PHYTOCHEMICAL STUDY OF BIOACTIVE CONSTITUENTS FROM SATUREJA MONTANA L. GROWING IN EGYPT AND THEIR ANTIMICROBIAL AND ANTIOXIDANT ACTIVITIES

 Objective: This work aimed to investigate the lipid constituents and flavonoidal compounds of Satureja montana, in addition to evaluation of different extracts and/or isolated compounds as antimicrobials and antioxidants.Methods: The volatile and lipid constituents were extracted with n-hexane by partition from hydroalcoholic extract of S. montana L. aerial parts, after then were fractionated to unsaponifiable matters and fatty acid methyl esters which were identified by gas–liquid chromatography and/or gas chromatography–mass spectrometry. The phenolic constituents were isolated from the ethyl acetate fraction of the aqueous methanolic extract of the aerial parts of the plant. The antimicrobial activity of different extracts and the isolated compounds was evaluated against Gram-positive, Gram-negative bacteria, yeast, and fungus using a modified Kirby-Bauer disc diffusion method.Results: The identified compounds are luteolin-7-rhamnoside-4'-O-β-glucopyranoside (1), quercetin-3-O-α-L-rhamnopyranoside (2), quercetin- 7-O-glucopyranoside (3), luteolin-7-O-glucopyranoside (4), 5-hydroxy-6,7,8,4'-tetramethoxy flavone (5), gallic acid (6), 2,3-hexahydroxydiphenoyl 1-galloyl glucopyranoside (7), and quercetin (8). The structure of all isolated compounds was established using different chromatographic and spectroscopic measurements (PC, thin-layer chromatography, ultraviolet [UV], 1D, 2D-nuclear magnetic resonance, and MS). Compound-2 showed the highest antibacterial activity against all the tested microorganisms. Hydroalcoholic extract exhibited high antioxidant activity (87.7%). On the other hand, hexane fraction showed a low antioxidant activity (46.4%), in addition to the compound-8 showed the highest antioxidant activity (96.27%) in 2,2-diphenyl-1-picrylhydrazyl assay.Conclusion: It can be concluded that the hydroalcoholic extract of S. montana showed significant antimicrobial and antioxidant activity

POTENTIAL ROLE OF MILK THISTLE SEED AND ITS OIL EXTRACTS AGAINST HEART AND BRAIN INJURIES INDUCED BY γ-RADIATION EXPOSURE

Objective: This study aimed to investigate the protective effect of Silybum marianum (S. marianum) seeds extract its oil fraction against damage effect of γ-radiation in female albino rats.Methods: Ultrasonic-assisted extraction was used for the extraction of S. marianum seeds. Lipid patterns of S. marianum seeds oil were elucidated using gas chromatography-mass spectrometry (GC-MS). S. marianum seeds extract was analyzed using high-performance liquid chromatography (HPLC). Malondialdehyde (MDA), reduced glutathione (GSH) and metallothionein (MT) were estimated in heart and brain tissues of the examined rats. Lactate dehydrogenase (LDH) and creatine kinase-MB (CKMB) were measured in the serum of the examined rats, and the brain biomarkers; dopamine and serotonin were also measured.Results: The oil was found to be rich in linoleic acid (58.20%) and arachidic acid (23.38%). S. marianum seeds extract revealed the presence of taxifolin and six main active constituents of silymarin, including silydianin, silychristin, silybin A, silybin B, isosilybin A and isosilybin B. Treatment of γ-radiation damage effect using S. marianum seeds extract and its oil fraction led to a significant reduction of MDA levels in heart (139.6 and 165.5 nmol/g, respectively) and brain (158.5 and 135.2 nmol/g, respectively) tissues, however, significant increase of GSH levels in heart (316.4 and 293 mg/g, respectively) and brain (210.4 and 227 mg/g, respectively) tissues was observed, also a significant increase of dopamine levels (85.27 and 65.74 ng/g, respectively) and MT levels of heart tissues (108.5 and 70.52 mg/g, respectively) was observed.Conclusion: S. marianum seeds extract and its oil fraction showed a protective effect against γ-radiation-induced damage in heart and brain.Â

Evaluation of the antioxidant and antimicrobial activities of fucoxanthin from Dilophys fasciola and as a food additive in stirred yoghurt

