Characterization and antimicrobial activity of a chitosan-selenium nanocomposite biosynthesized using Posidonia oceanica.

Nanobiotechnological approaches can provide effective solutions for overcoming food products' contamination and spoilage. The development of rapid and eco-friendly approaches for synthesizing nanocomposites from chitosan nanoparticles (Cht), Neptune grass "Posidonia oceanica" extract (NG), and NG-mediated selenium nanoparticles (SeNPs) was targeted, with their investigation as potential antimicrobial, antioxidant, and biopreservatives of fresh chicken fillets. SeNPs were biosynthesized with NG, and their conjugates with Cht were composited. Characterization approaches, including infrared analysis, physiognomic analysis, and electron microscopy of synthesized nanomaterials and composites, were applied. The nanomaterials' antibacterial properties were assessed against Staphylococcus aureus, Salmonella typhimurium, and Escherichia coli qualitatively, quantitatively, and with ultrastructure imaging. The antimicrobial and antioxidant potentialities of nanomaterials were employed for preserving chicken fillets, and the sensorial and microbiological parameters were assessed for coated fillets. SeNPs were effectively biosynthesized by NG, with mean diameters of 12.41 nm; the NG/SeNPs had homogenous spherical shapes with good distribution. The prepared Cht/NG/SeNPs nanoconjugates had a mean diameter of 164.61 nm, semi-spherical or smooth structures, and charges of +21.5 mV. The infrared analyses revealed the involvement of biochemical groups in nanomaterial biosynthesis and interactions. The antibacterial actions of nanomaterials were proven against the entire challenged strains; Cht/NG/SeNPs was the most active agent, and Salmonella typhimurium was the most susceptible bacteria. Scanning micrographs of Cht/NG/SeNPs-treated Staphylococcus aureus and Salmonella typhimurium indicate the severe time-dependent destruction of bacterial cells within 8 h of exposure. The antioxidant potentiality of Cht/NG/SeNPs was the highest (91.36%), followed by NG/SeNPs (79.45%). The chicken fillets' coating with Cht, NG, NG/SeNPs, and Cht/NG/SeNPs resulted in a remarkable reduction in microbial group count and raised the sensorial attributes of coated fillets after 14 days of cold storage, with increased potentialities in the order: Cht/NG/SeNPs > NG/SeNPs > NG > Cht > control. The inventive, facile biosynthesis of Cht, NG, and SeNPs could provide effective antimicrobial and antioxidant nanocomposites for prospective applications in food biopreservation.

Toward Scaling up the Production of Metal Oxide Nanoparticles for Application on Washable Antimicrobial Cotton Fabrics.

To examine the utilization of metal oxide nanoparticles (NPs) in different commercial products, this work focuses on the determination of cost-effective and scalable synthesis protocols. The solvothermal protocol is well-known as a scalable method but has recently been shown to lack economic feasibility. The mechanochemical method has recently been recognized to be a more economic and environmentally friendly substitute for the solvothermal method. In this study, zinc oxide nanoparticles (ZnO NPs) and copper oxide nanoparticles (CuO NPs) were synthesized using two (aqueous and organic) solvothermal (wet) methods and two (manual and automated) mechanochemical (dry) methods. The four methods were evaluated and compared. The automated mechanochemical method generated a significantly higher yield of ZnO NPs (82%) and CuO NPs (84%) using the least energy and time. However, the prepared ZnO NPs displayed higher cytotoxicity against Vero E6 cells when compared to that of CuO NPs. Because of their low cytotoxicity, CuO NPs synthesized via the automated mechanochemical method were selected for application onto cotton fabrics. Lower cytotoxicity was observed for CuO NPs treated fabrics with an IC50 of 562 mg/mL and ZnO treated fabrics with an IC50 at 23.93 mg/mL when the treated fabrics were tested against L929 fibroblast cells. Additionally, the cotton fabrics retained bactericidal and virucidal effects after four washes. Thus, the current study recommends the automated mechanochemical method as a cost-effective scalable approach for the synthesis of CuO NPs. The application of CuO NPs onto cotton fabrics generated washable antimicrobial face masks.

