The effect of butyric acid and nucleotides supplementation on broiler (Gallus gallus domesticus) growth performance, immune status, intestinal histology, and serum parameters.

Background: Butyric acid and its derivatives support the immune system, lessen inflammation, and lessen oxidative stress in broilers in addition to preserving gut homeostasis and epithelial integrity. Broiler performance has also been demonstrated to rise with the addition of nucleotides to the diet. Aim: The purpose of the study was to ascertain the effects of butyric acid and nucleotides added to feed on the overall performance, immunity, oxidant/antioxidant enzyme levels, intestinal histology, and hepatic functions of broilers. Methods: Four experimental groups of thirty chickens, each were used in the present study. The groups were assigned as a control group that received normal diet without additives, butyrate (B) group received the diet supplemented with butyric acid (250 g/ton feed), nucleotides (N) group received the diet supplemented with nucleotides (200 g/ton feed), and the fourth group received the diet supplemented with a combination of butyrate and nucleotide (BN) (250 g/ton B feed, and 200 g/ton N feed, respectively). Necrotic enteritis was produced in ten birds from each group to assess the immune-modulatory effect of these supplements, antioxidant status, intestinal histology, and liver functions were measured in all experimental groups. Results: The addition of butyric acid and nucleotides to feed enhanced body weight, growth performance, hepatic functions, and antioxidant capabilities. Histological sections of the gut from challenged or unchallenged (with necrotic enteritis) groups in the BN group showed considerable improvement, as shown by strong proliferation in intestinal crypts and villus enterocytes. Conclusion: Nucleotides and butyric acid can be added to broiler feeding regimens to enhance growth and health.

Efficacy of different routes of vitamin B12 supplementation for the treatment of patients with vitamin B12 deficiency: A systematic review and network meta-analysis.

BACKGROUND: This systematic review and network meta-analysis aimed to evaluate the three different administration routes of vitamin B12: oral, intramuscular (IM), and sublingual (SL) routes. METHODS: We searched four electronic databases (PubMed, Scopus, Web of Science, and Cochrane CENTRAL Register of Controlled Trials). We included only comparative studies. We performed a frequentist network meta-analysis to measure network estimates for the relative outcomes. Moreover, we conducted a pairwise meta-analysis using a random effect model to obtain direct estimates for outcomes. All outcomes were continuous, and the relative treatment effects were pooled as mean difference (MD) with 95% confidence intervals. RESULTS: Thirteen studies were included in the meta-analysis, with a total of 4275 patients. Regarding increasing vitamin B12 levels, the IM route ranked first, followed by the SL route (MD = 94.09 and 43.31 pg/mL, respectively) compared to the oral route. However, these differences did not reach statistical significance owing to the limited number of studies. Regarding the hemoglobin level, the pooled effect sizes showed no difference between all routes of administration that could reach statistical significance. However, the top two ranked administration routes were the oral route (78.3) and the IM route (49.6). CONCLUSION: All IM, oral, and SL routes of administration of vitamin B12 can effectively increase the level of vitamin B12 without significant differences between them, as thought previously. However, the IM route was the top-ranked statistically but without clinical significance. We found no significant difference among studied administrated routes in all other CBC parameters and homocysteine levels.

Efficacy and safety of calcium channel blockers in preventing cardiac siderosis in thalassemia patients: An updated meta-analysis with trial sequential analysis.

