Endophytic Aspergillus fumigatiaffinis: Novel paclitaxel production and optimization insights.

This study investigated the potential of endophytic fungi to produce paclitaxel (Taxol®), a potent anticancer compound widely employed in chemotherapy. This research aimed to identify, confirm, and characterize endophytic fungi capable of paclitaxel (PTX) production and assess their paclitaxel yield. Additionally, it aimed to investigate factors influencing paclitaxel production. A total of 100 endophytic fungal isolates were collected and identified from the roots of Artemisia judaica. Aspergillus fumigatiaffinis exhibited the highest PTX production (26.373 µg L-1) among the isolated endophytic fungi. The strain was identified as A. fumigatiaffinis (Accession No. PP235788.1). Molecular identification confirmed its novelty, representing the first report of PTX production by A. fumigatiaffinis, an endophyte of Artemisia judaica. Optimization through full factorial design of experiments (DOE) and response surface methodology (RSM) significantly enhanced PTX production to 110.23 µg L-1 from 1 g of dry weight of the fungal culture under optimal conditions of pH 8.0, 150 µg L-1 becozyme supplementation, and 18 days of fermentation in potato dextrose broth. The presence of paclitaxel was confirmed using thin layer chromatography, high performance liquid chromatography, and gas chromatography-mass spectrometry. These findings maximize the role of endophytic fungus to produce a secondary metabolite that might be able to replace the chemically produced PTX and gives an opportunity to provide a sustainable source of PTX eco-friendly at high concentrations. KEY POINTS: • Endophytic fungi, like A. fumigatiaffinis, show promise for eco-friendly paclitaxel production • Optimization strategies boost paclitaxel yield significantly, reaching 110.23 µg L -1 • Molecular identification confirms novelty, offering a sustainable PTX source.

Experimental study and kinetic modeling of methanol conversion to propylene with co-feeding of C4 and C5/C6 hydrocarbon cuts over a ZSM-5 catalyst.

Extensive experimental data were used to develop a comprehensive kinetic model for the methanol to propylene (MTP) process over a ZSM-5 catalyst. Preliminary experiments were performed to determine the reaction conditions that would ensure the absence of external (film) and internal mass transfer resistances. The kinetic experiments were subsequently carried out at 420-500 °C under conditions where mass transfer limitations were absent. A detailed reaction network was proposed for the MTP process based on the experimental product distribution and various reported kinetic models in the literature. According to the first series of experiments (without C4 and C5/C6 recycle streams) conducted at various temperatures, the best yield for propylene production was achieved at 480 °C with a water to methanol ratio of 0.7. Subsequently, kinetic experiments were performed at 480 °C and a water to methanol ratio of 0.7 using feeds with different amounts of C4 and C5/C6 hydrocarbons as recycle streams. Species material balances for the integral tubular reactor along with power-law rate functions and the Arrhenius equation for rate constants were employed in an optimization algorithm to obtain the kinetic parameters. The predictive ability of the model was checked against experimental data, and the kinetic parameters were validated by additional experiments.

Evaluation of the therapeutic potential of cerebrolysin and/or lithium in the male Wistar rat model of Parkinson's disease induced by reserpine.

Parkinson's disease (PD) is the second most prevalent neurodegenerative disease worldwide and represents a challenge for clinicians. The present study aims to investigate the effects of cerebrolysin and/or lithium on the behavioral, neurochemical and histopathological alterations induced by reserpine as a model of PD. The rats were divided into control and reserpine-induced PD model groups. The model animals were further divided into four subgroups: rat PD model, rat PD model treated with cerebrolysin, rat PD model treated with lithium and rat PD model treated with a combination of cerebrolysin and lithium. Treatment with cerebrolysin and/or lithium ameliorated most of the alterations in oxidative stress parameters, acetylcholinesterase and monoamines in the striatum and midbrain of reserpine-induced PD model. It also ameliorated the changes in nuclear factor-kappa and improved the histopathological picture induced by reserpine. It could be suggested that cerebrolysin and/or lithium showed promising therapeutic potential against the variations induced in the reserpine model of PD. However, the ameliorating effects of lithium on the neurochemical, histopathological and behavioral alterations induced by reserpine were more prominent than those of cerebrolysin alone or combined with lithium. It can be concluded that the antioxidant and anti-inflammatory effects of both drugs played a significant role in their therapeutic potency.

