Paracetamol (Acetaminophen)-associated SJS, TEN, AGEP, and DRESS Syndromes - A Narrative Review.

INTRODUCTION: Paracetamol (Acetaminophen) is a very common OTC drug that is found in more than 200 OTC products sold as pain, cough and cold remedies. Paracetamol is commonly used as an antipyretic to reduce fever and as an alternative to Non-steroidal anti-inflammatory drugs (NSAIDs) that are contraindicated in certain patients to relieve mild-moderate pain. OBJECTIVE: This review article focuses on SJS, TEN, SJS/TEN overlap, AGEP, and DRESS syndromes associated with the use of paracetamol or paracetamol-containing products. METHODS: To find published articles relevant to paracetamol-associated SJS, TEN, AGEP, and DRESS, we searched the online databases Medline/Pubmed/PMC, Google Scholar, Science Direct, Ebsco, Scopus, Web of Science, Embase, and reference lists using keywords like Stevens-Johnson Syndrome, Acetaminophen, Paracetamol, Toxic epidermal necrolysis, Acute generalized exanthematous pustulosis, Drug reaction with eosinophilia and systemic symptoms. RESULTS: The paracetamol-associated SJS, TEN, SJS/TEN overlap, AGEP, and DRESS syndromes have been identified by a number of publications. CONCLUSION: When evaluating drug-induced hypersensitivity skin reactions, healthcare professionals, including prescribers, pharmacists, and others, should be aware of this rare risk. Patients who exhibit signs and symptoms of paracetamol-associated hypersensitivity should be referred to physicians by pharmacists for further treatment. At the first sign of a skin rash or other hypersensitivity reaction while taking paracetamol, patients should be told to stop taking it and see a doctor right away.

Potential of Black Seeds (Nigella sativa) in the Management of Long COVID or Post-acute Sequelae of COVID-19 (PASC) and Persistent COVID-19 Symptoms - An Insight.

BACKGROUND: Some individuals may experience symptoms persisting for many months after the recovery from COVID-19 and patients with Long COVID are managed mainly with symptomatic treatment and supportive care. OBJECTIVE: This review article focuses on the beneficial effects of black seeds (Nigella sativa) in the management of long COVID and persistent COVID symptoms. METHODS: The literature was searched in databases such as LitCOVID, Web of Science, Google Scholar, bioRxiv, medRxiv, Science Direct, EBSCO, Scopus, Embase, and reference lists to identify studies, which evaluated various effects of black seeds (N. sativa) related to signs and symptoms of long COVID. RESULTS: Black seeds (N. sativa) have shown potential anti-COVID, antiviral, anti-inflammatory, antioxidant, immunomodulatory, antihypertensive, anti-obesity, antidiabetic, antihyperlipidemic, and antiasthmatic properties in various clinical, animal, in vitro, in vivo, and in silico studies, which would help the patients recovered from COVID to mitigate Long COVID complications. CONCLUSION: Patients experiencing Long COVID may use black seeds (N. sativa) as adjunctive therapy in combination with symptomatic treatment and supportive care to prevent further deterioration and hospitalization. The safety and efficacy of N. sativa in patients with Long-COVID would further be established by future randomized controlled clinical trials.

Protective Effect of Litchi chinensis Peel Extract-Prepared Nanoparticles on Rabbits Experimentally Infected with Eimeria stiedae.

The present study used Litchi chinensis peel extract to synthesize silver nanoparticles (AgNPs). This technique is eco-friendly and can be performed in a single step; thus, it has attracted great attention for NPs biosynthesis. Herein, we biosynthesized AgNPs with L. chinensis peel extract and examined their anticoccidial activity in rabbit hepatic coccidiosis induced by E. stiedae infection. Thirty-five rabbits were allocated into seven groups: a healthy group (G1), an infected control group (G2), four groups infected before treatment with 10 mg/kg L. chinensis peel extract-biosynthesized AgNPs (G3, G5) or 50 mg/kg amprolium (G4, G6), and rabbits infected after two weeks of pretreatment with 10 mg/kg L. chinensis eel extract-biosynthesized AgNPs (G7). In this study, both pre-and post-treatment with AgNPs produced a substantial reduction in fecal oocyst output, liver enzyme levels, and histopathological hepatic lesions relative to the infected group. In conclusion, L. chinensis peel extract-prepared AgNPs should be considered harmless and efficient in the cure of hepatic coccidiosis in rabbits.

