Activation of AMPK/mTOR-Driven Autophagy and Suppression of the HMGB1/TLR4 Pathway with Pentoxifylline Attenuates Doxorubicin-Induced Hepatic Injury in Rats.

Despite being an effective chemotherapeutic agent, the clinical use of doxorubicin (DOX) is limited by several organ toxicities including hepatic injury. Pentoxifylline (PTX) is a methylxanthine derivative with marked anti-inflammatory and anti-apoptotic features. It is unknown, however, whether PTX can mitigate DOX-evoked hepatotoxicity. This study aims to explore the potential hepatoprotective impact of PTX in DOX-induced hepatic injury and the underlying molecular mechanisms. Histopathology, immunohistochemistry, and ELISA were used to examine liver tissues. The current findings revealed that PTX administration to DOX-intoxicated rats mitigated the pathological manifestations of hepatic injury, reduced microscopical damage scores, and improved serum ALT and AST markers, revealing restored hepatic cellular integrity. These favorable effects were attributed to PTX's ability to mitigate inflammation by reducing hepatic IL-1ß and TNF-α levels and suppressing the pro-inflammatory HMGB1/TLR4/NF-κB axis. Moreover, PTX curtailed the hepatic apoptotic abnormalities by suppressing caspase 3 activity and lowering the Bax/Bcl-2 ratio. In tandem, PTX improved the defective autophagy events by lowering hepatic SQSTM-1/p62 accumulation and enhancing the AMPK/mTOR pathway, favoring autophagy and hepatic cell preservation. Together, for the first time, our findings demonstrate the ameliorative effect of PTX against DOX-evoked hepatotoxicity by dampening the hepatic HMGB1/TLR4/NF-κB pro-inflammatory axis and augmenting hepatic AMPK/mTOR-driven autophagy. Thus, PTX could be utilized as an adjunct agent with DOX regimens to mitigate DOX-induced hepatic injury.

Assessment of the Implementation of Global Initiative for Asthma (GINA) 2019 Guidelines for Treatment of Mild Asthma Among Pediatric Registrars: A Quasi-Interventional Study.

Background and Aims: It is essential to have proper treatment and management for asthma in order to minimise symptoms, lessen the burden, and lower the chance of exacerbations. To better control asthma, the purpose of this study was to evaluate and enhance paediatric registrars' understanding and application of asthma treatment. Methods: The Sudan Medical Specialisation Board (SMSB) paediatric registrars provided data for this quasi-interventional study between April and September of 2021. Twice, both before to and following the intervention education sessions, the questionnaire was delivered. SPSS version 28 was used to analyse the data after it had been cleaned up in an Excel document. Results: 203 (or 77.8%) of the 261 were women. A substantial rise from 8.1 ± 4.12 SD to 18 ± 5.03 SD in the mean overall knowledge score of registrars between the pre-and post-intervention periods. A significant difference (p=0.001) was observed in the post-intervention phase, with first-year registrars (R1) demonstrating higher scores than their senior colleagues. The registrars' total knowledge scores did not differ significantly from one another during the pre-intervention period. The Global Initiative of Asthma (GINA) guidelines of management were implemented to a certain extent, according to the study. Of the registrars, 148 (56.7%) and 203 (77.8%) evaluated step one management in children ages 5 and under; 66 (25.3%) and 213 (81.6%) evaluated step one management in children ages 6 to 11; and 66 (25.3%) and 213 (81.6%) evaluated step one management in children ages 6 to 11 in pre- and post-intervention, respectively. Conclusion: Given that the intervention in this study greatly increased registrars' knowledge, doctors should obtain training on the GINA 2019 recommendations through conferences, workshops, and academic programmes. To find out why R1 outperforms their older counterparts, more investigation has to be done.

In silico Evaluation of Ferulic Acid Based Multifunctional Conjugates as Potential Drug Candidates.