Persisting chemosensory dysfunction in COVID-19 - a cross-sectional population-based survey.

BACKGROUND: Chemosensory dysfunction (CD) has been reported as a common symptom of SARS-CoV-2 infection, but it is not well understood whether and for how long changes of smell, taste and chemesthesis persist in infected individuals. METHODOLOGY: Unselected adult residents of the German federal state of Schleswig-Holstein with Polymerase Chain Reaction (PCR)-test-confirmed SARS-CoV-2 infection were invited to participate in this large cross-sectional study. Data on the medical history and subjective chemosensory function of participants were obtained through questionnaires and visual analogue scales (VAS). Olfactory function (OF) was objectified with the Sniffin Sticks test (SST), including threshold (T), discrimination (D) and identification (I) test as well as summarized TDI score, and compared to that in healthy controls. Gustatory function (GF) was evaluated with the suprathreshold taste strips (TS) test, and trigeminal function was tested with an ampoule containing ammonia. RESULTS: Between November 2020 and June 2021, 667 infected individuals (mean age: 48.2 years) were examined 9.1 months, on average, after positive PCR testing. Of these, 45.6% had persisting subjective olfactory dysfunction (OD), 36.2% had subjective gustatory dysfunction (GD). Tested OD, tested GD and impaired trigeminal function were observed in 34.6%, 7.3% and 1.8% of participants, respectively. The mean TDI score of participants was significantly lower compared to healthy subjects. Significant associations were observed between subjective OD and GD, and between tested OD and GD. CONCLUSION: Nine months after SARS-CoV-2 infection, OD prevalence is significantly increased among infected members of the general population. Therefore, OD should be included in the list of symptoms collectively defining Long-COVID.

Estrogen Receptor Gene Polymorphism as a Possible Genetic Risk Factor for Treatment Response in ER-Positive Breast Cancer Patients.

Estrogen receptor-α (ESR1) single nucleotide polymorphisms (SNPs) have been related to breast cancer (BC) susceptibility. In this retrospective study we investigated ESR1 SNPs in association with survival and treatment response in BC patients. Seven ESR1 SNPs were genotyped using TaqMan probe assay in 100 formalin-fixed paraffin embedded blocks of Egyptian ER+BC patients. Log-binomial regression was used to assess the association of 5 ESR1 SNPs with relative risk of non-response to adjuvant-hormonal treatment. We compared the performance of five machine learning classification models for prediction of treatment response. Predictive models were developed using rs1801132, rs2228480, and rs9322354 that were significantly associated with increased risk for non-response along with the relevant clinical features. Survival analysis was performed to detect prognostic significance of ESR1 SNPs in ESR+BC patients. rs1801132 (C), rs2228480 (A), and rs9322354 (G) minor alleles significantly increased the risk of non-response to tamoxifen by more than 81, 84, and 117%, respectively, in ER+BC patients on anthracycline/anthracycline-taxanes-based chemotherapy. Multivariate Cox regression survival analysis revealed that rs1801132 (C) and large tumor size were independent predictors for poor survival outcome in ER+BC. The best response predictive model was a combination random forest, K-nearest neighbor, and decision tree having an area under the curve of 0.94 and an accuracy of 90.8%. Our proposed predictive model based on ESR1 rs1801132, rs2228480, and rs9322354 SNPs represents a promising genetic risk stratification for selection patients who could benefit from tamoxifen therapy in such a way that might facilitate personalized medicine required to improve ER+BC patients' outcome.

Anti-inflammatory effects of diet and caloric restriction in metabolic syndrome.

