Impacts of enzymes and probiotic in improving the utilization of sieved olive pulp meal in growing rabbit diets.

Objective: This research assesses the utilization of sieved olive pulp (SOP) in the diet of growing rabbits through the use of an exogenous enzyme or dry yeast as a pretreatment. Materials and Methods: One hundred sixty-eight male V-Line rabbits aged 5 weeks (weighing 550 ± 25 gm) were randomly divided into seven groups with eight replicates each as follows: the control group was fed a basal diet without supplementation; while the other six groups were fed basal diets containing 20% and 25% of SOP and supplemented with 0.1 gm/kg Econase (E), 0.5 gm/kg dry yeast (Y), and a combination of both. The experiment lasted for 8 weeks. Results: The results indicated that supplementation of E, Y, and EY into rabbit diets containing SOP improved live body weight, body weight gain, feed conversion ratio, and nutrient digestibility. A higher dressing percentage was observed in the groups fed a 20% and 25% SOP diet supplemented with EY (p < 0.05). The treated groups showed an increase in total protein, albumin, globulin, A/G ratio, total antioxidant capacity, superoxide dismutase, and glutathione peroxidase (p < 0.05), while there was a significant decrease in triglycerides, total cholesterol, and malondialdehyde levels (p < 0.05) compared to the control. Rabbit groups fed an SOP diet supplemented with E, Y, or EY demonstrated higher (p < 0.05) economic efficiency compared to the control. Conclusion: Supplementing the diet of rabbits containing SOP with exogenous enzymes and/or dry yeast enhances the nutritional value of SOP while improving rabbit performance, nutrient digestibility, and antioxidant status.

Effects of Dietary Supplementations of Vitamin C, Organic Selenium, Betaine, and Pomegranate Peel on Alleviating the Effect of Heat Stress on Growing Rabbits.

The aim of this study was to investigate the biological activity and sustainable biorefinery development of vitamin C, organic selenium, betaine, and pomegranate peel on the performance, cecal fermentation, and antioxidant status of growing rabbits to alleviate the negative impacts of heat stress. A total of 105 male rabbits at 35 days old with an average weight of 752.55 ± 27.56 g were randomly assigned to five groups (21 rabbits in each). The experimental dietary groups included a control group fed a basal diet without additives (control group) and four treated groups, A, B, C, and D, fed a basal diet supplemented with either a 1000 mg vitamin C/kg diet, a 25 mg organic selenium/kg diet, a 1000 mg betaine/kg diet, or a 20 g pomegranate peel/kg diet, respectively. No negative group (not heat-stressed) was included in the trial. Rabbits given A, B, C, and D supplements showed a significant increase (p < 0.05) in growth performance, nutrient digestion, concentration of total volatile fatty acids (VFA), acetic, and propionic acids, and total bacterial count, and a significant decrease (p < 0.05) in NH3-N concentration, Enterococcus, coliforms, and E. coli counts in the cecum of rabbits. Total protein, albumin, globulin, superoxide dismutase (SOD), catalase (CAT), reduced glutathione (GSH), and glutathione peroxidase (GPx) were significantly (p < 0.05) higher in groups supplemented with A, B, C, and D supplements compared to those in the control group. Total cholesterol, triglycerides, creatinine, urea, and malondialdehyde (MDA) were significantly (p < 0.05) lower in groups supplemented with A, B, C, and D supplements compared to those in the control group. In conclusion, the finding showed that the supplementation of vitamin C, organic selenium, betaine, and pomegranate peel played a significant role in alleviating heat stress and had a further beneficial impact on rabbit performance, cecal fermentation and microbiota, and antioxidant status. However, betaine supplementation had a superior positive effect on the nutritional and physiological profile of heat-stressed rabbits.

Placenta percreta in primigravida with unscarred uterus complicated by uterine rupture and sudden maternal and fetal death: an autopsy case report.

