Systemic inflammation response index is associated MACE in patients with NSTEMI.

OBJECTIVE: Non-ST segment elevation myocardial infarction (NSTEMI) poses a significant health concern. The systemic inflammation response index (SIRI), an emerging inflammatory marker linked to conditions like stroke and cancer, has shown potential relevance. Inflammation's pivotal role in acute coronary syndromes is well-established, yet its specific association with NSTEMI and SIRI remains unexplored. This study aims to elucidate the correlation between SIRI and major adverse cardiovascular events (MACE) in patients with NSTEMI. PATIENTS AND METHODS: A cohort of 935 consecutive NSTEMI patients who underwent percutaneous intervention was recruited. MACE was defined to encompass all-cause death, malignant arrhythmia, and unplanned percutaneous coronary intervention. The systemic inflammation response index, a composite metric involving three distinct inflammatory cell counts, was computed as the product of neutrophil count and monocyte count divided by lymphocyte count. A receiver operator characteristic (ROC) curve analysis was used to define a cut-off level of SIRI to predict MACE. Then, the study population was divided into two groups according to the cut-off SIRI level in ROC curve analysis. The 12-month follow-up results of the patients were recorded retrospectively. RESULTS: The participants exhibited a mean age of 64.12. Notably, the mean SIRI level registered at 1.98 among patients experiencing MACE and 4.97 among others. Through rigorous multivariate logistic regression analysis, SIRI emerged as an independent predictor of MACE. Further analysis via ROC curve yielded a sensitivity of 68% and specificity of 76% for MACE detection, with a SIRI cut-off of 2.3. CONCLUSIONS: In the context of NSTEMI, SIRI emerges as a robust independent predictor of MACE. These findings underscore the potential utility of SIRI as a prognostic indicator for adverse cardiovascular events, enhancing our understanding of the disease's pathophysiological mechanisms and potential avenues for improved clinical management.

Evaluation of Serum Endocan Levels in Endometriosis: A case-control study.

OBJECTIVE: To evaluate the possible associations between serum endocan levels and endometriosis. STUDY DESIGN: A total of 60 women with histologically proven endometriosis and 40 women who underwent laparoscopy due to unexplained infertility without endometriosis were evaluated in a case-control study. Serum endocan, CA125, CA19.9, and CA15.3 levels were measured. Demographic, clinical, and laboratory parameters were compared. RESULTS: There was no significant difference between the groups regarding age, body-mass-index, parity, and serum CRP and WBC levels. Serum endocan (p<0.001), CA125 (p<0.001), CA19.9 (p=0.022) and CA15.3 (p=0.013) levels were significantly higher in the endometriosis group compared to the control group. The correlation analysis showed that serum endocan level was positively correlated with the stage of the disease, CRP, and WBC, but not with remaining parameters, age, BMI, dysmenorrhea score, CA125, CA19.9, and CA15.3. Serum CA125 can predict endometriosis (Cut off=26.2 IU/mL, AUC=0.955) with a sensitivity of 89% and specificity of 88%. Serum endocan can predict endometriosis (Cut off=454 ng/mL AUC=0.749) with a 93% sensitivity and 61% specificity. CONCLUSIONS: The serum endocan levels were significantly elevated in women with endometriosis compared to the control group. Serum endocan can predict endometriosis with a sensitivity of 93% and specificity of 61.

Early Switch to Mammalian Target of Rapamycin Inhibitors Is a Sustainable Treatment Approach in Renal Transplant Recipients: 7-Year Results.

