Antioxidant, hypoglycemic and anti-diabetic activities of Ziziphus spina-christi (L) Willd (Rhamnacae) leaf extract

Purpose: To investigate the antioxidant, hypoglycemic and antidiabetic activities as well as the phenolic composition of Ziziphus spina-christi (ZSC)Methods: Eighty percent methanol extract (ZSC-1), as well as ethyl acetate (ZSC-2), n-butanol (ZSC-3) and aqueous (ZSC-4) fractions were administered orally to mice at doses of 250 and 500 mg/kg of body weight. The hypoglycemic and anti-diabetic activities of these fractions in the treated mice were evaluated after 7 and 15 days, using glibenclamide as a standard. Antioxidant activities in vitro were determined using stable free radical DPPH and ABTS radical scavenging techniques.Results: The strongest (p < 0.001) anti-diabetic activity (25.59 and 39.48 % after 7 and 15 days, respectively) was found following treatment with 500 mg/kg ZSC-3 fraction. Similarly, the highest (p > 0.001) hypoglycemic effect was achieved with 500 mg/kg ZSC-3 treatment (29.07 and 35.56 % after 7 and 15 days, respectively). ZSC-1 possessed the highest content of total flavonoids (36.2 mg/g) and total polyphenol (82.3 mg/g).Conclusion: Fraction ZSC-3 displayed potential hypoglycemic activity while ZSC-1, ZSC-2 and ZSC-3 possess remarkable DPPH scavenging ability equivalent to 89, 96 and 80.3 % of the activity of the standard drug respectively.Keywords: Ziziphus spina, Rhamnaceae, Hypoglycemic, Anti-diabetic, Flavonoids, Polypheno

Hepatoprotective, nephroprotective, anti-amylase, and antiglucosidase effects of Ziziphus spina-christi (L.) against carbon tetrachloride-induced toxicity in rats

Purpose: To explore the hepatoprotective, nephroprotective, anti-amylase, and anti-glucosidase effects of the medicinal plant Ziziphus spina-christi (L.). Methods: Ziziphus spina-christi (L.) methanol extract (ZS-1) and its ethyl-acetate (ZS-2), n-butanol (ZS3), and aqueous (ZS-4) fractions were evaluated for their hepatoprotective, anti-amylase, and antiglucosidase activities. Adult male Wister rats were divided into 11 groups (I- XI) with 6 mice per group. Group I was normal control, while the treatment groups were as follows: group II, CCl4; group III, Silymarin + CCl4; group IV, Ziziphus spina-christi total methanol extract (ZS-1), 100 mg/kg) + CCl4; group V, ZS-1 (200 mg/kg) + CCl4; group VI, ethyl acetate fraction (ZS-2), 100 mg/kg + CCl4; group VII: ZS-2 (200 mg/kg) + CCl4; group VIII, butanol fraction (ZS-3), 100 mg/kg) + CCl4; group IX, ZS-3 (200 mg/kg) + CCl4; group X, aqueous fraction (ZS-4), 100 mg/kg) + CCl4; group XI: ZS-4 (200 mg/kg) + CCl4. Silymarin was used as the standard. Biomarkers of liver and kidney toxicity and histopathological changes were evaluated. Results: Liver and kidney malondialdehyde (MDA), non-protein sulfhydryls (NP-SH) and total protein levels were elevated in CCl4-treated rats; however, ZS-1 and ZS-4 of Z. spina-christi significantly reduced these levels. ZS-2 and ZS-3 did not significantly improve the studied parameters. These results were confirmed by results from histopathological examination. ZS-1 and ZS-2 showed mild inhibitory activities against α-amylase and α-glucosidase (54 and 43 % at 100 µg/ml, respectively). Conclusion: The results indicate that ZS-1 and ZS-4 samples displayed dose-dependent hepatoprotective and nephroprotective effects, whereas ZS-2 and ZS-3 samples did not exhibit these effects. Similarly, α-amylase and α-glucosidase enzymes are considerably inhibited by ZS-1 and ZS-2

