypes with yield stability to cope with the current waves of climate change. A total of 34 rice genotypes were exposed to multilocation trials. These locations had different environmental conditions, mainly normal, heat stress with low humidity, and salinity-affected soils. The genotypes were assessed for their yield stability under these conditions. The newly developed metan package of R-studio was employed to perform additive main effects and multiplicative interactions modelling and genotype-by-environment modelling. The results indicated that there were highly significant differences among the tested genotypes and environments. The main effects of the environments accounted for the largest portion of the total yield sum of squared deviations, while different sets of genotypes showed good performance in different environments. AMMI1 and GGE biplots confirmed that Giza179 was the highest-yielding genotype, whereas Giza178 was considered the most-adopted and highest-yielding genotype across environments. These findings were further confirmed by the which–won–where analysis, which explained that Giza178 has the greatest adaptability to the different climatic conditions under study. While Giza179 was the best under normal environments, N22 recorded the uppermost values under heat stress coupled with low humidity, and GZ1968-S-5-4 manifested superior performance regarding salinity-affected soils. Giza 177 was implicated regarding harsh environments. The mean vs. stability-based rankings indicated that the highest-ranked genotypes were Giza179 > Giza178 > IET1444 > IR65600-77 > GZ1968-S-5-4 > N22 > IR11L236 > IR12G3213. Among them, Giza178, IR65600-77, and IR12G3213 were the most stable genotypes. Furthermore, these results were confirmed by cluster-analysis-based stability indices. A significant and positive correlation was detected between the overall yield under all the environments with panicle length, number of panicles per plant, and thousand grain weight. Our study sheds light on the notion that the Indica/Japonica and Indica types have greater stability potential over the Japonica ones, as well as the potential utilization of genotypes with wide adaptability, stability, and high yield, such as Giza178, in the breeding programs for climate change resilience in rice.

Objective: The study aimed to evaluate the effect of mild and moderate hemodilution during CPB on the neurocognitive dysfunction in patients undergoing coronary artery bypass grafting. Design: A randomized clinical study. Setting: Cardiac center. Patients: 186 patients scheduled for cardiac surgery with cardiopulmonary bypass. Intervention: The patients were classified into 2 groups (each = 93), Mild hemodilution group: The hematocrit value was maintained >25% by transfusion of packed-red blood cells plus hemofiltration during CPB. Moderate hemodilution group: the hematocrit value was maintained within the range of 21-25%. Measurements: The monitors included the hemofiltrated volume, number of transfused packed red blood cells, and the incidence of postoperative cognitive dysfunction. Main Results: The hemofiltrated volume during CPB was too much higher with mild hemodilution compared to the moderate hemodilution (p = 0.001). The number of the transfused packed red blood cells during CPB was higher with mild hemodilution compared to the moderate hemodilution (p = 0.001), but after CPB, the number of the transfused packed red blood cells was lower with the mild hemodilution group than the moderate hemodilution (p = 0.001). The incidence of total postoperative neurological complications was significantly lower with the mild hemodilution group than moderate hemodilution (p = 0.033). The incidence of neurocognitive dysfunction was significantly lower with mild hemodilution group than moderate hemodilution (p = 0.042). Conclusions: The mild hemodilution was associated with a significant decrease in the incidence of neurocognitive dysfunction compared to moderate hemodilution in patients undergoing coronary artery bypass grafting. Also, the transfused packed red blood cells increased during CPB and decreased after CPB with the mild hemodilution than moderate hemodilution.

Abstract Background For patients undergoing noncardiac surgery, bleeding and hypotension are frequent and associated with increased mortality and cardiovascular complications. Tranexamic acid (TXA) is an antifibrinolytic agent with the potential to reduce surgical bleeding; however, there is uncertainty about its efficacy and safety in noncardiac surgery. Although usual perioperative care is commonly consistent with a hypertension-avoidance strategy (i.e., most patients continue their antihypertensive medications throughout the perioperative period and intraoperative mean arterial pressures of 60 mmHg are commonly accepted), a hypotension-avoidance strategy may improve perioperative outcomes. Methods The PeriOperative Ischemic Evaluation (POISE)-3 Trial is a large international randomized controlled trial designed to determine if TXA is superior to placebo for the composite outcome of life-threatening, major, and critical organ bleeding, and non-inferior to placebo for the occurrence of major arterial and venous thrombotic events, at 30 days after randomization. Using a partial factorial design, POISE-3 will additionally determine the effect of a hypotension-avoidance strategy versus a hypertension-avoidance strategy on the risk of major cardiovascular events, at 30 days after randomization. The target sample size is 10,000 participants. Patients ≥45 years of age undergoing noncardiac surgery, with or at risk of cardiovascular and bleeding complications, are randomized to receive a TXA 1 g intravenous bolus or matching placebo at the start and at the end of surgery. Patients, health care providers, data collectors, outcome adjudicators, and investigators are blinded to the treatment allocation. Patients on ≥ 1 chronic antihypertensive medication are also randomized to either of the two blood pressure management strategies, which differ in the management of patient antihypertensive medications on the morning of surgery and on the first 2 days after surgery, and in the target mean arterial pressure during surgery. Outcome adjudicators are blinded to the blood pressure treatment allocation. Patients are followed up at 30 days and 1 year after randomization. Discussion Bleeding and hypotension in noncardiac surgery are common and have a substantial impact on patient prognosis. The POISE-3 trial will evaluate two interventions to determine their impact on bleeding, cardiovascular complications, and mortality. Trial registration ClinicalTrials.gov NCT03505723. Registered on 23 April 2018.

