Efficiency of Three Extracts of Carica papaya as Molluscicidal and Anti-schistosomal Agents against Biomphalaria alexandrina and Schistosoma mansoni by Flow Cytometry

Schistosomiasis a prevalent parasitic disease in tropical and sub-tropical areas, which comes in the second place in terms of socioeconomic and public health burden. Around 600 million people in 74 countries are infected yearly, predominantly in the developing world. The aim of this work was to assess the efficiency of three extracts from Carica papaya (methanol, ethanol and butanol extracts) for their molluscicidal and anti-schistosomal activities. The LC50of methanol, ethanol and butanol extracts of Carica papaya against B. alexandrinea were 180, 499.3 and 509.1 mg/L while the respective LC90values were 220.3, 700.6, 769.6 mg/L respectively. The effect of these extracts on Biomphalaria alexandrina snails and larval stages of Schistosma mansoni, for miracidia the LC50of methanol, ethanol and butanol extracts ofCaricapapaya against miracidia were 3.4, 15.4and 8.1 mg/L, respectively, while the respective LC90values were 8.4, 38.2, 11.2 mg/L, and for cercariae the LC50of methanol, ethanol and butanol extracts ofCaricapapaya were 2, 20and 4mg/L, while the respective LC90values were 13.5, 80.5, 18.5mg/L respectively was evaluated, in addition to flowcytometric analysis of CD4, CD25, FOXP3 and TGF-βlevels during S. mansoniinfection in mice. The in-vivo results showed that the three extracts have variable potential against snails and miracidia and cercariae ofS. mansoni. The mortality rate in B. alexandrinasnails for methanol, ethanol and butanol extracts ofCarcia papaywere 86%, 45% and 64%, respectively. While it was 83%, 35% and 66%, respectively in miracidia and 92%, 40% and 70%, respectively in cercariae. The results indicated that methanol extract from Carica papaya recorded higher activity against snails, miracidia and cercariae. The levels of CD4, CD25, FOXP3 regulatory T (Treg) cells were decreased significantly (p<0.001) in infected mice compared to healthy controls. However, there was a significant (p<0.001) increase in levels of TGF-β. A significant increase in the levels of CD4, CD25, and FOXP3 Treg in Carica papaya treated group compared to infected control group, with a significant (p<0.001) decrease in TGF-βlevel than infected group. In conclusion, methanol extract was more effective at concentration of LC50 180 and LC90 220.3than ethanol and butanol extracts ofCaricapapaya therefore controlling B. alexandrinasnails by methanol extract is a promising way as it is an eco-friendly strategy in rural areas of developing countries, where schistosomiasis is endemic. Moreover, the increased immune defense mechanism in treated group with the same extracts is a promising target for new immune modulatory strategies against schistosomiasis

Evaluation of gold nanoparticles coated sandwich elisa as innovative diagnosis for human bancroftian filariasis

This study compared the traditional sandwich ELISA and nano-sandwich ELISA methods for diagnosis of lymphatic filariasis. With the ability to interact with matter at the nanoscale, the development of nanotechnology architecture and materials could potentially extend molecular detection beyond the limits of conventional diagnostic modalities. This study included 142 subjects who were classified into; filarial diseased, other parasitic diseased and healthy control groups. Firstly, thick blood film was done for all subjects under study and their sera were obtained and preserved. A prepared sitarial antigen was injected into a rabbit to obtain polyclonal antibodies. That rabbit serum was purified, then pure IgG was obtained and a part of it was conjugated with gold nanoparticles. Conventional ELISA and nano-ELISA were done for patient's serum to detect circulating filarial antigen. Examination of blood film for microfilaria resulted in that; 5.1% of all patients were positive however 94.9% were negative. In comparison between ELISA and nano-ELISA readings, it was obvious that nano-ELISA is advantageous than traditional ELISA in all cases. The sensitivity, specificity, positive predictive value and negative predictive value of ELISA were 90.7%, 75%, 84.8% and 84% respectively. While by using nano-ELISA, they were 95.1%, 87.5%, 92.9% and 91.3% respectively. It was concluded that using nano-sandwich ELISA of the serum samples for detection of circulating filarial antigen in patients infected with W. bancrofti gave higher sensitivity and specificity than conventional ELISA, as proved by statistical study

randomized trial of brief treatment of early-stage Hodgkin lymphoma: is it effective?