BACKGROUND: Recent research has shown that ferulic acid (FA, trans-4-hydroxy-3- methoxycinnamic acid) has remarkable antioxidant properties and a wide range of biological activities. Conjugation of two or more biologically active compounds to produce a novel molecular scaffold is justified by the need to enhance biological activity against a single target or obtain a conjugate that behaves as a multi-target-directed ligand. In addition, the conjugation strategy decreases dose-dependent side effects by promoting the use of smaller doses of conjugated components to treat the disease. Moreover, the patient's compliance is positively affected when conjugating two active compounds into a single more active compound as this reduces the number of pills to be taken daily. OBJECTIVE: This study aims to shed light on studies that design and synthesize FA-based hybrid compounds with enhanced biological activities and to in silico assess these compounds as potential drug candidates. METHODS: The conjugate compounds were found by searching the literature using the keywords (ferulic acid-based hybrid or ferulic acid-based conjugate). To study conjugate pharmacokinetic parameters and toxicity (ADMET), software suites from Biovia Inc. (San Diego, California) were integrated into Discovery Studio 4.5. The structures were created using ChemDraw Ultra 7.0. RESULTS: 14 conjugates exhibiting variable biological activities were collected and three of them (compounds 3,5, and 6) in addition to the cis FA (compound 12) are the best-predicted compounds with low Daphnia toxicity and hepatotoxicity with acceptable pharmacokinetic properties. CONCLUSION: Cis FA, FA conjugates 3,5, and 6 act as good drug candidates that can be used to modify new hits.

First Emergence of NDM-5 and OqxAB Efflux Pumps Among Multidrug-Resistant Klebsiella pneumoniae Isolated from Pediatric Patients in Assiut, Egypt.

Introduction: New Delhi metallo-ß-lactamase (NDM)-producing K. pneumoniae poses a high risk, especially among Egyptian pediatric patients who consume carbapenems antibiotics very widely and without adequate diagnostic sources. In addition, presence of efflux pump genes such as OqxAB increases resistance against many groups of antimicrobials which exacerbates the problem faced for human health. This study aimed to determine NDM variants among K. pneumoniae strains isolated from pediatric patients in Egypt, analyze the presence of OqxAB genes, and molecular characterization of blaNDM-5-positive K. pneumoniae. Methods: Fifty-six K. pneumoniae isolates were recovered from pediatric patients, and tested for carbapenemase by modified carbapenem inactivation methods (mCIM) test. Minimum inhibitory concentrations of meropenem and colistin were determined by meropenem E-test strips and broth microdilution, respectively. PCR was used for the detection of the resistant genes (ESBL gene (blaCTX-M), carbapenemase genes (blaNDM, blaKPC) colistin resistant (mcr1, mcr2)) and genes for efflux pump (oqxA and oqxB). BlaNDM was sequenced. The effect of efflux pump in NDM-5-producing isolates was assessed by measuring MIC of ciprofloxacin and meropenem before and after exposure to the carbonyl cyanide 3-chlorophenylhydrazone (CCCP). The horizontal gene transfer ability of blaNDM-5 was determined using liquid mating assay and PCR-based replicon typing (PBRT) was done to determine the major plasmid incompatibility group. Results: Twenty-nine isolates were positive for blaNDM-1, nine isolates were positive for blaNDM-5, and 15 isolates were positive for blaKPC. There is a significant increase of meropenem MIC of NDM-5-positive isolates compared with NDM-1-positive isolates. In addition, 38 isolates were positive for CTX-M, and 15 isolates were positive for mcr1. Both OqxA and OqxB were detected in 26 isolates and 13 isolates were positive for OqxA while 11 isolates were positive for OqxB only. All NDM-5-producing isolates except one isolate could transfer their plasmids by conjugation to their corresponding transconjugants (E. coli J53). Plasmid replicon typing showed that FII was predominant in NDM-5-producing K. pneumoniae. Similar strains were found between the three isolates and similarity was also detected between the two isolates. Conclusion: The highly resistant K. pneumoniae producing blaNDM-5 type was firstly isolated from pediatric patients. The association of efflux pump genes such as OqxAB is involved in resistance to ciprofloxacin. This highlighted the severity risk of blaNDM-5-positive K. pneumonia as it could transfer blaNDM-5 to other bacteria and has more resistance against carbapenems. This underlines the importance of continuous monitoring of infection control guidelines, and the urgent need for a national antimicrobial stewardship plan in Egyptian hospitals.

