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Objective: The objective of this study was to assess the effectiveness of pre-emptive dexmedetomidine versus amiodarone in preventing junctional ectopic tachycardia (JET) in pediatric cardiac surgery. Design: This is a prospective, controlled study. Setting: This study was carried out at a single university hospital. Subjects and Methods: Ninety patients of both sexes, American Society of Anesthesiologists Physical Status II and III, age range from 2 to 18 years, and scheduled for elective cardiac surgery for congenital and acquired heart diseases were selected as the study participants. Interventions: Patients were randomized into three groups (30 each). Group I received dexmedetomidine 1 mcg/kg diluted in 100 ml of normal saline intravenously (IV) over a period of 20 min, and the infusion was completed 10 min before the induction followed by a 0.5 mcg/kg/h infusion for 72 h postoperative, Group II received amiodarone 5 mg/kg diluted in 100 ml of normal saline IV over a period of 20 min, and the infusion was completed 10 min before the induction followed by a 10-15 mcg/kg/h infusion for 72 h postoperative, and Group III received 100 ml of normal saline IV. Primary outcome was the incidence of postoperative JET. Secondary outcomes included vasoactive-inotropic score, ventilation time (VT), pediatric cardiac care unit stay, hospital length of stay, and perioperative mortality. Measurements and Main Results: The incidence of JET was significantly reduced in Group I and Group II (P = 0.004) compared to Group III. Heart rate while coming off from cardiopulmonary bypass (CPB) was significantly low in Group I compared to Group II and Group III (P = 0.000). Mean VT, mean duration of Intensive Care Unit stay, and length of hospital stay (day) were significantly short (P = 0.000) in Group I and Group II compared to Group III (P = 0.000). Conclusion: Perioperative use of dexmedetomidine and amiodarone is associated with significantly decreased incidence of JET as compared to placebo without significant side effects.

Postoperative arrhythmia is a common complication after open heart surgery in children. JET is the most common and dangerous arrhythmia. We aimed to assess safety and efficacy of prophylactic amiodarone in preventing JET in children underwent cardiac surgery and to assess risk factors for JET among our patients. In total, 117 children who underwent cardiac surgery for CHD at Tanta University Hospital from October 2011 to April 2015 were divided in two groups; amiodarone group (65 patients) was given prophylactic amiodarone intraoperatively and placebo group (52 patients). Amiodarone is started as loading dose of 5 mg/kg IV in the operating room after induction of anesthesia and continued for 3 days as continuous infusion 10–15 μg/kg/min. Primary outcome and secondary outcomes of amiodarone administration were reported. We studied pre-, intra- and postoperative factors to determine risk factors for occurrence of JET among these children. Prophylactic amiodarone was found to significantly decrease incidence of postoperative JET from 28.9 % in placebo group to 9.2 % in amiodarone group, and symptomatic JET from 11.5 % in placebo group to 3.1 % in amiodarone group, and shorten postoperative intensive care unit and hospital stay without significant side effects. Risk factors for occurrence of JET were younger age, lower body weight, longer cardiopulmonary bypass, aortic cross-clamp time, hypokalemia, hypomagnesemia, acidosis and high dose of inotropes. JET was more associated with surgical repair of right ventricular outlet obstruction as in case of tetralogy of Fallot and pulmonary stenosis. Most of JET 15/21 (71.4 %) occurred in the first day postoperatively, and 6/21 occurred in the second day (28.6 %). Prophylactic amiodarone is safe and effective in preventing early JET in children after open heart surgery.

