Real-world comparison of terlipressin vs. octreotide as an adjuvant treatment in the management of variceal bleeding

Variceal bleeding is a major complication and the leading cause of death in patients with cirrhosis and portal hypertension. This study aims to compare the efficacy and safety of terlipressin vs octreotide as an adjuvant to endoscopic management of patients with esophageal variceal bleeding in a real-time scenario. We reviewed the medical records of patients with esophageal variceal bleeding from January 2005 to December 2020 at our tertiary care Aga Khan University Hospital. Mortality was assessed after 6 weeks. A total of 842 patients with variceal bleed were evaluated. 624 patients (74.1%) and 218 patients (25.9%) received Terlipressin and Octreotide respectively. On multiple regression analysis, cardiac events during hospital stay (OR: 11.22), presence of Porto-systemic encephalopathy (OR: 3.79), and elevated bilirubin levels at the time of presentation were found to be independent risk factors for increased six weeks mortality. Moreover, cardiac events during hospital stay (OR: 3.26), Porto-systemic encephalopathy at presentation (OR: 3.06), and octreotide administration (OR: 1.80) were identified as independent risk factors for increased length of hospital stay. Terlipressin and Octreotide have similar outcomes in terms of control of bleeding, hospital stay, mortality, and side effects when used as adjuvant therapy for the management of variceal bleeding.

Understanding neuropsychiatric symptoms in Alzheimer's disease: challenges and advances in diagnosis and treatment

Neuropsychiatric symptoms (NPS) in Alzheimer's disease (AD) affect up to 97% of AD patients, with an estimated 80% of current AD patients experiencing these symptoms. Common AD-associated NPS include depression, anxiety, agitation, aggression, and apathy. The severity of NPS in AD is typically linked to the disease's progression and the extent of cognitive decline. Additionally, these symptoms are responsible for a significant increase in morbidity, mortality, caregiver burden, earlier nursing home placement, and greater healthcare expenditure. Despite their high prevalence and significant impact, there is a notable lack of clinical research on NPS in AD. In this article, we explore and analyze the prevalence, symptom manifestations, challenges in diagnosis, and treatment options of NPS associated with AD. Our literature review reveals that distinguishing and accurately diagnosing the NPS associated with AD remains a challenging task in clinical settings. It is often difficult to discern whether NPS are secondary to pathophysiological changes from AD or are comorbid psychiatric conditions. Furthermore, the availability of effective pharmaceutical interventions, as well as non-pharmacotherapies for NPS in AD, remains limited. By highlighting the advance and challenges in diagnosis and treatment of AD-associated NPS, we aspire to offer new insights into the complexity of identifying and treating these symptoms within the context of AD, and contribute to a deeper understanding of the multifaceted nature of NPS in AD.

Activation of a novel α2AAR-spinophilin-cofilin axis determines the effect of α2 adrenergic drugs on fear memory reconsolidation

Posttraumatic stress disorder (PTSD) after the pandemic has emerged as a major neuropsychiatric component of post-acute COVID-19 syndrome, yet the current pharmacotherapy for PTSD is limited. The use of adrenergic drugs to treat PTSD has been suggested; however, it is hindered by conflicting clinical results and a lack of mechanistic understanding of drug actions. Our studies, using both genetically modified mice and human induced pluripotent stem cell-derived neurons, reveal a novel α2A adrenergic receptor (α2AAR)-spinophilin-cofilin axis in the hippocampus that is critical for regulation of contextual fear memory reconsolidation. In addition, we have found that two α2 ligands, clonidine and guanfacine, exhibit differential abilities in activating this signaling axis to disrupt fear memory reconsolidation. Stimulation of α2AAR with clonidine, but not guanfacine, promotes the interaction of the actin binding protein cofilin with the receptor and with the dendritic spine scaffolding protein spinophilin to induce cofilin activation at the synapse. Spinophilin-dependent regulation of cofilin is required for clonidine-induced disruption of contextual fear memory reconsolidation. Our results inform the interpretation of differential clinical observations of these two drugs on PTSD and suggest that clonidine could provide immediate treatment for PTSD symptoms related to the current pandemic. Furthermore, our study indicates that modulation of dendritic spine morphology may represent an effective strategy for the development of new pharmacotherapies for PTSD.

941 The Effect of COVID-19 on Orthopaedic Trauma Theatre Efficiency and Surgical Training in the North and East of Scotland Major Trauma Centres – a Year On

Aim

To determine the orthopaedic trauma theatre efficiency in two large major trauma centres (MTCs) in Scotland before and after the outbreak of Coronavirus disease (COVID-19) pandemic.