Isolation and characterization of synthetic pyrethroids-degrading bacterial strains from agricultural soil.

Pyrethroid pesticides are commonly used for pest control in agriculture setup, veterinary and home garden. They are now posing increased risks to non-targeted organisms associated to human beings due to their considerable use. The present work deals with the isolation of bacteria with tolerance to high concentrations of bifenthrin and cypermethrin from contaminated soil. Enrichment culture technique (bifenthrin concentration = 50-800 mg/L) was used for bacterial isolation. Bacteria that showed growth on minimal media with bifenthrin were also sub-cultured on minimal media with cypermethrin. Bacteria showing luxurious growth on both the pyrethroid, were screened out based on their morphological, biochemical parameters and by API 20NE Kit. Phylogenetic studies revealed that, one bacterial isolate (MG04) belonging to Acinetobacter lwoffii and other five bacterial isolates (MG06, MG05, MG01, MG03 and MG02) cluster with Pseudomonas aeruginosa, Pseudomonas putida respectively. Isolated members of genera Pseudomonas and Acinetobacter could be used for further detailed degradation studies by using FTIR, HPLC-MS or GC-MS analysis.

Optical Goos-Hänchen effect in uniaxially strained graphene.

We prove the existence of relatively large Goos-Hänchen (GH) shifts for graphene in the presence of an applied strain in different crystallographic directions for p and s polarized beams. It is shown that GH shifts are smoothly increased by stretching the graphene's lattice. Moreover, we investigate the GH effect for strained graphene as a function of Fermi energy, which can be controlled by external factors such as gate voltage. We show that applied strain along zigzag and armchair orientations gives different results for GH shifts, which could provide a proper tool for the detection of strain in graphene.

Economic hardship among principal family caregivers of cancer patients at Khartoum oncology hospital 2020: a cross-sectional study.

BACKGROUND: The impact of cancer extends beyond patients and consumes their families. Family members are widely recognized as informal caregivers. The economic burden on family caregivers is increased with new treatments, prolonged survival, and reduced stay in the acute care setting. This is especially true in African countries where family bonds are sacred and health system is fragile that they need to pay out of pocket for care. The aim of this study is to estimate the perceived caregivers' economic burden in the subsequent aspects: financial strain, inability to make ends meet, not enough money for necessities, and economic adjustments/cutbacks. METHOD: This study was a quantitative, descriptive cross-sectional study conducted at Khartoum oncology hospital. Included 143 caregivers of cancer patients. Data were collected through face-to-face interviews using the socio-demographic Questionnaire and Economic Hardship Questionnaire (EHQ). RESULTS: One hundred forty-three cancer patients and their caregivers were included. 56.6% of patients were females, and about 32.2% were aged 51-65 years. The most common cancer types were breast cancer and leukemia. Roughly 33% of patients had stage IV cancer on presentation, and about 53.9% received chemotherapy. Unlike cancer patients, (47.6%) of family caregivers were aged 18-34 years, yet they were mainly females (54.4%). Most of them (34.3%) were unemployed, with a mean monthly gross income of 53.3 dollars, while the mean household monthly gross income was 113.0 dollars. The mean score of the economic hardship scale was 35.8 out of 64. Most of the caregivers experience no difficulties affording necessities. However, they experience difficulties with medical and leisure activities. There was no significant association between caregiver economic hardship and cancer patient characteristics (patients' age, cancer stage, and treatment type). However, there was a significant association between caregivers' economic hardships and their gender, marital status, educational level, occupation, caregiver monthly gross income, and household monthly gross income. CONCLUSION: The study findings suggest a moderate financial burden among cancer caregivers. The predicting factors include being single, a student, male, of higher educational level, and lower income. Financial difficulties are associated with maladaptive behavior and should come to light.

