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ORIGINAL ARTICLES
Volatile compounds, antioxidants, and anticancer activities of Cape gooseberry fruit (Physalis peruviana L.): An in-vitro study
Manal M Ramadan, Ahmed H El-Ghorab, Kadry Z Ghanem
July-December 2015, 10(2):56-64
DOI:10.4103/1687-4293.175556  
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.
  15 5,572 743
Volatile compounds and antioxidant activity of the aromatic herb Anethum graveolens
Manal M Ramadan, Nadia N Abd-Algader, Hatil H El-kamali, Kadry Z Ghanem, Abdel Razik H Farrag
July-December 2013, 8(2):79-88
DOI:10.4103/1687-4293.123791  
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.
  13 2,832 305
Assessment of compliance to standard precautions among surgeons in Zagazig University Hospitals, Egypt, using the Health Belief Model
Eman M Mortada, Marwa M Zalat
January-June 2014, 9(1):6-14
DOI:10.4103/1687-4293.137319  
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.
  7 4,398 485
Health related quality of life of children with epilepsy in Egypt
Zeinab M Monir, Inas R EL-Alameey, Eman Eltahlawy
July-December 2013, 8(2):53-66
DOI:10.4103/1687-4293.123787  
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.
  7 3,358 321
Serum vitamin D level as a predictor of bronchial asthma in Egyptian children
Hala G Elnadya, Eman M Foudac, Ola M Elsheikha, Inas R ElAlameeya, Amal I Elshafied, Lobna S Sherifa, Eman R Younessb, Nadia A Mohamedb
July-December 2013, 8(2):67-73
DOI:10.4103/1687-4293.123788  
Background/Aim This study was designed to assess the relationship between the serum level of 25-hydroxyvitamin D and the clinical, functional severity and the level of asthma control among Egyptian asthmatic children. Patients and methods This case-control cross-sectional study was conducted on 50 asthmatic patients from those regularly attending the Pediatric Chest Clinic, Children's Hospital, Ain Shams University. Twenty healthy children of matched age and sex were recruited as the control group. Results Pulmonary function tests were significantly decreased in the asthmatic cases compared with the control (P < 0.01). The serum vitamin D level was found to be significantly decreased in asthmatic children compared with the control group (P < 0.001). Out of the 50 asthmatic children, 20 had a serum vitamin D level of less than 25 ng/ml, and were considered to be 'vitamin D deficient', whereas the remaining 30 children had a level ranging between >25 ng/ml and ≤30 ng/ml and were considered to be 'vitamin D insufficient'. The asthmatic children had a highly significant increase in the total leukocytic count, the eosinophilic count, serum immunoglobulin E, and serum alkaline phosphatase (P < 0.001 in all). There was also a significant increase in the serum phosphorus level in the asthmatic children group compared with the control group (P < 0.01). The serum vitamin D level was 24.1 ng/ml ± 2.9 in the asthmatic patients on inhaled corticosteroid therapy and 28 ng/ml ± 1.4 in those not on inhaled corticosteroid therapy. Significant positive correlations were found between the serum vitamin D level and the predicted percentage of forced expiratory volume in 1 s (r = 0.871, P < 0.001). A highly significant negative correlation was found between the serum vitamin D level and serum immunoglobulin E (marker of allergy; r = −0.589, P < 0.001). Moreover, serum vitamin D showed an inverse correlation with the clinical severity of bronchial asthma (r = 0.903, P < 0.001) and the level of control of asthma (r = 0.923, P < 0.001), classified according to the Global Initiative for Asthma (GINA) classification. The accuracy of vitamin D as a predictor of asthma was found to be 88% by automatic linear modeling. Conclusion Our results revealed an important support for the association between bronchial asthma in children and vitamin D deficiency, with a direct relationship between its serum level and pulmonary function test measures and the increased asthma severity. Vitamin D deficiency can be considered as a strong predictor of asthma. Improving the vitamin D status can help in the primary prevention of asthma and in decreasing exacerbations of attacks. Clinical trials of vitamin D supplementation to prevent asthma exacerbation are recommended.
  6 1,986 178
Determinants of unintended pregnancy and its impact on the health of women in some governorates of Upper Egypt
Ammal M Metwally, Rehan M Saleh, Amira M Abdelhamed, Somia I Salama, Carine W Mores, Fatma A Shaaban, Osama M Azmy
January-June 2015, 10(1):1-8
DOI:10.4103/1687-4293.159368  
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.
