Strain Rate Changes during Stress Echocardiography Are the Most Accurate Predictors of Significant Coronary Artery Disease in Patients with Previously Treated Acute Coronary Syndrome.

BACKGROUND AND AIMS: Dobutamine stress echocardiography (DSE) is a well-established non-invasive investigation for the detection of ischemic myocardial dysfunction. The aim of this study was to evaluate the accuracy of myocardial deformation parameters measured by speckle tracking echocardiography (STE) in predicting culprit coronary artery lesions in patients with prior revascularization and acute coronary syndrome (ACS). METHODS: We prospectively studied 33 patients with ischemic heart disease, a history of at least one episode of ACS and prior revascularization. All patients underwent a complete stress Doppler echocardiographic examination, including the myocardial deformation parameters of peak systolic strain (PSS), peak systolic strain rate (SR) and wall motion score index (WMSI). The regional PSS and SR were analyzed for different culprit lesions. RESULTS: The mean age of patients was 59 ± 11 years and 72.7% were males. At peak dobutamine stress, the change in regional PSS and SR in territories supplied by the LAD showed smaller increases compared to those in patients without culprit LAD lesions (p < 0.05 for all). Likewise, the regional parameters of myocardial deformation were reduced in patients with culprit LCx lesions compared to those with non-culprit LCx lesions and in patients with culprit RCA legions compared to those with non-culprit RCA lesions (p < 0.05 for all). In the multivariate analysis, the △ regional PSS (1.134 (CI = 1.059-3.315, p = 0.02)) and the △ regional SR (1.566 (CI = 1.191-9.013, p = 0.001)) for LAD territories predicted the presence of LAD lesions. Similarly, in a multivariable analysis, the △ regional PSS and the △SR predicted LCx culprit lesions and RCA culprit lesions (p < 0.05 for all). In an ROC analysis, the PSS and SR had higher accuracies compared to the regional WMSI in predicting culprit lesions. A △ regional SR of -0.24 for the LAD territories was 88% sensitive and 76% specific (AUC = 0.75; p < 0.001), a △ regional PSS of -1.20 was 78% sensitive and 71% specific (AUC = 0.76, p < 0.001) and a △ WMSI of -0.35 was 67% sensitive and 68% specific (AUC = 0.68, p = 0.02) in predicting LAD culprit lesions. Similarly, the △ SR for LCx and RCA territories had higher accuracies in predicting LCx and RCA culprit lesions. CONCLUSIONS: The myocardial deformation parameters, particularly the change in regional strain rate, are the most powerful predictors of culprit lesions. These findings strengthen the role of myocardial deformation in increasing the accuracy of DSE analyses in patients with prior cardiac events and revascularization.

Prognostic value of right ventricular diastolic dysfunction in patients with inferior ST-elevated myocardial infarction.

BACKGROUND: Right ventricle infarction (RVI) is predominantly a complication of inferior wall myocardial infarction; it occurs in approximately one third of these patients. Right ventricular dysfunction in patients with inferior STEMI and RV infarction was under assessed. Nevertheless, studies which targeted RV assessment by echocardiography, did not routinely evaluate RV diastolic dysfunction. In this study, we aimed to evaluate RV diastolic dysfunction and its prognostic value in patients with inferior STEMI and RVI. RESULTS: Sixty patients with inferior STEMI and RV infarction, who underwent primary PCI were enrolled in the study. Patients with pre-existing clinical conditions that might affect RV function, were excluded. Echocardiography was performed within twenty-four hours following the PCI, to assess the RV systolic and diastolic functions with special focus on tricuspid inflow velocities (E velocity, A velocity and E/A ratio) by pulsed wave (PW) doppler and tricuspid annular velocities by tissue doppler index (TDI) (E', A' and E/E' ratio). Clinical features and MACE, including cardiogenic shock, arrhythmia, stroke, reinfarction and death were analyzed in all our patients within 3 months follow up period. The average age of the study population was 51.58 ± 10.11 years, 10% were females. Five patients developed MACE (death, cardiogenic shock and pulmonary edema, anterior STEMI and cardiogenic shock, recurrent inferior STEMI, and arrhythmia and stroke), of whom four occurred in hospital within the first 48 h. Patients who developed MACE had high filling pressures, as all of them had E/E' > 6. E' velocity ≤ 6 cm/sec was associated with increased MACE as 25% of patients with E' velocity ≤ 6 had MACE compared with 2.3% of patients with E' velocity > 6 with a p value of 0.015. CONCLUSIONS: Tricuspid annular velocities by TDI are essential when evaluating RV diastolic dysfunction. E/E' and E' velocity have a prognostic value in patients with inferior STEMI and RV infarction; E/E' > 6 and E' velocity ≤ 6 cm/sec were associated more MACE in patients with inferior STEMI and RVI.

