Thrombosis with thrombocytopenia syndrome after administration of AZD1222 or Ad26.COV2.S vaccine for COVID-19: A systematic review

Background: Cases of thrombosis with thrombocytopenia syndrome (TTS) have been reported following vaccination with AZD1222 or Ad26.COV2.S. This review aimed to explore the pathophysiology, epidemiology, diagnosis, management, and prognosis of TTS.Methods: A systematic review was conducted to identify evidence on TTS till 4th September 2021. Case reports and series reporting patient-level data were included. Descriptive statistics were reported and compared across patients with different sexes, age groups, vaccines, types of thrombosis, and outcomes.Findings: Sixty-two studies reporting 160 cases were included from 16 countries. Patients were predominantly females with a median age of 42.50 (22) years. AZD1222 was administered to 140 patients (87·5%). TTS onset occurred in a median of 9 (4) days after vaccination. Venous thrombosis was most common (61.0%). Most patients developed cerebral venous sinus thrombosis (CVST; 66.3%). CVST was significantly more common in female vs male patients (p = 0·001) and in patients aged \u3c45 years vs ≥45 years (p = 0·004). The mortality rate was 36.2%, and patients with suspected TTS, venous thrombosis, CVST, pulmonary embolism, or intraneural complications, patients not managed with non-heparin anticoagulants or IVIG, patients receiving platelet transfusions, and patients requiring intensive care unit admission, mechanical ventilation, or inpatient neurosurgery were more likely to expire than recover.Interpretation: These findings help to understand the pathophysiology of TTS while also recommending diagnostic and management approaches to improve prognosis in patients.Funding: This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors

Effect of viral load on hepatic fibrosis in patients with chronic hepatitis B patients: assessed by fibroscan

Background: Hepatitis B virus (HBV) infection is a severe worldwide health problem and a primary cause of chronic hepatitis, hepatic fibrosis, cirrhosis, and hepatocellular cancer. In Egypt, the prevalence of HBsAg is of intermediate endemicity (2–8%). It has been known that the viral load and degree of hepatic fibrosis are considered independent factors that predict clinical outcomes after persistent HBV infection. However, the exact relationship between viral load and hepatic fibrosis is not well studied. Objectives: Our objective was to investigate the clinical effects of viral load on the severity of hepatic fibrosis. Patients and methods: Sixty patients with evident chronic HBV infection were enrolled. Using transient elastography, the patients were divided into two groups. Group 1: low fibrosis stage F1–2, and Group 2: high or significant fibrosis stage (F3–F4). Both groups were statistically compared for HBV-DNA viremia (PCR), clinical, and laboratory tests. Results: Serum bilirubin (p = 0.048), international normalised ratio (p 0.0001), and albumin (p = 0.01) were significantly increased in patients with higher grades of liver fibrosis on top of CHB. In addition, the viral load was found to be considerably greater in individuals who had higher grades of liver fibrosis and cirrhosis (P = 0.03). Conclusions: During follow-up, an obvious increase in the viraemia level may indicate significant hepatic fibrosis in patients with chronic HBV infection. Our results could influence the decision about liver biopsy or treatment at that point

Characterization and Toxicity of Bacillus Thuringiensis Strain Kfr-24, And Commercial Formulations against Spodoptera Littolaris

Under these studies Bacillus thuringiensis wettable powder comparable to standard strain, there are only one isolate which confirmed by molecular characterization. Scanning electron microscopy observed that the presence of cuboidal crystals in Bacillus thuringiensis Alex-13 and observed bipyramidal crystals in case of Bacillus thuringiensis HD-1, as standard strain. Polymerase chain reactions (PCR) revealed the presence of Cry1-like sequences in addition to standard strain, which confirmed by gel electrophoresis. Also, during these studies. Bioassay recorded that the highest mortality rate by determination of LC50 for 5 days against Spodoptera littolaris third instars larvae were 69, 86, and 100(%) in case of Bt Alex-13, Bt-HD-1 standard strain and Bt commercial wettable powder, respectively

Characterization and Toxicity of Bacillus Thuringiensis Strain Kfr-24, And Commercial Formulations against Spodoptera Littolaris

Under these studies Bacillus thuringiensis wettable powder comparable to standard strain, there are only one isolate which confirmed by molecular characterization. Scanning electron microscopy observed that the presence of cuboidal crystals in Bacillus thuringiensis Alex-13, and observed bipyramidal crystals in case of Bacillus thuringiensis HD-1, as standard strain. Polymerase chain reactions (PCR) revealed the presence of Cry1-like sequences in addition to standard strain, which confirmed by gel electrophoresis. Also, during these studies.Bioassay recorded that the highest mortality rate by determination of LC50 for 5 days against Spodoptera littolaris third instars larvae were 69, 86, and 100(%) in case of Bt Alex-13, Bt-HD-1 standard strain and Bt commercial wettable powder, respectively

Isolation and Molecular Identification of Insecticidal Activity Bacillus Thuringiensis Strain Alex-13 Isolated from Different Ecosystems in Egypt against Spodoptera Littolaris

