Studies on the effect of curcumin and quercetin in the liver of male albino rats exposed to gamma irradiation.

Ionizing radiation produces deleterious effects on living organisms. The present investigation has been carried out to study the prophylactic as well as the therapeutic effects of treated rats with quercetin (Quer) and curcumin (Cur), which are two medicinal herbs known for their antioxidant activities against damages induced by whole-body fractionated gamma irradiation. Exposure of rats to whole-body gamma irradiation induced a significant decrease in erythrocyte (RBC), leukocyte (WBCs), platelet count (Plt), hemoglobin concentration (Hb), hematocrit (Hct %), mean erythrocyte hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), and mean erythrocyte volume (MCV); a high increase in plasma thiobarbituric acid reactive substances (TBARS); a nonsignificant statistical decrease in the mean value of serum glutathione (GSH); a significant increase in plasma alanine transferase (ALT), aspartate transferase (AST), alkaline phosphates (ALP), serum total protein, serum total cholesterol levels, total triglycerides levels, high-density lipoprotein (HDL), and low-density lipoprotein (LDL) levels; and with marked histological changes and structural changes measured by Fourier transform infrared (FTIR). Applying both quercetin and curcumin pre- and postexposure to gamma radiation revealed a remarkable improvement in all the studied parameters. The cellular damage by gamma radiation is greatly mitigated by the coadministration of curcumin and quercetin before radiation exposure.

Synthesis, in vitro and in vivo antitumor and antiviral activity of novel 1-substituted benzimidazole derivatives.

A novel series of 5-nitro-1H-benzimidazole derivatives substituted at position 1 by heterocyclic rings was synthesized. Cytotoxicity and antiviral activity of the new compounds were tested. Compound 3 was more active than doxorubicin against A-549, HCT-116 and MCF-7. However, compound 3 showed no activity against human liver carcinoma Hep G-2 cell line. Compounds 9 and 17b (E) showed potency near to doxorubicin against the four cell lines. The acute toxicity of compound 9 on liver cancer induced in rats was determined in vivo. Interestingly, it showed restoration activity of liver function and pathology towards normal as compared to the cancer-bearing rats induced by DENA. Compounds 17a (Z), 17b (E) and 18a (Z) were the most promising compounds for their antiviral activity against rotavirus Wa strain.

The association of modic changes and chronic low back pain: A systematic review.

Background: Modic changes (MC) have been proposed as a cause of low back pain (LBP). However, the proposition remains controversial. There is uncertainty over the existence or degree of association between the two and whether, if there is an association, it is a causal relationship. Previous systematic reviews of the evidence have had methodological flaws. Aims: The aim was to synthesize the current evidence to test the hypothesis that there is an association between MC and LBP and if there is, to evaluate the strength of the association. Methods: MEDLINE, EMBASE, and CINAHL were searched for all studies up to 31 December 2018 for cohort, case-control, and cross-sectional studies. Screening, quality assessment, and data extraction were conducted by two independent reviewers. Quality was assessed using the Joanna Biggs Institute tools for observational studies. The clinical heterogeneity among these studies ruled out pooling so a narrative review was undertaken. Results: Fifteen studies met the inclusion criteria, varying in patient characteristics, characteristics of MC, coexisting spinal conditions, and outcomes. The quality of evidence was poor in six and moderate in seven. There was wide clinical heterogeneity amongst the studies. The inclusion ages varied from early teens to over 65s, pain duration varied from under 6 weeks to over three months, and characteristics of the MC chosen for the studies also differed. The results were inconsistent across the studies: the odds ratios varied from showing an inverse relationship [Kovacs] with an odds ratio 0.31 (95% confidence interval, 0.1-0.95) to a very strong positive association 121.4 (11.21-1315.08) [Nakamae]. There was no consistency in associations for: type of MC, lumbar levels affected, position in relation to the vertebra, and presence of co-existing spinal conditions. The associations were possibly spurious arising from potential biases suggested by incomplete reporting: publication bias, selective reporting, and post hoc analysis. Only one study at low risk of bias found a substantial association but it was a small study of a narrow group meaning its results may not be generalizable. Discussion: The inconsistency of findings and the possibility that they were spurious means that no conclusions can be drawn about an association between MC and LBP. Future research should be designed as prospective cohort studies with adherence to reporting guidelines pertaining to observational studies and to MRI. Currently, clinicians should not look for the presence or absence of MC to guide their management of patients with LBP.