Method

All trauma patients presented to the North and East of Scotland's MTCs prior to the outbreak of COVID-19 (7th May to 7th June 2019), during the first peak of COVID-19 (7th May to 7th June 2020), after Aerosol Generating Procedures updates (7th November to 7th December 2020) and the ‘new normal’ (7th May to 7th June 2021) were retrospectively reviewed. Training opportunities and theatre time were compared. The Kruskall-Wallis test was used.

Results

There were no significant differences in the length of hospital stay (p=0.117, 0.065) and time from injuries and surgery within groups in both MTCs (p=0.508, 0.384). The pandemic has negatively affected the anaesthetic and surgical preparation time, time between end of procedure and send for next case, and turnover time, with more profound effect on the North of Scotland's MTC. The trainee's involvement as main surgeon had decreased with the outbreak of the pandemic, with the junior trainees being affected most severely in North of Scotland. The time taken for patient to arrive to theatre after sending and total downtime were twice as long in the North of Scotland.

Conclusion

The COVID-19 pandemic has negatively impacted the orthopaedic trauma theatre efficiency and training opportunities. Actions should be taken to improve the turnover time to maximise theatre efficiency while prioritizing training opportunities.

947 COVID19 and Its Impact on the North and East of Scotland Orthopaedic Trainees

Aim

We conducted a trainee survey at the first peak of the pandemic to investigate the impact of COVID-19 on the North of Scotland (NoS) and East of Scotland (EoS) orthopaedic trainees.

Method

An online survey was distributed to all NoS and EoS orthopaedic trainees. All data collection was anonymous.

Results

Across both Scottish deaneries, 28 trainees had responded: 39% from EoS and 61% from NoS. Trainees at all stages of training responded to the survey, with the most responses received from specialist trainees in third year of training (ST3) (25%). In response to the pandemic, 18% of trainees had been redeployed and they were from NoS. Since the reconfiguration of service, 18% of trainees had done >20 operations in a month and they were senior trainees. If COVID-19 outbreak is likely going to reduce operating opportunities for a long period, only 36% of trainees would be open to the idea of making standard surgical specialty training longer whereas 57% of trainees would be open to longer working hours to achieve certification in Trauma and Orthopaedic surgery within 96 months.

Conclusion

The outbreak of COVID-19 has impacted both deaneries orthopaedic training and urgent restoration of surgical training is essential for individual trainees. Changes in working practices necessitated by COVID-19 have known to impact theatre efficiency. Actions should be taken to improve the theatre efficiency while prioritizing training opportunities.

ARID1A-deficient bladder cancer is dependent on PI3K signaling and sensitive to EZH2 and PI3K inhibitors

Metastatic urothelial carcinoma is generally incurable with current systemic therapies. Chromatin modifiers are frequently mutated in bladder cancer, with ARID1A-inactivating mutations present in about 20% of tumors. EZH2, a histone methyltransferase, acts as an oncogene that functionally opposes ARID1A. In addition, PI3K signaling is activated in more than 20% of bladder cancers. Using a combination of in vitro and in vivo data, including patient-derived xenografts, we show that ARID1A-mutant tumors were more sensitive to EZH2 inhibition than ARID1A WT tumors. Mechanistic studies revealed that (a) ARID1A deficiency results in a dependency on PI3K/AKT/mTOR signaling via upregulation of a noncanonical PI3K regulatory subunit, PIK3R3, and downregulation of MAPK signaling and (b) EZH2 inhibitor sensitivity is due to upregulation of PIK3IP1, a protein inhibitor of PI3K signaling. We show that PIK3IP1 inhibited PI3K signaling by inducing proteasomal degradation of PIK3R3. Furthermore, ARID1A-deficient bladder cancer was sensitive to combination therapies with EZH2 and PI3K inhibitors in a synergistic manner. Thus, our studies suggest that bladder cancers with ARID1A mutations can be treated with inhibitors of EZH2 and/or PI3K and revealed mechanistic insights into the role of noncanonical PI3K constituents in bladder cancer biology.

Competing risks survival data under middle censoring-An application to COVID-19 pandemic

Survival data is being analysed here under the middle censoring scheme, using specifically quantile function modelling under competing risks. The use of middle censoring scheme has been shown to be very appropriate under the COVID-19 pandemic scenario. Cause-specific quantile inference under middle censoring is employed. Such quantile inferences are obtained through cumulative incidence function based on cause-specific proportional hazards model. The baseline lifetime is assumed to follow a very general parametric model namely the Weibull distribution, and is independent of the censoring mechanism. We obtain estimates of the unknown parameters and cause specific quantile functions under classical as well as a Bayesian set-up. A Monte Carlo simulation study assesses the relative performance of the different estimators. Finally, a real life data analysis is given for illustration of the proposed methods.