Prognostic value of myocardial scar in ischaemic and non-ischaemic cardiomyopathy using cardiac magnetic resonance imaging.

AIM: The aim of this research was to evaluate the prognostic value of myocardial scar using cardiac magnetic resonance (CMR) imaging in patients with ischaemic cardiomyopathy (ICM) and non-ischaemic cardiomyopathy (NICM). METHODS: One hundred and fifty-four patients with either ICM or NICM underwent CMR with late gadolinium enhancement sequences for assessment of left ventricular ejection fraction (LVEF), and detection and quantification of any myocardial scar using three methods: manual, number of segments involved, and percentage of scarred myocardium. Patients were followed up for at least six months for clinical cardiac events. RESULTS: Patients were divided into two groups: group I, patients with ICM (58%) and group II, those with NICM (42%). Clinical presentation ranged from eventless lpar;10%) to chest pain (18%), heart failure (15%), hospitalisation (35%), syncope (1%), ventricular tachycardia (< 1%) and cardiac arrest (< 1%). The scar mass was larger in size in group I (17 ± 15%) than in group II (8 ± 13%). A direct relationship was observed between scar size and event severity (p < 0.001). An inverse relationship between LVEF and event severity was found in group I (p < 0.001) but not in group II (p = 0.128). CONCLUSIONS: Myocardial scar size was a strong predictor of clinical outcome in both the ICM and NICM patients. LVEF was less reliable in predicting morbidity in cardiomyopathy patients.

Cortisol/DHEA ratio in morbidly obese patients before and after bariatric surgery: Relation to metabolic parameters and cardiovascular performance.

INTRODUCTION: Bariatric surgery (BS) is the most effective therapy for morbid obesity. Cortisol and DHEA are steroid hormones with opposing effects, thus using Cortisol/DHEA ratio (C/D) rather than the use of either hormone alone has been found to predict health outcomes more reliably. It was interesting to study C/D as an indicator of favorable metabolic and cardiovascular outcomes after BS. OBJECTIVE: To assess C/D in morbidly obese patients before and after BS in relation to metabolic parameters and cardiovascular performance. PATIENTS AND METHODS: Forty morbidly obese patients were followed prospectively for 1 year after BS. Fasting blood glucose (FBG), fasting insulin (FI), C/D, lipid profile, high-sensitive CRP (hs-CRP), and echocardiography were done before BS and at 3 months and 1 year post BS. RESULTS: A total of 40 morbidly obese patients undergone sleeve gastrectomy. Blood pressure, FBG, FI, hs-CRP, C/D were significantly decreased after BS (p < 0.001). At 1 year post BS; significant reduction in left ventricular posterior wall thickness (LVPW) (p < 0.001), left ventricular mass (LVM) (p = 0.003), relative wall thickness (RWT) (p < 0.001) with a significant improvement in early diastolic velocity (E) (p < 0.001), early diastolic velocity/late diastolic velocity (E/A) (p = 0.01). After BS; C/D significantly positively correlated with FBG (p = 0.019), hs-CRP (p = 0.008), interventricular septum thickness (IVS) (p = 0.028), LVPW (p = 0.028), relative wall thickness (RWT) (p = 0.022), early diastolic velocity /early diastolic velocity (E') measured by pulsed tissue Doppler imaging (E/E') (p = 0.001), and significantly negatively correlated with E' (p = 0.032). C/D was the single significant independent variable affecting E' and E/E' post BS. CONCLUSION: C/D can be used as a surrogate marker of the improved FBG and the resolution of inflammation post BS. C/D is an independent predictor of diastolic function improvement post BS.