Purpose: Zearalenone (ZEN) which is one of the known fusarium species mycotoxin, produced primarily on many cereal crops. Consequently, the current study aims to estimate the possibility of labeling zearalenone and the pattern of accumulation of the produced labeled zearalenone [125I]-ZEN in different mice tissues, and the possible protective effect of Lactobacillus plantarum to reduce organ accumulation of Zearalenone. Materials and methods: the experiment was conducted on two groups of mice were used; the two groups received [125I] Zearalenone administered by tail vein injection, the first group receive nothing else while the second group received also L. plantarum (as a control agent) orally. The mice were kept under observation for 120 min to monitor zearalenone distribution. Results: by monitoring the zearalenone distribution the maximum concentration was found to be mainly primarily in the intestine (45.8 %) followed by the liver (27.15 %) while in the ovary (the most susceptible organ was (3.22 %) after120 min, in the first group of mice. The same pattern was observed in the second group with concentrations of (46.1 %), (30.19 %) and (0.09 %) in the intestine, liver respectively. Conclusion: These results indicated the lactic acid bacteria played a role in decreasing labeled zearalenone in the ovaries which is the target organ. [125I]-labeled ZEN is a promising novel tracer for organ imaging and that a significant role that L. plantarum could play in decreasing the zearalenone bioavailability of in mice organs.

The impact of supplementing chelated chromium (Cr) in transition cows has increased recently. The objective of this study was to conduct a systematic review of randomized controlled trials to evaluate the effectiveness of supplementation of chelated chromium (Cr) on plasma glucose, non-esterified fatty acid (NEFA) and insulin during the transition period in dairy cows. A total of 322 transition dairy cows, belonged to seven studies from five papers, were used. The complete steps of meta-analysis were performed according to the standard pathway of PRISMA. For this reason, a comprehensive meta-analysis was used to accomplish this mission. The effect model and I2 statistic was used to estimate the degree of heterogeneity. Forest plot was used to present a graphic means and their confidence intervals, and a heterogeneous degree was explored with meta-regression, also Beggꞌs test was conducted to investigate the publication bias. Estimated the effect size of chelated Cr on glucose, NEFA, and insulin outcomes during the threetime points (i.e. before, at, after calving) was no significant (glucose ES=(0.049-0.078) 0.015, p-value=0.649; NEFA ES=(-0.719-0.45) -0.134, p-value=0.653; and insulin ES=(-0.090-0.154) 0.032, p-value=0.611. The heterogeneity was not significant for all variables (glucose I2=0, p-value=0.981; NEFA I2=0 p-value=1; and insulin I2=0, pvalue=0.980). Consequently, fixed-effects models were used for the analysis of such data. Furthermore, Beggꞌs test indicated no evidence of substantial publication bias for all parameters. The influence analysis showed that the removal of any study did not change the direction or significance of point estimates. The meta-analysis of our study indicated that chelated Cr supplementation of diets of dairy cows during the transition period provided a glucose tolerance effect by increasing the insulin response and decrease NEFA concentration, but not in a significant level.

Food waste worldwide is beginning to become a "heavy" problem of one billion tons. It is almost unbelievable that in 2021, global food waste reached an extraordinary value of 931 million tons. Of these, over 60% is represented by food waste at the household level. In this context, the research analysed which countries have the highest level of food waste, presenting a double Top 10: the first - Top 10 of the countries with the highest food waste at national level and the second - Top 10 countries with the highest food waste per capita, based on data collected from external sources, data provided by organizations and institutions, as well as reference publications in the field.

Shimaa Kilany,1 Lmyaa Ata,1 Asmaa Gomaa,1 Aliaa Sabry,1 Ali Nada,1 El-Sayed Tharwa,1 Gamal Badra,1 Ashraf Abogabal,1 Mohamed Elwaraky,2 Enas Moaz,3 Sameera Ezzat,3 Ahmed Elsharawy,4 Imam Waked1 1Hepatology and Gastroenterology Department, National Liver Institute, Menoufia University, Menoufia, Egypt; 2Radiology Department, National Liver Institute, Menoufia University, Menoufia, Egypt; 3Epidemiology Department, National Liver Institute, Menoufia University, Menoufia, Egypt; 4Clinical Pathology Department, National Liver Institute, Menoufia University, Menoufia, EgyptCorrespondence: Imam WakedNational Liver Institute, Menoufia University, Shebeen El-Kom, Menoufia, EgyptTel +20-12-2215-7256Fax +20-48-2234586Email iwaked@liver-eg.orgBackground and Aim: Existing data are controversial regarding the incidence of hepatitis C (HCV)–related hepatocellular carcinoma (HCC) following directly acting antiviral (DAA) therapy. This prospective study aimed to assess incidence, and risk factorss of HCC following DAA therapy in patients with HCV-related advanced fibrosis (F3) and cirrhosis (F4).Methods: Incidence of HCC was calculated in 1,630 patients with HCV-related F3 and F4 treated with DAA prospectively followed for up to 43 months in a single tertiary referral center and compared to historical controls. Risk factors of incident HCC were also determined.Results: The crude outcome rate was 2.15/100 person-years, significantly lower than a similar historical cohort (5.57/100 person-years). Risk of developing HCC was higher with the presence of cirrhosis (F4 vs F3, AHR 3.59) and treatment failure (vs achieving SVR, AHR 3.37). Presence of decompensated cirrhosis, platelet count < 100× 103/mL, and high AFP were independent risk factors of developing HCC.Conclusion: Incidence of HCC was significantly lower in patients with HCV-related advanced fibrosis and cirrhosis treated with DAAs than in a historical cohort of untreated patients. Decompensated cirrhosis, baseline AFP ≥ 10 ng/mL, diabetes, and nonresponse to DAA were independent risk factors of incident HCC.Keywords: HCC, DAA, HCC incidence, HCC predictors, HCC characteristics

