Adjuvant role of corticosteroids in the treatment of community-acquired pneumonia

AbstractBackgroundDespite progress in life-support measures and antimicrobial therapy, the mortality of severe pneumonia has not varied since the mid-1990s, suggesting that other factors are of crucial importance in the evolution of this respiratory infection.ObjectiveTo evaluate the impact of hydrocortisone infusion in community-acquired pneumonia (CAP) in the attenuation of systemic inflammation and reduction of sepsis-related complications.MethodsThe study enrolled 80 patients, clinically and radiolodically diagnosed as community-acquired pneumonia, admitted to Chest department, Respiratory Intensive Care Unit, General Medicine Department and General Medicine Intensive Care Unit of Zagazig University Hospitals. Sixty of them were randomized to receive hydrocortisone as a bolus dose of 200mg intravenously once (only at day 1) then 10mg/h IV infusion for 7days and twenty received placebo, along with antibiotics according to IDSA/ATS 2007 guidelines which were given for both groups. The following parameters were compared in both groups; PaO2 and PaO2/FiO2 ratio, length of hospital stay, duration of IV antibiotic treatment, duration of mechanical ventilation, weaning success from mechanical ventilation, pneumonia complication and hospital outcome.ResultsHydrocortisone treated patients showed a significant improvement in PaO2 and PaO2/FiO2 ratio, a significant reduction in White blood cell count, C-reactive protein levels, Erythrocyte sedimentation rate, a significant reduction in the duration of mechanical ventilation, duration of IV antibiotic treatment, pneumonia complications, and length of hospital stay. Also there was an improvement of hospital outcome, weaning success from mechanical ventilation and radiological resolution compared to the placebo group.ConclusionAdjunctive 7day course of low dose hydrocortisone IV in patients with CAP hastens clinical recovery and prevents the development of sepsis-related complications with a significant reduction in the duration of mechanical ventilation, duration of IV antibiotics and length of hospital stay with the improvement in hospital outcome and weaning success from mechanical ventilation

Searching for anti-hyperglycemic phytomolecules of Tecoma stans

Tecoma stans plant is well postulated to decrease blood glucose level, but its mode of action and the molecules responsible are still controversial. Thus, the aim of this study was to evaluate the effect of leaves methanol extract of Tecoma stans and some of its fractions on starch tolerance in healthy rats, in vitro inhibition of α-amylase, and their effects of sub-chronic administration of glucose, lipid pattern, kidney and liver functions and antioxidant status in streptozotocin (STZ) induced diabetic rats. In starch tolerance experiment, both ethyl acetate and crude flavonoids fractions decreased glycemic peak values in healthy rats to extent similar to that of acarbose. In STZ sub-chronic experiment all preparations of Tecoma stans significantly decreased fasting glucose with variable degrees. The results indicated that the crude methanol extract had the most antidiabetic potential followed by the methylene chloride rich alkaloid fraction while the crude flavonoids fraction achieved the lowest effect. All Tecoma stans different preparations have positive effects on serum lipid pattern, kidney and liver function parameters, in addition to the antioxidant parameters (MDA and GSH) in liver tissues. In conclusion, the present study suggested that the alkaloids synergistically act as antidiabetic agent with other bioactive compounds of Tecoma stans especially flavonoids as hypoglycemic agents and the ethyl acetate fraction had the most powerful effects

Role of CD10 Marker in Differentiating Malignant Thyroid Neoplasms from Benign Thyroid Lesions (Immunohistochemical & Histopathological Study)

BACKGROUND: CD10 was initially recognised as a cell–surface antigen expressed by acute lymphoblastic leukaemias, and hence it’s early designation as Common Acute Lymphoblastic Leukemia Antigen (CALLA). Also, it has been proven to be reactive in various non-lymphoid cells and tissue and different types of neoplasms. AIM: To evaluate the immunohistochemical expression of CD10 in malignant thyroid neoplasms and different benign lesions and to assess whether CD10 can be used as a malignancy marker in thyroid pathology or not. MATERIAL AND METHODS: A total of 83 archived, formalin fixed, paraffin embedded tissue blocks of 83 cases of malignant thyroid neoplasms and different benign lesions. The samples were immunohistochemically analysed for CD10 expression. A p-value of less than 0.05 was considered statistically significant. RESULTS: CD10 was expressed in 91% of the studied malignant thyroid neoplasms and 58% of benign thyroid lesions. It was expressed in 26 of 28 (92.9%) conventional papillary carcinomas, ten of 10 (100%) follicular variants of papillary carcinoma, seven of nine (77.8%) minimally invasive follicular carcinomas, two of three (66.7%) widely invasive follicular carcinomas, and seven of 7 (100%) undifferentiated carcinomas, seven of 11 (66.7%) adenomatous nodules and eight of 15 (53.3%) follicular adenomas. No statistically significant correlations were detected between CD10 expression and patients’ age, sex, lymph node metastasis, tumour stage and capsular invasion. CONCLUSION: CD10 shows strong sensitivity (91.2%) and moderate specificity (42.3%) in the diagnosis of malignancy overall and shows strong sensitivity (86.4%) and moderate specificity (42.3%) in the diagnosis of malignancy in the follicular-patterned lesions. So, CD10 might be useful in differentiating malignant from benign thyroid lesions (good positive test) and in the diagnosis of follicular variant of papillary carcinoma

