Evaluation of stool and urine parameters correlation to CRP and D-dimer in COVID-19 infected adults and their contact children

Aim: Aim is to depict suggestive urine and stool parameters in asymptomatic suspected contact children living with COVID-19 infected adults. These parameters will facilitate identifying  children who deserve the confirmatory diagnosis of COVID-19 by PCR test.  Methods: Study was conducted in the National Hepatology and Tropical Medicine Research institute (NHTMRI) Cairo, Egypt. It included 66 mild COVID-19 adult patients (group1) and their 82 asymptomatic contact children (group 2). Results:  In group 1, both C reactive protein (CRP) and D-dimer levels were significantly high. C reactive protein was significantly positively correlated with urinary microalbumin> 30, albumin/ creatinine ratio and urine pus >10 cells / HPF and significantly negatively correlated with vitamin C. D-dimer was significantly negatively correlated with vitamin C. In group 2, CRP and D-dimer were significantly negatively correlated with urine specific gravity (SG), urinary vitamin C. CRP was significantly negatively correlated with stool pus > 10 cells/ HPF, while D-dimer was significantly positively correlated with stool occult blood.   Receiver Operating Curve (ROC) analysis revealed that urine SG showed the highest area under the curve (AUC); 0.859, 0.96, sensitivity of 100%, 100% and specificity of 71.8%, 77.8% with reference to D-dimer and CRP; respectively. Conclusions: In contact children of adult COVID-19 proved infection, urine SG, stool occult blood and stool pus > 10 cells/ HPF can be feasible tool for suspected COVID-19 infection, based on its results COVID-19 PCR request can be an imperative option to confirm the diagnosis; particularly in developing countries where detection of COVID -19 by PCR is not readily feasible.COVID19; urine; stool; childre

Possible Potentiation by Certain Antioxidants of the Anti-Inflammatory Effects of Diclofenac in Rats

In the present study, we investigated the potential beneficial impact of the addition of antioxidant supplements to diclofenac regimen in a model of carrageenan-induced paw. Rats were treated daily with antioxidants, that is, a-lipoic acid (50 mg/kg), selenium (2.5 mg/kg), vitamin C (1 g/kg), vitamin E (300 mg/kg), or zinc (25 mg/kg) on seven successive days and then received a single treatment with diclofenac or saline before carrageenan was injected to induce paw inflammation. The results indicated that these combinations did not significantly affect the percentage inhibition of paw edema caused by diclofenac alone; however, some combination treatments ameliorated signs of concomitant oxidative stress (such as alterations in plasma malondialdehyde (MDA) levels, hemolysate reduced glutathione levels, and erythrocytic superoxide dismutase enzyme activities) imparted by diclofenac alone. In some cases, few tested antioxidants in combination with diclofenac resulted in increased plasma levels of interleukin- (IL-) 6 and C-reactive protein (CRP). In conclusion, the results of these studies suggested to us that the added presence of natural antioxidants could be beneficial as standard anti-inflammatory therapeutics for a patient under diclofenac treatment, albeit that these effects do not appear to significantly build upon those that could be obtained from this common anti-inflammatory agent per se

Role of Metformin in the Management of Colorectal Cancer: A Systematic Review

Introduction: Colorectal cancer (CRC) is the second-leading cause of mortality and morbidity worldwide with multiple standard therapies that failed to improve outcomes. Metformin, an old, repurposed medication with pleiotropic effect in a number of cancers, arise as a possible treatment for CRC. This review aimed to assess the effect of metformin in addition to the treatment plan of CRC patients. Methods: To identify relevant studies, Google scholar, PubMed, Egyptian knowledge bank (EKB) and clinical trial.gov were systematically searched. Pre-defined search keywords were used as “Metformin”, “colorectal cancer”, “randomized controlled trials”, “interventional studies”, “observational studies”. Only English-based trials that are in full text were included. Results: A total of 20 studies with different therapeutic adjuvant treatment options were evaluated for metformin treatment effect in CRC. Randomized control trials and observational studies were the main interest of the review while preventive and pre-clinical studies including animals and cell lines were excluded. Conclusion: Most of the studies except few showed promising results on overall survival (OS), disease free survival, relapse-free time for metformin use as treatment in CRC. Also, a reductive effect of metformin was shown in toxicities as oxaliplatin-induced peripheral neuropathy and poor prognostic features as vessel co-option vasculature in liver metastasis. Future clinical randomized controlled studies are essential to confirm these results

Immunomodulatory effect of Premna odorata volatile oils in Mycobacterium tuberculosis by inhibiting TLR4/NF-κB pathway