Antifungal and antitoxin effects of propolis and its nanoemulsion formulation against Aspergillus flavus isolated from human sputum and milk powder samples.

BACKGROUND AND AIM: Aspergillus flavus causes human and animal diseases through either inhalation of fungal spores or ingestion of mycotoxins as aflatoxins produced in human and animal feed as secondary metabolites. This study was aimed to detect the incidence of A. flavus and its aflatoxins in human sputum and milk powder samples and explore the efficacy of pure propolis (PP) and propolis nanoemulsion (PNE) as natural decontaminants against fungal growth and its released aflatoxins. MATERIALS AND METHODS: A. flavus was isolated by mycological culture and identified macroscopically and microscopically. Coconut agar medium and thin-layer chromatography (TLC) were used to qualitatively detect aflatoxins in the isolated strains. Toxins were extracted from toxigenic strains by the fast extraction technique. The quantitative detection of toxin types was explored by high-performance liquid chromatography (HPLC). PNE was prepared by a novel method using natural components and characterized by Fourier-transform infrared spectroscopy, Zetasizer, and transmission electron microscopy. The effects of PP and PNE on A. flavus growth and its toxin were determined by the well-diffusion method and HPLC. RESULTS: The mycological culture showed that 30.9% and 29.2% of sputum and milk powder samples were positive for A. flavus, respectively. TLC confirmed the production of 61.8% and 63.2% aflatoxin by the isolated strains in sputum and milk powder, respectively. PP and PNE showed antifungal activity on A. flavus growth with mean±standard error (SE) inhibition zones of 27.55±3.98 and 39.133±5.32 mm, respectively. HPLC revealed positive contamination of toxin extracts with AFB1, AFB2, and AFG2 at 0.57±0.026, 0.28±0.043, and 0.1±0.05 mg/L, respectively. After treatment with PP and PNE, a significant decrease in AFB1, AFB2, and AFG2 concentrations was observed. CONCLUSION: This study suggested using propolis and its nanoformulation as antifungal and antitoxins in human medicine and the food industry to increase the food safety level and stop food spoilage.

Green synthesis, in vivo and in vitro pharmacological studies of Tamarindus indica based gold nanoparticles.

The current investigation aims to synthesize gold nanoparticles (AuNPs) from aqueous extract of Tamarindus indica and to evaluate the in vitro anti-bacterial and in vivo sedative and anelgescic activities of crude extract as well as synthesized AuNPs. Several methods have been reported to synthesize AuNPs; however, most of them were not ecofriendly. In the present study, the green synthesis of AuNPs has been carried out. Using the green synthesis method, AuNPs of T. indica were synthesized at room temperature (25 °C) by mixing 5 mL of HAuCl4 (1 mM) with 1 mL of T. indica seed extract solution. This extract solution was prepared by taking 5 gm dry seeds in 100 mL of double deionized water with continuous stirring for up to 24 h at 80 °C. The stability of AuNPs was confirmed with the help of relevant experimental techniques including ultraviolet-visible (UV/Vis) showing maximum absorbance at 535-540 nm, Fourier transform infrared showing a broad signal at 3464 cm-1 which can be attributed to either amide or hydroxyl functionalities and atomic force microscopy analysis showed that the biomaterial surrounding AuNPs was agglomerated which proves the formation of discrete nanostructutres. These AuNPs have been evaluated for their antibacterial potential. The results revealed good antibacterial activity of the samples against. Klebsiella pneumonia, Bacillus subtilis and Staphylococcus epidermidis with 10-12 mm zone of inhibition range. The AuNPs were also found stable at high temperature, over a range of pH and in 1 mM salt solution. Moreover, the crude extract and respective AuNPs also exhibited interesting sedative and analgesic activities. Hence, we focused on phytochemicals-mediated synthesis of AuNPs considered as greatest attention in the treatment of anti-bacterial, analgesic, and sedative.