Detection of soluble urokinase type plasminogen activator receptors in children with gingivitis and normal subjects.

BACKGROUND: Gingivitis is a reversible condition; however, if left untreated, it progresses to periodontitis, which a serious infection that leads to bone destruction. Soluble urokinase-type plasminogen activator receptor (suPAR) measurement may be of value in the early assessment of gingivitis in children, thereby minimizing risk of tooth loss. OBJECTIVES: In this observational study, we assessed salivary and serum concentrations of suPAR for the diagnosis of gingivitis and correlation of salivary suPAR with the periodontal clinical parameters. METHODS: Ninety children participated in the study, with 20 healthy subjects as controls and 70 patients with gingivitis. The gingivitis group was divided into mild, moderate, and severe cases. According to the gingival index (GI), salivary and serum samples were analyzed for the suPAR and C-reactive protein levels using an enzyme-linked immunosorbent assay. RESULTS: The salivary suPAR was significantly higher in patients with gingivitis (10.8 ± 2.9 ng/mL) than in the control group (7.0 ± 1.1 ng/mL) as P < 0.001. SuPAR was correlated with gingivitis severity. It was 7.7 ± 1.5 1 ng/mL in mild cases, 10.9 ± 1.2 ng/mL in moderate cases, and 14.4 ± 0.9 ng/mL in severe cases. The difference was significantly high (P < 0.001) between the groups; however, the difference between the mild cases and the control was nonsignificant as P < 0.066. The salivary suPAR was correlated with periodontal clinical parameters, which included GI and simple oral hygiene index (SOHI). Conversely the serum suPAR was not correlated with the salivary suPAR or the periodontal clinical parameters. CONCLUSION: The results of the present study demonstrated that the salivary suPAR is increased in proportionate with the degree of severity of gingivitis in children. Moreover, salivary suPAR was correlated with the periodontal clinical parameters.

Microbiological investigation study for Apis mellifera yemenitica and Apis mellifera carnica bee venoms on selected bacterial strains.

Bees are one of the ancient and the most social insects worldwide. They are of great economic and medical importance. Bee venom (BV) has many therapeutic effects and has been used since ancient times for the treatment of many diseases. The present study aimed to evaluate and compare the antibacterial effect of BV from two different bee subspecies Apis mellifera yemenitica (A. m. yemenitica) (indigenous strain) and Apis mellifera carnica (A. m. carnica) (carniolan strain) against selected Gram-positive and Gram-negative bacteria. Experimentally, venoms were extracted using an electrical venom collector from honey bee colonies of the subspecies, A. m. yemenitica and A. m. carnica, in Hail, Saudi Arabia. Each venom was tested against selected medically important Gram-negative strains, Salmonella Typhimurium, Pseudomonas aeruginosa, and Escherichia coli, while Staphylococcus aureus was selected as Gram-positive test organism. The minimum inhibitory concentration (MIC) method was used to compare the effect of BV from the two subspecies on the growth of the selected bacterial strains. Results showed that BV from both subspecies could equally inhibit the growth of Salmonella Typhimurium, Pseudomonas aeruginosa, and Escherichia coli at an MIC of 10 mg/ml. However, S. aureus was inhibited by an MIC of 5 and 10 mg/ml of BV from A. m. carnica and A. m. yemenitica, respectively. This suggested that the BV of the carnica subspecie was more inhibitory to this Gram-positive pathogen than its counterpart produced by the yemenitica subspecies. The present study shows that bee venom has a promising antibacterial effect.

Prevalence Rate and Molecular Characteristics of Oestrus ovis L. (Diptera, Oestridae) in Sheep and Goats from Riyadh, Saudi Arabia.

