EFFECT OF SILYMARIN EXTRACTED FROM SILYBUM MARIANUM ON NICKEL HEMATOTOXICITY AND NEPHROTOXICITY IN MALE ALBINO WISTAR RATS

Objective: The objective of this study was to investigate the effect of silymarin extract from Silybum marianum against nickel-induced alterations in haematological indices, kidney dysfunction and renal antioxidant defence system.Methods: Male albino Wistar rats were divided into four groups seven each. Control, silymarin, nickel and nickel plus silymarin. Silymarin was administrated orally (100 mg/kg b. wt) and nickel as nickel sulfate (NiSO4 6H20) was given intraperitoneally (20 mg/kg b. wt) at alternative days. The experiment continued for three consecutive weeks. Body weight was recorded regularly. After overnight fasting, animals were killed and serum creatinine, serum urea, serum uric acid, hematological parameters and renal antioxidant markers were determined.Results: The treatment with nickel led to a significant decrease in body weight with an increase in both absolute and relative kidney weights and a significant increase in renal markers, which confirmed by histopathological alteration. A microcytic anemia was also observed, which was manifested by a reduction of red blood cells count (RBC), hemoglobin (Hb) concentration, platelet counts (Plt), hematocrit and white blood cells counts (WBC). The level of lipid peroxidation was increased. Whereas, GSH concentration and enzymatic antioxidants SOD, GSH-Px and CAT activities were decreased. The co-treatment with methanolic extract of milk thistle attenuated the variation in the hematological and renal markers, decreasing renal lipid peroxidation (p<0.05) with a concomitant increasing reduced glutathione content (p<0.01) and restoring the antioxidant enzymes (SOD, CAT, GSH-Px) in kidney, as well as an improvement in histological changes compared to those previously noticed in nickel group.Conclusion: To conclude, these findings demonstrated that silymarin extract effectively improved heamatotoxicity and nephrotoxicity caused by nickel

Antihypercholesterolemic effect of Cleome arabica L on high cholesterol diet induced damage in rats

Dietary cholesterol is known to be one of the main risk factors that accelerate oxidation process leading to hypercholesterolemia and attendant cardiovascular diseases. The purpose of this study, carried out on adult male Wistar rats, was to evaluate the inhibitory effects of supplementation with aqueous of Cleome arabica leaf extract on hypercholesterolemia. After 3 months of treatment, animals were sacrificed by decapitation. Blood serum was obtained by centrifugation. Under our experimental conditions, administration of Cleome arabica leaf extract decreased the total cholesterol (TC), LDL-cholesterol (LDL-chol) and triglycerides (TG) levels by 27 %, 52 %, 37 %, respectively, and reduced SGOT, SGPT, LDH and PAL levels in blood serum compared to untreated hypercholesterolemic rats. TBARS concentrations decreased by 21 % in liver, 22 % in heart and 30 % in kidney in a group of rats treated with cholesterol and Cleome arabica (Chol C.ar) compared to a Chol-treated group. The same treatment with Cleome arabica leaf extract increased superoxide dismutase and enhanced glutathione peroxidase activity. Catalase activity was found to increase in liver, heart and kidney by 17 %, 16 % and 23 %, respectively, in the C.ar Chol-treated group. The protective effect of Cleome arabica on hypercholesterolemia inducing oxidative stress in several organs was mainly attributed to antioxidant properties. The latter were due to the presence of phenolic acids and flavonoids shown by the obtained HPLC profiles

Protective effect of Ruta Chalepensis L. extract on oxidative stress and liver-kidney function induced by polymicrobial sepsis in rats