Phytochemical investigation of Rhus tripartita and its activity against cyclooxygenases and acetylcholinesterase

Purpose: To investigate the inhibitory activity of crude methanol extract, fractions and two pure compounds from Rhus tripartita stem cyclooxygenases (COX-1 and COX-2) and acetylcholinesterase (AChE); also, to evaluate their antioxidant properties in in-vitro assays.Methods: R. tripartita extract and fractions were examined as inhibitors of COX-1 and COX-2 and AChE. Their antioxidant properties were also evaluated using various antioxidant tests, including free radical scavenging, nitric oxide, and total antioxidant capacity.Results: Ethyl acetate fraction (RT2), aqueous fraction (RT4), subfraction RT2-II, and subfraction RT2-III had a potent inhibitory effect on AChE with low IC50 values. At the same time, a subfraction (RT2-III) was an effective COX-2 inhibitor (94.5 % at 10 μg/mL) followed by ethyl acetate fraction (RT2; 79.39 %), aqueous fraction (RT4; 70 %), total extract (RT; 66.18 %), subfraction RT2-III (64.08 %), compound 5 (epicatechin; 61.25 %), compound 2 (taxifolin; 55.63 %), subfraction RT2-II (46.85 %), and butanol fraction (RT3; 40.80%). RT2, RT4, RT2-II, RT2-III, and compound 2 each showed 100 % inhibition at 20 μg/mL.Conclusion: The ethyl acetate fraction (RT2), aqueous fraction (RT4) and subfractions RT2-II and RT2- III are effective natural inhibitors of AChE. Subfraction RT2-III is the best COX-2 inhibitor, followed by ethyl acetate fraction RT2 and aqueous fraction (RT4). These bioactive materials can be considered natural COX-2 and AChE inhibitorsKeywords: Cyclooxygenase, Anti-nflammatory, Acetylcholinesterase, Anacardiaceous, Taxifolin, Epicatechi

Biochemical and histological evidences for the antitumor potential of Teucrium Oliverianum and Rhazya stricta in chemically-induced hepatocellular carcinoma

Background: Teucrium oliverianum and Rhazya stricta are medicinal plants used in traditional and herbal medicine for the treatment of diabetes, liver diseases and inflammatory conditions. The present study was planned to investigate the antitumor efficacy of Teucrium oliverianum and Rhazya stricta in chemically-induced hepatocellular carcinoma (HCC) in rats.Materials and Methods: Forty adult male rats weighing 170-200 g were divided into four groups; each group was comprised of ten rats: (1): Normal healthy animals served as negative control group, (2):  Hepatocellular carcinoma (HCC) group in which the rats were orally administered Nnitrosodiethylamine (dissolved in 0.9% normal saline), in a dose of 20 mg/kg b.wt. five times a week for six weeks, (3): HCC group treated with Teucrium oliverianum extract in a dose of 600 mg/kg b.wt for two months and (4): HCC group treated with Rhazya stricta extract in a dose of 750 mg/kg b.wt for two months. Serum alanine  aminotransferase (ALT), asparatate aminotransferase (AST), alkaline phosphatase (ALP) and  gammaglutamyl transferase (γ-GT) activities were estimated. Serum  carcinoembyronic antigen (CEA), alpha-fetoprotein (AFP), alpha-L-fucosidase (AFU), glypican-3 (GPC-3), golgi protein 73 (Gp-73) and vascular endothelial growth factor (VEGF) levels were determined. Histopathological examination of liver tissue sections was also carried out.Results: The HCC group showed significant elevation in serum AST, ALT, ALP and γ-GT activities as well  as CEA, AFP, AFU, Gpc-3, Gp 73 and VEGF levels versus the negative control group. Photomicrograph of liver tissue sections of rats in HCC revealed hepatic parenchyma with foci of anaplastic hepatocellular carcinoma as well as other foci of cystic cholangio carcinoma associated with areas of telangictasis with haemorrhage as well as individual hepatocellular necrosis.Conclusion: Treatment of HCC groups with Teucrium oliverianum or Rhazya stricta extract experienced significant improvement in the measured biochemical parameters as well as in the structural  organization of the liver. In conclusion, the current study provided experimental evidences for the antitumor efficacy of Teucrium oliverianum and Rhazya stricta against hepatocellular carcinoma. Such effect could be attributed to hepatoprotective properties, antiproliferative activity and antiangiogenic potential.Keywords: Hepatocellular carcinoma, Teucrium oliverianum, Rhazya stricta, rat

