Anticancer activity of aqueous myrrh extract alone and in combination with cisplatin in HeLa cells

Purpose: To study the impact of an aqueous myrrh extract on the proliferation of cervical cancer cells in vitro.Methods: First, 100 g of ground myrrh resin was boiled in 1000 mL of distilled water for 30 min. Different components of the decoction were identified using gas chromatography–mass spectrometry and high-performance liquid chromatography. The effects of high (20 μg/mL) and low (10 μg/mL) concentrations of cisplatin, serial concentrations of myrrh (20, 40, 60, and 80 μg/mL), and a combination of both were evaluated using cell proliferation assay, DNA fragmentation, and electron microscopy.Results: All four myrrh concentrations decreased the viability of HeLa cells (16.25 % p < 0.01). A significant further decrease occurred when myrrh was combined with 10 μg/mL cisplatin (11.42 % p < 0.01). This was confirmed by quantifying DNA fragmentation. Ultrastructurally, HeLa cells showed typical apoptosis after treatment with 10 μg/mL cisplatin or a high dose of myrrh. The use of 20 μg/mL cisplatin or the combined therapy resulted in cell necrosis with ruptured cell membranes and autophagosomes. The effect of combined therapy was more lethal than the effect of either of them alone.Conclusion: Myrrh induces apoptosis and autophagy and enhances the activity of cisplatin in vitro. It is potentially a basis for further studies of other types of cancer cell. The clinical use of myrrh in the palliative therapy of human cervical carcinoma might be justified.Keywords: Cervical cancer, Cell viability, Chemotherapy, DNA fragmentation, Myrrh, Cisplatin, Cell ultrastructure, HeLa cell

Prevention of stillbirths: impact of a two-stage screening for vasa previa

Objectives: To examine the feasibility and effectiveness of a two-stage ultrasound screening strategy for detection of vasa previa and estimate the potential impact of screening on prevention of stillbirth. Methods: This was a retrospective examination of data from prospective screening for vasa previa in singleton pregnancies undertaken at the Fetal Medicine Centre at Medway Maritime Hospital, UK between 2012 and 2018. Women booked for prenatal care and delivery in our hospital had routine ultrasound examinations at 11-13 and 20-22 weeks’ gestation. Those with velamentous cord insertion at the inferior part of the placenta at the first-trimester scan and those with low-lying placenta at the second-trimester scan were classified as high-risk for vasa previa and had transvaginal sonography specifically searching for vasa previa at the time of the 20-22 weeks scan. The management and outcome of cases with suspected vasa previa is described. We excluded cases of miscarriage or termination at <24 weeks’ gestation. Results: The study population of 26,830 singleton pregnancies, included 21 (0.08% or 1 in 1,278) with vasa previa. In all cases of vasa previa the diagnosis was made at the 20-22 weeks scan and confirmed by gross and histological examination of the placenta postnatally. At the 11-13 weeks scan the cord insertion was classified as central in 25,071 (93.4%) cases, marginal in 1,680 (6.3%), and velamentous in 79 (0.3%). In 16 (76.2%) of the 21 cases of vasa previa, the cord insertion at the first-trimester scan was classified as velamentous at the inferior part of the placenta, in 2 (9.5%) as marginal and in 3 (14.3%) as central. The 21 cases of vasa previa were managed on an outpatient basis with serial scans for measurement of cervical length and elective cesarean section at 34 weeks’ gestation; all babies were liveborn but there was one neonatal death. In the study population there were 83 stillbirths and postnatal examination showed no evidence of vasa previa in any of the cases. On the assumption that if we had not diagnosed prenatally all 21 cases of vasa previa in our population half of these cases would have resulted in stillbirth, then the potential impact of screening is prevention of 9.6% (10/104) of stillbirths. Conclusion: A two-stage strategy of screening for vasa previa can be incorporated into routine clinical practice and such strategy could potentially reduce the rate of stillbirth

The beneficial roles of insulin and parathyroid hormones in the treatment of experimentally induced diabetic osteoporosis in female rats: bone mineral density, morphometric and histological studies