Heads of sheep (n = 600) and goats (n = 800) slaughtered at Al-Aziziah Abattoir in Riyadh, Saudi Arabia, were inspected for the presence of O. ovis larvae (L). Heads were split along the longitudinal axes, and larvae (L1, L2, and L3) were gathered. The infestation rate was significantly higher in goats (44.5%; 356/800) than that in sheep (22.3%; 134/600). Out of the 151 collected larvae from sheep, 0% were L1, 1.3% were L2, and 98.7% were L3. Out of the total of 468 larvae from goats, 0% were L1, 1.2% were L2, and 98.8% were L3. The infestation rate was significantly higher in males than that in females. Myiasis-causing larvae collected from Riyadh, Saudi Arabia, were authenticated as O. ovis, according to morphological characteristics. Polymerase chain reaction (PCR) amplification of a partial fragment (600 bp) of the mitochondrial cytochrome c oxidase subunit I (mtCOI) gene further confirmed the species. Phylogenetic analysis based on the partial mtCOI gene sequence demonstrated that 23 unique sequences showed high similarity based on nucleotide pairs of O. ovis accessions retrieved from GenBank.

Study the Effect of Microinjection of Zn, Fe, and Cu Loaded in Montmorillonite on Development Activities in Fertilized Chicken Eggs.

This study aims to reduce embryonic mortality, increase body weight, and improve immune system in chicken. A total of 240 eggs were assigned to three treatments (n = 60) and injected with cooper (Cu), zinc (Zn), and iron (Fe) loaded by montmorillonite (Mnt), and one untreated group (n = 60). Some hormones and enzymes related with growth were measured in terms of serum, and expression of some genes related to growth, immune, and programmed cell deaths that were determined in the liver and spleen of chicken by RT-qPCR. The embryonic death on the fifth and seventh days after injecting eggs with Fe-Mnt was less obvious than in other groups. The heaviest body weight was recorded for Fe-Mnt and Cu-Mnt treatment. Fe-Mnt treatment had higher serum GSH, SOD, GH, and Myostatin contents and lower MDA than those in the other treatments. Cu-Mnt treatment included the highest contents of CAT enzyme and IGF-1 hormone in serum. The highest expression of IGF-1, GH, BCL6, and SYK genes in liver tissue were recorded by Zn-Mnt, IGFBP2, FGF8, and IFNW1 genes by Cu-Mnt, and TC1RG1 and IFNW1 genes by Fe-Mnt in spleen tissue. In conclusion, Fe-Mnt was the best treatment for reducing embryonic mortality, and increasing body weight of chickens and expression of growth and immune genes, followed by Cu-Mnt treatment.

The role of honeybee pollen as a natural source of antioxidants in the in vitro maturation medium of sheep oocytes and its effect on gene expression.

This study aimed to investigate the effect of honeybee pollen as an antioxidant source in a maturation medium of sheep oocytes on the in vitro maturation rate, glutathione concentration, and gene expression. To our knowledge, this study might be the first of its kind in this field. Sheep oocytes were cultured in vitro with honeybee pollen at four different concentrations (0.0, 1.0, 10.0, and 50.0 µg/ml). The results indicated that the ratio of oocytes that reached metaphase II stage was higher in the honeybee pollen-treated groups than in the control group (p ≤ 0.05). The reduced glutathione (GSH) mean content of matured oocytes was 9.85 nmol/25 oocytes, when honeybee pollen was added to the in vitro maturation (IVM) medium at a concentration of 1.0 µg/ml, compared with 5.84 and 4.44 nmol when using 10.0 and 50.0 µg/ml honeybee pollen, respectively. On the other hand, there was no significant difference in glutathione concentration between the control and 1.0 µg/ml honeybee pollen groups. Expression of candidate genes (GDF-9, BAX, Cyclin B, C-MOS, and IGF1) was upregulated in oocytes cultured with honeybee pollen when compared with oocytes cultured without honeybee pollen. In conclusion, the addition of honeybee pollen at a concentration of 1.0 µg/ml to IVM medium improved the in vitro maturation rate of sheep oocytes, increased the glutathione concentration, and improved gene expression.