OBJECTIVES: Iron overload in patients with thalassemia represents a serious complication by affecting numerous organ systems. This meta-analysis aims to establish an evidence regarding the effect of amlodipine on cardiac iron overload in thalassemia patients. METHODS: We searched PubMed, Scopus, Web of Science, Cochrane Central, and EMBASE for all relevant randomized controlled trials (RCTs). The primary outcomes were cardiac T2* and myocardial iron concentration (MIC). Secondary outcomes were liver iron concentration (LIC), risk of Gastrointestinal (G.I.) upset and risk of lower limb edema. We used Hedges' g to pool continuous outcomes, while odds ratio was used for dichotomous outcomes. RESULTS: Seven RCTs were eligible for this systematic review and meta-analysis, comprising of 233 patients included in the analysis. Amlodipine had a statistically significant lower MIC (Hedges' g = -0.82, 95% confidence interval [CI] [-1.40, -0.24], p < .001) and higher cardiac T2* (Hedges' g = 0.36, 95% CI [0.10, 0.62], p = .03). Amlodipine was comparable to standard chelation therapy in terms of the risk of lower limb edema and GI upset. CONCLUSION: Our meta-analysis found that amlodipine significantly increases cardiac T2* and decreases MIC, hence decreasing the incidence of cardiomyopathy-related iron overload in thalassemia patients.

Hepatic and gastrointestinal disturbances in Egyptian patients infected with coronavirus disease 2019: A multicentre cohort study.

BACKGROUND: Various liver and gastrointestinal involvements occur in patients with coronavirus disease 2019 (COVID-19) at variable prevalence. Most studies report mild liver function disturbances correlated with COVID-19 severity, though liver failure is unusual. AIM: To study liver and gastrointestinal dysfunctions in Egyptian patients with COVID-19 and their relation to disease outcomes. METHODS: This multicentre cohort study was conducted on 547 Egyptian patients from April 15, 2020 to July 29, 2020. Consecutive polymerase chain reaction-confirmed COVID-19 cases were included from four quarantine hospitals affiliated to the Egyptian ministry of health. Demographic information, laboratory characteristics, treatments, fibrosis-4 (FIB-4) index, COVID-19 severity, and outcomes were recorded and compared according to the degree of liver enzyme elevation and the presence of gastrointestinal symptoms. Follow-ups were conducted until discharge or death. Regression analyses were performed to determine the independent factors affecting mortality. RESULTS: This study included 547 patients, of whom 53 (9.68%) died during hospitalization and 1 was discharged upon his request. Patients' mean age was 45.04 ± 17.61 years, and 21.98% had severe or critical COVID-19. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were available for 430 and 428 patients, respectively. In total, 26% and 32% of patients had elevated ALT and AST, respectively. Significant liver injury with ALT or AST elevation exceeding 3-fold was recorded in 21 (4.91%) and 16 (3.73%) patients, respectively. Male gender, smoking, hypertension, chronic hepatitis C, and lung involvement were associated with elevated AST or ALT. AST was elevated in 50% of patients over 60-years-old. FIB-4 was significantly higher in patients admitted to the intensive care unit (ICU), those with more severe COVID-19, and non-survivors. The independent variables affecting outcome were supplementary vitamin C intake (1 g daily capsules) [odds ratio (OR): 0.05, 95% confidence interval (CI): 0.008-0.337]; lung consolidation (OR: 4.540, 95%CI: 1.155-17.840); ICU admission (OR: 25.032, 95%CI: 7.110-88.128); and FIB-4 score > 3.25 (OR: 10.393, 95%CI: 2.459-43.925). Among 60 (13.98%) patients with gastrointestinal symptoms, 52 (86.67%) had diarrhoea. Patients with gastrointestinal symptoms were predominantly females with higher body mass index, and 50 (83.40%) patients had non-severe COVID-19. CONCLUSION: Few Egyptian patients with COVID-19 developed a significant liver injury. The independent variables affecting mortality were supplementary vitamin C intake, lung consolidation, ICU admission, and FIB-4 score.

Metformin-loaded lecithin nanoparticles induce colorectal cancer cytotoxicity via epigenetic modulation of noncoding RNAs.

