Lead poisoning has been known as an important disorder that affects individuals through acute, sub-acute and chronic exposure in environmental and occupational settings. This study was conducted to compare the curative role of garlic combined with silymarin versus dimercaptosuccinic acid (DMSA) in decreasing lead induced nephrotoxicity in adult male albino rats. The period of lead intoxication extended for 3 months followed by either 1 month treatment with garlic and silymarin or 5 days treatment with DMSA. Lead poisoning caused non-significant difference in kidney function tests (BUN and serum creatinine) while, it caused significant elevation in kidney lead level, significant decrease in renal antioxidant enzyme glutathione peroxidase and significant elevation in kidney malondialdehyde. Histologically, lead induced disorganization and shrinkage of glomeruli with sloughing and vaculation of epithelium, widening of Bowman's space and inflammatory infiltration in renal medulla. Treatment by garlic extract combined with silymarin as well as treatment with DMSA resulted in significant improvement in the affected parameters. Also, both methods of treatment resulted in improvement of the histopathological changes. It can be concluded that garlic extract combined to silymarin is comparable to DMSA in amelioration of lead induced nephrotoxicity.

Lead (Pb) is one of the most common toxic heavy metals. It is a well-known testicular toxicant. Selenium nanoparticles (SeNPs) are a more effective form of elemental selenium that reduces drug-induced toxicities. This study aimed to study the possible ameliorating effect of SeNPs on the toxicological and morphological changes in testes of lead acetate intoxicated rats. The study was conducted on 40 adult male albino rats divided into four groups; control, SeNPs-treated, lead acetate-treated, lead acetate and SeNPS treated groups.The concurrent treatment of lead acetate-exposed rats with SeNPs (0.1 mg/kg/ day) for 12 weeks significantly lowered the blood and testicular lead levels, increased serum testosterone, and decreased luteinizing hormone and folliclestimulating hormone to approach control values. In addition, it improved the histopathological, and ultrastructural alterations of the testes and improved the immunohistochemical expression of the c-kit. This was accompanied by maintenance of the testicular oxidant/antioxidant balance and reversing the lead-induced disrupted calmodulin-related genes expression in testicular tissue in the form of downregulation of CAMMK2 and MAP2K6 and upregulation of CXCR4 genes. There was a strong positive correlation between testicular malondialdehyde and MAP2K6 expression level as well as a strong positive correlation between CXCR4 gene expression and the C-kit area %. In conclusion, SeNPs can be considered as a potential therapy for a lead-induced testicular injury.

This study was designed to investigate structural and ultra-structural changes induced by nitrate in rat liver, examine their molecular basis, and evaluate the possible protective role of S-Allylcysteine (SAC). Adult male albino rats were assigned to: control, SAC, nitrate, and nitrate+ SAC groups. Serum ALT and AST were measured. Liver samples were processed for light and electron microscope examinations, biochemical analysis, real-time PCR, and immunohistochemistry of heat shock protein 70 (HSP70) and Bcl-2. Nitrate induced histopathological and biochemical alterations in rat liver. The underlying mechanisms included nitrosative and oxidative stress, inflammation, fibrosis, and apoptosis that are alleviated by SAC.

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Toluene was widely used volatile organic compound that accumulates in tissues with high lipid content. Stem cells have been proposed as an increasingly attractive approach for repair of damaged nervous system, we aimed to evaluate the ability of breast milk mesenchymal stem cells (MSc) to ameliorate toluene-induced encephalopathy. Sixty adult male albino rats were assigned to 3 groups, control, toluene, and toluene/breast milk-MSc. Neurological assessment was evaluated as well as serum levels of glial fibrillary acidic protein (GFAP), tumor necrosis factor-alpha (TNF-α), nerve growth factor (NGF), vascular endothelial growth factor (VEGF), tissue dopamine and oxidative markers. Gene expression of peroxisome Proliferator-Activated Receptor-Gamma (PPAR-ɣ), nuclear factor-kappaB (NF-kB), and interleukin-6 (IL-6) were evaluated. Moreover, histological and immunohistochemical investigation were done. Results revealed that toluene caused cerebral injury, as evidenced by a significant increase in serum GFAP, TNF-α, malondialdehyde (MDA) and nitric oxide (NO), a significant decrease in serum NGF, tissue dopamine and oxidative markers, besides, a non-significant change in VEGF. Toluene also caused changes in normal cerebral structure and cellular degeneration, including a significant decrease in the total number of neurons and thickness of frontal cortex. Meninges showing signs of inflammation with inflammatory cell infiltration and exudation, a significant decrease in MBP immunoreactivity, and increase in the percent of high motility group box protein-1 (HMGB1) positive cells. PPAR- ɣ, NF-kB, and IL-6 gene expression were all considerably elevated by toluene. These changes were greatly improved by breast milk MSc. Therefore, we conclude that breast milk MSc can attenuate toluene-induced encephalopathy.