Prevalence and determinants of normal, high-normal and high blood pressure and association with cardiovascular risk in Egypt.

Background: High-normal blood pressure (HNBP) has become associated with a 2-3-fold increase in the risk of developing hypertension. Cardiovascular diseases (CVDs) are independently linked to HNBP. Aims: To estimate the prevalence of HNBP, its predictors, and association with CVD risk among a country-representative sample of Egyptian adults. Methods: This study draws on data from the most recent Egyptian Health Issues Survey, and includes 13 983 adults aged 18-59 years. Sociodemographic data and anthropometric and blood pressure (BP) measurements were obtained, and the 10-year cardiovascular risk score was calculated using World Health Organization CVD risk charts for participants aged ≥ 40 years. Results: Overall, 15.31% and 21.0% of the study population had HNBP and hypertension, respectively. Compared to people aged 18-30 years, the odds of HNBP were 1.36, 1.67 and 2.39 among those aged 31-40, 41-50 and 51-59 years, respectively. The odds of HNBP were higher among male, overweight and obese adults, and patients with diabetes. The odds of HNBP and hypertension were higher among participants with high WHO CVD risk than those with low WHO CVD risk. Conclusion: HNBP is an alarming risk factor among Egyptian adults because it is strongly associated with CVD risk. Policy-makers should devise long-term, effective strategies for its prevention and control.

Inflammatory biomarkers and severity of COVID-19: Cross sectional study among Egyptian patients.

The newly emerging coronavirus disease 2019 (COVID-19) is characterized by multisystem inflammatory syndrome. The development of SARS-CoV-2 complications usually starts within few days following infection, and the severity of the disease determines its outcome. Vitamin D insufficiency is associated with risk of lung infections, also cell-based studies reported the ability of vitamin D to control enveloped virus growth. We aimed to investigate the relationship between the most eminent inflammatory biomarkers and the level of vitamin D aiming to provide a tool for early diagnosis and prediction of disease progression. The current study was approved by Research Ethics Committee (REC), Kasr Al-Ainy. After confirmation of being COVID-19 by PCR, the admitted patients were categorized as mild-moderate, and severe-critically ill based on clinical and radiologic data. The total levels of serum 25(OH)D, as well as other pro-inflammatory biomarkers were measured and were analyzed by receiver operating characteristic curve (ROC) analysis for detection of their association with COVID-19 disease severity and to determine their sensitivity and specificity at optimum cutoff points. The area under the curve (AUC) ROC for predicting COVID-19 disease severity was the highest (of 0.97) for vitamin D, inflammatory cytokines, liver enzymes, ferritin, and D-Dimer. In addition, high serum levels of creatinine, and elevated liver enzymes associated with severe-critical COVID-19. The low 25(OH)D was associated with the disease severity.

Effect of Patient Empowerment Model on Smoking Cessation: Randomized Controlled Trial.

BACKGROUND: Smoking is a preventable cause of chronic morbidity. Patient empowerment is a process through which people establish greater control over their health-related decisions and actions. To assess the effect of patient empowerment versus health education on the nicotine dependence score and progress of patients under different stages of smoking cessation. METHODS: This was a single-blinded randomized controlled clinical trial that included 76 smokers attending family medicine clinics. Participants were divided into two groups: empowerment and health education groups. Their nicotine-dependence score and smoking cessation stage were identified. All study participants were subjected to five health education sessions with a 3-month follow-up period. RESULTS: The mean nicotine-dependence score decreased significantly in both groups after the intervention. This decrease was slightly higher in the empowerment group; however, the difference was not statistically significant. After the intervention, 16.7% of the health education and 30.0% of the empowerment group transitioned from stage 1 to stages 2-4 of smoking cessation, with the change being statistically significant only in the empowerment group. There was no statistically significant difference in the number of study participants who stopped smoking between the health education and empowerment groups. CONCLUSION: Both the empowerment model and traditional health education have similar positive effects on decreasing the nicotine-dependence level. There was a significant improvement in the stage of change for patients under the empowerment model, although there was no statistically significant difference between the groups regarding the number of participants who stopped smoking.