BIOCHEMICAL AND HISTOLOGICAL EVIDENCES FOR THE ANTITUMOR POTENTIAL OF TEUCRIUM OLIVERIANUM AND RHAZYA STRICTA IN CHEMICALLY-INDUCED HEPATOCELLULAR CARCINOMA

Background: Teucrium oliverianum and Rhazya stricta are medicinal plants used in traditional and herbal medicine for the treatment of diabetes, liver diseases and inflammatory conditions. The present study was planned to investigate the antitumor efficacy of Teucrium oliverianum and Rhazya stricta in chemically-induced hepatocellular carcinoma (HCC) in rats. Materials and Methods: Forty adult male rats weighing 170-200 g were divided into four groups; each group was comprised of ten rats: (1): Normal healthy animals served as negative control group, (2): Hepatocellular carcinoma (HCC) group in which the rats were orally administered Nnitrosodiethylamine (dissolved in 0.9% normal saline), in a dose of 20 mg/kg b.wt. five times a week for six weeks, (3): HCC group treated with Teucrium oliverianum extract in a dose of 600 mg/kg b.wt for two months and (4): HCC group treated with Rhazya stricta extract in a dose of 750 mg/kg b.wt for two months. Serum alanine aminotransferase (ALT), asparatate aminotransferase (AST), alkaline phosphatase (ALP) and gammaglutamyl transferase (γ-GT) activities were estimated. Serum carcinoembyronic antigen (CEA), alpha-fetoprotein (AFP), alpha-L-fucosidase (AFU), glypican-3 (GPC-3), golgi protein 73 (Gp-73) and vascular endothelial growth factor (VEGF) levels were determined. Histopathological examination of liver tissue sections was also carried out. Results: The HCC group showed significant elevation in serum AST, ALT, ALP and γ-GT activities as well as CEA, AFP, AFU, Gpc-3, Gp 73 and VEGF levels versus the negative control group. Photomicrograph of liver tissue sections of rats in HCC revealed hepatic parenchyma with foci of anaplastic hepatocellular carcinoma as well as other foci of cystic cholangio carcinoma associated with areas of telangictasis with haemorrhage as well as individual hepatocellular necrosis. Conclusion: Treatment of HCC groups with Teucrium oliverianum or Rhazya stricta extract experienced significant improvement in the measured biochemical parameters as well as in the structural organization of the liver. In conclusion, the current study provided experimental evidences for the antitumor efficacy of Teucrium oliverianum and Rhazya stricta against hepatocellular carcinoma. Such effect could be attributed to hepatoprotective properties, antiproliferative activity and antiangiogenic potential

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

The Amount of Sustainable Development Dimensions in the Developed Content of Fifth Grade Science Curriculum in the Sultanate of Oman