OBJECTIVE: The aim of this study was to investigate the safety and sustainability of mammalian target of rapamycin inhibitor (m-TORi)-based treatment protocols in renal transplant patients. METHODS: We retrospectively evaluated a total of 206 patients who were switched to low-dose calcineurin inhibitors (CNI) + m-TORi or mycophenolate mofetil (MMF) + m-TORi treatment protocols in the first 3 months of renal transplantation between January 2010 and August 2011 in our center. Demographic and laboratory features of the patients were recorded. RESULTS: Of the patients included in the study, 89 (43.2%) were female and 117 (56.8%) were male. The mean age was 41.9 ± 13.8 years. Panel reactive antibody was negative in 95% of the recipients. One hundred thirty-four (65%) patients received anti-thymocyte globulin induction therapy. Initially, 108 patients were treated with cyclosporine and 98 (47.6%) were treated with tacrolimus-based regimens. One hundred thirty-five patients (65.5%) were switched to low-dose CNI + m-TORi and 71 patients (34.5%) were switched to MMF + m-TORi. The mean switching time was 3 months. At the end of the study, 161 patients (78.2%) were still continuing the m-TORi treatment protocol and 45 patients (21.8%) could not continue for various reasons (11.4% proteinuria, 5.5% edema, 2.9% acute rejection, 1% acne + oral aphthae, 1% neuropathy). The biopsy-proven acute rejection rate was 4.5% (n = 9). The mean duration of sustainability of m-TORi treatment protocol was 84.15 ± 6.79 months. Mean serum creatinine of patients who were still continuing m-TORi was 1.42 ± 1.09 mg/dL. CONCLUSION: Switching to m-TORi in the early posttransplant period is a safe and sustainable treatment approach.

Cutaneuos findings in patients with predialysis chronic kidney disease.

BACKGROUND: Several cutaneous findings are seen in dialysis dependent chronic kidney disease (CKD) patients. However, there are only a few small studies on cutaneous findings in predialysis CKD patients. We aimed to determine cutaneous findings in predialysis CKD patients. METHODS: This was a cross-sectional study. Consecutive predialysis CKD patients from nephrology outpatient clinic in a university affiliated hospital were recruited to this study. Detailed dermatologic examination was performed by a senior dermatologist. Blood urea, creatinine, hepatitis B surface antigen and hepatitis C antibody test were studied for each participant. RESULTS: A total of 365 consecutive predialysis CKD patients (stages 2-5) included in the study. Three hundred and fifty-eight patients (98.1%) had at least one dermatologic finding. The most common cutaneous finding was xerosis (64.9%) followed by hair findings (41.4%), pruritus (19.2%), pigmentary changes (17.5%), nail findings (15.3%) and oral mucosal findings (9.3%). Longitudinal striations was the most common nail finding, diffuse brown hyperpigmentation was the most common pigmentary change, coated tongue was the most common oral mucosal finding and androgenetic alopecia was the most common hair finding. Frequency and diversity of dermatologic findings did not change across CKD stages. CONCLUSIONS: This is the largest study investigating dermatologic findings in a well-characterized predialysis CKD patient population. We found that at least one cutaneous finding was present in almost all of the CKD patients. Cutaneous findings are very common and diverse among predialysis CKD patients.

Comparison of maternal and umbilical cord blood soluble lectin-like oxidized low-density lipoprotein receptor 1 levels in early- and late-onset preeclampsia.

BACKGROUND: The main purpose of this study was to determine the maternal and umbilical cord blood oxidized LDL (oxLDL) and soluble lectin-like oxidized low-density lipoprotein receptor-1 (sLOX-1) levels in early- and late-onset preeclampsia (PE). MATERIALS AND METHODS: A case-control study was conducted in pregnant women with early-onset (before 34 weeks' gestation n = 19) and late-onset (after 34 weeks' gestation n = 22) PE compared to healthy normotensive pregnant controls (n = 44). Groups were compared for the maternal and umbilical cord plasma oxLDL and serum sLOX-1 levels. RESULTS: The mean maternal and umbilical cord serum sLOX-1 and plasma oxLDL levels were significantly increased in early- and late-onset PE compared to controls (p < 0.001). When early- and late-onset PE women were compared with serum sLOX-1 levels, the increase was more pronounced in early PE (p < 0.001). However, same comparison is not statistically significant in cord blood for oxLDL where as it is significantly higher in maternal blood for oxLDL in early-onset PE group. Maternal and cord blood oxLDL and sLOX-1 levels are positively correlated with each other; however, they are negatively correlated with fetal weight and gestational age. CONCLUSIONS: According to our results, maternal and umbilical cord blood levels of oxLDL and sLOX-1 were higher in preeclamptic pregnant. Thus, for the first time it has been shown that oxLDL and sLOX-1 levels were higher in fetal circulation as well as plasma of preeclamptic pregnant. However, sLOX-1 levels seem to be more implying than oxLDL for the differentiation of early and late preeclampsia.

Effects of montelukast and zileuton on testicular torsion/detorsion injury in rats.