House Officers' Choice of Family Medicine Specialty amid the Implementation of the New Universal Health Insurance Law.

BACKGROUND: The new Egyptian Universal Health Insurance Law is introduced through family-oriented primary health care. Increasing the number of recent graduates who specialized in family medicine is considered a national need to overcome family physicians' shortage. AIM: To explore the factors affecting the house officers' choice of Family Medicine as a future career amid the implementation of the new Universal Health Insurance Law in Egypt. METHODS: This is a cross-sectional study conducted on house officers during their training in Cairo university hospitals from the first of March 2020 to February 2021. The researchers offered an anonymous self-administered questionnaire to all house officers at the beginning of their 2-week family medicine training (1170 house officers). RESULTS: A total of 1052 completed the questionnaire (response rate 90%). Family medicine as a specialty was considered by 53.6% (n = 564) of participants, while only 23.4% (n = 246) of participants had an obvious intention to choose family medicine. Multivariate (adjusted) logistic regression model revealed that factors significantly associated with intention to choose family medicine were marital status, knowledge about governmental advantages for family medicine offered to the specialized recent graduates, and previously encountered with family practice as customers. CONCLUSIONS: The choice of family medicine specialty is increasing among house officers. This could be attributed to the growing interest in family medicine in Egypt, especially after implementing the new insurance law's first phase in several Egyptian governorates.

Psychoeducational Program for the Family Member Caregivers of People with Dementia to Reduce Perceived Burden and Increase Patient's Quality of Life: A Randomized Controlled Trial.

BACKGROUND: Dementia is one of the world's greatest public health issues. Most people with dementia receive home care, and family members are vulnerable to feeling burdened and depressed that reinforces the need for caregiver-driven services to mitigate these negative effects. OBJECTIVE: The purpose of this research was to evaluate the effect of the psychoeducational program on burden and quality of life of family caregivers for people with dementia. METHODS: This randomized controlled trial (RCT) was conducted on 60 family caregivers. Participants were randomly assigned to receive either the 8-session psychoeducational program (study group) or routine care only (control group). The demographic data of the caregivers and their patients, the burden of caregivers using Zarit Burden Interview (ZBI), and the quality of life of the patients using Quality of Life in Alzheimer Disease (QoL-AD) questionnaire were measured before and after the psychoeducational program and compared between the study group and the control group. RESULTS: The results revealed that 80% of the family caregivers were female and 42% were daughters. The mean ± SD of the baseline burden was 61 ± 13.7 and 60.9 ± 10 in the study and the control group, respectively. ZBI burden score in the study group demonstrated a significant drop after the psychoeducational program compared to the control group. Logistic regression analysis showed that caregivers who received the psychoeducational program have OR (95% CI) of 14 (3.1-67.8) compared to those who did not receive the psychoeducational program. CONCLUSIONS: Psychoeducational program is effective in reducing the family caregivers' perceived burden. These findings need to be considered in developing comprehensive dementia care programs to well increase the strategies that help caregivers to deal with their patients.

Prevalence and determinants of hypertension unawareness among Egyptian adults: the 2015 EHIS.