Antibacterial Effect of Metronidazole vs Chlorhexidine Solutions in Treatment of Root Canals of Primary Anterior Teeth.

AIM: The aim of this study was to evaluate and compare the antibacterial effect of 0.5% metronidazole, 2% chlorhexidine, and normal saline irrigant solutions against Enterococcus faecalis bacteria in the treatment of root canals of primary anterior teeth. MATERIALS AND METHODS: This study was carried out on sixty nonvital primary anterior teeth of Egyptian children diagnosed with (early childhood caries) ECC. These teeth were classified equally into three groups according to irrigation materials. A fresh sample was collected from each root canal after access opening before and 3 days after irrigation with the help of a paper point. The number of organisms (E. faecalis) before and after irrigation was compared for each group. RESULTS: The bacterial count of E. faecalis was decreased in all groups however, these differences were statistically insignificant where (p <0.05). CONCLUSION: Both 0.5% metronidazole and 2.0% chlorhexidine appeared to be superior against E. faecalis bacteria as endodontic irrigants in pulpectomy anterior primary teeth with higher antibacterial efficacy compared to saline. CLINICAL SIGNIFICANCE: The success of endodontic treatment depends on the removal of microbes, from the root canals and avoidance of reinfection thus; this study provides an insight on the effects of different irrigant solutions to further help dental practitioners in the endodontic management of primary dentition.

Use of black seed (Nigella sativa) honey bee to improve sheep oocyte maturation medium.

Sheep are important livestock and a source of milk, meat, and wool globally. The increasing demand for animal protein requires increased productivity in sheep. In vitro fertilization and maturation can improve sheep productivity. The aims of this study were to evaluate the effects of honey bee addition as a supplementation medium on in vitro maturation improvement, gene expression of matured sheep oocytes, and determine the optimum concentration from honey bee for in vitro maturation of sheep oocytes. Cumulus oocyte complexes were obtained from the ovaries of slaughtered female sheep. Grade A and B oocytes were cultured for 24 h in medium without honey bee (control, G1) or medium supplemented with 5% (G2), 10% (G3), or 20% (G4) honey bee. Oocyte maturation rate, glutathione concentration, and the expression of candidate genes (GDF-9, BAX, Cyclin B, C-MOS, IGF1) were determined in the matured oocytes. The maturation rate of sheep oocyte was better in the presence of 5% and 10% honey bee; the mean number of oocytes in metaphase II stage was higher than that in G1 and G4 groups. Glutathione concentration was highest in G2 (10.93 ± 0.57). In general, gene expression levels were similar in G2 and G3, which were greater that in G1 and G4. In conclusion, the optimal concentration of black seeds honey bee that can be added to the maturation medium is 5% to obtain the highest mean MII and glutathione concentration values, and to improve gene expression in in vitro matured sheep oocytes.

Effects of Eugenol on Haemoproteus columbae in domestic pigeons (Columba livia domestica) from Riyadh, Saudi Arabia.

Eugenol was investigated for the treatment of Haemoproteus columbae (H. columbae) infected squabs (young domestic pigeons, Columba domestica). Thirty naturally-infected squabs were divided into three groups of 10 each. One group was treated with Eugenol, while the positive and negative control groups were administered buparvaquone (Butalex®) and distilled water, respectively. The number of infected red blood cells (RBCs) was calculated in all groups before and after treatment at 4-day intervals for 16 days. The results showed a significant therapeutic effect of Eugenol, with a progressive decrease in the number of infected RBCs from 89.20 ± 2.11 before treatment to 0.90 ± 0.31 at the end of treatment (P≤0.05). Butalex® was able to suppress the number of infected RBCs from 93.70 ± 1.72 before treatment to 0.90 ± 0.35 at the end of the experiment (P≤0.05). Eugenol showed therapeutic effects against H. columbae and may be regarded as a candidate for further studies to develop new drugs against blood parasites, in both animals and humans.