BACKGROUND: Weight loss in patients with metabolic syndrome has positive effects on cardiovascular and type 2 diabetes risks, but its effects on peripheral cytokines and lipid profiles in patients are still unclear. AIM: To determine the effects of diet-induced weight loss on metabolic parameters, lipids and cytokine profiles. METHODS: Eighteen adult males with metabolic syndrome (defined according to IDF 2009) and Body Mass Index (BMI) between 25 and 35 kg/m2 were subjected to a balanced hypocaloric diet for 6 months to reach at least a 5% body weight loss. RESULTS: After weight loss, a significant improvement in BMI, waist circumference, insulin, fasting blood glucose and HOMA-IR (homeostasis model assessment of insulin resistance) was observed. The analysis of LDL (low-density lipoprotein cholesterol) and HDL (high-density lipoprotein cholesterol) lipoproteins showed a change in their composition with a massive transfer of triacylglycerols from HDL to LDL. This was associated with a significant reduction in peripheral pro-inflammatory cytokines such as IL-6, TNF-α, IL-8 and MIP-1ß, leading to an overall decreased inflammatory score. An interesting positive correlation was also observed among peripheral cytokines levels after diet and peripheral levels of CETP (cholesteryl ester transfer protein), an enzyme with a key role in lipid change. CONCLUSION: Weight loss through caloric restriction is associated with an improvement in peripheral lipid and cytokine profiles that may play a major role in improving cardiovascular risk.

Botulinum toxin for benign essential blepharospasm: A systematic review and an algorithmic approach.

BACKGROUND: Currently, there is no standardised approach for benign essential blepharospasm treatment with botulinum toxin, and controversies still exist regarding this subject. OBJECTIVE: The objective of this systematic review is to summarise and compare all the published data regarding benign essential blepharospasm treatment with botulinum toxin. METHODS: On October 3, 2018, an online search of the Medline database was conducted. All articles with a detailed description of their botulinum toxin injection technique for benign essential blepharospasm were included in this review. RESULTS: Five studies were selected for inclusion with a total of 854 patients. Four of the included studies used onabotulinumtoxin A and one study used abobotulinumtoxin A. All studies injected the pretarsal orbicularis occuli muscle. The preseptal orbicularis occuli was injected in four studies, and the preorbital muscle in three studies. The most commonly used method of evaluation was the Jankovic Rating Scale. Adverse events were transient, and dose related. Ptosis was more frequently encountered with the preseptal orbicularis injections. CONCLUSION: Botulinum toxin injection for benign essential blepharospasm is a non-invasive and safe procedure. The pretarsal muscle should be considered as the key component when treating benign essential blepharospasm with botulinum toxin. We developed an algorithmic approach to the treatment of benign essential blepharospasm with botulinum toxin. However, further randomised controlled trials are warranted.

Behavior of uranium series in groundwater of the Wajid Formation, Wadi AdDawasir, Saudi Arabia.

The inventories and the possible mechanisms behind the relative deficiency of both radium and uranium release processes within an elevated gamma-anomalous rock were investigated. A field survey was performed on the highest radioactive anomalous zone that was recorded at Jabal Al Alam (20° 13' 10.06″ N and 44° 14' 32.13″), with the ferruginous sandstone, iron oxide band, and iron concretions (with uranium content and reaching up to1500 ppm). The chemical analyses and the laboratory's gamma-ray spectrometric measurements demonstrated high uranium levels in the analyzed rock samples of the Wajid Sandstone (up to 1000 ppm). The borehole geophysical logs further confirmed that the radioactive anomalies are attributed to the sandstone sequence of the Wajid Formation that is often found associated with elevated concentrations of uranium. The groundwater samples taken from the wells tapping the Wajid aquifer showed uranium concentrations ranging from 0.01 to 5.5 ppb (µg/L). The average 226Ra in groundwater samples was 0.2 Bq L-1. The majority of the 226Ra and 228Ra activities were below the lower limit of detection (LLD). The radiochemical analyses of water samples from the Wajid aquifer display low concentrations of both uranium and 226Ra, with relation to uranium content in host rocks. This was attributed to the fact that uranium is susceptible to form iron oxide complexes, causing them to precipitate in a more stable form. Furthermore, iron oxides coat the sand grains of the Wajid Formation and accordingly might act as a foundation for re-adsorption for both uranium and radium, resulting in their relative deficiency in the surrounding water. The coating might also act as a physical barrier resulting in hindrance of the recoil nuclei due to its significant thickness (several orders of magnitude) compared with that of the average (120 nm) whole alpha-recoil track (ART). The coating layer thickness was determined via scanning electron microscopy (SEM) and was found to be up to 180 µm.