The aim of this study was to evaluate and compare the effects of 5-lipoxygenase enzyme (5-LO) inhibitor zileuton and cysteinyl leukotriene receptor (CysLT1R) antagonist montelukast in testicular torsion/detorsion (T/D) injury model in rats. Rats were anaesthetised with 75 mg kg(-1) ketamine hydrochloride and 8 mg kg(-1) xylazine intraperitoneal before the operation. Torsion was created by rotating the right testis 720° clockwise and maintained by fixing the testis. The rats were treated with CysLT1R antagonist montelukast (10 mg kg(-1); i.p.), 5-LO inhibitor zileuton (3 mg kg(-1); i.p.), and vehicle, at 30 min prior detorsion. After 1 h of torsion, the testis was counter-rotated to the natural position and replaced into the scrotum. Malondialdehyde (MDA) level was measured in testicular tissue after 3 h of reperfusion. Histological examination was performed after 24 h of reperfusion. T/D caused a significant increase in MDA level and histopathological injury in testes. Montelukast and zileuton treatments prevented the T/D-induced augmentation in MDA levels. Only zileuton treatment significantly reduced the T/D-induced histopathological injury. In this study, we demonstrated for the first time that zileuton had protective effects on testicular T/D injury. We have also found that zileuton is more effective than montelukast on histopathological injury.

Multi-organ injuries caused by lipopolysaccharide-induced periodontal inflammation in rats: role of melatonin.

BACKGROUND AND OBJECTIVE: Periodontitis, a chronic inflammatory disease caused by oral bacterial infection, is considered to be a risk factor for systemic diseases including diabetes mellitus, bacterial pneumonia, hyperlipidemia and atherosclerosis. The aim of this study was to evaluate the effectiveness of melatonin against periodontal inflammation-induced multiple organ injury in rats. MATERIAL AND METHODS: Eighteen female Wistar albino rats were randomly divided into three groups of six rats each: control; lipopolysaccharide (LPS); and LPS + melatonin. During the experimental period (10 d) all rats in the LPS and LPS + melatonin groups were given 10 µL of LPS (from a 10 mg/mL standard solution of LPS dissolved in saline) on days 1, 3 and 5. The rats in the LPS + melatonin group were given 50 mg/kg of melatonin, daily for 10 d, starting on day 1 after the administration of LPS. All rats were killed at the end of the experimental period. Liver, kidney and lung tissues were removed for investigation by light microscopy. RESULTS: The levels of serum aspartate aminotransferase (AST), alanine transaminase (ALT) and blood urea nitrogen (BUN) were significantly increased in the LPS group compared with the LPS + melatonin group (p < 0.05). There was no significant change in the serum creatinine levels in the groups. However, the changes in serum AST, ALT and BUN levels in the experimental groups did not correlate with changes in histological data. Both LPS and LPS + melatonin groups displayed structural features similar to those of the control group. CONCLUSION: The results revealed that increased serum AST, ALT and BUN levels following periodontitis are ameliorated with melatonin treatment.

Platelet distribution width and saphenous vein disease in patients after CABG. Association with graft occlusion.

OBJECTIVE: Platelets are involved in the pathogenesis of atherosclerosis. The inflammatory process in atherosclerosis may cause an increase in red blood cell distribution width (RDW) and platelet distribution width (PDW) values. Therefore, in this study we aimed to investigate whether PDW and RDW are associated with the patency of saphenous vein graft in patients at least 1 year after coronary artery bypass graft (CABG) surgery. METHODS: Patients who had undergone CABG surgery at least 1 year previously with at least one saphenous vein graft were included in the study population. Patients were referred to cardiac catheterization for stable anginal symptoms or positive stress test results. Before coronary angiography, all patients referred had routine blood tests including RDW and PDW values. RESULTS: Saphenous vein grafts were found to be patent in 69 patients and occluded in 40 patients. Although RDW levels were similar between patients with patent and occluded grafts (13.1 ± 1.1% and 13.2 ± 0.7% respectively, p = 0.37), PDW levels were significantly different between the two groups (13.1 ± 1.3% and 14.1 ± 1.1 respectively, p = 0.03). Although time after CABG operation differs significantly between the two groups (p < 0.001), multiple logistic regression analyses showed that PDW levels were found to be significantly associated with the patency of vein graft (ß = 1.682, 95% CI 1.117-2.532, p = 0.013). CONCLUSION: Our results showed that PDW levels were higher in patients with an occluded saphenous vein graft. However no association was found between the saphenous vein graft disease and RDW values. To verify this relationship between PDW values and saphenous vein graft patency, further investigations are needed.