Intravenous Carbetocin Versus Rectal Misoprostol for the Active Management of the Third Stage of Labor: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Globally, postpartum hemorrhage (PPH) is the top cause of maternal death. Multiple uterotonic medications are available to prevent PPH; however, it is still unclear whether one is the most effective. The current study compared the efficacy and safety of intravenous carbetocin with rectal misoprostol for the active management of the third stage of labor in order to prevent PPH. Eligible studies were found utilizing digital medical sources, including the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science (WOS), PubMed, Scopus, and Google Scholar, from inception until September 2022. Only randomized controlled trials (RCTs) that matched the inclusion requirements were chosen. We used the Cochrane Risk of Bias scale (version 2) to assess the quality of the included studies. The Review Manager (version 5.4 for Windows) was used to conduct the meta-analysis. The results were summarized as mean difference (MD) or risk ratio (RR) with a 95% confidence interval (CI) in fixed- or random-effects models according to the degree of between-study heterogeneity. Collectively, we screened 621 articles after omitting duplicates and eventually included three RCTs for analysis. Overall, 404 patients were included in these studies; 202 patients were allocated to the intravenous carbetocin group whereas 202 patients were allocated to the rectal misoprostol group. Two RCTs were judged as "low" risk of bias, whereas one RCT was judged as having "some concerns" regarding the quality assessment. Regarding efficacy endpoints, the intravenous carbetocin group had significantly lower blood loss (n=3 RCTs, MD=-117.74 mL, 95% CI [-185.41, -50.07], p<0.001), need for additional uterotonics (n=2 RCTs, RR=0.06, 95% CI [0.01, 0.46], p=0.007), need for uterine massage (n=2 RCTs, RR=0.40, 95% CI [0.20, 0.80], p=0.009), and need for blood transfusion (n=2 RCTs, RR=0.38, 95% CI [0.15, 0.95], p=0.04) compared with the rectal misoprostol group. Regarding safety endpoints, the rates of diarrhea (n=3 RCTs, RR=0.18, 95% CI [0.06, 0.55], p=0.003) and chills (n=2 RCTs, RR=0.31, 95% CI [0.12, 0.83], p=0.02) were significantly lower in the intravenous carbetocin group compared with the rectal misoprostol group. However, there was no significant difference between both groups regarding the rates of headache (n=3 RCTs, RR=1.23, 95% CI [0.06, 1.91], p=0.35) and facial flushing (n=2 RCTs, RR=0.88, 95% CI [0.46, 1.68], p=0.70). In conclusion, it was discovered that intravenous carbetocin was a superior substitute for rectal misoprostol for the active management of the third stage of labor. With far fewer side effects, intravenous carbetocin decreased postpartum blood loss and further uterotonic use. For women who have a high risk of PPH, intravenous carbetocin is advised.

Efficacy of High-Dose Vitamin C Infusion on Outcomes in Sepsis Requiring Mechanical Ventilation: A Double-Blind Randomized Controlled Trial.

Background: Critically ill patients have an increased requirement for vitamin C in sepsis and these patients have low levels of vitamin C. The researchers validated the efficacy of high-dose vitamin C intravenous infusion (IVI) in patients with sepsis requiring mechanical ventilation. Methods: Forty patients were randomly assigned to 2 groups (20 each) in a 1 : 1 ratio in accordance with the vitamin C treatment regimen: Group I (GI): patients received 1.5 g/6 h vitamin C in 50 ml of dextrose 5% in water (D5W) IVI over 30 minutes for 4 consecutive days; Group II (GII): patients received 100 mg vitamin C/day as a first single dose in 50 ml of D5W IVI over 30 minutes and the other three subsequent doses were 50 ml of plain D5W IVI over 30 minutes for 4 consecutive days. Primary outcomes were the change in sequential organ failure assessment (SOFA) score at day 7, the incidence of ventilator-associated pneumonia (VAP), and the plasma vitamin C level. The glutathione peroxidase (GPX) activity, C-reactive protein (CRP) level, duration of vasopressor therapy, and 28-day mortality were secondary outcomes. Results: The change in SOFA score at day 7 showed a significant difference between GI and GII (p < 0.001). The incidence of early VAP was significantly lower in GI (p=0.044). Vitamin C levels showed a significant rise in GI at day 1 and day 4 (p < 0.001 and p < 0.001, respectively). GPX activity of day 4 and day 7 was significantly higher in GI (p=0.005 and p=0.014, respectively). CRP levels of day 4 and day 7 were significantly higher in GII (p < 0.001 and p < 0.001, respectively). There was a significant difference in 28-day mortality (p=0.038) and duration of vasopressor therapy (p=0.033) in GI compared to GII. Conclusion: The early use of high-dose vitamin C intravenous infusion in patients with sepsis requiring mechanical ventilation in combination with the standard treatment for sepsis lowered the incidence of VAP, increased the antioxidant status, and improved the illness severity. Trial Registration. This trial is registered with ClinicalTrials.gov Identifier (NCT04029675).

