In vitro cancer cell growth inhibition and antioxidant activity of Bombax ceiba (Bombacaceae) flower extracts.

The flowers of Bombax ceiba were investigated for their chemical composition, antioxidant effects and antiproliferative activity against seven human cancer cell lines. The antiproliferative responses of diethyl ether (DE) and light petroleum (PE) extracts were evaluated by sulforhodamine B (SRB) assay against MCF-7, HeLa, COR-L23, C32, A375, ACHN, and LNCaP cells in comparison with a human normal cell line, 142BR. Moreover, extracts were characterized by GC-MS analysis and tested for their antioxidant properties by different in vitro systems, namely DPPH, Fe-chelating activity and β-carotene bleaching test. Both PE and DE extracts showed the highest antiproliferative activity against human renal adenocarcinoma (ACHN) in a concentration-dependent manner. PE extract showed the highest radical scavenging activity against the DPPH radical, while DE extract was more active in the β-carotene bleaching test. The presence of β-sitosterol and some fatty acids may contribute to the bioactivity of B. ceiba flower extracts

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Phytoconstituents and bioactivities of the Bark of Pleiogynium timorense (DC.) Leenh (Anacardiaceae)

Introduction: The purpose of this study was to evaluate the phytoconstituents and various bioactivities of Pleiogynium timorense bark as a step towards the production of a new drug from natural origin to overcome the complications of the synthetic drugs. Methods: The phenolic compounds were isolated and identified by chromatographic and spectroscopic methods as ultraviolet (UV) and nuclear magnetic resonance (NMR) spectra. The isolated compounds, as well as 70% methanol extract of P. timorense bark were tested for cytotoxicity against human colon carcinoma (HCT 116), human hepatocellular liver carcinoma (HepG2), normal melanocytes (HFB-4) and human breast carcinoma (MCF-7) cell lines. In addition, the methanol extract was evaluated for renal protective, hepatoprotective, antioxidant and antihyperglycaemic activities. Results: Seven phenolic compounds were isolated from the bark of the plant for the first time which were identified as; pyrogallol, catechin, gallic acid, kaempferol, quercetin, rutin and quercetrin. Moreover, the methanol extract of the bark showed a promising cytotoxic effect against HepG2 cell line more than that of the isolated compounds comparing with doxorubicin (a positive control), where catechin and gallic acid showed moderate effects. In addition, the methanol extract showed potent antioxidant, hepatorenal protective and antihyperglycaemic effects. Conclusion: Pleiogynium timorense extract possesses a potent cytotoxic effect against HepG2 cell line and significant antioxidant, hepatorenal protective and antihyperglycaemic effects

Phenolic contents and bioactivities of pericarp and seeds of Pleiogynium solandri (Benth.) Engl. (Anacardiaceae)

Objective(s): This study aimed to develop drugs from natural sources to overcome the side effects of many of synthetic drugs. Methanol extracts of both pericarp and seeds of Pleiogynium solandri were used to investigate antioxidant, hepatoprotective, and renal function protective, analgesic, and anti-inflammatory effects and to determine the chemical composition of the extract responsible for bioactivity. Materials and Methods: Methanol (70%) extracts of the seeds and pericarps of P. solandri were prepared. Hot plate method was used to test analgesic activity, carrageenan-induced paw inflammation method was used to test anti-inflammatory activity, and colorimetric methods were used to test antioxidant, hepatoprotective (by determination of serum alanine and aspartate aminotransferase activities), and renal function protective effects (by measuring uric acid and creatinine levels). Chromatographic methods and means of 1H-NMR, 13C –NMR, and UV spectra were used for isolation and identification of the responsible compounds. Results:In this study for the first time,four phenolic compounds were isolated from the pericarp of P. solandri which were identified as catechin, quercetin, quercetrin and rutin[m1] . Methanolic extract of both seeds and pericarp of P. solandri showed strong antioxidant effect, hepatoprotective, renal function protective, analgesic, and anti-inflammatory effects. However, seed extract had lower effect than pericarp in a dose dependent manner. Conclusion: This study showed that methanol extract of pericarp of P. solandri is more powerful than that of the seed regarding its antioxidant, hepato-protective; renal function protective, analgesic, and anti-inflammatory effects[m2] . The phenolic compounds isolated from the methanol extract of pericarp were responsible for bioactivity