Immunotoxicity evaluation of novel bioactive composites in male mice as promising orthopaedic implants.

OBJECTIVE: In orthopaedics, novel bioactive composites are largely needed to improve the synthetic achievement of the implants. In this work, semiconducting metal oxides such as SiO2, TiO2, and ZrO2 particles (Ps) were used individually and in different ratios to obtain different biphasic composites. The immunotoxicity of these composites was tested to inspect the potential toxicity prior to their use in further medical applications. MATERIALS AND METHODS: In vitro mineralisation ability was inspected by soaking the composites in simulated body fluid (SBF). Additionally, in vivo experiments were performed consuming male mice using ISSR-PCR, micronucleus (MN) test, comet assay, glutathione peroxidase activity, and determination of albumin, globulin, lymphocyte population, ALT, and AST levels. Several groups of adult male albino mice were treated with 100, 200, and 400 mg/kg body weight of SiO2, TiO2, and ZrO2-Ps in pure or mixed forms. RESULTS: Our findings revealed that treatment of mice with low and medium doses of SiO2, TiO2, and ZrO2-Ps in pure or mixed form revealed values relatively similar to the control group. However, using 400 mg/kg especially from TiO2-Ps in genuine form or mixed with SiO2 showed proliferation in the toxicity rates compared with the high dose of SiO2 and ZrO2-Ps. CONCLUSIONS: The results suggest that TiO2 composite induced in vivo toxicity, oxidative DNA damage, bargain of the antioxidant enzymes, and variations in the levels of albumin, globulin, lymphocyte population, ALT, and AST in a dose-dependent manner. However, SiO2, and ZrO2 composites revealed a lower toxicity in mice compared with that of TiO2.

Effect of various concentrations of caffeine, pentoxifylline, and kallikrein on hyperactivation of frozen bovine semen.

Caffeine, pentoxifylline, and kallikrein are substances that affect the efficiency of sperms in the fertilization process; however, they have not been adequately studied. The present study aimed to examine the influence of caffeine, kallikrein, and pentoxifylline on sperm motility in bovine as well as investigate their optimum concentrations for increasing the movement of sperms in bovine. Frozen bovine sperms were thawed in universal IVF medium supplemented with 1, 5, and 10 mM caffeine or pentoxifylline or 1, 4, and 8 U/mL kallikrein and were then incubated for 30 min. Treated semen parameters were analyzed using a computer assisted semen analyzer (CASA). Data analysis showed that the mean values concerning progression and motility of sperm increased in caffeine and pentoxifylline treatments when compared with the kallikrein group. The obtained results revealed that kallikrein is not necessary for the improvement of bovine sperm motility. Additionally, our results revealed that 5 mM from caffeine was the best concentration added to the medium, followed by 1 or 5 mM from pentoxifylline. Therefore, it is concluded from the present study that caffeine has hyperactivation efficacy at 5 mM concentration compared to other treatments.

Stereocomplexation of polylactide enhanced by poly(methyl methacrylate): improved processability and thermomechanical properties of stereocomplexable polylactide-based materials.

Stereocomplexable polylactides (PLAs) with improved processability and thermomechanical properties have been prepared by one-step melt blending of high-molecular-weight poly(l-lactide) (PLLA), poly(d-lactide) (PDLA), and poly(methyl methacrylate) (PMMA). Crystallization of PLA stereocomplexes occurred during cooling from the melt, and, surprisingly, PMMA enhanced the amount of stereocomplex formation, especially with the addition of 30-40 % PMMA. The prepared ternary blends were found to be miscible, and such miscibility is likely a key factor to the role of PMMA in enhancing stereocomplexation. In addition, the incorporation of PMMA during compounding substantially raised the melt viscosity at 230 °C. Therefore, to some extent, the use of PMMA could also overcome processing difficulties associated with low viscosities of stereocomplexable PLA-based materials. Semicrystalline miscible blends with good transparency were recovered after injection molding, and in a first approach, the thermomechanical properties could be tuned by the PMMA content. Superior storage modulus and thermal resistance to deformation were thereby found for semicrystalline ternary blends compared to binary PLLA/PMMA blends. The amount of PLA stereocomplexes could be significantly increased with an additional thermal treatment, without compromising transparency. This could result in a remarkable thermal resistance to deformation at much higher temperatures than with conventional PLA. Consequently, stereocomplex crystallization into miscible PLLA/PDLA/PMMA blends represents a relevant approach to developing transparent, heat-resistant, and partly biobased polymers using conventional injection-molding processes.