Wet Electrospun Nanofibers-Fortified Gelatin/Alginate-Based Nanocomposite as a Single-Dose Biomimicking Skin Substitute.

We report the development and evaluation of a series of well-designed single-dose extracellular matrix (ECM)-mimicking nanofibers (NFs)-reinforced hydrogel (HG)-based skin substitute for wound healing. The HG matrix of the proposed skin substitute is composed of gelatin (GE) and sodium alginate (SA), and incorporates hyaluronic acid (HA) as a key component of the natural ECM, as well as the antimicrobial Punica granatum extract (PE). This HG nanocomposite was cross-linked by the biocompatible N-(3-(dimethylamino)propyl)-N'-ethylcarbodiimide hydrochloride (EDC) cross-linker, and was reinforced with fragmented trans-ferulic acid (FA)-loaded cellulose acetate/polycaprolactone (PCL/CA) NFs. The NFs were obtained via wet electrospinning into a poly(vinyl alcohol) (PVA) coagulating solution to closely resemble the porous structure of the ECM fibers, which facilitates cell migration, attachment, and proliferation. The proposed design of the skin substitute allows adjustable mechanical characteristics and outstanding physical properties (swelling and biodegradability), as well as an excellent porous microstructure. The developed skin substitutes were characterized using Fourier transform infrared (FTIR) spectroscopy, differential scanning calorimetry (DSC), and electron microscopy. In addition, the biodegradability, biocompatibility, bioactivity, mechanical, and in vitro drug release characteristics were investigated. Moreover, an in vivo excisional full-thickness defect model was conducted to assess skin regeneration and healing effectiveness. The average diameters of the plain and FA-loaded NFs are 210 ± 12 nm and 452 ± 25 nm, respectively. The developed ECM-mimicking skin substitutes demonstrated good antibacterial activity, free-radical scavenging activity, cytocompatibility, porosity, water absorption ability, and good biodegradability. In vivo application of the ECM-mimicking skin substitutes revealed their excellent wound-healing activity and their suitability for single-dose treatment of deep wounds with reducing the wound diameter to 0.95 mm after 15 days of treatment. Moreover, the histological investigation of the wound area demonstrated that the applied skin substitutes have not only enhanced the wound healing progress, but also can participate in improving the quality of the regenerated skin in the treated area via facilitating collagen fibers regeneration and deposition.

Not Telling Patients Their Cancer Diagnosis in Egypt: Is It Associated With Less Anxiety and Depression and Better Quality of Life?

PURPOSE: In many countries, including Egypt, it is still believed that not telling patients their cancer diagnosis is associated with less psychological morbidity. This study was conducted to explore whether not telling Egyptian patients their cancer diagnosis is associated with less anxiety and depression and better quality-of-life (QoL) or not. METHODS: A cross-sectional observational study was conducted in two Egyptian cancer care facilities and included 292 adult patients with cancer of whom 197 (67%) were aware of their diagnosis and 95 (33%) were unaware. The Hospital Anxiety and Depression Scale (HADS) was used to assess anxiety and depression and the Functional Assessment of Cancer Therapy-General 7 questionnaire to assess QoL. RESULTS: Patients unaware of their cancer diagnosis were significantly more likely to be less educated, with no family history of cancer, interviewed within 6 months of cancer diagnosis, diagnosed with a cancer other than breast and colorectal cancer, in a poorer performance status, and with no history of anticancer treatment. There was no significant difference between unaware and aware patients in the scores of HADS-Anxiety (median [interquartile range (IQR)] = 6 [3-11] and 7 [4-11], P = .203), HADS-Depression (median [IQR] = 8 [4-12] and 8 [4-11], P = .64), and Functional Assessment of Cancer Therapy-General 7 (median [IQR] = 16 [12-20] and 16 [11-21], P = .754). In multiple regression analysis with adjustment, diagnosis unawareness did not associate significantly with anxiety, depression, and QoL (P = .394, .662, and .845, respectively). CONCLUSION: The results of the current study confirm that not telling adult patients their cancer diagnosis is not associated with less anxiety and depression nor better QoL.