Context Acute pulmonary embolism (PE) is a lethal sequela of venous thromboembolism (VTE). Surgical trauma injures the tissue directly, releasing a large number of tissue agent. The frequency of re-exploration owing to bleeding after lung surgery is between 1 and 3.7%, whereas the need of allogenic blood transfusion spans from 20 to 52%. Aims To assess the role of tranexamic acid (TXA) in reducing the need of allogenic blood transfusion in patients undergoing elective lung surgery. Patients and methods This retrospective study was conducted on 140 patients who underwent elective lung surgery. Patients were allocated into two groups. Group I patients received TXA at the end of procedure, and group II patients received blood and/or blood product transfusion. Statistical analysis Qualitative variables are expressed as mean±SD. Quantitative variables are compared by using the Student’s t test. Results The patients comprised 80 males and 60 females in our series. All cases in group II needed transfusion of one or more of the following: concentrated red blood cells, whole blood, fresh frozen plasma, and platelets. There was an obvious decrease in the postoperative hemoglobin level between groups, in favor of blood transfusion group (group II), and this was statistically significant. Conclusions Elective thoracic surgery patients have a low incidence of VTE and PE (2.85 and 2.14%, respectively). Hence, TXA helps in minimizing not only transfusion-related hazards but also operative cost.

Myocardial injury in open-heart surgery is related to several factors including ischemia–reperfusion injury, generation of reactive oxygen species, increased production of inflammatory mediators, and enhancement of apoptosis of cardiomyocytes. The aim of this study was to study the effect of L-carnitine on myocardial injury in children undergoing open-heart surgery. This clinical trial was performed on 60 children with congenital heart disease (CHD) who underwent open-heart surgery. They were randomized into two groups: L-carnitine group who received L-carnitine 50 mg\\kg\\day once daily for 1 month before cardiac surgery and control group who received placebo for 1 month before cardiac surgery. Left ventricular cardiac function was assessed by conventional echocardiography to measure left ventricular ejection fraction (LVEF) and two-dimensional speckle tracking echocardiography (2D-STE) to determine left ventricular global longitudinal strain (2D-LV GLS). Blood samples were obtained pre-operatively at baseline before the administration of L-carnitine or placebo and 12 h post-operatively to measure the level of malondialdehyde (MDA), superoxide dismutase (SOD), fas, caspase-3, creatinine kinase-MB (CK-MB), and troponin I. L-carnitine group had significantly lower post-operative level of oxidative stress marker (MDA), apoptosis markers (fas and caspase-3), and myocardial injury markers (CK-MB and troponin I), but they had significantly higher SOD post-operative level compared to the control group. In addition, post-operative LVEF and 2D-LVGLS were significantly lower in the control group compared to L-carnitine group.   Conclusion : L-carnitine can reduce myocardial injury, improve post-operative left ventricular cardiac function, and may provide myocardium protection in children with CHD who underwent open-heart surgery.   Trial registration : The clinical trial was registered at www.pactr.org with registration number PACTR202010570607420 at 29/10/2020 before recruiting the patients. What is Known: • Myocardial injury in open-heart surgery is related to several factors including ischemia–reperfusion injury, generation of reactive oxygen species, increased production of inflammatory mediators, and enhancement of apoptosis of cardiomyocytes. • L-carnitine was reported to have myocardial protective effects in rheumatic valvular surgery and coronary artery bypass graft (CABG) in adults; however, there is no evidence on its effectiveness in children undergoing open-heart surgery. What is New: • L-carnitine significantly lowered the post-operative level of oxidative stress marker (MDA), apoptosis markers (fas and caspase-3), and myocardial injury markers (CK-MB and troponin I) in the treatment group. • L-carnitine can reduce myocardial injury, improve post-operative left ventricular cardiac function, and may provide myocardium protection in children with CHD who underwent open-heart surgery.