Background: Diabetes mellitus (DM) and osteoporosis are two frequent medical conditions with an increasing prevalence in elderly people and are responsible for large number of incurable fractures. This study is designed experimentally in female rats in order to determine whether combined treatment of insulin and parathyroid hormone (PTH) enhances the reversibility of the osteoporotic changes that occurred in streptozotocin (STZ)-induced DM. Materials and methods: In this study, 30 adult female rats aged 3 months were used, they were randomly divided into: control group (6 rats) and diabetes group (24 rats), in which experimental DM was induced by i.p. injection of a single dose of STZ (60 mg/kg/body weight). Diabetic group was further divided into four subgroups (6 rats each): non-treated diabetic, insulin-treated (8–12 units s.c./day of Humalin U-40), PTH-treated (6.0 μg s.c./kg/day) and combined insulin and PTH-treated subgroups. All tested groups were assessed for body weight, food and water consumptions. Results: At the end of the experimental period, the bone mineral density (BMD) was measured for all rats of different groups; then the rats were sacrificed and blood samples were collected for measuring glucose, alkaline phosphatase and osteocalcin levels. Right femora were dissected out and subjected to measurement of diameter of neck and shaft, length of shaft, and weight. Then the femora specimens were processed and stained with haematoxylin and eosin for histological study. The results showed that there was a statistically significant, decrease in BMD, increase in the level of alkaline phosphate, and decrease in the level of osteocalcin in rats in diabetic group compared with other groups; these parameters improved in other groups, especially in diabetes/insulin/PTH group. The rats in diabetic group showed statistically significant decrease in neck and shaft diameters and weight of femur bone compared with other groups, while rats in diabetes/insulin/PTH group showed a significant improvement of these parameters. In diabetic group, there were different histopathological changes in cortical bone and Haversian canals, which improved in other groups, especially in rats in diabetes/insulin/PTH group. Conclusions: The untreated DM resulted in dramatic reduction in BMD and morphometric parameters. Treatment with insulin ameliorated these effects to some extent, while PTH co­-treatment had a more positive effect. The combination of PTH and insulin resulted in stronger improvement of all parameters to approximately like those of control rats

Oxidative stress pattern in hepatitis C patients co-infected with schistosomiasis

This study was designed to investigate the role of hepatitis C virus (HCV)-induced oxidative stress in the pathogenesis of the disease with the measurement of tumor necrosis factor (TNF-∝) and super oxide dismutase (SOD). Eighty patients from Hepatology Unit, Faculty of Medicine, Ain Shams University, were investigated. Thirty patients with bilharzial HCV and 30 patients with non-bilharzial HCV as compared to 20 healthy controls of the same age and sex ratio were investigated. The concentrations of liver enzymes [glutamic oxaloacetic transaminase (GOT), glutamic pyruvic transaminase (GPT), alkaline phosphatase (ALP)], bilirubin (Bil), albumin (Alb) and total protein (TP) as well as TNF-α and Mn-SOD were determined. The mean level of the different liver function tests in the three groups in the study showed that the levels of GOT, GPT and ALP were significantly higher in the HCV groups as compared to the control group (p &lt; 0.05). While serum bilirubin, albumin and total protein were non-significantly decreased in the HCV groups as compared to the control group (p &gt; 0.05). Furthermore, the mean level of TNF-α was significantly higher in the HCV groups as compared to the control group (p &lt; 0.001) and SOD was significantly decreased in the HCV groups as compared to the control group (p &lt; 0.001). There is a cause-effect relationship between increased levels of TNF-α and decreased levels of SOD, relative to progression of chronic HCV, especially with bilharzias co-infection. Supporting the view that oxidative damage plays a role in chronic HCV infection, also TNF-α establishes a positive auto regulatory loop that can amplify the inflammatory response and lead to chronic inflammation. More evidence indicates that HCV block apoptosis and prolong survival of the host cell in order to gain time for replication and increase viral progeny production.Key words: Hepatitis C virus, tumor necrosis factor-alpha, superoxide dismutase, oxidative stress, schistosomiasis

Subclinical hypothyroidism among Egyptian children with systemic lupus erythematosus

