Investigation of non-pharmaceutical cures for acute pancreatitis induced by cerulein in rats

Purpose: To investigate the effect of N-acetylcysteine (NAC) alone or in  combination with α-lipoic acid (ALA) on cerulein induced acute pancreatitis (AP) in rats.Methods: AP was induced in 40 healthy male albino rats using a daily dose of cerulein (40 μg/kg) for three days. The rats were divided into four  groups: control, recovery (pancreatitis rats left without treatment), NAC (pancreatitis rats injected intraperitoneal (i.p.) with 25 mg NAC/kg daily) and NAC+ALA (pancreatitis rats treated with 25 mg NAC+100mg ALA/kg daily). The levels of carcinoembryonic antigen (CEA), cancer antigen242 (CA242), tumor necrosis factor-α (TNF-α), interlukin-1β (IL-1β), deoxyribonucleic acid (DNA) and ribonucleic acid (RNA) as well as the enzyme activities (amylase, lipase and trypsinogen activation peptide) were determined after 2- and 4-weeks of treatment.Results: Treatment with NAC or NAC+ALA led to a marked decrease in the levels of tumor markers, inflammatory cytokines, enzymes activity, DNA and RNA. The best amelioration effect occurred in the NAC+ALA rats group.Conclusion: NAC induces a significant improvement in all studied  parameters. Incorporation of NAC and ALA results in preeminent effects and it is considered an ideal cure for acute pancreatitis.Keywords: Acute pancreatitis, Cerulein, N-acetylcysteine, α-Lipoic aci

Assessment of Urinary Kidney Injury Molecule-1 as an Indicator of Early Renal Insult in Children with Cystic Fibrosis

BACKGROUND: The risk of acute kidney injury in cystic fibrosis (CF) patients is due to renal tubular affection by CFTR gene. AIM: Our study aimed at early detection of renal impairment in CF patients, to enable careful monitoring and adjustment of nephrotoxic medications. METHODS: Fifty patients with CF were enrolled in our study; they were age- and sex-matched to 40 healthy control children. All subjects were screened by urine analysis, measurements of kidney function tests, fractional excretion of sodium, β2-microglobulin (beta-2-M) excretion, and renal ultrasound examination. Urinary kidney injury molecule-1 (KIM-1) was assayed using ELISA technique. RESULTS: Both urinary beta-2-M and KIM-1 concentrations were significantly higher in CF patients compared to the control group (p < 0.001). The duration of the disease was significantly positively correlated with the urinary beta-2-M and KIM-1 levels (r = 0.6 and 0.7, respectively; p < 0.01). CONCLUSIONS: Our results showed that urinary KIM-1 can be considered as a sensitive early indicator of acute renal injury

Hepatoprotective effect of taurine and coenzyme Q10 and their combination against acrylamide-induced oxidative stress in rats

Purpose: To clarify the protective effects of Taurine (TA) and Coenzyme Q10 (CoQ10) for mitigation of acrylamide- induced oxidative damage. .Method: Acrylamide (AA), TA and CoQ10 were administered orally to rats for 2 and 4 weeks. Sixty albino rats of either sex weighing 200 ± 5 were randomly divided into five groups; control group, AA group, AA+ TA group, AA+ CoQ10 group and AA+ TA+ CoQ10 Group ( 15, 500 and 200 mg/kg/day dose, respectively). Hepatoprotection was assessed. The level of hepatic marker enzymes including serum lactate dehydrogenase (LDH), aspartate transaminase (AST) and alanine transaminase (ALT) were evaluated. The proinflammatory cytokines including serum levels of tumor necrosis factor-α (TNF- α), interleukin- 1β (IL- 1β) and interleukin-6(IL-6) were assessed. The levels of reduced glutathione (GSH), malondialdehyde (MDA) and myeloperoxidase (MPO) in liver homogenate were also performed.Results: TA or CoQ10 significantly decreased (p < 0.05) the elevation of hepatic markers (LDH, AST and ALT) induced by AA in rats. Reduction of serum proinflammatory cytokines (TNF-α, IL- 1β and IL-6) were also observed compared to AA group, and it was a time-effect relationship. Treatment with TA or CoQ10 also significantly reduced the oxidative stress induced by AA as shown by an increase in GSH level, and reduction of MDA level and MPO activities compared to rats treated with AA alone (p < 0.05). The hepatoprotective effect of both TA and CoQ10 combination was more efficient than the effect of either of them alone.Conclusion: The combination of TA and Co Q10 possesses a good potential to inhibit oxidative stress from liver and also exhibits anti-inflammatory activity. Thus, they have the potential to be used to mitigate AA- induced liver injury.Keywords: Taurine, Coenzyme Q10, Acrylamide, Oxidative stress, Biochemical profile, Proinflammatory cytokine