Abstract Background Bacterial wilt of tomato (BWP) caused by Ralstonia solanacearum (Smith) is a very important disease. Biological control of this disease is a very important tool to protect the plant and environment from pollution of chemical control. Results Twenty isolates of genus, Pantoea were isolated from healthy tomato root. Out of 20 isolates, 2 strains, PHYTPO1 and PHYTPO2, showed highly antagonistic property to control the growth of R. solanacearum in vitro conditions. They were identified as P. agglomerans by using 16S rRNA nucleotide sequence analysis. The 2 isolates were selected to study their effect (as cell suspension or culture filtrate) on the bacterial wilt under greenhouse conditions. PHYTPO1 inhibited maximum growth reduction of R. solanacearum and formed 2.5 cm2 of inhibition zone, followed by 1.2 cm2 in PHYTOPO2 under in vitro conditions. Treating with both isolates of P. agglomerans was significantly reduced disease severity of tomato wilt disease. The disease severity was reduced to 74.1 when treated as cell suspension, while when treated as culture filtrate, it reduced the disease severity up to 69.4 than infected control. Conclusion The strains of Pantoea can be used as an ecofriendly method to control of the most economic pathogen of tomato under greenhouse conditions. Further study is needed to find an appropriate formulation and approving application of these bacteria under field conditions.

Background and Aim: Intestinal disorders represented a large proportion of abdominal emergencies in bovine practice, and their definite diagnosis was a big challenge. The study described different intestinal disorders in cattle either in the small intestine (SI) or large intestine with their sequelae and peritonitis between SI loops. Materials and Methods: This study involved healthy (n=20) and diseased (n=40) cattle with intestinal disorders. All animals were undergoing clinical examination, laboratory analyses, and ultrasonographic examination. Results: Diseased cattle had monocytic leukocytosis as well as hypoproteinemia and hypoalbuminemia. The SI ileus of either proximal (n=12) or distal (n=15), intussusception (n=3), cecal, and/or colonal dilatation (n=10) were diagnosed by ultrasound and other diagnostic tools. Duodenum intussusception was imaged in cross-section as bull's eyes lesions. Animals with SI obstructions showed complete cessation (ileus with complete obstruction) or partial reduction of the peristaltic SI movement (ileus with partial obstruction), dilated duodenum (6.5-9.9 cm), and dilated jejunum and/or ileum (4.4-6.8 cm). Ultrasonography diagnosed SI ileus, due to either intestinal obstruction or peritonitis, and detected the ileus site, either proximal or distal. Cecal/colonal dilatation was detected using ultrasonography in which SI was not imaged and the peristaltic movements were completely reduced. The recorded intestinal disorders were associated with other disorders (e.g., liver cirrhosis or peritonitis). Conclusion: Ultrasonography played an important role in the differential diagnosis of intestinal disorders in cattle. Peritonitis between SI loops and cecal and/or colonal dilatation was also diagnosed.

Background: Ketosis is one of the most critical metabolic disorders that occur in dairy cows after parturition due to negative energy balance (NEB) around calving. Aim: The study evaluated a specific therapeutic regimen of ketosis in Holstein dairy cattle by using combination therapy including hormones, corticosteroids, propylene glycol, and vitamin B12 as well as the use of milk yield rates, insulin, insulin sensitivity, and abomasal functions monitors as diagnostic biomarkers for the recovery of ketotic cows either pre-therapy (0 days) or post-therapy (7 and 14 days). Methods: This study was conducted on ketotic cattle (n=20) belonged to different dairy farms in Cairo and Giza governorates, Egypt. The diseased cows were undergoing clinical and biochemical investigations for the estimation of serum insulin. Quantitative Insulin Sensitivity Check Index (RQUICKI) and abomasal functions monitor mainly serum levels of gastrin, pepsinogen, and chloride. Results: The milk production rates, cost: benefit analysis ratio, and benefit of the dairy farm in ketotic animals were significantly increased post-treatment. An improvement of insulin sensitivity was stated as serum insulin, and RQUICKI were remarkably increased in post-therapeutic ketotic cows. Monitors of the abomasal function revealed abomasal functions improvement through the significant elevation of blood gastrin and a substantial reduction in serum pepsinogen due to treatment. Conclusion: the study revealed high efficacy of the applied therapeutic strategy regime. It led to a high recovery rate and a very low relapse rate for ketosis. An improvement in milk yield rates, insulin sensitivity, and abomasal function monitors was reported. Hypoinsulinaemia was still reported, however, serum insulin was improved.

