Therapeutic effect of autophagy induced by rapamycin versus intermittent fasting in animal model of fatty liver.

INTRODUCTION: High-fructose, high-fat diet consumption (HFHF) is one of the primary causes of non-alcoholic fatt liver disease (NAFLD), which is due to impaired beta-oxidation or apolipoprotein secretion by hepatocytes. Activation of autophagy in hepatocytes could be a therapeutic method against hepatic complications. This study was designed to compare effects of rapamycin and intermittent fasting-inducing autophagy in rats with experimentally induced nonalcoholic fatty liver. MATERIAL AND METHODS: Male rats were divided into five groups: C (control, n = 6), the experimental group (EX) subdivided, EXIa (HFHF, n = 6), EXIb (recovery, n = 6), EXII (rapamycin, n = 6) and EXIII (intermittent fasting, n = 6). All rats in the experimental group received HFHF diet for 8 weeks to induce nonalcoholic-fatty liver and obesity. Then, for the next 8 weeks the animals received either a daily oral dose of rapamycin (EXII group) or to intermittent fasting (IF) for 16 hours daily (EXIII group). Blood samples were drawn, and serum TG concentration as well as ALT and AST activities were determined. Hepatic sections were examined by light and electron microscopy. LC3B immunohistochemical staining, morphometric and statistical studies were performed. RESULTS: Subgroups EXIa (HFHF subgroup) and EXIb (Recovery subgroup) showed marked increase in TG, ALT, and AST levels associated with loss of normal hepatic architecture, cytoplasmic vacuolations and faint LC3B immunoreactivity. Ultrathin sections exhibited many autophagosomes in hepatocytes. On the other hand, rapamycin (EXII) and IF (EXIII) groups showed significant improvement to a variable extent in comparison to EXI groups. CONCLUSIONS: It could be concluded that rapamycin and intermittent fasting significantly improved NAFLD-induced changes of liver structure and function by inducing autophagy in hepatocytes.

Effect Of Corticosteroid And Immune-Suppressive Drugs On Oral Manifestations In Hospitalized COVID-19 Patients.

Objectives: To explore if the oral lesions in coronavirus disease-2019 patients are caused by the drugs used in the treatment or by the virus itself. Method: The cross-sectional study was conducted from September 2020 to September 2021 at the Kafrelsheikh University Hospital, Egypt, and comprised coronavirus disease-2019 patients of either gender aged 20-60 years having severe pneumonia and breathing difficulties who had no comorbidities. Based on the level of interleukin-6 and procalcitonin, the patients were classified into high group I receiving tocilizumab and methylprednisolone, medium group II receiving methylprednisolone alone, and low group III receiving antiviral drugs. The oral manifestations were recorded at the time of admission before treatment and at 2 weeks after the respective treatment. Data was analysed using SPSS 20. RESULTS: Of the 90 patients, 30(33.3%) were in group I; 16(%) males and 14(%) females with mean age 44.82±6.10 years. Group II had 27(%) patients; 14(%) males and 13(%) females with mean age 43.74±4.87 years. Group III had 33(%) patients; 9(%) males and 14(%) females with mean age 42.66±2.51 years (p>0.05). There was no significant difference among the groups at baseline and after 2 weeks of treatment regarding oral manifestations. Intragroup comparison demonstrated a significant difference in the two values in all the three groups (p<0.05). CONCLUSIONS: Oral lesions in coronavirus disease-2019 patients were caused by the virus itself rather than the drugs used in its treatment.

The Effect Of Interleukin-6 And Procalcitonin Level On The Development Of Oral Manifestation In Hospitalized COVID-19 Patients.

Objectives: To evaluate the effect of interleukin-6 and procalcitonin levels in plasma on the development of oral manifestation in patients of coronavirus disease-2019. Method: The case-control study was conducted from January to September 2021 at Kafrelsheikh University Hospital, Egypt, and comprised severe coronavirus disease.One hundred patients of either gender aged 30-60 years were included.. The patients were divided into two equal groups, with group I having patients with oral manifestations, and group II had those without any oral symptoms. Plasma samples from both the groups were used to determine serum interleukin-6 and procalcitonin levels using electrochemiluminescence immunoassay. Data was analysed using SPSS 20. RESULTS: Of the 100 patients, 50(50%) were in each of the two groups. Group I had 29(58%) males and 21(42%) females with overall mean age 44.83±6.12 years. Group II had 26(52%) males and 24(48%) females with overall mean age of 43.68±4.62 years. Interleukin 6 wassignificantly high in group I than in group II (p<0.05), while there was no significant difference between the groups for procalcitonin level (p>0.05). CONCLUSIONS: Interleukin-6 level could play an important role in the development of oral manifestation in coronavirus disease-2019 patients.

Does amyloid ß precursor protein gene expression have a role in diagnosis of biliary atresia?