An integrated water quality assessment of Damietta and Rosetta branches (Nile River, Egypt) using chemical and biological indices.

Rosetta and Damietta are the main branches of the Nile River in Egypt. They provide the required freshwater for different usage for about 20 million people. In the present study, chemical and biological indices were used to assess the water quality and provide a full image of the environmental status in the investigated area. Generally, the chemical parameters, except the dissolved oxygen, were at higher levels in Rosetta Branch when compared to Damietta Branch. Also, Damietta Branch frequently showed the presence of the macroinvertebrate families that are bioindicators of moderate and good water quality. Contrarily, the most resistant species to pollution were frequently recorded in the Rosetta Branch. According to Canadian WQI, the water of Rosetta Branch is classified from "marginal" to "poor" for the drinking and aquatic life uses and "fair" to "good" for irrigation usage. On the other side, the water quality of Damietta Branch is classified as "fair" with respect to drinking water and "good" to aquatic life and irrigation. Based on using macroinvertebrate families as bioindicators, the Biological Monitoring Working Party (BMWP) index and the Nile Biotic Pollution Index (NBPI) indicated that the water quality of the Damietta Branch was within "moderate" class, while Rosetta Branch is categorized from "very polluted" to "extremely polluted" classes. The results proved that both BMWP and NBPI have coincided with the CWQI for the drinking and aquatic life indices (p < 0.0001) indicating the validity of BMWP and NBPI to assess the water quality of the investigated area.

Prognostic significance of circulating tumor cells (CTCs) in Egyptian non-metastatic colorectal cancer patients: A comparative study for four different techniques of detection (Flowcytometry, CellSearch, Quantitative Real-time PCR and Cytomorphology).

PURPOSE: We assessed CTCs counts in NMCRC patients using four different techniques. METHODS: CTCs were detected in 63 NMCRC patients, 40 benign bowel diseases (BBD) and 40 normal controls (NC) using, flow-cytometry (FCM), CellSearch (CS), cytomorphology and quantitative real time (qPCR) for CK19, MUC1, CD44, CD133, ALDH1 expression. Results were correlated to progression free (PFS) and overall (OS). RESULTS: Positive CTCs (≥4 cells /7.5 mL blood) were detected in 50.8% (32/63) NMCRC by FCM and 7.5% (3/40) BBD (p < .001). CTCs were detected in 34/63 (54%) NMCRC, 4/40 (10%) BBD (p < .001) by CS. CK19, MUC1, CD44, CD133 and ALDH1 were expressed in 35 (55.6%), 29 (46.0%), 28 (44.4%), 26 (41.3%) and 25 (41.3%) cases of NMCRC. In BBD 4/40 (10%) cases expressed CK19, MUC1 and CD44, while 2/40 (5%) expressed CD133. Cytomorphology showed the lowest sensitivity (47.6%) and specificity (90%) for CTCs detection. The combined use of FCM or CS with CTCs-mRNA markers improved the sensitivity and specificity to 68.3%, and 95.0%; respectively. Positive CTCs and mRNA markers expression were significantly associated with shorter 5-yr PFS and OS. In multivariate analysis, CTCs mRNA markers were independent prognostic factors for PFS and OS. CONCLUSIONS: Enumeration of CTCs by FCM and RNA expression for specific colon cancer markers are comparable to CS regarding sensitivity and specificity. CTCs also represent novel therapeutic targets for NMCRC cases.

Integrating obstetrical simulation into the medical curriculum: one more gap in women's health for low-income countries.

Low-income countries do not have well-established simulation centers; introduction of simulation-based learning in obstetrics faces many cost-associated difficulties. Simulation-based learning yield many benefits that are reported in many studies such as improved maternal and neonatal outcomes, social stature of medical teachers, and better management of difficult situations. Though low-income countries do not have established surgical simulations, centralization, and cooperation amongst the educational institutions and local and regional hospitals for maintenance of medical educational practices and financial supplementation through both established and newly created entities will provide the potential for improved patient outcomes and maintenance of quality of education, that is, comparable to the medical education found in higher income countries.

MiRNAs as molecular biomarkers in stage II egyptian colorectal cancer patients.

