In the era of favoring environment-friendly approaches for pharmaceutical synthesis, “green synthesis” is expanding. Green-based nanomedicine (NM), being less toxic and if having biomedical acceptable activities, thence, the chemical methods of synthesis are to be replaced by plants for reductive synthesis. Iron oxide nanoparticles (IONPs) exhibited remarkable anti-microbial and anti-cancer properties, besides being a drug delivery tool. However, owing to limitations related to the chemical synthetic method, plant-mediated green synthesis has been recognized as a promising alternative synthetic method. This systematic review (SR) is addressing plant-based IONPs green synthesis, characteristics, and toxicity studies as well as their potential biomedical applications. Furthermore, the plant-based green-synthesized IONPs in comparison to nanoparticles (NPs) synthesized via other conventional methods, characteristics, and efficacy or toxicity profiles would be mentioned (if available). Search strategy design utilized electronic databases including Science Direct, PubMed, and Google Scholar search. Selection criteria included recent clinical studies, available in the English language, published till PROSPERO registration. After screening articles obtained by first electronic database search, by title, abstract and applying the PICO criteria, the search results yielded a total of 453 articles. After further full text filtrations only 48 articles were included. In conclusion, the current SR emphasizes the perspective of the IONPs plant-mediated green synthesis advantage(s) when utilized in the biomedical pharmaceutical field, with less toxicity.
Quality by Design (QbD) and chemometric models are different sides of the same coin. While QbD models utilize experimentally designed settings for optimization of some quality attributes, these settings can also be utilized for chemometric prediction of the same attributes. We aimed to synchronize optimization of comparative dissolution results of carvedilol immediate release tablets with chemometric prediction of dissolution profile and content uniformity of the product. As an industrial application, selection of variables for optimization was done by performing risk assessment utilizing the archived product records at the pharmaceutical site. Experimental tablets were produced with 20 different settings with the variables being contents of sucrose, sodium starch glycolate, lactose monohydrate, and avicel Ph 101. Contents of the excipients were modelled with F1 dissimilarity factor and F2 similarity factor in HCL, acetate, and USP dissolution media to determine the design space. We initiatively utilized Partial Least Square based Structural Equation Modelling (PLS-SEM) to explore how the excipients and their NIR records explained dissolution of the product. Finally, the optimized formula was utilized with varied content of carvedilol for chemometric prediction of the content uniformity.
Background and Aims SARS-CoV-2 infection has been recorded in 230 countries to date. Obesity has a negative impact on one’s quality of life and is one of the main causes of mortality globally. Obesity affects the immune system, making the host more susceptible to infectious infections. Also, obesity commonly provokes the severity of respiratory diseases so the correlation of LEP rs7799039 Polymorphism in corpulent patients with COVID-19 infection was clearly investigated in the current study. Methods A total of 232 patients were recruited, 116 patients were obese with COVID-19 infection, and 116 patients were non obese COVID-19. Fasting blood glucose test (FBG), hemoglobin A1C (HbA1C), complete blood count (CBC), international normalized ratio (INR), urea, alanine transaminase (ALT), aspartate aminotransferase (AST), D dimer and C-reactive protein (CRP) were estimated. C.T. scan was performed for each patient, and C.T. severity score was calculated. Genotyping for the leptin rs7799039 SNPs was performed by TaqMan ® (Applied Biosystems Step One TM Real-time PCR). Results Regarding LEP polymorphism, all individuals of non-obese groups significantly had the homozygous allele GG (100%), whereas only 56% of obese groups had GG alleles (P = 0.001). The severity scores significantly (P = 0.001) varied regarding LEP polymorphism regarding Rs7799039, where the largest proportion of those with Grade IV had the homozygous allele AA (57.1%). Conclusion There was a correlation between the leptin gene allelic discrimination and COVID-19 CT brutality in obese patients. The A allele was considered a risk factor for severity in COVID-19 patients while the G allele contributes to decreasing that risk.
BACKGROUND Pancreatic cystic lesions (PCLs) are common in clinical practice. The accurate classification and diagnosis of these lesions are crucial to avoid unnecessary treatment of benign lesions and missed opportunities for early treatment of potentially malignant lesions. AIM To evaluate the role of cyst fluid analysis of different tumor markers such as cancer antigens [ e.g. , cancer antigen (CA)19-9, CA72-4], carcinoembryonic antigen (CEA), serine protease inhibitor Kazal-type 1 (SPINK1), interleukin 1 beta (IL1-β), vascular endothelial growth factor A (VEGF-A), and prostaglandin E2 (PGE2)], amylase, and mucin stain in diagnosing pancreatic cysts and differentiating malignant from benign lesions. METHODS This study included 76 patients diagnosed with PCLs using different imaging modalities. All patients underwent endoscopic ultrasound (EUS) and EUS-fine needle aspiration (EUS-FNA) for characterization and sampling of different PCLs. RESULTS The mean age of studied patients was 47.4 ± 11.4 years, with a slight female predominance (59.2%). Mucin stain showed high statistical significance in predicting malignancy with a sensitivity of 87.1% and specificity of 95.56%. It also showed a positive predictive value and negative predictive value of 93.1% and 91.49%, respectively ( P < 0.001). We found that positive mucin stain, cyst fluid glucose, SPINK1, amylase, and CEA levels had high statistical significance ( P < 0.0001). In contrast, IL-1β, CA 72-4, VEGF-A, VEGFR2, and PGE2 did not show any statistical significance. Univariate regression analysis for prediction of malignancy in PCLs showed a statistically significant positive correlation with mural nodules, lymph nodes, cyst diameter, mucin stain, and cyst fluid CEA. Meanwhile, logistic multivariable regression analysis proved that mural nodules, mucin stain, and SPINK1 were independent predictors of malignancy in cystic pancreatic lesions. CONCLUSION EUS examination of cyst morphology with cytopathological analysis and cyst fluid analysis could improve the differentiation between malignant and benign pancreatic cysts. Also, CEA, glucose, and SPINK1 could be used as promising markers to predict malignant pancreatic cysts.