The effects of resveratrol on the healing of left colonic anastomosis.

INTRODUCTION: Resveratrol (RSV) is a natural polyphenolic compound found in grape skins and the red wine which improves histological reorganization of the regenerating tissue in dermal wound healing. Since anastomotic healing possesses paramount importance to prevent complications in colorectal surgery, the present study is aimed to evaluate the effect of RSV on the healing of experimental left colonic anastomoses. METHODS: Thirty-two male Wistar albino rats were randomized into two groups and subjected to colonic anastomosis. The study group was treated with RSV and the control group received tap water instead. The rats were sacrificed 3 and 7 days postoperatively. Wound complications, intra-abdominal abscesses, and anastomotic leaks and stenosis were recorded. Four types of assessment were performed: bursting pressure, hydroxyproline (OHP) content, histopathology, and biochemical analysis. RESULTS: Compared to the control group, the RSV-treated rats displayed a higher bursting pressure (p < .001) and anastomotic OHP content (p < .05)]. RSV treatment leads to significant increase in PON activity at both time points and decrease in malondialdehyde levels on postoperative day 3 (p < .001). Histopathological analysis revealed that RSV administration leads to a better anastomotic healing in terms of mucosal ischemia, neovascularization, reepithelialization, fibroblast, and lymphocyte infiltration. CONCLUSION: The study results suggest that exogenous RSV administration exerts a positive effect on experimental colonic wound healing in the rat. Although the precise cellular mechanisms by which RSV enhances anastomotic wound healing is not clear, stimulation of neovascularization, generation of collagen synthesis, inhibition of over inflammation, and restriction of oxidative injury seems to be of paramount importance.

Simvastatin improves wound strength after intestinal anastomosis in the rat.

BACKGROUND: Simvastatin is a 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor commonly known as a cholesterol-lowering drug with additional pleiotropic effects. Also, it is demonstrated that it prevents postoperative peritoneal adhesions in rat. This study was designed to assess its effects on the healing process of colonic anastomosis. METHODS: Thirty-two male Wistar albino rats were randomized into two groups and subjected to colonic anastomosis. The study group was treated with simvastatin and the control group received only tap water instead. The rats were killed 3 and 7 days postoperatively. Wound complications, intra-abdominal abscesses, and anastomotic leaks and stenosis were recorded. Four types of assessment were performed: bursting pressure, hydroxyproline content, histopathology, and biochemical analysis. RESULTS: Compared to the control group, simvastatin-treated rats displayed a higher bursting pressure (p < 0.001) and anastomotic hydroxyproline content (p < 0.05). Simvastatin treatment leads to a significant decrease in malondealdehyde levels (p < 0.05) and increase in paraoxonase activity (p < 0.001) at both time points. Histopathological analysis revealed that simvastatin administration leads to a better anastomotic healing in terms of reepithelialization, decreased granuloma formation, reduced ischemic necrosis, and inflammatory infiltration to muscle layer. CONCLUSION: Clinically relevant doses of simvastatin do not have a negative impact on colonic anastomosis but improve intestinal wound healing in rats.

Effects of dexmedetomidine or methylprednisolone on inflammatory responses in spinal cord injury.

BACKGROUND: The aim of this study was to compare the anti-inflammatory response of methylprednisolone and the alpha2-agonist dexmedetomidine in spinal cord injury (SCI). METHODS: Twenty-four male adult Wistar albino rats, weight 200-250 g, were included in the study. The rats were divided into four groups as follows: the control group (n: 6) received only laminectomy; the SCI group (n: 6) with trauma alone; the SCI+methylprednisolone group (n: 6) with trauma and 30 mg/kg methylprednisolone, followed by a maintenance dose of 5.4 mg/kg/h; and the SCI+dexmedetomidine group (n: 6) with trauma and 10 microg/kg dexmedetomidine treatment intraperitoneally. Twenty-four hours after the trauma, spinal cord samples were taken for histopathological examination and serum samples were collected for interleukin-6 (IL-6) and tumor necrosis factor (TNF)-alpha measurement. RESULTS: TNF-alpha (P=0.009) and IL-6 (P=0.009) levels were significantly increased in the SCI group. TNF-alpha and IL-6 levels were significantly decreased with methylprednisolone (P=0.002, 0.002) and dexmedetomidine (P=0.002, 0.009) treatment, respectively. Methylprednisolone and dexmedetomidine treatment reduced neutrophils' infiltration in SCI. CONCLUSIONS: The current study does not clarify the definitive mechanism by which dexmedetomidine decreases inflammatory cytokines but it is the first study to report the anti-inflammatory effect of dexmedetomidine in SCI. Further studies are required to elucidate the effects of dexmedetomidine on the inflammatory response.

