Break the Silence: Knowledge and Attitude Towards Sexual and Reproductive Health Among Egyptian Youth.

Sexual health and education are rarely investigated in the Middle East countries, including Egypt. We performed the current study to investigate the knowledge, attitudes and behaviors towards sexual health practices among Egyptian youth. A self-administered questionnaire was translated from English to Arabic. After pilot-testing, the eligible population was invited to fill it online. Nine-hundred and fifty-five participants filled the questionnaire (53% males and 88.5% single). Around 61% of the participants were of the opinion that sexual education is necessary and rejected the notion that sexual education is religiously prohibited. Only 26% discussed sex-related matters with a parent. Although over 80% think that masturbation is either prohibited, wrong or medically harmful, 62% have masturbated before. Living with parents was not associated with less masturbation (p = 0.23). Moreover, although 85% of the participants think that watching pornography is either wrong or prohibited, 74% have watched porn clips before (significantly more frequent among males: p < 0.0001). A quarter of the responders indicated that they have been touched by a stranger/relative against their will. In conclusion, the majority of surveyed Egyptian youth expressed unfavorable attitudes towards masturbation and watching pornography -despite being quite common- and supported the importance of sexual education.

Sexual dysfunction in male patients with Parkinson's disease: related factors and impact on quality of life.

BACKGROUND: Sexual dysfunction (SD) is a common, yet under-reported, non-motor symptom (NMS) of Parkinson's disease (PD). The present study investigated the sexual functions in PD male patients, its correlation with motor and other NMSs, and their impact on health-related quality of life (HRQoL). METHODS: The sexual functions of 40 PD male patients were assessed using the International Index of Erectile Function (IIEF) and compared to 25 healthy age-matched controls. Patients were evaluated using the NMS Scale (NMSS) and the Arabic version of the Parkinson's-Disease Questionnaire (PDQ-39). We compared the sexual functions of younger (≤ 55 years) and elder (> 55 years) males and tested the correlations between sexual functions and motor, other NMSs, and HRQoL. RESULTS: Seventy percent of PD male patients reported erectile dysfunction. They showed significantly worse total (p < 0.001) and subscores of IIEF, compared to healthy controls. The total IIEF was inversely correlated to age of patients (p = 0.013), age at onset (p = 0.043), total, cognitive/mood, gastrointestinal and urinary domains of NMSS, and the cognitive domain of PDQ-39 (p = 0.013). Age was the main predictor (ß = - 0.581, p = 0.006) of SD. Elder patients showed worse sexual functions, stronger correlations to other NMSs, and more impact on HRQoL than younger patients. CONCLUSION: Sexual functions are worse among PD male patients with age as the main predictor. SD was associated with worse cognitive/mood and urinary domains of NMSS and has a negative impact on the patients' HRQoL among elder males.

Fucoidan protects against subacute diazinon-induced oxidative damage in cardiac, hepatic, and renal tissues.

Fucoidans (FUC) are organic sulfated polysaccharides from natural seaweeds with multiple biological actions. The current study was performed to assess the chemoprotective, antioxidant, and anti-inflammatory effects of FUC from Laminaria japonicum against diazinon (DZN)-induced injuries to rat cardiac, hepatic, and renal tissues. Forty male Wistar rats were assigned into five groups, receiving saline, oral FUC 200 mg/kg/day, subcutaneous DZN 20 mg/kg/day, DZN plus FUC 100 mg/kg/day, or DZN plus FUC 200 mg/kg/day (each treatment was given daily for 4 weeks). Data analysis showed that DZN-intoxicated rats exhibited significantly higher (p < 0.05) serum levels of alanine transaminase, aspartate transaminase, alkaline phosphatase, urea, creatine, creatine kinase, creatine kinase-MB, lactate dehydrogenase, cholesterol, interleukin-6, and tumor necrosis factor-α, as well as lower levels of acetylcholinesterase, compared to control rats. In addition, DZN intoxication was associated with significantly higher (p < 0.05) cardiac, hepatic, and renal tissue concentrations of malondialdehyde and nitric oxide, as well as lower glutathione concentrations, and activities of glutathione peroxidase, superoxide dismutase, and catalase enzymes in comparison to control rats. Treatment with FUC (at 100 or 200 mg/kg/day) ameliorated all the aforementioned alterations in a dose-dependent manner. In conclusion, FUC from Laminaria japonicum ameliorated DZN-induced oxidative stress, pro-inflammatory effects, and injuries to the cardiac, hepatic, and renal tissues. These effects may be related to the antioxidant and anti-inflammatory effects of FUC.