Antifungal application of biosynthesized selenium nanoparticles with pomegranate peels and nanochitosan as edible coatings for citrus green mold protection.

BACKGROUND: Citrus production and trading are seriously affected by fungal decays worldwide; the green mold infection by Penicillium digitatum could be the most disastrous. The substitutions of chemical and synthetic fungicides with effectual natural alternatives are global demands; plant extract from pomegranates peels (PPE), biosynthesized selenium nanoparticles with PPE (PPE/SeNPs) and chitosan nanoparticles (NCT) were suggested as efficacious fungicidal agents/nanocomposites to control P. digitatum strains. METHOD: PPE from Punica granatum was extracted and employed directly for synthesizing SeNPs, whereas NCT was produced using ionic gelation method of chitosan extracted from white prawn (Fenneropenaeus indicus) shells. The physiochemical, biochemical and structural characterization of generated molecules were conducted using infra-red spectroscopy, particles' size (Ps) and charge assessment and electron microscopes imaging. Antifungal potentialities were investigated in vitro and in infected fruits with P. digitatum by applying NCT nanocomposites-based edible coating. RESULTS: The synthesis of PPE-synthesized SeNPs and NCT was successfully achieved, the molecular bonding in synthesized agents/composites were proved with infrared spectroscopy to have both biochemical and physical interactions. The nanoparticles had 82.72, 9.41 and 85.17 nm mean diameters for NCT, PPE/SeNPs and NCT/PPE/SeNPs nanocomposites, respectively. The nanoparticles had homogenous spherical shapes and good distribution attributes. The entire agents/nanocomposites exhibited potent fungicidal potentialities toward P. digitatum isolates; NCT/PPE/SeNPs nanocomposite was the most forceful and significantly exceeded the fungicidal action of standard fungicide. The direct treatment of fungal mycelia with NCT/PPE/SeNPs nanocomposite led to remarkable lysis and deformations of P. digitatum hyphae within 12 h of treatment. The coating of infected orange with NCT-based edible coatings reduced the green mold infection signs by 91.7, 95.4 and 100%, for NCT, NCT/PPE and NCT/PPE/SeNPs based coating solutions, respectively. CONCLUSIONS: NCT, PPE-synthesized SeNPs, and their innovative nanocomposites NCT/PPE/SeNPs are convincingly recommended for formulating effectual antifungal and edible coatings to eliminate postharvest fungal pathogen, both with protection from their invasion or with destructing their existing infections.

Manifestation of the Jahn-Teller effect subject to quadraticT⊗e+t2problem in ultrasonic attenuation. Case study of CaF2:Cr crystal with isovalent and aliovalent substitution.

A new approach is introduced to obtain information about the adiabatic potential energy surface of the Jahn-Teller (JT) complexes subject to theT⊗e+t2problem in doped crystals. It employs simulation of the contribution of the JT sub-system to ultrasonic attenuation with account of three mechanisms of relaxation and subsequent comparison with the experimental data on temperature dependence of the attenuation obtained with the use of doped crystal and nominally pure one. The approach has been applied to the CaF2crystal doped with chromium. The experiment has been carried out at the frequencies of (13-158) × 106Hz at low temperatures (4-170 K). Peak for all the ultrasonic normal modes propagating along the [110] axis has been observed at about 8 K. It has been considered as the JT effect manifestation by the sub-system of Cr2+F8-complexes. Symmetry properties of the global minima and saddle points have been identified, the JT stabilization energies and coordinates of the extrema points in the five-dimensional space of symmetrized displacements have been evaluated. Besides, a broad shoulder has been found at 15-40 K and attributed to contribution of the Cr3+F8-sub-system.

Diagnosis Disclosure Preferences of Cancer Patients in Egypt: A Multi-Institutional Cross-Sectional Study.

