Background/aim Cape gooseberry is golden-colored spherical fruit commercially produced in Egypt. It is primarily used in folk medicine for treating some diseases. To identify the aroma compounds in Cape gooseberry and to evaluate its antioxidant activities as well as its anticancer (for colon and breast cancers) effects in human cell lines. Materials and methods The volatile compounds were identified using gas chromatography (GC) and gas chromatography-mass spectrometry (GC-MS). Polyphenols (phenolics and flavonoids) were also determined. Antioxidant activity was determined by three different methods: 2,2΄-diphenyl-1-picrylhydrazyl (DPPH), 2,2-azinobis(3-ethyl-benzothiazoline-6-sulfonic acid) (ABTS), and ferric reducing antioxidant power (FRAP) assays. Anticancer (for colon or breast cancer) activity was determined in cancer cell lines using 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assay. Results A total of 34 components of the essential oil were identified by GC and GC-MS. The volatile compounds were grouped in classes of substances, including 11 terpene compounds (six monoterpenoids and five sesquiterpene), 11 esters, five alcohols, two phenolic compounds, two aldehydes, two ketones, and one lactone. Terpenes (monoterpenes and sesquiterpenes) were the most abundant volatile constituents, accounting for the largest portion of the total volatiles (36.09%). The next most abundant compounds were esters, comprising 17.17% of the total volatile components identified. Phenolic compounds were the next most abundant compounds, comprising 16.04% of the total volatiles. Alcohols and aldehydes represented 6.37 and 1.88% of the total volatile compounds, respectively. Ketones and lactones are less abundant in the profile of volatile compounds in Cape gooseberry. Ethanol extract had higher phenolic and flavonoid contents than did hexane extract. As ethanol extract of Cape gooseberry achieved higher antioxidant activity than did hexane extract, it tested as an anticancer (for colon or breast cancer) agent. Cape gooseberry extract was more potent in inhibiting colon cell lines (IC ₅₀ : 142 μg/ml) compared with breast cell line (IC ₅₀ : 371 μg/ml). Conclusion Egyptian Cape gooseberry fruits may be suggested as a potential source of natural antioxidants and anticancer agents.

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Background Bile duct injury (BDI) is a major complication in biliary surgery such as laparoscopic cholecystectomy. The management of major BDI is a surgical challenge even for experienced hepatobiliary surgeons. The aim of this study was to introduce a new surgical technique for reconstruction of the biliary duct by primary repair after stent placement. Patients and methods The present study was carried out on a selected group of BDI patients (34 patients), who were referred for management of BDIs. Patients were divided into two equal groups: group A underwent primary repair of the bile duct by placement of a plastic stent (which is used in endoscopic retrograde cholangiopancreatography) and group B underwent Roux-en-Y hepaticojejunostomy. Results The study included 34 patients, 10 men (30.9%) and 24 women (69.1%) with a mean age of 40.84 years, whose main presentations were postoperative jaundice (82%) and bile leak (15%). All the patients underwent surgery successfully. There was no intraoperative mortality and bile leakage during the observation period, but primary repair of the bile duct with plastic stent placement was associated with better results as regards operation time, hospital stay, cost, safety, and postoperative complications. Conclusion Primary repair of the bile duct with stent placement showed good results, involved minimal morbidity, hospital stay, and cost; and helped avoid the drawbacks of Roux-Y hepaticojejunostomy. It also replaced exploration of the common bile duct with a T-tube, with advantages of function of the Oddis sphincter.

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Background/aim Herpes simplex virus is a frequently encountered contagious infectivity causing several diseases. The aim of the present study was to compare the effect of pomegranate peel extract and chlorhexidine (CHX) mouthwashes in the treatment of recurrent intraoral herpes (RIOH), a clinical form of herpes simplex virus infection. Patients and methods A total of 12 immunocompetent patients aged from 18 to 35 years with RIOH lesions affecting their keratinized mucosa were selected. The participants were randomly divided into two groups: group I (pomegranate group, n=6) was treated using pharmacologically prepared pomegranate peel extract mouthwash and group II (CHX group, n=6) was treated using CHX mouthwash. Both treatment modalities were used three times per /day for 10 days. Pain and erythema scores were recorded at 2, 4, 6, and 8 days from baseline in both study groups to assess the effect of mouthwashes used. Results Pain and erythema scores showed statistically significant decrease by time in both groups. A higher mean score was recorded in group II, with statistically significant difference in pain scores, but this difference did not reach the level of significance as regarding the erythema score. The percentage of change in both pain and erythema scores revealed better and superior improvement in group I than group II. Conclusion Pomegranate peel extract mouthwash was more effective in reducing pain and accelerating wound healing when compared with CHX as topical treatment for RIOH.