Topiramate Reprofiling for the Attenuation of Cadmium-Induced Testicular Impairment in Rats: Role of NLRP3 Inflammasome and AMPK/mTOR-Linked Autophagy.

Topiramate, a promising drug classically used for the management of neurological disorders including epilepsy and migraine, has demonstrated marked anti-inflammatory and anti-apoptotic actions in murine models of cardiac post-infarction inflammation, wound healing, and gastric/intestinal injury. However, its potential impact on cadmium-induced testicular injury remains to be elucidated. Herein, the present study aimed to explore the effect of topiramate against cadmium-invoked testicular impairment with emphasis on the molecular mechanisms linked to inflammation, apoptosis, and autophagy. Herein, administration of topiramate (50 mg/kg/day, by gavage) continued for 60 days and the testes were examined by histology, immunohistochemistry, and biochemical assays. The present data demonstrated that serum testosterone, sperm count/abnormalities, relative testicular weight, and histopathological aberrations were improved by topiramate administration to cadmium-intoxicated rats. The rescue of testicular dysfunction was driven by multi-pronged mechanisms including suppression of NLRP3/caspase-1/IL-1ß cascade, which was evidenced by dampened caspase-1 activity, lowered IL-1ß/IL-18 production, and decreased nuclear levels of activated NF-κBp65. Moreover, curbing testicular apoptosis was seen by lowered Bax expression, decreased caspase-3 activity, and upregulation of Bcl-2. In tandem, testicular autophagy was activated as seen by diminished p62 SQSTM1 accumulation alongside Beclin-1 upregulation. Autophagy activation was associated with AMPK/mTOR pathway stimulation demonstrated by decreased mTOR (Ser2448) phosphorylation and increased AMPK (Ser487) phosphorylation. In conclusion, combating inflammation/apoptosis and enhancing autophagic events by topiramate were engaged in ameliorating cadmium-induced testicular impairment.

Seeing the unforeseen: an insight into kingdom-wide psychological impact of COVID-19 pandemic.

OBJECTIVE: The aim of the manuscript was to measure the levels of psychological stress, both acute and post-traumatic in the Saudi Arabian population during the situation resulting from the COVID-19 outbreak. MATERIALS AND METHODS: A cross-sectional survey was carried out among people of Saudi Arabia (SA) to measure levels of psychological stress, both acute and post-traumatic during the COVID-19 outbreak. Data were collected from five regions in SA using validated questionnaires including Kessler Psychological Distress Scale (K10) and Impact of Events Scale (IES) through social media channels from March 2021 to January 2022. RESULTS: The total number of participants was 1,560. Most of participants (60.2%) were females. Around 53.6% of the sample were aged between 16-24 years old. The majority of participants (87.3%) was Saudi national. About 82% of participants was from Eastern (40.1%) and Western (42.2%) regions, followed by those from Central, Northern, and Southern. More than 60% of them had a college degree or above. The mean K 10 score was 28.33 for the sample which was above the cut-off of 25, implying significant levels of acute stress in the sample. IES values showed a mean of 28.19, well above the cut-off of significant Post Traumatic Stress Disorder (PTSD) symptoms (24). K-10 and IES scores revealed that about 76.7% of the participants suffered from significant acute stress and 59.1% suffered from symptoms of PTSD during the COVID-19 era. CONCLUSIONS: The nationwide study emphasizes the fact that the Saudi population was found to be extremely stressed and traumatized during the COVID-19 pandemic era and calls for effective.

Intestinal tuberculosis-the challenging mimicker-in a young Sudanese patient: A case report.

This article reported a case of intestinal tuberculosis (ITB)in a young patient. ITB could mimic many other diseases such as inflammatory bowel diseases (Crohn's disease), abdominal lymphoma, and others which make it difficult to differentiate; hence, many ITB patients could get mis-diagnosed and suffer wrong treatment consequences.

A persistent high ambient temperature waned the community spread of severe acute respiratory syndrome coronavirus-2 in Pakistan.

