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Covid -19 is a viral disease play important role in danger pathogens for human, it is infecting on respiratory, hepatic, central nervous systems and gastrointestinal, in addition to that, the triggers included cytokine storm is inflammatory response to viral infection     Therefore, excessive enhance of immune cells lead to new of pro-inflammatory cytokines. COVID-19 interaction with the cardiovascular system on different levels, rising death percent in people underlying cardiovascular state provoking myocardial injury. Respiratory infection varying from   mild  cold to  the severe illness like  as Middle East Respiratory Syndrome and Severe Acute Respiratory Syndrome the most important coronavirus (COVID-19) complications, however individuals with asymptomatic disease were also suspected of possible infectious transmission, which further adds to the uncertainty of the dynamic of disease transmission in COVID-19 infections, Suppression of  angiotensin-converting enzyme (ACE2) expression by inflammatory cytokines accompanied by the decrease of estrogens and androgens  of the elderly, establish a negative correlation between   ACE2 expression and mortality in other cases may lead to infertility. Early detection by PCR has aided the identification of the pathogen at an early level.  Furthermore, the treatment includes the effectiveness of glucocorticoid drugs (dexamethasone), anti-malaria drug (hydroxychloroquine), azithromycin (antibacterial drug) and favipiravir are all drugs recommended in illness with Covid-19. Remdesivir suppression COVID-19 replication and decreases viral load, alleviates clinical signs and improves pulmonary injury, therefore Remdesivir drug has been used as a compassionate medicine for treating COVID-19 patients.

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Hepatotoxicity is a term used to describe serious health complications of liver disease caused by a variety of factors. Nuclear factor erythroid-2 linked factor (Nrf2) as a potential mediator of hepatotoxicity via inflammatory and induction of oxidative stress, oxidation produces more toxic compounds caused more pathogenic cases; therefore, to maintain sufficient homeostasis, involve antioxidant materials and detoxification factors. Controlling cytokine activity in normal cells is a useful way to regulate the signaling pathway of Nrf2. Recent studies found a relation between each Nrf2 and NF-κB activation and drug-induced liver injury.  This review presents a detailed and conformation update of Nrf2 roles in hepatotoxicity which considers that drug-induced liver injury is the main problem to draw attention in medical clinics and to develop new drugs with less harmful to the liver. In addition to that. Kept each of normal oxidation and cytokines levels is crucial responses for cells alteration and remaining to survive.

Objective: Polycystic ovarian syndrome (PCOS) is a complex disease occurred throw genital period of women depends on the age, genetic factors, and ethnicity. Monocyte Chemoattractant Protein-1 (MCP-1) has been implicated in the metabolic disturbances and menstrual irregularities.Methods: In the biochemical test, the blood was collected in plain tubes then separated by centrifugation. Serum was collected in test tubes then, MCP, haemoglobin (Hb), packed cell volume (PCV), fasting blood glucose (FBG), urea, creatinine, prolactin, testosterone, luteinizing hormone (LH), follicle stimulating hormone (FSH), T3, T4, and thyroid-stimulating hormone (TSH) were determined by enzyme-linked immune-sorbent assay and relevant clinical features were collected simultaneously in all subjects.Results: The results showed no significant increased in means of age, body mass index in PCOS women (patients) when compared with healthy subjects (control groups) also there was no significant decreased in levels of Hb, PCV while increased in FBG, urea and creatinine in PCOS women when compared with healthy subjects. In addition, mean of LH and 17 β-Estradiol were no significant increased except the significantly increased in the ratio of LH/FSH, prolactin, and testosterone, while FSH was significantly decreased in PCOS women when compared with healthy subjects. Levels of triiodothyronine (T3) and thyroxine (T4) were found significantly decreased while an increased level of TSH when compared with healthy subjects. Finally, MCP-1 was showed significantly increased in PCOS women when compared with healthy subjects.Conclusions: It can be concluded that PCOS women might suffer from changes in the levels of MCP-1(an inflammation marker). Besides, it was detected that TSH might be responsible related metabolic disturbances could be related to TSH and MCP which can be considered as relevant features in such disturbances.

Hepatic encephalopathy (HE) is a neurological and psychological syndrome related to acute and chronic liver failure especially during cirrhosis, it is associated with over production of ammonia in gastrointestinal tract with failure excretion by the liver in addition to increased free radical and bacterial transmission have played an important role. A symptom of disease includes coma, ophthalmia, irregular sleeping, stress and difficult breathing. It may be develop to intestinal bleeding; reduced blood pressure and electrolyte disturbances. Myasthenia is early symptoms of muscle dystrophies and prevalence of antibodies against acetylcholine receptors, nicotine receptors, tyrosine kinase and low-density lipoprotein proteins thus severely weakening muscles and skeletons have been demonstrated, it is playing important role in myasthenia progressing especially after five years of liver antibodies detection. Recently, the treatment is mainly depending on the reduced intestinal ammonia with non-absorbent disaccha¬rides from intestine and MRI should be used to follow up in addition to newer immunosuppressive drugs such as Rifaxamin, an inhibitor of interleukins and steroids is very important to treat this disease.

Nrf2 is active protein presents in the cytoplasm in the cells of the body. In the presence of an activators, Nrf2 can enter the nucleus which bind to Antioxidant Responses Elements (ARE) or otherwise named human ARE (hARE) which control the whole antioxidants activity in human cell. Many factors may contribute to defective or overwhelmed cellular antioxidants activities for instances aging and cellular damages. These cellular damages can be produced by free radicals or oxidative stress. In the mechanism, if Nrf2 activated in the nucleus, can caused the production of collaborative antioxidants enzymes especially: catalase, glutathione (GLT) and superoxide dismutase (SOD) as a responsible for detoxification of free radical inside the cells.