BACKGROUND: Colorectal cancer (CRC) is major aliment around the word, with a cumulative rate of mortality. Metformin (MT) was recently approved as anticancer drug against solid tumors, such as CRC. Resistance to MT therapy remains to be a challenging matter facing the development of possible anti-cancer strategy. To circumvent this problem, MT nano-encapsulation has been introduced to sensitize resistant cancer cells. The purpose of the current study is to explore the MT's aptitude encapsulated in lecithin (LC) and chitosan (CS) nanoparticles to inhibit CRC proliferation through modulations of long noncoding RNAs (lncRNAs), micro RNAs (miRNAs), and some biochemical markers. METHODS AND RESULTS: Cytotoxic screenings of the newly synthesized MT-based regimens; MT, MT-LC NPs (NP1), MT-CS NPs (NP2), and MT-LC-CS NPs (NP3) against colorectal cancerous Caco-2 and HCT116 cell lines versus normal WI-38 cells were performed. The epigenetic mechanistic effects of these proposed regimens on lncRNAs and miRNAs were investigated. Additionally, some protein levels were assessed in CRC cells upon treatments; YKL-40, PPARγ, E-cadherin (ECN), and VEGF. We resulted that NP1 recorded the highest significant cytotoxic effect on CRC cells. HCT116 cells were more sensitive to the NP1 compared to Caco-2 cells. Intriguingly, it was suggested that NP1 tackled the CRC cells through down-regulation of the H19, HOTTIP, HULC, LINC00641, miR-200, miR-92a, miR-21, YKL-40, PPARγ, and VEGF expressions, as well as up-regulation of the miR-944 and ECN expressions. CONCLUSIONS: We concluded that the NP1 can potentially be cytotoxic to CRC cells in-vitro by modulating noncoding RNA.

Forty years of Basic Health Care in Tunisia: From "Health for All" to "Universal Health Coverage".

INTRODUCTION: The descriptor "Basic Health Care" (SSB), is the Tunisian name of "Primary Health Care" (SSP), implemented in Tunisia at the beginning of 1980. The objective of this reflection was to compare the practices of SSBs in Tunisia with the principles of the SSP vision. METHODS: Based on key conferences in the history of SSP, from the Alma Ata conference (1978), to the Astana conference (2018), including the Millennium Development Summit (2000), the Sustainable Development Goals (2015) and Universal Health Coverage (2017), the SSB policy has been reviewed, through its conformity with the vision of PHC and the relevance of its programs to current health needs. RESULTS: The PHC policy has been based on two fundamental statements. The first was that of Alma Ata, having clarified a vision of public health, based on social justice, the right to health, solidarity, the felt needs of the population, community participation and the intersectoral approach, as well as basic health programs including maternal and child protection, immunization, treatment of common diseases and provision of essential drugs. The second was that of Astana, who affirmed a commitment to PHC through four pillars: 1. Strengthening cumulative expertise. 2. Support for human resources, 3. Facilitation of access to healthcare and information technologies; 4. Funding reform, tackling financial difficulties. However, during the last four decades, the national SSB policy in Tunisia has been limited to a package of health programs, static, disconnected from the public health paradigm (equity, community participation, multisectoral approach) and facing an important problem of under-financing (scarcity of resources, access barriers, waste of expenditure). CONCLUSION: The Tunisian SSB policy today needs a new range of programs, adapted to the global burden of morbidity, and inserted in a vision of social justice and in a socialized system of financing (health for all, leaving no one behind).

Evaluation of the Primary Health Care policy in the Maghreb. Feedback from Expert-Leaders in Tunisia.