Identification study of solar cell/module using recent optimization techniques

This paper proposes the application of a novel metaphor-free population optimization based on the mathematics of the Runge Kutta method (RUN) for parameter extraction of a double-diode model of the unknown solar cell and photovoltaic (PV) module parameters. The RUN optimizer is employed to determine the seven unknown parameters of the two-diode model. Fitting the experimental data is the main objective of the extracted unknown parameters to develop a generic PV model. Consequently, the root means squared error (RMSE) between the measured and estimated data is considered as the primary objective function. The suggested objective function achieves the closeness degree between the estimated and experimental data. For getting the generic model, applications of the proposed RUN are carried out on two different commercial PV cells. To assess the proposed algorithm, a comprehensive comparison study is employed and compared with several well-matured optimization algorithms reported in the literature. Numerical simulations prove the high precision and fast response of the proposed RUN algorithm for solving multiple PV models. Added to that, the RUN can be considered as a good alternative optimization method for solving power systems optimization problems

Contraception use among Muslim women in Alexandria, Egypt: a descriptive pilot study

Background: This pilot study aimed to create a questionnaire survey directed to understand knowledge gaps related to contraception among Muslim women in Alexandria, Egypt, so potential interventions could be designed to enable more informed decision-making. The project was a mixed-method, cross-sectional study using a questionnaire survey.Methods: Participants were randomly selected at outpatient clinics at Alexandria university hospitals in September and October 2020. The inclusion criteria were to be an 18 year old or older woman and able to give consent. The recruitment goal for this pilot study was 100 participants. The consented participants were interviewed about demographics, socio-structural and contraception use. The questionnaire was tested using a focus group of 11 women. The study data was collected using KoBoToolbox and exported to the SPSS software for descriptive analysis. The primary outcome was to validate the survey questionnaire and the secondary outcome to assess knowledge regarding contraception methods and emergency contraception.Results: The age of study participants ranged from 18-60 with a mean of 34 years. Almost all participants had previously heard of various contraceptive methods and 75% used them before. The majority did not know about emergency contraception. Most respondents had a favorable attitude toward family planning, and their primary sources of information were family and friends.Conclusions: Preliminary findings show that most women knew about contraception methods, though few of them heard of emergency contraception. Because of the patriarchal nature of Egyptian society, family planning education should target the whole population

Oral diclofenac potassium versus hyoscine-N-butyl bromide for pain relief during copper intrauterine device insertion: randomized clinical trial

Background: Present study was carried out to compare the analgesic effect of oral diclofenac potassium versus hyoscine-N-butyl bromide (HBB) for pain relief during copper intrauterine device (IUD) insertion.Methods: It was a a randomized clinical trial carried out at Assiut University Hospital, Assiut, Egypt. Parous women eligible for Copper IUD insertion were recruited and randomized in a 1:1 ratio to diclofenac potassium or HBB. The participants were asked to take 2 tablets of the study medications 30 minutes before IUD insertion. The primary outcome was the participant's self-rated pain perception using a 10-cm Visual Analogue Scale (VAS) during IUD insertion. We considered a 1.5 cm difference in VAS scores between study groups as clinically significant.Results: One hundred eight women were enrolled (n=54 in each group). Diclofenac significantly has lower mean pain score during speculum placement (1.73 vs. 2.13) and tenaculum placement (1.85 vs. 2.3) than HBB with p<0.001. No statistical significant differences between both groups in other steps of IUD insertion. Additionally, the duration of IUD insertion was significantly lower in the diclofenac group (5.34±0.76 vs. 5.74±1.23 minutes, p=0.045). No women reported side effects in both groups.Conclusions: The use of oral diclofenac potassium 30 minutes prior to copper IUD insertion slightly reduce the insertional pain and duration than oral HBB with no adverse effects

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

Nature as a treasure trove of potential anti-SARS-CoV drug leads:a structural/mechanistic rationale

The novel Coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 is a potential factor for fatal illness and a tremendous concern for global public health. The COVID-19 pandemic has entered a dangerous new phase. In the context of drug discovery, the structurally-unique and chemically-diverse natural products have been valuable sources for drug leads. In this review, we report for potential candidates derived from natural sources with well-reported in vitro efficacy against SARS-CoV during the last decade. Additionally, a library of 496 phenolic metabolites was subjected to a computer-aided virtual screening against the active site of the recently reported SARS-CoV Main protease (M(pro)). Analysis of physicochemical properties of these natural products has been carried out and presented for all the tested phenolic metabolites. Only three of the top candidates, viz. acetylglucopetunidin (31), isoxanthohumol (32) and ellagic acid (33), which are widely available in many edible fruits, obey both Lipinski's and Veber's rules of drug-likeness and thus possess high degrees of predicted bioavailability. These natural products are suggested as potential drug candidates for the development of anti-SARS-CoV-2 therapeutics in the near future