Phytochemical analysis, and antioxidant and hepatoprotective activities of Chamaerops humilis L. leaves; a focus on xanthine oxidase.

Chamaerops humilis L. is clumping palm of the family Arecaceae with promising health-promoting effects. Parts of this species are utilized as food and employed in folk medicine to treat several disorders. This study investigated the phytochemical constituents of C. humilis leaves and their antioxidant and xanthine (XO) inhibitory activities in vitro and in acetaminophen (APAP)-induced hepatotoxicity in rats. Eleven compounds were isolated from C. humilis ethanolic extract (CHEE). CHEE and the butanol, n-hexane, and dichloromethane fractions exhibited in vitro radical scavenging and XO inhibitory efficacy. The computational findings revealed the tendency of the isolated compounds towards the active site of XO. In vivo, CHEE ameliorated liver function markers (ALT, AST, ALP, and albumin) and prevented tissue injury induced by APAP in rats. CHEE suppressed hepatic XO, decreased serum uric acid and liver MDA, and enhanced GSH, SOD, and catalase in APAP-treated rats. CHEE ameliorated serum TNF-α and IL-1ß in APAP-treated rats. Thus, C. humilis is rich in beneficial phytochemicals that possess binding affinity towards XO. C. humilis exhibited potent in vitro antioxidant and XO inhibitory activities, and prevented APAP hepatotoxicity by attenuating tissue injury, oxidative stress and inflammation.

Defensive medicine practices as a result of malpractice claims and workplace physical violence: a cross-sectional study from Egypt.

Defensive medicine refers to practices motivated mainly by legal rather than medical purposes. Increased healthcare costs, overutilization of medical services, and potential harm to patients from unnecessary procedures are among its drawbacks. We performed this study to assess the prevalence of defensive medicine practices in Egypt and their associations with experiencing malpractice claims and workplace physical violence. We investigated 1797 physicians (68.1% male), with an average age of 36.8 ± 9.1 years, practicing in Egypt between January 14th and February 23rd, 2023. SPSS was used for statistical analysis. The majority reported engaging in defensive medicine practices. Specifically, 89.6% acknowledged avoiding high-risk procedures, 87.8% refrained from treating high-risk patients, 86.8% admitted to making unnecessary referrals, 84.9% acknowledged ordering unnecessary tests, 61.4% reported performing unnecessary procedures, and 56.4% disclosed prescribing unnecessary medications. Obstetricians and surgeons exhibited the highest rates of defensive medicine. Using linear regression analysis adjusted for age and sex, malpractice claims and workplace physical violence were associated with defensive medicine score (zero-100): ßs (95% CIs) = 5.05 (3.10, 6.99) and 5.60 (3.50, 7.71), respectively, (p values < 0.001). In conclusion, defensive medicine is deeply ingrained in the clinical routines of Egyptian physicians. Establishing a comprehensive national medical liability framework is required.

Correct Patient Centering Increases Image Quality without Concomitant Increase of Radiation Dose during Adult Intracranial Computed Tomography.

PURPOSE: To evaluate the impact of patient centering and radiation dose during intracranial computed tomography (ICT) on quantitative and qualitative image quality. MATERIALS AND METHODS: A total of 500 consecutive patients who underwent ICT were retrospectively reviewed using a 128-slice CT scanner (Definition AS+, Siemens, Germany). Patients were subjected in equal numbers to one of two positioning protocols: group A, poorly centered; and group B involved accurate centering before imaging. Gray-white matter (GWM) conspicuity, contrast-to-noise ratio (CNR), and signal-to-noise ratio (SNR) in each group were calculated. Qualitative image quality in terms of GWM differentiation, distinctness of posterior fossa contents, and overall diagnostic acceptability were evaluated by 2 neuroradiologists. The dose length product, CNR, SNR, and noise were measured between each group and data generated were compared using Mann-Whitney U nonparametric statistics. Visual grading characteristic and Kappa analyses were performed. RESULTS: The mean noise index was significantly lower in group B (2.61 ± 0.29) compared with A (2.66 ± 0.21; P < .02). The mean attenuation of GWM, SNR, and CNR in the frontal lobe (A, 1:0.77, 0.84, 8.70 ± 1.36; and B, 1:0.65, 0.85, 15.32 ± 1.21; P < .02), occipital lobe (A, 1:1.10, 1.18, 10.79±2.11; and B, 1:0.94, 0.64, 14.41 ± 3.09; P < .04), and cerebellum (A, 1:0.79, 0.90, 12.56 ± 4.08; and B, 1:0.82, 0.87, 14.07 ± 2.28; P < .04) were significantly higher in group B compared with A, while the globus pallidus, caudate nucleus, and optic track in the basal ganglia demonstrated no difference in each group (P > .05). Mean dose length product demonstrated no significance between each group (A, 1312.03 ± 133.92; B, 1298.11 ± 130.61). The qualitative analyses demonstrated significant increases in visual grading characteristic for each reader (P < .02) and interobserver agreement was significantly increased in protocol B (k = 0.81) compared with A (k = 0.62). CONCLUSIONS: Correct patient centering increases the CNR and SNR in both GWM in the left and right hemispheres of the brain during ICT.