Immobilized lipase enzyme on green synthesized magnetic nanoparticles using Psidium guava leaves for dye degradation and antimicrobial activities.

Zinc ferrite nanoparticles (ZnF NPs) were synthesized by a green method using Psidium guava Leaves extract and characterized via structural and optical properties. The surface of ZnF NPs was stabilized with citric acid (CA) by a direct addition method to obtain (ZnF-CA NPs), and then lipase (LP) enzyme was immobilized on ZnF-CA NPs to obtain a modified ZnF-CA-LP nanocomposite (NCs). The prepared sample's photocatalytic activity against Methylene blue dye (MB) was determined. The antioxidant activity of ZnF-CA-LP NCs was measured using 1,1-diphenyl-2-picryl hydrazyl (DPPH) as a source of free radicals. In addition, the antibacterial and antibiofilm capabilities of these substances were investigated by testing them against gram-positive Staphylococcus aureus (S. aureus ATCC 25923) and gram-negative Escherichia coli (E. coli ATCC 25922) bacterial strains. The synthesized ZnF NPs were discovered to be situated at the core of the material, as determined by XRD, HRTEM, and SEM investigations, while the CA and lipase enzymes were coated in this core. The ZnF-CA-LP NCs crystallite size was around 35.0 nm at the (311) plane. Results obtained suggested that 0.01 g of ZnF-CA-LP NCs achieved 96.0% removal of 5.0 ppm of MB at pH 9.0. In-vitro zone of inhibition (ZOI) and minimum inhibitory concentration (MIC) results verified that ZnF-CA-LP NCs exhibited its encouraged antimicrobial activity against S. aureus and E. coli (20.0 ± 0.512, and 27.0 ± 0.651 mm ZOI, respectively) & (1.25, and 0.625 µg/ml MIC, respectively). ZnF-CA-LP NPs showed antibiofilm percentage against S. aureus (88.4%) and E. coli (96.6%). Hence, ZnF-CA-LP NCs are promising for potential applications in environmental and biomedical uses.

Evaluation of the antioxidant and anti-inflammatory effect of sublingual glutathione on COPD patients.

Glutathione (GSH) is a potent antioxidant and anti-inflammatory, proven effective in reducing treatment duration, prescribed doses, and hospitalization for several diseases. This study assessed the therapeutic response of chronic obstructive pulmonary disease (COPD) patients by measuring oxidative superoxide dismutase (SOD3), glutathione peroxidase 1 (GPX1), and inflammatory biomarkers such as tumor necrosis factor-alpha (TNF-α) and Interleukin-8 (IL-8) after sublingual administration of glutathione supplements. A cohort of 50 COPD individuals was involved and divided into two groups of 25 each. The first group received conventional therapy involving the administration of formoterol fumarate (12 µg inhaler) twice daily. The second group received the conventional treatment alongside sublingual glutathione (300 mg twice daily) for two months. The levels of serum IL-8, TNF-α, SOD3, and GPX1 were assessed before therapy, as well as at one and two months after treatment, in both cohorts. Both groups exhibited a notable reduction in the inflammatory mediators IL-8 and TNF-α when compared to their respective pre-treatment levels (P value <0.05). However, it is worth noting that the observed difference between the groups was not statistically significant (P value >0.05). The levels of SOD3 and GPX1 exhibited a substantial rise in both groups; however, they were found to be greater in group 2 compared to group 1 (P value >0.05). The administration of glutathione resulted in enhanced levels of antioxidant biomarkers among individuals diagnosed with COPD, accompanied by a minor and statistically insignificant decrease in the levels of the anti-inflammatory mediators IL-8 and TNF-alpha.

Histologic Evaluation of Artificial Floors Under MTA and Nano-Filled Resin-Modified Glass Ionomer Used to Repair Furcation Perforations in Dogs.