Older adults are mostly affected by chronic lymphocytic leukemia (CLL). The present study aimed to evaluate oxidative stress in CLL and to assess its impact on IL-9, Th9 cells levels and prognosis of cases. Seventy Egyptian CLL patients and 15 healthy controls were included. Th9 cell and immunophenotyping of abnormal B cells were assessed by flow cytometry, IL-9 level using ELISA, IL-9 mRNA by qRT-PCR, cytogenetics using FISH, and oxidative stress parameters were determined spectrophotometrically and with native gel electrophoresis. Oxidative stress was elevated in CLL that correlated with abnormal immunophenotyping, cytogenetic changes, bad prognosis, Th9 cells, and overexpression of IL-9. Levels of IL-9 and Th9 cells were strongly correlated with oxidative stress and bad prognostic markers in CLL, indicating that these cells may contribute to CLL by novel mechanisms that could include oxidant injury.

Using the internal transcribed spacer (ITS) region for identification, three strains of Aspergillus terreus were identified and designated AUMC 15760, AUMC 15762, and AUMC 15763 for the Assiut University Mycological Centre culture collection. The ability of the three strains to manufacture lovastatin in solid-state fermentation (SSF) using wheat bran was assessed using gas chromatography-mass spectroscopy (GC-MS). The most potent strain was strain AUMC 15760, which was chosen to ferment nine types of lignocellulosic waste (barley bran, bean hay, date palm leaves, flax seeds, orange peels, rice straw, soy bean, sugarcane bagasse, and wheat bran), with sugarcane bagasse turning out to be the best substrate. After 10 days at pH 6.0 at 25 °C using sodium nitrate as the nitrogen source and a moisture content of 70%, the lovastatin output reached its maximum quantity (18.2 mg/g substrate). The medication was produced in lactone form as a white powder in its purest form using column chromatography. In-depth spectroscopy examination, including 1H, 13C-NMR, HR-ESI-MS, optical density, and LC-MS/MS analysis, as well as a comparison of the physical and spectroscopic data with published data, were used to identify the medication. At an IC50 of 69.536 ± 5.73 µM, the purified lovastatin displayed DPPH activity. Staphylococcus aureus and Staphylococcus epidermidis had MICs of 1.25 mg/mL, whereas Candida albicans and Candida glabrata had MICs of 2.5 mg/mL and 5.0 mg/mL, respectively, against pure lovastatin. As a component of sustainable development, this study offers a green (environmentally friendly) method for using sugarcane bagasse waste to produce valuable chemicals and value-added commodities.

Abstract Background Autoimmunity is used to cause by impairment of adaptive immunity alone, whereas autoinflammatory was originally defined as a consequence of unregulated innate immunity. So, the pathogenetic mechanisms of autoimmune diseases were well-thought-out to be mediated by B and T lymphocytes. Whereas, autoinflammatory diseases were defined as unprovoked times of inflammation with the absence of a high titre of autoantibodies. Main body of the abstract Autoimmune and autoinflammatory diseases were split into two groups, but considering the similarities, it can be considered as only one group of diseases with a large immune pathological and clinical spectrum which involves at one end pure autoimmune diseases and the other pure autoinflammatory diseases. Conclusions We can safely conclude that there is bridging between autoinflammatory and autoimmune diseases.

A total of 200 1-week-old Japanese quails were randomly allocated into five treatment groups, each consisting of 40 unsexed birds (five replicates, eight birds each). Quails were reared in traditional cages (90 × 40 × 40 cm), and feed and water were made available throughout the 5-week trial. The treatment groups were as follows: the 1st was fed basal diet, whereas the 2nd, 3rd, 4th, and 5th groups were fed with ration supplemented with nano zinc (Zn-NPs) at doses of 0.1, 0.2, 0.3, and 0.4 g/kg diet, respectively. Results showed that, a significant (p ≤ .0001) improvement in body weight, weight gain, feed intake, and feed conversion ratio was observed in birds fed diets supplemented with 0.2 g/kg of Zn-NPs. Supplementation of Zn-NPs at doses of 0.1–0.3 g/kg diet demonstrated a positive impact on the activity of ALT, AST, and LDH. The liver profile parameters were not statistically influenced (p > .05) by dietary biological nano zinc, with the exception of total cholesterol (TC), high density lipoprotein (HDL), and low density lipoprotein (LDL). Also, dietary supplementation of biological Zn-NPs at concentrations of 0.1–0.3 g/kg diet demonstrated a positive impact on superoxide dismutase (SOD), glutathione peroxidase (GPX), malondialdehyde (MDA), immunoglobulin G (IgG), and immunoglobulin M (IgM). Dietary supplementation of Zn-NPs led to an increase in beneficial microbial populations. From the obtained results, Zn-NPs supplementation at 0.2 g/kg diet had a positive effect on the performance and physiological status of growing Japanese quails.HIGHLIGHTS Zinc (Zn) is an important trace element for the general functioning of the animal body. A significant improvement in growth performance was observed in birds fed diet enriched with 0.2 g/kg of Zn-NPs. Supplementation of Zn-NPs (0.1–0.3 g/kg diet) demonstrated a positive impact on immunity and antioxidant indices