INTRODUCTION: The Basic Health Care Policy (BHC), the Maghrebian version of WHO's Primary Health Care, is celebrating forty years in Tunisia. The aim of this paper was to contribute to the evaluation of BHCs in Tunisia, by listening to the testimonies of experts / leaders who have led their journey during these four decades. METHODS: The experts / leaders included in this testimony were invited via email and throu gh the use of the Delphi technique to report the acquired lessons and the errors. The collected qualitative data was analyzed through a process of categorization which classified them into: assets (strengths and opportunities) and handicaps (weaknesses and threats). RESULTS: Four experts / leaders took part in this call for testimonies, including two consultants to international organizations, a trade union doctor and a professor of Preventive Medicine. The main assets of the BHC in Tunisia, according to the participants, were: 1. The medical leadership initiated from the student phase;  2. The political commitment of public authorities ; 3. The academic support from the medical faculties and their Preventive Medicine departments ; 4. The institutionalization of the organizational framework of the Health Unit ; 5. The Academic training of professionals in integrated medicine. As for the handicaps of BHC in Tunisia, the experts / leaders particularly mentioned: 1. The weakness of community participation ; 2. The international attractiveness of accompanying national doctors; 3. The pressures of academic career imperatives ; 4. The lack of a National School of Public Health; 5. The context of privatization and hospital-centrism. CONCLUSION: This feedback from the experts / leaders concerning BHC policies in Tunisia highlighted the perception of its performance "in tune" with WHO and "three years before Alma Ata". The new generation of BHC leaders have an obligation to safeguard their principles and adapt their practices to population expectations and new managerial approaches.

Holmium Laser Enucleation Versus Bipolar Plasmakinetic Resection for Management of Lower Urinary Tract Symptoms in Patients with Large-Volume Benign Prostatic Hyperplasia: Randomized-Controlled Trial.

Objectives: To compare the safety and efficacy of holmium laser enucleation of prostate (HoLEP) vs bipolar plasmakinetic resection of prostate (BPRP) in the management of large-sized (≥75 g) benign prostatic hyperplasia (BPH). Methods: This randomized-controlled trial recruited 145 symptomatic BPH patients who had failed medical management, and who had undergone either HoLEP (Versa pulse® 100 W; n = 73) or BPRP (AUTOCON® II 400 ESU; n = 72). Both groups were compared using the Mann-Whitney, chi-square, Student-t, or Fisher exact tests as appropriate. Preoperative vs postoperative findings (24 months) were compared using paired t-test or Wilcoxon signed-rank test. Results: The two groups were comparable for most preoperative findings including prostate size (p = 0.629), although HoLEP included more patients on anticoagulants (p = 0.001). HoLEP was associated with significantly less operative duration (p < 0.001), hemoglobin loss (p < 0.001), catheterization duration (p = 0.009), and hospital stay (p < 0.001). There was no significant difference in total complications (p = 0.291) and each separate complication. Blood transfusion was reported only with BPRP (p = 0.058). At 24 months of follow-up, there was significant improvement in all the parameters in each group (International Prostate Symptom Score [IPSS], maximum urinary flow rate [Qmax], quality of life [QoL], and postvoid residual urine [PVRU]; p < 0.001). There was no significant difference between both groups in postoperative IPSS (p = 0.08), Qmax (p = 0.051), QoL (p = 0.057), or PVRU (p = 0.069). There was significantly better percentage improvement of both IPSS (p = 0.006) and QoL (p = 0.025) in HoLEP. HoLEP and smaller removed (resected or enucleated) tissues were associated with a reduction in the primary outcomes (hemoglobin loss and operative duration) in logistic regression analysis. Conclusion: HoLEP showed better safety profile with significantly less operative duration, hemoglobin loss, hospital stay, and catheterization duration. Although both procedures were effective, HoLEP showed significantly better percentage improvement of both IPSS and QoL. ClinicalTrials.gov Identifier: NCT04143399.

Argan oil ameliorates sodium fluoride-induced renal damage via inhibiting oxidative damage, inflammation, and intermediate filament protein expression in male rats.