Objective: This study aimed to compare the tissue reaction of two repair materials for furcation perforations, nano-filled resin modified glass ionomer (Nano-FRMGI) and mineral trioxide aggregate (MTA), used with or without an artificial floor. Methods: A total of 96 teeth in 6 dogs were used for this study. After access cavities, root canals were prepared and obturated with gutta percha using cold lateral condensation technique. Perforations were then created on the floors of the pulp chambers. The perforations divided into four groups n=24/group that were sealed with MTA alone, MTA with calcium sulphate artificial floor (CSAF), FRMGI alone and Nano-FRMGI with CSAF. All access cavities were filled with composite resin. Two dogs were sacrificed at 1, 3, and 6 month. The experimental tooth along with the surrounding alveolar bone were cut in block sections and histologically evaluated for tissue response. Data were analyzed by Chi-square (P≤0.05). Results: MTA and MTA with CSAF showed more bone and cementum apposition when compared to Nano-FRMGI at 6-month interval. MTA and MTA with CSAF showed less bone resorption, epithelium proliferation and inflammation compared to Nano-FRMGI at 6-month interval. Conclusion: MTA with CSAF or MTA-alone show better outcomes in the repair of pulp chamber floor perforation.

Real time endoscopic ultrasound elastography and strain ratio in the diagnosis of solid pancreatic lesions.

AIM: To evaluate the accuracy of the elastography score combined to the strain ratio in the diagnosis of solid pancreatic lesions (SPL). METHODS: A total of 172 patients with SPL identified by endoscopic ultrasound were enrolled in the study to evaluate the efficacy of elastography and strain ratio in differentiating malignant from benign lesions. The semi quantitative score of elastography was represented by the strain ratio method. Two areas were selected, area (A) representing the region of interest and area (B) representing the normal area. Area (B) was then divided by area (A). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated by comparing diagnoses made by elastography, strain ratio and final diagnoses. RESULTS: SPL were shown to be benign in 49 patients and malignant in 123 patients. Elastography alone had a sensitivity of 99%, a specificity of 63%, and an accuracy of 88%, a PPV of 87% and an NPV of 96%. The best cut-off level of strain ratio to obtain the maximal area under the curve was 7.8 with a sensitivity of 92%, specificity of 77%, PPV of 91%, NPV of 80% and an accuracy of 88%. Another estimated cut off strain ratio level of 3.8 had a higher sensitivity of 99% and NPV of 96%, but with less specificity, PPV and accuracy 53%, 84% and 86%, respectively. Adding both elastography to strain ratio resulted in a sensitivity of 98%, specificity of 77%, PPV of 91%, NPV of 95% and accuracy of 92% for the diagnosis of SPL. CONCLUSION: Combining elastography to strain ratio increases the accuracy of the differentiation of benign from malignant SPL.

Nodular Lymphoid Hyperplasia of the Gastrointestinal Tract : a comprehensive review.

Nodular lymphoid hyperplasia (NLH) is a rare benign condition that is characterized by diffuse hyperplasia of the lymphoid follicles of the gastrointestinal tract (GIT). During endoscopy, NLH appears as multiple or occasionally innumerable nodules measuring a few millimeters in diameter. NLH occurs mainly in the small intestine, less commonly in the large intestine and rarely involves the stomach. There are multiple associated diseases such as immunoglobulin deficiency syndromes, giardiasis, Helicobacter pylori (H. pylori) infection, HIV and celiac disease. NLH elicits a wide range of symptoms that can range from asymptomatic to chronic diarrhea, weight loss, bleeding from the rectum and, very infrequently, intestinal obstruction. The clinical significance of NLH relies not only on the associated conditions but also on the possible complications. The most important of which are malignant transformation, particularly to gastric carcinoma, and intestinal or extra-intestinal lymphoma. There is no consensus regarding the management and surveillance of NLH. However, surveillance is recommended by most authors, but the intervals and duration have not yet been identified.

Double-balloon enteroscopy (DBE) in patients presenting with obscure gastrointestinal bleeding (OGIB).

