Objective: Cerebral venous thrombosis (CVT) is a rare pathology with life threatening consequences, most of these fatal complications are due to raised intracranial pressure due to venous infarction and cerebral swelling, the purpose of this study is to evaluate the efficiency of decompressive craniectomy for favorable outcome. Methods: A retrospective analysis of clinical, radiological and surgical data of patients who underwent decompressive craniectomy for CVT in a tertiary referral hospital between the years 2016 through 2020. Results: The study included 7 patients, female predominance was noted (5/7), mean age was 18.14 years. Mean Glasgow coma score (GCS) at surgery was 8.26, good clinical outcome was achieved for the majority of cases 71.4%, and one case of mortality 14.28%. Conclusions Decompressive craniectomy is a life saving procedure for patients with severe brain swelling as a sequela of CVT, majority of patients (71.4%) showed favorable functional outcome by 6 months postoperatively.

PURPOSE: We evaluate the role of transanal tube drainage (TD) as a conservative treatment for patients with anastomotic leakage (AL). METHODS: Patients treated for AL who had undergone a low or an ultralow anterior resection with colorectal or coloanal anastomosis for the treatment of rectal cancer between January 2013 and January 2017 were enrolled in this study. The data were collected prospectively and analyzed retrospectively. The primary outcomes were the diagnosis and the management of AL. RESULTS: Two hundred thirteen consecutive patients, 122 males and 91 females, were included. The mean age was 66.91 ± 11.15 years, and the median body mass index was 24 kg/m2 (range, 20–35 kg/m2). The median tumor distance from the anal verge was 8 cm (range, 4–12 cm). Ninety-three patients (44%) received neoadjuvant therapy for nodal disease and/or locally advanced rectal cancer. Only 13 patients (6%) developed AL. Six patients developed subclinical AL as they had a defunctioning ileostomy at the time of the initial procedure. They were treated conservatively with TD under endoscopic guidance in the endoscopy unit and received intravenous antibiotics. Six weeks after discharge, these 6 patients underwent follow-up flexible sigmoidoscopy which showed a completely healed anastomotic defect with no residual stenosis. Seven patients developed a clinically significant AL and required reoperation with pelvic abscess drainage and Hartmann colostomy formation. CONCLUSION: These results suggest that TD for management of patients with AL is safe, cheap, and effective. Salvaging the anastomosis will help decrease the need for Hartmann colostomy formation. Proper patient selection is important.
Abscess ; Anastomotic Leak* ; Anti-Bacterial Agents ; Body Mass Index ; Colostomy ; Constriction, Pathologic ; Diagnosis ; Drainage* ; Endoscopy ; Female ; Follow-Up Studies ; Humans ; Ileostomy ; Male ; Neoadjuvant Therapy ; Patient Selection ; Prospective Studies ; Rectal Neoplasms ; Reoperation ; Retrospective Studies ; Sigmoidoscopy

One of the leading causes of death worldwide is cardiovascular disease, hence searching for a cure is an important endeavor. The totally safe, edible, and inexpensive Boswellia plant exudate, known as olibanum or frankincense, is considered to possess diverse medicinal values in traditional medicine and from recent biological studies. Investigating the cardioprotective and antioxidant activities of olibanum from a Boswellia species, family Bursearaceae, namely Boswellia carteri Birdw. was the aim of this study. Cardioprotective activity was evaluated using a model of myocardial infarction induced by isoprenaline (ISO), while antioxidant activity was tested adopting nitric oxide scavenging (NOS) and azino-bis-3-ethyl benzthiazoline-6-sulfonic acid (ABTS) assays. The results revealed a mild cardioprotective effect and weak antioxidant activity.
Animals ; Antioxidants ; administration & dosage ; analysis ; Boswellia ; chemistry ; Frankincense ; administration & dosage ; analysis ; Humans ; Male ; Myocardial Infarction ; drug therapy ; pathology ; Myocardium ; pathology ; Rats ; Rats, Wistar