AIM: To assess the role of aberrant miRNAs expressions in stage II CRC patients from Egypt. METHODS: Tumor tissue samples were obtained from 124 CRC stage II patients compared to 100 healthy controls for assessing miRNAs expression using; 1) a cataloged 84-miRNAs PCR array panel, and 2) another five miRNAs (miR-21, miR-137, miR-145, miR-320 and miR-498) that have been reported in previous studies to have a role in CRC, by quantitative real time PCR (qPCR). The results were correlated to patients' characteristics, response to treatment and survival. RESULTS: There were 17 out of 84 miRNAs differentially expressed in the CRC patients. Twenty six miRNAs were significantly differentially expressed in the female CRC patients, while 16 miRNAs were significantly differentially expressed in the male CRC patients. Only, five miRNAs (miR-21, Let-7a-5p, miR-100-5p, miR-200c-3p and miR-23b-3p) were significantly common deregulated in CRC patients regardless gender. miR-21 was overexpressed in 48.4% of the patients and it was significantly downregulated in females and over expressed in males. In univariate analysis; performance status, over-expression of miR-21 and miR-498 and reduced miR-137, miR-145, and miR-320 associated significantly with reduced DFS and OS whereas in multivariate analysis; miR-498 and miR-320 were independent prognostic factors for DFS and miR-21 was independent prognostic factors for OS. CONCLUSION: miRNAs expression differs significantly between male and female stage II CRC patients, miR-21, Let-7a-5p, miR-100-5p, miR-200c-3p and miR-23b-3p could be used as common diagnostic biomarkers for CRC. On the other hand, a three miRNAs panel (miR-21, miR-498 and miR-320) can predict recurrence and survival in those patients.

Simeprevir oxidative degradation product: Molecular modeling, in silico toxicity and resolution by synchronous spectrofluorimetry.

In this article, one of the potential degradation products of the novel antiviral drug simeprevir was isolated and characterized by means of infrared (IR) and mass spectrometry. Moreover, comparative molecular docking, ADMET (absorption, distribution, metabolism, excretion - toxicity) and insilico toxicity prediction studies were applied to evaluate the activity of simeprevir and its degradation product. Furthermore,a simple, accurate and selective second derivative synchronous spectrofluorimetric method was developed for the determination of simeprevir in the presence of its oxidative degradation product.The synchronous fluorescence spectra of both compounds were measured in ethanol at pH 2.0 usingΔλ of 140 nm and the peak amplitude of the second derivative spectra were measured at 442 nm. The method was rectilinear over the concentration range of 0.2 to 2.0 µg/ml and validated according to the ICH (International Conference on Harmonization) guidelines. Moreover, the method was statistically compared to the reverse-phase high-performance liquid chromatography (RP-HPLC) method and good results were obtained.

The chronic effect of pulsed 1800 MHz electromagnetic radiation on amino acid neurotransmitters in three different areas of juvenile and young adult rat brain.

The extensive use of mobile phones worldwide has raised increasing concerns about the effects of electromagnetic radiation (EMR) on the brain due to the proximity of the mobile phone to the head and the appearance of several adverse neurological effects after mobile phone use. It has been hypothesized that the EMR-induced neurological effects may be mediated by amino acid neurotransmitters. Thus, the present study investigated the effect of EMR (frequency 1800 MHz, specific absorption rate 0.843 W/kg, power density 0.02 mW/cm2, modulated at 217 Hz) on the concentrations of amino acid neurotransmitters (glutamic acid, aspartic acid, gamma aminobutyric acid, glycine, taurine, and the amide glutamine) in the hippocampus, striatum, and hypothalamus of juvenile and young adult rats. The juvenile and young adult animals were each divided into two groups: control rats and rats exposed to EMR 1 h daily for 1, 2, and 4 months. A subgroup of rats were exposed daily to EMR for 4 months and then left without exposure for 1 month to study the recovery from EMR exposure. Amino acid neurotransmitters were measured in the hippocampus, striatum, and hypothalamus using high-performance liquid chromatography. Exposure to EMR induced significant changes in amino acid neurotransmitters in the studied brain areas of juvenile and young adult rats, being more prominent in juvenile animals. It could be concluded that the alterations in amino acid neurotransmitters induced by EMR exposure of juvenile and young adult rats may underlie many of the neurological effects reported after EMR exposure including cognitive and memory impairment and sleep disorders. Some of these effects may persist for some time after stopping exposure.