Dietary Catharanthus roseus modulates intestinal microarchitecture in broilers

The study evaluated the efficacy of ethanolic extracts of Catharanthus roseus (C. roseus) in altering growth performance, viscera  development and intestinal microarchitecture in broilers. Day-old broiler chicks (n = 175) were randomly divided into seven groups (n = 25/group) with 5 replicates (n = 5). The chicks in the control groups were fed a corn-soya-based basal diet, whereas groups 2 - 4 had the same basal diets supplemented with 0.05%, 0.1%, and 0.2% ethanolic leaf extracts (ELE), respectively. Chicks in groups 5 - 7 were fed the basal diet supplemented with 0.05%, 0.1%, and 0.2% ethanolic root extracts (ERE) of C. roseus, respectively. The growth performance and feed conversion ratio remained unchanged, but feed consumption of birds supplemented with 0.1% ERE increased in weeks 1 and 3. The relative length of the small intestine was lower in the 0.05% ERE group compared with the control. Villus height, width, surface area, and lamina propria thickness were higher in the 0.1% ERE group in all three segments of the small intestine than in the control. Broilers supplemented with 0.1% ERE performed better in terms of feed consumption and improved intestinal microarchitecture of the small intestine.

Orthopaedic assessment unit: a service model for the delivery of orthopaedic trauma care in a major trauma centre during the global pandemic (COVID-19)

INTRODUCTION

We describe a new service model, the Orthopaedic Assessment Unit (OAU), designed to provide care for trauma patients during the COVID-19 pandemic. Patients without COVID-19 symptoms and isolated musculoskeletal injuries were redirected to the OAU.

METHODS

We prospectively reviewed patients throughput during the peak of the global pandemic (7 May 2020 to 7 June 2020) and compared with our historic service provision (7 May 2019 to 7 June 2019). The Mann-Whitney and Fisher Exact tests were used to test the statistical significance of data.

RESULTS

A total of 1,147 patients were seen, with peak attendances between 11am and 2pm; 96% of all referrals were seen within 4h. The majority of patients were seen by orthopaedic registrars (52%) and nurse practitioners (44%). The majority of patients suffered from sprains and strains (39%), followed by fractures (22%) and wounds (20%); 73% of patients were discharged on the same day, 15% given follow up, 8% underwent surgery and 3% were admitted but did not undergo surgery. Our volume of trauma admissions and theatre cases decreased by 22% and 17%, respectively (p=0.058; 0.139). There was a significant reduction of virtual fracture clinic referrals after reconfiguration of services (p<0.001).

CONCLUSIONS

Rapid implementation of a specialist OAU during a pandemic can provide early definitive trauma care while exceeding national waiting time standards. The fall in trauma attendances was lower than anticipated. The retention of orthopaedic staff in the department to staff the unit and maintain a high standard of care is imperative.

Evaluation of serum analytes in pregnant and non-pregnant dairy cows as indicators of pregnancy

This study was conducted to reveal the dynamics of haematological indicators in pregnant and non-pregnant dairy cows. Sixty multiparous healthy dairy cows were divided into four groups based on the length of time they had been pregnant, namely first, second and third trimesters, and non-pregnant (n=15 each). Blood was collected from each animal, and serum was harvested and stored at -20 °C for biochemical profiling. Concentrations of serum total oxidants (TOC), ceruloplasmin oxidase (CpO) and triiodothyronine (T3) were higher (P <0.05) during the third trimester compared with non-pregnant cows. Serum arylesterase (Ary) concentration was lower (P <0.05) during the second and the third trimesters compared with the non-pregnant cows. The concentration of serum total homocysteine (tHcy) was higher (P <0.05) the third trimester compared with the first and the second trimesters. The concentrations of serum total antioxidants (TAC), paraoxonase 1 (PON1), thyroxine (T4), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were not different in the pregnant and the non-pregnant cows. Thus, TOC, Ary, CpO, tHcy and T3 could be taken as biological markers to assess the progression of pregnancy and to develop management tools to improve health status during late gestation in dairy cows Keywords: ceruloplasmin, hepatic enzymes, late gestation, triiodothyronine

Synthesis of CuO-NPS by simple wet chemical method using various dicarboxylic acid salts as precursors: Spectral characterization and in-vitro biological evaluation

