Endophytic Aspergillus fumigatiaffinis: Novel paclitaxel production and optimization insights.

This study investigated the potential of endophytic fungi to produce paclitaxel (Taxol®), a potent anticancer compound widely employed in chemotherapy. This research aimed to identify, confirm, and characterize endophytic fungi capable of paclitaxel (PTX) production and assess their paclitaxel yield. Additionally, it aimed to investigate factors influencing paclitaxel production. A total of 100 endophytic fungal isolates were collected and identified from the roots of Artemisia judaica. Aspergillus fumigatiaffinis exhibited the highest PTX production (26.373 µg L-1) among the isolated endophytic fungi. The strain was identified as A. fumigatiaffinis (Accession No. PP235788.1). Molecular identification confirmed its novelty, representing the first report of PTX production by A. fumigatiaffinis, an endophyte of Artemisia judaica. Optimization through full factorial design of experiments (DOE) and response surface methodology (RSM) significantly enhanced PTX production to 110.23 µg L-1 from 1 g of dry weight of the fungal culture under optimal conditions of pH 8.0, 150 µg L-1 becozyme supplementation, and 18 days of fermentation in potato dextrose broth. The presence of paclitaxel was confirmed using thin layer chromatography, high performance liquid chromatography, and gas chromatography-mass spectrometry. These findings maximize the role of endophytic fungus to produce a secondary metabolite that might be able to replace the chemically produced PTX and gives an opportunity to provide a sustainable source of PTX eco-friendly at high concentrations. KEY POINTS: • Endophytic fungi, like A. fumigatiaffinis, show promise for eco-friendly paclitaxel production • Optimization strategies boost paclitaxel yield significantly, reaching 110.23 µg L -1 • Molecular identification confirms novelty, offering a sustainable PTX source.

Comparative evaluation of silver nanoparticles and human platelet rich-plasma versus traditional therapy in the treatment of murine chronic toxoplasmosis.

Toxoplasmosis is a worldwide parasitic disease infecting about one-third of the human population. At present, licensed medications are incapable of curing human chronic infection. The present work aimed to evaluate for the first time the combination between (spiramycin and human platelet rich plasma), in addition to (spiramycin and silver-nanoparticles) in treating murine experimental toxoplasmosis using parasitological, biochemical, histopathological and immunohistochemical studies. Seventy-seven Swiss albino male mice divided into seven groups according to the treatment used as follows: (GI): control negative; (GII): control infected; (GIII): spiramycin; (GIV): Silver nanoparticles (AgNPs); (GV): Human platelet-rich plasma (HPRP); (GVI): combined spiramycin and AgNPs; (GVII): combined spiramycin and HPRP. Obtained results demonstrated that (spiramycin and AgNPs) treated group showed significant reduction of T. gondii tissue cysts number, the lowest level of serum malondialdehyde, remarkable improvement in pathological changes in different tissues of mice e.g. brain and liver and weak expression of EGFR in brain tissues of mice compared to control infected group. Moreover, AgNPs administered alone produced minimal anti-Toxoplasma results, whereas their combination with spiramycin exhibited significant therapeutic efficacy. In conclusion, combination therapy of spiramycin and AgNPs may represent a unique possible adjuvant therapy for reducing the pathogenic, toxic, and inflammatory consequences of toxoplasmosis on the brain and liver tissues in immunocompetent mice, and the expression of EGFR in brain tissues of mice is a good tool for evaluating the therapeutic improvement of murine toxoplasmosis.

COVID-19 Vaccine as a Potential Triggering Factor for Anti-Glomerular Basement Membrane (GBM) Disease: A Case Report and Literature Review.

