RELATIONSHIP OF SERUM DIPEPTIDYL PEPTIDASE-IV ACTIVITY AND ANTI-CASEIN ANTIBODIES TO GASTROINTESTINAL SYMPTOMS AMONG CHILDREN WITH AUTISM SPECTRUM DISORDER: AN EGYPTIAN STUDY

 Objectives: The objectives of the study were to assess serum dipeptidyl peptidase-IV (DPP-IV) activity in autistic children suffering from severe gastrointestinal (GI) disorder and to examine the hypothesis that there is a link between DPP-IV activity in serum and GI disorder in a subgroup of children with autism spectrum disorder (ASD).Subjects and Methods: Serum levels of casein antibodies and DPP-IV enzyme activity from 40 autistic children with chronic GI symptoms, and 40 of age-matched children without autism or gastrointestinal (GI) symptoms were assayed using enzyme-linked immunosorbent assay kits.Results: In comparison with controls, developmental milestones were delayed among autistic children. The serum DPP-IV activity was significantly lower in the studied patients (p<0.05), while the mean serum levels of casein antibodies were statistically significantly higher in the studied patients (p<0.01). Multiple logistic regression analysis recorded significant association between the high serum level of antibodies to casein, food selectivity and recurrent attacks of abdominal pain (p<0.05), while the low serum DPP-IV enzyme activity was associated with recurrent attacks of abdominal pain in the studied patients with a prediction of 95% (p<0.05).Conclusions: Serum levels of casein antibodies were higher in children with ASD, and maybe contributes to their abdominal pain, and food selectivity. Serum DPP-IV enzyme activity was lower and associated with recurrent attacks of abdominal pain in the studied patients. They may benefit from a supplemental digestive enzyme formula

Isolation of biologically active metabolites from Bougainvillea spectabilis Willd. cultivated in Egypt

Bougainvillea spectabilis Willd.  is an ornamental plant cultivated in tropical, subtropical regions and other places as Egypt. The present study aimed to perform bioassay guided fractionation and isolation of some of the bioactive compounds from the Egyptian cultivate. The total ethanol extracts of the leaves (T.ET.L.), stems (T.ET.S.) and flowers (T.ET.F.) were screened for some pharmacological activities viz. in vivo anti-oxidant and anti-hepatotoxic, in addition to in vitro cytotoxic activities. The anti-oxidant effect was assessed by measuring serum glutathione level (GSH) in alloxan-induced diabetic rats. The anti-hepatotoxic activity was evaluated via measuring serum markers level viz. alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase (ALP) in CCl4-induced hepatotoxicity in rats. In vitro cytotoxicity of the different extracts was estimated for liver cancer cell line (HEPG2) adopting Sulforhodamine B stain assay. T.ET.L. exhibited significantly potent anti-oxidant and anti-hepatotoxic activities, while T.ET.S. showed the highest cytotoxic activity. Through biological guided fractionation, leaves and stems were subjected to successive solvent extraction, whereas the leaves ethyl acetate (Et.Ac.L.) and the stems ethanol 70% (Et.70%S.) extracts showed highly potent activities. Thus, different chromatographic techniques were performed on Et.Ac.L. and Et.70%S. extracts leading to the isolation of five bioactive metabolites. Three flavonoids were isolated from Et.Ac.L.; genistein-7-O-rutinoside (1), formononetin-7-O-rutinoside (2) and myricetin (3), while orobol-7-O-glucoside (4) and hesperidin (5) were isolated from Et.70%S. This work demonstrated the importance of the plant as a promising anti-oxidant, anti-hepatotoxic and cytotoxic product for nutraceutical use

Herd Immunity against Severe Acute Respiratory Syndrome Coronavirus 2 Infection in 10 Communities, Qatar.

We investigated what proportion of the population acquired severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and whether the herd immunity threshold has been reached in 10 communities in Qatar. The study included 4,970 participants during June 21-September 9, 2020. Antibodies against SARS-CoV-2 were detected by using an electrochemiluminescence immunoassay. Seropositivity ranged from 54.9% (95% CI 50.2%-59.4%) to 83.8% (95% CI 79.1%-87.7%) across communities and showed a pooled mean of 66.1% (95% CI 61.5%-70.6%). A range of other epidemiologic measures indicated that active infection is rare, with limited if any sustainable infection transmission for clusters to occur. Only 5 infections were ever severe and 1 was critical in these young communities; infection severity rate of 0.2% (95% CI 0.1%-0.4%). Specific communities in Qatar have or nearly reached herd immunity for SARS-CoV-2 infection: 65%-70% of the population has been infected

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

Phytochemical and biological study of callus cultures of <i>Tulbaghia violacea</i> Harv. Cultivated in Egypt

<p>As <i>in vitro</i> plant cultures are used extensively to produce bioactive metabolites, our goal was to establish calli from <i>Tulbaghia violacea</i> Harv. flowers and assess the tissue phytochemically and biologically. Murashige & Skoog medium(MS) + 22.6 μM 2,4-dichlorophenoxyacetic acid +2.2 μM benzylaminopurine induced callus from flowers. Gas chromatography/mass spectrometry(GC/MS) analyses of <i>n</i>-hexane extracts of calli(HC) and flowers(HF) revealed 33 and 32 components(92.6 and 98.5%, respectively). Hydrocarbons were predominant in HC (55.0%), whereas a higher percentage of oxygenated compounds was found in HF(74.6%). <i>Trans</i>(E)-anethole(39.1%) and 16-hentriacontanone (30.3%) dominated in HF and HC, respectively. However, sulphur compounds were only detected in HF. Quantitative estimation of thiosulphinates, phenolics, flavonoids and saponins in ethanolic extracts of calli(EC) and flowers(EF) showed much higher contents in EF. Antioxidant, antimicrobial and cytotoxic screening of extracts demonstrated that EF was the most potent, followed by HF and EC; conversely, HC was inactive. Although HC and EC were less biologically active, these calli could be an alternative source of bioactive metabolites.</p

Effect of obstructive sleep apnea syndrome on sleep architecture: comparative study between geriatrics and middle-aged adult patients

Background Obstructive sleep apnea (OSA) is a prevalent sleep disordered breathing in geriatrics but still frequently undiagnosed. Sleep architecture changes with ageing. Geriatrics spend more time in the N1, N2 than in N3, REM. Also, there are more frequent awakenings, arousals and sleep stage shifts. This leads to decrease in sleep efficiency. Geriatric patients with OSA have more affected sleep architecture than middle-aged adults. The aim This work aimed to assess and compare sleep architecture changes in geriatrics versus middle-aged adult patients with OSA syndrome. Patients and methods This comparative study conducted in chest department Menoufia University Hospitals included 50 patients divided to two equal groups; geriatric group age 65 years old or more and middle-aged adult group aged from 18 to 50 years old. All patients were complaining of symptoms suggestive of OSA. All patients underwent sleep questionnaires and Polysomnography using model; Philipsrespironic alice6. Results There was no statistically significant difference between the studied groups regarding sex, smoking, co morbidities, BMI and symptoms. Regarding changes in sleep architecture, geriatric group showed a significantly higher Sleep latency and wakefulness after sleep onset in comparison to middle-aged adults (P=0.004 and 0.039, respectively) versus significantly lower Sleep efficiency, N3%, REM% (P=0.009,0.011 and 0.001, respectively). The median Total Apnea-Hypopnea index was 40.2 (/h sleep) in geriatric group and 35.4 in middle-aged adult group. Regarding severity of OSA; geriatric group showed mild OSA in five (20%) patients, moderate in five (20%) patient and severe in 15 (60%) patients. Middle-aged adults showed mild OSA in 10 (40%) patients, moderate in two (8%) patients, and severe in 13 (52%) patients. Conclusions Sleep architecture is affected in all OSA patients, but these changes are more obvious in geriatric patients. Geriatric patients have higher wakefulness after sleep onset and sleep latency. On the other hand, they have a lower N3%, REM% and sleep efficiency

SERUM ANTIGLIADIN ANTIBODIES IN EGYPTIAN CHILDREN WITH AUTISM SPECTRUM DISORDER: RELATIONSHIP TO GASTROINTESTINAL SYMPTOMS, BEHAVIORAL AND SOCIAL COMMUNICATIONS

 Objectives: Gastrointestinal symptoms are major characteristic in children with autism spectrum disorder (ASD), drawing attention to a potent association with gluten sensitivity. The goal of this study was to evaluate anti-gliadin antibodies serum levels in a group of Egyptian children with ASDs and to address the potential link to gastrointestinal (GI) symptoms, behavioral, and social communications.Patients and Methods: This descriptive case–control study included 45 children diagnosed as ASD according to Diagnostic and Statistical Manual of Mental Disorders 5th Edition and a history of GI symptoms, compared with 45 apparently healthy children of matched age and sex. Serum anti-gliadin antibodies were measured using enzyme-linked immunosorbent assay kits.Results: Serum levels of IgM, IgA, and IgG class antibodies to gliadin showed a significant increase compared to healthy controls (p&lt;0.000). Multiple logistic regression analysis showed a significant association between the high serum levels of IgA and IgM class antibodies to gliadin in the studied patients and GI symptoms (p&lt;0.05). A significant association was detected between the high serum levels of IgG antibodies to gliadin and the behavior symptoms (p&lt;0.05).Conclusions: The anti-gliadin antibody response and its association with GI symptoms indicated the involvement of abnormal immunologic intestinal permeability in affected children. Immune system of some autistic patients could be abnormally triggered by gluten assumption

RELATIONSHIP OF SERUM DIPEPTIDYL PEPTIDASE-IV ACTIVITY AND ANTI-CASEIN ANTIBODIES TO GASTROINTESTINAL SYMPTOMS AMONG CHILDREN WITH AUTISM SPECTRUM DISORDER: AN EGYPTIAN STUDY

 Objectives: The objectives of the study were to assess serum dipeptidyl peptidase-IV (DPP-IV) activity in autistic children suffering from severe gastrointestinal (GI) disorder and to examine the hypothesis that there is a link between DPP-IV activity in serum and GI disorder in a subgroup of children with autism spectrum disorder (ASD).Subjects and Methods: Serum levels of casein antibodies and DPP-IV enzyme activity from 40 autistic children with chronic GI symptoms, and 40 of age-matched children without autism or gastrointestinal (GI) symptoms were assayed using enzyme-linked immunosorbent assay kits.Results: In comparison with controls, developmental milestones were delayed among autistic children. The serum DPP-IV activity was significantly lower in the studied patients (p&lt;0.05), while the mean serum levels of casein antibodies were statistically significantly higher in the studied patients (p&lt;0.01). Multiple logistic regression analysis recorded significant association between the high serum level of antibodies to casein, food selectivity and recurrent attacks of abdominal pain (p&lt;0.05), while the low serum DPP-IV enzyme activity was associated with recurrent attacks of abdominal pain in the studied patients with a prediction of 95% (p&lt;0.05).Conclusions: Serum levels of casein antibodies were higher in children with ASD, and maybe contributes to their abdominal pain, and food selectivity. Serum DPP-IV enzyme activity was lower and associated with recurrent attacks of abdominal pain in the studied patients. They may benefit from a supplemental digestive enzyme formula

SERUM ANTIGLIADIN ANTIBODIES IN EGYPTIAN CHILDREN WITH AUTISM SPECTRUM DISORDER: RELATIONSHIP TO GASTROINTESTINAL SYMPTOMS, BEHAVIORAL AND SOCIAL COMMUNICATIONS

 Objectives: Gastrointestinal symptoms are major characteristic in children with autism spectrum disorder (ASD), drawing attention to a potent association with gluten sensitivity. The goal of this study was to evaluate anti-gliadin antibodies serum levels in a group of Egyptian children with ASDs and to address the potential link to gastrointestinal (GI) symptoms, behavioral, and social communications.Patients and Methods: This descriptive case–control study included 45 children diagnosed as ASD according to Diagnostic and Statistical Manual of Mental Disorders 5th Edition and a history of GI symptoms, compared with 45 apparently healthy children of matched age and sex. Serum anti-gliadin antibodies were measured using enzyme-linked immunosorbent assay kits.Results: Serum levels of IgM, IgA, and IgG class antibodies to gliadin showed a significant increase compared to healthy controls (p&lt;0.000). Multiple logistic regression analysis showed a significant association between the high serum levels of IgA and IgM class antibodies to gliadin in the studied patients and GI symptoms (p&lt;0.05). A significant association was detected between the high serum levels of IgG antibodies to gliadin and the behavior symptoms (p&lt;0.05).Conclusions: The anti-gliadin antibody response and its association with GI symptoms indicated the involvement of abnormal immunologic intestinal permeability in affected children. Immune system of some autistic patients could be abnormally triggered by gluten assumption

Hepatoprotective and antioxidant polyphenols from a standardized methanolic extract of the leaves of Liquidambar styraciflua L.

The methanolic extract of the leaves of Liquidambar styraciflua L. (Altingiaceae) (LSE) was evaluated for hepatoprotective and antioxidant activities in carbon tetrachloride liver-damaged rats. Hepatotoxicity was induced via intraperitoneal injection of CCl4 1:9 in olive oil, at a dose of 0.5 ml/kg b.wt. The animals received the extract, orally, at two dose levels (250 and 500 mg/kg b.wt.) The administration regimen was twice a week, for six consecutive weeks. LSE exhibited a significant dose-dependent protective effect by lowering the serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), malondialdehyde (MDA) and ameliorating the level of serum protein. In addition, LSE showed antioxidant activity through improving the levels of blood glutathione (GSH), vitamin C, vitamin E and hepatic total protein contents. The LSE revealed activity approached that of silymarin, a known hepatoprotective agent. These biochemical observations were supported by examination of the histopathological features of the liver. Chromatographic fractionation of LSE afforded seven phenolic compounds. These were identified on the basis of chromatographic, chemical and spectroscopic analyses as: gallic acid (1), isorugosin B (2), casuarictin (3), quercetin-3-O-β-d-4C1-glucopyranoside (4), myricetin-3-O-α-l-1C4-rhamnopyranoside (myricetrin) (5), quercetin (6) and myricetin (7). The isolated phenolics probably account for the antioxidant and hepatoprotective effects exhibited by the parent extract. Furthermore, a validated RP-HPLC method was devised for standardization of LSE, in view to fulfill the requirements of efficient research methodology for evaluation of bioactive herbal drugs. The above findings suggested that LSE could be considered as a standardized herbal product with antifibrotic, hepatoprotective and antioxidant potential