Serum Levels of Tissue Inhibitors of Metalloproteinase 2 in Patients With Systemic Sclerosis With Duration More Than 2 Years: Correlation With Cardiac and Pulmonary Abnormalities

In this study, we measured the serum concentration of TIMP-2 in patients with systemic sclerosis (SSc) and explored its possible correlation with cardiac and pulmonary lesions. We studied 42 patients with SSc, with duration equal to or more than 2 years. CT chest, ECG, echocardiography, and serum TIMP-2 concentration measurement using ELISA technique were performed in all patients and in 25 normal controls. The mean serum levels of TIMP-2 in patients was higher than in controls (P = .005). The mean CT score of dSSc patients with elevated TIMP-2 levels was significantly higher than dSSc patients with normal levels (P = .013). Four patients out of five with elevated TIMP-2 levels showed diastolic dysfunction (80%), compared to 2 out of 15 lSSc patients with normal levels (13.3%), with P = .014. Our research, though involving a small group of patients, points to the probable role of TIMP-2 in the development of pulmonary lesions in dSSc patients and cardiac lesions in lSSc patients with duration equal to or more than 2 years

Assessment of Ceruloplasmin, Hemopexin, and Haptoglobin in Asthmatic Children

BACKGROUND: Ceruloplasmin (Cp), haptoglobin, and hemopexin play a role in iron homeostasis and may function to modulate the systemic inflammatory response and be involved in tissue repair. We hypothesized that these proteins could be biological markers for bronchial asthma that reflect the involvement of iron oxidative stress in asthma pathogenesis. AIM: Evaluation of serum levels of proteins involved in iron homeostasis (Cp, hemopexin, and haptoglobin) in asthmatic children and their correlation to pulmonary functions. MATERIALS AND METHODS: Sixty moderate to severe persistent asthmatic children aged 6–13 years were included (30 during attacks and 30 in-between attacks). Thirty healthy matched controls were also recruited. All children were subjected to history taking, clinical evaluation and assessment of complete blood picture, serum levels of Cp, haptoglobin, hemopexin, and total IgE. Pulmonary function tests were assessed for all patients. RESULTS: Serum Cp and haptoglobin were significantly elevated in asthmatic children between attacks (448.04 ± 386.79), (993.33 ± 554.56) compared to controls (168.42 ± 13.46), (473.33 ± 350.3), (p = 0.0002, p < 0.0001) and to asthmatics during exacerbations (288.8 ± 219.6), (620 ± 467.86), (p = 0.014, p = 0.006). Serum hemopexin was significantly higher in asthmatics between attacks (509.33 ± 341.51) compared to controls (296.67 ± 158.38) (p < 0.003) but no significant difference compared to acute exacerbations (477.33 ± 396.6). No significant correlations were found between any of the assessed protein levels and pulmonary functions. Hemoglobin concentration was significantly higher among stable asthmatics compared to acute exacerbation and control groups. CONCLUSION: Cp, haptoglobin, and hemopexin can be used as a panel of non-invasive biomarkers that reflect the involvement of iron oxidative stress in asthma pathogenesis

Clinical characteristics and outcomes of COVID-19 patients with a history of cardiovascular disease

New emerging severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) primarily affects the lungs, but the virus may cause cardiovascular disease (CVD), and a history of CVD is usually associated with comorbidities, which could increase the severity of infections. In this study, we collected demographic and clinical characteristics data from 123 patients with a history of CVD, who were confirmed to have SARS-CoV-2 infection by polymerase chain reaction (PCR) test in Razi Hospital, Rasht, Iran, from March 2021 to June 2021. Chi-Square and Fisher's Exact test with a significance level of P less than 0.05 was performed. All statistical analysis was performed with SPSS software version 26.0. Among the studied patients, 99 patients were discharged and 24 of them died. 62 (50.4%) of the study population were female and 61 (49.6%) were male, and there is no significant association between gender and the outcome of patients (P = 0.159). The total mean age of patients was 68.35±12.41. Statistical analysis has represented a significant relation of death outcomes in CVD patients with age 60 years and older (P = 0.001), in comparison with patients younger than 60 years. In this present study, no significant relation between underlying disease and mortality rate was reported, but in COVID-19 patients with a history of CVD and age upper than 60 years, death outcome was more probable

Cystic Fibrosis in Egyptian Children: Achievements and Future Directions

Cystic fibrosis (CF) is the most common potentially lethal and life-shortening genetic disease caused by mutations of the cystic fibrosis transmembrane conductance regulator (CFTR) gene. Clinical consequences of the CFTR defect are site-specific and range from severe (lungs, pancreas, male reproductive tract) to mild (intestine) to asymptomatic (sweat glands). In many developing countries CF has remained largely unrecognized, and inadequately managed, resulting in avoidable death or suffering in infancy, childhood, and adulthood. Delivering adequate CF services is met by substantial difficulties as the spectrum and distribution of CF in Egypt are still not well known. Against this background, the aim of this work is to emphasize the challenges facing initiation of a CF center in low privileged settings with the objectives of improving diagnosis, survival, and to eventually provide optimum management. Strategies for the implementation and development of CF services, as well as proper collection and documentation of patient data are therefore of vital importance. The characterization of the prevalence and molecular genetics of CF in Egypt is of utmost importance so that appropriate genetic counseling to CF patients and their families can be achieved and to pave the way for new treatment modalities