Fluoride is widely distributed in the environment and has been associated with the development of different health hazards in animals and humans. Argan oil (AO) is a natural vegetable oil with various beneficial pharmacological effects. This study was designed to investigate the potential protective effect of AO supplementation as pre-treatment or co-treatment on sodium fluoride (NaF)-induced nephrotoxicity in rats. Male Sprague Dawley rats (n = 50) were randomly assigned to one of five equal groups: control group, AO-treated group (6 ml/kg b.wt.), NaF-treated group (20 mg/kg b.wt.), pre-treated group, and co-treated group. All rats were daily administered by oral gavage for duration of 30 days. The results showed that AO administration significantly improved renal function and antioxidant status and decreased the lipid peroxidation in NaF-treated rats. Additionally, AO normalized the renal levels of inflammatory markers and mRNA expression level of the intermediate filament protein genes, indicating NaF-induced podocyte damage was ameliorated. Histopathological evaluation of the kidney confirmed the before mentioned biochemical results. AO counteracted the nephrotoxic effects of NaF in rats particularly at co-exposure. These results concluded that AO administration exhibited a significant nephroprotective effect against renal injury induced by NaF in rats.

Counter-COVID- 19 pandemic strategy in the Maghreb Central. Qualitative study of the perceptions of health professionals.

CONTEXT: The Maghreb Central, like all the countries of the world, was strongly mobilized (governments, ministries of health, population, civil society) in the response against COVID-19, immediately after the registration of the first cases on its territory (end of February, beginning of March) and according to pre-established control strategies. OBJECTIVES: Describe the perceptions of health professionals in the Central Maghreb (Tunisia, Algeria and Morocco) as to the Strengths/Opportunities and Weaknesses/Threats of the national response plans against COVID-19, during the first weeks of their execution, and report their proposals for optimizing the performance of control strategies. METHODS: This is a qualitative study of the perceptions of health professionals in the Maghreb Central regarding their experience of the first six weeks of fighting the COVID-19 pandemic. The data was collected using the "Delphi" technique in one turn, based on an electronic form such as "Google Form", developed according to SWOT analysis. The respondents' verbatim was grouped into homogeneous groups of items, the occurrence of which was subsequently measured. RESULTS: A total of 382 health professionals from the Maghreb Central participated in this study, with a median age of 37 years and a median professional tenure of 10 years. The major force of the Maghreb response strategies, the most shared by the respondents, was the performance of the human resources mobilized (doctors, biologists, nurses, etc.) who succeeded in quickly learning from the international epidemiological expertise accumulated in Asia and in Europe. The fight against COVID-19 in the Central Maghreb was confronted with the general and chronic fragility of the national health systems and the low support of the general population for the recommendations of the steering committees of response, threatening the capacity of the Maghreb to confront new epidemics. CONCLUSION: The success of the national response plans against COVID-19 and of possible epidemics or pandemics in the Central Maghreb, is strongly attributed to the commitment of health professionals and to community participation, necessitating the launch of assistant motivation programs. and development of health personnel and mobilization and loyalty of civil society.

Lessons learned from the fight against COVID-19 in the Great Maghreb.Five lessons for better resilience.

OBJECTIVE: To compile the lessons learned in the Greater Maghreb, during the first six months of the fight against the COVID-19 pandemic, in the field of "capacity building" of community resilience. METHODS: An expert consultation was conducted during the first week of May 2020, using the "Delphi" technique. An email was sent requesting the formulation of a lesson, in the form of a "Public Health" good practice recommendation. The final text of the lessons was finalized by the group coordinator and validated by the signatories of the manuscript. RESULTS: A list of five lessons of resilience has been deduced and approved : 1. Elaboration of "white plans" for epidemic management; 2. Training in epidemic management; 3. Uniqueness of the health system command; 4. Mobilization of retirees and volunteers; 5. Revision of the map sanitary. CONCLUSION: Based on the evaluation of the performance of the Maghreb fight against COVID-19, characterized by low resilience, this list of lessons could constitute a roadmap for the reform of Maghreb health systems, towards more performance to manage possible waves of COVID-19 or new emerging diseases with epidemic tendency.

Lessons learned from the fight against COVID-19 in the Great Maghreb. Five lessons for a better response.