Placenta percreta is a rare, aggressive, and severe form of the placenta accreta spectrum. One of its most devastating effects is the sudden rupture of uterus. Uterine scarring is the leading risk factor for uterine rupture, although it can also happen, but rarely, in an unscarred uterus showing more severe repercussions. The present study reported a case of an Egyptian primigravida female, aged 29 years old, at 32 weeks of gestation who died suddenly due to uterine rupture complicating placenta percreta, the diagnosis of which was first settled during autopsy. There was no history of abdominal trauma. No medical history of significance was present. Autopsy denoted an intrauterine fetal death of 32 weeks gestational age. The fundus of the uterus had a laceration (rupture) of the uterine wall including the serosa and myometrium. The placenta has extensively infiltrated the fundus uterine wall and penetrated the myometrium and serosa. Histopathological examination of the ruptured site on the uterus confirms total invasion of the uterine wall by chorionic villi with the presence of hemorrhage and fibrin indicating placenta percreta. Uterine rupture due to placenta percreta may go unnoticed, especially when no associated high-risk factors exist. The current case depicts that placenta percreta is a rare but critical complication of pregnancy that may exist at any stage of pregnancy without any associated high-risk factors with unusual symptoms and leads to uterine rupture and sudden death.

Silver nanoparticles induced testicular damage targeting NQO1 and APE1 dysregulation, apoptosis via Bax/Bcl-2 pathway, fibrosis via TGF-ß/α-SMA upregulation in rats.

In medicine, silver nanoparticles (AgNPs) are employed often. They do, however, have negative impacts, particularly on the reproductive organs. This research aimed to assess AgNP impact on the testis and the possible intracellular mechanisms to induce testicular deteriorations in rats at various concentrations and different time intervals. Sprague Dawley rats (n = 40) were allocated into four equal groups: the control one, and three other groups injected intra-peritoneally with AgNP solution 0.25, 0.5, and 1 mg/kg b.w. respectively for 15 and 30 days. Our findings revealed that AgNPs reduced body and testicular weights, estradiol (E2) and testosterone (T) hormone levels, and sperm parameters while elevating the nitric oxide and malondialdehyde levels with inhibition of reduced glutathione contents in testicular tissue. Interestingly, AgNPs significantly upregulated the testicular inducible nitric oxide synthase, B cell lymphoma 2 (Bcl-2)-associated X, transforming growth factor, and alpha-smooth muscle actin (α-SMA) expression levels. However, apurinic/apyrimidinic endo deoxyribonuclease 1 (APE1), NAD (P) H quinone dehydrogenase 1 (NQO1), and Bcl-2 expression levels were all downregulated indicating exhaustion of body antioxidant and repairing defense mechanisms in testicles in comparison with the control rats. Various histological alterations were also detected which dramatically increased in rats sacrificed after 30 days such as loss of the lining cells of seminiferous tubules with no spermatozoa and tubular irregularities associated with thickening of their basement membranes. Immunolabeling implicated in the apoptotic pathway revealed a negative expression of Bcl-2 and marked immunoreactivity for caspase-3 after 30 days of AgNP treatment in comparison to the control rats. To our knowledge, there have been no previous publications on the role of the α-SMA, APE1, and NQO1 genes in the molecular pathogenesis of AgNP testicular cytotoxicity following AgNP acute and chronic exposure.

Lactating buffalos' productive performance, ruminal kinetics, nutrients digestibility and oxidative status as response to supplementing diets with alpinia galanga.

The current study investigated the effect of adding different doses of galangal rhizome powder (Alpinia galanga) to the diets of lactating buffaloes on milk production, composition and in vitro ruminal fermentation kinetics. Twenty buffaloes were divided into four groups: (T1) a control diet comprising of concentrates, corn silage and rice straw at 50: 35: 15 on a DM basis, (T2) a control diet plus 15 g of galangal/animal/day and (T3) a control diet plus 30 g of galangal/animal/day and (T4) a control diet plus 45 g of galangal/animal/day. Results showed that inclusion of galangal in diets decreased (p < 0.05) the concentrations of butyrate, ammonia-nitrogen, CO2, and total protozoa count as compared with T1. Acetate concentration was lower in T4 as compared with other groups (p < 0.05). While propionate concentration was lower (p < 0.05) in T2 as compared with T1. T3 and T4 lowered (p < 0.05) methane, CO2 productions, and protozoa count. T3 increased (p < 0.05) milk yield, energy corrected milk (ECM), yield of total solids, total protein, and solids not fat (SNF) than recorded for T1. While T4 recorded the lowest values (p < 0.05) of milk yield, ECM, total solids, fat, and total protein. The current results support the hypothesis that the inclusion of galangal in lactating buffaloes' diets at 30 g per animal daily improved feed intake and milk yield.