  5 3,100 389
Ameliorative role of ethanolic extract of Moringa oleifera leaf on aflatoxin B1-induced genotoxicity and biochemical alterations in rats
Ibrahim M Farag, Hanaa M Roshdy, Hasnaa A Radwan, Inas S Ghaly, Sherifa H Salah, Emam A Abdel-Rahim, Aboelfetoh M Abdalla
January-June 2018, 13(1):60-70
DOI:10.4103/jasmr.jasmr_33_17  
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.
  5 2,813 318
Evaluation of the phenolic content and antioxidant potential of Althaea rosea cultivated in Egypt
Nagwa M Ammar, El-Sayeda A El-Kashoury, Lamiaa T Abou El-Kassem, Rasha E Abd El-Hakeem
July-December 2013, 8(2):48-52
DOI:10.4103/1687-4293.123786  
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.
  5 2,498 317
The antifibrotic effect of Zilla spinosa extracts targeting apoptosis in CCl4-induced liver damage in rats
Enayat A Omara, Sayed A El-Toumy, Marwa E Shabana, Abdel-Razik H Farrag, Somaia A Nada, Nermeen Shafee
July-December 2018, 13(2):129-143
DOI:10.4103/jasmr.jasmr_29_18  
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).
  3 2,250 222
Protective effect of Hypericum perforatum on dexamethasone-induced diabetic depression in rats
Mohamed E Elhadidy, Abeer A.A. Salama, Mahitab El-Kassaby, Enayat A Omara
January-June 2019, 14(1):25-32
DOI:10.4103/jasmr.jasmr_7_19  
Background/aim Complex interactions among psychological, social, and biological factors are the reason for diabetic depression. The present study was designed to evaluate the effect of Hypericum perforatum extract on dexamethasone-induced diabetic depression. Materials and methods A total of 24 adult male Wistar rats were divided into four groups (six rats each): group 1: control; group 2: daily treated with dexamethasone (0.44 mg/kg; intraperitoneally for 28 days); and groups 3 and 4: daily treated with H. perforatum extract (100 and 200 mg/kg; orally) concurrent with dexamethasone injection for 15 consecutive days. Plasma levels of blood glucose, glucose transporter-2, CD4, total antioxidant capacity, malondialdehyde, and nitric oxide were measured. In addition, the brain contents of serotonin, dopamine, cyclooxygenase-2, and transforming growth factor-β1 were determined. Moreover, assessment of histopathological changes of brain tissues and immunohistochemical analysis of caspase-9 were performed. Results Significant elevations were recorded in blood glucose level and plasma levels of malondialdehyde and nitric oxide. In addition, brain contents of dopamine, transforming growth factor-β1, and cyclooxygenase-2 were increased significantly in dexamethasone-treated group. However, plasma levels of glucose transporter-2, CD4, and total antioxidant capacity and the brain content of serotonin were significantly decreased in comparison with control group. Both doses of H. perforatum significantly ameliorated all biochemical parameters and alleviated histopathological and immunohistochemical apoptotic changes induced by dexamethasone in the rat cortex, striatum, and hippocampus. Conclusion H. perforatum extract possesses antioxidant, anti-inflammatory, and immunomodulatory effects against dexamethasone-induced diabetic depression.
  3 1,957 225
Improving the production of unsaturated fatty acid esters and flavonoids from date palm pollen and their effects as anti-breast-cancer and antiviral agents: An in-vitro study
Kadry Z Ghanem, Manal M Ramadan, Hassan Z Ghanem, Mohamed Fadel
July-December 2015, 10(2):47-55
DOI:10.4103/1687-4293.175555  
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.