The entomopathogenic bacterium Bacillus thuringiensis (Bt) is the most widely used biopesticide. The specific toxic activity to insects and other organisms is related to the presence of crystals that have different morphologies, sizes, numbers and compositions according to the Bt strain. The crystals contain different proteins, which are encoded by distinct Cry (crystal) genes. In this work we isolated 334 colonies from 59 soil samples in 13 local area in Egypt, colonies examination has carried out under microscope for toxin production, during screening of these isolates we found 16 bacterial strains has been identified by using biochemical reactions and insecticidal activity against Spodoptera littolaris in addition to Bacillus thuringiensis wettable powder comparable to standard strain, only one isolate which are considered most potent strain were confirmed by molecular characterization. Scanning electron microscopy observed that the presence of cuboidal crystals in Bacillus thuringiensis Alex-13 and observed bipyramidal crystals in case of Bacillus thuringiensis HD-1, as standard strain. Polymerase chain reactions (PCR) revealed the presence of Cry1-like sequences in addition to standard strain, which confirmed by gel electrophoresis. Also, during the studying environmental and nutritional conditions requirements (data not show). Bioassay recorded that the highest mortality rate by determination of LC50 for 5 days against Spodoptera littolaris third instars larvae were 69, 86, and 100(%) in case of Bt Alex-13, Bt-HD-1 standard strain and Bt commercial wettable powder, respectively

Treatment of newly diagnosed glioblastoma in the elderly

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To determine the most effective and best‐tolerated approaches for the treatment of elderly people with newly diagnosed glioblastoma. To summarise current evidence for the incremental resource use, utilities, costs and cost‐effectiveness associated with the different management strategies for newly diagnosed glioblastoma among adults aged over 70 years

¹H-NMR metabolic profiling, antioxidant activity, and docking study of common medicinal plant-derived honey

The purpose of this investigation was to determine ¹H-NMR profiling and antioxidant activity of the most common types of honey, namely, citrus honey (HC1) (Morcott tangerine L. and Jaffa orange L.), marjoram honey (HM1) (Origanum majorana L.), and clover honey (HT1) (Trifolium alexandrinum L.), compared to their secondary metabolites (HC2, HM2, HT2, respectively). By using a ¹H-NMR-based metabolomic technique, PCA, and PLS-DA multivariate analysis, we found that HC2, HM2, HC1, and HM1 were clustered together. However, HT1 and HT2 were quite far from these and each other. This indicated that HC1, HM1, HC2, and HM2 have similar chemical compositions, while HT1 and HT2 were unique in their chemical profiles. Antioxidation potentials were determined colorimetrically for scavenging activities against DPPH, ABTS, ORAC, 5-LOX, and metal chelating activity in all honey extract samples and their secondary metabolites. Our results revealed that HC2 and HM2 possessed more antioxidant activities than HT2 in vitro. HC2 demonstrated the highest antioxidant effect in all assays, followed by HM2 (DPPH assay: IC50 2.91, 10.7 μg/mL; ABTS assay: 431.2, 210.24 at 50 ug/mL Trolox equivalent; ORAC assay: 259.5, 234.8 at 50 ug/mL Trolox equivalent; 5-LOX screening assay/IC50: 2.293, 6.136 ug/mL; and metal chelating activity at 50 ug/mL: 73.34526%, 63.75881% inhibition). We suggest that the presence of some secondary metabolites in HC and HM, such as hesperetin, linalool, and caffeic acid, increased the antioxidant activity in citrus and marjoram compared to clover honey

Wound healing and antioxidant properties of <i>Launaea procumbens</i> supported by metabolomic profiling and molecular docking

Wounds adversely affect people’s quality of life and have psychological, social, and economic impacts. Herbal remedies of Launaea procumbens (LP) are used to treat wounds. In an excision wound model, topical application of LP significantly promoted wound closure (on day 14, LP-treated animals had the highest percentages of wound closure in comparison with the other groups, as the wound was entirely closed with a closure percentage of 100%, p < 0.05). Histological analysis revealed a considerable rise in the number of fibroblasts, the amount of collagen, and its cross-linking in LP-treated wounds. Gene expression patterns showed significant elevation of TGF-β levels (2.1-fold change after 7 days treatment and 2.7-fold change in 14 days treatment) and downregulation of the inflammatory TNF-α and IL-1β levels in LP-treated wounds. Regarding in vitro antioxidant activity, LP extract significantly diminished the formation of H(2)O(2) radical (IC(50) = 171.6 μg/mL) and scavenged the superoxide radical (IC(50) of 286.7 µg/mL), indicating antioxidant potential in a dose-dependent manner. Dereplication of the secondary metabolites using LC-HRMS resulted in the annotation of 16 metabolites. The identified compounds were docked against important wound-healing targets, including vascular endothelial growth factor (VEGF), collagen α-1, tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and transforming growth factor-β (TGF-β). Among dereplicated compounds, luteolin 8-C-glucoside (orientin) demonstrated binding potential to four investigated targets (VEGF, interleukin 1β, TNF-α, and collagen α-1). To conclude, Launaea procumbens extract could be regarded as a promising topical therapy to promote wound healing in excisional wounds, and luteolin 8-C-glucoside (orientin), one of its constituents, is a potential wound-healing drug lead