The relationship between carotid and coronary calcification in patients with coronary artery disease.

BACKGROUND: Atherosclerosis is a multi-system pathology with heterogeneous involvement. We aimed to investigate the relationship between the presence and severity of carotid and coronary calcification in a group of patients with coronary artery disease. METHODS: Sixty-three patients presenting with unstable angina or positive stress test for myocardial ischaemia were enrolled in this study. All patients underwent CT scanning of the carotid and coronary arteries using the conventional protocol and Agatston scoring system. Risk factors for atherosclerosis were also analyzed for correlation with the extent of arterial calcification. RESULTS: Total coronary artery calcium score (CAC) was several times higher than total carotid calcium score (1274 (1018) vs 6 (124), p = 0·0001, respectively). The left carotid calcium score correlated strongly with the right carotid calcium score (rho = 0·69, p < 0·0001). The total CAC score correlated modestly with the total carotid calcium score (rho = 0·34, p = 0·007), in particular with left carotid score (rho = 0·38, p = 0·002), but not with the right carotid score. The left coronary calcium score correlated with the right coronary calcium score (rho = 0·35, p = 0·004), left carotid calcium score (rho = 0·33, p = 0·007) and left carotid calcium score at the bifurcation (rho = 0·34, p = 0·006). While hypertension correlated with carotid calcium score, diabetes and dyslipidaemia correlated with left CAC score. CONCLUSION: In patients with coronary disease, the carotid calcification pattern appeared to be similar between the right and left system in contrast to that of the coronary arteries. CAC correlated only modestly with the carotid score, despite being significantly higher. Hypertension was related to carotid calcium score while diabetes and dyslipidaemia correlated with coronary calcification.

Anti-inflammatory and In Silico Docking Studies of Heterophragma adenophyllum Seem Stem Constituents.

Heterophragma adenophyllum is a traditional medicinal plant that has been used as anti-inflammatory and to relief muscular tension. In the current research, four isolated constitutes namely lapacho (1), peshawaraquinone (2), indanone derivatives (3), α-lapachone (4) of H. adenophyllum were tested for anti-inflammatory effect using the carrageenan- and histamine-induced paw edema paradigm. The tested compounds (1-4) were evaluated for anti-inflammatory effect during the early and late phase of edema induction. In the early phase, all tested compounds (0.5 2.5 mg/kg each i.p.) demonstrated less than 50% effect, while in the later phase, compounds (2 and 3) demonstrated 85.66 and 89.87% attenuation. In addition, compounds (1-4) were subjected to histamine-induced inflammation, where compounds 2 and 3 exhibited excellent effects 86.87 and 89.98%, respectively at 5 mg/kg after the 2nd hour of administration, whereas compounds 1 and 4 did not exhibit any significant effect as compared with the negative control. Molecular docking results revealed a very high potency of compound based on the protein-ligand interaction (PLI) profile, which was further evaluated through a molecular dynamic simulation study. Therefore, the anti-inflammatory effect of H. adenophyllum attributed to the presence of these bioactive compounds (1-4) strongly supports the traditional uses of H. adenophyllum for treatment of inflammation. However, compounds 2 and 3 which exerted anti-inflammatory effect must be subjected for further mechanistic studies.

New cytotoxic flavonoids from aerial parts of Platycladus orientalis L.