  3 3,199 355
ORIGINAL ARTICLES: DENTAL MEDICINE
Osteogenic potential of human dental pulp-derived mesenchymal stem cells in bone regeneration of rabbit
Eman E.A. Mohammed, Mohamed El-Zawahry, Abdel Razik H Farrag, Nahla N Abdel Aziz, Nourhan Abou-Shahba, Marwa Mahmoud, Wael A El-Mohandes, Mahmoud A El-Farmawy, Alice K Abdel Aleem
July-December 2019, 14(2):102-112
DOI:10.4103/jasmr.jasmr_21_19  
Background/aim Human dental pulp-derived mesenchymal stem cells (hDP-MSCs) offer a promising source of progenitor cells for regenerative medicine and bone tissue engineering. Cranial defects are common complications that can arise secondary to trauma, surgery, or infection. This study aimed to evaluate the osteogenic differentiation potential of hMSCs isolated from dental pulp of third molar teeth in vitro cultures and the bone regenerative capacity of hDP-MSCs transplanted into induced temporomandibular joint (TMJ) defect in rabbits. Patients and methods hDP-MSCs were isolated from third molar teeth and cultured. Alizarin staining was performed to assess the osteogenic differentiation at the 14th and 28th days. The therapeutic potential of hDP-MSCs in craniofacial bone defects was investigated in the left side of the rabbits’ TMJ. The transplanted cells involved three groups: the osteogenic differentiated DP-MSCs (O), undifferentiated MSCs (M), and control group (cell-free matrix) (C). Cells were loaded on gel foam. Eighteen rabbits were used and sacrificed at subsequent three time points, 4, 6, and 9 weeks, after transplantation, with six rabbits/each time point and two rabbits/each cell group. Histopathological studies were applied to evaluate the healing potential of hDP-MSCs in the induced rabbit TMJ defect. Results hDP-MSCs showed a high proliferative potential and osteogenic differentiation in vitro. Histological results demonstrated a timely correlated mandibular defects’ repair in all the experimental groups, including the control group, with more enhanced bone healing effect for the osteogenic differentiated DP-MSCs. Conclusion hDP-MSCs possess high proliferation capacity and osteogenic differentiation potential in vitro. Histological observations revealed the osteogenic differentiated DP-MSCs have higher bone healing potential than the undifferentiated DP-MSCs at 9 weeks after transplantation, and gel foam promotes bone formation in the control group. The bone regenerative potential of osteogenic differentiated DP-MSCs revealed a significant capacity when implanted in rabbit TMJ defect. Hence, hDP-MSCs could be a promising source for craniofacial bone regeneration.
  3 1,126 136
ORIGINAL ARTICLE: BIOCHEMISTRY
Brain-derived neurotrophic factor and coenzyme Q10 levels in blood of children with learning disorder
Mohamed E Elhadidy, Ola H Gebril, Adel Hashish, Ayman Kilany, Neveen H Nashaat, Ehab R Abdelraouf
July-December 2019, 14(2):124-129
DOI:10.4103/jasmr.jasmr_15_19  
Background Learning disorder (LD) is manifested by significant difficulties in the acquisition and use of reasoning, reading, writing, or mathematical abilities, despite average intelligence and proper education. Its etiological factors were suggested to be related to neurodevelopmental alterations. Measurement of the levels of brain-derived neurotrophic factor (BDNF) and coenzyme Q10 (CoQ10) was targeted in children with LD in comparison with typically developing (TD) ones. Materials and methods This study included 82 Egyptian Arabic-speaking children matched for age and sex and socioeconomic status, comprising 42 with specific LD (group I) and 40 TD children (group II). All participants were subjected to clinical and full neurological examination after reporting a full medical history. Furthermore, LD group was subjected to Stanford–Binet intelligence scale, dyslexia assessment test, and phonological awareness test, which evaluates cognitive and learning aptitudes. The levels of BDNF and CoQ10 were determined in serum by enzyme-linked immunosorbent assay. Results All children with LD obtained a score of 1 or more as at-risk quotient by the dyslexia assessment test, which indicated a specific reading disorder. The BDNF and CoQ10 levels in the LD group were significantly less than those in the TD group. No correlations were found between the measured markers and each other or between them and the measured factors of the used tests. Conclusion The detected low levels of BDNF and CoQ10 in children with specific LD with impairment in reading would be suspected to be related to etiological or exaggerating factors for the deficits in such children.