Use of warm priming solution in open heart surgery: its effects on hemodynamics and acute inflammation.

Cardiac surgery causes an acute inflammatory response and organ damage. In this study, for the first time in the literature, we compared the effects of priming solutions at 20 degrees C and 36 degrees C on acute inflammatory markers and hemodynamic parameters. Forty patients were recruited and randomized into two groups, each consisting of 20 participants who underwent elective coronary artery bypass grafting operation. Groups were primed with the same solution at different temperatures. Hemodynamic parameters were recorded. Blood samples were drawn pre-operatively and at the 15(th) and 60(th) minutes of aortic cross-clamping and the 24(th) hour following surgery. Serum pre-albumin, alpha-1 antitrypsin, and tumor necrosis factor-alpha levels were determined. The groups were compared statistically. Both of the groups were comparable for mean aortic cross-clamping time and mean time for cardiopulmonary bypass. Mean blood pressure value was significantly lower and the mean amount of ephedrine hydrochloride used was significantly higher in the cold priming group. Spontaneous beating of the heart after removal of aortic cross-clamp significantly was more frequent in the warm priming group. A significant rise was observed in systemic inflammatory markers in the cold priming group. In our study, the lesser amount of ephedrine hydrochloride used and the higher frequency of spontaneous beating of the heart in the warm priming group may be considered as improvements in hemodynamic status. Use of warm priming solution also induced a significant improvement in the acute inflammatory markers. We recommend the use of warm priming solution in open heart surgery.

Experimental and Computational Models for Simulating Sound Propagation Within the Lungs.

An acoustic boundary element model is used to simulate sound propagation in the lung parenchyma and surrounding chest wall. It is validated theoretically and numerically and then compared with experimental studies on lung-chest phantom models that simulate the lung pathology of pneumothorax. Studies quantify the effect of the simulated lung pathology on the resulting acoustic field measured at the phantom chest surface. This work is relevant to the development of advanced auscultatory techniques for lung, vascular, and cardiac sounds within the torso that utilize multiple noninvasive sensors to create acoustic images of the sound generation and transmission to identify certain pathologies.

Experimental obstructive jaundice results in oxidized low-density-lipoprotein accumulation in surgical wound of rats.

INTRODUCTION: Mounting evidence suggests that impaired wound healing is a well-defined consequence in obstructive jaundice and, as redox-regulated processes are relevant to wound healing, it is not unreasonable to suppose that oxidative stress associated with lipid peroxidation in cholestasis might be a systemic phenomenon probably comprising all tissues and organs, including wounds. The aim of the present investigation was to analyse the lipid peroxidation status of surgical wounds, in terms of oxidized low-density-lipoprotein (oxLDL) accumulation in experimental obstructive jaundice. METHODS: Sixteen Wistar-Albino rats weighing 200-230 gr were randomly divided into two groups. Group I (n = 8) was designed as the prolonged obstructive jaundice group and was subjected to bile duct ligation. Group II (Sham-control, n = 8) rats underwent laparotomy alone and bile duct was just dissected from the surrounding tissue. Histopathological evaluation, immunohistochemical screening and immunoflourescent staining of the surgical wound was conducted to the bile-duct ligated rats and control group on the 21st postoperative day. RESULTS: Wound healing was found to be impaired in jaundiced rats histopathologically. When compared with the control group, significant positive oxLDL staining and intracellular accumulation of TNF-alpha, IL-2 and IL-6 was detected in the wound sections of the prolonged obstructive jaundice group. CONCLUSION: Our present data is the first in the literature, indicating significant oxLDL accumulation in surgical wounds of cholestatic rats, which might be one of the results of systemic oxidative stress leading to deficient healing capacity as a consequence of persistent inflammation.