Aim of the study: Biliary atresia (BA) is an important cause of surgical jaundice. Although the precise etiology is unknown, ß-amyloid (Aß) has been observed around the bile ducts in BA livers. It is unclear whether Aß plays a role in the pathogenesis of this disease. This study aims to assess the amyloid ß precursor protein (APP) gene expression in infants with BA in comparison with other causes of neonatal cholestasis. This could help explore the role of Aß in the pathogenesis and diagnosis of BA. Material and methods: A prospective study was conducted at the outpatient clinic of Paediatric Hepatology, Gastroenterology, and Nutrition Department, National Liver Institute, Menoufia University, Shebin El Kom, Menoufia, Egypt during the period March 2022 to December 2022. Clinical data were gathered and laboratory and radiological investigations were conducted including ß precursor protein gene expression measured in liver biopsies of the three groups using quantitative real-time PCR (qPCR). Results: Gene expression of APP was considerably higher in the BA group (p = 0.0001) compared to neonatal cholestasis (NC) patients. Gamma glutamyl transferase (GGT) and APP had a positive correlation (p = 0.001). No significant association was found between APP and fibrosis. APP was noticeably higher in BA than NC other than BA. Also, APP in BA was higher (statistically significant, p = 0.0001) than the control. There was no statistically significant difference among NC, BA, and control groups regarding APP (p = 0.07). Both males and females did not show significant differences as regards APP (p = 0.851). Age did not have a statistically significant correlation with APP (p = 0.532). Also, there were no correlations between APP and alkaline phosphatase (ALP), aspartate transaminase (AST), or total bilirubin (TB) (p > 0.05). Conclusions: We concluded that the development and identification of BA may depend on the liver expression of serum APP. Surgeons may be able to carry out early intraoperative cholangiography for BA confirmation if the combination of APP with GGT and other hepatic function parameters exhibits a high predictive potential as a diagnostic test for BA. To evaluate this hypothesis, more research with sizable sample numbers is necessary.

Histological and immunological insights to hydatid disease in camels.

PURPOSE: To investigate the immuno-histological evidences in viable and non-viable hydatid cysts obtained from naturally infected camels. METHODS: A cohort study (February 2018-December 2019), a total of 15 hydatidosis-infected camels from slaughter houses in Cairo were involved. Specimens were investigated for parasite viability, liver histological changes, IL-17A cytokine immunohistochemical expressions in the adventitial layer, and the anti-nuclear antibodies (ANAs) immunofluorescent expression in the metacestode's structures. Real-Time Quantitative -Morphocytometry and SPSS were utilized. RESULTS: Multi-focal lesions and high viability were found in 60% of the cases. Overall accumulation of collagen associated the parasite establishment that involved infiltrations of mononuclear cells with significantly increased IL-17A expression. Interestingly, the ANAs appeared to have a role in the immune-defense against the metacestode showing different patterns. ANAs production correlated with IL-17A expression and the viability of the parasite. CONCLUSION: IL-17A responses in hydatidosis is associated with collagen deposition and ANA production as a sort of anti-parasite immunity in a viability dependent manner.

Combined gemfibrozil (peroxisome proliferator-activated receptor alpha agonist) with reduced steroid dose gives a similar management picture as the full steroid dose in a rat adjuvant-induced arthritis model.

Objectives: The study aimed to evaluate the efficacy of combined gemfibrozil with prednisolone in the management of adjuvant-induced arthritis (AIA) rat model. Methods: Seventy two adult male Wistar albino rats were divided equally into 1-control group, three diseased groups: 2- Adjuvant induced arthritis (AIA), 3- high fat diet (HF), and 4- combined AIA-HF, and treated groups: 5- gemfibrozil 30 mg/kg treated AIA group (AIA-G) and the combined AIA-HF treated groups: 6- prednisolone equivalent to human 10 mg (AIA-HF-P10), 7- prednisolone equivalent to human 5 mg (AIA-HF-P5) 8- gemfibrozil (HF-AIA-G) and 9- combined treatment (HF-AIA-G-P5) Results: HF diet represents a precipitating factor for knee arthritis. Gemfibrozil improved the inflammatory findings in both AIA and AIA-HF groups. Combined administration of gemfibrozil with reduced steroid dose gave a similar therapeutic effect to the full steroid dose. Fortunately, we reported more reduction in the nuclear factor kappa-B (NF-κB) and high mobility group box 1 (HMGB1) in the HF-AIA-G-P5 compared with the HF-AIA-P10 group. The improvement was proved by the histological findings. Conclusion: Combined reduced prednisolone dose with gemfibrozil potentiates its anti-inflammatory activity. This could be a target in the management of rheumatoid arthritis.

Dentists' perception of primary health care services in family health and mother and child health clinics in Alexandria, Egypt.