Investigation of Platycladus orientalis yielded five flavonoids, including aglycone flavone 1 (apigenin), flavone glycoside 2 (apigenin 7-O-ß-D-glucopyranoside), new gernaylated flavone glycoside 3 (apigenin 8-gernayl-4'-O-α-gluco pyranoside) and two new pernylated flavonoid glycosides 4 & 5 (apigenin 8-pernyl-4'-glucopyranosyl-7-O-α-glucopyranoside and apigenin 5-pernyl-7-glucopyranosyl-4'-O-ß-D-glucopyranoside). Their structures were elucidated on the basis of spectroscopic evidence. The cytotoxicity of compounds 1-5 were tested against Lung adenocarcinoma (A549), human hepatocellular liver carcinoma (HepG2), human breast carcinoma (MCF-7) cell lines and mouse fibroblast cell line NIH/3T3 as normal cells. This assay gave spot on structure activity relationship which, showed that cytotoxicity of compounds (1) and (2) against three cell lines was weak as IC50 > 15. Compounds (4) and (5) had moderate cytotoxic and no toxic effect on normal cell. Compound (3) showed high cytotoxic activity against tested three cell lines with no toxic effect of normal cells.[Formula: see text].

Evaluation of the impact of percutaneous coronary intervention of chronic total occlusion on regional myocardial function using strain echocardiography.

BACKGROUND: Successful revascularization of chronic total occlusions has been associated with potential effects on left ventricular (LV) function. Strain and strain rate are more sensitive measures of LV mechanics than LV ejection fraction (LVEF). This study was conducted to investigate the impact of revascularization of chronic total occlusion (CTO) on LV function using tissue Doppler (TDI) strain echocardiography. RESULTS: This study included 60 patients divided into two main groups: the percutaneous coronary intervention (PCI) group including patients who had a successful PCI of CTO on left anterior descending (LAD) artery and was presented for elective PCI with symptomatic angina and/or positive functional ischemic study. They included 18 males with a mean age of 57 ± 5 years. The optimum medical treatment (OMT) group, including 30 patients, had non-revascularized CTO-LAD and was kept on OMT alone; 20 of them were males with a mean age of 58 ± 4 years. In the PCI group, there was a significant improvement in all the TDI strain parameters of the LAD territory segments. Six months after PCI, the peak systolic strain rate improved from - 0.65 ± 0.21 to 1.05 ± 0.31 1/s (p value < 0.01), the peak systolic strain improved from 6.54 ± 2.48 to 11.51 ± 3.33% ( p value < 0.001 ), and the end systolic strain improved from 7.88 ± 2.77 to 10.51 ± 3.14% (p value < 0.01 ). There was no significant improvement in the mean LVEF (60.70 ± 8.33 vs 61.91 ± 8.16% (p value = 0.6)). In the OMT group, there was no improvement in all the strain parameters and there was no change in the mean LVEF. In the PCI group, there was a significant improvement in the angina class (p value = 0.03) while, in the OMT group, there was no significant improvement (p value = 0.835). CONCLUSIONS: Successful PCI for CTO improved regional LV myocardial function assessed by TDI strain echocardiography. This improvement was associated with improvement in the angina class.

Green synthesis, characterisation and biological evaluation of plant-based silver nanoparticles using Quercus semecarpifolia Smith aqueous leaf extract.

The development of reliable and green methods for the fabrication of metallic nanoparticles (NPs) has many advantages in the field of nanotechnology. In this direction, the present work describes an eco-friendly and cost-effective protocol for the production of silver NPs (AgNPs) using an aqueous extract of Quercus semecarpifolia leaves. Different techniques were carried out for the characterisation of the synthesised AgNPs. The ultraviolet-visible spectroscopic analysis showed the highest absorbance peak at 430 nm. The particle size and structure were confirmed by scanning electron microscopy as well as transmission electron microscopy (TEM) analysis. From TEM imaging, it was revealed that the formed particles were spherical with an average size of 20-50 nm. The crystalline nature of the NPs was determined by X-ray powder diffraction patterns. Thermogravimetry and differential thermal analysis were also evaluated by a temperature increment from 100 to 1000°C. Bio-inspired synthesis of AgNPs was performed for their pharmacological evaluation in relation to the activities of the crude methanolic, n-hexane, chloroform, ethyl acetate, and aqueous extracts. Good cytotoxic activity was exhibited by the green-synthesised AgNPs (77%). Furthermore, the AgNPs were found to exhibit significant antioxidant activity at 300 µg/ml (82%). The AgNPs also exhibited good phytotoxic potential (75%).