Limonoids are important constituents of citrus that have a significant impact on promoting human health. Therefore, the primary focus of this research was to assess the overall limonoid content and isolate limonoids from Adalia lemon ( Citrus limon L.) peels for their potential use as antioxidants and anti-diabetic agents. The levels of limonoid aglycones in the C. limon peel extract were quantified through a colorimetric assay, revealing a concentration of 16.53 ± 0.93 mg/L limonin equivalent. Furthermore, the total concentration of limonoid glucosides was determined to be 54.38 ± 1.02 mg/L. The study successfully identified five isolated limonoids, namely limonin, deacetylnomilin, nomilin, obacunone 17-O-β-D-glucopyranoside, and limonin 17-O-β-D-glucopyranoside, along with their respective yields. The efficacy of the limonoids-rich extract and the five isolated compounds was evaluated at three different concentrations (50, 100, and 200 µg/mL). It was found that both obacunone 17-O-β-D-glucopyranoside and limonin 17-O-β-D-glucopyranoside possessed the highest antioxidant, free radical scavenging, and anti-diabetic activities, followed by deacetylnomilin, and then the limonoids-rich extract. The molecular dynamic simulations were conducted to predict the behavior of the isolated compounds upon binding to the protein's active site, as well as their interaction and stability. The results revealed that limonin 17-O-β-D-glucopyranoside bound to the protein complex system exhibited a relatively more stable conformation than the Apo system. The analysis of Solvent Accessible Surface Area (SASA), in conjunction with the data obtained from Root-Mean-Square Deviation (RMSD), Root-Mean-Square Fluctuation (RMSF), and Radius of Gyration (ROG) computations, provided further evidence that the limonin 17-O-β-D-glucopyranoside complex system remained stable within the catalytic domain binding site of the human pancreatic alpha-amylase (HPA)-receptor. The research findings suggest that the limonoids found in Adalia lemon peels have the potential to be used as effective natural substances in creating innovative therapeutic treatments for conditions related to oxidative stress and disorders in carbohydrate metabolism.

White mustard ( Sinapis alba L.) seeds are the most commonly used mustard species in herbal medicine to treat a wide range of inflammatory disorders. Due to its increased bioavailability and lower toxicity, the green biosynthesis of metal nanoparticles (M-NPs) utilizing plant extract as a capping agent has been demonstrated over a number of years. Thus, the current study sought to examine the in vitro biological activity of copper oxide nanoparticles  (CuO-NPs) and selenium nanoparticles (Se-NPs) that were biosynthesized using aqueous, methanolic, and petroleum ether extracts from S. alba seeds. Phytochemical and in vitro biological activities (antioxidant, scavenging, anti-diabetic, anti-acetylcholinesterase, anti-arthritic, anti-inflammatory, and cytotoxic activities) were assayed in all prepared extracts before and after being used for the biosynthesis of the M-NPs. It was found that the total methanolic extract possessed the highest biological activities compared to other native extracts. The LC-ESI-MS/MS analysis of secondary metabolites showed that the total methanolic extract contained 7 phenolic acids and 9 flavonoid aglycones. This helped find the active ingredients. We characterized 8 phenolic acid derivatives, 7 flavonoid glycosides, 4 aliphatic glucosinolates, and 3 aromatic aryl glucosinolates in the aqueous extract. Furthermore, the methanolic extract contains the highest concentrations of total polyphenols, condensed tannins, and total flavonoid compounds. The biosynthesized Se-NPs using methanolic extract showed higher in vitro biological activities compared to those of the biosynthesized CuO-NPs. The median lethal dose (LD 50 ) showed that the biosynthesized Se-NPs using the studied extracts appeared safer compared to those of the biosynthesized CuO-NPs. The findings of this study concluded that the total methanolic extract is the most suitable bioresource for biosynthesizing Se-NPs through green nanotechnology, with higher biological efficiency in relation to its metabolite fingerprint.