Silver nanoparticles induced hepatoxicity via the apoptotic/antiapoptotic pathway with activation of TGFß-1 and α-SMA triggered liver fibrosis in Sprague Dawley rats.

Despite the extraordinary use of silver nanoparticles (AgNPs) in medicinal purposes and the food industry, there is rising worry about potential hazards to human health and the environment. The existing study aims to assess the hepatotoxic effects of different dosages of AgNPs by evaluating hematobiochemical parameters, oxidative stress, liver morphological alterations, immunohistochemical staining, and gene expression to clarify the mechanism of AgNPs' hepatic toxic potential. Forty male Sprague Dawley rats were randomly assigned into control and three AgNPs intraperitoneally treated groups 0.25, 0.5, and 1 mg/kg b.w. daily for 15 and 30 days. AgNP exposure reduced body weight, caused haematological abnormalities, and enhanced hepatic oxidative and nitrosative stress with depletion of the hepatic GSH level. Serum hepatic injury biomarkers with pathological hepatic lesions where cholangiopathy emerges as the main hepatic alteration in a dosage- and duration-dependent manner were also elevated. Furthermore, immunohistochemical labelling of apoptotic markers demonstrated that Bcl-2 was significantly downregulated while caspase-3 was significantly upregulated. In conclusion, the hepatotoxic impact of AgNPs may be regulated by two mechanisms, implying the apoptotic/antiapoptotic pathway via raising BAX and inhibiting Bcl-2 expression levels in a dose-dependent manner. The TGF-ß1 and α-SMA pathway which triggered fibrosis with incorporation of iNOS which consequently activates the inflammatory process were also elevated. To our knowledge, there has been no prior report on the experimental administration of AgNPs in three different dosages for short and long durations in rats with the assessment of Bcl-2, BAX, iNOS, TGF-ß1, and α-SMA gene expressions.

The Effect of Sargassum siliquastrum Supplementation on Growth Performance, Cecal Fermentation, Intestine Histomorphology, and Immune Response of Japanese Quails.

This study aimed to investigate the dietary effects of Sargassum siliquastrum on the growth performance, nutrient digestibility, cecal fermentation, microbial populations, antioxidant status, immune response, and intestine histomorphology of Japanese quails. A total of 450 Japanese quails, aged 7 days, weighing 27.35 ± 0.23 g, were randomly distributed to three dietary groups in a 42-day feeding experiment. Five replicates were prepared per group, with each replicate consisting of 30 chicks in a cage. The three dietary groups consisted of a basal diet (0% supplementation, which was the control) and diets supplemented with 1% and 2% of S. siliquastrum. The results showed that the S. siliquastrum-supplemented groups and the control group had similar final body weight (FBW), average body gain (ADG), and average feed intake (ADFI). However, the S. siliquastrum-supplemented groups had a better feed conversion ratio (FCR), as well as a lower mortality rate, compared to the control group. S. siliquastrum supplementation improved the nutrient digestibility of dry matter (DM), organic matter (OM), crude protein (CP), and crude fiber (CF) (p < 0.05). The S. siliquastrum-supplemented groups exhibited the heaviest empty intestine and cecum weights, as well as the longest intestinal and cecal length. Furthermore, the total volatile fatty acid (VFA) and the propionic acid concentrations increased significantly in quails fed S. siliquastrum-supplemented diets (p < 0.05), although the concentration of NH3-N decreased (p < 0.05). The dietary inclusion of S. siliquastrum had a beneficial effect on cecal microbial populations, where the Lactobacillus sp. counts increased, and the E. coli and Clostridium perfringens counts decreased. The histopathological examination of the duodenum confirmed that S. siliquastrum dietary supplementation enhanced the height and width of the villi. Quails fed S. siliquastrum-supplemented diet exhibited the highest total antioxidant capacity, superoxide dismutase, glutathione peroxidase, and glutathione reductase activities, but the thiobarbituric acid reactive substance was decreased (p < 0.05). Serum IgA, IgG, and IgM concentrations increased considerably (p < 0.05) in S. siliquastrum-supplemented groups. In conclusion, S. siliquastrum supplementation in the diet of Japanese quail can provide beneficial effects on performance, cecal fermentation, beneficial bacteria populations, and the immune response, and could be considered as an alternative feed additive in poultry production.

Grape seed alleviates lindane-induced oxidative stress and improves growth performance, caecal fermentation and antioxidant capacity in growing rabbits.