This study compared dentists' perceptions of provided services in Family Health (FH) and Mother and Child Health (MCH) clinics. A questionnaire was distributed to 120 dentists in 7 FH and 4 MCH clinics in Alexandria, Egypt in 2012. The questionnaire assessed personal and professional background, perceptions of primary health care (PHC) role, types of services provided, patient recall and referral systems and perception of service quality. The response rate was 100%. More FH dentists perceived their role to include providing care for children and pregnant women. Restorations and scaling were provided by 90% of all dentists. More FH dentists reported providing simple extractions, paediatric extractions and multi-rooted endodontic treatment (P = 0.03, 0.001 and 0.001). In FH clinics, where the performance-based incentive system was implemented, a greater number of patients was served and there was a shift in the type of services provided although dentists had a less positive perception of quality aspects. Thus, there is a need for the establishment of a mission and clear guidelines for the FH clinics to guide service provision.

Dentists' perception of primary health care services in family health and mother and child health clinics in Alexandria, Egypt

This study compared dentists' perceptions of provided services in Family Health [FH] and Mother and Child Health [MCH] clinics. A questionnaire was distributed to 120 dentists in 7 FH and 4 MCH clinics in Alexandria, Egypt in 2012. The questionnaire assessed personal and professional background, perceptions of primary health care [PHC] role, types of services provided, patient recall and referral systems and perception of service quality. The response rate was 100%. More FH dentists perceived their role to include providing care for children and pregnant women. Restorations and scaling were provided by 90% of all dentists. More FH dentists reported providing simple extractions, paediatric extractions and multi-rooted endodontic treatment [P = 0.03, 0.001 and 0.001]. In FH clinics, where the performance-based incentive system was implemented, a greater number of patients was served and there was a shift in the type of services provided although dentists had a less positive perception of quality aspects. Thus, there is a need for the establishment of a mission and clear guidelines for the FH clinics to guide service provision

La présente étude avait pour objectif de comparer la perception des dentistes travaillant dans des établissements de santé de la famille et de santé maternelle et infantile vis-à-vis des services offerts. Un questionnaire a été distribué à 120 dentistes de sept cliniques de santé de la famille et de quatre dispensaires de santé maternelle et infantile à Alexandrie [Egypte] en 2012. Ledit questionnaire évaluait l'expérience personnelle et professionnelle, les perceptions du rôle des soins de santé primaires, les types de services offerts, les systèmes de rappel des patients et d'orientation-recours, ainsi que la perception de la qualité des services. Le taux de réponse a été de 100%. Davantage de dentistes des établissements de santé de la famille pensaient que leur rôle incluait la prestation de soins pour les enfants et les femmes enceintes. Les restaurations dentaires et le détartrage étaient offerts par 90% de tous les dentistes. Un plus grand nombre de dentistes en santé de la famille ont déclaré procéder à de simples extractions, à des extractions chez l'enfant et à un traitement endodontique des dents pluriradiculées [p = 0,03, 0,001 et 0,001]. Dans les cliniques de santé de la famille, où un système d'incitation reposant sur les performances était mis en place, un plus grand nombre de patients étaient traités, bien que les dentistes aient une moins bonne perception de la qualité. Il est donc nécessaire d'organiser une mission, ainsi que de mettre au point des directives claires pour les cliniques de santé de la famille, afin d'orienter la prestation de services

Histolgical and immunohistochemical study on the effect of stem cell therapy on bleomycin induced pulmonary fibrosis in albino rat.

AIM OF WORK: To demonstrate the bleomycin induced histological changes in the lung and the possible protective and/or therapeutic effect of stem cell therapy. MATERIALS AND METHODS: Study was carried out on 36 adult male albino rats, classified into 4 groups: group I (control), group II (bleomycin treated group), group III (early stem cell treated group: immediately after bleomycin), group IV (late stem cell treated group: 7 days after bleomycin). Sections were taken at the 14(th) day of experiment. stained with Hematoxylin and Eosin, Masson's trichrome, immunohistochemichal stains for α-SMA & PCNA. Sections were examined by light & immunofluroscent microscopy. Area percent of collagen fibers, area percent & optical density of α-SMA immunopositive cells were measured as well as the number of H&E and PCNA stained pneumocytes type II was counted. RESULTS: Group II showed, thickening of septa, extravasation of blood, dividing pneumocytes type II cells with acinar formation, cellular infiltration, fibroblast cells, almost complete loss of normal lung architecture in certain fields, consolidation and replacement of the lung tissue with fibrous tissue in other fields. Restoring of lung tissue with significant decrease in mean area % of collagen fibers, α-SMA immunopositive cells were detected in group III. CONCLUSIONS: Early treatment with bone marrow derived mesenchymal stem cells (BMSCs) immediately after bleomycin administration showed a significant reduction in fibrotic changes, however the late treatment with BMSCs (7 days) after bleomycin administration showed non significant results.