  2 1,709 163
ORIGINAL ARTICLES
Cytotoxicity and antimicrobial activity of naturally and chemically synthesized zinc oxide nanoparticles
Amr A El-Waseif
January-June 2019, 14(1):42-51
DOI:10.4103/jasmr.jasmr_8_19  
Background/aim Zinc oxide (ZnO) is a polar inorganic compound with numerous applications, for example, as an antimicrobial agent. The present study aims to synthesize ZnO nanoparticles (NPs) by two different methods, and then determine the antimicrobial activity of ZnO NPs from both methods. It then focuses on comparison between the cytotoxicity of both ZnO NPs. Materials and methods ZnO NPs were synthesized using natural and chemical methods. The synthesized and prepared ZnO NPs were detected by precipitation in both methods using de Man, Rogosa, and Sharpe broth and alkaline medium, respectively. The characterization of ZnO NPs was performed using ultraviolet spectroscopy, zeta potential, and transmission electron microscopy (TEM) to decide properties of NPs. Viability tests are essential for assessing the effect of toxicants on cells. To measure cell viability following NP exposure, MTT assay was used. Results Results of ultraviolet and TEM experiments for both NPs indicated absorbance at 356–360 nm, which is typical for ZnO NPs. Results show that naturally prepared ZnO NPs had an average size within 7.8 nm; they were small spherical particles with a narrow size distribution relatively with smooth surfaces. The chemically prepared ZnO NPs’ TEM images showed an average size of 27.6 nm. Zeta value of naturally synthesized ZnO NPs was estimated to be −25.30 mV at pH=7. However, the value of zeta potential in chemical preparation strategy showed −18.6 mV. Results revealed that toxicity of naturally synthesized ZnO NPs was less than that of chemically prepared ZnO NPs. Furthermore, the decline in cytotoxicity attributed to ZnO NP exposure was dependent on the concentration of ZnO NPs. The antimicrobial activity results of ZnO NPs showed that the ZnO NPs produced from both methods recorded antimicrobial activities against the pathogenic strain models used. Conclusion The microbial synthesized ZnO NPs within size 7.8 nm when used at concentration 625 μg/ml as antimicrobial agent recorded the lowest cytotoxicity when compared with chemically synthesized. So that natural synthesis of ZnO was recommended.
  2 2,134 276
Role of citicoline as a protective agent on toluene-induced toxicity in rats
Nermeen Shaffie, Marwa E Shabana
January-June 2019, 14(1):14-24
DOI:10.4103/jasmr.jasmr_9_19  
Background/aim Toluene is used as an organic solvent; it has toxic effects on liver, renal, and neurological tissues. Citicoline has antioxidant effects. The aim of this study was to investigate the protective effect of citicoline against toluene-induced toxicity in rats. Material and methods A total of 24 rats were divided in four equal groups with six rats each. Rats in group 1 were the control. Rats in group 2 were exposed to toluene intraperitoneally at 900 mg/kg. Rats in group 3 were exposed to toluene 900 mg/kg in combination with citicoline at 150 mg/kg orally. The rats in group 4 were exposed to toluene 900 mg/kg in combination with citicoline 300 mg/kg orally. All treatments were used daily for 6 days. All rats were killed by decapitation. Tissue sections were stained with routine histological methods and examined under light microscope. In addition, sections were immunohistochemically staining with caspase-3 for liver and renal tissues and glial fibrillary acidic protein (GFAP) for brain tissue, and area percentage of positivity was measure by image analysis system. Results Histopathological and immunomorphometric studies of GFAP in brain and caspase-3 in liver and kidney were done. Toluene-treated groups showed vacuolar degeneration of hepatocytes and epithelial lining of renal tubules, neuronal damage, and neurodegeneration. There was an increase in caspase-3 in liver and kidney, which show marked increase in control positive rats that treated with toluene alone, but when large dose of citicoline 300 mg was added to toluene, the area percentage of caspase-3 was markedly decreased in liver and kidney. In addition, GFAP expression in brain tissue was decreased in toluene-treated control positive group, which then increased when treated with citicoline especially with a large dose. Conclusion The results of this study indicate that citicoline treatment can protect against toluene-induced toxicity in rats.
  2 2,310 274
VELscope versus toluidine blue for detection of dysplastic changes in oral keratotic lesions: diagnostic accuracy study
Mostafa Belal, Wesam A Elmoneim, Sherine Nasry, Basma Mostafa, Shereen Ali
January-June 2018, 13(1):45-52
DOI:10.4103/jasmr.jasmr_2_18  
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.