Protective effects of thymoquinone and diallyl sulphide against malathion-induced toxicity in rats.

Malathion is a potent organophosphate insecticide that inhibits acetylcholinesterase (AChE) enzyme. Our experimental objective was to investigate the beneficial effects of diallyl sulphide (DAS) and thymoquinone (TQ) against malathion-induced oxidative stress in rat cerebral, hepatic, and renal tissues. For 30 days, rats received corn oil alone (negative control) or malathion by intragastric gavage (200 mg/kg daily), either alone (positive control) or combined with oral DAS (200 mg/kg daily) or TQ (10 mg/kg daily) (treatment groups). Later, blood samples were collected via direct cardiac puncture and tissue samples were obtained for biochemical analysis. Malathion administration was associated with significant increases (p < 0.05) in the serum levels of aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, lactate dehydrogenase, γ-glutamyl transferase, cholesterol, urea, creatinine, and 8-OHdG (DNA damage biomarker), as well as significant (p < 0.05) decreases in the serum levels of total proteins, albumin, triglycerides, and AChE. Moreover, it significantly increased the tissue concentrations of malondialdehyde and nitric oxide and reduced tissue glutathione concentration and activities of antioxidant enzymes (glutathione peroxidase, superoxide dismutase, and catalase). Treatment of malathion-intoxicated rats with DAS or TQ significantly minimized these biochemical and oxidative effects with more frequent reversal to normal ranges of serum biomarkers, tissue oxidative markers, and antioxidant enzymes in the TQ group. In conclusion, treatment with DAS or TQ ameliorated the biochemical and oxidative effects of malathion, probably through reducing the generation of reactive oxygen and nitrogen radicals, as well as enhancing the antioxidant defense mechanisms.

Fucoidan alleviates microcystin-LR-induced hepatic, renal, and cardiac oxidative stress and inflammatory injuries in mice.

Fucoidans (FUCs) are sulfated polysaccharides that have a wide range of bioactivities. The current study was designed to evaluate the antioxidant potential of FUC against microcystin-LR (MC-LR)-induced toxicity. Five mice groups (n = 8) were used. Group 1 received saline, Group 2 received oral FUC 100 mg/kg/day for 21 days, Group 3 received i.p. MC-LR 10 µg/kg/day for 14 days, Group 4 received MC-LR plus FUC 50 mg/kg/day, and Group 5 received MC-LR plus FUC 100 mg/kg/day. The present study showed that MC-LR administration was associated with significant increases (p < 0.01) in serum concentrations of hepatic (aspartate transferase, alanine transferase, and alkaline phosphatase), renal (urea and creatinine), and cardiac (creatine kinase and CK-MB) injury biomarkers, as well as serum lactate dehydrogenase, cholesterol, and pro-inflammatory cytokines (interleukins-1ß and 6, and tumor necrosis factor-α), compared with the control group. Further, MC-LR-intoxicated mice exhibited significantly higher (p < 0.01) hepatic, renal, and cardiac tissue levels of malondialdehyde and nitric oxide, as well as lower tissue levels of reduced glutathione and activities of glutathione peroxidase, superoxide dismutase, and catalase enzymes in comparison with control mice. Treatment by FUC significantly ameliorated all the above-mentioned alterations in a dose-dependent manner with frequent restoration of the normal ranges in the FUC 100 mg/kg/day dose group. Moreover, treatment by FUC alone at 100 mg/kg/day was not associated with significant negative alterations in the assessed biochemical parameters, highlighting its safety at this dose. In conclusion, treatment by FUC significantly ameliorated organ injury, induced by MC-LR in mouse hepatic, renal, and cardiac tissues.

The effects of abamectin on oxidative stress and gene expression in rat liver and brain tissues: Modulation by sesame oil and ascorbic acid.