Hypertension (HTN) is a major cardiovascular risk factor that affects 1.3 billion people and accounts for 17.9 million deaths annually worldwide. Seventy-five percent of global deaths due to HTN occur in low- and middle-income countries where HTN prevalence is higher, and HTN control and population awareness are lower, than in high-income countries. Approximately 26% of Egyptian adults meet criteria for HTN, but the prevalence of HTN unawareness is unknown in this population. The purpose of this study was to assess prevalence and predictors of HTN unawareness among Egyptian adults. Using data from the 2015 Egyptian Health Issues Survey (EHIS), we identified 2869 participants 18-59 years of age whose blood pressure met criteria for HTN at the time of data collection. Our outcome of interest, hypertension unawareness, was indicated when a participant reported that they had not been diagnosed with HTN (despite meeting criteria). Descriptive statistics and multivariable logistic regression were performed to determine prevalence of, and risk factors for, HTN unawareness. Fifty-six percent of the sample were unaware of their HTN status. The odds of HTN unawareness were highest among participants 18-39 years old compared to those 40-59 years old (OR 1.91; 95% CI 1.48-2.47); males compared to females (OR 2.59; 95% CI 1.85-3.62); and never married compared to currently married participants (OR 1.96; 95% CI 1.19-3.24). Compared to those who had a college level education, the odds of HTN unawareness were highest among participants who had no education (OR 2.21; 95% CI 1.45-3.38). In addition, the odds of HTN unawareness were higher for participants who had a normal body mass index compared to those who were obese (OR 1.82; 95% CI 1.26-2.65); and those considered healthy compared to those who had at least one chronic illness (OR 4.53; 95% CI 3.29-6.24). Our findings indicate that more than half of Egyptian adults who meet criteria for HTN are unaware of their blood pressure status. Younger, healthier, and normal weight people-who are typically at lowest risk for HTN-appear mostly likely to be unaware of their HTN status. Less educated people are least likely to know their hypertensive status. This suggests the need for a targeted health education campaign and regular blood pressure screening in Egypt.

Promoting family practice-based model of care: the role of WHO's professional diploma in family medicine in the Eastern Mediterranean Region.

Strengthening Primary Health Care (PHC) through family practice-based model of care is an essential bedrock in achieving Universal Health Coverage (UHC), as called for in Sustainable Development Goal (SDG) 3, target 3.8. However, the shortage of family practitioners worldwide and in most countries of the Eastern Mediterranean Region (EMR) is a daunting challenge. The current production rate of family physicians in the EMR is around 700 annually, against the needed estimate of 21 000 physicians per year based on one family physician/1300 population and the current EMR population growth rate, which reflects the huge shortage of family physicians in the Region.

Perceived Stress Scale Among Adolescents with Polycystic Ovary Syndrome.

INTRODUCTION: Polycystic ovary syndrome (PCOS) is a common disorder that affects women during their reproductive age. Previous studies have suggested that PCOS may be linked to some mental disorders. AIM: The study aimed to estimate the perceived stress among adolescents with PCOS and investigate the relationship between PCOS symptoms and perceived stress scale (PSS) in adolescents. METHODS: This was a case control study with 72 participants (between 11 and 19 years); 36 adolescents with PCOS and 36 matched controls were recruited from family medicine and gynecological outpatient clinics at Cairo University hospitals. They participated in a structured interview using a pre-designed questionnaire. Full general examination was conducted, including anthropometric measures, acne staging, and hirsutism staging using the Ferriman-Gallwey score. We assessed the severity of stress over the previous month of interview using the 10-item perceived stress scale (PSS-10). RESULTS: There was a statistically significant difference in PSS scores among adolescents with and without PCOS; most cases with severe PSS scores were found to have PCOS. The mean score of PSS was higher in PCOS adolescents (20.416) than in the non-PCOS control group (18.8), but with no statistical significance. There was no significant correlation between the severity of PSS in PCOS adolescents and BMI, WC, acne or hirsutism severity; there was only weak positive correlation between PSS score and DBP (r=0.167). CONCLUSION: PCOS adolescents have higher incidence of severe perceived stress; however, degree of PSS was independent of BMI, WC, acne or hirsutism severity and shows only weak correlations with DBP. Our results urge the need for implementing a holistic approach that should include stress reduction programs to help adolescents get ready for their adult life.

Clinician's guide for the management and research of osteoporosis in North African men: a guidelines comparison, a cost-effectiveness analysis, and a local algorithm.