The global, regional, and national burden of cirrhosis by cause in 195 countries and territories, 1990-2017 : a systematic analysis for the Global Burden of Disease Study 2017

Background Cirrhosis and other chronic liver diseases (collectively referred to as cirrhosis in this paper) are a major cause of morbidity and mortality globally, although the burden and underlying causes differ across locations and demographic groups. We report on results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 on the burden of cirrhosis and its trends since 1990, by cause, sex, and age, for 195 countries and territories. Methods We used data from vital registrations, vital registration samples, and verbal autopsies to estimate mortality. We modelled prevalence of total, compensated, and decompensated cirrhosis on the basis of hospital and claims data. Disability-adjusted life-years (DALYs) were calculated as the sum of years of life lost due to premature death and years lived with disability. Estimates are presented as numbers and age-standardised or age-specific rates per 100 000 population, with 95% uncertainty intervals (UIs). All estimates are presented for five causes of cirrhosis: hepatitis B, hepatitis C, alcohol-related liver disease, non-alcoholic steatohepatitis (NASH), and other causes. We compared mortality, prevalence, and DALY estimates with those expected according to the Socio-demographic Index (SDI) as a proxy for the development status of regions and countries. Findings In 2017, cirrhosis caused more than 1.32 million (95% UI 1.27-1.45) deaths (440000 [416 000-518 000; 33.3%] in females and 883 000 [838 000-967 000; 66.7%] in males) globally, compared with less than 899 000 (829 000-948 000) deaths in 1990. Deaths due to cirrhosis constituted 2.4% (2.3-2.6) of total deaths globally in 2017 compared with 1.9% (1.8-2.0) in 1990. Despite an increase in the number of deaths, the age-standardised death rate decreased from 21.0 (19.2-22.3) per 100 000 population in 1990 to 16.5 (15.8-18-1) per 100 000 population in 2017. Sub-Saharan Africa had the highest age-standardised death rate among GBD super-regions for all years of the study period (32.2 [25.8-38.6] deaths per 100 000 population in 2017), and the high-income super-region had the lowest (10.1 [9.8-10-5] deaths per 100 000 population in 2017). The age-standardised death rate decreased or remained constant from 1990 to 2017 in all GBD regions except eastern Europe and central Asia, where the age-standardised death rate increased, primarily due to increases in alcohol-related liver disease prevalence. At the national level, the age-standardised death rate of cirrhosis was lowest in Singapore in 2017 (3.7 [3.3-4.0] per 100 000 in 2017) and highest in Egypt in all years since 1990 (103.3 [64.4-133.4] per 100 000 in 2017). There were 10.6 million (10.3-10.9) prevalent cases of decompensated cirrhosis and 112 million (107-119) prevalent cases of compensated cirrhosis globally in 2017. There was a significant increase in age-standardised prevalence rate of decompensated cirrhosis between 1990 and 2017. Cirrhosis caused by NASH had a steady age-standardised death rate throughout the study period, whereas the other four causes showed declines in age-standardised death rate. The age-standardised prevalence of compensated and decompensated cirrhosis due to NASH increased more than for any other cause of cirrhosis (by 33.2% for compensated cirrhosis and 54.8% for decompensated cirrhosis) over the study period. From 1990 to 2017, the number of prevalent cases snore than doubled for compensated cirrhosis due to NASH and more than tripled for decompensated cirrhosis due to NASH. In 2017, age-standardised death and DALY rates were lower among countries and territories with higher SDI. Interpretation Cirrhosis imposes a substantial health burden on many countries and this burden has increased at the global level since 1990, partly due to population growth and ageing. Although the age-standardised death and DALY rates of cirrhosis decreased from 1990 to 2017, numbers of deaths and DALYs and the proportion of all global deaths due to cirrhosis increased. Despite the availability of effective interventions for the prevention and treatment of hepatitis B and C, they were still the main causes of cirrhosis burden worldwide, particularly in low-income countries. The impact of hepatitis B and C is expected to be attenuated and overtaken by that of NASH in the near future. Cost-effective interventions are required to continue the prevention and treatment of viral hepatitis, and to achieve early diagnosis and prevention of cirrhosis due to alcohol-related liver disease and NASH. Copyright (C) 2020 The Author(s). Published by Elsevier Ltd.Peer reviewe