  2 2,894 310
ORIGINAL ARTICLES: DENTAL MEDICINE
Effect of surface treatment of milled cobalt–chromium alloy on shear bond strength to porcelain
Ghada E Hamza, Hanaa Sallam, Elzahraa Eldwakhly
July-December 2019, 14(2):113-123
DOI:10.4103/jasmr.jasmr_24_19  
Background/aim Strong bond between metal and porcelain is essential for success and longevity of porcelain-fused-to-metal restorations. Therefore, the present study aimed to evaluate shear bond strength (SBS) between porcelain and CAD/CAM milled cobalt–chromium (Co–Cr) alloy treated by sandblasting, oxidation, and laser etching in comparison with cast alloy treatment. Materials and methods Co–Cr alloys were used for fabrication of sixty discs (2.5 mm thickness×10 mm diameters), which were split into half (n=30 each): group A, milled discs, and group B, conventional casting discs. Both groups were split into thirds (n=10) according to Co–Cr surface treatment: subgroup S, sandblasting (control); subgroup O, oxidation; and subgroup L, laser etching. Surface morphology of the samples was examined before and after surface treatments by scanning electron microscope. Feldspathic porcelain (3 mm thickness×5 mm diameter) was added to the Co–Cr discs (opaque, dentin, and enamel) and fired. SBS test (MPa) was carried out using material testing machine at crosshead speed of 0.5 mm/min till failure. The modes of failure were evaluated by scanning electron microscope and digital microscope. Statistics were performed by two-way analysis of variance (ANOVA), one-way ANOVA, Tukey post-hoc test, and t-test (P<0.05). Results Two-way ANOVA results indicated insignificant differences in SBS among Co–Cr fabrication techniques (P=0.259). In contrast, significant differences were demonstrated between the different surface treatments (P<0.001), where laser etching showed the least SBS mean values with both fabrication techniques. Regardless of the fabrication technique, all subgroups exhibited cohesive failure within the porcelain, except for the laser etching subgroups, which showed mixed failure mode. Conclusion Bond between surface treated Co–Cr alloys and porcelain is independent of the fabrication technique. Laser etching recorded the least SBS among the tested surface treatments irrespective of the fabrication technique. All SBS values recorded in the present study were clinically acceptable.
  2 1,355 161
ORIGINAL ARTICLES
Comparing pomegranate extract and chlorhexidine mouthwashes in treatment of recurrent intraoral herpes
Mai Zakaria, Basma Mostafa
January-June 2018, 13(1):53-59
DOI:10.4103/jasmr.jasmr_5_18  
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.
  1 4,847 466
Risk management approach of needle stick and sharp injuries among nurses, Saudi Arabia: An interventional study
Abdullah M Al Jarallah, Amani S Ahmed
July-December 2016, 11(2):50-55
DOI:10.4103/1687-4293.199300  
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.
  1 3,732 447
Studying of B-cell differentiation and macrophage colony-stimulating factors as new players in the diagnosis of rheumatoid arthritis
Mohamed A Mokhles, Hala Z Raslan, Hiba Sibaii, Salwa R El-Zayat, Mahitab El-Kassaby, Hagar Hassan
July-December 2017, 12(2):79-85
DOI:10.4103/jasmr.jasmr_21_17  
Background/aim There is an imperative, yet unmet need for the development of a biomarker panel for progression of rheumatoid arthritis (RA). This study aimed to investigate the reliability of B-cell differentiation factor (BCDF) and macrophage colony-stimulating factor (MCSF) as diagnostic and prognostic biomarkers of RA. Patients and methods A total of 25 RA patients were enrolled and divided into three subgroups according to the disease activity score, remission/minimal, moderate, and severe, in addition to 20 healthy controls. Enzyme-linked immunosorbent assay was used to measure serum BCDF, MCSF, and interleukin (IL)-2, and the calorimetric method was used to measure immunoglobulin G (IgG). In addition, the erythrocyte sedimentation rate was measured at 1 h in the RA patients. Results BCDF, MCSF, and IgG were significantly higher in the RA patients compared with the controls. BCDF was significantly higher in the severe disease group compared with the remission/mild and the moderate disease groups, whereas IgG was significantly higher among the moderate disease group compared with the remission/mild disease group, and among the severe disease group compared with the remission/mild disease group, whereas the erythrocyte sedimentation rate did not show any significant difference between the three subgroups of the disease group. BCDF delineates RA from controls at a cut-off value of 102 pg/ml, whereas at a cut-off value of 37.5 ng/l MCSF delineates RA from controls. Conclusion Serum BCDF and MCSF can be used as RA diagnostic biomarkers, whereas BCDF can be used additionally as a prognostic biomarker.