Coronavirus 2019 (COVID-19) is considered one of the most significant medical pandemics of this century, with high morbidity and mortality associated with the pandemic. The virus was recognized initially as a cause of pneumonia, but subsequent studies showed significant association with gastrointestinal, neurological, and autoimmune diseases. By 2020, several vaccines became available for use, significantly reducing the infection rate. A good safety profile supported most of the studies related to vaccines. However, this area is still under study, and some reports linked the COVID-19 vaccine to the development of thrombocytopenia, thrombosis, Guillain-Barre syndrome, autoimmune diseases, and myocarditis. These side effects need to be reported to VAERS (Vaccine Adverse Event Reporting System). The exact etiology of anti-glomerular basement (Anti-GBM) disease remains unknown, but the disease is thought to be triggered by environmental factors in genetically predisposed individuals. It is considered one of the serious diseases that could lead to permanent kidney impairment if not treated early and adequately. That's why a great effort is being made by health care practitioners to figure out and avoid the risk and triggering factors. Few previously published papers linked the COVID-19 vaccine and the development of anti-GBM disease, which raised concerns about digging more into this area. Herein, we are reporting a case of a patient who developed rapidly progressive glomerulonephritis (RPGN) due to anti-glomerular basement membrane (GBM) antibody disease two days after receiving the second dose of the COVID-19 vaccine.

Safety and outcomes of thrombolytic therapy in patients with pulmonary embolism and thrombocytopenia: A systematic review.

Thrombolysis is an established therapeutic modality for patients with high-risk (and some selected intermediate-risk) pulmonary embolism (PE) with hemodynamic instability. Physicians sometimes experience cases where both a high-risk PE and thrombocytopenia coexist. Although thrombocytopenia of <  100 × 103/mm3 is considered a contraindication in patients with ischemic stroke, the safety and outcomes of thrombolysis in patients with acute PE and thrombocytopenia are unknown. This systemic review aimed to pool data on the safety and outcomes of thrombolysis use in patients with PE and platelet count less than 150 × 103/mm3. Patients' demographics, clinical characteristics, management, type of thrombolytic therapy, and outcomes were extracted and analyzed. Of 283 articles identified through the systematic search, 11 case reports fulfilled the inclusion criteria. The mean age of the patients was 52.27 years, and 54.5% were women. The median platelet level before thrombolysis was 65.50 × 103/mm3. Before thrombolysis was initiated, the lowest and highest platelet levels were 29 × 103/mm3 and 105 × 103/mm3, respectively. Alteplase was used in 10 patients and urokinase in one patient. One patient who had a massive PE died of aspiration pneumonia. Interestingly, no thrombocytopenia-related complications were reported. This systematic review highlights the potential benefits and safety of thrombolysis in patients with acute PE in the context of thrombocytopenia. Nevertheless, data available in the literature concerning this topic are scarce and limited to case reports. More extensive studies on the use of thrombolysis in patients with PE and thrombocytopenia are desperately needed. Systematic review registration: The protocol has been registered in the International Prospective Register of Systematic Reviews (PROSPERO): CRD42021286415.

Risk Factors for Endometriosis Among Egyptian Infertile Women with Different Disease Stages.

Background: Endometriosis is regarded as a benign condition, despite the potential for recurrence and metastasis,. It might lead to secondary ovarian cancer from endometrioma. Objective: The aim of this current study was to determine the relationship between risk factors for endometriosis and disease stages. Methods: This current cross-sectional study was performed at the endoscopic unit at Zagazig University Hospitals, Egypt. The participants included 85 women who were candidates for laparoscopy and diagnosed with endometriosis in the period from November 2019 to November 2020. The tools used for data collection were a structured interviewing form and the American Society of Reproductive Medicine scoring tool (ASRM) for determining stages of endometriosis. Results: The high percentages of studied women were nulliparous (74.1%) and (51.8%) have secondary infertility. Endometriosis was staged as 20.0% minimal (ASRM stage I), 34.1% mild (ASRM stage II), 29.4% moderate (ASRM stage III), and 16.5% severe (ASRM stage IV). Congestive dysmenorrhea (78.8%), dyspareunia (77.6%), and secondary infertility (51.8%) were more reported symptoms in all stages of endometriosis. Conclusion: This study concluded that women within reproductive age, nulliparity, lower body weight, urban residence, and past surgery of the pelvic were considered as risk factors in all disease stages.

Eltrombopag Use for Treatment of Thrombocytopenia in a Patient with Chronic Liver Disease and Portal Vein Thrombosis: Case Report.