We investigated the effects of fucoxanthin isolated from the edible macroalga Dilophys fasciola on pathogenic microbes and probiotics in vitro and the antioxidant activity of fucoxanthin. The yield concentration of the obtained crude was 50.5% fucoxanthin. We found strong inhibition against Gram-positive Staphylococcus aureus and Listeria monocytogenes, and lower inhibition against Gram-negative bacteria and fungi. The probiotic strains progressed between 1.2 and 1.67 log cycles at a concentration of 30 μg/mL. The antioxidant activity ranged between 54.76% and 88.36% at a concentration of 40 μg/mL. The 50% lethal dose of algal fucoxanthin was shown to be more than 2511.88 mg/kg. The production of stirred yoghurt incorporated with 20 mg and 30 mg of fucoxanthin per kilogram of milk was evaluated through chemical, microbiological, and sensory analyses during storage for 21 days and compared with control samples. The maximum growth for probiotics (Bifidobacterium bifidum and Lacticaseibacillus casei) was found on day 14, but more viability counts were detected in the treatment with 30 mg/kg. All treatments were free from mould and yeast counts up to 7 days, and the small numbers of mould, yeast, and psychrotrophic counts appeared first in control samples. Also, the highest dry matter content was observed for treatments with 30 mg/kg. Moreover, the protein, fat, and ash content of all treatments increased with a progressive cold storage period. Greater reductions in the pH were found in treatments than in the control, and were consistent with the development of acidity. During storage, the amount of crude fucoxanthin had no significant impact on the flavour, colour, or appearance scores. Significance: • Fucoxanthin is a type of carotenoid that offers many benefits to human health. • The fucoxanthin of edible Dilophys fasciola had a strong antimicrobial effect against Gram-positive bacteria, Gram-negative bacteria, and fungi. • Stirred yoghurt fortified with crude fucoxanthin had good overall acceptability and the percentage of crude fucoxanthin had no noticeable effects on the flavour, colour, or appearance. Fucoxanthin, therefore, has potential benefit as a food additive

FOLFIRINOX or Gemcitabine-based Chemotherapy for Borderline Resectable and Locally Advanced Pancreatic Cancer: A Multi-institutional, Patient-Level, Meta-analysis and Systematic Review

BackgroundPancreatic cancer often presents as locally advanced (LAPC) or borderline resectable (BRPC). Neoadjuvant systemic therapy is recommended as initial treatment. It is currently unclear what chemotherapy should be preferred for patients with BRPC or LAPC.MethodsWe performed a systematic review and multi-institutional meta-analysis of patient-level data regarding the use of initial systemic therapy for BRPC and LAPC. Outcomes were reported separately for tumor entity and by chemotherapy regimen including FOLFIRINOX (FIO) or gemcitabine-based.ResultsA total of 23 studies comprising 2930 patients were analyzed for overall survival (OS) calculated from the beginning of systemic treatment. OS for patients with BRPC was 22.0 months with FIO, 16.9 months with gemcitabine/nab-paclitaxel (Gem/nab), 21.6 months with gemcitabine/cisplatin or oxaliplatin or docetaxel or capecitabine (GemX), and 10 months with gemcitabine monotherapy (Gem-mono) (p < 0.0001). In patients with LAPC, OS also was higher with FIO (17.1 months) compared with Gem/nab (12.5 months), GemX (12.3 months), and Gem-mono (9.4 months; p < 0.0001). This difference was driven by the patients who did not undergo surgery, where FIO was superior to other regimens. The resection rates for patients with BRPC were 0.55 for gemcitabine-based chemotherapy and 0.53 with FIO. In patients with LAPC, resection rates were 0.19 with Gemcitabine and 0.28 with FIO. In resected patients, OS for patients with BRPC was 32.9 months with FIO and not different compared to Gem/nab, (28.6 months, p = 0.285), GemX (38.8 months, p = 0.1), or Gem-mono (23.1 months, p = 0.083). A similar trend was observed in resected patients converted from LAPC.ConclusionsIn patients with BRPC or LAPC, primary treatment with FOLFIRINOX compared with Gemcitabine-based chemotherapy appears to provide a survival benefit for patients that are ultimately unresectable. For patients that undergo surgical resection, outcomes are similar between GEM+ and FOLFIRINOX when delivered in the neoadjuvant setting

ASO Visual Abstract: FOLFIRINOX or Gemcitabine Based Chemotherapy for Borderline Resectable and Locally Advanced Pancreatic Cancer: A Multi-Institutional, Patient-Level Meta-Analysis and Systematic Review

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Trends in HIV/AIDS morbidity and mortality in Eastern 3 Mediterranean countries, 1990–2015: findings from the Global 4 Burden of Disease 2015 study

Objectives We used the results of the Global Burden of Disease 2015 study to estimate trends of HIV/AIDS burden in Eastern Mediterranean Region (EMR) countries between 1990 and 2015. Methods Tailored estimation methods were used to produce final estimates of mortality. Years of life lost (YLLs) were calculated by multiplying the mortality rate by population by age-specific life expectancy. Years lived with disability (YLDs) were computed as the prevalence of a sequela multiplied by its disability weight. Results In 2015, the rate of HIV/AIDS deaths in the EMR was 1.8 (1.4–2.5) per 100,000 population, a 43% increase from 1990 (0.3; 0.2–0.8). Consequently, the rate of YLLs due to HIV/AIDS increased from 15.3 (7.6–36.2) per 100,000 in 1990 to 81.9 (65.3–114.4) in 2015. The rate of YLDs increased from 1.3 (0.6–3.1) in 1990 to 4.4 (2.7–6.6) in 2015. Conclusions HIV/AIDS morbidity and mortality increased in the EMR since 1990. To reverse this trend and achieve epidemic control, EMR countries should strengthen HIV surveillance,and scale up HIV antiretroviral therapy and comprehensive prevention services

Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

As mortality rates decline, life expectancy increases, and populations age, non-fatal outcomes of diseases and injuries are becoming a larger component of the global burden of disease. The Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) provides a comprehensive assessment of prevalence, incidence, and years lived with disability (YLDs) for 328 causes in 195 countries and territories from 1990 to 2016

Global, regional, and national disability-adjusted life-years (DALYs) for 333 diseases and injuries and healthy life expectancy (HALE) for 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016

BACKGROUND: Measurement of changes in health across locations is useful to compare and contrast changing epidemiological patterns against health system performance and identify specific needs for resource allocation in research, policy development, and programme decision making. Using the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we drew from two widely used summary measures to monitor such changes in population health: disability-adjusted life-years (DALYs) and healthy life expectancy (HALE). We used these measures to track trends and benchmark progress compared with expected trends on the basis of the Socio-demographic Index (SDI). METHODS: We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 for all-cause mortality, cause-specific mortality, and non-fatal disease burden to derive HALE and DALYs by sex for 195 countries and territories from 1990 to 2016. We calculated DALYs by summing years of life lost and years of life lived with disability for each location, age group, sex, and year. We estimated HALE using age-specific death rates and years of life lived with disability per capita. We explored how DALYs and HALE differed from expected trends when compared with the SDI: the geometric mean of income per person, educational attainment in the population older than age 15 years, and total fertility rate. FINDINGS: The highest globally observed HALE at birth for both women and men was in Singapore, at 75·2 years (95% uncertainty interval 71·9-78·6) for females and 72·0 years (68·8-75·1) for males. The lowest for females was in the Central African Republic (45·6 years [42·0-49·5]) and for males was in Lesotho (41·5 years [39·0-44·0]). From 1990 to 2016, global HALE increased by an average of 6·24 years (5·97-6·48) for both sexes combined. Global HALE increased by 6·04 years (5·74-6·27) for males and 6·49 years (6·08-6·77) for females, whereas HALE at age 65 years increased by 1·78 years (1·61-1·93) for males and 1·96 years (1·69-2·13) for females. Total global DALYs remained largely unchanged from 1990 to 2016 (-2·3% [-5·9 to 0·9]), with decreases in communicable, maternal, neonatal, and nutritional (CMNN) disease DALYs offset by increased DALYs due to non-communicable diseases (NCDs). The exemplars, calculated as the five lowest ratios of observed to expected age-standardised DALY rates in 2016, were Nicaragua, Costa Rica, the Maldives, Peru, and Israel. The leading three causes of DALYs globally were ischaemic heart disease, cerebrovascular disease, and lower respiratory infections, comprising 16·1% of all DALYs. Total DALYs and age-standardised DALY rates due to most CMNN causes decreased from 1990 to 2016. Conversely, the total DALY burden rose for most NCDs; however, age-standardised DALY rates due to NCDs declined globally. INTERPRETATION: At a global level, DALYs and HALE continue to show improvements. At the same time, we observe that many populations are facing growing functional health loss. Rising SDI was associated with increases in cumulative years of life lived with disability and decreases in CMNN DALYs offset by increased NCD DALYs. Relative compression of morbidity highlights the importance of continued health interventions, which has changed in most locations in pace with the gross domestic product per person, education, and family planning. The analysis of DALYs and HALE and their relationship to SDI represents a robust framework with which to benchmark location-specific health performance. Country-specific drivers of disease burden, particularly for causes with higher-than-expected DALYs, should inform health policies, health system improvement initiatives, targeted prevention efforts, and development assistance for health, including financial and research investments for all countries, regardless of their level of sociodemographic development. The presence of countries that substantially outperform others suggests the need for increased scrutiny for proven examples of best practices, which can help to extend gains, whereas the presence of underperforming countries suggests the need for devotion of extra attention to health systems that need more robust support. FUNDING: Bill & Melinda Gates Foundation

Measuring progress and projecting attainment on the basis of past trends of the health-related Sustainable Development Goals in 188 countries: an analysis from the Global Burden of Disease Study 2016

The UN’s Sustainable Development Goals (SDGs) are grounded in the global ambition of “leaving no one behind”. Understanding today’s gains and gaps for the health-related SDGs is essential for decision makers as they aim to improve the health of populations. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016), we measured 37 of the 50 health-related SDG indicators over the period 1990–2016 for 188 countries, and then on the basis of these past trends, we projected indicators to 2030

Measuring performance on the Healthcare Access and Quality Index for 195 countries and territories and selected subnational locations: A systematic analysis from the Global Burden of Disease Study 2016

Background: A key component of achieving universal health coverage is ensuring that all populations have access to quality health care. Examining where gains have occurred or progress has faltered across and within countries is crucial to guiding decisions and strategies for future improvement. We used the Global Burden of Diseases, Injuries, and Risk Factors Study 2016 (GBD 2016) to assess personal health-care access and quality with the Healthcare Access and Quality (HAQ) Index for 195 countries and territories, as well as subnational locations in seven countries, from 1990 to 2016. Methods Drawing from established methods and updated estimates from GBD 2016, we used 32 causes from which death should not occur in the presence of effective care to approximate personal health-care access and quality by location and over time. To better isolate potential effects of personal health-care access and quality from underlying risk factor patterns, we risk-standardised cause-specific deaths due to non-cancers by location-year, replacing the local joint exposure of environmental and behavioural risks with the global level of exposure. Supported by the expansion of cancer registry data in GBD 2016, we used mortality-to-incidence ratios for cancers instead of risk-standardised death rates to provide a stronger signal of the effects of personal health care and access on cancer survival. We transformed each cause to a scale of 0-100, with 0 as the first percentile (worst) observed between 1990 and 2016, and 100 as the 99th percentile (best); we set these thresholds at the country level, and then applied them to subnational locations. We applied a principal components analysis to construct the HAQ Index using all scaled cause values, providing an overall score of 0-100 of personal health-care access and quality by location over time. We then compared HAQ Index levels and trends by quintiles on the Socio-demographic Index (SDI), a summary measure of overall development. As derived from the broader GBD study and other data sources, we examined relationships between national HAQ Index scores and potential correlates of performance, such as total health spending per capita. Findings In 2016, HAQ Index performance spanned from a high of 97\ub71 (95% UI 95\ub78-98\ub71) in Iceland, followed by 96\ub76 (94\ub79-97\ub79) in Norway and 96\ub71 (94\ub75-97\ub73) in the Netherlands, to values as low as 18\ub76 (13\ub71-24\ub74) in the Central African Republic, 19\ub70 (14\ub73-23\ub77) in Somalia, and 23\ub74 (20\ub72-26\ub78) in Guinea-Bissau. The pace of progress achieved between 1990 and 2016 varied, with markedly faster improvements occurring between 2000 and 2016 for many countries in sub-Saharan Africa and southeast Asia, whereas several countries in Latin America and elsewhere saw progress stagnate after experiencing considerable advances in the HAQ Index between 1990 and 2000. Striking subnational disparities emerged in personal health-care access and quality, with China and India having particularly large gaps between locations with the highest and lowest scores in 2016. In China, performance ranged from 91\ub75 (89\ub71-93\ub76) in Beijing to 48\ub70 (43\ub74-53\ub72) in Tibet (a 43\ub75-point difference), while India saw a 30\ub78-point disparity, from 64\ub78 (59\ub76-68\ub78) in Goa to 34\ub70 (30\ub73-38\ub71) in Assam. Japan recorded the smallest range in subnational HAQ performance in 2016 (a 4\ub78-point difference), whereas differences between subnational locations with the highest and lowest HAQ Index values were more than two times as high for the USA and three times as high for England. State-level gaps in the HAQ Index in Mexico somewhat narrowed from 1990 to 2016 (from a 20\ub79-point to 17\ub70-point difference), whereas in Brazil, disparities slightly increased across states during this time (a 17\ub72-point to 20\ub74-point difference). Performance on the HAQ Index showed strong linkages to overall development, with high and high-middle SDI countries generally having higher scores and faster gains for non-communicable diseases. Nonetheless, countries across the development spectrum saw substantial gains in some key health service areas from 2000 to 2016, most notably vaccine-preventable diseases. Overall, national performance on the HAQ Index was positively associated with higher levels of total health spending per capita, as well as health systems inputs, but these relationships were quite heterogeneous, particularly among low-to-middle SDI countries. Interpretation GBD 2016 provides a more detailed understanding of past success and current challenges in improving personal health-care access and quality worldwide. Despite substantial gains since 2000, many low-SDI and middle- SDI countries face considerable challenges unless heightened policy action and investments focus on advancing access to and quality of health care across key health services, especially non-communicable diseases. Stagnating or minimal improvements experienced by several low-middle to high-middle SDI countries could reflect the complexities of re-orienting both primary and secondary health-care services beyond the more limited foci of the Millennium Development Goals. Alongside initiatives to strengthen public health programmes, the pursuit of universal health coverage hinges upon improving both access and quality worldwide, and thus requires adopting a more comprehensive view-and subsequent provision-of quality health care for all populations