The present work was designed to assess the modulatory effects of sesame oil (SO) and ascorbic acid (AA) on abamectin (ABM)-induced oxidative stress and altered gene expression of hepatic cytochrome P450 2E1 (CYP-2E1), p38 MAPK, and caspase-3 and cerebral P-glycoprotein (Abcb1a receptor). Male rats were distributed into five groups (6 rats/group), receiving distilled water, ABM 2 mg/kg bwt 1/5 LD50 orally for 5 days, ABM + AA 100 mg/kg bwt orally, ABM + SO 5 ml/kg bwt orally, or ABM + SO + AA at the aforementioned doses. Nineteen compounds were identified in the SO sample by GC-MS analysis, including tetradecane,2,6,10-trimethyl, octadecane, 1-hexadecanol,2-methyl, and octadecane,6-methyl. Abamectin significantly upregulated the hepatic CYP-2E1 expression with excess generation of oxidative radicals, as evident by the significant depletion of reduced glutathione and elevation of malondialdehyde concentration (p ≤ 0.05) in rat liver and brain tissues. Further, ABM significantly increased TNF-α concentration, the expression of caspase-3 and p38 MAPK in the liver, as well as p-glycoprotein and GABA-A receptor in the brain. These results were in line with the observed histopathological changes. Sesame oil and/or AA supplementation alleviated ABM-induced cell damage by modulating all tested parameters. In conclusion, ABM induces oxidative stress and increases the expression of CYP-2E1, caspase-3, and p38 MAPK in the liver, as well as P-gp and GABA-A receptor in the brain. These effects could be ameliorated by SO and AA, alone and in combination, probably due to their anti-oxidant, anti-apoptotic, and gene-regulating activities.

Outcomes of Direct Flow Medical vs Sapien 3 Transcatheter Aortic Valve Devices.

This retrospective study was aimed to compare the safety and efficacy of the Direct Flow Medical (DFM) valve with the more established Sapien 3 (S3) valve in transfemoral TAVI in high-risk aortic stenosis (AS) patients. Between February 2014 and August 2016, 99 and 68 patients had the S3 and DFM valves at our center, respectively. The device success rate was statistically similar among the S3 and DFM groups (p = 0.15). The overall post-procedural complication rate was similar between the two groups (p = 0.4). The procedural time was significantly shorter in the S3 group (p < 0.001) and the post-procedure peak pressure gradient (p < 0.001) was significantly higher in the DFM group. However, the frequency of valvular or paravalvular leaks was similar between both valve groups. We found no significant differences in terms of safety between the DFM and S3 valves. This study confirms the safety and efficacy of the DFM valve in high-risk AS patients.

Refractory Open Jaw Oromandibular Tardive Dystonia with a Sensory Trick, Treated with Botulinum Toxin: A Case Report.

Jaw-opening oromandibular dystonia (O-OMD) is a clinical subtype of OMD, commonly resistant to treatment. Here, we report a distinct case of tardive O-OMD with a characteristic sensory trick, successfully treated with high-dose botulinum toxin (BTX) injection. A 34-year-old male patient presented with involuntary jaw opening, tongue protrusion, dysarthria, and mild cervical dystonia. The patient reported improved abilities to talk and close his mouth after putting something, like a cigarette, between his teeth. After an unsuccessful treatment with anticholinergic medications, the patient received electromyography-guided BTX injection to the lateral pterygoids (through an extraoral approach), sternocleidomastoids, trapezius, tongue, and platysma muscles. Following the injection, the patient reported marked improvements in his ability to talk and close his mouth without using his sensory trick. One month later, we detected a 58.2% improvement in the Abnormal Involuntary Movement Scale score. Therefore, high-dose BTX injection may be an effective alternative in refractory O-OMD.

Temporal trends, ethnic determinants, and short-term and long-term risk of cardiac death in cancer patients: a cohort study.