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Background/aim Although it is recommended that healthcare professionals should comply with the standard precautions to prevent acquiring blood-borne diseases (AIDS, hepatitis B and C), yet, they frequently do not comply with this recommendation. Understanding the reasons for compliance and noncompliance will help in designing educational programs for hospital staff and in determining a strategy for improving health behavior. The present study aimed to assess surgeons' compliance to standard precautions and determine surgeons' perceived beliefs affecting their compliance using the Health Belief Model. Participants and methods A cross-sectional study was carried out at surgical departments in Zagazig University Hospitals from December 2012 to May 2013. A questionnaire on various aspects of infection control and standard precautions practices was provided to 307 surgeons, with a response rate of 70%. Results Our findings indicated that 57.5% of the surgeons sampled in Zagazig University Hospitals were compliant with standard precautions. 59.8% of compliant surgeons had been exposed to at least one needle-stick injury in the previous 3 months, whereas slightly less than half of compliant surgeons (48.4%) had been exposed to splashes, with a highly significant difference compared with nonexposed surgeons. All Health Belief Model subscales were correlated directly with the surgeons' compliance, except perceived barriers. Conclusion There is adequate compliance with standard precautions among surgeons in Zagazig University Hospitals, especially female surgeons, with a high level of knowledge among compliant compared with noncompliant surgeons. All Health Belief Model subscales were correlated directly with the surgeons' compliance, except perceived barriers. Adequate training of surgeons, provision of infection prevention equipment, regular reporting, follow-up, and assessment of occupational exposures need to be introduced.

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Background/aim Awareness towards the symptoms of obstetric complications will lead to timely access to appropriate emergency obstetric care. The aim of the study was to assess and compare the awareness towards obstetric danger symptoms among never-pregnant and ever-pregnant women and to identify predictors of their awareness as a measure for the need to promote a preconceptional educational program in Egypt. Participants and methods This study was conducted in selected villages of Alfayoum and Benisuef governorates as a comparative study between 173 newly married never-pregnant women and 827 ever-pregnant women who were randomly targeted by a structured interview during a period of 8 months. The questionnaire included personal data, social data, and data related to awareness of obstetric danger symptoms, complications, and action taken on having any of these symptoms. The scoring system was designed for women's awareness, with one degree allocated for a correct answer. Results The study revealed that the percent of women who gained a score of knowledge of at least 50% was higher among ever-pregnant women than among never-pregnant women (43.9 and 19.1%, respectively). Although bleeding is the highest reported cause for obstetric complications and is one of the reported causes of maternal deaths in the studied villages, only 26.6 and 20.2% of the never pregnant and 43.9 and 34.3% of the ever pregnant groups, respectively, knew that bleeding is a danger symptom during delivery and the postnatal period. Meanwhile, better awareness about obstetric danger symptoms and exposure to health educational messages was significantly higher among ever-pregnant women (OR = 3.08 and 2.28, respectively) (P < 0.001). Conclusion This study reflects the need for intensifying antenatal health educational messages given to pregnant women and the need for the implementation of preconceptional health education programs.

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Background/aim Nurses are the most frequent health occupational group to suffer from needle stick and sharp injuries (NSI), which puts nurses under the risk to acquire serious blood-borne diseases. The aim of the study was to assess the incidence of NSIs among nurses, and to assess their knowledge and evaluate the effect of intervention on raising knowledge, awareness, and decreasing the incidence of NSIs. Patients and methods An intervention study was carried out among all nurses of both sexes working at a military hospital in Saudi Arabia during the period from February 2015 to May 2016. The study was carried out in three phases, the pre-intervention phase where data collection was carried out using a questionnaire, the second phase where health education and a training program were provided to the nurses, followed by the post-intervention assessment after 1 year of the intervention. Results The incidence of NSIs among nurses decreased after the intervention from 9.42 to 3.93%. Whereas the total knowledge score increased from 54.45 to 91.57%. After intervention, all incidents were reported and had proper management after exposure, whereas before intervention 66.67% reported the incident and 55.56% had proper management after exposure. Conclusion Health education and training program provided to the nurses about NSIs had a great effect on decreasing the incidence and raising the knowledge and awareness of nurses toward reporting and proper management after exposure.

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Background Infection caused by blood protozoa is becoming very common, especially in developed countries because of immunosuppressed persons and travelers. Therefore, this review aimed to illustrate the dangers of blood protozoa exposure among persons working in medical laboratories, especially when dealing with samples containing blood protozoa such as Babesia, Leishmania, Plasmodium, and Trypanosoma spp. Conclusion As protozoa multiply rapidly in humans even with a small inoculum, they can cause illness, in contrast to helminths. Diagnoses of infection can be confirmed through dermal scraping, examination of the stained slides by light microscopy, obtaining biopsy specimens for thin, stained smear, and needle aspiration for cultures of Leishmania spp. In addition, protocols should be provided for handling specimens that could carry viable organisms, using protective laboratory equipment.