This study evaluated the protective effect of grape seed on performance, caecal characteristics, blood metabolites and liver antioxidant status in lindane-treated rabbits. Four-week-old New Zealand White rabbits (n = 96) with an initial body weight of 0.750 ± 0.23 g were randomly divided into four groups (n = 24). One group was the control received only corn oil orally, while group L were received lindane daily via gavage in corn oil (4 mg/kg BW; 1/50 LD50 for oral dose), group GS was treated with 50 g grape seed /kg diet, and group LGS treated with a combination of both L and GS for 98 days. Results revealed that final body weight (FBW), average daily gain (ADG), dry matter intake and feed efficiency (FE) were similar between GS and control groups, and achieved the highest FBW and ADG, and the best FE. Caecum pH of the L group increased, while the caecum pH of the GS group decreased sharply. There was a significant increase in the concentration of total VFA, acetic acid, propionic acid and NH3 -N in the GS group, but butyric acid level decreased. GS treatment resulted in a significant increase in the concentrations of total protein, albumin and AChE. GPx, GST, CAT and SOD activity decreased, but TBARS activity significantly increased in the group L, while GS caused a significant elevation of antioxidant activity in the liver. These results confirm that the antioxidant compounds present in grape seed can alleviate the oxidative stress caused by lindane-induced hepatotoxicity and could be a useful supplement to maintain health and improve performance in rabbits.

Amelioration of Sarcoptic Mange-Induced Oxidative Stress and Growth Performance in Ivermectin-Treated Growing Rabbits Using Turmeric Extract Supplementation.

In this experiment, the protective effect of turmeric extract (TE) on side effects of Ivermectin-treated rabbits, while improving their performance, blood characteristics, and antioxidant status, was investigated. Sixty-three clinically Sarcoptes-infested rabbits aged 60 days were randomly allocated into three groups, with 21 rabbits in each group, to receive either no TE or TE supplementation (1 or 2 mg/kg diet) for 30 days after being subcutaneously injected with Ivermectin (IVM) 1% w/v at a dose of 0.2 mg/kg body weight twice a week. Another 21 healthy rabbits were used as the control. Treatment with IVM + 1 and 2 mg TE improved body weight (BW), body weight gain (BWG), feed intake (FI), and feed conversion ratio (FCR) in infested rabbits (p < 0.05). The IVM alone treatment had the highest mortality rate compared with the other treatments. Rabbits treated with IVM + 1 and 2 mg TE demonstrated progressive recovery manifested by improved nutrient digestibility and nitrogen balance. On day 7, the serum total protein, albumin, and albumin/globulin (A/G) ratio were significantly lower in the treated groups compared with the control group; also, the lowest values were observed in rabbits treated only with Ivermectin, followed by IVM + 1 and 2 mg TE. Treated rabbits had higher thiobarbituric acid reactive substance (TBAR) levels, but lower total antioxidant capacity (TAC), superoxidase dismutase (SOD), and glutathion peroxidase (GSH-Px) levels compared with the control group. On day 30 post-treatment, the rabbits in the IVM + 1 and 2 mg TE treatment groups showed progressive recovery manifested by improved biochemichal parameters, as well as a remarkable improvements in the oxidant/antioxidant balance towards normalcy (p < 0.05), and became comparable to that of the control compared with IVM alone treatment. In conclusion, turmeric extract improved rabbits' performance toward normalcy, and has remarkable antioxidant properties and can be used in conjunction with a miticide to treat sarcoptic mange in rabbits.

Stem cell therapies for autoimmune hepatitis.

Autoimmune hepatitis is a chronic inflammatory hepatic disorder which may cause liver fibrosis. Appropriate treatment of autoimmune hepatitis is therefore important. Adult stem cells have been investigated as therapies for a variety of disorders in latest years. Hematopoietic stem cells (HSCs) were the first known adult stem cells (ASCs) and can give rise to all of the cell types in the blood and immune system. Originally, HSC transplantation was served as a therapy for hematological malignancies, but more recently researchers have found the treatment to have positive effects in autoimmune diseases such as multiple sclerosis. Mesenchymal stem cells (MSCs) are ASCs which can be extracted from different tissues, such as bone marrow, adipose tissue, umbilical cord, and dental pulp. MSCs interact with several immune response pathways either by direct cell-to-cell interactions or by the secretion of soluble factors. These characteristics make MSCs potentially valuable as a therapy for autoimmune diseases. Both ASC and ASC-derived exosomes have been investigated as a therapy for autoimmune hepatitis. This review aims to summarize studies focused on the effects of ASCs and their products on autoimmune hepatitis.