BACKGROUND: We evaluated the risk of cardiac death in patients with prior cancer diagnoses and compared risk by cancer type and ethnicity in a large US population. METHOD: Utilizing the Surveillance, Epidemiology, and End Results database, data on patients with a cancer diagnosis between 2000 and 2014 were obtained. We calculated the standardized mortality ratio (SMR) of cardiac death after a cancer diagnosis and the excess risk per 10,000 person-years. We stratified the analysis according to the time interval between cancer and cardiac events, cancer site, cancer stage, and race. RESULTS: A total of 4,671,989 patients with a cancer diagnosis were included, of which 163,255 died due to cardiac causes within 10 years of diagnosis. We found a significantly higher rate of cardiac death for cancer patients [SMR=1.16, 95% confidence interval (CI) 1.15-1.16] compared to the general population. When observed for each cancer site, the highest SMR was after a diagnosis of hepatocellular carcinoma (SMR=2.58, 95% CI 2.45-2.72), pancreatic cancer (SMR=2.36, 95% CI 2.25-2.47), and lung cancer (SMR=2.30, 95% CI 2.27-2.34). Patients with metastatic disease had a higher rate of cardiac death (SMR=2.16, 95% CI 2.13-2.19). When stratified by ethnicity, SMR for cardiac death was 1.76, 2.28, 3.68, 2.65, and 1.84 for whites, blacks, American Indians/Alaska Natives, Asians/Pacific Islanders, and Hispanics, respectively. CONCLUSIONS: Cancer patients are more vulnerable to cardiac death than the general population, especially those with nonwhite ethnicity; liver, lung, and pancreatic cancers; and history of metastasis. Healthcare providers should be aware of this risk and pay particular attention to the highest-risk groups.

Mesenchymal Stem Cell Therapy for Doxorubicin-Induced Cardiomyopathy: Potential Mechanisms, Governing Factors, and Implications of the Heart Stem Cell Debate.

Over the past decades, researchers have reported several mechanisms for doxorubicin (DOX)-induced cardiomyopathy, including oxidative stress, inflammation, and apoptosis. Another mechanism that has been suggested is that DOX interferes with the cell cycle and induces oxidative stress in C-kit+ cells (commonly known as cardiac progenitor cells), reducing their regenerative capacity. Cardiac regeneration through enhancing the regenerative capacity of these cells or administration of other stem cells types has been the axis of several studies over the past 20 years. Several experiments revealed that local or systemic injections with mesenchymal stem cells (MSCs) were associated with significantly improved cardiac function, ameliorated inflammatory response, and reduced myocardial fibrosis. They also showed that several factors can affect the outcome of MSC treatment for DOX cardiomyopathy, including the MSC type, dose, route, and timing of administration. However, there is growing evidence that the C-kit+ cells do not have a cardiac regenerative potential in the adult mammalian heart. Similarly, the protective mechanisms of MSCs against DOX-induced cardiomyopathy are not likely to include direct differentiation into cardiomyocytes and probably occur through paracrine secretion, antioxidant and anti-inflammatory effects. Better understanding of the involved mechanisms and the factors governing the outcomes of MSCs therapy are essential before moving to clinical application in patients with DOX-induced cardiomyopathy.

The ameliorative effects of ceftriaxone and vitamin E against cisplatin-induced nephrotoxicity.

Nephrotoxicity is a common adverse effect of treatment with cisplatin (CDDP). This study was performed to evaluate the antioxidant and nephroprotective efficacy of ceftriaxone (CTX) and vitamin E (Vit.E), alone and in combination against CDDP-induced acute renal injury. Fifty-six male albino rats were equally divided into seven groups, receiving (I) normal saline, (II) CTX (100 mg/kg, intraperitoneal [i.p] injection), (III) Vit.E (100 mg/kg orally), (IV) CDDP (5 mg/kg i.p injection), (V) CDDP plus CTX, (VI) CDDP plus Vit.E, and (VII) CDDP plus CTX in combination with Vit.E. All treatments were administered daily for 10 days except CDDP, which was given as a single dose at the sixth day of the study. Compared to normal control rats, CDDP-injected rats showed significantly (p < 0.05) higher serum levels of renal injury biomarkers (uric acid, urea, and creatinine) and tumor necrosis factor-α (TNF-α), as well as increased renal tissue concentrations of malondialdehyde, nitric oxide, and TNF-α. Moreover, CDDP administration was associated with significantly lower (p < 0.05) renal tissue levels of reduced glutathione and activities of endogenous antioxidant enzymes (glutathione peroxidase, superoxide dismutase, and catalase) and total antioxidant capacity. All these alterations were significantly ameliorated in CDDP-injected rats, receiving CTX and/or Vit.E, compared to rats receiving CDDP alone. Interestingly, the antioxidant and anti-inflammatory effects were more marked in the CTX-Vit.E combination group, compared to groups receiving either drug alone. In conclusion, CTX and Vit.E (especially in combination) could counteract the nephrotoxic effect of CDDP, probably through their antioxidant activities.