The present study aimed to evaluate the impact of different nitrogen sources combined with an algal biostimulant on the biochemical composition and biological activities of Corchorus olitorius (Mulukhiyah) grown under saline irrigation. A pot experiment was conducted during the summer season of 2023 at the Algal Biotechnology Unit, National Research Centre, Cairo, Egypt. Seeds were soaked in algal slurry and cultivated in sandy soil, irrigated with Pandorina sp. slurry (3846.4 ppm on average), and supplemented with an in situ algal biostimulator applied as a foliar spray (1.0 mL L −1 ) in combination with nitrogen, phosphorus, and potassium (NPK) fertilization. Phytochemical analyses revealed that leaves consistently accumulated higher levels of sterols, terpenes, fatty acids, pigments, polyphenols, tannins, and flavonoids compared with stems. Among the three fertilization regimes, ammonium nitrate, in combination with the biostimulant, produced the highest concentrations of sterols (1.03% in leaves), terpenes (0.93%), fatty acids (3.05%), chlorophylls (4.16 mg/g), carotenoids (3.79 mg/g), polyphenols (252.76 mg/100 g), condensed tannins (101.10 μg/mL), and flavonoids (6.19 mg/g). HPLC profiling confirmed the presence of diverse phenolic and flavonoid compounds, including gallic acid, chlorogenic acid, caffeic acid, rutin, quercetin, and kaempferol, with leaves exhibiting a broader and higher profile than stems. In vitro biological assays demonstrated that ammonium nitrate–treated extracts exhibited superior antioxidant activity (total antioxidant capacity: 129.6 ± 2.3 mg GAE/g; DPPH scavenging IC₅₀: 41.8 ± 1.2 µg/mL), anti-Alzheimer activity (AChE inhibition: 67.4% at 200 µg/mL), anti-diabetic activity (α-amylase IC₅₀: 72.3 ± 1.5 µg/mL), and cytotoxic effects, particularly against Caco-2 cells (IC₅₀: 50.65 ± 2.84 µg/mL). Conversely, no significant enhancement was observed in anti-inflammatory and anti-arthritic properties, where all extracts showed comparable inhibition (~ 48–52%) relative to the standard drug diclofenac. Overall, the findings indicate that the combined application of ammonium nitrate fertilizer and algal biostimulant enhances the accumulation of bioactive phytochemicals in C. olitorius , which translates into improved pharmacological potential, particularly antioxidant and cytotoxic activities. These results support the use of optimized fertilization strategies for improving the nutraceutical and medicinal value of C. olitorius under saline conditions.

Paracetamol is the most commonly used analgesic-antipyretic drugs. Its excess use causes an acute hepatotoxicity. It is well known that the Bacillariophyta alga Amphora coffeaeformis is rich in many photosynthetic pigments with antioxidant activities as well as a series of biologically active substances. The current work has been designed to study the phytochemical composition of different A. coffeaeformis algal extracts to select the most effective one. It was verified that acetone A. coffeaeformis algal extract is rich in various pigments and polyphenolic compounds (β-carotene (9.31 ± 0.06 mg·g-1), gallic acid (28.31 µg·g-1), catechin (38.08 µg·g-1) and p-coumaric acid (38.69 µg·g-1)). The pigments and phenolic profiles in acetone extract were determined in addition to isolation of β-carotene and fucoxanthin which exhibited free radical scavenging activity by 74.80% and 69.40%, respectively. Therefore, the highest total antioxidant capacity and free radical scavenging activity were noticed with this extract. Consequently, efficiency of this algal extract was evaluated against hepatic intoxication induced by paracetamol in rats. The biochemical measurements (liver functions and markers of oxidative stress) were assayed. Moreover, the native protein, lipid and calcium moieties of native protein patterns in addition to catalase (CAT); peroxidases (POX); α- and β-esterase (EST) isoenzymes and genomic DNA patterns were electrophoretically detected in liver tissues. It was found that paracetamol caused significant (P < 0.05) elevation in serum liver functions associated with decline in activities of the antioxidant enzymes in that tissues. Also, it caused alterations represented electrophoretically at qualitative level from variations in the bands number and arrangement. So that, the paracetamol treated group was noticed with the lowest similarity index (SI). In addition, it caused abnormalities at the quantitative level through variations in quantity of normal bands. Algal extract restored all the biochemical functions to normal levels in the algal extract simult-treated and pre-treated groups. Furthermore, it exhibited ameliorative effect against the electrophoretic alterations through restoring the absent normal bands and hiding the abnormal ones and hence increasing the SI values especially in the extract simult-treated group. Algal extract exhibited antagonistic effect against the hepatic injury and the deleterious effects induced by paracetamol in the extract simult-treated group.

The recently launched Egyptian Genome Project aims to sequence genomic variants of 100,000 apparently healthy Egyptian adults, with around 8,000 individuals suspected to have a genetic disease, as well as 200 ancient Egyptian mummies. The project will provide the first comprehensive genomic dataset from Egypt and North Africa.