Temperature responsive smart polymer for enabling affinity enrichment of current coronavirus (SARS-CoV-2) to improve its diagnostic sensitivity.

The current commercially available SARS-CoV-2 diagnostic approaches including nucleic acid molecular assaying using polymerase chain reaction (PCR) have many limitations and drawbacks. SARS-CoV-2 diagnostic strategies were reported to have a high false-negative rate and low sensitivity due to low viral antibodies or antigenic load in the specimens, that is why even PCR test is recommended to be repeated to overcome this problem. Thus, in anticipation of COVID-19 current wave and the upcoming waves, we should have an accurate and rapid diagnostic tool to control this pandemic. In this study, we developed a novel preanalytical strategy to be used for SARS-CoV-2 specimen enrichment to avoid misdiagnosis. This method depends on the immuno-affinity trapping of the viral target followed by in situ thermal precipitation and enrichment. We designed, synthesized, and characterized a thermal-responsive polymer poly (N-isopropylacrylamide-co-2-hydroxyisopropylacrylamide-co-strained alkyne isopropylacrylamide) followed by decoration with SARS-CoV-2 antibody. Different investigations approved the successful synthesis of the polymeric antibody conjugate. This conjugate was shown to enrich recombinant SARS-CoV-2 nucleocapsid protein samples to about 6 folds. This developed system succeeded in avoiding the misdiagnosis of low viral load specimens using the lateral flow immunoassay test. The strength of this work is that, to the best of our knowledge, this report may be the first to functionalize SARS-CoV-2 antibody to a thermo-responsive polymer for increasing its screening sensitivity during the current pandemic.

Date press cake replaces corn grains in the diet of lactating Egyptian buffaloes and Barki rams.

High prices of corn grains due to their shortage in some regions force researcher to explore nonconventional alternatives. Therefore, the present study aimed to evaluate the effect of replacing corn grains at 25% (dry matter (DM) basis) with date press cake (DPC) without/with exogenous enzymes at 2 L/ton feed in diets of Barki sheep (24 rams divided as 6 rams/treatment) and Egyptian buffaloes (16 buffaloes divided as 4 buffalo/treatment). Each experiment was conducted under 4 treatments regime: control diet containing only corn grains, T1 diet where the control diet supplemented with exogenous enzyme, T2 diet where the control diet contained DPC on corn replacement (25% DM basis), and T3 diet where the control diet contained DPC on corn replacement (25% DM basis) along with exogenous enzyme supplement. The control diet contained concentrate feed mixture, corn silage, and rice straw at 50:40:10, respectively. Data on nutrient intake, digestibility, and nitrogen balance in sheep, as well as on blood parameters, milk production, and composition in buffaloes, were analyzed using the PROC GLM/MIXED procedure of SAS. The sheep under T2 and T3 treatments demonstrated greater digestibility of dry matter, organic matter, and neutral detergent fibers, along with improved nitrogen balance. The milk yield and its constituents were improved in the buffaloes under T3 treatment followed by those buffaloes under T2 and T1 treatments. This investigation could conclude that replacing corn grains with DPC at 25% (DM basis) in ruminant diets had beneficial effects on nutrients digestibility and milk yield along with its composition.

The Potential Safe Antifibrotic Effect of Stem Cell Conditioned Medium and Nilotinib Combined Therapy by Selective Elimination of Rat Activated HSCs.

Hepatic fibrosis is a progressive disease with serious clinical complications that arise from abnormal propagation and activation of multiple inflammatory pathways. Nilotinib is an oral tyrosine kinase inhibitor with antifibrotic activity. Mesenchymal stem cells (MSCs) are blank cells and can differentiate into specific cell types. They have the potential to repair and regenerate cells. MSCs have a special paracrine fashion where they produce special exosomes, microvesicles, and cytokines like IL-6, transforming growth factor-beta (TGF-ß), and HGF as well as hepatic stellate cell suppressors. This paracrine fashion can decrease collagen deposition, enhance antifibrotic, anti-inflammatory, and angiogenic activity in vitro and in vivo. In our study, the rat's hepatic stellate cells (HSCs) in addition to different normal cell lines were treated with Nilotinib alone and in combination with liver mesenchymal stem cells conditioned medium (LMSCs-CM) for 24 h. Mono and combined therapy antifibrotic and cytotoxicity effects were evaluated using different parameters including α-SMA, cytochrome c, P53 expression, collagen deposition, DNA content, oxidative stress parameters, cell viability, and apoptosis by flow cytometry analysis. Our results showed that Nilotinib and LMSCs-CM in combination had a significantly potent antifibrotic and anti-inflammatory effect on activated hepatic stellate cells than Nilotinib alone; otherwise, this combination showed the best safety with minimal cytotoxicity on different normal cell lines.