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Background/aim Sperm cryopreservation causes extensive damage to sperm membranes and its ultrastructural morphology, affecting the fertilization ability by decreasing the percentage of normal intact acrosomes and consequently the acrosine activity. This retrospective study aims at detecting the effect of sperm cryopreservation on the baby's sex after intracytoplasmic sperm injection (ICSI) in terms of the susceptibility of X versus Y chromosome baring spermatozoa to cryopreservation. Patients and methods This retrospective study included 87 ICSI cycles performed with post-thawed spermatozoa. The patients were classified into two groups (I and II) according to the total sperm count before freezing. Results This study included 87 ICSI cycles performed with post-thawed spermatozoa. Patients were classified into two groups (I and II) according to the total sperm count before freezing. Group I included 43 patients with a sperm count less than 0.1 × 10 ⁶ /sample (countable samples). Group II included 44 patients with a sperm count more than 0.1 × 10 ⁶ /sample (uncountable samples). The numbers of fertilized M II, good embryos, clinical pregnancy, and male babies were significantly higher in group I compared with group II. Conclusion ICSI using post-thawed spermatozoa of countable samples yielded a higher male sex ratio (80.8%) compared with uncountable samples (28.6%). Thus, spermatozoa that successfully survived the freeze-thaw procedure exhibited an improved chromatin structure and nuclear maturity. These data suggest that sperm cryopreservation may improve the fertilization rate, enhance early embryo development parameters, as well as pregnancy outcome after ICSI.

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Background/aim Pollens from different plants contain unsaturated fatty acid esters (USFAEs) and flavonoids that play a very important role as bioactive compounds. Therefore, the present study was designed to improve the production of volatile USFAEs and flavonoids from date palm pollen (DPP) in a culture of Trichoderma koningii and test its activities as an anti-breast-cancer and antiviral agent. Materials and methods The volatile esters of fermented and nonfermented date palm pollens (FDPPs) were identified using gas chromatographic-mass spectrometric (GC-MS) analysis. Antioxidant activities were determined using three different methods: the 2,2′-diphenyl-1-picrylhydrazyl (DPPH) assay, the ferric reducing antioxidant power assay, and the 2,2-azinobis(3-ethyl-benzothiazoline-6-sulfonic acid) (ABTS) assay. Polyphenols (phenolics and flavonoids) were also determined. Anti-breast-cancer and antiviral activities were determined using the 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assay. Results GC-MS analysis showed an improvement in the level of USFAE in FDPP (47.99%) almost double that of the DPP results (24.11%) extract concentration. Flavonoids content of the FDPP extract (93.4 ± 6.3 mg/ml) was higher than that obtained by the DPP extract (45.4 ± 2.1 mg/ml), which was more than double the value. Antioxidant activity of the FDPP extract increased 3.16, 3.42, and 2.14 times that of the DPP extract as determined by the ABTS, ferric reducing antioxidant power (FRAP), and DPPH assays, respectively. The extract of FDPP showed strong anticancer activity against the MCF-7 cell line (IC ₅₀ : 9.52 μg/ml) compared with the DPP extract (IC ₅₀ : 96.22 μg/ml). Also, the FDPP extract had strong antiviral activity (CC ₅₀ : 16.5 μg/ml) compared with DPP (CC ₅₀ : 38.8 μg/ml). This is the first report in which the FDPP extract is used in biological studies as anti-breast-cancer and antiviral agents. Conclusion Fermentation of DPP by T. koningii improves many bioactive volatile USFAE and flavonoid contents; these have anti-breast-cancer and antiviral activity.

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Background/aim Children with epilepsy are at an increased risk of poor health-related quality of life even in the absence of active seizures. The study was undertaken to assess the health-related quality of life and its predictors in children with epilepsy, comparing the relationship between different types of seizures and health-related quality of life in Egypt. Patients/methods This cross sectional case control study included 50 epileptic children aged 8-12 years, with a mean age of 9.35 ± 1.59 years and a male to female ratio of 1.8 : 1. They were divided into two subgroups according to the types of seizures: 26 patients with generalized seizures in subgroup I and 24 patients with partial seizures in subgroup II, and 50 apparently healthy children of matched age, sex, and social class were included as the control group. The Arabic version of the 23-item Pediatric quality of life Generic Core Scale (Parents' scale) was applied to evaluate the health-related quality of life of both patients and healthy controls. Results Diminished health-related quality of life is a common feature of epilepsy. Highly significant lower overall quality of life scores of all functioning domains of health-related quality of life were present between patients' subgroups (P < 0.001), and between total patients versus control groups (P < 0.001). Univariate analysis was performed to identify significant predictors of poorer quality of life in children with epilepsy. On analyzing the risk factors using odds ratio, epilepsy-related risk factors such as age at onset of seizures, types of seizures, duration of the illness, number and duration of antiepileptic drugs as well as children's clinical variables such as learning problems, developmental delay in milestones, limitation in child hobbies, urine incontinence, and prolonged sleep, and some family-related variables such as marital disharmony and parental anxiety were found to be significantly strong predictors of poorer health-related quality of life in children with epilepsy, with prediction of 95%. Conclusion Epileptic patients were found to be at a higher risk of developing impaired quality of life with lower mean scores of all domains of quality of life, especially patients with generalized, frequent fits, those on polytherapy, and patients with a younger age of seizure onset and a longer duration of illness. The scope of management of epilepsy should include optimal seizure control and improvement of the health-related quality of life of the affected children.