Introduction: The development of multi drug resistant (MDR) tuberculosis (TB) and extensively drug resistant (XDR) TB, increased the interest in the usage of medicinal plants that are complementary to antibiotics to improve anti-TB efficacy. The present study aimed to confirm the anti-TB efficacy of volatile oils (VOs) isolated from different parts of Premna odorata in vivo, and moreover, to test the possible involvement of TLR4/NF-κB signaling pathway in its anti-TB efficacy. Methods: Thirty mice were divided into six equal groups. Group 1: healthy mice (negative control). Groups 2-6 were injected intravenously with a positive TB solution of purified MeDiPro Mycobacterium tuberculosis (MTB) antigen for 7 days to induce tuberculosis. Group 3-6: TB-injected mice treated respectively with leaves VO (300 μL/d), young stems VO (300 μL/d), flowers VO and a combination of the three essential VOs (1:1:1). Various immunologic factors and antioxidant activity were evaluated and compared in the groups. Results: TB-infected mice showed a significant increase in the serum levels of tumor necrosis factor-α (TNF-α), interferon-gamma (IFN-γ), interleukin (IL) 1-β and the mRNA expression levels of toll-like receptor 4 (TLR-4) & nuclear factor-κB (NF-κB) and a decrease in IL-10 & total antioxidant capacity (TAC). While pretreatment with VOs extracted from leaves, flowers, young stems and a combination of the three oils reversed these effects. Conclusion: The immunomodulatory effects of VOs extracted from different parts of P. odorata against TB infection involve the TLR-4/NFκB signaling pathway as well as, antioxidant effects, recommending that the use of this plant may help TB infected patients

The cardioprotective effects of secoisolariciresinol diglucoside (flaxseed lignan) against cafeteria diet-induced cardiac fibrosis and vascular injury in rats: an insight into apelin/AMPK/FOXO3a signaling pathways

Introduction: Fast food is a major risk factor for atherosclerosis, a leading cause of morbidity and mortality in the Western world. Apelin, the endogenous adipokine, can protect against cardiovascular disease via activating its receptor, APJ. Concurrently, secoisolariciresinol diglucoside (SDG), a flaxseed lignan extract (FLE), showed a therapeutic impact on atherosclerosis. The current study aimed to examine the effect of SDG on cafeteria diet (CAFD)-induced vascular injury and cardiac fibrosis via tracking the involvement of the apelin/APJ pathway.Methods: Thirty male rats were allocated into control, FLE-, CAFD-, CAFD/FLE-, and CAFD/FLE/F13A-treated rats, where F13A is an APJ blocker. All treatments lasted for 12 weeks.Results and discussion: The CAFD-induced cardiovascular injury was evidenced by histological distortions, dyslipidemia, elevated atherogenic indices, cardiac troponin I, collagen percentage, glycogen content, and apoptotic markers. CAFD increased both the gene and protein expression levels of cardiac APJ, apelin, and FOXO3a, in addition to increasing endothelin-1, VCAM1, and plasminogen activator inhibitor-1 serum levels and upregulating cardiac MMP-9 gene expression. Moreover, CAFD reduced serum paraoxonase 1 and nitric oxide levels, cardiac AMPK, and nuclear Nrf2 expression. FLE attenuated CAFD-induced cardiovascular injury. Such effect was reduced in rats receiving the APJ blocker, implicating the involvement of apelin/APJ in FLE protective mechanisms.Conclusion: FLE supplementation abrogated CAFD-induced cardiac injury and endothelial dysfunction in an apelin/APJ-dependent manner

Topiramate-Induced Modulation of Hepatic Molecular Mechanisms: An Aspect for Its Anti-Insulin Resistant Effect

Topiramate is an antiepileptic drug known to ameliorate insulin resistance besides reducing body weight. Albeit liver plays a fundamental role in regulation of overall insulin resistance, yet the effect of topiramate on this organ is controversial and is not fully investigated. The current work aimed to study the potential hepatic molecular mechanistic cassette of the anti-insulin resistance effect of topiramate. To this end, male Wistar rats were fed high fat/high fructose diet (HFFD) for 10 weeks to induce obese, insulin resistant, hyperglycemic animals, but with no overt diabetes. Two HFFD-groups received oral topiramate, 40 or 100 mg/kg, for two weeks. Topiramate, on the hepatic molecular level, has opposed the high fat/high fructose diet effect, where it significantly increased adiponectin receptors, GLUT2, and tyrosine kinase activity, while decreased insulin receptor isoforms. Besides, it improved the altered glucose homeostasis and lipid profile, lowered the ALT level, caused subtle, yet significant decrease in TNF-α, and boosted adiponectin in a dose dependent manner. Moreover, topiramate decreased liver weight/, visceral fat weight/, and epididymal fat weight/body weight ratios. The study proved that insulin-resistance has an effect on hepatic molecular level and that the topiramate-mediated insulin sensitivity is ensued partly by modulation of hepatic insulin receptor isoforms, activation of tyrosine kinase, induction of GLUT2 and elevation of adiponectin receptors, as well as their ligand, adiponectin, besides its known improving effect on glucose tolerance and lipid homeostasis