Muhamad R Abdel Hameed,1 Esam Abdel-Moneim Sadek Elbeih,1 Heba Mahmoud Abd El-Aziz,2 Ola Abdel-Haleem Afifi,3 Lamiaa Mohammed Refaat Khalaf,4 Mohammed Zakaria Ali Abu Rahma,5 Abeer Sabry6 1Department of Internal Medicine & Hematology Unit, Assiut University Hospitals and Bone Marrow Transplantation Unit, South Egypt Cancer Institute, Assiut University, Assiut, Egypt; 2Department of Internal Medicine, Assiut University Hospitals, Assiut University, Assiut, Egypt; 3Department of Clinical Pathology, Assiut University Hospitals, Assiut University, Assiut, Egypt; 4Department of Radiology, South Egypt Cancer Institute, Assiut University, Assiut, Egypt; 5Department of Tropical Medicine and Gastroenterology, Assiut University, Assiut, Egypt; 6Department of Internal Medicine, Helwan University, Helwan, EgyptCorrespondence: Muhamad R Abdel HameedDepartment of Internal Medicine & Hematology Unit, Assiut University Hospitals and Bone Marrow Transplantation Unit, South Egypt Cancer Institute, Assiut University, Assiut, EgyptTel (+2)01097510010Email dr.muhamadramadan@yahoo.comBackground and Objectives: Budd-Chiari syndrome (BCS) is a rare disorder caused by obstruction to hepatic venous outflow. It affects all races, usually during the third or fourth decade of life. Higher prevalence had being evident in developing countries. The aim of the present study was to clarify sociodemographic features, clinical, radiological presentations, and etiology of BCS among Upper Egyptian patients.Patients and Methods: This retrospective cohort study enrolled 50 Upper Egyptian Patients with confirmed primary BCS. Liver, coagulation, and thrombophilia workup profiles were performed as anticardiolipin antibodies, lupus anticoagulant, protein C, protein S, and antithrombin III assays. Factor V Leiden and JAK2 mutations were assessed. Full radiological assessment was done.Results: Fifty patients were included. There were 28 males (56%) and 22 females (44%) with mean age (32.5 ± 11.1 years). The etiological factor was not identified in 22% of cases (n=11). Isolated factor C deficiency was found in 26% (n=13) with male predominance 39.3% and protein S deficiency in 10% (n=5). Factor V Leiden mutation was the etiology in 5 patients (10%). Membranous web and antiphospholipid syndrome each were the etiology in 8% (n=4). Behςet’s disease was diagnosed in 4% (n=2). Cases of liver cirrhosis(LC) were 41/50(82%)they were :33/50(66%) LC child class C, 8 /50(16%) LC child class B, and 0/50 (0%) LC child class A. Abdominal pain was the most common symptom (96%), and ascites was the most common sign (82%). Obstruction of hepatic veins was present in 80%.Conclusion: BCS in Upper Egyptian patients was mainly occurred in males in the third and fourth decade of life, mostly with liver cirrhosis. The most common etiology is isolated protein C deficiency followed by Factor V Leiden mutation and isolated protein S deficiency. Hepatic veins obstruction was the most common pattern of vascular involvement.Keywords: Budd-Chiari syndrome, Upper Egypt, factor V Leiden, thrombophilia, etiology, protein C

The background to determine the standard macro minerals requirement for geese is very important for growth, production and health. Until now, there are no clear standard mineral requirements for the local Egyptian geese. Consequently, the present experiment was aimed at estimating the influence of different dietary calcium (Ca) and phosphorus (P) concentrations on lipid profile, antioxidant and immunity parameters of the growing Egyptian geese. A total number of 120 Egyptian goslings (4 weeks old), with almost the same body weights were divided into 4 groups (30 goslings/group) randomly. All groups were subdivided into six replicates, each replicate contains five birds. A 2 × 2 factorial experiment was done with 2 dietary levels of Ca (0.70 and 0.85%) and P (0.35 and 0.45%) in the diets. Lipid parameters were not significantly changed except for low density lipoprotein (LDL) cholesterol and total cholesterol decreased significantly at dietary 0.85% Ca, and 0.45% P levels. The lipid parameters were not altered by the interaction between Ca and P levels except triglycerides and very low density lipoprotein (VLDL) cholesterol. Dietary supplementation of 0.85% Ca, and 0.45% P improved superoxide dismutase (SOD), catalase (CAT) and reduced glutathione (GSH) and decreased the malondialdehyde (MDA) concentration. The most examined immune parameters were improved by the main and the interaction effect of P and Ca levels in geese diets. In conclusion, the present findings show that the best dietary Ca and P requirements for growing Egyptian geese are 0.85%, and 0.45% respectively, without any detrimental effects on health and immune status.HIGHLIGHTS Calcium and phosphorus are very important nutrients in formulations of geese. Ca is essential for coagulation, eggshell formation, muscle and nerve function. Phosphorus has an important role in nervous system and is a significant component of eggshells, phospholipids and nucleic acids. The standard Ca and P requirement for growing geese are 0.85% and 0.45%, respectively.