OBJECTIVE: Identify the lessons learned in the Greater Maghreb, during the first semester of the fight against the COVID-19 pandemic, in the field of response. METHODS: During the first week of May 2020, a consultation of experts was conducted, using the "Delphi" technique, through an email asking each of them, the drafting of a good practice recommendation for "Public health". The Group coordinator finalized the text of the lessons, later validated by the signatories of the manuscript. RESULTS: Five lessons of good «response¼ against epidemics have been deduced and approved by Maghreb experts, linked to the following aspects: 1. Total reservation of hospital beds for patients; 2. Clinical management of the response; 3. Discreet conflict of interest; 4. Community participation in the response; 5. Contextualization of the global fight strategy. CONCLUSION: Based on the finding of low relevance of the Maghreb response against COVID-19, this list of lessons would help support the performance of Maghreb health systems in the management of epidemics.

Management crisis of health personnel in the great Maghreb. Mauritania case study.

OBJECTIVE: To describe the number and distribution of health personnel in Mauritania during 2017, according to their academic grades and administrative assignments. METHODS: This is a quantitative study of the number and uses of health human resources in Mauritania, based on the 2017 data from the Personnel Register of the Ministry of Health. The number of doctors, midwives and nurses in the six administrative regions of Mauritania and its "wilayas", were standardized according to the size of the population (health workers /10 000 inhabitants). Interregional inequalities in the allocation of health personnel have been studied through the correlation between the percentages of the health professions and the populations of the regions affected. RESULTS: In 2017, the number of health workers in all categories was 6608 in Mauritania, a ratio of 17.5 / 10000 health workers / inhabitants, ranging from 8.6 in "Gargot" wilaya to 37.3 in the wilaya of "Inchiri". The densities of specialist physicians, general practitioners, midwives and nurses were respectively 0.9, 0.84, 1.8, and 3.32 per 10,000 inhabitants, respectively. In the Nouakchott region, covering 28.5% of the Mauritanian population, 76.5% of specialist doctors and 56.8% of midwives, had ratios (health workers / 10 000 inhabitants) two and three times higher than national levels. CONCLUSION: This study documented on the one hand the persistence of the shortage of health personnel in Mauritania in 2017, in all its professional categories, and on the other hand the inequalities of their distribution in its administrative zones, with a relative abundance in the region of Nouakchott.

Effect of Dietary Modulation of Selenium Form and Level on Performance, Tissue Retention, Quality of Frozen Stored Meat and Gene Expression of Antioxidant Status in Ross Broiler Chickens.

This study compares between different selenium forms (sodium selenite; SeS, selenomethionine; Met-Se or nano-Se) and levels on growth performance, Se retention, antioxidative potential of fresh and frozen meat, and genes related to oxidative stress in Ross broilers. Birds (n = 450) were randomly divided into nine experimental groups with five replicates in each and were fed diets supplemented with 0.3, 0.45, and 0.6 mg Se/kg as (SeS, Met-Se), or nano-Se. For overall growth performance, dietary inclusion of Met-Se or nano-Se significantly increased (p < 0.05) body weight gain and improved the feed conversion ratio of Ross broiler chicks at the level of 0.45 and 0.6 mg/kg when compared with the group fed the same level of SeS. Se sources and levels significantly affected (p < 0.05) its concentrations in breast muscle, liver, and serum. Moreover, Se retention in muscle was higher (p < 0.05) after feeding of broiler chicks on a diet supplemented with Met-Se or nano-Se compared to the SeS group, especially at 0.6 mg/kg. Additionally, higher dietary levels from Met-Se or nano-Se significantly reduced oxidative changes in breast and thigh meat in the fresh state and after a four-week storage period and increased muscular pH after 24 h of slaughter. Also, broiler's meat in the Met-Se and nano-Se groups showed cooking loss and lower drip compared to the SeS group (p < 0.05). In the liver, the mRNA expression levels of glutathione peroxidase, superoxide dismutase, and catalase were elevated by increasing dietary Se levels from Met-Se and nano-Se groups up to 0.6 mg/kg when compared with SeS. Therefore, dietary supplementation with 0.6 mg/kg Met-Se and nano-Se improved growth performance and were more efficiently retained than with SeS. Both sources of selenium (Met-Se and nano-Se) downregulated the oxidation processes of meat during the first four weeks of frozen storage, especially in thigh meat, compared with an inorganic source. Finally, dietary supplementation of Met-Se and nano-Se produced acceptable Se levels in chicken meat offered for consumers.