Three new coumarin types from aerial parts of Ammi majus L. and their cytotoxic activity.

Three new coumarin types were isolated from the aerial parts of the wild medicinal plant Ammi majus, which was collected from western Asia (Saudi Arabia), including pyrano coumarin, namely, 5-isobutylcoumarin-6-C-glucoside (1); furanocoumarin, namely, 6,7,9-Trimethoxy-3-(8'-methoxy-2'-oxo-2H-chromen-3-yl)-2H-furo[3,2-g]chromen-2(3H)-one (2); and pyrone coumarin, namely, 6-hydroxy-3-(2-hydroxypropyl)-7-methoxy-4 methyl coumarin (3). The structures were determined by spectroscopic methods, mainly 1D- and 2D-NMR. In vitro cytotoxicity was evaluated by 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyl-tetrazolium bromide (MTT) assay. The results of cytotoxicity depending on their structure features showed that compound 3 had high activity on different cell lines, while compound 1 showed no activity against HCT116. Compound 2 had high activity towards HCT116 cell line.

Long-term prognostic implication of coronary plaque characterization as detected by 64-multidetector computed tomography in Egyptian population.

OBJECTIVES: We aimed to determine the role of multi-detector computed tomography (MDCT) in prognosis of patients with known or suspected coronary artery disease (CAD) by applying plaque characterization and whether obstructive versus non-obstructive plaque volume is a predictor of future cardiac events. BACKGROUND: Vulnerable plaques may occur across the full spectrum of severity of stenosis, underlining that also non-obstructive lesions may contribute to coronary events. METHODS: We included 1000 consecutive patients with intermediate pretest likelihood of CAD who were evaluated by 64-MDCT. Coronary artery calcium scoring, assessment of degree of coronary stenosis and quantitative assessment of plaque composition and volume were performed. The end point was cardiac death, acute coronary syndrome, or symptom-driven revascularization. RESULTS: After a median follow-up of 16 months, 190 patients had suffered cardiac events. In a multivariate regression analysis for events, the total amount of non-calcified plaque (NCP) in non-obstructive lesions was independently associated with an increased hazard ratio for non-fatal MI (1.01-1.9/100-mm3 plaque volume increase, p = 0.039), total amount of obstructive plaque was independently associated with symptoms driven revascularization (p = 0.04) and coronary artery calcium scoring (CACS) was independently associated with cardiac deaths (p = 0.001). CONCLUSION: MDCT is a non-invasive imaging modality with a prognostic utility in patients with known or suspected coronary artery disease by applying plaque characterization and it could identify vulnerable plaques by measuring the total amount of NCP in non-obstructive lesions which could be useful for detecting patients at risk of acute coronary syndrome (ACS) and guide further preventive therapeutic strategies. CACS was shown to be an independent predictor of mortality, while total amount of obstructive volume was shown to be an independent predictor of symptoms driven revascularization.

Cytotoxic new furoquinoline alkaloid isolated from Ammi majus L. growing in Egypt.