Abstract Background With widespread use of pediatric head CT, it is critically important to protect patients from radiation hazards, using reduced dose CT techniques. In this regard, adaptive statistical iterative reconstruction-V (ASIR-V) algorithm can decrease image noise, generating CT images of reasonable diagnostic quality with less radiation. The objective of this study was radiation dose assessment, quantitative and qualitative evaluation of reduced dose pediatric head CT using ASIR-V 60% and 80% reconstruction. Results Retrospective analysis was performed on two groups of pediatric head CT examinations, a reduced dose CT examination group with ASIR-V reconstruction (ASIR group) (n = 27) and a standard dose CT examination group without ASIR reconstruction (non-ASIR group) (n = 14). The average effective dose (ED) of ASIR group was significantly lower than that of the non-ASIR group (1.04 ± 0.1 mS vs 3.48 ± 0.45 mS; p = 0.001). Quantitative analysis revealed comparable results of signal to noise ratio (SNR) and contrast to noise ratio (CNR) of ASIR and non-ASIR groups (p > 0.05). Qualitative evaluation of resulting images by two readers revealed comparable results of both ASIR and non-ASIR groups (p > 0.05) with excellent inter-reader agreement (κ = 0.97). Both quantitative and qualitative assessment demonstrated better ASIR-V 80% than ASIR-V 60% reconstructed images. Conclusion ASIR-V algorithm is a promising technology for effective dose reduction of pediatric head CT with preservation of diagnostic image quality.

Background and Aim: Campylobacteriosis is one of the most well-characterized bacterial foodborne infections worldwide that arise chiefly due to the consumption of foods of animal origin such as poultry, milk, and their products. The disease is caused by numerous species within the genus Campylobacter, but Campylobacter jejuni is the most commonly isolated species from established cases of human campylobacteriosis. This study was conducted to determine the prevalence and virulence of Campylobacter isolates from human, chicken, and milk and milk products in Egypt. Materials and Methods: A total of 1299 samples (547 chicken intestine and liver, 647 milk and milk products, and 105 human stool) were collected and microbiologically investigated, confirmed by multiplex polymerase chain reaction (PCR) targeting the 23S rRNA, hipO, and glyA genes specific for Campylobacter spp., C. jejuni, and Campylobacter Coli, respectively, followed by virulence genes (Campylobacter adhesion to fibronectin F [cadF] and cdtB) detection using PCR. Results: About 38.09%, 37.84%, and 8.5% of human stool, chicken, and milk and milk product samples, respectively, were bacteriologically positive, with a total of 302 Campylobacter isolates. All isolates were molecularly confirmed as Campylobacter spp. (100%) where 285 isolates (94.37%) were identified as C. jejuni and 17 isolates (5.62%) as C. coli. Regarding the virulence pattern, all isolates (100%) carried cadF gene while cytolethal distending toxin B gene was definite in 284/302 isolates (94%), concisely, 282/285 (98.94%) C. jejuni isolates, and in 2/17 (11.76%) C. coli isolates. Conclusion: The widespread presence of these highly virulent Campylobacter, especially C. jejuni, proofs the urgent need for the implementation of stringent control, public health, and food protection strategies to protect consumers from this zoonotic pathogen. The availability of information about pathogen virulence will enable enhanced local policy drafting by food safety and public health officials.

Abstract Background Liver cancer (HCC) ranks as the fifth most prevalent cancer worldwide and is ranked third as a common cause of death due to cancer. The benefit of Fibroscan in assessing the risk of developing liver cancer that was evaluated in this work was not fully demonstrated. The aim of this work was to study the role and clinical significance of Fibroscan for early detection of liver cancer in hepatitis C patients with cirrhosis. Results As regards binary logistic regression for predictors of HCC, it was found that Child C, AST, Fibroscan, and AFP were predictors for developing HCC. Liver stiffness values were significantly high in all groups, and the specific cutoff value for hepatocellular carcinoma detection was above 24 kPa in hepatitis C virus patients. Therefore, liver stiffness of more than 24 kPa can be considered as an independent risk factor for the development of liver cancer in HCV patients. Conclusion Liver stiffness of more than 24 kPa was an independent risk factor for developing new liver cancer in HCV patients.

Abstract Background Conventional brain MRI cannot always distinguish between different white matter lesions. Susceptibility weighted imaging (SWI) can detect a sign called central vein sign which is suggested to discriminate between multiple sclerosis and other white matter lesions thus increasing the accuracy of MRI in MS diagnosis. This study aimed to evaluate the role of MR susceptibility weighted imaging in differentiating MS from CSVD lesions. Results The central vein sign (CVS) was found to have a premium diagnostic performance in diagnosis of MS with sensitivity 83.3%, specificity 70%, positive predictive value 80.6%, and negative predictive value 73.7%. When CVS positive lesions load was ≥ 44.24%, the specificity of CVS in diagnosing MS raised to 100%. Conclusion Detection of the CVS on SWI can reliably discriminate between MS and CSVD.