Tunisian documentation of «Public Health¼ in post revolution, with a taste of freedom. For a fair, participatory and efficient National Health System.

CONTEXT: Following the Tunisian revolution of 2010/2011, a new Public Health literature emerged, by the ministerial departments as well as the civil society, which was marked by the transparency and the comprehensiveness of the approach. OBJECTIVE: To identify the key ideas of the new Tunisian Public Health discourse, reconciling the principles of a globalizing paradigm with the health problems of a country in transition. METHODS: During this qualitative research, a selected series of three Tunisian reports of Public Health, published in the first quinquennium of the revolution, was read by an independent team of experts in Public Health, not having contributed to their elaboration, to identify the consensual foundations of the new Public Health discourse. These documents were: the "2011 Health Map" of the Department of Studies and Planning of the Ministry of Health, the "Societal Dialogue Report on Health Policies, Strategies and Plans" (2014), and the "Report on the right to health in Tunisia" (2016). RESULTS: The reading of this sample of the Tunisian Public Health literature of the post-revolution brought out three consensual ideas: 1. The constitutional principle of the "right to health" (article 38 of the constitution) with its corollary the State's obligation to ensure access to comprehensive, quality and secure care; 2. The challenge of social "inequalities" of access to care, reinforced by a regional disparity in the distribution of resources, particularly high-tech (specialist doctors, university structures); 3. Advocacy for a National Health System, based on a universal health coverage for its funding and citizen participation in its governance. CONCLUSION: The new Tunisian Public Health literature, in post-revolution, calls on all stakeholders in Preventive and Community Medicine to replace their segmental, technical and hospital practices with a new approach, centered on the implementation of a National Health System that is based on a socialized financing of care and citizen participation in its management.

Chemopreventive and therapeutic potentials of thymoquinone in HepG2 cells: mechanistic perspectives.

Liver cancer is the fifth commonest malignancy worldwide and the third leading cause of death. Identifying novel curative and preventive therapy may improve its prognosis. In this study, thymoquinone (TQ), the most active biological ingredient of Nigella sativa Linn, was investigated for its antitumor activity. Mechanistic perspectives underlying this antitumor activity were explored by testing its effect on cell cycle, apoptosis, and angiogenesis. In addition, the chemopreventive effect of TQ was carried out by measuring its effect on phase I CYP1A1 and phase II glutathione S-transferase (GST) drug-metabolizing enzymes. The results of the present study revealed the effectiveness of TQ as an antitumor agent against different types of cancer including brain, colon, cervix and liver at both a time- and concentration-dependent manner. In HepG2 cells, it induced G2/M phase cell cycle arrest and a concentration-dependent increase in the percentage of apoptotic cells with an increase in the ratio of Bax/BCL-2. Moreover, the expression of mRNA and protein level of vascular endothelial growth factor decreased as the concentration of TQ increased. Our data showed a significant inhibition of induced phase I CYP1A1 enzyme, and elevation in the content of glutathione and activity of phase II enzyme GST, in HepG2 cells. Our results provide support for the beneficial use of TQ as a therapeutic and chemopreventive agent against liver cancer.

Immunomodulation of RAW 264.7 murine macrophage functions and antioxidant activities of 11 plant extracts.