Two alkaloids of the furoquinoline-type were isolated from Ammi majus L.; a new one and was identified as 4-hydro-7-hydroxy-8-methoxyfuroquinoline (1), and the other was isolated for the second time from nature and was identified as 4-hydro-7-hydroxy-8-prenyloxyfuroquinoline (2). The structures of the isolated compounds were established and confirmed by 1D and 2D NMR spectroscopy including 1H, 13C NMR, COSY, HSQC and HMBC, while the exact masses were confirmed by HRESI/MS. The cytotoxic activity of the isolated compounds (1 and 2) was evaluated against HepG-2, PC-3, A-549 and MCF-7 and the obtained results suggested selective antiproliferative and cytotoxic effects, with IC50 = 230.2 and 326.5 µM against HepG-2 and MCF-7, respectively, for compound (1). While, compound (2) recorded IC50 = 234.2 µM against MCF-7.

Identification of High-Risk Patients with Non-ST Segment Elevation Myocardial Infarction using Strain Doppler Echocardiography: Correlation with Cardiac Magnetic Resonance Imaging.

UNLABELLED: Assessment of left ventricular (LV) function is important for decision-making and risk stratification in patients with acute coronary syndrome. Many patients with non-ST segment elevation myocardial infarction (NSTEMI) have substantial infarction, but these patients often do not reveal clinical signs of instability, and they rarely fulfill criteria for acute revascularization therapy. AIM: This study evaluated the potential of strain Doppler echocardiography analysis for the assessment of LV infarct size when compared with standard two-dimensional echo and cardiac magnetic resonance (CMR) data. METHODS: Thirty patients with NSTEMI were examined using echocardiography after hospitalization for 1.8 ± 1.1 days for the assessment of left ventricular ejection fraction, wall motion score index (WMSI), and LV global longitudinal strain (GLS). Infarct size was assessed using delayed enhancement CMR 6.97 ± 3.2 days after admission as a percentage of total myocardial volume. RESULTS: GLS was performed in 30 patients, and 82.9% of the LV segments were accepted for GLS analysis. Comparisons between patients with a complete set of GLS and standard echo, GLS and CMR were performed. The linear relationship demonstrated moderately strong and significant associations between GLS and ejection fraction (EF) as determined using standard echo (r = 0.452, P = 0.012), WMSI (r = 0.462, P = 0.010), and the gold standard CMR-determined EF (r = 0.57, P < 0.001). Receiver operating characteristic curves were used to analyze the ability of GLS to evaluate infarct size. GLS was the best predictor of infarct size in a multivariate linear regression analysis (ß = 1.51, P = 0.027). WMSI >1.125 and a GLS cutoff value of -11.29% identified patients with substantial infarction (≥12% of total myocardial volume measured using CMR) with accuracies of 76.7% and 80%, respectively. However, GLS remained the only independent predictor in a multivariate logistic regression analysis to identify an infarct size ≥12%. CONCLUSION: GLS is a good predictor of infarct size in NSTEMI, and it may serve as a tool in conjunction with risk stratification scores for the selection of high-risk NSTEMI patients.

Cytotoxity of two new coumarin derivatives isolated from Launaea mucronata.

The chloroform fraction of methanol (MeOH) extract of the aerial parts of Launaea mucronata was in vitro investigated for cytotoxicity against HCT116, HepG2 and MCF-7 cell lines, and resulted with IC50 = 20.0, 18.6 and 14.30 µg/mL, respectively. The chloroform fraction of the MeOH extract was subjected to further fractionation, which led to the isolation of two new coumarin compounds (6-isobutyl coumarin and 6-isobutyl-7-methyl- coumarin). The structures of the new compounds were elucidated by high field 1D and 2D NMR and ESI-MS spectroscopies. Low polar fractions revealed the isolation of other known triterpene compounds which were identified according to its spectral data and comparison with the literature. New coumarin compounds show high cytotoxicity against MCF-7, HCT116 and HepG2 cell lines.

The ameliorative effect of propolis against methoxychlor induced ovarian toxicity in rat.