Background: Thyroid autoimmune diseases have been associated with systemic lupus erythematosus (SLE). Both hypothyroidism and hyperthyroidism are seen, but hypothyroidism is the most common abnormality. Subclinical hypothyroidism (SCH) has been reported among adult lupus patients. SCH is not without risk as it might contribute to a proatherogenic state. Objectives: This study was aimed to assess the frequency of SCH in a group of Egyptian children with SLE and its effects on the serum lipids. Methods: Forty patients with pediatric SLE who regularly follow up at our center were enrolled in this study. They were subjected to routine laboratory investigations of SLE and measurement of serum lipids (serum triglycerides, cholesterol, LDL and HDL) as well as free thyroxine (T4), thyroid stimulating hormone (TSH) and anti-thyroperoxidase antibody (anti-TPO-ab) titre. SLE activity was assessed using the systemic lupus erythematosus disease activity index (SLEDAI). Results: Six patients (15%) were found to have SCH while the remaining 34 patients (85%) had normal thyroid function. Anti-TPO-abs were positive in 4 out of the 6 (66.6 %) SLE patients with SCH and in 20 out of the 34 (58.8%) SLE patients with normal thyroid function. In SLE patients with SCH, TSH correlated positively yet insignificantly with anti-TPO-ab titre and the duration of SLE (p = 0.17, p = 0.12, respectively). There were no statistically significant correlations between the serum lipids of SLE patients with SCH and their thyroid function or anti-TPO-ab titre. Conclusion: SCH is not uncommon among children with SLE. This SCH does not seem to affect serum lipids. However, further longitudinal studies on wider scales are needed to assess the long term effects of SCH in those patients.Keywords: SLE, anti-thyroperoxidase antibodies, subclinical hypothyroidismEgypt J Pediatr Allergy Immunol 2011;9(2):87-9

Fahmy's four quadrant sutures: a new technique for control of blood loss during cesarean delivery for placenta previa

Background: The objective of this study is to assess the efficacy and safety of Fahmy's four quadrant suture technique (FFQS) in controlling blood loss during cesarean delivery for placenta previa (PP).Methods: The study was carried out in a tertiary University Hospital between January 2017 to December 2017 involved 12 women with heavy bleeding occurred after removal of the placenta from the lower section during cesarean delivery for PP. The FFQS technique consisted of two sutures to ligate the uterine branches on both sides and two sutures on the anterior and posterior wall of the lower uterine segment. Details regarding the management and maternal outcomes were recorded.Results: The mean age of the study participants was 29.58±5.29 years and the mean parity was 2.25±1.14. The mean gestational age at termination of pregnancy was 36.91±1.38 weeks.  The mean duration of the whole surgery was 78.75±43.28 minutes, while the mean duration of FFQS technique was only 10±2.09 minutes. The technique was exclusively effective in 8 out of 12 cases (66.67%) while 2 cases needed bilateral internal iliac artery ligation and 2 cases needed hysterectomy. The mean amount of blood loss in all cases was 2433.33±833.76 ml. the mean amount of transfused packed RBCs was 3.92±1.68 units and fresh frozen plasma (FFP) was 3.42±1.44 units. All cases had uneventful postoperative course and no mortality cases in present series.Conclusions: The new technique; FFQS represents a rapid, effective, and inexpensive opportunity for women with bleeding from the lower segment of uterus due to PP. This simple procedure should be attempted before other complex measures to achieve good hemostasis

ANTIOXIDANT AND HEPATOPROTECTIVE EFFECTS OF JUSTICIA SPICIGERA ETHYL ACETATE FRACTION AND CHARACTERIZATION OF ITS ANTHOCYANIN CONTENT

Objective: The antioxidant and hepatoprotective activities of ethyl acetate (EA) fraction of the dried aerial part of Justicia spicigera were evaluated and the characterization of its anthocyanin content was done. Methods: Hepatic fibrosis was induced by carbon tetrachloride (CCl4) in rats. The ethyl acetate fraction was obtained by successive liquid/liquid fractionation of the crude cold ethanolic extract and the pigments were characterized by HPLC technique. The in vitro studies were carried out through evaluation of the EA fraction on the attenuation of 1, 1-Diphenyl-2-picrylhydrazyl (DPPH) free radicals. The in vivo biological evaluation was done in CCl4 injured rats through determination of liver function indices, oxidative stress markers and the histopathological picture of the treated liver.Results: The phenolic content in the EA fraction was 42.94 mg/g. Twelve anthocyanins were identified, the major of which are peonidin 3, 5-diglucoside (64.30%), malvidin 3, 5-diglucoside (10.59%) and petunidin 3,5-diglucoside (4.71%). Treatment of CCl4 intoxicated rats with EA fraction recorded improvement in the liver function indices and oxidative stress markers. The histopathological observations confirmed our results.Conclusion: The ethyl acetate fraction of the dried aerial part of Justicia spicigera recorded antioxidant and hepato protective activities.Â