A group of 11 medicinal plants, including Lavandula pubescens, Trigonella foenugricium, Salsola schweinforthi, Calligonum comosum, Silene succulenta, Silene villosa, Bogonvillea glabra, Cakile maritime, Gomphrene celesoids, Mirabilis jalaba, and Silene nocturna growing in Egypt, were extracted and examined for their immunomodulatory and antioxidant activities. RAW 264.7 cells were recruited to investigate the immunomodulatory effect through multiple parameters analysis. First, the proliferation index of macrophages cells was evaluated revealing that Trigonella foenugricium, Silene succulenta and Silene villosa have a significant cytotoxic effect on RAW cells. Interestingly, we observed enhancement of macrophages phagocytic function of by all extracts except Cakile maritime, Gomphrena celosioides and Silene nocturna. Afterwards, macrophages were challenged by incubation with LPS and the effect of various extracts on inflammatory responses was investigated; the generation of NO from activated macrophage was substantially suppressed by 7 extracts namely, Trigonella foenugricium, Calligonum comosum, Silene succulenta, Bougainvillea glabra, Mirabilis jalaba, Gomphrena celosioides and Silene nocturna. TNF-α was decreased by percentage range from 3.8 to 85.8% and Trigonella foenugricium extract showed the highest inhibition of TNF-α release. All extracts except Trigonella foenugricium, Salsola schweinforthi, Silene succulenta and Mirabilis jalaba significantly inhibited COX-2 production from stimulated macrophage. Moreover, evaluating the potential antioxidant activity of these extracts showed that Trigonella foenugricium, Salsola schweinforthi, Calligonum comosum, Bogonvillea glabra and Mirabilis jalaba exhibited some antioxidant activities. Taken together, our results suggest that some of these extracts may have a considerable antinflammatory and antioxidant effects and may be a potential therapeutic choice in the treatment of inflammatory diseases.

Evaluation of immunomodulatory effect of three herbal plants growing in Egypt.

A group of medicinal plant including Silene (Silene nocturna), Black seed (Nigella sativa) and Chamomile (Matricaria chamomilla) growing in Egypt were examined for their immunomodulatory effect in Balb/c mice. Treatment (intraperitoneal injection) with five doses of methanolic extract for each plant was found to enhance the total white blood cells count (up to 1.2 × 10(4) cells/mm(3)). Bone marrow cellularity also increased significantly (P < 0.01) after the administration of the extract of each of three test plants. Furthermore, spleen weight of the treated groups was significantly increased (P < 0.01). Two groups of mice were immunosuppressed with cyclophosphamide, the one which pretreated with the plants extracts significantly (P < 0.01) restored their resistance against lethal infection with the predominately granulocyte-dependant Candida albicans. These results confirm the immunomodulatory activity of Silene, Black seed, and Chamomile extracts and may have therapeutical implications in prophylactic treatment of opportunistic infections and as supportive treatment in oncogenic cases.

[Immunological profile of coeliac disease in a subgroup of patients with symptoms of irritable bowel syndrome]. / Profil immunologique de la maladie coeliaque chez un sous- groupe de patients atteints d'un syndrome de l'intestin irritable.

AIM: The purpose of this study was to determine if authentic cases of irritable bowel syndrome could be secondary in a latent or potential coeliac disease. METHODS: All new patients who consulted for irritable bowel syndrome fulfilling Rome II criteria between 01/04/2003 and 30/03/2004 were included. All patients had upper endoscopy with duodenal biopsy and colonoscopy or enema. Then they were investigated for celiac disease by analysis of serum IgA antigliadin, IgG antigliadin, and endomysial antibodies. RESULTS: One hundred patients with irritable bowel syndrome were included. They had an average age of 45,5 +/- 0,98 and they were 61 women. Clinical signs were dominated by abdominal pains associated to constipation (69% of the cases). Five patients had positive antigliadin antibody (IgG for 2 patients and IgA for 3 patients). None of them had endomysial antibodies nor abnormal duodenal biopsy. CONCLUSION: This study didn't provide a relation between celiac disease and irritable bowel syndrome when it is associated to constipation.