A local management algorithm and practice recommendations for the management of osteoporosis in Egyptian males were developed after assessing the applicability of current international recommendations and the cost effectiveness of local drugs. A systematic review and sensitivity analyses augmented the quality of the research efforts. PURPOSE: Osteoporosis affects both men and women; however, no local recommendations for the condition are available for the male population. Therefore, this study was undertaken to produce recommendations for men based on the applicability of current international recommendations and the cost effectiveness of local drugs. METHODS: The International Osteoporosis Foundation website, EMBASE, and SUMSEARCH-2 databases were searched to identify all guidelines that included recommendations for males. Regional and international guidelines were then appraised using the Advancing Guideline Development, Reporting, and Evaluation in Healthcare-II tool. A cost-effectiveness analysis was conducted using the perspective of an uninsured patient, international outcomes, and local costs. Recommendations were then formulated using the Grading of Recommendations Assessment, Development and Evaluation guidelines, and symbolic representations. RESULTS: Twenty-six guidelines were found. Only one of the guidelines focused entirely on males, with the remainder making inferences based on recommendations for females. Six regional guidelines were mainly of low quality. Alendronate was considered to be the most cost-effective drug, while teriparatide was found to be unaffordable. CONCLUSION: Recommendations for men with osteoporosis are based on that of women, and the topic lacks exploration in the Middle East. International recommendations and other guidelines were evaluated and adopted to create guidance for the management of osteoporosis in men for application in Egypt.

Taurine abates the liver damage induced by γ-irradiation in rats through anti-inflammatory and anti-apoptotic pathways.

BACKGROUND: Radiotherapy is the most common regimen for treating human cancers; however, ionizing radiation (IR) has hazardous effects on metabolically active organs such as the liver. AIM: This study aimed to investigate the possible protective (prophylactic and therapeutic) action of taurine against liver damage induced by gamma irradiation at different time intervals as well as the mechanisms by which taurine could provide its potential amelioration actions. METHODS: In this study, 90 adult male rats (∼150 g) were randomly divided into five groups. Group 1 is the control group, group 2 received an oral daily dose (500 mg/kg) of taurine for two weeks, group 3 was exposed to a whole-body single dose of γ-irradiation (6 Gy), and groups 4 and 5 received taurine before or after γ-irradiation, respectively. Six rats from each group were sacrificed after 1, 2, and 3 weeks. RESULTS: Over the period of the 3 weeks studied, there were significant increases in MDA, NO, TNF-α, and cytochrome-c levels and ALT, caspases-9 and -3 activities and significant decreases in GSH, SOD, CAT, and GPx in the irradiated group when compared with the relevant control. The liver of irradiated rats showed dilatation in the central and portal veins, edema, and degenerated hepatocytes. CONCLUSIONS: Taken together, IR caused maximum devastation in the liver 2 weeks after exposure as shown by elevation of the inflammatory and apoptotic markers and reducing the antioxidants. Taurine was able to alleviate the deleterious biochemical and histological effects whether given before or after IR. The magnitude of the observed protective effects was in both cases very similar.

Association of Vitamin D Deficiency with Chronic Stable Angina: A Case Control Study.

INTRODUCTION: Coronary heart disease is a major cause of death worldwide. Although the relationship between vitamin D status and cardiovascular diseases is not clearly understood, vitamin D deficiency could be a potentially modifiable and underestimated risk factor for ischemic heart diseases. This study aims to assess and compare vitamin D status between patient group with chronic stable angina and matched control group. METHODS: A case-control study was conducted on chronic stable angina patients and matched controls attending family medicine/internal medicine clinics at Cairo University Hospitals. Forty two adult patients with chronic stable angina and forty two matched controls were studied. Detailed medical history, examination, and laboratory tests (vitamin D, fasting lipid profile, and blood sugar) were collected from study participants of both groups. RESULTS: Severe vitamin D deficiency was found in 78.6% and 7.1% of cases and controls, respectively. Vitamin D level was found to be a significant predictor of chronic stable angina. Every unit (ng/ml) increase in vitamin D level decreases the chance of the subject to have chronic stable angina by 0.30 times. CONCLUSION: There is a significant association between vitamin D deficiency and the occurrence of chronic stable angina.

Effect of patient education on metabolic syndrome components among females in Zagazig University outpatient clinics, Egypt: An intervention study.

BACKGROUND: Metabolic syndrome (MS) is a major health problem worldwide. This study aimed to assess the effectiveness of lifestyle modification regarding MS components among adult females. METHODS: An intervention study performed on 120 adult females with MS (60 intervention and 60 controls) selected randomly from Zagazig University outpatient clinics. Intervention group received patient education program while controls received traditional management. MS components were compared with three months interval representing Pre-Post follow up results. RESULTS: Two groups showed significant improvement in all MS components but mean change was significantly higher in intervention group. Three months follow up demonstrated that 63.4% of intervention group had reversal of their MS versus 15% of control group. CONCLUSION: Patient education improved all MS components and considered significantly more effective than traditionally adopted management. So, we recommend its application on all MS patients.