Objective To compare the degree of ameliorative effects of Melatonin (MEL), Ursodeoxycholic acid (UDCA) and Balanites aegyptiaca (BA) against hepatotoxicity induced by MTX for one month. Methods Eighty adult male rats (Sprague Dawely) weighing (190 ± 10 g), were randomly divided into eight equal groups: Control, MTX, MEL, BA, UDCA, MTX + MEL, MTX + BA, MTX + UDCA. Liver function biomarker enzymes, liver tissue oxidative stress parameters, together with total antioxidant capacity and tumor necrosis factor (TNF-α) were determined. Histopathological and immunohistochemistry examinations for TNF-α were also done. Results MTX showed significant increase in alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), gamma glutamyl transferase (GGT), total and direct bilirubin, as well as TNF-α levels, oxidized glutathione (GSSG), malodialdehyde (MDA) and nitric oxide (NO). Whereas total protein, albumin, total antioxidant capacity, reduced glutathione (GSH), glutathione peroxidase (GPx), glutathione reductase (GR), glutathione S-transferase (GST), superoxide dismutase (SOD) and catalase (CAT) levels were significantly decreased in MTX treated group. These alterations were improved by MEL and BA treatment, whereas no improvement was noticed in UDCA treatment. Conclusions BA may be as promising as MEL in the hepatoprotection against MTX toxicity through their antioxidant and radical scavenging activities. In addition, it is not recommended to co-administer UDCA with MTX as it enhanced inflammation and damage to the liver.

Objective: To examine the antioxidant and antihemolytic activities of the aqueous extract, total polyphenols and total flavonoids of Thymus satureioides (T. satureioides). Methods: This plant was collected from Tafilalet Region of Morocco. The aqueous extract was obtained by cold maceration, and the components were obtained by Soxhlet extraction using solvents of varying polarity. The identification and quantification of phenol (caffeic and rosmarinic acids) and flavones (luteolin 7-glycoside and hesperetin) were carried out by high performance liquid chromatography analysis. Results: Total polyphenol and flavonoids contents in the aqueous extract of T. satureioides were (456.73±6.94) mg caffeic acid equivalent/g of dry plant and (172.79±2.12) mg rutin equivalent/g of dry plant, respectively. Different extracts showed good antioxidant activity. IC50 for 1,1-diphenyl-2-picrylhydrazil radical scavenging activity was (0.480±0.010), (0.418±0.005), (43.891±2.467) and (0.510±0.010) mg/mL for the aqueous extract, total polyphenol, flavonoids and trolox, respectively. Also, the extracts showed ferric reducing antioxidant power and the values were (50.79±2.02), (117.51±6.46), (7.03±0.29) and (44.33±7.55) mmol trolox/ g for the aqueous extract, total polyphenol, flavonoids and trolox, respectively. Serum levels of malondialdehyde was significantly decreased in comparison with the oxidized control (P<0.001). They showed good activity against 2,2,-azobis 2-amidinopropane dihydrochloride induced hemolysis in erythrocytes of rabbit blood. In addition, they ameliorate the half time of hemolysis. Conclusions: Our results provide evidence that aqueous extract, total polyphenols and total flavonoids of T. satureioides exhibit marked antioxidant and antihemolytic activities, thus confirming and justifying the popular uses of this plant to relieve some pains.

OBJECTIVEAnabasis aretioides (Coss & Moq.), a Saharan plant belonging to Chenopodiaceae family, is widely distributed in semi-desert areas from the Tafilalet region of Morocco. This plant is extensively used by local population against diabetes and cardiovascular disorders. The purpose of the study was to investigate the effect of the aqueous A. aretioides extract on lipid metabolism in normal and streptozotocin (STZ)-induced diabetic rats and to identify the polyphenolic compounds present. In addition, the in vitro antioxidant activity of the aqueous A. aretioides extract was also evaluated.