Cardiac magnetic resonance indices reflecting pulmonary regurgitation burden after tetralogy of Fallot repair.

AIM: To investigate cardiac magnetic resonance (CMR)-derived parameters to determine a convenient index reflecting the degree of pulmonary regurgitation (PR) after Tetralogy of Fallot (TOF) repair. MATERIALS AND METHODS: Sixty-three patients (age at CMR study, 23.6 [10.2-34.7] years, 55.6% male) underwent CMR after TOF repair. PR was quantified using ventricular stroke volume difference and phase-contrast mapping of the main pulmonary artery flow. In both approaches, the PRV index (PRVI) and the PR fraction (PRF) were calculated and correlated to the right ventricle end-diastolic volume index (RVEDVI) and the right ventricle end-systolic volume index (RVESVI). RESULTS: No statistically significant difference was observed between the PR volumes and the PRF measured by the stroke volume difference or the phase-contrast method. The PRVI was better correlated to RVEDVI and RVESVI than the PRF. CONCLUSION: The PRVI exhibits more correlation to the RVEDVI than PRF. Thus, it could be a preferable parameter to reflect the PR burden.

Molecular characterization of the unique Mesostephanus appendiculatus (Trematoda: Cyathocotylidae) by small ribosomal RNA from Egypt.

M esostephanus appendiculatus (Family: Cyathocotylidae) is one of the unique trematodes that complete their cycles in human and animal intestines in many countries of the world. The main source of its transmission is eating raw or undercooked infected fish muscle. Earliest analyses of genes to different parasites supported the analysis of helminthes either biological or morphological. This paper detected M. appendiculatus sequence with GenBank accession number gb (KY026782). Comparison of M. appendiculatus with other helminthes using BioEdit 7 and MEGA7 program shows some similarity in different points along its sequence. The phylogenetic analysis clarifies that it was closely related to both trematodes (Clinostomum complanatum and Echinochasmus japonicus) and some cestodes of fish origin such as Polyonchobothrium polypteri, Bothriocephalus sp., and Haplobothrium globuliforme. The obtained results provide a good source for genome analysis of M. appendiculatus in relation to other Platyhelminthes.

New approach to molecular characterization of Paramphistomum cervi and Carmyerius gregarius and comparative analyses with selected trematodes.

The two ruminant parasites, Paramphistomum cervi and Carmyerius gregarius, were collected from fresh-slaughtered native cattle at local abattoirs in Sadat district, Menoufia province and identified morphologically, then molecularly by sequencing the nucleotides of 18S ribosomal RNA gene (18S rRNA). The nucleotide sequences of the two isolates were 456 (P. cervi) and 401 bases for (C. gregarius). The data were used along with those of several other helminth species from the GenBank to identify these two species genetically. The nucleotide sequences were aligned using multiple sequence alignments of nucleotides by Clustal W 12.1 V and construct their relationship. Neighbor-joining analytical method was used showing sister relationship between C. gregarius from Sadat district and Gastrodiscoides hominis (EF027096) with relative identity of (98%) due to the presence of single nucleotides polymorphisms (SNPs) in the form of indels as nine nucleotides positions. But when clustering of P. cervi Sadat isolate with Paramphistomoidea sp. S4 isolate P5 (GU735643), this relationship shows complete identity (99%) between them. The homology and diversity was done using Bayesian analyses in MrBayes v3.1. This work will give a useful guide for other researchers for the molecular taxonomic position of Paramphistomatidae spp. in Sadat district among the different species around the world.

The antioxidant effect of Green Tea Mega EGCG against electromagnetic radiation-induced oxidative stress in the hippocampus and striatum of rats.