BACKGROUND: Although diagnosis disclosure to cancer patients has important roles in cancer care, it is not a routine practice in countries like Egypt. Respecting patients' autonomy and responding to their preferences are among the factors that should guide the practice of cancer diagnosis disclosure. OBJECTIVES: To assess the preferences of Egyptian cancer patients regarding the disclosure of cancer diagnosis and to determine factors that may affect their preferences. METHODS: The study included 295 patients aware of their cancer diagnosis from 3 cancer care facilities in Egypt. Patients were asked if they would have preferred to be informed of the diagnosis or not, whom they would have preferred to receive the diagnosis information from, and if they would have preferred to tell their families or not. RESULTS: The vast majority (91%) of the included patients preferred to be informed about their diagnosis, 59% preferred to disclose the diagnosis to their families and 66% preferred to receive the diagnosis information from a physician. In univariate analysis, male gender, higher education level and employment were significantly associated with the preference for disclosure. None of the studied variables associated significantly with the preferences in multivariate analysis. CONCLUSION: The majority of Egyptian cancer patients in our study preferred to be informed about their diagnosis, which should be respected. The results may help in changing the diagnosis disclosure practice of health care professionals and refuting the misconception of family caregivers about cancer diagnosis disclosure in Egypt and countries with similar culture.

SUBJECTIVE AND CLINICAL OUTCOMES OF SURGERY FOR CORRECTION OF RHEUMATOID FOREFOOT DEFORMITIES.

Hoffmann-Clayton procedures appears to be promising surgical treatment in severe rheumatoid forefoot deformities. It has been reported that 80% to 90% of foot deformities in adults are due to rheumatoid arthritis. Despite of various surgical approaches, early functional and cosmetic results have been the greatest concern among patients. Thus, optimal surgical approach in correction of severe rheumatoid forefoot deformities is of vital importance for better subjective and clinical results. Clinical study was conducted on 56 painful chronic rheumatoid foot who were treated by arthrodesis of 1st metatarsophalangeal (MTP) and lesser metatarsal head resections. They were divided into 2 groups based on surgical approach in lesser metatarsal head resections. 1st group had 25 feet with dorsal approach (Clayton) and 2nd group - 31 feet with plantar approach (Hoffmann). Subjective and clinical outcomes were evaluated in both groups. The mean post-operative AOFAS scores were 67.82 (range: 32 - 82) and mean post-operative Foot Function Index (FFI) was 0.51 (range: 0.23 to 0.63) in both groups. Eighty seven percent (48/56 feet) reported early pain relief, improved cosmetic appearance, and improved footwear comfort in Hoffmann group. The mean hallux valgus angles improved from 37 to 15 degrees and the 1st intermetatarsal angle from 17 to 8 degrees in both groups. Four feet had non-union of the 1st MTP joint arthrodesis and three among them were re-operated. Hoffmann and Clayton procedures are optimal methods for excision arthroplasty of lesser metatarsal heads. However, Hoffmann (plantar approach) serves to be more convenient resulting in early recovery, adequate functional stability, rehabilitation and better cosmetic results.

Mental Well-Being and Self-Efficacy of Healthcare Workers in Saudi Arabia During the COVID-19 Pandemic.

PURPOSE: To assess mental well-being (MW), self-efficacy (SE), and their predictors among healthcare workers (HCWs) in Saudi Arabia during the COVID-19 pandemic. METHODS: Analytical cross-sectional study recruited 1046 HCWs by cluster random sampling technique. Socio-demographic, health, and occupational characteristics were collected for all participants. The WHO five Well-Being Index (WHO-5) and General Self-Efficacy Scale (GSES) were used to assess MW and SE of the participants, respectively. The binary logistic regression model was fit to the dependent (outcomes), namely mental well-being and self-efficacy, and independent other variables (predictors). RESULTS: Out of all participants (n=1046), 27.2% had negative MW scores, and 36.6% had low SE scores. The mean scores of both MW and SE were in the normal levels (16.7±5.90 and 31.5±6.63 out of 25 and 40, respectively). Younger and older ages, irregular exercise, nursing professions, history of anxiety and/or depression, lesser years of experience, and longer daily working hours were found to be the main predictors of negative MW and low SE, among study participants. CONCLUSION: Mental well-being (MW) and self-efficacy (SE) of the HCWs in Saudi Arabia are satisfactory but attention should be paid towards supporting the vulnerable groups for promoting the resilience of HCWs during the battle against the current pandemic.

Fear of COVID-19 and Stress-Relieving Practices Among Social Media Users, Makkah Region, Saudi Arabia.