Boundary element model for simulating sound propagation and source localization within the lungs.

An acoustic boundary element (BE) model is used to simulate sound propagation in the lung parenchyma. It is computationally validated and then compared with experimental studies on lung phantom models. Parametric studies quantify the effect of different model parameters on the resulting acoustic field within the lung phantoms. The BE model is then coupled with a source localization algorithm to predict the position of an acoustic source within the phantom. Experimental studies validate the BE-based source localization algorithm and show that the same algorithm does not perform as well if the BE simulation is replaced with a free field assumption that neglects reflections and standing wave patterns created within the finite-size lung phantom. The BE model and source localization procedure are then applied to actual lung geometry taken from the National Library of Medicine's Visible Human Project. These numerical studies are in agreement with the studies on simpler geometry in that use of a BE model in place of the free field assumption alters the predicted acoustic field and source localization results. This work is relevant to the development of advanced auscultatory techniques that utilize multiple noninvasive sensors to construct acoustic images of sound generation and transmission to identify pathologies.

Molecular characterization of the largest mycoviral-like double-stranded RNAs associated with Amasya cherry disease, a disease of presumed fungal aetiology.

The sequence of the four large (L) double-stranded RNAs (dsRNAs) associated with Amasya cherry disease (ACD), which has a presumed fungal aetiology, is reported. ACD L dsRNAs 1 (5121 bp) and 2 (5047 bp) potentially encode proteins of 1628 and 1620 aa, respectively, that are 37% identical and of unknown function. ACD L dsRNAs 3 (4458 bp) and 4 (4303 bp) potentially encode proteins that are 68% identical and contain the eight motifs conserved in RNA-dependent RNA polymerases (RdRp) of dsRNA mycoviruses, having highest similarity with those of members of the family Totiviridae. Both terminal regions share extensive conservation in all four RNAs, suggesting a functional relationship between them. As ACD L dsRNAs 1 and 2 do not encode RdRps, both are probably replicated by those from either ACD L dsRNA 3 or 4. Partial characterization of the equivalent L dsRNAs 3 and 4 associated with cherry chlorotic rusty spot revealed essentially identical sequences.

Effect of hyperthyroidism and propylthiouracil treatment on liver biochemical tests.

Liver biochemical test (LBT) changes can be commonly observed in hyperthyroid patients. Those kinds of changes could also be observed because of propylthiouracil (PTU) therapy. We prospectively evaluated LBT changes because of PTU use for 1 year in patients who had been diagnosed with hyperthyroidism first. We studied 64 patients who had been diagnosed with hyperthyroidism. These patients took at least 1-year PTU treatment. We analysed LBT at diagnosis and after 2 and 12 months of treatment with PTU. Prior to PTU treatment, 30 (46.8%) of the 64 patients had at least one LBT abnormality. We observed at least one LBT abnormality in 11 (32%) patients after 2 months and nine (26%) patients after 12 months of treatment with PTU in 34 patients whose CBT were normal before treatment. We did not observe any deterioration in clinical picture and bilirubin levels. Elevated serum LBT during the pretreatment and PTU treatment period is common and usually transient and asymptomatic. PTU could be used for long times by lowering the dose and close follow-up in patients who have elevated LBT during the pretreatment and after PTU treatment period.

The effect of topical CCNU(1-(2-chloroethyl)-3 cyclohexyl 1 nitrosurea) treatment on lipid peroxidation of glial tumours transplanted on rat brain.

1. The effect of topical CCNU treatment on lipid peroxidation of glial tumors transplanted on rat brain has been investigated in 22 rats. 2. Four groups have been selected as normal brain tissue, normal brain tissue+CCNU, tumour tissue, tumour tissue+CCNU. In these groups malondialdehyde (MDA) levels have been measured as a marker of lipid peroxidation. 3. Lipid peroxidation was high in tumour tissue in respect to controls (P < 0.05). In normal tissues topical CCNU treatment caused increase in lipid peroxidation (P < 0.05). In tumor tissues, topical CCNU decreased lipid peroxidation (P < 0.05). It is concluded that further studies have to be performed in order to determine whether increases in lipid peroxidation on CCNU treated normal brain tissues is a result of the inhibitory effect on cellular defence systems or promotion of free radical production.