The recent pandemic caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has increased the global concern over its transmission and prevention. Since there was an incontrovertible perception that environmental conditions might affect the spread of SARS-CoV-2, we analyzed the environmental variables impact on SARS-CoV-2 transmission in Pakistan. Our analytical study revealed that when the temperature remained high for consecutive 10 to 15 days, a significant decrease is witnessed in the forthcoming week in the COVID-19 cases. We found that a persistent high ambient temperature of 36 °C and above is detrimental to SARS-CoV-2 transmission and has paused the community spread of COVID-19 in Pakistan. Importantly, during the fall period of SARS-CoV-2, a high relative humidity of 63-72% was noted that showed a positive role in COVID-19 inhibition. Hence, the community spread of SARS-CoV-2 was paused by the warm humid climate and the ambient temperature was the yardstick in turning down the epidemic in Pakistan.

Bilateral sternalis muscle in a Sudanese cadaver.

INTRODUCTION AND IMPORTANCE: Sternalis/rectus sterni is a rare muscle found in the anterior chest wall, it occurs in 35% of humans. The early detection of its presence is critical in regular mammogram screening in order to avoid possible differential diagnostic dilemma. CASE PRESENTATION: We report here a case of the sternalis muscle observed bilaterally, it was found during routine dissection session of an elderly male cadaver in the dissection room, Faculty of Medicine, University of Khartoum. CLINICAL DISCUSSION AND CONCLUSION: Sternalis muscle is a familiar entity to anatomists, but can pose a diagnostic and surgical dilemma to some clinicians. Presence of the muscle can be confusing in regular mammogram screening and CT and MRI should be utilized to clear the dilemma, and further evidence needs to be explored and studied.

Escalamiento de antimicrobianos con la inclusión de una lista de verificación en la unidad de cuidados intensivos pediátricos / Antibiotic escalation with the inclusion of a checklist in the pediatric intensive care unit

Resumen Introducción: La vigilancia de la administración de los antimicrobianos mejora su prescripción. Objetivo: Disminuir el escalamiento en el uso de antimicrobianos a las 48 h del inicio, en la unidad de cuidados intensivos pediátricos (UCIP). Material y Métodos: Estudio de cohortes ambispectivo, realizado en una UCIP e incluyó pacientes ingresados que recibieron antibioterapia, implementando una lista de verificación del uso de antimicrobianos (checklist) en forma prospectiva, Se comparó con una cohorte histórica previa al checklist. Fueron evaluados el escalamiento de antimicrobianos a las 48 h, la consulta con infectólogos y la indicación de vancomicina .La comparación de las variables entre las dos cohortes se realizó con la prueba de χ2, el test de Fischer y la U de Mann Whitney. Los resultados principales se expresaron en RR y RAR. Estudio aprobado por el Comité de Ética institucional. Resultados: Ingresaron 70 pacientes en la etapa del checklist, y fueron comparados con 124 pacientes de la cohorte histórica. La introducción del checklist redujo el escalamiento de antimicrobianos a las 48 h, desde 56,4 a 21,4% (p < 0,0001) con una RAR de 35%; la prescripción de la vancomicina desde 64,5 a 40% (p < 0,001), RAR 24,5% e incrementó la consulta con infectólogo en 23%, (desde 9,6 a 32,8%) (p < 0,0001). No hubo diferencias en la mortalidad y duración de la antibioterapia a los 10 días. Conclusiones: El checklist permitió disminuir el escalamiento de antimicrobianos a las 48 h del inicio, la indicación de vancomicina y aumentó la consulta con infectólogos.

