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 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 Reduction of female sex hormones is associated with health disorders including cardiovascular diseases such as hypertension. Supplementation with vitamin B complex can lower the incidence of these disorders. The present study aimed to study the potential cardioprotective effects of vitamin B complex and ethinyl estradiol (EE) when administered alone or in combination to hormonal-deprived ovariectomized (OVX) rats. Materials and methods Fifty female Wister rats were classified into five equal groups: the first group included normal rats, the second group was OVX (positive control), and the third to fifth groups were OVX rats that were treated by EE (0.03 mg/kg), vitamin B complex (9.036 mg/kg), and a combination of both treatments, respectively. Treatment continued for eight successive weeks. Blood pressure (BP), cystathionine γ-lyase (CSE), reduced glutathione (R-GSH), superoxide dismutase (SOD), catalase (CAT), and interleukin-β6 (IL-β6) were measured. Results The OVX rats showed a significant increase in BP, reduction in CSE, R-GSH, SOD, and CAT, and increase in IL-β6 levels, whereas the treated OVX rats showed a significant decrease in BP, increase in CSE, R-GSH, SOD, and CAT, and reduction in IL-β6 levels. Conclusion Vitamin B complex and EE exert cardioprotective effects in OVX rats.

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Background/aim Sodium hypochloride (NaOCl) was used recently as an alternative material for formocresol. The purpose of this study was to evaluate the clinical and radiographic outcome of pulpotomy treatment in deciduous molars using 2.5% NaOCl, 5% NaOCl, and Buckley’s formocresol. Participants and methods A total of 60 primary molars teeth of 30 children aged 5–9 years were selected for the study. The selected teeth were randomly distributed into three groups treated by 2.5% NaOCl, 5% NaOCl, and formocresol. Pulpotomy was carried out using the three medications, and the teeth were restored with stainless steel crowns. The clinical and radiographic evaluations were performed at 3 and 6 months postoperatively. Results At the 3-month follow-up, 100% of the pulpotomy medicaments were clinically successful. At the 6-month follow-up, all pulpotomized dentitions in 2.5% NaOCl and formocresol were clinically successful. In 5% NaOCl group, gingival inflammation was observed in two teeth. Regarding the radiographic findings, at the 3-month follow-up, all pulpotomized teeth in 2.5% NaOCl group were successfully treated. Radiographic changes were seen in 5% of the teeth in the 5% NaOCl group and 5.5% of teeth in the formocresol group. At the 6-month follow-up, radiographic changes were seen in 6% of the teeth in 2.5% NaOCl group, 11% of the teeth in 5% NaOCl group, and 12.5% of the teeth in formocresol group. No significant differences were found in the clinical and radiographic outcomes among the three groups (P>0.05). Conclusion There is no difference in the clinical and radiographic finding of pulpotomized molars using 2.5%, 5% NaOCl, and formocresol. The results show that 2.5% NaOCl is as effective as 5% NaOCl, so it could be used safely as a therapeutic agent in the treatment of deciduous teeth with pulp involvement.

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Background/aim The aims of the present study were to investigate the role of procalcitonin (PCT) as a diagnostic biomarker for community-acquired pneumonia (CAP) in children and its value to distinguish between bacterial and nonbacterial infections. Patients and methods The study enrolled 64 children admitted to the Department of Pediatrics at El-Helal Specialized Hospital of Pediatrics, Cairo, for clinical and radiological evidence of CAP, aged from 1 month to 7.5 years. They were divided into two groups according to pathogen detection: group I comprised bacterial pneumonia (33 cases) and group II included nonbacterial pneumonia (31 cases). In addition, 37 healthy children were also enrolled as a control group. Full clinical examination was conducted, and venous blood samples were taken from all participants for the assessment of complete blood count, serum levels of PCT by ELISA, and C-reactive protein (CRP) by latex agglutination technique. Results PCT and CRP levels in peripheral blood were significantly higher (P<0.001) in all children with pneumonia compared with controls (357.4±70.8, 18.8±5.1, vs. 121.5±21.3, 5.61±1.82, respectively). Serum PCT level was higher in the bacterial pneumonic group compared with those with nonbacterial pneumonia (P<0.001). There was also a positive correlation between PCT level and both CRP (P≤0.05), and leukocytic count (P<0.05). Conclusion PCT can be considered as an important indicator for CAP and can be used for differentiation between bacterial and nonbacterial pneumonia.

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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.

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Background/aim The incidence of developing complications in type 1 diabetic children and adolescents is increased along with increased development of vascular complications. Endoglin is a cell-surface coreceptor for the transforming growth factor β1 it is highly expressed in the endothelial cell having a crucial role in angiogenesis, indicating endothelial dysfunction and diabetic complications and pathologies. The present study aims to assess serum endoglin levels in relation to vascular and endothelial dysfunction associated with type 1 diabetes in a group of children and adolescents. Patients and methods This study was conducted on 30 diabetic children and adolescents, aged 6–16 years, in addition to 30 healthy children served as a control group of matched age. Clinical examination and anthropometric assessment were done for all children. In addition, endoglin, metabolic lipid parameters, glycated hemoglobin, and urinary albumin were determined, in addition to ophthalmologic examination for diabetic retinopathy. Results The levels of serum endoglin, systolic blood pressure Z-score, diastolic blood pressure Z-score, cholesterol, low-density lipoprotein, high-density lipoprotein, and triglycerides in patients were significantly higher than in controls. Endoglin levels were higher in cases with albuminuria and retinopathy compared with other cases. Significant correlations were detected between endoglin and systolic blood pressure Z-score, diastolic blood pressure Z-score, cholesterol, triglycerides, low-density lipoprotein, glycated hemoglobin, and albuminuria. Conclusion We conclude that endoglin can serve as a predictor of cardiovascular risk in pediatric population and other diabetes-associated complications such as retinopathy and albuminuria.

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Background/aim Retinal degeneration is a leading cause of vision loss. Exposure to pesticides is a high risk factor of retinal degeneration. The aim of the work is to investigate the molecular structural changes of retina associated with the topical application of glyphosate (GLP), an organophosphorus compound pesticide. Materials and methods Twenty rabbits were randomly categorized into four groups. Group I served as control (n=5, 10 eye balls) and the other three groups (each composed of five rabbits) received topical instillation of 100 μl twice a day of GLP in three concentrations of 0.12, 0.97, and 7.8 mg/kg, respectively. After 1 week, eyes were enucleated and retinae were removed and prepared for analysis by infrared spectroscopy (Fourier-transform infrared spectroscopy). Results The regions of NH–OH spectra indicated a significant decrease (P<0.05) in wavenumber and restriction of two components related to _strO–H and OH_asym band after application of GLP. The protein secondary structure components in terms of β sheets, alpha helices and β turns were changed in groups III and IV. Also the fingerprint regions indicate changes in the surrounding environment after all doses of GLP. Conclusion Certain retinal structure modifications may lead to the degeneration of retina after topical exposure to GLP in rabbits. So this herbicide should be handled with caution. National governments must introduce a GLP reduction program because of its damage effect on retina function.

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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.

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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.

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