Background The ongoing COVID-19 pandemic and its associated consequences can trigger feelings of fear, concern, and anxiety among the population, leading to unfavorable consequences on mental health. This study aimed to assess fear of COVID-19 and stress-relieving practices among social media users in the Makkah region, Saudi Arabia. Methods A cross-sectional analytic study was conducted among 532 adults inhabiting the Makkah region of Saudi Arabia over a period of one month, from June 15 to July 15, 2020. A predesigned, self-administered questionnaire, including assessments of fear of COVID-19 and stress-relieving practices, was used for data collection. Results The mean Fear of COVID-19 Scale score was 17.3±5.21 out of 35. Individuals aged 30-49 years and married individuals had higher mean scores (18.4±5.20 and 18.4±5.29, respectively) compared to other groups (p<0.05). Additionally, individuals with histories of anxiety and depression, individuals suffering from chronic diseases, and those who did not exercise regularly had higher levels of fear compared to other groups (p<0.05). Practicing religious and spiritual rituals was the most commonly adopted stress-relieving practice among study participants (68.6%). Conclusion Adults in Saudi Arabia have considerable levels of fear of COVID-19. Special attention is recommended for highly susceptible groups. Additionally, mental health education programs are recommended for the promotion of the community's psychological resilience in such a global crisis. Spiritual aspects should be included in such mental health education programs.

Mirtazapine in Cancer-Associated Anorexia and Cachexia: A Double-Blind Placebo-Controlled Randomized Trial.

CONTEXT: Few pharmacological interventions are available for cancer-associated anorexia and cachexia. Mirtazapine has been suggested for use in cancer-associated anorexia and cachexia. OBJECTIVES: This study was conducted to assess the efficacy and tolerability of mirtazapine in cancer-associated anorexia and cachexia. METHODS: A double-blind placebo-controlled randomized trial. The study included 120 incurable solid tumour patients with anorexia (appetite loss ≥4 on 0 - 10 scale, 10 = maximum appetite loss), cachexia (>5% body weight loss over 6 months or >2% plus body mass index <20) and depression score ≤3 on 0-6 scale (6 = extreme feelings of depression). Patients were 1:1 randomized to receive mirtazapine 15mg daily at night for 8 weeks or placebo. The primary endpoint was change in appetite from baseline to day 28. Other outcomes included changes in quality-of-life, fatigue, depressive symptoms, body weight, lean body mass, handgrip strength, inflammatory markers, adverse events and survival. RESULTS: 48 (80%) patients in the mirtazapine arm and 52 (87%) in the placebo were assessable for the 1ry endpoint. Appetite score increased significantly with mirtazapine as well as with placebo (P < 0.0001 each). The increase in appetite score did not differ significantly between the two arms in the per-protocol and intention-to-treat analysis (P = 0.472 and 0.462, respectively). Mirtazapine was associated with significantly less increase in depressive symptoms and higher prevalence of somnolence. The change in other outcomes did not differ significantly between mirtazapine and placebo. CONCLUSION: Mirtazapine 15mg at night for 28 days is no better than placebo in improving the appetite of incurable solid tumor patients with cancer-associated anorexia and cachexia.

Development of a silk fibroin-based multitask aerosolized nanopowder formula for efficient wound healing.

Most of the spray products in the market for wound healing applications are loaded with antibiotics that exert their antibacterial effect within the inflammatory stage of wound healing without demonstrating any effect in the subsequent proliferation stage. This study introduces a new aerosolized nanopowder (ANP) formula that not only exhibits antibacterial effect but also antioxidant and enhanced cell proliferation effects. Within the introduced ANP formula, Avicenna marina (Am) extract and neomycin (NM) antibiotic have been loaded within silk-fibroin nanoparticles (FB NPs). The Am has been extracted via different solvent systems, and investigated for its antioxidant and antibacterial activity as well as its ability to enhance cell proliferation. The physicochemical properties, size, zeta-potential and morphology of the prepared Am/FB NPs, NM/FB NPs and ANP formula were investigated. Besides, the ANP formula exhibited good antibacterial activities against Staphylococcus aureus, Methicillin resistant S. aureus, Pseudomonas aeruginosa and Resistant P. aeruginosa. Scratch wound healing assay on human fibroblast monolayers demonstrated 100% wound closure after 24 h upon using the ANP formula as compared to 70% wound closure for positive control (NM). The wound healing ability of the ANP formula has been further confirmed by histopathological evaluation of the wound site and depicted a marked increase in fibroblast proliferation and reduction of inflammatory cells after 15 days with a complete wound closure as compared to controls. The obtained results prove the beneficial effects of the Am extract on wound healing and introduce the developed multitask nanopowder formula as a potential wound healing spray.