In this study, a simple chemical reduction method was employed to synthesize CuO-NPs.  Various dicarboxylic acids were converted into Cu(II) salt of dicarboxylic acid which were used as precursors. NPs were produced by reducing precursors with NaBH4. Characteristics of synthesized NPs were investigated by using important analytical techniques including Fourier transform infrared (FTIR) spectroscopy, X-ray diffraction (XRD), thermo gravimetric analysis (TGA) and scanning electron microscopy (SEM). Developed NPs were investigated for their antibacterial activity against a range of bacterial strains by employing agar well diffusion method. CuO-NPs exhibited good to moderate activity against E-Coli, B. Subtilis and poor activity against K. pneumonia and Methicillin-resistant Staphylococcus aureus (MRSA). It was found that amongst all experienced compounds sample 2 showed good activity with minimum inhibition concentration (MIC) 10 µg/mL (zone of inhibition: 22± 0.12 mm) while sample 3 showed poor activity with MIC 40 µg/mL (zone of inhibition: 8.0 ± 0.18 mm).                     KEY WORDS: CuO-NPs, Dicarboxylic acids, Sodium borohydride, Antibacterial study   Bull. Chem. Soc. Ethiop. 2020, 34(2), 323-334 DOI: https://dx.doi.org/10.4314/bcse.v34i2.10

Spinal epidural abscesses - The role for non-operative management: A systematic review

BACKGROUND

Spinal Epidural Abscesses (SEAs) are traditionally seen as a surgical emergency. However, SEAs can be discovered in entirely asymptomatic patients. This presents a dilemma for the attending clinician as to whether to subject these patients to significant surgery. This systematic review updates the evidence surrounding the efficacy of non-operative SEA management by means of intravenous antibiotics ± radiologically-guided aspiration.

AIMS

1. To assess failure rates of medical therapy for SEA. The absolute definition of 'failure' used by the study was recorded, and comparisons made. 2. To review of risk factors for success/failure of medical treatment for SEA.

METHODS

A database search with the MESH term 'epidural abscess' and keywords ['treatment' OR 'management'] were used.

RESULTS

14 studies were included. The number of SEA patients managed non-operatively ranged from 19 to 142. There was significant heterogeneity across the studies. Pooled Failure of Medical Therapy (FMT) (defined as any poor outcome) was 29.40%. When FMT = mortality the pooled rate was 11.49%. Commonly cited risk factors for FMT included acute neurological compromise, diabetes mellitus, increasing age and Staphylococcus aureus.

CONCLUSION

SEA will always be a condition mostly managed surgically. Despite this, there is growing evidence that non-operative management can be possible in the correct patients. The key is in patient selection - patients with any of the above-mentioned risk factors have the potential to deteriorate further on medical treatment and have a worse outcome than if they had undergone emergency surgery straight away. Ongoing research will hopefully further investigate this crucial step.

Effect of maternal yeast feeding on dam performance and serum health biomarkers of Beetal goat kids

Supplementation with dietary yeast has improved digestibility and productive performance in ruminants. In this research the primary objective was to appraise the effects of dietary yeast supplementation of female goats during the transition period on milk composition and yield and on production and serum health biomarkers of their kids. Twenty-four Beetal goats (4 ± 1.2 years) were randomly assigned to three groups, which received 0, 5, and 10 grams/animal/day of live dried yeast Saccharomyces cerevisiae for 60 days (30 days pre- and post-partum). All goats were fed 500 grams of concentrate with water and green fodder ad libitum. Milk samples were collected at 7, 14, 21, and 28 days post kidding. Kids were weighed on days 0, 7, 15, 22, and 30, and blood samples were collected on days 15 and 30 for serum metabolites (glucose, urea, cholesterol, non-esterified fatty acids (NEFA), serum total proteins, albumin, globulin, albumin to globulin ratio, serum oxidant and antioxidant activity (malondialdehyde) (MDA) and catalase), and liver enzymes aspartate aminotransferase (AST) and alanine transaminase (ALT) assessment. Milk yield was significantly (P =0.02) higher during the post-partum period in yeast-fed goats. Yeast-fed goats also produced milk containing more fat (P <0.001) and protein (P <0.001) compared with control goats. Birth weight, average daily gain, and serum health biomarkers of the kids were not influenced by the treatments. In conclusion, dietary yeast supplementation resulted in increased production performance of the dams without significant impact on their offspring.Keywords: average daily gain, catalase activity, hepatic enzymes, milk production, Saccharomyces cerevisiae, transition period