  1 1,702 191
Role of a combination of myrtle extract and fish oil supplementation in improving endothelial dysfunction in streptozotocin-induced diabetic rats
Omnia Aly, Tahany R Elias, Mervet H Agaibyi, Wafaa I Rasheed, Magdi N Ashour, Jihan S Hussein
July-December 2017, 12(2):86-91
DOI:10.4103/jasmr.jasmr_26_17  
Background/aim Diabetes mellitus is one of the most important systemic diseases in the world and considered as the leading cause of endothelial dysfunction. Our previous studies have been clarified the antioxidant, anti-inflammatory, and antidiabetic effects of myrtle extract and fish oil. This study aimed to explore the effect of supplementation of a combination of myrtle extract and fish oil in improving the endothelial dysfunction associated with diabetes. Materials and methods Sixty albino rats were classified into three groups (20 rats each): control group, diabetic group, and treated diabetic group that received myrtle extract and fish oil. Plasma 5-lipoxygenase (5-LOX), interleukin-1β, tumor necrosis factor α, lipoxin-A4, asymmetric dimethylarginine, nitric oxide, glucose, insulin, insulin resistance, and cell membrane fatty acids [arachidonic acid (ω-6), linoleic acid (ω-6), α-linolenic acid (ω-3), and oleic acid (ω-9)] were estimated. Results Using a combination of myrtle extract and fish oil induced significant decrease in the plasma level of 5-lipoxygenase, asymmetric dimethylarginine, arachidonic acid (ω-6), linoleic acid (ω-60), and glucose, whereas induced significant increase in lipoxin-A4, nitric oxide, and α-linolenic acid (ω-3). Conclusion A combination of myrtle extract and fish oil has a potential effect that exceed the beneficial role of each of them in reducing endothelial dysfunction as well as oxidative stress and inflammation associated with diabetes mellitus.
  1 1,693 178
Behavioral determinants of hand hygiene compliance among physicians in Riyadh region in Saudi Arabia
Hala A Amer, Abdalla F Bahar, Muhammad N Algamal, Hind A Alzoman, Ammal M Metwally
July-December 2017, 12(2):99-105
DOI:10.4103/jasmr.jasmr_23_17  
Background/aims Hand hygiene is recognized globally as a leading measure to reduce healthcare-associated infection. However, compliance with hand hygiene is unacceptably low. Physicians − in particular − have repeatedly been observed to be poor compliers. Promotion of this important practice is a complex issue. It is important to study the behavioral determinants in relation to hand hygiene practices to develop effective improvement strategies. The aims of our study are to assess the knowledge of the physician and their attitudes and practices of hand hygiene, to identify the behavioral determinants of noncompliance, and to recommend interventions that could increase the practice. Participants and methods An anonymous questionnaire was administered that included four sections: participants’ demographic data, self-reported compliance on the basis of the Centers for Disease Control and Prevention Guidelines, attitudes in relation to the studied behavior adapted from a validated published questionnaire, and the knowledge assessment section chosen from the WHO questionnaire. The questionnaire was distributed by infection control practitioners at King Saud Medical City − a tertiary care hospital in Riyadh, Saudi Arabia − and self-completed by 127 physicians of different specialties during March–May 2015. Results The response rate was 75%. The mean self-reported compliance rate was 89.4%. A multiple linear regression analysis was carried out on the studied variables that identified three main predictors most likely to be correlated with hand hygiene behavior noncompliance: self-efficacy (β=0.252; P=0.004), time-related attitude (β=0.16), and usefulness-related attitude (β=0.148). Conclusion Understanding the determinants of a fundamental behavior such as hand hygiene in healthcare settings is among the essential steps to plan more effectual intervention strategies for compliance improvement. Contributions from behavioral and social sciences are crucial when designing studies to investigate and improve behavior acquiescence. The healthcare system is complex and more studies are needed to elaborate specific behavioral determinants in relation to the practice of hand hygiene in other variable work situations and among different healthcare workers categories and employee belong to different culture group.