Off-label drug use refers to drug use beyond the specifications authorized for marketing [J Med Case Rep. 2014 Dec;8(1):303]. Eltrombopag is a thrombopoietin receptor agonist that has been used in treating thrombocytopenia due to chronic liver disease (CLD) as an off-label medication. Treatment of thrombocytopenia in patients with CLD constitute a real dilemma as the options are limited and some of them are invasive. However, thrombopoietin receptor agonist has been increasingly used for this purpose. Here we report a 34-year-old woman who has been diagnosed with CLD due to autoimmune hepatitis 20 years ago. Her condition was complicated with portal vein thrombosis, chronic thrombocytopenia, and variceal hemorrhage, and she has been listed as a candidate for liver transplantation. Given her high risk of bleeding, we started her on low dose of eltrombopag (25 mg daily) in order to maintain a platelet level of ≥50 × 103/µL. However, 1 year after initiation of the therapy, she developed left lower limb deep vein thrombosis.

Impact of Endometriosis-Related Adhesions on Quality of Life among Infertile Women.

BACKGROUND: Endometriosis is considered the most common cause of pelvic adhesions in women. Endometriosisassociated adhesions could result in the formation of fibrous bands, which contain endometriotic glands, stroma and scarring. The aim of this study was to identify the impact of endometriosis-related adhesions on quality of life among infertile women. MATERIALS AND METHODS: This descriptive study was conducted at Endoscopic Unit, in Zagazig University Hospitals, Egypt. Oral consent for participation in this study was taken from 109 women who were candidates for laparoscopy as infertile cases and were diagnosed with endometriosis. They were classified into two groups namely, group I (n=41) who had endometriosis with adhesions and group II (n=68) who had endometriosis without adhesions. A structured interviewing form, adhesion scoring method of the American Fertility Society, and Global Quality of Life Scale were used to collect required information. RESULTS: The prevalence of adhesions resulted from endometriosis was 37.6%. Demographic characteristics of the women with endometriosis-related adhesions were not significantly different from those of women without endometriosis- related adhesions. The most common location for endometriotic adhesions was adnexal adhesion (51.2%) followed by adhesion of anterior abdominal wall (24.4%). Quality of life was significantly impacted by endometriosisrelated adhesions (P=0.002). CONCLUSION: A high percentage of studied patients had a moderate degree of adhesions. Adhesions caused by endometriosis had an impact on quality of life of the studied women.

RELATION BETWEEN SCHISTOSOME PAST INFECTION AND METABOLIC SYNDROME.

Schistosome antigens modulate host metabolic profiles in experimental animals. The effects of previous schistosome infection (PSI) and the development of metabolic syndrome remain unknown in humans. This study evaluated previous schistosome infection (PSI) related to metabolic syndrome (MS). A total of 547 participants aged >40 years from rural areas of Zagazig district were enrolled. Of them, 269 patients with. PSI and 305 normal served as controls. For all participants blood pressure, height, body weight and waist circumstance (WC) were measured. Blood samples were examined biochemically to determine triglyceride (TG), fasting blood glucose (FBG) and high-density lipoprotein cholesterol (HIDL-C). Associations between PSI and MS were evaluated using logistic regression. Patients with PSI had significantly lower levels of body mass index (BMI), WC, TG, insignificantly low levels of fasting -blood glucose (FBG) and significantly higher levels of high-density lipoprotein cholesterol (HDL-C) compared with controls. Prevalence of MS in PSI was significantly low than controls (32.7% vs. 42.3% respectively). PSI significantly associated with low prevalence of metabolic syndrome and its components, including central obesity, hypertension, hyperglycemia, hypertriglyceridemia and low HDL-C. Potential long-term effects of PSI may reduce metabolic syndrome risk.

Evaluation of perfusion index as a tool for pain assessment in critically ill patients.