Abstract Background: Antibiotic surveillance improves the appropriate antibiotic therapy. Aim: To decrease the antibiotic scaling, 48 hours after starting prescription in the pediatric intensive care unit (PICU). Methods: A ambispective cohort study was performed in the PICU including patients admitted in whom antibiotic therapy was started and a checklist was applied prospectively. They were compared with a historical cohort, prior the checklist. The main outcome was the antibiotic scaling 48 hours after starting and the secondary endpoints were consultation with infectious diseases (ID) specialist and vancomycin prescription. To compare the variables between the two cohorts, the χ2 test, Fischer test and U Mann-Whitney test were used. The results of the main variables were expressed in RR and RAR. The study was approved by the institution's Ethics Committee. Results: 70 patients were admitted in the checklist cohort and they were compared with 124 patients of the historical cohort. The checklist implementation decreased the antibiotic scaling at 48 h after starting from 56.4 to 21.4% (p < 0.0001) ARR = 35% and vancomycin prescription from 64.5 to 40% (p < 0.001) ARR =24.5%. The consultation with ID specialist increased from 9.6 to 32.8% (p < 0.0001). There were no differences in mortality and duration of antibiotic therapy at 10 days of hospitalization. Conclusion: The checklist implementation decreased the antibiotic scaling,48 hs after starting and the vancomycin prescription while the ID specialist consultation increased.

[Antibiotic escalation with the inclusion of a checklist in the pediatric intensive care unit]. / Escalamiento de antimicrobianos con la inclusión de una lista de verificación en la unidad de cuidados intensivos pediátricos.

BACKGROUND: Antibiotic surveillance improves the appropriate antibiotic therapy. AIM: To decrease the antibiotic scaling, 48 hours after starting prescription in the pediatric intensive care unit (PICU). METHODS: A ambispective cohort study was performed in the PICU including patients admitted in whom antibiotic therapy was started and a checklist was applied prospectively. They were compared with a historical cohort, prior the checklist. The main outcome was the antibiotic scaling 48 hours after starting and the secondary endpoints were consultation with infectious diseases (ID) specialist and vancomycin prescription. To compare the variables between the two cohorts, the χ2 test, Fischer test and U Mann-Whitney test were used. The results of the main variables were expressed in RR and RAR. The study was approved by the institution's Ethics Committee. RESULTS: 70 patients were admitted in the checklist cohort and they were compared with 124 patients of the historical cohort. The checklist implementation decreased the antibiotic scaling at 48 h after starting from 56.4 to 21.4% (p < 0.0001) ARR = 35% and vancomycin prescription from 64.5 to 40% (p < 0.001) ARR =24.5%. The consultation with ID specialist increased from 9.6 to 32.8% (p < 0.0001). There were no differences in mortality and duration of antibiotic therapy at 10 days of hospitalization. CONCLUSION: The checklist implementation decreased the antibiotic scaling,48 hs after starting and the vancomycin prescription while the ID specialist consultation increased.

Rheological and quality characteristics of composite gluten-free dough and biscuits supplemented with fermented and unfermented Agaricus bisporus polysaccharide flour.

In this study, functional, rheological and physicochemical characteristics were carried out for composite gluten-free (CGF) flours, dough and biscuits, respectively fortified with fermented and unfermented Agaricus bisporus polysaccharide (FABP and UABP) flours. Addition of both FABP flour and UABP flour improved functional properties, while addition of FABP flour decreased viscosity property. Incorporation of both polysaccharide flours in CGF biscuit dough revealed a significant increase in rheological moduli (G' and G″) and a decrease in tan (δ). Supplementation of UABP flour increased thickness, whereas supplementation of FABP flour increased diameter and spread ratio. All CGF biscuit formulations exhibited lower fracture strength and hardness compared to the control. Furthermore, both UABP flour and FABP flour formulation (F3) contained the highest nutrients in terms of protein, dietary fibers, amino acids and minerals among the CGF biscuit formulations. The sensory evaluation result showed that FABP flour formulation (F1) and UABP flour F1 were most acceptable.

Immunohistopathologic evaluation of Drynaria fortunei rhizome extract in the management of Class II furcation defects in a canine model.