Introduction: Carbon monoxide (CO) poisoning is the leading cause of death from intoxication. The heart is extremely susceptible to CO-induced hypoxia due to its high oxygen demand. Cardiovascular involvement in CO poisoning could be clinically occult and undiagnosed due to lack of overt symptoms or specific electrocardiogram (ECG) changes. There is an emerging need for early and specific markers for myocardial hypoxia. One potential candidate is the glycogen phosphorylase BB isoenzyme (GPBB). Aim of the study: The study was planned to assess the role of glycogen phosphorylase in early prediction of myocardial toxicity due to CO poisoning. Methods: This prospective study included 2 groups; Control group and Patient group. Control group included 15 non-smokers healthy adults aged between 20 and 35 years old selected from patients' companions presented to Zagazig University Hospitals. Patient group included 30 adults aged 20-35 years old with history of CO exposure within 6 hrs. They were subdivided into mild & moderate CO poisoning groups according to COHB% & clinical manifestations. The study was performed during the period between January 2015 to April 2016. All the subjects enrolled in the study were subjected to clinical examination, ECG, echocardiogram (Echo), cardiac troponin 1 (cTn-1) and GPBB assessment. Results: There was a significant increase in heart rate between patient and control groups. Also, a significant increase in GPBB was found between patient and control groups and this was associated with a significant decrease of ejection fraction evaluated by Echo in moderate CO poisoning group when compared with control group. No significant difference was found as regard ECG findings between patient and control groups. Conclusion: GPBB can be used as an early predictor of CO-induced myocardial ischemia which in turn may modify management plan to avoid later sequelae affecting ventricular function.

Background A better understanding of medical students’ competencies about antimicrobial resistance and their use could facilitate a more effective education for them as future prescribers. The aim is to explore the educational impact of an elective course on medical students’ knowledge, perception, and attitude toward antibiotic resistance and use. Methods Between December 2021 and January 2022, when a 2-credit hours elective course was designed and implemented, this interventional study was conducted. The primary outcome measure was the change in medical students’ knowledge, perception, and attitude about antibiotic resistance and use. Using a pre-post course questionnaire, this outcome was assessed. The secondary measure included students’ perception of the course; assessed by a post-course online survey. Results Among the 50 enrolled students, the total knowledge score had significantly increased after the course with 95% CI After the course, with medium effect size ( Cohen’s d= -0.7 ) the participants’ mean ± SD total perception and attitude scores had significantly increased (52.38 ± 5.53 vs. 56.84 ± 5.86) respectively, (p = 0.000) with large effect size (( Cohen’s d= -0.8) There was a significant positive correlation between the total knowledge, attitude, and perception after the course (r = 0.542, p < 0.01). The mean ± SD of the overall course satisfaction was 4.20 ± 0.94. out of 5. Conclusion Medical students’ knowledge, perceptions, and attitudes towards antimicrobial prescription have been improved after the elective antibiotic prescribing etiquette course. Elective courses could offer a great opportunity to enable the students to understand the extent of the problem, stand on the facts, and take responsibility for the antibiotic resistance crisis. Trial registration NA

Introduction: Ivermectin (IVM) and paracetamol (APAP) are among drugs used for treatment of mild and moderate cases of covid-19 infection. Aim: this study aimed to evaluate the potential hepatotoxic effects on combination of both Paracetamol and Ivermectin in adult male albino rats. Methodology: fifty adult male albino rats were divided into control groups (negative and Positive) and IVM and APAP treated group which included thirty rats and subdivided equally into 3 subgroups (III A, B, C). Each rat received orally 3.7mg/kg/day of Ivermectin concomitantly with 370 mg/kg /day of paracetamol (groups III A, B, C were sacrificed after 7 days, 14 days and 28 days respectively). Serum levels of aminotransferases ALT, AST, glutamate dehydrogenase (GLDH) and Hyaluronan (HA), Histopathological examination of liver and immunohistochemical staining for inducible nitric oxide synthase (iNOS) were performed. Results: HA was elevated after 7 days followed by GLDH which increased after 14 days while aminotransferases levels increase only after 28 days of combined IVM and APAP treatment. After 7 days, the histopathological changes in IVM andAPAP treated group was restricted to congestion of central vein with some vaculation in the hepatocytic cytoplasm then aggravated with increased duration of treatment to periportal fibrosis, inflammatory infiltration areas and necrotic foci. Conclusion: Combination of IVM and APAP induced liver injury, detected 7 days after treatment by HA level and accompanied by histopathological changes which became more severe with increasing duration of treatment. IVM and APAP should be used cautiously to avoid possibility of aggravation of liver injury which is believed to be one of covid-19 complications.