Pain is a common and undertreated problem in critically ill patients. Pain assessment in critically ill patients is challenging and relies on complex scoring systems. The aim of this work was to find out the possible role of the perfusion index (PI) measured by a pulse oximeter (Masimo Radical 7; Masimo Corp., Irvine, CA, USA) in pain assessment in critically ill patients. A prospective observational study was carried out on 87 sedated non-intubated patients in a surgical intensive care unit. In addition to routine monitoring, a Masimo pulse oximeter probe was used for PI measurement. The sedation level of the patients was assessed by using the Richmond Agitation-Sedation Scale (RASS). The pain intensity was determined by applying the behavioral pain scale for non-intubated (BPS-NI) patients. The PI, arterial blood pressure, heart rate, RASS, and BPS-NI values before and after the application of a standard painful stimulus (changing the patient position) were reported. Correlation between the PI and other variables was carried out at the two measurements. Correlation between changes in the PI (delta PI) and in the hemodynamic variables, RASS, and BPS-NI was also done. Changing the patient position resulted in a significant increase in SBP (128 ± 20 vs 120.4 ± 20.6, P = 0.009), DBP (71.3 ± 11.2 vs 68.7 ± 11.3, P = 0.021), heart rate (99.5 ± 19 vs 92.7 ± 18.2, P = 0.013), and BPS-NI (7[6-8] vs 3[3-3], P < 0.001) values and a significant decrease in the PI (1[0.5-1.9] vs 2.2[0.97-3.6], P < 0.001) value compared to the baseline readings. There was no correlation between the values of the PI and the ABP, BPS-NI, and RASS at the two measurements. A good correlation was found between the delta PI and delta BPS-NI (r = -0.616, P < 0.001). A weak correlation was observed between the PI and heart rate after the patient positioning (r = -0.249, P < 0.02). In surgical critically ill non-intubated patients, the application of a painful stimulus was associated with decreased PI. There was a good correlation between the change in the PI and the change in BPS-NI values after the application of painful stimulus.

The relation between the prevalence of soil transmitted parasites in the soil and among school children in Zagazig district, Sharkyia Governorate, Egypt.

Soil transmitted helminths are highly prevalent throughout the developing countries of the world and Egypt is categorized as one of the developing countries. This study aimed to detect the relation between the presence and prevalence of STH in the soil and their reflection on the prevalence among school-children living in rural and urban areas in Zagazig district, Egypt. The present study was carried out on (859) school-children aged 6-13 years in Zagazig district all over the year 2013. They were subjected to stool examination. Out of them 100 suspected children were serotested for anti-TES IgG antibodies Toxocara spp. Soil samples also were collected from their places and regions. The results showed overall prevalence of parasitic infections was 21.07 % for helminthic infection and 39.46 % for protozoa. The prevalence of parasitic infections was more among children in rural areas (28, 49.2, 11.1 %) than those who live in urban areas (6.4, 18, 2.2 %) for helminths, protozoa and Toxocara as the most prevalent helminth respectively. Highly significant association was found between soil-transmitted helminthic infections detected by stool examination of the studied children group and the prevalence of geohelminthes in the examined soil samples, taken from residency areas of those children. This association was missed regarding protozoal infections. According to the results, low level of education and consequently poor socio-economic and hygienic conditions of families appear to be powerful determinants of infection. Thus, improving environmental sanitation is imperative for the control of soil-transmitted helminths.

Detection of the epidermal growth factor receptor, amphiregulin and epiregulin in formalin-fixed paraffin-embedded human placenta tissue by matrix-assisted laser desorption/ionization mass spectrometry imaging.

The study of the expression and the tissue distribution of the tyrosine kinase drug-target epidermal growth factor receptor (EGFR) is of interest in oncology as a marker of potential efficacy of treatment. It has been reported, however, that the response rates to anti-EGFR drugs are poorly linked to its expression. Clinical studies have also revealed a patient response correlation with the expression levels of two EGFR ligands; amphiregulin and epiregulin. Here, we report the development of a matrix-assisted laser desorption/ionisation mass spectrometry imaging methodology for the study of EGFR, epiregulin and amphiregulin distribution in formalin fixed paraffin embedded human placental tissue and a comparison to expression patterns obtained by immunohiostochemistry. Using on-tissue digests and imaging of specific peptides, the tissue distribution of these proteins has been obtained down to 30 microm spatial resolution.

Annulatascus nilensis sp. nov., a new freshwater ascomycete from the River Nile, Egypt.

Annulatascus nilensis sp. nov., from freshwater habitats in Egypt, is described, illustrated and compared to other species in the genus. Phylogenetic analyses of its LSU rDNA sequence with similar fungi placed the new species in the genus Annulatascus (Annulatascaceae, Sordariomycetidae incertae sedis). Annulatascus nilensis is characterized by immersed ascomata with an ascomatal neck oriented horizontally to the substrate surface, asci with a long, narrow stalk and massive bipartite apical ring, and 5-11-septate, hyaline ascospores surrounded by a large irregular, granular sheath that is not seen in water.