A literature analysis on anti-vascular endothelial growth factor therapy (anti-VEGF) using a bibliometric approach.

We performed the current study to assess the citation performance of research works on anti-vascular endothelial growth factor (anti-VEGF) therapy. We searched Web of Science (WoS) to identify relevant publications and analyze them with reference to their publication year, journal title, citation count, WoS category, and article type. The bibliometric software (VOSviewer) was used for citation analyses of countries and journals and to generate a term map that visualizes the recurring terms appearing in the titles and abstracts of published articles. The literature search resulted in 7364 articles, with a mean citation count of 26.2. Over half of them (50.2%) were published during the past 5 years. Original articles constituted the majority (67.8%). The publications were mainly classified into WoS categories of ophthalmology (43.2%) and oncology (20.6%). The most prolific ophthalmology and cancer journals were Investigative Ophthalmology & Visual Science (7.3%) and Cancer Research (1.4%), respectively. The correlation between journal impact factor and citation count was weak to moderate (for journals with impact factor up to 5 and 10, respectively), and open-access articles had significantly more citations than non-open-access articles (p < 0.001). The frequently targeted tumors by anti-VEGF therapy included metastatic colorectal cancer (196; 49.2 citations per article (CPA)), breast cancers (167; 37.2 CPA), and renal cell carcinoma (122; 38.2 CPA). The frequently targeted eye pathologies were age-related macular degeneration (828; 18.2 CPA), diabetic macular edema (466; 10.8 CPA), and diabetic retinopathy (358; 31.9 CPA). These results indicate that anti-VEGF therapy has a wide range of applications and its publications are highly cited.

The nephroprotective effects of allicin and ascorbic acid against cisplatin-induced toxicity in rats.

Cisplatin (CDDP) may induce nephrotoxicity through oxidative stress, DNA damage, and inflammation. This study was performed to evaluate the antioxidant and anti-inflammatory effects of allicin and ascorbic acid (AA) and investigate the nephroprotective efficacy of their combination against CDDP-induced intoxication. Rats were divided into seven groups: control, allicin (10 mg/kg for 14 days), AA (20 mg/kg for 14 days), CDDP (7 mg/kg as a single dose on the seventh experimental day), CDDP-allicin, CDDP-AA, and CDDP-allicin-AA (at the aforementioned doses). The administration of CDDP induced marked body weight loss and renal damage, manifested by significant increases (p < 0.05) in serum creatinine, urea, and uric acid levels and significant reductions in serum Na, Ca, and phosphorus concentrations, in addition to severe alterations in serum and renal tissue levels of tumor necrosis factor-α in comparison with control rats. Moreover, CDDP-intoxicated rats exhibited significantly (p < 0.05) higher lipid peroxidation, as well as lower levels of reduced glutathione and activities of glutathione peroxidase, superoxide dismutase, and catalase enzymes in the renal tissue, compared with control rats. The administration of allicin or AA significantly reduced (p < 0.05) the CDDP-induced changes in all the aforementioned parameters. Interestingly, allicin achieved comparable nephroprotection to AA in most assessed parameters; however, the restoration of normal serum and renal tissue concentrations of these parameters was more frequent in the CDDP-AA group. In conclusion, both allicin and AA showed significant nephroprotective effects against CDDP intoxication and their combination exhibited better protection than either agent alone. These results are probably mediated by their antioxidant and anti-inflammatory activities.

Influence of Spirulina platensis and ascorbic acid on amikacin-induced nephrotoxicity in rabbits.