Electromagnetic radiation (EMR) of cellular phones may affect biological systems by increasing free radicals and changing the antioxidant defense systems of tissues, eventually leading to oxidative stress. Green tea has recently attracted significant attention due to its health benefits in a variety of disorders, ranging from cancer to weight loss. Thus, the aim of the present study was to investigate the effect of EMR (frequency 900 MHz modulated at 217 Hz, power density 0.02 mW/cm2, SAR 1.245 W/kg) on different oxidative stress parameters in the hippocampus and striatum of adult rats. This study also extends to evaluate the therapeutic effect of green tea mega EGCG on the previous parameters in animals exposed to EMR after and during EMR exposure. The experimental animals were divided into four groups: EMR-exposed animals, animals treated with green tea mega EGCG after 2 months of EMR exposure, animals treated with green tea mega EGCG during EMR exposure and control animals. EMR exposure resulted in oxidative stress in the hippocampus and striatum as evident from the disturbances in oxidant and antioxidant parameters. Co-administration of green tea mega EGCG at the beginning of EMR exposure for 2 and 3 months had more beneficial effect against EMR-induced oxidative stress than oral administration of green tea mega EGCG after 2 months of exposure. This recommends the use of green tea before any stressor to attenuate the state of oxidative stress and stimulate the antioxidant mechanism of the brain.

Paravalvular leak after transcatheter aortic valve implantation: is it anatomically predictable or procedurally determined? MDCT study.

AIM: To investigate the determinants of paravalvular leak (PVL) occurring after transcatheter aortic valve implantation (TAVI). MATERIALS AND METHODS: One hundred and eight patients with severe symptomatic aortic stenosis (mean age 75.5±11.8 years, 72.2% male) underwent contrast-enhanced electrocardiogram (ECG)-gated multidetector computed tomography (MDCT) then successful TAVI. The following parameters were determined in the late systolic phase: annular and left ventricular outflow tract (LVOT) diameters, annular perimeter, ellipticity index, annular area, indexed annular area, LVOT perimeter, annulus/LVOT perimeter difference ratio, the LVOT to ascending aorta angle (< LVOT-AO). In the diastolic phase, the extent of calcification of the aortic valve (AVC) was assessed visually and graded semi-quantitatively as grade I, II, and III at the annulus, LVOT, and aortic cusps levels. Pre-discharge transthoracic echocardiography (TTE) was performed, and the PVL was graded as grade I, II, and III. The area-dependent device-annulus sizing ratio was calculated. RESULTS: Absence of PVL was observed in 44.44% of the patients, 30.56% had grade I PVL, 25% of the patients had grade II or above, and any PVL was observed in 55.56%. There was no statistically significant association between the degree of PVL and the extent or the distribution of AVC, aortic annulus diameters, ellipticity index, annulus/LVOT perimeter difference ratio or < LVOT-AO. The frequency of PVL was not significantly different with the use of balloon-expandable or self-expandable valves. A larger transcatheter heart valve (THV)/annulus sizing ratio was associated with a lower incidence and degree of PVL (p<0.001); there was no detectable PVL with a mean sizing ratio of 14.89±7.29, and grade I PVL occurred with a mean sizing ratio 12.43±0.84, while PVL of grade II or above occurred using the mean sizing ratio -0.42±5.57. CONCLUSION: The procedure-related THV/annulus sizing ratio was an important determinant of the degree of PVL after TAVI, whereas the MDCT-derived anatomical measurements of the aortic root and AVC were not predictors of PVL.

Effect of induced acute mild arterial hypertension on postoperative analgesic requirements after laparoscopic ovarian cystectomy: a randomized double blinded study.

Objective: To evaluate the effectiveness of inducing acute hypertension during laparoscopic ovarian cystectomy on postoperative nalbuphine analgesic requirements. Methods: The total dose of nalbuphine used in the hypertension group was significantly lower than that in the control group (p <0.001). The VAS score was significantly lower in the hypertension group on arrival to PACU and during the period between 1 and 6 hours postoperatively. Results: The total dose of nalbuphine used in the hypertension group was significantly lower than that in the control group (p <0.001). The VAS score was significantly lower in the hypertension group on arrival to PACU and during the period between 1 and 6 hours postoperatively. Conclusion: This study demonstrates that pharmacologically induced mild acute intraoperative hypertension significantly reduces postoperative nalbuphine consumption and pain scores following laparoscopic ovarian cystectomy. Trial registration in Pan African Clinical Trial Registry: identification number for the registry is PACTR201508001247179.