Coronavirus (SARS-CoV-2) in gastroenterology and its current epidemiological situation: An updated review until January 2021.

Coronaviruses are positive-sense single-strand RNA viruses that infect amphibians, birds, and mammals. Coronavirus Disease 2019 (COVID-19) has become a major health problem caused by one of the coronaviruses called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It has spread fast throughout the globe since its first identification in Wuhan, China, in December 2019. Although COVID-19 is principally defined by its respiratory symptoms, it is now clear that the virus can also affect the digestive system causing gastrointestinal (GI) symptoms like diarrhea, loss of appetite, nausea/vomiting, and abdominal pain as a major complaint. GI symptoms could be the initial signs of preceding respiratory signs, carrying a potential for slowed investigation and raised disease transmission opportunities. Various studies recognized the COVID-19 RNA in stool specimens of infected patients, and its viral receptor angiotensin-converting enzyme-2 (ACE-2) is highly expressed in GI epithelial cells. Many cases were reported negative using nasopharyngeal/oropharyngeal swabs and finally, SARS-CoV-2 RNA was detected in their anal/rectal swabs and stool specimens. These suggest that COVID-19 can actively infect and replicate in the GI tract. In this review, we elaborate on the close relationship between SARS-CoV-2 and the digestive system, focusing on the current status in the field of COVID-19 in gastroenterology, liver injury, endoscopy, inflammatory bowel disease, imaging, and the potential underlying mechanisms with illustrating the current epidemiological status regarding this pandemic.

Post-placental intrauterine device insertion vs puerperal insertion in women undergoing caesarean delivery in Egypt: a 1 year randomised controlled trial.

OBJECTIVE: The aim of the study was to compare 6 month expulsion rates of the copper-bearing intrauterine device (IUD) inserted after delivery of the placenta or at the 6 week postpartum visit in women undergoing caesarean section. METHODS: A parallel-group randomised trial was conducted in an Egyptian university hospital between February 2016 and December 2018. Participants were randomised to either post-placental IUD insertion or IUD insertion at the 6 week postpartum visit. Participants were followed for 12 months. Primary outcomes were IUD expulsion and the proportion of women using an IUD at 6 months. A secondary outcome was the cumulative pregnancy rate at 12 months. RESULTS: Five hundred participants were enrolled in each group. At 6 months the total expulsions were 58/416 (13.9%) in the post-placental group and 4/214 (1.9%) in the puerperal group; IUD use at 6 months was 416/478 (87.0%) in the post-placental group and 214/232 (92.2%) in the puerperal group. Data collected by phone at 12 months showed a higher cumulative pregnancy rate in the puerperal group (84/500, 16.8%) vs the post-placental group (22/500, 4.4%). IUD continuation at 12 months was higher in the post-placental group. CONCLUSION: Participants in the post-placental group had a higher expulsion rate at 6 months, but more IUDs were placed in this group and fewer pregnancies had occurred at 12 months compared with the puerperal group. TRIAL REGISTRATION: Clinicaltrials.gov NCT02679820.

Current coronavirus (SARS-CoV-2) epidemiological, diagnostic and therapeutic approaches: An updated review until June 2020.