BACKGROUND AND STUDY AIMS: Obscure gastrointestinal bleeding (OGIB) is defined as bleeding of unknown origin that persists or recurs after an initial negative investigation. Identifying the source of OGIB represents a diagnostic challenge that is frequently focused on visualizing the small intestine. Conventional diagnostic methods, such as push enteroscopy, small-bowel follow-through, radionuclide scanning, and angiography, each exhibit inherent limitations. Double balloon enteroscopy (DBE) was designed specifically to evaluate the entire small bowel. DBE allows for better visualization, biopsy of the identified lesions and application of therapeutic techniques. This study sought to assess the role of DBE in the diagnosis and management of patients with OGIB. PATIENTS AND METHODS: This prospective study was conducted to analyse data from 31 patients presenting with OGIB referred for DBE in the Endoscopy Unit at the Internal Medicine Department of the Faculty of Medicine, Cairo University. RESULTS: Five patients had lesions in locations other than the small intestine that accounted for GI bleeding. Thus, the potential source of OGIB was defined as the small intestine in 18 of 26 patients (69.2%), and negative DBE findings were noted in eight patients (30.8%). Major findings included small intestinal tumours in eight patients, vascular bleeding lesions in 8 patients and ulcerations in 2 patients. Endoscopic haemostasis was performed in eight patients with vascular lesions. The three patients with Petuz-Jegher syndrome underwent polypectomy of their major polyps. Patients with gastrointestinal tumours were referred for surgery. CONCLUSION: DBE is an excellent endoscopic procedure that has a relatively high diagnostic and therapeutic yield. The procedure is feasible and exhibits a high safety profile with a low complication rate when performed by an experienced endoscopist.

Flavonoid chemical composition and antidiabetic potential of Brachychiton acerifolius leaves extract

Objective:To evaluate Brachychiton acerifolius leaf extracts as antidiabetic potential agent and to identify the main active constituents using bioactivity guided fractionation.Methods:In vitro antioxidant activity was evaluated for B.acerifolius different extracts using DPPH assay and vitamin C as control.Antidiabetic activity was then determined using STZ-induced rats treated daily with ethyl acetate and 70％ ethanol leaf extracts for 4 weeks at a dose of 200 g/kg body weight against gliclazide reference drug.Blood glucose,α-amylase,lipid profile,liver function enzymes and oxidative stress markers were assessed along with histopathological study for liver and pancreatic tissues.Isolation and structural elucidation of active compounds were made using Diaion and Sephadex followed by spectral analyses.Results:The results indicated that ethyl acetate and ethanol leaf extracts exhibited the strongest antioxidant activity compared to that of vitamin C (IC50 0.05,0.03 and 12 mg/mL,respectively).Both extracts showed potent anti-hyperglycemic activity evidenced by a significant decrease in serum glucose levels by 82.5％ and 80.9％ and α-amylase by 45.2％ and 53.6％,as compared with gliclazide 68％ and 59.4％,respectively.Fractionation of ethanol extract resulted in the isolation of 9 flavonoids including apigenin-7-O-α-rhamnosyl(1 → 2)-β-D-glucuronidc,apigenin-7-O-β-D-glucuronide,apigcnin-7-O-β-D-glucoside and luteolin-7-O-β-D-glucuronide.Conclusions:This study highlights the potential use of B.acerifolius leaf extract enriched in flavones for the treatment of diabetes that would warrant further clinical trials investigation.

Role of endoscopic ultrasound-guided fine needle aspiration and ultrasound-guided fine-needle aspiration in diagnosis of cystic pancreatic lesions.

BACKGROUND AND OBJECTIVE: The addition of fine-needle aspiration (FNA) to different imaging modalities has raised the accuracy for diagnosis of cystic pancreatic lesions. We aim to differentiate benign from neoplastic pancreatic cysts by evaluating cyst fluid carcinoembryonic antigen (CEA), carbohydrate antigen (CA19-9), and amylase levels and cytopathological examination, including mucin stain. PATIENTS AND METHODS: This prospective study included 77 patients with pancreatic cystic lesions. Ultrasound-FNA (US-FNA) or endoscopic ultrasound-FNA (EUS-FNA) was done according to the accessibility of the lesion. The aspirated specimens were subjected to cytopathological examination (including mucin staining), tumor markers (CEA, CA19-9), and amylase level. RESULTS: Cyst CEA value of 279 or more showed high statistical significance in differentiating mucinous from nonmucinous lesions with sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of 73%, 60%, 50%, 80%, and 65%, respectively. Cyst amylase could differentiate between neoplastic and nonneoplastic cysts at a level of 1043 with sensitivity of 58%, specificity of 75%, PPV of 73%, NPV of 60%, and accuracy of 66%. CA19-9 could not differentiate between neoplastic and nonneoplastic cysts. Mucin examination showed a sensitivity of 85%, specificity of 95%, PPV of 92%, NPV of 91%, and accuracy of 91% in differentiating mucinous from non-mucinous lesions. Cytopathological examination showed a sensitivity of 81%, specificity of 94%, PPV of 94%, NPV of 83%, and accuracy of 88%. CONCLUSION: US or EUS-FNA with analysis of cyst CEA level, CA19-9, amylase, mucin stain, and cytopathological examination increases the diagnostic accuracy of cystic pancreatic lesions.