Effects of endocrine disruptor furan on reproductive physiology of Sprague Dawley rats: An F1 Extended One-Generation Reproductive Toxicity Study (EOGRTS)

The present study investigated the reproductive toxicity of furan in an Extended One-Generation Reproductive Toxicity Study in rats. Sprague Dawley F0 weaning rats (30 per sex per group) were exposed to furan orally at 0, 1, 2.5, 5, and 10 mg kg^-1 for 10 weeks (males) and 2 weeks (females) and then mated. Results of F0 indicated that in the furan-treated groups (5 mg kg^-1 and 10 mg kg^-1), body weight (bw) gain decreased during prebreed and gestational period while increased during lactation periods. F0 animals prebreeding exposure resulted in head tilt and foot splay at 10 mg kg^-1. Number of live pups at birth were decreased (p < 0.001) at 10 mg kg^-1. At postnatal day (PND) 70, a significant (p = 0.03) decrease in testosterone levels of male rats and estrogen levels of female rats (p = 0.05) was observed in 10 mg kg^-1 furan-treated group in F1 generation. Luteinizing hormone, follicle-stimulating hormone, and progesterone levels were also reduced, but their reduction was not statistically significant in all groups. In higher dose furan group (10 mg kg^-1), testicular and ovarian weights were reduced in F1 generation at PND 70, with decreased daily sperm production (p = 0.01) and disturbed estrous cyclicity (p < 0.01). Some histopathological changes were also observed in testis and ovaries in groups whose parents were previously exposed to 10 mg kg^-1 bw of furan group. Based on the above results, it is suggested that exposure to food-based contaminant furan induced remarkable changes in the F0 (parental stage) and F1 (offspring, pubertal, and adult stage) generations of Sprague Dawley rats.

Supplemental chromium-loaded chitosan nanoparticles affect growth, serum metabolites and intestinal histology in broilers

The goal of the present research was to evaluate the effects of chromium-loaded chitosan nanoparticles (Cr-CNPs) on production performance, viscera development, serum metabolites and intestinal histology in broilers. Two hundred (200) day-old broilers were randomly divided into five groups with five replicates (n = 8). Birds in the first group served as control and were fed a corn soybean-based diet, while the remaining four supplemented groups were offered 200, 400, 800, and 1200 μg Cr-CNPs/kg of feed, respectively, for 35 days. Weight gain, feed intake and feed conversion ratio (FCR) remained unaffected with Cr-CNP supplementation. No changes were observed in the relative weights of viscera. The relative length of the small intestine was decreased in birds supplemented with 200 and 800 μg Cr-CNPs/kg compared with the 1200 μg Cr-CNP-supplemented group and control. Serum metabolites remained unaffected with Cr-CNP supplementation except for serum HDL, which was increased. Cr-CNPs decreased the retention of chromium in the bone at higher concentrations. Jejunal villus height, villus surface area, and villus height to crypt depth ratio were increased in the 800 μg Cr-CNP-supplemented group. In conclusion, Cr-CNPs did not affect growth performance, viscera development, and most of the serum metabolites, but enhanced jejunal morphological attributes at 800 μg Cr-CNPs/kg of feed. Keywords: blood biochemistry, health, nano-biotechnology, prebiotics, poultry, trace mineral

Immunosuppressant drug tacrolimus induced mitochondrial nephrotoxicity, modified PCNA and Bcl-2 expression attenuated by Ocimum basilicum L. in CD1 mice

Tacrolimus (TAC) is used sporadically as an immunosuppressive agent for organ transplantation, but its clinical used is limited due to its marked nephrotoxicity. Ocimum basilicum L. (Lamiaceae) (OB) had been shown to possess antioxidant, anti-inflammatory and nephroprotective activity, and effective at improving renal inflammation and glomerular. In our study, we aim to evaluate the efficacy of the OB against TAC-induced mitochondrial nephrotoxicity in CD1 mice. Mice were randomly divided into four groups. Group 1 (control group); administered orally with normal saline (1 mL/kg) for two weeks; Group 2 (OB extract treated-group) (500 mg/kg b.wt) gavaged once/day for two weeks; Group 3 (TAC-treated group) (3 mg/kg b.wt, administered ip once a day for two weeks); and Group 4; (TAC plus OB extract treated-group). Tacrolimus-induced nephrotoxicity was assessed biochemically and histopathologically. The OB extract was high in phenolic content (50.3 mg/g of gallic acid equivalent), total flavonoids (14.5 mg/g CE equivalent). The potential antioxidant efficacy of the extract (IC50) was 24.5 μg/mL. OB pretreatment significantly improved the TAC-induced changes in biochemical markers of nephrotoxicity for instance blood urea nitrogen (BUN), creatinine, total protein, and albumin (P < 0.01, when compared with TAC treated group). Also, it significantly restored the increase activities of TBARS, protein carbonyl (PC) (P < 0.001, when compared to healthy control group) and decreased activities of nonprotein thiol (NP-SH) levels, Mn-superoxide dismutase (Mn-SOD) and glutathione peroxidase (GPx) antioxidants of mitochondria. The nephroprotective efficacy of the OB leaves extract was further evident by histopathological analysis together with the PCNA-ir and Bcl2. The upshot of the present study revealed that the OB possessed significant antioxidant and nephroprotective activity and had a preventive effect on the biochemical alterations and histological changes in TAC-treated mice.