Wael Abd Elgwad Elsewify,1 Elham Ahmed Hassan,2 Mohamed A Mekky,2 Abeer Sharaf El-Din Abd El-Rehim,2 Zain El-Abdeen Ahmed Sayed,3 Mohamed Omar Abdel Malek,2 Tarek TH ElMelegy,4 Abeer Sabry5 1Department of Internal Medicine, Faculty of Medicine, Aswan University, Aswan, Egypt; 2Department of Gastroenterology and Tropical Medicine, Faculty of Medicine, Assiut University, Assiut, Egypt; 3Department of Internal Medicine, Faculty of Medicine, Assiut University, Assiut, Egypt; 4Department of Clinical Pathology, Faculty of Medicine, Assiut University, Assiut, Egypt; 5Department of Internal Medicine, Faculty of Medicine, Helwan University, Cairo, EgyptCorrespondence: Wael Abd Elgwad ElsewifyDepartment of Internal Medicine, Faculty of Medicine, Aswan University, Aswan 81528, EgyptTel +20 1001657295Fax +20 973480449Email waelelsewify@yahoo.comBackground: Screening of hepatocellular carcinoma (HCC) is challenged especially in patients with normal alpha-fetoprotein (AFP) levels. Aberrant p16 methylation has been implicated in HCC.Objectives and Aims: This study aimed to assess serum methylated p16 (MP16) expression levels and to evaluate MP16 diagnostic performance in HCC detection among HCV-infected Egyptian patients with normal AFP levels.Methods: MP16 levels were quantified using real-time PCR in 230 serum samples (30 healthy controls, 95 with HCV-HCC, 40 with chronic hepatitis C “CHC” and 65 with HCV cirrhosis). Diagnostic performance of MP16 for diagnosis of HCC was done using receiver operator characteristic curve analysis.Results: Serum MP16 levels were significantly higher in HCC than CHC, cirrhosis, and healthy subjects and significantly higher in HCC with normal AFP levels than those with higher AFP. ROC curves revealed promising diagnostic performance for MP16 in discriminating HCC with normal AFP levels from non-HCC cases. This predictive ability improved by combining MP16 and AFP (AUC of 0.872 with 100% sensitivity, 76.5% specificity, 79.1% positive predictive value, 100% negative predictive value, and 87.5% accuracy).Conclusion: MP16 can be a potential noninvasive molecular biomarker for HCC detection in patients with hepatic mass(es) and normal AFP levels especially in those where liver biopsy and radiological imaging cannot be done.Keywords: methylated p16, hepatitis C virus, hepatocellular carcinoma, alpha-fetoprotein, quantitative real-time PCR

Background Chronic hepatitis C virus infection is one of the most important health problems in Egypt. Since November 2015, generic sofosbuvir (SOF) with daclatasvir (DCV)±ribavirin (RBV) became the standard treatment in all National Committee for Control of Viral Hepatitis centers. Yet, the long-term efficacy, safety, and late complications of generic direct-acting antiviral drugs have not been studied. Aims Evaluation of the efficacy and safety of generic DCV-containing regimens in the treatment of chronic hepatitis C patients after 72 weeks of close follow-up. Patients and methods A total of 150 chronic hepatitis C virus patients were classified into easy-to-treat group (naïve patients with no evidence of cirrhosis) and difficult-to-treat group (treatment experienced or have any evidence of cirrhosis) and treated for 12 weeks with generic medications: DCV 60 mg and SOF 400 mg±RBV in easy and difficult-to-treat groups, respectively. A close follow-up of up to 72 weeks was done to assess the efficacy and safety of the generic drugs. Results Overall sustained virologic response (SVR12) was 94.0%, while the end of treatment response rate was 94.7%. SVR12 rates in easy-to-treat and difficult-to-treat groups were 97.06 and 91.46%, respectively. Multivariate analysis revealed that absence of cirrhosis, higher baseline albumin, lower baseline international normalized ratio, higher baseline platelet count, lower baseline alpha-fetoprotein, normal splenic size, and naivety to previous antiviral therapy were associated with SVR12. PCR after 72 weeks for those who achieve SVR12 is still undetectable. Three cases died during the follow-up period and were related to their advanced liver disease. No serious adverse events were reported. Conclusion Generic DCV, SOF±RBV regimen is safe and effective for treatment of chronic hepatitis C with minimal adverse events and SVR12 is efficient to predict persistent viral clearance.