CYTOTOXIC EFFECT, ANTIOXIDANT POTENTIAL, AND PHYTOCHEMICAL STUDY OF THE ETHYL ACETATE EXTRACT OF PLEIOGYNIUM TIMORENSE SEEDS

Objective: The aim of the current research was to evaluate the cytotoxicity of Pleiogynium timorense seeds against different human cancer cell lines, its antioxidant activity and to investigate its phytoconstituents. Methods:  Ethyl acetate extract of Pleiogynium timorense seeds was assayed for the cytotoxic effect against liver cancer cell line (HepG2), ovarian cancer cell line (SKOV-3) and prostate cancer cell line (PC-3) using SRB (Sulforhodamine B) assay. The antioxidant activity was evaluated by the DPPH radical scavenging assay using Trolox as a standard. The phytochemical components of the plant extract were examined using various phytochemical screening methods. The polyphenolic contents of the extract were analyzed using high performance liquid chromatography (HPLC). Results: The result revealed that the seed extract exhibited very potent effect against HepG-2 cancer cell line with IC50=1.62 μg/mL, and against SKOV-3 cancer cell line with IC50 =6.37 μg/mL, while a moderate effect against PC-3 cancer cell line with IC50=46 μg/mL, by comparing with that of Doxorubicin. Moreover, IC50 values of Trolox and the seed extract were 24.42 ± 0.87 and 90.4±0.32 μg/ml, respectively. The results revealed the presence of the flavonoids, tannins and triterpenes and/or sterols in the seed extract. While, it revealed the absence of coumarins, alkaloids, saponins and carbohydrate and/or glycosides from the extract. Conclusion: In conclusion, the current study highlights the effect of ethyl acetate extract of Pleiogynium timorense seeds as antioxidant and a potent cytotoxic agent against different human cell lines aiming to be the first step towards the discovery of safe natural anticancer drug.                        Peer Review History: Received: 3 May 2022; Revised: 15 June; Accepted: 6 July, Available online: 15 July 2022 Academic Editor: Dr. Tamer Elhabibi, Suez Canal University, Egypt, [email protected] Received file:                             Reviewer's Comments: Average Peer review marks at initial stage: 5.5/10 Average Peer review marks at publication stage: 7.0/10 Reviewers: Dr. Sangeetha Arullappan, Universiti Tunku Abdul Rahman, Malaysia, [email protected] Prof. Dr. Ali Gamal Ahmed Al-kaf, Sana'a university, Yemen, [email protected] Similar Articles:   CYTOTOXIC EFFECT AND PHYTOCHEMICAL STUDY OF PETROLEUM ETHER EXTRACT OF TILIA CORDATA MILL ANTIOXIDANT EFFICACY OF VITELLARIA PARADOXA NUTS DERIVATIVE PRODUCTS (BUTTER, HULLS AND PRESS CAKES) ANTIHYPERGLYCEMIC AND ANTI-OXIDANT POTENTIAL OF ETHANOL EXTRACT OF VITEX THYRSIFLORA LEAVES ON DIABETIC RAT

Gastroprotective and antisecretory effects of Ailanthus excelsa (Roxb)