Ischemic preconditioning attenuates acute lung injury after partial liver transplantation

Pulmonary complications frequently occur after liver transplantation and are often life-threatening. Thus, we investigated whether hepatic ischemic preconditioning (IP) attenuates acute lung injury (ALI) after small-for-size liver transplantation. Rat livers were explanted after 9-min ischemia plus 5-min reperfusion, reduced to 50% of original size ex vivo, and implanted into recipients with approximately twice the donor body weight, resulting in quarter-size liver grafts (QSG). After QSG transplantation, hepatic Toll-like receptor 4 (TLR4) and tumor necrosis factor-α (TNFα ) expression increased markedly and high mobility group box-1 (HMGB1), an endogenous damage-associated molecular pattern molecule (DAMP), was released from QSG into the blood. IP blunted TLR4 and TNFα expression and HMGB1 release from QSG. In the lungs of QSG recipients without IP treatment, nuclear factor-κB (NF-κB) activation and intercellular adhesion molecule (ICAM)-1 expression increased; alveolar septal walls thickened with increased cellularity as neutrophils, monocytes/macrophage and T lymphocytes infiltrated into alveolar septa and alveolar spaces; and pulmonary cleaved caspase-8 and -3 and TUNEL-positive cells increased. In contrast, in the lungs of recipients of ischemic-preconditioned QSG, NF-κB activation and ICAM-1 expression were blunted; leukocyte infiltration was decreased; and alveolar septal wall thickening, caspase activation, and cell apoptosis were attenuated. IP did not increase heat-shock proteins in the lungs of QSG recipients. In conclusion, toxic cytokine and HMGB1 released from failing small-for-size grafts leads to pulmonary adhesion molecule expression, leukocyte infiltration and injury. IP prevents DAMP release and toxic cytokine formation in small-for-size grafts, thereby attenuating ALI.

Effect of Moringa oleifera leaf powder supplementation on growth performance and intestinal morphology in broiler chickens

Due to public health hazards of subtherapeutic use of antibiotics in poultry feed, there is a need for alternatives. Moringa oleifera is a phytobiotic, which is reported to possess antimicrobial and immuno-modulatory properties. This study aimed to investigate effects of M. oleifera leaf powder (MOLP) supplementation on growth performance and intestinal microarchitecture of broiler chickens. Day-old broiler chicks (n = 100) were randomly divided into five groups with four replicates each having five birds. Birds were fed a corn-based basal diet or the same diet supplemented with 0.6, 0.9, 1.2 and 1.5% MOLP. Body weight and feed conversion ratio were recorded on weekly basis. On day 35, two birds per replicate were selected to collect samples of duodenum, jejunum, ileum, caecal tonsils and bursa of Fabricius. Tissue samples were stained with haematoxylin and eosin or combined alcian blue and PAS technique. Supplementation of MOLP had no effect on feed intake, feed conversion ratio, bursa weight and intra-epithelial lymphocytes (IEL) count. Birds fed with 1.2% MOLP had higher (p < 0.05) body weight, length and empty weight of small intestine, and weight of empty and filled ceca. Villus height (duodenum, jejunum, ileum), villus surface area (duodenum) and villus height:crypt depth (ileum) were higher (p < 0.05) in 1.2% MOLP group compared with non-supplemented group. In duodenum, total goblet cell count was higher (p < 0.05) in all the supplemented groups when compared with non-supplemented birds. Acidic mucin count was higher (p < 0.05) in duodenum, jejunum and ileum of 1.2% MOLP group compared with the control group. Bursal follicle count was higher (p < 0.05) in 1.2% MOLP group compared with non-supplemented group. In conclusion, dietary supplementation of 1.2% MOLP modulated intestinal microarchitecture and acidic mucin production without any apparent effect on growth.

