The hepatoprotective activity of the ethanol extract of Astragalus kahiricus (Fabaceae) roots against ethanol-induced liver apoptosis was evaluated and it showed very promising hepatoprotective actions through different mechanisms. The extract counteracted the ethanol-induced liver enzymes leakage and glutathione depletion. In addition, it demonstrated anti-apoptotic effects against caspase-3 activation and DNA fragmentation that were confirmed by liver histopathological examination. Moreover, the phytochemical study of this extract led to the isolation of four cycloartane-type triterpenes identified as astrasieversianin II (1), astramembrannin II (2), astrasieversianin XIV (3), and cycloastragenol (4). The structures of these isolates were established by HRESI-MS and 1D and 2D NMR experiments. The antimicrobial, antimalarial, and cytotoxic activities of the isolates were further evaluated, but none of them showed any activity.
Animals ; Apoptosis ; drug effects ; Astragalus Plant ; chemistry ; Caspase 3 ; metabolism ; Chemical and Drug Induced Liver Injury ; drug therapy ; genetics ; physiopathology ; prevention & control ; DNA Fragmentation ; drug effects ; Ethanol ; toxicity ; Female ; Humans ; Liver ; cytology ; drug effects ; enzymology ; Plant Extracts ; administration & dosage ; Plant Roots ; chemistry ; Protective Agents ; administration & dosage ; Rats ; Rats, Sprague-Dawley

PURPOSE"Polytrauma" patients are of a higher risk of complications and death than the summation of expected mortality and morbidity of their individual injuries. The ideal goal in trauma resuscitation care is to identify and treat all injuries. With clinical and technological advanced imaging available for diagnosis and treatment of traumatic patients, point of care-rapid ultrasound in shock and hypotension (RUSH) significantly affects modern trauma services and patient outcomes. This study aims to evaluate the accuracy of RUSH and patient outcomes by early detection of the causes of unstable polytrauma.

METHODSThis cross-sectional, prospective study included 100 unstable polytrauma patients admitted in Suez Canal University Hospital. Clinical exam, RUSH and pan-computed tomography (pan-CT) were conducted. The result of CT was taken as the standard. Patients were managed according to the advanced trauma life support (ATLS) guidelines and treated of life threatening conditions if present. Patients were followed up for 28 days for a short outcome.

RESULTSThe most diagnostic causes of unstability in polytrauma patients by RUSH are hypovolemic shock (64%), followed by obstructive shock (14%), distributive shock (12%) and cardiogenic shock (10%) respectively. RUSH had 94.2% sensitivity in the diagnosis of unstable polytrauma patients; the accuracy of RUSH in shock patients was 95.2%.

CONCLUSIONRUSH is accurate in the diagnosis of unstable polytrauma patients; and 4% of patients were diagnosed during follow-up after admission by RUSH and pan-CT.

Adolescent ; Adult ; Aged ; Child ; Cross-Sectional Studies ; Female ; Humans ; Hypotension ; diagnostic imaging ; Male ; Middle Aged ; Multiple Trauma ; complications ; diagnostic imaging ; mortality ; Point-of-Care Systems ; Prospective Studies ; Shock ; diagnostic imaging ; Young Adult