Endoscopic Ultrasound-Guided Fine Needle Aspiration versus Percutaneous Ultrasound-Guided Fine Needle Aspiration in Diagnosis of Focal Pancreatic Masses.

OBJECTIVE: Pancreatic carcinoma is one of the leading cancer morbidity and mortality world-wide. Controversy has arisen about whether the percutaneous approach with computed tomography/ultrasonography-guidance fine needle aspiration (US-FNA) or endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is the preferred method to obtain diagnostic tissue. Our purpose of this study is to compare between the diagnostic accuracy of EUS-FNA and percutaneous US-FNA in diagnosis of pancreatic cancer. PATIENTS AND METHODS: A total of 197 patients with pancreatic masses were included in the study, 125 patients underwent US-FNA (Group 1) and 72 patients underwent EUS-FNA (Group 2). RESULTS: EUS-FNA has nearly the same accuracy (88.9%) as US-FNA (87.2%) in diagnosis of pancreatic cancer. The sensitivity, specificity, positive predictive value and negative predictive value for EUS-FNA was 84%, 100%, 100%, 73.3% respectively. It was 85.5%, 90.4%, 94.7%, 76% respectively for US-FNA. EUS-FNA had a lower complication rate (1.38%) than US-FNA (5.6%). CONCLUSION: EUS-FNA has nearly the same accuracy as US-FNA of pancreatic masses with a lower complication rate.

Effect of lactic acid irrigant on shear bond strength of Epiphany adhesive sealer to human dentin surface.

OBJECTIVE: To examine the effects of varied dilutions of lactic acid as a root canal irrigant and compare the shear bond strength of Epiphany adhesive sealer to human dentin surface with other solutions deemed to be suitable root canal irrigants. STUDY DESIGN: The occlusal surfaces of 60 extracted molar teeth were ground wet and treated with one of the following irrigants: 1) no irrigant (control); 1) 5% hydrogen peroxide; 3) 5% sodium hypochlorite; 4) 15% ethylenediaminetetraacetic acid (EDTA); 5) 10% lactic acid; or 6) 20% lactic acid. An additional specimen for each group was critical-point dried and freeze-fractured to evaluate the dentin surfaces after treatment by scanning electron microscopy. Specimens were treated with Epiphany primer, hollow steel tubes were placed on the dentin surfaces, and resin sealer (Epiphany) was applied to dentin inside the tubes. Specimens were stored in 100% humidity, then loaded to failure in a universal testing machine in the shear mode with a cross speed of 0.05 mm/min. RESULTS: Dentin surface treatment resulted in significant differences for surface topography and shear bond strength of Epiphany sealer (P < .001). Lactic acid and EDTA significantly improved epiphany- dentin bond strengths when compared with other irrigants (P < .001). The highest mean (SD) bond strength was 1.95 (0.47) MPa for dentin surfaces treated with 20% lactic acid. The lowest mean bond strength [0.41 (0.29) MPa] was associated with untreated dentin surfaces. Scanning electron micrographs showed that the surface of the control specimens had a smear layer that contained smear plug material. Similarly, hydrogen peroxide and sodium hypochlorite produced surfaces with a smear layer. Lactic acid solutions and EDTA, however, removed the dentinal smear layer but left remnants of smear plugs in the dentinal tubules. CONCLUSION: Lactic acid irrigant performed similarly to 15% EDTA and demonstrated higher bond strength of Epiphany sealer to dentin surface.