Ecological variations and role of heat shock protein in Artemisia judaica L. in response to temperature regimes of Tabuk, Saudi Arabia

Artemisia judaica L. (Compositae) are shrubby herbs growing wildly in Tabuk region and distributed in the desert regions. This region is characterized by extremely variable environmental conditions where the temperature varies from extreme low to extreme high. These temperature regimes have a profound effect on morphology, growth physiology and biochemistry of the plants. The plant samples were collected from Tabuk-Jordan road (760 m above sea level) in the month of January, April, July and October 2013 to evaluate the effect of temperature dynamics on A. judaica L. in four different seasons. Physiological, biochemical alterations and heat shock proteins (HSPs) were studied during these seasons in order to evaluate the environmental adaptation and stress tolerance in response to temperature variations. Plant growth parameters showed a significant increase in height, fresh and dry matter accumulation, total chlorophyll, nitrogen, phosphorus, potassium, artemisinin and leaf relative water contents investigated in the month of April and October. Growth of plant was suppressed and an active role of carbonic anhydrase (CA), catalase (CAT), peroxidase (POD) and superoxide dismutase (SOD) was observed to cope with the extreme low temperature in January and extreme high temperature in July 2013. However, the plants collected in October and April did not show a statistical difference. Inductions in the expression of HSP90 were recorded in all the plants collected during April and October 2013 with no statistically significant difference. Therefore, based on the results it is recommended that during April and October the environmental conditions are best suitable for growth, development and medicinal use of Artemisia.

Pressure flow pattern of varicocele veins and its correlation with testicular blood flow and semen parameters

The pressure pattern in varicocele veins of infertile patients and its correlation with semen quality and testicular blood flow was determined. Consecutive patients at andro-urology clinic of a teaching hospital undergoing microsurgical varicocelectomy were included. Their semen quality and testicular blood flow were determined. Peak systolic velocity (PSV) and resistive index (RI) of subcapsular and intraparenchymal branches of testicular artery were noted by colour Doppler ultrasonography. During surgery before ligation of varicocele veins, intravenous pressures of internal spermatic (ISV) and external spermatic (ESV) veins were determined at baseline and after Valsalva manoeuvre. Thirty patients, 20-45 years old, were evaluated. Baseline pressure for maximum dilated ISV (A), less dilated ISV (B) and ESV was 15.93 ± 6.34, 12.38 ± 4.60 and 12.92 ± 5.65 mm. Hg, respectively, which increased after Valsalva by 104.4%, 116.2% and 38.22% respectively. Correlation (r = -.71; p < .05) was appreciated between percentage increase in pressure of ISV B with PSV of intraparenchymal testicular arteries and progressive motility (r = -.759; p < .05), nonprogressive motility (r = -.738; p < .05) and morphology (r = -.653; p = .07) of spermatozoa. In conclusion, ISV develops higher pressure on Valsalva as compared to ESV and has correlation with semen quality and testicular blood flow.

8-pCPT-cGMP prevents mitochondrial depolarization and improves the outcome of steatotic partial liver transplantation

Permeant cGMP analogs prevent the mitochondria permeability transition (MPT) in vitro. In this study, we explored whether 8-pCPT-cGMP prevents the MPT and decreases post-transplant damage to fatty partial liver grafts (FPG) in vivo. Rats were fed a control or high-fat, high-fructose diet for 2-week. Lean and fatty liver explants were reduced in size ex vivo to ~35% and stored in the University of Wisconsin solution with and without 8-pCPT-cGMP (300 µM) for 2 h. After transplantation, alanine aminotransferase release (indicator of hepatocellular injury), hyperbilirubinemia (indicator of poor liver function), and cell death were all higher in FPG than in lean partial grafts (LPG). Liver regeneration increased in LPG but was suppressed in FPG. 8-pCPT-cGMP blunted graft injury, improved liver regeneration and function, and increased survival of FPG. Hepatic mitochondrial depolarization detected by intravital multiphoton microscopy of rhodamine 123 in living rats was ~3.5-fold higher in FPG than in LPG. 8-pCPT-cGMP decreased mitochondrial depolarization in FPG almost to the level of LPG. Activation of mammalian target of rapamycin (mTOR), an energy sensitive kinase that stimulates cell proliferation and growth, and p70S6 kinase, a downstream signaling molecule of mTOR, was increased in LPG but suppressed in FPG. 8-pCPT-cGMP restored the activity of mTOR and p70S6 kinase in FPG. 8-pCPT-cGMP also increased activation of cAMP response element-binding protein (CREB) and expression of cyclins D1 and E in FPG. Non-alcoholic steatosis increases injury and suppresses regeneration after partial liver transplantation, at least in part, due to more severe mitochondrial dysfunction. Protection of mitochondria with a cGMP analog effectively improves outcomes of FPG transplantation.