Recent Advances in the Regenerative Approaches for Traumatic Spinal Cord Injury: Materials Perspective.

Spinal cord injury (SCI) is a devastating health condition that may lead to permanent disabilities and death. Understanding the pathophysiological perspectives of traumatic SCI is essential to define mechanisms that can help in designing recovery strategies. Since central nervous system tissues are notorious for their deficient ability to heal, efforts have been made to identify solutions to aid in restoration of the spinal cord tissues and thus its function. The two main approaches proposed to address this issue are neuroprotection and neuro-regeneration. Neuroprotection involves administering drugs to restore the injured microenvironment to normal after SCI. As for the neuro-regeneration approach, it focuses on axonal sprouting for functional recovery of the injured neural tissues and damaged axons. Despite the progress made in the field, neural regeneration treatment after SCI is still unsatisfactory owing to the disorganized way of axonal growth and extension. Nanomedicine and tissue engineering are considered promising therapeutic approaches that enhance axonal growth and directionality through implanting or injecting of the biomaterial scaffolds. One of these recent approaches is nanofibrous scaffolds that are used to provide physical support to maintain directional axonal growth in the lesion site. Furthermore, these preferable tissue-engineered substrates can afford axonal regeneration by mimicking the extracellular matrix of the neural tissues in terms of biological, chemical, and architectural characteristics. In this review, we discuss the regenerative approach using nanofibrous scaffolds with a focus on their fabrication methods and their properties that define their functionality performed to heal the neural tissue efficiently.

The ameliorative effect of curcumin extract on the morphological and skeletal abnormalities induced by sunset yellow and tartrazine in the developing chick embryo Gallus domesticus.

Previous studies have suggested that food dyes are responsible for causing number of health problems. The study under consideration aims to show the possible morphological and skeletal malformation induced due to in ovo administration of sunset yellow (SY) and tartrazine (Tz) with or without curcumin (Cur) during organogenesis of developing chick embryo at doses 1.575mg/egg, 0.375mg/egg and 3mg/kg eggs for SY, Tz and Cur comparing with control. The investigation revealed evident reduction in the weight and length of embryos as well as malformations in feather, head, and limbs. Most of the congenital malformations were seen in SY and Tz injected groups such as short beak, excencephaly, kniked tail and pygostyle, curved scapula and retardation in the degree of ossification were the most evident in endoskeleton malformation. In addition, the length of ossified long bones in SY and Tz groups was affected. Co-administration of Cur with SY and Tz ameliorate the reversed effect of SY and Tz on the shape, length, body weight and skeleton of embryos.

Anti-islet Cell Antibodies in a Sample of Egyptian Females with Gestational Diabetes and its Relation to Development of Type 1 Diabetes Mellitus.

BACKGROUND: Gestational diabetes mellitus is any degree of glucose intolerance with first diagnosis during pregnancy; it affects 3-10% of pregnancies. The presence of diabetes-related autoantibodies has shown to be able to predict the development of type 1 diabetes before hyperglycemia arises. OBJECTIVE: To recognize the prevalence of islet cell antibodies among a sample of Egyptian females with gestational diabetes and its possible relation to development of Type 1 diabetes within one year postpartum. METHODS: Our cross sectional study was conducted on 150 Egyptian pregnant females with gestational diabetes aged 19-39 years diagnosed by 75-g 2-hour oral glucose tolerance test. All females were subjected to full history, thorough clinical examination and laboratory measurement of anti-islet cell antibodies. Those females with positive antibodies were followed up six months and one year after delivery for their fasting insulin, fasting blood glucose and two hours post prandial glucose levels. RESULTS: The prevalence of pregnant females with gestational diabetes having positive anti islet cell antibodies was (44%), the prevalence of females diagnosed to have diabetes mellitus was (37.88%) six months and (51.52%) one year postpartum. CONCLUSION: The high prevalence of ICAs among pregnant Egyptian females with GDM and the risk of developing type 1diabetes later in life makes screening for ICA among women with GDM important to recognize those at risk of developing type 1 diabetes later in life.