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Background/aim Symptomatic biliary diseases in pregnant women remain a great challenge to surgeons. The present study aimed to evaluate the safety and feasibility of laparoscopic cholecystectomy (LC) during pregnancy. Patients and methods This prospective, observational study was conducted on 27 pregnant women with a mean age of 27.3 ± 4.1 (range 21–36) years who presented with symptomatic gallbladder diseases (stones or cholecystitis) and underwent LC. Gestational age, operative time, and maternal and fetal outcomes were noted. Results The mean operative time was 58.7 (range 32–78.5) min. Conversion to open cholecystectomy occurred only in one patient with acute cholecystitis due to the presence of severe adhesions (3.7%). No intraoperative or postoperative complications were observed, except for mild wound infection in only one patient (3.7%) and mild uterine contractions in two patients (7.4%). All patients went on to deliver at full term with no abortion or preterm labor. Conclusion Pregnant women with repeated attacks of biliary colic and/or cholecystitis after failure of conservative treatment can undergo LC easily and safely without hazardous effects on either mothers or fetuses, especially in the second trimester.

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Background/aim Osteoporosis is a disease characterized by a decrease in bone mass and is widely recognized as a major health problem. Ovarian hormone deficiency is a major risk factor for osteoporosis. A sharp decrease in ovarian estrogen production is the predominant cause of rapid bone loss and deterioration of bone architecture, resulting in increased bone fragility during the first decade after menopause. Materials and methods A total of 70 albino rats were used, divided into seven groups of 10 rats each. Group 1 was subjected to sham operation and used as a control group. In group 2, rats were ovariectomized (OVX) and used as a model of postmenopausal osteoporosis. Three months after the operation the OVX rats (group 2) were divided into six subgroups: one was considered the positive control group; another one was treated with synthetic estrogen compound; and the other four subgroups were fed a diet containing red clover, fennel, carob, and a combination of the three plants. At the end of the experiment (after 3 months' treatment) the animals were killed, and the femur shafts were extracted, decalcified, and processed into paraffin blocks. Sections were stained with hematoxylin and eosin for histopathological, image analysis, and morphometric studies. Other sections were stained with periodic acid Schiff for histochemical investigations. Results The histopathological results of this study revealed that ovariectomy caused a decrease in thickness of the cortical compact bone in the middle shaft of the femur and of the trabeculae in cancellous bone in the head of the femur bone. Histochemical results showed new bone formation in sections of rats treated with plants. The best results were detected in sections of rats treated with a combination of the three plants. Red clover, fennel, and carob individually or combined have a better ameliorating effect on ovariectomy-induced osteoporosis than does synthetic estrogen compound. Conclusion Treatment of OVX rats with phytoestrogens such as red clover, fennel, and carob might improve the histopathological and histochemical changes and morphometric parameters in bone with ovariectomy-induced osteoporosis.

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Background/aim The ideal operation for the treatment of adolescent varicocele has been debated for many years. The division of lymphatic vessels during varicocelectomy is complicated by hydrocele formation and decline in testicular function. The aim of this study is to report on our series of children who underwent lymphatic and testicular artery-sparing laparoscopic varicocelectomy (LTASLV). Patients and methods Thirty boys with primary left-sided varicocele were subjected to LTASLV. The indications for intervention were scrotal pain and discomfort in 18 cases (60%), hypotrophy in nine cases (30%), and family preference in three cases (10%). An intraparenchymal injection of 2 ml methylene blue was administered after induction of anesthesia. LTASLV was performed for all patients. The main outcome measurements included operative time, hospital stay, development of hydrocele, varicocele recurrence, and testicular atrophy. Results The study included 30 patients with primary left-sided varicocele. Their mean age was 12.25 ± 1.6 years (range 9-16 years). Grade 3 varicocele was present in 21 cases (70%) and grade 2 varicocele was present in nine cases (30%). Stained lymphatics could easily be observed alongside the testicular artery and veins in 28 cases, whereas in two cases, a second injection of methylene blue with lowering of CO ₂ pressure was required for visualization. All procedures were completed laparoscopically without conversions or complications. The mean operative time was 40 ± 2.6 min (range 30-50 min). All patients achieved full recovery and were discharged within 24 h. The mean follow-up period was 18 ± 4.3 months (range 10-36 months). Residual varicocele was noted in one case (3.3%) with no hydrocele formation or testicular atrophy. Conclusion This study shows good results with respect to postoperative hydrocele rates. LTASLV resulted in 0% of hydrocele and decreased the risk of varicocele recurrence. However, larger series are necessary.

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Background/aim The present study was conducted to assess the ameliorative role of Moringa oleifera leaf extract (MOLE) on genotoxicity and biochemical alteration of aflatoxin B₁ (AFB₁) in rats. Materials and methods The rat groups involved negative control, control of DMSO, positive control that received AFB₁ in DMSO (0.7 g/kg, body weight) four times weekly for 1 month, groups 4–6 that received the same dose of AFB₁ in DMSO at the same period plus MOLE doses (3.3, 4.0 and 4.7 g/kg) daily for 1 month, and groups 7–9 that received MOLE alone at the same doses for 15 days after cessation of AFB₁ treatment. Molecular genetic, cytogenetic, sperm, and biochemical studies were documented. Results Genetic and sperm results revealed that AFB₁ treatment induced significant elevation of genetic alterations and sperm abnormalities as compared with normal control. Biochemical studies showed that the treatment with AFB₁ disturbed the parameters of liver functions, where aspartate-transaminase, alanine-transaminase, and alkaline phosphatase were activated and bilirubin contents as well as the rate of malondialdehyde were increased significantly, but the endogenous antioxidative system (catalase, superoxide-dismutase activities and glutathione as well as total antioxidant capacity) and protein profile were reduced significantly. Moreover, kidney functions (urea, uric acid, and creatinine contents) were elevated under AFB₁ administration. The treatment with MOLE significantly minimizes the genetic alterations, sperm abnormalities, and biochemical destruction. These ameliorations were increased by increasing the dose level. Better findings were seen by using MOLE as a therapeutic agent than its using as a protective agent. Conclusion This study revealed that MOLE contains therapeutic factors used in curing of genotoxicity induced by AFB₁ in rats, and treatment of animals that were exposed to AFB₁ with MOLE significantly ameliorated the genetic, sperm, and biochemical parameters as compared with animals treated with AFB₁ alone.

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Background/aim Worldwide, more than half of all unintended pregnancies end in abortion, indicating the preference for increasingly smaller families. The present work aimed to assess the determinants of unintended pregnancy and its impact on women's health in El Fayoum and Benisuef governorates. Participants and methods A community-based cross-sectional household survey was conducted among 827 married women of reproductive age. The study was conducted in two governorates, El Fayoum and Benisuef, for a period of 6 months. Results The current study revealed that 15.9% of women who participated in the study had an unmet need for family planning, with subsequent unintended pregnancy. Higher age of women and her age at the time of marriage, illiteracy, short interpregnancy spacing, exceeding the desired number of children, negative attitude of husbands toward the use of family planning methods, and absence of discussion between partners on the use of means to postpone pregnancy increased the number of unintended pregnancies. Also, women with unintended pregnancy were at a higher risk of experiencing health problems during her pregnancy. Conclusion Despite the efforts taken by family planners, the problem of unintended pregnancy continues to increase in Egypt, with its adverse effect on pregnancy and maternal outcomes. Therefore, the strategy for maternal mortality reduction in Egypt should focus on addressing the unmet needs of high-parity, uneducated, nonworking women.

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Background/aim Various techniques have been implemented in the early detection of oral potentially malignant disorders including commonly occurring hyperkeratotic lesions. The objective of the present study was to assess the efficacy of visually enhanced lesion scope (VELscope Vx) versus toluidine blue (TB) with reference to histopathological examination in the detection of dysplastic changes in oral keratotic lesions. Patients and methods A total of 30 patients having oral keratotic lesions were clinically diagnosed and subjected to VELscope Vx and TB examination. Histopathological assessment of biopsied lesions was also done. Sensitivity, specificity, positive and negative predictive values were obtained for both VELscope and TB and were compared with histopathological examination. Results VELscope Vx was able to identify four out of seven cases with mild dysplasia and a case of oral squamous cell carcinoma, while TB was able to identify five cases and the oral squamous cell carcinoma case as true positive cases. Thus, sensitivity was 62.5 and 75% for VELscope Vx and TB, respectively. Regarding the specificity of VELscope Vx, it was 71.4% while TB had a specificity of 85.7%. Conclusion The sensitivity and specificity of TB examination outweighed those of VELscope Vx in detecting dysplastic changes within keratotic lesions.

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Background/Aim Anethum graveolens L. (dill) (Apiaceae) is one of the most popular culinary herbs in the world. Dill has been cultivated since ancient times, and the use of this plant for medicinal and consumption purposes has been recorded dating back to the Greek and Egyptian civilizations. Dill is widely used to give flavor to food. The aim of this work was to assess the chemical composition of the volatile compounds in dill as well as their hepatoprotective and nephroprotective activity against free radicals generated by paracetamol. Materials and methods The chemical composition of the volatile compounds of dill was assessed by gas chromatography and gas chromatography-mass spectrometry. Four groups of rats were used (the normal control group, the A. graveolens-supplemented group, the paracetamol-intoxicated group, and the A. graveolens-protected group) for studying the effect of plant infusion on panadol (paracetamol)-induced free radicals and hepatotoxicity. Plasma total antioxidant capacity, plasma catalase, cellular glutathione peroxidase, plasma total protein, albumin, alanine amino transferase, aspartate amino transferase, alkaline phosphate, γ-glutamyl transferase, total bilirubin, and direct bilirubin levels were determined. In addition, kidney functions (plasma urea and creatinine) and histopathological and histochemical changes in the liver were investigated. Results The phytochemical results identified volatile components 7-α-hydroxy manool (24.43%), l-carvone (14.28%), limonene (13.9%), epi-α-bisabolol (6.81%), α-terpinene (5.44%), and α-phellandrene (4.63%) as the main constituents. p-Cymene (2.13%), sabinene (1.98), and α-pinene (1.43%) were determined as the minor constituents. The biochemical results showed that a mega dose of paracetamol induced the production of free radicals, which caused damage to hepatocytes and nephrocytes in rats. The aqueous extract of dill revealed high antioxidant properties and acted as an extracellular neutralizer of free radicals. Histopathological and histochemical observations showed severe damage in the liver. Supplementation with dill in paracetamol-intoxicated rats attenuated the damage to the liver. Conclusion The present study revealed that A. graveolens has antihepatotoxic properties that could minimize the deleterious effects generated by hepatotoxin paracetamol, and therefore it can be used as a potent antihepatotoxic agent.

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Background/aim Nowadays, packaging research is receiving considerable attention because of the development of ecofriendly materials made from natural polymers such as starch and chitosan. This study aimed to prepare composite films from starch-chitosan, incorporated with Thymus vulgaris essential oil (S-CH-Th), and to evaluate their antibacterial, antioxidant and optical properties. Materials and methods The molecular weight of chitosan was (~400 kDa, 75-85% deacetylated). 27% amylose corn starch, Tween 80, DPPH (2, 2-diphenyl-1-picrylhydrazyl) and Folin-Ciocalteu reagent were used to carry out research. Antibacterial activity testing was performed using the disk method. Antioxidant activity test was performed using a spectrophotometric method with DPPH as the radical source. Essential oil concentrations ranging from 0 to 2%, incorporated into a starch-chitosan composite (S-CH) film, were used. Results Antibacterial and antioxidant properties increased significantly with the incorporation of Essential oils (EO) (P < 0.05). On incorporating EO, there was an increase in the total colour differences (ΔE ), yellowness index and whiteness index, which were significantly higher than those of the control, and the transparency was reduced. Also, the results showed that chitosan edible films incorporated with T. vulgaris EO could be used as active films because of their excellent antibacterial and antioxidant activities. Conclusion S-CH edible films incorporated with thyme EO as a natural antibacterial and antioxidant agent may potentially be used as an active packaging to enhance the safety of foods and food products.

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Background/aim Liver fibrosis is a major global health problem. The present study aimed to evaluate the antioxidant and antifibrogenic potential of Punica granatum peels extract against thioacetamide (TAA)-induced hepatic fibrosis. Materials and methods Rats were divided into six groups. Group 1 was the control; group 2 was injected with TAA (150 mg/kg, intraperitoneal) (fibrosis group) for 4 weeks; group 3 received P. granatum peels extract only (200 mg/kg); group 4 rats were given oral sliymarin (50 mg/kg) for 4 weeks after withdrawal of TAA; groups 5 and 6 rats were given oral P. granatum peels extract (100 and 200 mg/kg) for 4 weeks after withdrawal of TAA. Fibrosis was assessed histologically and by measuring the hepatic hydroxyproline content. The degree of liver fibrosis was assessed by Masson’s trichrome staining and α-smooth muscle actin as the marker of the activated hepatic stellate cells was detected immunohistochemically. Serum markers of liver damage and oxidative stress were also assessed. Results The biochemical analyses have shown that P. granatum peels extract or sliymarin significantly reduced the progression of hepatic fibrosis. The plant extract or sliymarin resulted in a significant improvement of liver damage by the reduced levels of serum alanine aminotransferase and alkaline phosphatase. Oral administration of P. granatum peels or sliymarin has also restored normal levels of malondialdehyde, hydroxyproline content as markers of fibrosis content (P<0.05) in the liver, and retained control activities of endogenous antioxidants such as superoxide dismutase, nitric oxide, and glutathione. The histological evaluation showed that the plant extract or silymarin treatment maintained the architecture of the liver nearly normal and attenuate the accumulation of excessive collagen in the liver fibrosis caused by TAA. We also observed that P. granatum peels extract or silymarin-treated rats reduced α-smooth muscle actin. Conclusion The obtained results have shown that P. granatum peels extract effectively blocked hepatic stellate cell proliferation and they may be beneficial in the treatment of liver fibrosis.

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Background/aim Healthcare workers (HCWs) are at a high risk for blood-borne pathogens due to their contact with patients and contaminated instruments. The present study aimed to determine the risk of exposure to hepatitis B virus (HBV) and hepatitis C virus (HCV) infections among Egyptian HCWs in relation to the level of infection control education, the number of hepatitis B vaccine doses received, and the resulting immunity. Participants and methods This cross-sectional study was conducted on 228 HCWs. Hepatitis B surface antigen, hepatitis B core antibody, hepatitis B surface antibody titer, and hepatitis C virus antibody (HCV-Ab) were tested by using the enzyme-linked immunosorbent assay technique. Real-time PCR for both HBV-DNA and HCV-RNA in serum was done with positive hepatitis B surface antigen and HCV-Ab, respectively. Results During the study period, 78% of the HCWs received full HBV vaccination; 73.6% of them were vaccinated in the last 5 years. Lack of protective hepatitis B surface antibody (HBs-Ab) titer was found in 27.2% of the participants. HCV-Ab was positive in 6.14% HCWs, being significantly higher in individuals 40 years of age or older when compared with those under 40. Half of those with positive HCV-Ab had HCV-RNA below the detection limit. Conclusion Implementation of infection control guidelines played a role in reducing the prevalence of HCV infection among HCWs and in vaccinating HCWs in the last 5 years. Adopting safety-engineered devices is required to help in the reduction of needle stick and sharp medical devices injuries and risk for blood-borne infections.

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Background/aim Water pollution not only damages the environment but also kills wildlife. The present study aimed to investigate the effect of Escherichia coli, Salmonella typhi, and Staphylococcus aureus, which were isolated from drainage water at El-Rahawey area, Giza, Egypt, on experimental rats. Materials and methods Water samples were collected from the subsurface layer for bacteriological examination, stored in an ice box, and delivered to the laboratory and analyzed to count the total viable bacterial counts/ml using the most probable number technique. The isolated bacteria were given to rats for 21 days at a dose equal to 10³/ml and the liver and kidney were dissected for histopathological and histochcemical studies. Results Results showed that the average counts at 22 and 37°C were 10⁵ and 10⁶ CFU/ml, respectively, whereas the average counts by using the most probable number technique/100 ml were 10⁵, 10⁴, 10³, 10³, and 10² for total coliforms, fecal coliforms, E. coli, Salmonellae group, and total staphylococci, respectively. Isolation of pathogens from water sources were identified by using membrane filter technique on specific media. The histopathological examination of the liver of treated rats with E. coli, S. typhi, and S. aureus revealed swollen hepatocytes with decreased sinusoidal spaces and widely distributed necrotic foci. In the kidney, renal tubules showed extensive epithelial swelling with decreased lumen space and generalized necrotic changes with interstitial hemorrhage in renal cortex. The histochemical study indicated the depletion of staining of protein and polysaccharides. Conclusion E. coli, S. typhi, and S. aureus that are isolated from polluted drainage water cause histological and histochemical changes in the liver and kidney of rats.

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Background/aim Fibrosis represents the final common pathway of chronic tissue injury. Galectin-3 (Gal-3) is an important regulator of fibrosis that links chronic inflammation to fibrogenesis. We investigated the effect of Nigella sativa seed (black seed), a common hepatoprotective natural remedy, on Gal-3 level and progression of liver fibrosis in thioacetamide (TA)-induced liver injury in rats. Materials and methods Forty male Wistar rats were used in this study and were divided into four groups of 10 rats each. Group I served as control, groups from II to IV were intoxicated by TA (200 mg/kg body weight); meanwhile group III was treated with silymarin (50 mg/kg body weight) and group IV was treated with black seed (50 mg/kg body weight). Gal-3, transforming growth factor β1 (TGF-β1), some antioxidant and oxidative stress biomarkers were determined in the liver tissue homogenate. Moreover, serum liver function parameters, total cholesterol, triacylglycerols, and plasma glucose were determined. Quantitative measurement of fibrotic areas was achieved using computerized image analysis system. Results TA administration caused significant elevations in the levels of liver Gal-3, TGF-β1, malondialdehyde, nitric oxide and serum alanine transaminase and aspartate transaminase activities, total bilirubin, total cholesterol, triglycerides, and plasma glucose levels. Meanwhile, significant decreases were recorded in the level of liver total antioxidant capacity, catalase activity, and serum levels of total protein and albumin. Histopathological observation showed severe damage in the liver and presence of fibrotic areas. Treatment with silymarin and black seed resulted in decreasing levels of liver Gal-3 and TGF-β1 and marked improvement in liver functions, as well as reducing the fibrotic areas in the liver. Gal-3 exhibited positive correlation with TGF-β1, malondialdehyde, nitric oxide, alanine transaminase and aspartate transaminase, while it negatively correlated with total antioxidant capacity and catalase. Conclusion Black seed reduced liver Gal-3 level and ameliorated fibrogenesis in liver due to TA administration.

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Background/aim Liver fibrosis and its end-stage cirrhosis are the main reasons of morbidity and mortality all over the world. The current study aimed to evaluate the efficacy of Zilla spinosa (Z. spinosa) on CCl₄-induced liver fibrosis, apoptosis, and oxidative stresses in rats. Materials and methods Extract of aerial part of Z. spinosa was used in this study. Thirty male Sprague‑Dawley rats were enrolled in this study and divided into five groups (six each): group 1 served as control and groups 2–5 were treated with CCl₄ (1 ml/kg intraperitoneal twice a week for 8 weeks), where group 2 served as a control positive, group 3 received silymarin (50 mg/kg) daily, and groups 4 and 5 were administrated with Z. spinosa (100 and 200 mg/kg, respectively) daily for 8 weeks. At the end of each experiment, liver function tests were analyzed in serum, whereas malondialdehyde (MDA), Nitric oxide (NO), Glutathione (GSH), and hydroxyproline (HA) were analyzed in liver tissues. Liver fibrosis was confirmed histopathologically, and collagen content, caspase-3, and α-smooth muscle actin (α-SMA) were assayed immunhistochemically. Results Alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, total bilirubin, MDA, NO, and HA levels were increased (P<0.05), whereas total protein and GSH were decreased (P<0.05) in CCl₄-administrated rats. Histopathological results showed loss of lobular structure, fibrosis with expansion of portal tract by fibrous tissue together with inflammatory changes confined to portal tract and central vein, and intense centrilobular necrosis and remarkable fatty hydropic degeneration. In addition, extensive accumulation of connective tissue, marked depletion of glycogen, strong expression of α-SMA, and increased of caspase-3 were found in CCl₄-administrated rats. Oral administration of Z. spinosa at 100 or 200 mg/kg restored the normal levels of liver function parameters, MDA, NO and GSH; decreased HA; and reduced collagen, glycogen content, caspase-3, and α-SMA in liver tissue of rats. The high dose of 200 mg/kg showed more potent effect than low dose of 100 mg/kg when compared with silymarin treatment group. Conclusion The present study clarified that Z. spinosa extract has antioxidant and antiapoptotic properties in CCl₄-induced liver fibrosis in rats, and may be able to exert a therapeutic effect on developing hepatic fibrosis; moreover, high dose of 200 mg/kg appeared to be more potent than low dose (100 mg/kg).

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Background and aim Depression is one of the most serious and common mental diseases with major negative social consequences. Transresveratrol (trans-3,5,4΄-trihydroxystilbene) is a polyphenolic compound with a broad spectrum of pharmacological activities. It has been detected in some fruits and herbs, including the Asian plant Polygonum cuspidatum. The aim of this study was to assess the antidepressant-like effect of transresveratrol in a reserpine subchronic model of depression. Materials and methods Depression-like behaviours were induced in rats by reserpine injection (0.25 mg/kg, subcutaneously) every 48 h, for 20 days. Transresveratrol (60 and 120 mg/kg) and fluoxetine (10 mg/kg) were administered orally daily during the 20 days of the study. Behavioural tests, namely, open-field test and forced swimming test, as well as brain neurotransmitters levels and antioxidant contents and liver functions, were assessed. Results Data revealed that transresveratrol improved the rats' behaviour in both the open-field test and forced swimming test, and also elevated the brain's neurotransmitter content, normalized the liver enzymes level, and improved the antioxidant status of both the brain and liver, compared with those of fluoxetine. Conclusion The present study provided a clear evidence for the antidepressant-like of transresveratrol in the experimental model of depression. Further investigations are required to investigate the mechanism of action of transresveratrol as well as its applicability to be used as an antidepressant.

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Objective The aim of this study was to evaluate the total phenolic content (TPC) and antioxidant potential of Althaea rosea Cav., family Malvaceae, as well as to isolate and identify the flavonoid content of the methanolic extract of the aerial parts. In addition, a comparison between the TPC and antioxidant capacity of the methanolic extract of both aerial parts and flowers was carried out to discover new active constituents that can be utilized in drug industry. Materials and methods The extraction of the flavonoid compounds was carried out by percolation of the dried aerial parts of the plant under investigation with 70% methanol until exhaustion. The combined extract was then concentrated and defatted with petroleum ether (60-80°C). After separation of the lipoidal matter, the remaining extract was purified from mucilage and subjected to several column chromatographic techniques for isolation of the flavonoids. The identification of flavonoid compounds was carried out using physical, chemical, and spectral methods such as ultraviolet, ¹ H NMR, and ¹³ C NMR. The antioxidant potential of the methanolic extracts of both aerial parts and flowers was determined using the s[table 2], 2-diphenyl-1-picrylhydrazyl free radical scavenging activity method. Furthermore, their TPC was also determined using the Folin-Ciocalteu method. Results Five flavonoid compounds were isolated from the aerial parts of A. rosea Cav., which were identified as quercetin 3-O-β-d-glucuronopyranoside-8-C-β-d-glucopyranoside, kaempherol-3-O-β-d-rutinoside, kaempherol-4΄-O-β-d-glucoside, kaempherol-3-O-β-d-glucoside, and kaempherol. The antioxidant activity was measured in terms of their IC ₅₀ . The IC ₅₀ values of the methanolic extracts of the aerial parts and flowers were 11 and 1 mg/ml, respectively, whereas the TPCs were 48 and 73 μg/ml, respectively. Conclusion The methanolic extracts of both aerial parts and flowers of A. rosea Cav. are rich in phenolic compounds and have a prominent antioxidant activity. The antioxidant activity of both extracts may be attributed to their phenolic content.

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