Additive toxic effect of deltamethrin and cadmium on hepatic, hematological, and immunological parameters in mice

Exposure to natural and man-made environmental toxins concurrently can pose a greater threat to multiple organs. In the present work, we investigated interactions between deltamethrin (DM) and cadmium (Cd), whose mechanisms of action in humans are poorly understood. Albino mice were randomly divided into four groups, each containing six mice: saline as control, DM-treated, cadmium chloride (CdCl₂)-treated, and CdCl₂ plus DM treated. After 2 weeks of treatment biochemical and hematological effects, total leukocyte count (TLC), differential leukocyte count, humoral-mediated immune responses, and histopathological studies were conducted. Mice exposed to DM and Cd showed a significant increase in aspartate aminotransferase (AST) and alanine aminotransferase (ALT). Also, DM and Cd administration resulted in suppression of humoral immunity, erythrocyte count, hemoglobin, hematocrit, and TLC. Histopathological evidence revealed hepatic damage, supporting the AST and ALT findings. Cd and DM exhibited an additive type of toxicity. It could be concluded that these toxins either target different cellular pathways, or the individual amounts used in this study were not enough to saturate the toxicological target, thus producing additive effects.

The mitochondria-targeted antioxidant MitoQ attenuates liver fibrosis in mice

Oxidative stress plays an essential role in liver fibrosis. This study investigated whether MitoQ, an orally active mitochondrial antioxidant, decreases liver fibrosis. Mice were injected with corn oil or carbon tetrachloride (CCl4, 1:3 dilution in corn oil; 1 µl/g, ip) once every 3 days for up to 6 weeks. 4-Hydroxynonenal adducts increased markedly after CCl4 treatment, indicating oxidative stress. MitoQ attenuated oxidative stress after CCl4. Collagen 1α1 mRNA and hydroxyproline increased markedly after CCl4 treatment, indicating increased collagen formation and deposition. CCl4 caused overt pericentral fibrosis as revealed by both the sirius red staining and second harmonic generation microscopy. MitoQ blunted fibrosis after CCl4. Profibrotic transforming growth factor-β1 (TGF-β1) mRNA and expression of smooth muscle α-actin, an indicator of hepatic stellate cell (HSC) activation, increased markedly after CCl4 treatment. Smad 2/3, the major mediator of TGF-β fibrogenic effects, was also activated after CCl4 treatment. MitoQ blunted HSC activation, TGF-β expression, and Smad2/3 activation after CCl4 treatment. MitoQ also decreased necrosis, apoptosis and inflammation after CCl4 treatment. In cultured HSCs, MitoQ decreased oxidative stress, inhibited HSC activation, TGF-β1 expression, Smad2/3 activation, and extracellular signal-regulated protein kinase activation. Taken together, these data indicate that mitochondrial reactive oxygen species play an important role in liver fibrosis and that mitochondria-targeted antioxidants are promising potential therapies for prevention and treatment of liver fibrosis.

Recent incidence and descriptive epidemiological survey of breast cancer in Saudi Arabia

Objectives:

To review and analyze the pattern of breast cancer (BC) in the Kingdom of Saudi Arabia (KSA).

Methods:

A retrospective descriptive epidemiological review of BC of all diagnosed Saudi female cases from January 1990 to December 2014 was conducted at the Faculty of Sciences, Department of Biology, University of Tabuk, Tabuk, KSA. This report contains information obtained from the Saudi Cancer Registry and from King Faisal Specialist Hospital and Research Center.

Results:

The number of women with BC increased steadily from 1990-2010. On the basis of the number of cases, the percentage distribution of BC appears to be increasing. There were 1152 female BC cases in 2008 in comparison with 1308 in 2009, and 1473 in 2010. Breast cancer ranked first among females accounting for 27.4% of all newly diagnosed female cancers (5378) in the year 2010. The average age at the diagnosis of BC was 48; weighted average was 49.8, and range 43-52.

Conclusion:

Among Saudi patients, there was a significant increase in the number of cases of BC, which occurs at an earlier age than in Western countries. Continued vigilance, mammographic screening, and patient education are needed to establish early diagnosis and perform optimal treatment.