  1 2,360 167
Carotid intima–media thickness assessment in obese patients with chronic renal failure
Sahar A El-Masry, Hosneya A Mohamed, Ashraf M Enaite, Manal M Ali, Ibrahim A Ibrahim
January-June 2018, 13(1):18-24
DOI:10.4103/jasmr.jasmr_16_18  
Background/Aim Measurement of carotid artery intima–media thickness (CIMT) is reliable for early detection of atherosclerosis, one of obesity’s complications, which is a leading cause of mortality among patients with end-stage renal disease. The study aimed to evaluate CIMT in relation to obesity, chronic renal failure (CRF) and both, for the early prevention of cardiovascular problems. Patients and methods This cross-sectional study included 118 adult individuals of both sexes, aged 30–60 years. Patients with CRF were gathered from the renal dialysis unit of King Fahd Hospital-Kasr El Einy Hospital, and the obese without CRF from the ‘Management of Visceral obesity Unit’, in ‘Medical Excellence Research Center (MERC)’, National Research Centre, during the period spanning from June 2015 to April 2016.They were grouped into three groups: a case group, which included 45 obese individuals with CRF, and two control groups: one comprised 39 nonobese patients with CRF and the other group comprised 34 obese patients without CRF. Anthropometric assessment, lipid profile, and ultrasound measurement of CIMT were performed for each patient. Results CIMT was greater in all groups than the normal range (0.06–0.08 cm), particularly in the obese group without renal failure. CIMT had a highly significant correlation with waist circumference and insignificant correlation with BMI and lipid profile in different groups. Conclusion The increase in CIMT was related to obesity and renal failure, but it was more prominent with obesity. CIMT had highly significant correlation with central obesity in cases wherein obesity and renal failure were coexisting together and insignificant correlation with lipid profile.
  1 1,990 225
Caffeine and nifedipine effect on cataract induced by selenite in rats
Mona S Taalat, Eman M Aly, Eman S Mohamed, Mervat A Ali, Heba A Gaber
January-June 2018, 13(1):32-38
DOI:10.4103/jasmr.jasmr_6_18  
Background/aim Cataract is one of the major causes of visual impairment globally and the first cause of bilndness. The present study analyzed the impact of caffeine and/or nifedipine in a model of cataract caused by selenite. Materials and methods A total of 75 albino Wistar rats were alienated into five groups (15 each): group I served as control and group II was subcutaneously injected with 30 nmol/g body weight of sodium selenite. Group III received an intraperitoneal injection of 5.15 μmol of caffeine; group IV received 0.1 mg/kg of nifedipine; and group V received the two treatments in the same dose after selenite injection. Groups were decapitated after 5, 15, and 25 days of selenite injection. Comet assay to lens epithelium, refractive index, and ultraviolet absorption spectra for lens proteins were studied. Results The results indicated very high significant increase (P<0.001) in comet assay parameters and refractive index. Also variation of ultraviolet spectra for all groups injected with selenite was observed. Partial recovery was observed after treatment with caffeine or nifedipine but there were no significant differences in groups treated with a combination of caffeine and nifedipine. Conclusion The study stated that to achieve attenuation or delay of lens cataract formation, a calcium channel blocker must be used in addition to antioxidants.
  1 2,035 180
Autologus serum and sodium hyaluronate role in alkali corneal burn healing
Eman S Mohamed, Mervat A Ali
January-June 2018, 13(1):39-44
DOI:10.4103/jasmr.jasmr_13_18  
Background/aim Corneal burn wound healing includes a sequence of difficult processes that are focused on improving the outcomes, in particular, the healing time and the feature of the scar. Bodily fluids such as natural tears and autologus serum were used in the treatment of corneal burn. The aim of the study was to investigate the cure of corneal burn alkali injury by autologous serum (AS) and/or sodium hyaluronate. Materials and methods A total of 50 Wister rats (200–250 g) were distributed into five groups: group I acted as the control, group II had alkali burn (AB) with sodium hydroxide, group III had AB treated with AS, group IV was AB treated with sodium hyaluronate, and group V had AB with sodium hydroxide treated with autologus serum and sodium hyaluronate. Comet assay analysis was applied for cornea to determine DNA damage. Malondialdehyde, superoxide dismutase, glutathione peroxidase, and catalase were measured to estimate the balance between oxidants and antioxidants in the cornea. Results The data indicated a significant increase (P<0.05) in all comet assay parameters and malondialdehyde level in addition to a significant decrease (P<0.05) in superoxide dismutase, glutathione peroxidase, and catalase activity owing to AB. Enhancements of measured parameters were observed in all other treated groups. Conclusion AS accelerates the AB healing process, but the process was faster when diluted by sodium hyaluronate.
  1 2,389 174
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