Ailanthus excelsa (Roxb), an Egyptian medicinal species highly important for treating numerous diseases, was investigated against experimentally induced gastric ulcer in rodents. We evaluated the gastroprotective effect of four extracts (petroleum ether, diethyl ether, chloroform, and methanol) of A. excelsa bark by using the ethanol-induced gastric lesion model. The pretreatment of animals with methanolic, petroleum ether, and chloroformic extracts (100 mg/kg, oral (p.o.)) from A. excelsa significantly reduced gastric lesion induced by ulcerogenic agent (56, 47, and 70%, respectively) when compared with animals pretreated with vehicle. However, the diethyl ether pretreatment led to the least gastric lesion damage (83%), similar to the standard antiulcer drug, cimetidine, at the same dose (100 mg/kg, p.o.). The lower effective dose of diethyl ether extract, as well as cimetidine, given by intraduodenal route, significantly increased the pH values and reduced the acid output of gastric juice. Sterols, triterpenes, and quassinoids are present in the diethyl ether extract of A. excelsa stem bark, which presented the best gastroprotective action among the studied extracts. Our study confirmed the traditional indications of A. excelsa for the treatment of gastric ulcer

Surgical site infection after gastrointestinal surgery in children : an international, multicentre, prospective cohort study

Introduction Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). However, there is a lack of data available about SSI in children worldwide, especially from low-income and middle-income countries. This study aimed to estimate the incidence of SSI in children and associations between SSI and morbidity across human development settings. Methods A multicentre, international, prospective, validated cohort study of children aged under 16 years undergoing clean-contaminated, contaminated or dirty gastrointestinal surgery. Any hospital in the world providing paediatric surgery was eligible to contribute data between January and July 2016. The primary outcome was the incidence of SSI by 30 days. Relationships between explanatory variables and SSI were examined using multilevel logistic regression. Countries were stratified into high development, middle development and low development groups using the United Nations Human Development Index (HDI). Results Of 1159 children across 181 hospitals in 51 countries, 523 (45 center dot 1%) children were from high HDI, 397 (34 center dot 2%) from middle HDI and 239 (20 center dot 6%) from low HDI countries. The 30-day SSI rate was 6.3% (33/523) in high HDI, 12 center dot 8% (51/397) in middle HDI and 24 center dot 7% (59/239) in low HDI countries. SSI was associated with higher incidence of 30-day mortality, intervention, organ-space infection and other HAIs, with the highest rates seen in low HDI countries. Median length of stay in patients who had an SSI was longer (7.0 days), compared with 3.0 days in patients who did not have an SSI. Use of laparoscopy was associated with significantly lower SSI rates, even after accounting for HDI. Conclusion The odds of SSI in children is nearly four times greater in low HDI compared with high HDI countries. Policies to reduce SSI should be prioritised as part of the wider global agenda.Peer reviewe

Exploring the cost-effectiveness of high versus low perioperative fraction of inspired oxygen in the prevention of surgical site infections among abdominal surgery patients in three low- and middle-income countries

Background: This study assessed the potential cost-effectiveness of high (80–100%) vs low (21–35%) fraction of inspired oxygen (FiO2) at preventing surgical site infections (SSIs) after abdominal surgery in Nigeria, India, and South Africa. Methods: Decision-analytic models were constructed using best available evidence sourced from unbundled data of an ongoing pilot trial assessing the effectiveness of high FiO2, published literature, and a cost survey in Nigeria, India, and South Africa. Effectiveness was measured as percentage of SSIs at 30 days after surgery, a healthcare perspective was adopted, and costs were reported in US dollars ($). Results: High FiO2 may be cost-effective (cheaper and effective). In Nigeria, the average cost for high FiO2 was$216 compared with $222 for low FiO2 leading to a −$6 (95% confidence interval [CI]: −$13 to −$1) difference in costs. In India, the average cost for high FiO2 was $184 compared with$195 for low FiO2 leading to a −$11 (95$15 to −$6) difference in costs. In South Africa, the average cost for high FiO2 was$1164 compared with $1257 for low FiO2 leading to a −$93 (95% CI: −$132 to −$65) difference in costs. The high FiO2 arm had few SSIs, 7.33% compared with 8.38% for low FiO2, leading to a −1.05 (95% CI: −1.14 to −0.90) percentage point reduction in SSIs. Conclusion: High FiO2 could be cost-effective at preventing SSIs in the three countries but further data from large clinical trials are required to confirm this