هدفت الدراسة الحالية إلى التعرّف على مدى تضمين أبعاد التنمية المستدامة في منهج العلوم المطور للصف الخامس في سلطنة عُمان، وتمثلت عينة الدراسة في تحليل محتوى كتاب التلميذ والنشاط للصف الخامس للفصل الدراسي الأول للعام الدراسي 2021-2020م. ولتحقيق هدف الدراسة تم اتباع المنهج الوصفي التحليلي بأسلوب تحليل المحتوى، وتم تصميم بطاقة لتحليل المحتوى تضمنت أبعاد التنمية المستدامة (البعد البيئي، البعد الاجتماعي، البعد الاقتصادي)، وقد تم التحقق من صدقها بعرضها على مجموعة من المختصين في مجال تدريس العلوم والتنمية المستدامة. وقد أظهرت نتائج الدراسة أن محتوى الكتب المحللة تضمنت جميع أبعاد التنمية المستدامة وبنسب متفاوتة؛ حيث جاء البعد الاجتماعي بالمرتبة الأولى وبنسبة (80.07%)، يليه البعد البيئي وبنسبة تضمين (13.41%)، ثم جاء في المرتبة الأخيرة البعد الاقتصادي وبنسبة (6.52%). وأوصت الدراسة زيادة تضمين القضايا الفرعية في محتوى منهج العلوم المحلل التي لم تظهر بشكل كافٍ مقارنة بغيرها؛ نظرا لأهميتها في تحقيق الاستدامة.The current study aimed at identifying the amount of sustainable development dimensions were included in the developed science curriculum for the fifth grade in the Sultanate of Oman.  The sample of this study consisted of analyzing the content of the students’ textbook and activity book for the fifth grade for the first semester of the academic year 2020-2021. A descriptive content analysis was adopted to achieve the purpose of the study.  A content analysis card was further designed that included the dimensions of sustainable development (the environmental dimension, the social dimension, and the economic dimension) and the reliability was checked by some academic referees. The results of the study revealed that the content of the analyzed textbooks included all dimensions of sustainable development, to varying degrees. The availability of social dimension was the highest with (80.07%) percent, followed by the environmental dimension with a percentage of (13.41%), and the lowest dimension was economic with (6.52%) percent. Increasing the availability of sub-issues in the content of the analyzed science curriculum that did not appear sufficiently compared to others was recommended due to its relevance to achieve sustainability

Melatonin Mitigates Cisplatin-Induced Ovarian Dysfunction via Altering Steroidogenesis, Inflammation, Apoptosis, Oxidative Stress, and PTEN/PI3K/Akt/mTOR/AMPK Signaling Pathway in Female Rats

Ovarian damage and fertility impairment are major side effects of chemotherapy in pre-menopausal cancer patients. Cisplatin is a widely used chemotherapeutic drug. The present study was designed to assess the ameliorative effects of melatonin as an adjuvant for fertility preservation. Thirty-two adult female Wistar rats were divided randomly into four equal groups: Control, Melatonin, Cisplatin (CP) treated, and CP + Melatonin treated. The cisplatin-treated group showed decreased body and ovarian weights, decreased serum E2 and AMH, increased serum LH and FSH, reduced ovarian levels of SOD, CAT, GSH, and TAC, and increased ovarian MDA. The histopathological examination of the cisplatin-treated group showed deleterious changes within ovarian tissue in the form of damaged follicles and corpus luteum, hemorrhage, and inflammatory infiltrates with faint PAS reaction in zona pellucida, increased ovarian collagen deposition, and marked expression of caspase-3 immune reaction in granulosa and theca cells, stroma, and oocytes. Alongside, there was a significant downregulation in the mRNA expression of steroidogenic enzymes, IL10, AMPK, PI3K, AKT, mTOR, and PTEN, while TGF-β1, IL1β, IL6, TNF-α, NF-Kβ, P53, p38-MAPK, JNK, and FOXO3 mRNA expressions were upregulated in cisplatin-treated rats’ ovarian tissue. Coadministration of cisplatin-treated rats with melatonin reversed these changes significantly. In conclusion, melatonin’s antioxidant, anti-inflammatory, and anti-apoptotic activities could modulate ovarian disturbances induced by cisplatin and preserve fertility

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially