Evaluation of Turkish Delight Prepared With Pigments And Essential Oils Extracted From Clementine (Citrus Clementine) Peels As Natural Antioxidants

مستخلص قشر الكلمينتين غني بالمركبات الفعالة كالزيوت الطيارة والصبغات النشطة بيولوجيًا. وقد يؤدى خلط الملبن بمستحلص قشور الكلمينتين الى ان يصبح أكثر فائدة من الناحية  الصحية بالاضافة الى انه قد يؤثر على  صفات الجودة الفيزيائية والكيميائية والحسية للمنتج. وقد تم فى هذه الدراسة تقدير محتوى الزيوت الأساسية بواسطة ال GC/MS والصبغات والنشاط المضاد للأكسدة لقشور الكلمينتين بالأضافة الى التقييم الحسى لعينات الملبن. اظهرت النتائج ان الليمونين (66.88%) كان هو المركب الأعلى فى المحتوى مقارنة بالزيوت الأساسية الاخرى. أظهرت قشور الكلمينتين نشاط مضاد للأكسدة باستخدام طرق DPPH و ABTS . أظهرت جميع تركيزات المستخلص قيم حسية مقبولة من حيث المظهر واللون والرائحة والقبول العام مقارنة بالملبن الكونترول. إلى جانب ذلك ، أظهرت عينات الملبن المحتوية على 15 مللجرام من مستخلص صبغة الأستازانثين أعلى درجات التقييم الحسيى مقارنة بعينات الملبن الأخرى والكونترول. وكان المنتج الأقل قبولًا لدى المحكمين هو المحتوى على تركيز 3.75 مللجرام من مستخلص صبغة الأستازانثين مقارنةً بالكونترول. كما أظهرت جميع العينات التي تم تحليلها أن الملبن المدعم من صبغة الأستازانتين والتي تحتوي على نسبة عالية من الزيوت الأساسية لها نشاط مضادات للأكسدة جيد. و  توصى الدراسة باستخدام قشر الكلمينتين كمكون وظيفي مفيد ذو قيمة غذائية وصحية يمكن استخدامة فى الصناعات الغذائية كإضافات.This experiment presented essential oils by GC/MS, pigment content, and their antioxidant activities as well as sensory evaluation of delight samples. Limonene (66.88%) was the most prevalent yield. The peels of clementine had DPPH and ABT Scavenging activity. All levels of pigment extract had better scores for all sensory values and recorded acceptable scores in terms of appearance, color, aroma, and overall acceptability compared to control delight. Besides, delight samples containing 15 mg astaxanthin pigment extract showed maximum sensory scores compared to other samples and control delight. On the other hand, the product was less acceptable to the panelists compared to control in the case of the addition of 3.75 mg astaxanthin pigment extract. All the analyzed samples showed that delight fortified with astaxanthin pigment which has high contents of essential oils has good antioxidant activities. As a general conclusion, Clementine peels are recommended as a useful value-added functional ingredient for the food industry as natural additives that will be healthier than artificial additives

Assessment of knowledge, attitude and behavior towards antibiotic use in primary health care patients in Fayoum Governorate, Egypt

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Medical students’ attitudes towards patient-centered care, Fayoum Medical School, Egypt

Background: Patient-centered care has been considered the foundation of healthcare quality and the core competency of the doctor-patient relationship.Aims: To assess the attitudes of medical students toward a patient-centered approach and identify the predictors of patient-centeredness scores.Methods: A cross-sectional study was carried out in Fayoum Medical School/Egypt using a validated Arabic version of the Patient-Practitioner Orientation Scale (PPOS).Results: The total PPOS score showed variable score as the grades move up. The total PPOS ranged from 0.05 to 4.39 with an average score of (2.71 ± 0.66) for the entire sample. The sharing and caring subscale score ranged from 0.56 to 4.44 and 0.44 to 5.33 with an average score of (2.33 ± 0.49) and (3.09 ± 0.92) respectively.Conclusion: Medical students had low patient-centered attitude. Medical curricula should be redesigned, and medical students may also benefit from engagement in patient healthcare service

Novel, Functional Fermented Dairy Product: Preparation and Evaluation of Dried Kishk-like Products from Fenugreek Seeds with Cow’s Milk, Camel’s Milk, and Goat’s Milk

The objective of this study was to evaluate the nutritional value of dried Kishk-like products using burghal of wheat, oat, and fenugreek with cow’s milk, camel’s milk, and goat’s milk. Kishk is an artisanal product that is popular in Egypt and the Middle East. This product is made primarily with wheat; however, to our knowledge, no research has used fenugreek seeds in making it. Changes in the physicochemical, microbial, and sensory properties of Kishk samples were followed over 90 days of storage at room temperature. The proximate analysis of fenugreek–Kishk samples (CF, AF, and GF) revealed the levels of moisture content (4.05–7.86%), protein (21.49–22.66%), fat (22.07–26.07%), fiber (13.59–14.19%), carbohydrate (22.16–28.37%), and ash (8.00–9.03%), and acidity ranged from 3.00% to 5.98%. Notably, the GF sample displayed the highest a*, b*, dC*, and ΔE values, along with the lowest L* value among all samples. Counts of coliform, yeasts and molds, Staphylococci, and spore-forming bacteria were not detected at detection limit < log CFU/g for any prepared Kishk-like samples. This was due to the combined levels of organic acids, high acidity, and low moisture content in Kishk samples that resulted in a safe food with a long shelf life. The Kishk-like samples thus could provide a complementary diet for infants up to six months, as well as a suitable option for children and elderly individuals requiring specialized care, offering an alternative to commercially available extracts

STEROLS BIOACTIVITY OF RUTA GRAVEOLENS L. AND MURRAYA PANICULATA L.

Objective: Ruta graveolens L. (R. graveolens) and Murraya paniculata L. (M. paniculata) are medicinal plants belonging to Rutaceae family have many uses in traditional medicine. The aim of the present study was to investigate sterols bioactivity of the two Rutaceae plant leaves.Methods: Sterols of the two Rutaceae plant leaves were identified using GC/MS. The antioxidant activities of the sterols of these herbs were evaluated by three different methods; free radical scavenging using 2,2′-Azino-bis (3-ethylbenzthiazoline-6-sulfonic acid) (ABTS), 1,1-Diphenyl-2-picryl-hydrazyl (DPPH) and total antioxidant activity. The anticancer activity of the sterols was determined by MTT assay against colorectal cancer HCT116, breast cancer MCF7, liver cancer HepG2 and lung cancer A549 cell lines. Anti-inflammatory activity was evaluated using albumin denaturation assay and antiviral activities against H5N1 virus were carried out using plaque reduction assay.Results: GC/MS assay showed β-Sitosterol (36%) as the most abundant sterols of R. graveolens followed by stigmasterol (18%), while stigmasterol (25.2%) was the most abundant one of M. paniculata steroids. The anti-inflammatory potential of R. graveolens steroids was significantly higher than that of diclofenac sodium (standard drug). M. paniculata sterols have higher antiviral activity (IC50= 0.15 of µg/ml) than R. graveolens sterols (IC50= 7.8 of µg/ml). The sterols of R. graveolens showed anticancer activity against MCF7 and A549 cells with inhibition 84.3 and 81%, at 100 µg/ml respectively. While M. paniculata sterols showed 77.3% inhibition against A549 cells.Conclusion: The current study suggests that the sterols of M. paniculata have more anti-viral activity than R. graveolens sterols which showed more anticancer and anti-inflammatory activities

A Study of Post-Caesarean Section Wound Infections in a Regional Referral Hospital, Oman

Objectives: The aim of this study was to determine the incidence of surgical site infections (SSI) in patients undergoing a Caesarean section (CS) and to identify risk factors, common bacterial pathogens and antibiotic sensitivity. SSI significantly affect the patient’s quality of life by increasing morbidity and extending hospital stays. Methods: A retrospective cross-sectional study was conducted in Nizwa Hospital, Oman, to determine the incidence of post-Caesarean (PCS) SSI from 2001 to 2012. This was followed by a case-control study of 211 PCS cases with SSI. Controls (220) were randomly selected cases, at the same hospital in the same time period, who had undergone CS without any SSI. Data was collected on CS type, risk factors, demographic profile, type of organism, drug sensitivity and date of infection. Results: The total number of PCS wound infections was 211 (2.66%). There was a four-fold higher incidence of premature rupture of the membranes (37, 17.53%) and a three-fold higher incidence of diabetes (32, 15.16%) in the PCS cases compared with controls. The most common organisms responsible for SSI were Staphylococcus aureus (66, 31.27%) and the Gram-negative Escherichia coli group (40, 18.95%). The most sensitive antibiotics were aminoglycoside and cephalosporin. Polymicrobial infections were noted in 42 (19.90%), while 47 (22.27%) yielded no growth. A high incidence of associated risk factors like obesity, hypertension, anaemia and wound haematoma was noted. Conclusion: Measures are recommended to reduce the incidence of SSI, including the implementation of infection prevention practices and the administration of antibiotic prophylaxis with rigorous surgical techniques

Chemerin Level in the Serum of Knee Osteoarthritis Patients and its Relation to Disease Severity

Background: Chemerin is a new adipokine that has been linked to joint inflammation and degeneration. It has a proinflammatory effect and modulates immune system activity. Objective: The aim of the work was to assess the chemerin role in diagnosis as well as monitoring of severity of the disease in knee osteoarthritis (KOA) patients.Patients and Methods: This case-control study included a total of 60 subjects, 30 of them had knee osteoarthritis (KOA) and 30 served as controls, attending at Department of Rheumatology, Rehabilitation, and Physical Medicine, Zagazig University Hospitals. Chemerin level was measured for all the subjects by ELISA technique. In osteoarthritis group, knee osteoarthritis was assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Results: Statistically insignificant differences in age, BMI, as well as sex were found among the 2 studied groups. Serum chemerin levels in patients with KOA were statistically significantly higher than in controls, with a p-value of 0.001. Serum chemerin had no statistically significant correlations to age, BMI, or length of illness, while WOMAC scores, CRP, as well as ESR were strongly associated with serum chemerin levels. Conclusion: It could be concluded that serum chemerin can be utilized as an inflammatory marker in KOA patients and it can be considered as a therapeutic target. Further studies are recommended to assess its levels in other types of OA, and other rheumatic diseases

An Epidemiological and Clinical Analysis of Cutaneous Adverse Drug Reactions Seen in a Tertiary Care Outpatient Clinic in Cairo, Egypt

A cutaneous adverse drug reaction (CADR) is any undesirable change in the structure or function of the skin, its appendages, or mucous membranes caused by a drug. The frequency of CADRs is variable, with only few studies evaluating it. Our aim was to identify the clinical spectrum of CADRs and document the epidemiological data of different types of drug eruptions among Egyptian patients attending a tertiary care center. An observational hospital-based analytical study was planned for a period of six months (January-June 2015). All patients attending the outpatient Dermatology Clinic at Kasr El Aini hospital were examined to detect patients with CADRs, who were subjected to a detailed questionnaire with a detailed drug history. A skin biopsy was taken to confirm the diagnosis and to detect the type of CADRs. The primary incidence of CADRs reported in our study was 0.28% (78 patients) from a total number of 27,093 patients. The most common CADRs were SJS/TEN in 12 patients (15.3%) and lichenoid drug eruptions in 12 patients (15.3%), followed by exanthematous drug eruptions in 11 patients (14.1%) and vasculitic drug eruptions in 9 patients (11.5%). The most common drug incriminated was ibuprofen in 6 patients (7.6%), followed by penicillin in 4 patients (5.1%) and aspirin in 3 patients (3.8%). In conclusion, incidence of CADRs in our study was similar to incidence reported in different countries; however, the incidence of life-threatening reactions such as SJS/TEN was higher compared with studies conducted abroad.</p

The Comparative Toxicity, Biochemical and Physiological Impacts of Chlorantraniliprole and Indoxacarb on Mamestra brassicae (Lepidoptera: Noctuidae)

Background: The cabbage moth, Mamestra brassicae, is a polyphagous pest that attacks several crops. Here, the sublethal and lethal effects of chlorantraniliprole and indoxacarb were investigated on the developmental stages, detoxification enzymes, reproductive activity, calling behavior, peripheral physiology, and pheromone titer of M. brasssicae. Methods: To assess pesticide effects, the second instar larvae were maintained for 24 h on a semi-artificial diet containing insecticides at their LC10, LC30, and LC50 concentrations. Results: M. brassicae was more susceptible to chlorantraniliprole (LC50 = 0.35 mg/L) than indoxacarb (LC50 = 1.71 mg/L). A significantly increased developmental time was observed with both insecticides at all tested concentrations but decreases in pupation rate, pupal weight, and emergence were limited to the LC50 concentration. Reductions in both the total number of eggs laid per female and the egg viability were observed with both insecticides at their LC30 and LC50 concentrations. Both female calling activity and the sex pheromone (Z11-hexadecenyl acetate and hexadecenyl acetate) titer were significantly reduced by chlorantraniliprole in LC50 concentration. Antennal responses of female antennae to benzaldehyde and 3-octanone were significantly weaker than controls after exposure to the indoxocarb LC50 concentration. Significant reductions in the enzymatic activity of glutathione S-transferases, mixed-function oxidases, and carboxylesterases were observed in response to both insecticides

The serum thyroid hormone profile in mechanically ventilated children: Does euthyroid sick syndrome exist?

Background: The term "euthyroid sick syndrome" refers to alterations in thyroid function testing during critical illness. Mechanically ventilated children's thyroid hormone levels may be altered, although the reason for this remains a mystery.Objective: This study was aimed to evaluate thyroid hormone profile in mechanically ventilated children and their correlation with mortality.Patients and Methods: Thirty-four mechanically ventilated children were enrolled in a prospective cohort study. On the first and third days of mechanical ventilation, serum TSH, FT3, FT4 and reverse T3 were measured.Results: The mean age of the studied patients was of 31.06 ± 35.94 months. After three days of mechanical ventilation, the serum levels of FT3 and FT4 in the blood were significantly lower than the serum levels on the first day. The serum reverse T3 levels increased significantly on the third day of mechanical ventilation compared to the first day. There was a statistically significant increase in the number of patients with low FT3 and FT4 serum levels on the third day compared to the first day. Twenty-two patients (64.7%) died, and the frequency of low FT3 among dead patients was signiisignificantlycantly higher than among surviving patients.Conclusions: It could be concluded that the mechanically ventilated children had signs of euthyroid sick syndrome, shown by low levels of FT3 and FT4 and a rise in rT3 without a compensatory rise in TSH. Serum FT3 and FT4 decreased, but reverse T3 increased, on the third day of mechanical ventilation compared to the first day. Patients who had low FT3 levels died at a higher rate