Whether it is possible to reduce the intensity of treatment in early [stage I or II] Hodgkin lymphoma with a favorable prognosis remains unclear. Therefore, we conducted this random-ized trial, comparing two treatment groups consisting of a combination chemotherapy regimen of two different intensities followed by involved-field radiation therapy at two different dose levels. Prospective, randomized, in patients referred to the Department of Clinical Oncology and Nuclear Medicine. Ninety-eight patients with histologically proven early-stage Hodgkin lymphoma with a favorable prognosis were enrolled in this study between January 2008 and June 2010. They were randomly assigned in one of two treatment arms: arm I received four cycles of ABVD [Adriamycin, belomycin, vinblastine, dacarbazine]] followed by 30 Gy of involved-field radiation therapy; arm II received two cycles of ABVD followed by 20 Gy of involved-field radiation therapy. During the follow-up period, the 2-year relapse free survival rates were 96% and 95% in arm I and arm II, respectively [P=.8], while the 2-year overall survival rates were 98% and 95% in arm I and arm II, respectively [P=.16]. Acute toxicity affected 54% of patients treated with four cycles of ABVD, who had grade III or IV toxicity, as compared with 30% of those receiving two cycles [P<.02]. The rates of acute toxicity [grade III or IV] were also higher among patients treated with 30 Gy of involved-field radiation therapy than among those receiving 20 Gy [16% vs. 2.5%, P<.03]. In patients with early-stage Hodgkin lymphoma and a favorable prognosis, treatment with two cycles of ABVD followed by 20 Gy of involved-field radiation therapy was as effective as, and less toxic than, four cycles of ABVD followed by 30 Gy of involved-field radiation therapy

Laparoscopic adhesiolysis for bowel obstruction, preliminary results

Recurrent small bowel obstruction caused by postoperative adhesions has traditionally been treated by conventional laparotomy, but laparoscopic management of acute small bowel obstruction has been demonstrated. Our aim was to evaluate the feasibility of a laparoscopic as a minimal access approach for the management of patients with recurrent adhesive intestinal obstructions. After conservative treatment, elective laparoscopic treatment was attempted in 22 patients hospitalized for recurrent small bowel obstruction after abdominal surgery. The sites of postoperative adhesions were identified laparascopically in all patients. Complete laparoscopic adhesiolysis was feasible in 17 patients [77.3%], while conversion to laparotomy was required for 5 patients [22.7%] due to iatrogenic intestinal injury during adhesiolysis [one patient] or technical difficulties due to adhesion [in four patients]. The mean operating time was 95 minutes. Long-term follow up was possible in three patients for 27 months. One recurrence of small bowel obstructions was noted after 7 months. No available data was obtained [in two patients]. Laparoscopic adhesiolysis is a safe and effective treatment for recurrent small bowel obstruction. Conversion to laparotomy should be considered in patients with dense adhesions

use of cholinesterase reactivators as a part of management of tetanus

Tetanus is a common disease of tropical and subtropical countries with high mortality rate, its tetanospasmin inhibits cholinesterase enzyme leading to accumulation of acetyl choline at motor nerve endings. Therefore choline esterase restoring drug chemically designated as obidoxim chloride was added to the classical lines of treatment of tetanus. No mortalities were recorded in cases suffering from moderate type of tetanus after the use of obidoxim chloride while patients who received the classical treatment without the use of choline esterase reactivator had a mortality rate of 37.5%. The mortality rate was reduced from 62.5% to 22.72% in serve cases of tetanus. The period needed for improvement of the clinical manifestations [trismus, muscle rigidity and spasms] was shortened in all cases after adding choline esterase reactivator to the classical line of therapy