Apitherapeutics and phage-loaded nanofibers as wound dressings with enhanced wound healing and antibacterial activity.

AIM: Develop green wound dressings which exhibit enhanced wound-healing ability and potent antibacterial effects. METHODS: Honey, polyvinyl alcohol, chitosan nanofibers were electrospun and loaded with bee venom, propolis and/or bacteriophage against the multidrug-resistant Pseudomonas aeruginosa and examined for their antibacterial, wound-healing ability and cytotoxicity. RESULTS: Among different formulations of nanofibers, honey, polyvinyl alcohol, chitosan-bee venom/bacteriophage exhibited the most potent antibacterial activity against all tested bacterial strains (Gram-positive and -negative strains) and achieved nearly complete killing of multidrug-resistant P. aeruginosa. In vivo testing revealed enhanced wound-healing results and cytotoxicity testing proved improved biocompatibility. CONCLUSION: The developed biocompatible nanofibers represent competitive wound-healing dressings with potent antibacterial and wound-healing activity.

An unusual cause of tachyarrhythmia in an otherwise healthy young man.

CLINICAL INTRODUCTION: A 32-year-old man referred to the cardiology clinic for palpitations was found to have paroxysmal supraventricular tachycardia (SVT) on 24-hour Holter monitoring. His general and cardiac examinations were unremarkable. A transthoracic echocardiographic study to exclude structural heart disease was performed and showed an abnormal structure in relation to the right ventricular (RV) free wall; however, poor echocardiographic windows precluded proper characterisation. Cardiac MR (CMR) was therefore performed. Cine images (figure 1 and online supplementary videos 1 and 2) demonstrated the abnormal structure. Dynamic pass of contrast (rest perfusion module) showed the sequence of intracavitary enhancement across different cardiac chambers in the horizontal long-axis plane (figure 1 and online supplementary video 3).heartjnl;103/18/1472/F1F1F1Figure 1Still frames from balanced steady state free precession images in the horizontal long-axis plane (A,B). Still frames from the dynamic pass of contrast in the horizontal long-axis and the short axis following contrast injection into the right arm (C,D). Images in the horizontal long-axis plane at the basal level using T2-weighted short-tau inversion recovery (E) and half Fourier single-shot turbo spin echo (F).DC1SP110.1136/heartjnl-2017-311485.supp1Supplementary data DC2SP210.1136/heartjnl-2017-311485.supp2Supplementary data DC3SP310.1136/heartjnl-2017-311485.supp3Supplementary data QUESTION: The abnormal structure is most likely which of the following?Pericardial cystRight atrial appendage aneurysmRight ventricular aneurysmJuxtaposed left atrial appendageAccessory right ventricular chamber.

Acute Kawasaki disease with emphasis on the echocardiographic profile: A single center experience.

Background: Echocardiographic features of acute Kawasaki disease (KD) have not been well characterized in Egyptian children. This study aimed to provide insight into the pattern of cardiac involvement in Egyptian children with Kawasaki disease, focusing on echocardiographic coronary abnormalities and their associated risk predictors. Methods and Results: Medical records of 64 KD patients from 2012 to 2016 were retrospectively analyzed with recalculation of coronary artery z-scores during the first eight weeks after fever onset. All patients received intravenous immunoglobulin (IVIG) and 57.8% were treated within 10 days of illness onset. Coronary abnormalities were found in 53.1% of all patients, and in 43.2% of those who received IVIG within 10 days. Giant aneurysms (z-score>10) comprised 23.5% of all coronary abnormalities. Coronary thrombosis occurred in two patients (5%), both of whom developed myocardial infarction, and one succumbed to heart failure with eventual in-hospital death. Overall, 7% of patients had mitral regurgitation (n = 5), 1.5% had aortic regurgitation (n = 1), and 7.8% had pericardial effusion (n = 5). Among a number of laboratory and clinical predictors, platelet count had the strongest association with coronary abnormalities (Area under Receiver-operating characteristic (ROC) curve: 0.794; 95% confidence interval 0.678-0.910; P < 0.001). Conclusion: Coronary abnormalities occur in a substantial percentage of KD in Egypt, with associated evidence of severe inflammation. Further efforts are required to increase awareness of the disease and to emphasize the importance of early IVIG administration. Future studies should also be undertaken to characterize the long term progression profile of the disease as well as the possible genetic background of the disease in Egypt.