Sepsis, a systemic inflammatory disease developed after an infectious insult and remains the major cause of death in intensive care units. The aim of this study was to examine the protective effect of the ethanolic extract of Ruta chalepensis L. (ERC) against oxidative stress and liver-kidney functions in cecal and ligation puncture (CLP) rats. In vitro, the results showed that ERC rich in phenolic compounds possessed important antioxidant activity. In vivo, CLP-induced oxidative stress evidenced by the increase of the TBARS and decrease in the enzymatic antioxidants (SOD, CAT, GPX) in liver and kidney. Moreover, CLP induced liver-kidney toxicities showed by an increase in the ALT, AST, PAL, LDH, BUN and creatinine in the plasma. However, the administration of ERC to CLP-rats prevents all these disorders. Positive action of ERC was confirmed by histo-pathological examination. Therefore this study suggests that ERC could be a potential therapeutic agent for sepsis treatment

Risedronate adsorption on bioactive glass surface for applications as bone biomaterial

International audienceThe aim of the current work is to study the physicochemical interactions between bisphosphonates molecules, risedronate (RIS) and bioactive glass (46S6) after their association by adsorption phenomenon. To more understand the interaction processes of RIS with the 46S6 surface we have used complementary physicochemical techniques such as Infrared (FTIR), RAMAN and nuclear magnetic resonance (NMR) spectroscopy. The obtained results suggest that risedronate adsorption corresponds to an ion substitution reaction with silicon ions occurring at the bioactive glass surface. Thus, a pure bioactive glass was synthesized and fully characterized comparing the solids after adsorption (46S6-XRIS obtained after the interaction of 46S6 and X% risedronate). Therefore, based on the spectroscopic results FTIR, RMAN and MAS-NMR, it can be concluded that strong interactions have been established between RIS ions and 46S6 surface. In fact, FTIR and RAMAN spectroscopy illustrate the fixation of risedronate on the bioactive glass surface by the appearance of several bands characterizing risedrontre. The 31P MAS-NMR of the composite 46S6-XRIS show the presence of two species at a chemical shift of 15 and 19 ppm demonstrating thus the fixation of the RIS on 46S6 surface

Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.

BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112

Global economic burden of unmet surgical need for appendicitis

Background: There is a substantial gap in provision of adequate surgical care in many low-and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods: Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results: Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion: For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Mortality of emergency abdominal surgery in high-, middle- and low-income countries

Background: Surgical mortality data are collected routinely in high-income countries, yet virtually no low- or middle-income countries have outcome surveillance in place. The aim was prospectively to collect worldwide mortality data following emergency abdominal surgery, comparing findings across countries with a low, middle or high Human Development Index (HDI). Methods: This was a prospective, multicentre, cohort study. Self-selected hospitals performing emergency surgery submitted prespecified data for consecutive patients from at least one 2-week interval during July to December 2014. Postoperative mortality was analysed by hierarchical multivariable logistic regression. Results: Data were obtained for 10 745 patients from 357 centres in 58 countries; 6538 were from high-, 2889 from middle- and 1318 from low-HDI settings. The overall mortality rate was 1⋅6 per cent at 24 h (high 1⋅1 per cent, middle 1⋅9 per cent, low 3⋅4 per cent; P < 0⋅001), increasing to 5⋅4 per cent by 30 days (high 4⋅5 per cent, middle 6⋅0 per cent, low 8⋅6 per cent; P < 0⋅001). Of the 578 patients who died, 404 (69⋅9 per cent) did so between 24 h and 30 days following surgery (high 74⋅2 per cent, middle 68⋅8 per cent, low 60⋅5 per cent). After adjustment, 30-day mortality remained higher in middle-income (odds ratio (OR) 2⋅78, 95 per cent c.i. 1⋅84 to 4⋅20) and low-income (OR 2⋅97, 1⋅84 to 4⋅81) countries. Surgical safety checklist use was less frequent in low- and middle-income countries, but when used was associated with reduced mortality at 30 days. Conclusion: Mortality is three times higher in low- compared with high-HDI countries even when adjusted for prognostic factors. Patient safety factors may have an important role. Registration number: NCT02179112 (http://www.clinicaltrials.gov)