The current study was performed to investigate the nephroprotective efficacy of Spirulina platensis (SP) and the possible benefits of combining SP and ascorbic acid (AA) in protecting against amikacin (AMK)-induced nephrotoxicity in rabbits. Forty-two male New Zealand rabbits were allocated to seven equal groups, receiving (I) normal saline as negative controls, (II) oral SP (500 mg/kg body weight), (III) oral AA (20 mg/kg bw), (IV) intramuscular AMK injection (100 mg/kg bw), (V) AMK plus SP, (VI) AMK plus AA, or (VII) AMK plus SP and AA at the aforementioned doses. The treatments were given once/day for 7 days. Data analysis showed that in comparison to the control group, AMK-intoxicated rabbits showed significant increases (p ≤ 0.05) in serum concentrations of creatinine, uric acid, and urea, as well as renal tissue concentrations of tumor necrosis factor-α [TNF-α], malondialdehyde [MDA], and nitric oxide [NO]. Moreover, significant (p ≤ 0.05) reductions in renal glutathione concentration, antioxidant enzymatic activities (catalase, glutathione peroxidase, and superoxide dismutase), and total antioxidant capacity were noted following AMK intoxication. Treatment by SP ameliorated most of the aforementioned AMK-induced alterations. Although treatment with AA significantly reduced the renal tissue MDA, NO, and TNF-α concentrations, it was not associated with significant ameliorations of AMK-induced changes in the serum concentrations of renal function markers or renal tissue antioxidant parameters. The nephroprotective effects of SP-AA combination were more potent than SP alone in several parameters. In conclusion, SP alone or in combination with AA minimized the nephrotoxic effects of AMK through their antioxidant and anti-inflammatory activities.

Fib-4 Predicts Early Hematological Adverse Events Induced by Interferon-Based Triple Therapy in Chronic Hepatitis C Virus Patients.

Interferon-alpha (IFN-α)-based therapy is associated with several hematological adverse events in hepatitis C virus (HCV)-infected patients with advanced fibrosis. We performed this study to evaluate the association between Fibrosis-4 (Fib-4) index and hematological adverse events in patients with chronic HCV infection, undergoing IFN-α-based triple therapy. We included 120 HCV-infected patients, receiving triple therapy: weekly PegIFN-α, daily ribavirin (1,000-1,200 mg), and daily sofosbuvir (400 mg) for 12 weeks. We compared Fib-4 scores for patients who developed hematological adverse events at weeks 4 (w4) and w12 of treatment and w12 post-treatment versus those who did not. Treatment with the aforementioned triple regimen was associated with a sustained virological response (SVR)-12 rate of 93.9%. We found no significant associations (P > 0.05) between SVR12 rate and the degree of fibrosis or the risk of hematological adverse events. The Fib-4 score could predict patients who developed hematological adverse events (anemia, leukopenia, and neutropenia) in the first month of treatment, but not in later stages. A Fib-4 cutoff value of 3.59 had high specificity for anemia, leukopenia, and neutropenia (85.1%, 87.2%, and 88.2%, respectively), but had low sensitivity for detecting the 3 events. In conclusion, the Fib-4 score may predict early hematological adverse effects in HCV-infected patients on IFN-based triple therapy.

Evaluating the role of tissue microRNA-27b as a diagnostic marker for oral lichen planus and possible correlation with CD8.

BACKGROUND: MicroRNA-27b (miR27b) is a small, non-coding RNA that is involved in physiological keratinocyte differentiation and regulating inflammatory processes. We performed this study to investigate the value of miR27b as a diagnostic marker for oral lichen planus (OLP) and the correlation between CD8 (cytotoxic T-cell marker) and miR27b tissue expression in OLP patients. METHODS: Forty participants (including 20 OLP patients and 20 controls) underwent oral biopsy. The obtained specimens were examined by immunostaining and quantitative RT-PCR for CD8 and miR27b tissue expression, respectively. We used the Spearman rank correlation test to evaluate the correlation between both variables. RESULTS: Our analysis showed that in comparison with healthy tissues, OLP tissue samples exhibited significantly higher CD8 levels (P < 0.01), as well as a significant downregulation of miR27b expression (P < 0.0001). Upon comparing different OLP subgroups, no significant difference was detected in terms of miR27b expression; however, the tissue levels of CD8 varied significantly (highest in the erosive subgroup and lowest in the papular/plaque/reticular subgroup). The Spearman rank analysis showed a negative correlation between tissue expression of miR27b and CD8; however, this was not statistically significant (P > 0.05). Further, the receiver operating characteristic curve of tissue miR27b as an OLP biomarker revealed 100% sensitivity and 65% specificity at cutoff value of 4.4. CONCLUSION: This study demonstrated increased CD8 levels and downregulation of miR27b in OLP tissues, compared to healthy tissues. Moreover, it revealed the potential of miR27b as an OLP disease biomarker. The possible negative correlation between CD8 and miR27b tissue expression requires further investigation in larger studies.