KEYWORDSAmoxicillin, Clavulanate, Gallic acid, Vitamin C, Hemoxygenase gene.Amoxicillin/ Clavulanate (AC) combination has become one of the antibiotics most widely prescribed used in the treatment of several bacterial infections, associated with liver injury. This study aimed to investigate amoxicillin/clavulanic acid induced hepatotoxicity and the modulatory effect of gallic acid (GA)/ vitamin C (VTC) individually and in combination on oxidative stress-related liver damage. Sixty-four male albino rats were randomly separated into eight groups; negative control; GA group; VTC group; GA +VTC group; AC-treated group; AC + GA-treated group; AC + VTC treated group and AC+ GA + VTC treated group. A twice daily dose of AC (31.83 mg/kg) and a single daily dose of both GA (60 mg/kg) and VTC (200 mg/kg/day) were introduced to rats orally for 7 consecutive days. After sacrificed, blood was collected for biochemical analysis of aspartate aminotransferase (AST), alanine aminotransferase (ALT), serum tumor necrosis factor alpha (TNF-α), caspase-3, RNA of heme oxygenase-1 gene (HMOX-1) and liver sample for lipid peroxidation and histopathological study. The serum levels of AST, ALT and TNF-α were significantly increased and upregulation of caspase-3 protein in rats treated with AC. Hepatic contents of malondialdehyde (MDA) were markedly increased following AC administration but produced a significant decrease in the levels of reduced glutathione (GSH) and glutathione-S-transferase (GST) along with down regulated the expression of HMOX-1. These findings were in accordance with the histopathological findings. Co-administration of GA and/or VTC along with AC to rats reduced liver injury, oxidative stress, apoptosis and histopathological alterations. So, we concluded that GA and VTC pose a positive modulatory effect against AC induced hepatotoxicity.

Background: From a forensic pathologist's perspective, there are several aspects of the perinatal postmortem that are particularly important if the baby was born alive or dead. In cases of litigation for perinatal morbidities occurring in hospitals, access to the obstetric and neonatal notes if the baby is born alive and dies a few hours or days later is essential to reach a correct interpretation and conclusion. Hypoxic ischemic encephalopathy (HIE) after prenatal asphyxia is an important cause of neonatal morbidity and long-term neurological disability. It has many causes including intrauterine strangulation by umbilical cord (nuchal cord). Failure of early diagnosis of neonatal asphyxia and its treatment is considered a medicolegal negligence against the doctors. Aim: The present study aimed to use cord blood lactate & S100 protein levels as early markers of neonatal hypoxia caused by nuchal cord to minimize the risk of medicolegal liabilities against the doctors and hospitals. Methods: This is a comparative cross-sectional study conducted on 30 hypoxic neonates due to intrauterine cord strangulation. Lactate & S100 protein levels in the cord blood were measured. These were compared to 30 apparently healthy neonates matched in age, sex and body weight as a control group. Results: Lactate & S100 protein levels in cord blood were a higher significant difference in HIE neonates than control group. In conclusion: lactate & S100 protein levels in cord blood could be used as an early marker for diagnosis of neonatal HIE.

Di-Ethylhexyl phthalate (DEHP) is a global environmental pollutant. Human exposure to DEHP occurs through environmental sources. Community exposure (food, air, water), as well as medical settings' exposure, impose crucial effects on human health. DEHP had been reported to have cytotoxic, immunotoxic, genotoxic, and reproductive toxic properties. This work aims to assess the possible toxic effects of DEHP on adult albino rats' lungs and to evaluate the possible protective effects of N-acetylcysteine (NAC) using bodyweight and relative lung weight parameters. Assessment of DHEP toxicity is measured by biochemical, histopathological, and immunohistochemical methods. Fifty male adult albino rats were divided into five equal groups as follows: Group Ι (Negative control group), Group ΙΙ (Positive control group), Group IΙΙ (NAC-treated group): was given NAC orally (200 mg/kg/day), Group IV (DEHP-treated group): was given DEHP orally (3gm/kg once daily for 4 weeks) and Group V: (DEHP + NAC-treated group): was treated with DEHP concomitantly with NAC at the same previous doses. The results of the present study revealed that DEHP has significantly increased the lipid peroxidation level and significantly reduced glutathione content (GSH), superoxide dismutase (SOD) activity, and catalase activity. The histological results of group IV showed inflammatory cellular infiltration of the lungs associated with interstitial edema, hemorrhage, and inter-alveolar septal thickening that were markedly reduced in group V. Also, group V, showed a significant decrease in the collagen fibers accumulation and caspase-3 expression as compared to group IV. Conclusion: treatment with NAC can protect against DEHP induced pulmonary toxicity in rats by decreasing oxidative stress, inflammation, and apoptosis.

Background: Human serum paraoxonase-1 (PON-1) hydrolyzes organophosphate compounds (OPC) and so significantly alters an individual's susceptibility to the toxicity of these chemicals. Aim: The study was designed to assess the serum PON-1 activity in patients with OPC poisoning and to correlate its level with the severity and outcome of acutely organophosphate poisoned patients. Patients and methods: This was a prospective clinical study that was performed at Benha Poison Treatment and Toxicological Research Unit (BPTTRU), Benha University Hospitals, Egypt, for one year, from 1 August 2020 till 31 July 2021. Patients were divided into case and control groups. Socio-demographic information of patients, clinical findings, treatments given, length of hospital stay and outcome were collected into datasheets. Patients were classified according to degree of toxicity according to Peradeniya Organophosphorus Poisoning (POP) scale. Blood samples were collected from patients to assess pseudocholiesterase and PON-1 activities. Results: Reduction of serum pseudocholinesterase and paraoxonase-1 (PON-1) activities in poisoned patients and patients can be graded according to (POP) scale into: mild, moderate and severe cases. In conclusion: This study concluded that serum paraoxonase-1 (PON-1) activity was significantly lower in patients with severe organophosphorus compounds (OPC) poisoning as compared to patients with moderate poisoning. Lower PON-1 activity was significantly associated with lower serum cholinesterase and poorer outcomes. PON-1 activity may be considered as an indicator of prognosis in OPC poisoning.

Introduction: Outbreaks of infectious disease are also marked by sociocultural unrest, and a general atmosphere of fear and mistrust. On 30 January 2020, a COVID-19 (Coronavirus disease 2019) epidemic was declared an international public health emergency, this outbreak provoked a negative association, social stigma and a discriminatory behavior against people of certain ethnic foundations as well as anybody seen to have been in contact with the infection. Aim of the study: The goal of this study is to concentrate on the relationships between stigma evoked during the COVID-19 pandemic, breaking the privacy and confidentiality of infected individuals and job affection, social harm, seeking health assistance and also promoting awareness of these issues among Egyptians. Subjects and Methods: A comparative cross-sectional study questionnaire on a random sample of 500 respondents (250 for each) conducted at Benha city and Assiut city, Egypt. Results: Respondents to the questionnaire revealed that 60.0% of Upper Egypt preferred to home quarantine while (53.2%) of Lower Egypt preferred hospital quarantine. Most respondents from both Upper and Lower Egypt agreed to do COVID-19 PCR (Polymerase chain reaction) test. In addition, respondents in Upper and Lower Egypt declined to publish their names because participants in Upper Egypt related their refuse due to affection on their social lives while participants in Lower Egypt refused to publish their names because of a violation of their privacy. Conclusions: COVID-19 infection pandemic has a negative effect on the ethical issues as confidentiality breakdown of patients, emergence of stigma, economic and social implications.