Coronaviruses are a group of enveloped viruses with non-segmented, single-stranded, and positive-sense RNA genomes. In December 2019, an outbreak of coronavirus disease 2019 (COVID-19) caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), in Wuhan City, China. The World Health Organization (WHO) declared the coronavirus outbreak as a global pandemic in March 2020. Fever, dry cough and fatigue are found in the vast majority of all COVID-19 cases. Early diagnosis, treatment and future prevention are keys to COVID-19 management. Currently, the unmet need to develop cost-effective point-of-contact test kits and efficient laboratory techniques for confirmation of COVID-19 infection has powered a new frontier of diagnostic innovation. No proven effective therapies or vaccines for SARS-CoV-2 currently exist. The rapidly increasing research regarding COVID-19 virology provides a significant number of potential drug targets. Remdesivir may be the most promising therapy up till now. On May 1, 2020, Gilead Sciences, announced that the U.S. Food and Drug Administration (FDA) has granted emergency use authorization (EUA) for the investigational Remdesivir as a potential antiviral for COVID-19 treatment. On May 7, 2020, Gilead Sciences, announced that the Japanese Ministry of Health, Labour and Welfare (MHLW) has granted regulatory approval of Veklury® (Remdesivir) as a treatment for SARS-CoV-2 infection, the virus that causes COVID-19 acute respiratory syndrome, under an exceptional approval pathway. Also, Corticosteroids are recommended for severe cases only to suppress the immune response and reduce symptoms, but not for mild and moderate patients where they are associated with a high-risk side effect. Based on the currently published evidence, we tried to highlight different diagnostic approaches, side effects and therapeutic agents that could help physicians in the frontlines.

Antifibrotic Effect of Combination of Nilotinib and Stem Cell-Conditioned Media on CCl4-Induced Liver Fibrosis.

Liver fibrosis is the excessive extracellular matrix accumulation of proteins, such as collagen, which follows the chronic liver diseases. Advanced liver fibrosis leads to cirrhosis and liver failure. Nilotinib is a second-generation tyrosine kinase inhibitor, which showed antifibrotic efficacy. Stem cell therapy still has some limitations such as oncogenesis, unexpected differentiation, and ethical consideration. Stem cells secrete cytokines and growth factors that showed paracrine-mediated antifibrotic and anti-inflammatory effects in vivo and in vitro. Thus, stem cell-conditioned medium (SC-CM), which contains the secretory proteins of stem cells, may have an antifibrotic role. This study was carried out to examine the antifibrotic effect of Nilotinib and stem cell exosomes on CCl4-induced liver fibrosis in rats. Male Wistar rats were injected intraperitoneally with CCl4 twice a week for 9 weeks and given daily treatments of Nilotinib (20 mg/kg), stem cell exosomes (0.5 ml/rat), and the combination treatment of Nilotinib and stem cell exosomes during the last 5 weeks of CCl4 intoxication. Liver fibrosis and also antifibrotic efficacy of the treatments were estimated with liver function tests, oxidative stress parameters, apoptotic parameters, histopathological examination, and hydroxyproline contents. Results showed that the combination of Nilotinib and stem cell-conditioned media had more antifibrotic effects than each one alone (P value < 0.001).

Long-term evaluation of modified orthotopic Y-shaped ileal neobladder (Tanta pouch) with left retro-colic chimney.

PURPOSE: In the present study, we evaluated the long-term results of modified Y-shaped orthotopic ileal neobladder (Tanta pouch) with trans-mesenteric left retro-colic chimney. PATIENTS AND METHODS: A total of 70 patients with invasive bladder cancer underwent radical cystectomy and modified Y-shaped orthotopic ileal neobladder. (The left chimney elongated to pass to the left side through a window in the mesentery of the pelvic colon and the ureters were implanted directly end to side, in both chimneys after doing good spatulation. RESULTS: The mean follow-up period ranged between 7 and 10 years (mean 7.8 years). 18 patients died during the period of follow-up. 6 months postoperatively, there was a spherical orientation of the pouch (The mean capacity was 542 ± 47 cm3) and the maximum intra-pouch pressure was 24 ± 3.2 cm H2O. Daytime continence was achieved in 93% of the patients and nighttime continence was achieved in 87%. Stress incontinence occurred in 15% and total incontinence in 2%. Renal function was stable in 93% of renal units. Stricture ureter was not recorded of any case. Of 14 renal units with preoperative dilated ureters, 5 units had improved postoperatively and the others had persistent reflux. 13 renal units (3 unilateral and 5 bilateral) with normal preoperative ureters had persistent postoperative reflux. Persistent reflux showed no influence on renal function. CONCLUSION: Modified Y-shaper pouch is suitable for short, dilated ureters. Longitudinal orientation of the pouch facilitates ileo-urethral anastomosis, especially with short mesentery. Long-term follow-up for direct uretero-ileal anastomosis did not show deterioration of the renal function.