METHODSThe effect of an aerial part aqueous extract (APAE) of A. aretioides (5 mg/kg of lyophilized A. aretioides APAE) on plasma lipid profile was investigated in normal and STZ-induced diabetic rats (n = 6) after once daily oral administration for 15 days. The aqueous extract was tested for its 1,1-diphenyl-2-picrylhydrazyl (DPPH) radical-scavenging activity. Polyphenolic compounds in the extracts were definitively characterized by high-performance liquid chromatography-diode array detection-electrospray ionization-mass spectrometry.

RESULTSIn diabetic rats, oral administration of A. aretioides APAE provoked a significant decrease in both plasma cholesterol and triglyceride levels from the first to the second week (P < 0.01). A significant decrease on plasma triglyceride levels was also observed in normal rats (P < 0.01), where the reduction was 53%. In addition, the phytochemical analysis revealed the presence of 12 polyphenolic compounds. Moreover, according to the DPPH radical-scavenging activity, the aqueous extract showed an in vitro antioxidant activity.

CONCLUSIONAqueous A. aretioides APAE exhibits lipid-lowering and in vitro antioxidant activities. Many polyphenols were present in this extract and these phytoconstituents may be involved in the pharmacological activity of this plant.

Animals ; Antioxidants ; administration & dosage ; Chenopodiaceae ; chemistry ; Cholesterol ; blood ; Chromatography, High Pressure Liquid ; Diabetes Mellitus, Experimental ; blood ; drug therapy ; Humans ; Hypolipidemic Agents ; administration & dosage ; chemistry ; Male ; Phytochemicals ; administration & dosage ; chemistry ; Plant Extracts ; administration & dosage ; chemistry ; Polyphenols ; administration & dosage ; chemistry ; Rats ; Rats, Wistar ; Streptozocin ; Tandem Mass Spectrometry ; Triglycerides ; blood

The Asia-Pacific region carries a high disease burden, with over half of the global diabetic population residing in this region. Increasing evidence shows that without targeted intervention, the progression from impaired glucose tolerance (IGT) to type 2 diabetes occurs more frequently in Asians compared with Caucasians. Furthermore, IGT is independently associated with an increased risk of cardiovascular disease, and should be managed as early as possible. Because diabetes is now a major public health issue, strategies aimed at prevention and treatment are urgently required. Lifestyle modification, including weight loss, dietary changes and increased physical activity, play a major role in controlling the disease. Significant evidence also supports the effectiveness of a combination of lifestyle modification and pharmacologic therapy, such as metformin, in delaying the onset of diabetes. Although the importance of lifestyle interventions is well recognized throughout Asia, many countries do not have formal recommendations to guide the diagnosis and management of individuals at risk of progression to diabetes. At a recent regional meeting, experts from the Asian region convened to develop consensus recommendations to guide clinicians in the management of Asian patients with pre-diabetes. These consensus recommendations provide a clear and concise approach to the management of individuals with IGT based on the available evidence and current best clinical practice.

Human ; Male ; Female ; Adult ; Prediabetic State ; Asia

The Asia-Pacific region carries a high disease burden, with over half of the global diabetic population residing in thisregion. Increasing evidence shows that without targeted intervention, the progression from impaired glucose tolerance(IGT) to type 2 diabetes occurs more frequently in Asians compared with Caucasians. Furthermore, IGT is independently associated with an increased risk of cardiovascular disease, and should be managed as early as possible. Because diabetes is now a major public health issue, strategies aimed at prevention and treatment areurgently required. Lifestyle modification, including weight loss, dietary changes and increased physical activity, play a major role in controlling the disease. Significant evidence also supports the effectiveness of a combination of lifestylemodification and pharmacologic therapy, such as metformin, in delaying the onset of diabetes. Although the importanceof lifestyle interventions is well recognized throughout Asia, many countries do not have formal recommendations to guide the diagnosis and management of individuals at risk of progression to diabetes. At a recent regional meeting,experts from the Asian region convened to develop consensus recommendations to guide clinicians in themanagement of Asian patientswith pre-diabetes. These consensus recommendations provide a clear and conciseapproach to the management of individuals with IGT based on the available evidence and current best clinical practice.
Glucose Intolerance ; Asia