Taurine provides a time-dependent amelioration of the brain damage induced by γ-irradiation in rats.

Exposure to ionizing radiation (IR) is inevitable since over 80% of total average exposure comes from natural sources. Brain is vulnerable to the deleterious effects of IR. Therefore, scientists paid attention in identifying novel compounds to protect against radiation-induced brain injury. Adult male albino rats weighing 120-150 g were divided into five groups, 18 rats each. Group 1 served as control, group 2 received an oral daily dose of taurine (500 mg/kg) for 2 weeks. Group 3 was exposed to a whole body single dose of γ-irradiation (6 Gy). Groups 4 and 5 received taurine before and after γ-irradiation, respectively. Six rats from each group were sacrificed after 1, 2 or 3 weeks. Throughout the 3 weeks studied, there were significant increases in MDA, NO, TNF-α levels, and Cytochrome-c and activities of Caspases -9 and -3 and significant decreases in GSH, SOD, CAT and GPx in the irradiated group when compared with the relevant control. Cerebral cortex of irradiated rats showed vacuolization and nuclear pyknosis in the neuronal cells and focal gliosis. Taurine administration pre- or post-irradiation significantly ameliorated all these previous effects. Taurine had antioxidant, anti-inflammatory, and anti-apoptotic effects and ameliorated the histopathological changes in brain in a time-dependent mode.

Isolation of a new trypsin inhibitor from the Faba bean (Vicia faba cv. Giza 843) with potential medicinal applications.

A new 15-kDa Bowman-Birk type trypsin inhibitor (termed VFTI-G1) was isolated from the seeds of Faba bean (Vicia faba cv. Giza 843) using cation exchange chromatography on an SP-Sepharose column, anion exchange chromatography on Q-Sepharose and Mono Q columns, and finally size exclusion chromatography on a Superdex 75 column. VFTI-G1 manifested significant antiproteolytic activity against trypsin (5761 BAEE units/mg, K(i) 20.4 × 10(-9) M), but only a slight chymotrypsin inhibitory activity (< 10 BTEE units/mg). The suitable environment to sustain its trypsin inhibitory activity was at temperatures below 60 °C and at pH 7. Its trypsin inhibitory activity was inhibited by the reducing agent dithiothreitol in a dose-dependent manner, indicating the significance of intact disulfide bonds to the trypsin inhibitory activity. It inhibited HIV-1 reverse transcriptase (RT) activity with an IC(50) of about 0.76 µM. Furthermore, VFTI-G1 showed specific antiproliferative activity toward HepG2 hepatoma cells by inducing chromatin condensation and cell apoptosis. The HIV-1 RT inhibitory activity of VFTI-G1 and its specific antiproliferative activity toward Hep G2 cells may find medical applications.

Purification and modes of antifungal action by Vicia faba cv. Egypt trypsin inhibitor.

A new 15 kDa Bowman-Birk type trypsin inhibitor (termed VFTI-E1) from fava beans (Vicia faba cv. Egypt 1) was isolated using liquid chromatography. Though it exhibited substantial homology in N-terminal amino acid sequence to other protease inhibitors, VFTI-E1 showed antiproteolytic activity against trypsin (K(i) 11.9 × 10(-9) M) but hardly any activity against chymotrypsin. It demonstrated antifungal activity toward the filamentous fungus Valsa mali with an IC(50) of 20 µM. The mechanism of its antifungal action toward V. mali included (1) induction of alteration of hyphal morphology, (2) growth inhibition by chitin deposition at hyphal tips, and (3) permeabilization of fungal membrane. The antifungal activity of VFTI-E1 was dependent on the ambient ionic strength as increasing concentrations of NaCl, CaCl(2), and MgCl(2) diminished the activity. The membranolytic action of VFTI-E1 was confined to fungus, but not exerted on human and rabbit erythrocytes. This study sheds light on the mode of hyphal growth inhibitory activity of protease inhibitors with antifungal activity. The antifungal activity of VFTI-E1 amplifies the scope of its potential applications.