A study was designed to evaluate ameliorative effect of propolis against methoxychlor (MXC) induced ovarian toxicity in rat. The organochlorine pesticide (MXC) is a known endocrine disruptor with estrogenic, anti-estrogenic, and anti-androgenic properties. To investigate whether chronic exposure to MXC could cause ovarian dysfunction, two groups of Sprague-Dawley adult female rats were exposed to MXC alone in a dose of 200mg/kg, twice/weekly, orally or MXC dose as previous plus propolis in a dose of 200mg/l/day, in drinking water for 10 months. Another two groups of rat were given corn oil (control) or propolis. Multiple reproductive parameters, ovarian weight, serum hormone levels, ovarian oxidative status and ovarian morphology were examined. In MXC-exposed group, there is a significant decrease in body and ovarian weight vs. control. MXC decreases serum estradiol and progesterone levels. A significant increase in the levels of lipid peroxidation was obtained while a significant decrease of the total antioxidant was recorded. Ovarian histopathology showed primary, secondary and vesicular follicles displaying an atretic morphology. Increase in the ovarian surface epithelium height accompanied with vacuolated, pyknotic oocytes were obtained. The previous toxic effects were neutralized by the administration of propolis in MXC+propolis group. The present results suggest that propolis may be effective in decreasing of MXC-induced ovarian toxicity in rat.

Detection of anti-Fasciola isotypes among patients with fascioliasis before and after treatment with Mirazid.

Stool examination using modified Kato thick smear method was performed to detect Fasciola eggs and other parasites. Abdominal pain was the major presenting symptom (87.7%) followed by pallor (83.3%) and fever (16.7%). Anaemia and hepatomegaly were recorded in 77.7% of patients compared to 27.7% with splenomegaly. Abdominal ultrasonography revealed hepatomegaly and common bile duct dilatation in 77.7% of patients. Moreover, 5 cases showed diagnostic. Olympic game rings All patients had positive IgG4 levels, 55 cases were positive for specific total IgG and IgG1, whereas, only 24 cases had positive IgG2 levels (26.6%). All negative control group showed no cross reactions. On the other hand, ELISA detecting IgG4 showed the highest specificity (95%), followed by IgG2 (85%) and the least specific test was obtained with detection of IgG (70%) and IgG1 (65%). One month after treatment, 91.1% of patients (82/90) were completely cured and even after another two months follow-up. In completely cured patients none of anti-Fasciola isotypes was significantly changed. So, detection of anti-Fasciola isotypes especially IgG4 is very specific for the accurate diagnosis of human fascioliasis.

Genotyping of human giardiasis in relation to anti-Giardia secretory IgA and mucosal histopathology.

Comparative study between the prevalence of pathological grading and Giardia genotypes revealed that, in patients infected with Giardia group I and II, out of patients having Giardia genotype I the prevalence of grade 0 was 13.16%, grade I was 21.05%, grade II was 47.37%, grade III was 13.16% and grade IV was 2.26% in comparison to 0%, 30.77%, 46.15%, 7.69% and 15.38% in genotype II (13 patients) and 10%, 40%, 20%, 20% and 10% in group III (10 patients) also in relation to 25%, 43.75%, 18.75%, 6.25% and 6.25% in mixed genotype infections group (16 patients) and 25%, 25%, 35.71%, 10.71% and 3.57% in undetermined infection group (28 patients) for grade 0, I, II, III & IV pathology respectively. There was no statistically significant difference regarding the prevalence of pathological grading in different Giardia genotypes in Gs I & II (P > 0.05). The mean OD of anti-Giardia secretory IgA in relation to Giardia genotypes in patients infected with Giardia Gs I & II was significantly different in the mean OD values of anti-Giardia secretory IgA in patients with different Giardia genotypes which were 1.091 +/- 0.377, 1.079 +/- 0.474, 1.524 +/- 0.503, 1.292 +/- 0.472 & 1.004 +/- 0.31 groups of genotype I, II, III, mixed genotypes infection and undetermined infection group respecttively (P > 0.05), being more increased in patients infected with Giardia genotype III and in mixed genotype infection.