BACKGROUND: Management of furcation defects is still a challenging subject in periodontal therapy. Drynaria fortunei (Df) is a common type of traditional Chinese herb in the area of orthopedics and traumatology. In vitro and tissue engineering studies have shown that Df induces osteoblastic proliferation and promotes the differentiation of human periodontal ligament cells. This study investigated the management of Class II furcation defects in dogs using guided tissue regeneration (GTR) and Df granules mixed with ß-tricalcium phosphate (ß- TCP) alloplast. METHODS: Sixteen Class II critical-sized furcation defects were surgically created in four mongrel dogs: Eight defects were treated with GTR and Df granules mixed with (ß-TCP) alloplast served as the experimental group, while the other eight were managed with GTR and alloplast, served as control. Dogs were sacrificed at 4 and 8 weeks and the premolars were processed for the evaluation of treatment outcome including; osteoblastic count (OC), cementum layer thickness (CLT), percentage of collagen in bone matrix (CBM), and alkaline phosphatase (ALP) immunoreaction. RESULTS: Experimental group treated with Df showed a significant increase (P < 0.001) in the values of OC, CLT, CBM, and ALP immunoreactivity when compared with control at 4 and 8 weeks after treatment. CONCLUSION: Drynaria fortunei demonstrated increased regeneration and bone formation when used in the treatment of furcation defects in a canine model.

Combination of carvacrol with simvastatin improves the lipid-lowering efficacy and alleviates simvastatin side effects.

The present investigation was designed to examine the possible additive hypolipidemic effect of carvacrol (CARV) in combination with simvastatin (SIM) on poloxamer 407 (P407)-induced hyperlipidemia. Rats were injected with P407, (500 mg/ kg; i.p.), twice a week, for 30 days. Treatment was carried out by administration of SIM (20 mg/kg/day; p.o.) or CARV (50 mg/kg/day; p.o.) or combination of them. Treatment with CARV significantly decreased total cholesterol, triglycerides, low-density lipoprotein, atherogenic index, leptin, and increased high-density lipoprotein and adiponectin. Moreover, CARV potentiated the hypolipidemic effect of SIM. Both SIM and CARV alleviated the oxidative stress induced by P407. Interestingly, CARV, when combined with SIM, significantly ameliorated SIM-induced liver and muscle injury by reducing the level of alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, creatine kinase, and myoglobin and restoring the normal histological picture of both liver and muscle as well as apoptosis.

Role of Multi-Detector CT (MDCT) in Evaluation of Bowel Diseases.

INTRODUCTION: Multi-Detector Computed Tomography (MDCT) has revealed excellent results in various systems of the body. Its role in abdominal imaging for solid viscera has been proved beyond doubt. It is an emerging non invasive tool for evaluation of bowel diseases. AIM: To see the efficacy of MDCT in evaluation of various bowel diseases. MATERIALS AND METHODS: The study was carried out in the Department of Radiodiagnosis and Imaging, Batra Hospital and Medical Research Centre, Delhi, India. A total of 60 patients were enrolled in this study from March 2008 to June 2010 over a period of 24 months. All patients suspected to have inflammatory, obstructive, ischaemic and neoplastic diseases of small or large bowel disease were included in the study. The patients with past history of chronic renal failure, allergic reaction to contrast were excluded from the study. Comparison was made between CT findings with the operative findings, endoscopy, angiography or histopathology correlation whichever was relevant with case. All this data was compiled and statistically analysed. RESULTS: Out of 60 patients 12 patients were diagnosed having appendicitis using axial, Multiplaner Reconstruction (MPR) and curved MPR images. The findings of appendicitis were confirmed on surgery and subsequent histopathology correlation. Inflammatory bowel diseases comprised of 28 cases out of which seven persons were diagnosed with intestinal Koch's disease. Four patients had idiopathic inflammatory bowel diseases. Rest of the 17 patients were reported to have findings of non-specific colitis and they responded well with antibiotic treatment. CONCLUSION: The sensitivity and specificity of MDCT in case of bowel obstruction clearly demonstrates not only the site of obstruction, but also reveal the cause of obstruction which includes intraluminal, intramural and extrinsic factors. CT scan categorizes the lesion to inflammatory or neoplastic to a greater accuracy. MDCT can also demonstrate the complications associated with obstruction like strangulation and perforation. CT is now considered a good tool in the evaluation of patients with suspected bowel obstruction, particularly in indeterminate clinical and conventional radiographic findings.