This is a case–control study of our experience of mid-term follow-up of 40 children who had a transcatheter closure of very large atrial septal defects group (1). All cases had an atrial septal defect device size more than 1.5 times their weight, a ratio considered a contraindication for trans catheter closure (TCC) in some previous reports. The aim of this study is to report the outcomes and mid-term follow-up of transcatheter closure of large atrial septal defects using two-dimensional conventional echocardiography, tissue Doppler imaging, and four-dimensional speckle tracking imaging, and as such to compare results of same echocardiographic examination of age-matched control group of 40 healthy children group (2). Cardiac MRI was performed on cases group (1) only to detect right ventricle and left ventricle volumes and function and early signs of complications. There was no difference between cases and matched healthy controls in terms of the assessment of left ventricle and right ventricle by two-dimensional echocardiography, tissue Doppler imaging, and four-dimensional speckle tracking imaging. Similarly, there was no statistically significant difference between four-dimensional echocardiography and cardiac MRI in their respective assessment of both left ventricle and right ventricle volumes and function. We also detected no complications by echo or by cardiac MRI after a median follow-up period of 2 years and recorded a complete remodelling of right ventricle volumes in all children studied. This points to the safety and efficiency of transcatheter closure of large atrial septal defects in children on mid-term follow-up.
Background and rationale: Coronavirus disease 2019 (COVID-19) infection is a respiratory tract infection because of a novel coronavirus. The clinical picture ranges from asymptomatic to severe manifestations mandating intensive care and respiratory support. We aimed to assess the serum level of iron, total iron binding capacity (TIBC), and transferrin saturation in COVID-19 patients and their relation to disease severity and outcome. Methodology: This observational cross-sectional analytical study was conducted on 100 confirmed cases of COVID-19 who were admitted to Kasr Al-Ainy hospitals between June and December 2020.Serum levels of iron, total iron binding capacity (TIBC), and transferrin saturation were measured for all study populations. Result: One hundred patients were involved in this research, 51males and 49 females, with a mean age of 51±14.9years. Regarding the disease severity,53% were moderate cases, 34% were mild, and 13% were severe cases. Fifty-two (54.2%) patients showed normal serum levels of iron, 38 patients (39.6%) showed high serum levels of iron, and 6 patients (6.3%) showed low serum levels of iron. The mean ±SD values of iron, TIBC, and transferrin saturation were 163.1±105 mcg/dL, 366 ± 162.6 mcg/dL, 44.4 ± 20.2 %, respectively. Iron, total iron binding capacity (TIBC) levels and transferrin saturation did not show a significant association as regards either COVID-19 severity or mortality. Mortality and deterioration were detected in 31.7% out of 60 patients with COVID-19. The results showed that obese patients showed a higher percentage of severe COVID-19,which was statistically significant (p=0.037).There was a statistically significant higher mortality rate in patients with severe COVID-19 (p=0.000).High mortality was observed significantly in patients with diabetes mellitus (p=0.041).Iron levels, total iron binding capacity (TIBC) levels and transferrin saturation did not show a significant association regarding either COVID-19 severity or mortality. Conclusion: In our study, COVID-19 severity was not related to iron metabolism but was affected by obesity and diabetes mellitus. COVID-19 mortality was significantly associated with diabetes.
Background: HCV infection is a major burden in Egypt as it affects 15% of the population. The treatment depends upon direct acting antivirals(DAAs). It was implied earlier that Sofosbuvir(SOF) better be avoided for potential toxic effects in patients with moderate to severe renal impairment. This study aims to evaluate the efficacy and safety of SOF-based regimens against SOF-free in this special population of patients Methods: This is a retrospective study where data for all HCV patients with chronic kidney disease including those with end stage renal disease and on haemodialysis were reviewed and 6607 patients were enrolled according to the National Committee for Control of Viral Hepatitis (NCCVH) in Egypt; these patients received variety of DAAs regimens including SOF-based and SOF-free regimens, and were categorized into two groups based on renal profile.Results: Sustained virological response (SVR) rate in this study was of 98.3%; 98.7% for those who were on SOF-based regimen and 95.6% for those administered SOF-free regimen. Regarding patients who were on haemodialysis, SVR rate was 100% in patients who received SOF-based regimen opposite to SVR rate of 91.2% in those who received SOF-free regimen. Moreover, in patients with moderate renal affection ‘grade 3 CKD’ SVR rates were 98.7% with SOF-based regimens and 97.6% for SOF-free regimens. Conclusion: SOF-based regimens at full dose are considered more effective than SOF-free regimens in patients with moderate to severe renal impairment with good safety profile and better SVR rate.
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