Aquilegia vulgaris extract protects against the oxidative stress and the mutagenic effects of cadmium in Balb/c mice.

Cadmium (Cd) is a non-essential element and is a widespread environmental pollutant. Exposure to cadmium can result in cytotoxic, carcinogenic and mutagenic effects. The aim of the current work was to evaluate the protective effect of Aquilegia vulgaris extract against the oxidative stress and the genotoxicity induced by Cd using the chromosomal aberrations in somatic and germ cells assay and random amplified polymorphism DNA (RAPD-PCR) analysis. Forty male Balb/c mice were divided into four groups including the control group, Cd-treated group and the groups treated with the extract alone or plus Cd. The results indicated that Cd increased serum ALT, AST, urea, LDH, CK, lipid peroxidation in liver tissue accompanied with a significant decrease in GPX and SOD. Cd also increased the number of chromosomal aberrations in bone marrow and spermatocytes including structural and numerical aberrations. Animals treated with the extract alone were comparable to the control regarding all the tested parameters. The extract succeeded in preventing or diminishing the oxidative stress and the clastogenic effects of Cd. It could be concluded that Aquilegia vulgaris extract is a promising protective agent against oxidative stress and genotoxicity during the exposure to Cd.

Environmental surveillance of wild poliovirus circulation in Egypt--balancing between detection sensitivity and workload.

Examination of sewage specimens for poliovirus (environmental surveillance) was adopted as a supplementary tool in the surveillance of poliomyelitis in Egypt. Sewage samples were concentrated about 50-fold using a simple two-phase separation technique, and inoculated in cell cultures in two collaborating laboratories in parallel. All but 9 of the 293 (97%) samples collected from January 2001 to December 2002 contained poliovirus and/or other enteroviruses, with polioviruses being detected in 84% of the samples. The proportion of specimens containing type 1 wild poliovirus (PV1W, the North-East African (NEAF) genotype) was less in 2002 (16%) than in 2001 (57%), and further decreased in 2003. While the overall sensitivity to detect PV1W was similar in the two collaborating laboratories, the specimens scored positive were not identical. Parallel cultures inoculated with aliquots of a given specimen very frequently resulted in isolation of different viruses. Moreover, partial sequence analysis occasionally revealed representatives of different genetic lineages of PV1W in a given specimen. These results emphasize the need to use intensive laboratory analysis to optimise sample sensitivity in environmental poliovirus surveillance, and the difficulties in reproducing the isolation results by simple re-inoculation of samples containing a mixture of different viruses.

Prolonged detection of indigenous wild polioviruses in sewage from communities in Egypt.

Environmental surveillance for polioviruses has been implemented in Egypt. This paper reports on a study in which 130 sewage samples were collected between January 2001 and December 2001 from eight provinces of Egypt. Samples were analyzed by virus isolation in L20B and RD cell cultures, and wild polioviruses were characterized by sequencing of the VP1 protein coding region. Wild type 1 polioviruses were detected in 57% of the sewage samples and 91% of the study sites, only two of which reported paralytic poliomyelitis cases in 2001. Three genetic lineages of a single indigenous type 1 poliovirus genotype were detectable in sewage, and only one lineage was also detected through surveillance for acute flaccid paralysis. Wild polioviruses persisted in the environment despite implementation of oral poliovirus vaccine immunization campaigns. Continued analysis of sewage samples, critical evaluation of immunization coverage, and performance of surveillance for acute flaccid paralysis are proposed as follow-up activities.