Ali A Ghweil,1 Heba A Osman,1 Mohammed H Hassan,2 Abeer MM Sabry,3 Reem E Mahdy,4 Ahmed RH Ahmed,5 Ahmed Okasha,6 Ashraf Khodeary,7 Hesham H Ameen8 1Tropical Medicine and Gastroenterology Department, Faculty of Medicine, South Valley University, Qena, Egypt; 2Department of Medical Biochemistry, Faculty of Medicine, South Valley University, Qena, Egypt; 3Internal Medicine and Gastroenterology Department, Faculty of Medicine, Helwan University, Helwan, Egypt; 4Internal Medicine Department, Faculty of Medicine, Assiut University, Assiut, Egypt; 5Pathology Department, Faculty of Medicine, Sohag University, Sohag, Egypt; 6Radiology Department, Faculty of Medicine, South Valley University, Qena, Egypt; 7Clinical Pathology Department, Faculty of Medicine, Sohag University, Sohag, Egypt; 8Clinical Pathology Department, Faculty of Medicine, Al-Azhar University (Assiut Branch), Assiut, EgyptCorrespondence: Mohammed H HassanDepartment of Medical Biochemistry, Faculty of Medicine, South Valley University, Qena 83523, EgyptTel +20 109 847 3605Email mohammedhosnyhassaan@med.svu.edu.egBackground and aim: Gastric carcinomais a frequent neoplasm with poor outcome, and its early detection would improve prognosis. This study was designed to evaluate the possible use of new biomarkers, namely SAA and HMGB1, for early diagnosis of gastric cancer.Methods: A total of 100 patients presenting with gastric symptoms were included. All patients underwent upper endoscopic evaluation, histopathological diagnosis and serum CEA, SAA, and HMGB1 measurements.Results: Patients were classed endoscopically with neoplastic, inflammatory, and normal-appearing gastric mucosa: 50, 25, and 25 patients, respectively. Histologically, half the patients had chronic gastritis and the remaining cases gastric carcinoma of diffuse (n=28) or intestinal (n=22) type. SAA at cutoff of 18.5 mg/L had the best validity to differentiate gastritis from gastric carcinoma, with AUC, sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) of 0.99, 98%, 100%, 100%, and 98%, respectively, followed by HMGB1 at cutoff of 14.5 pg/μL, with AUC, sensitivity, specificity, PPV, and NPV of 0.91, 70%, 96%, 94.6%, and 76.2%, respectively. Sensitivity, specificity, PPV, and NPV of serum CEA at cutoff of 2.9 ng/mL to differentiate gastritis from gastric carcinoma were 42%, 72%, 60%, and 55.4%, respectively, with AUC of 0.53. Nonetheless, higher serum levels of both SAA and HMGB1 reflected higher tumor grade (P=0.027 and P=0.016, respectively) and advanced tumor stage (P-OBrk-0.001 for both).Conclusion: Serum levels of both SAA and HMGB1 could be of great value for early diagnosis of gastric carcinoma, comparable to the diagnostic role of serum CEA, which is not valid for early diagnosis of gastric cancer.Keywords: gastric carcinoma, early detection, SAA, HMGB1, CEA

Toxoplasmosis is one of the most common parasitic zoonoses that affects all vertebrates. The drugs most commonly used against toxoplasmosis have many side effects, making the development of new antiparasitic drugs a big challenge. The present study evaluated the therapeutic effectiveness of novel herbal treatments, including propolis and wheat germ oil (WGO), against acute toxoplasmosis. A total of 50 albino mice were divided into five groups: group 1 (G1) (non-infected and non-treated); group 2 (G2) (infected without treatment); group 3 (G3) (treated with propolis); group 4 (G4) (treated with WGO); group 5 (G5) (treated with a combination of propolis and WGO). The effects of the herbal substances on different organs, mainly liver, spleen, and lungs, were investigated using parasitological, molecular, and histopathological examinations. The results of parasitological examination demonstrated statistically significant (p < 0.05) differences in the parasitic load between treated groups (G3, G4, and G5) compared to the control positive group (G2). These differences were represented by a significant reduction in the parasite load in stained tissue smears from the liver obtained from the animals treated with propolis (G3) compared to the parasite load in the positive control group. Similarly, animals (G4) treated with WGO exhibited a significant reduction in the parasite load versus the positive control group, while the lowest parasite load was found in G5, treated with propolis and WGO. Quantification of the parasite burden through molecular methods (PCR) revealed similar findings represented by reduction in the parasite burden in all treated groups with WGO and propolis as compared to the control group. Importantly, these previous parasitological and molecular findings were accompanied by a marked improvement in the histopathological picture of the liver, spleen, and lungs. In conclusion, propolis and WGO showed a good combination of therapeutic efficacy against acute toxoplasmosis.

ABSTRACT: The present study was performed to evaluate the influence of low crude protein (CP) levels, zinc sources (organic as zinc methionine-Zn-Met and inorganic as zinc oxide-ZnO) and their interactions on growth performance, carcass traits, and blood components of growing Japanese quail. A total of 450 one-wk-old Japanese quail with the same body weights were randomly distributed into 9 groups of 50 birds. The 9-diet treatments comprised 3 levels of CP (20, 22, and 24%) and 3 Zn source (0 g of Zn/kg diet, 0.1 g ZnO/kg diet, and 0.1 g Zn-Met/kg diet). The results obtained from this study showed that there were no significant differences among the groups, except for differences in body weight (BW) and body weight gain (BWG) at 3 to 5 – and 1 to 5 wk of age for quail supplemented with 24% and 20% CP. All the studied biochemical parameters were significantly influenced by different levels of CP and Zn, except urea and creatinine, which were affected by CP levels only. In conclusion, dietary protein level for growing Japanese quails could be reduced to 20% without negative effects on their performance, carcass traits, and blood metabolites.