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Ammi visnaga L. (Visnaga daucoides Gaertn., Family Apiaceae), also known as Khella Baldi or toothpick weed, is an annual or biennial herb indigenous to the Mediterranean region of North Africa, Asia, and Europe. The plant is known to have been used in traditional medicine a long time ago. Nowadays, it is used in modern medicine to treat many aliments such as renal colic and coronary insufficiency, and is used as an antioxidant, antifungal, and antibacterial, with a larvicidal effect on mosquito larvae. Peer-reviewed studies show that these pharmacological activities are due its valuable chemical constituents that include mainly essential oil, polyphenolic compounds including flavonoids, as well as γ-pyrones, represented mainly by khellin and visnagin. Its essential oil is reported to have antiviral, antibacterial, and larvicidal effects, while its flavonoid content is responsible for its antioxidant activity. Its γ-pyrone content has a powerful effect on facilitating the passage of kidney stones and relieving renal colic, in addition to having a relaxant effect on smooth muscle including that of the coronary arteries. The current review represents the progress in research on A. visnaga in terms of either its chemistry or biological activities. This review represents scientific support material for the use of the plant by the pharmaceutical industry.

Our objective was to conduct a scoping review which summarizes the growing body of literature using wearable inertial sensors for gait analysis in lower limb osteoarthritis. We searched six databases using predetermined search terms which highlighted the broad areas of inertial sensors, gait, and osteoarthritis. Two authors independently conducted title and abstract reviews, followed by two authors independently completing full-text screenings. Study quality was also assessed by two independent raters and data were extracted by one reviewer in areas such as study design, osteoarthritis sample, protocols, and inertial sensor outcomes. A total of 72 articles were included, which studied the gait of 2159 adults with osteoarthritis (OA) using inertial sensors. The most common location of OA studied was the knee (n = 46), followed by the hip (n = 22), and the ankle (n = 7). The back (n = 41) and the shank (n = 40) were the most common placements for inertial sensors. The three most prevalent biomechanical outcomes studied were: mean spatiotemporal parameters (n = 45), segment or joint angles (n = 33), and linear acceleration magnitudes (n = 22). Our findings demonstrate exceptional growth in this field in the last 5 years. Nevertheless, there remains a need for more longitudinal study designs, patient-specific models, free-living assessments, and a push for “Code Reuse” to maximize the unique capabilities of these devices and ultimately improve how we diagnose and treat this debilitating disease.

Myrrh is the resinous exudate obtained by the incision in Commiphora molmol trees (Family Burseraceae). The bactericidal activity of its hexane extract was compared to its essential oil (MEO) using viable count technique against Staphylococcus aureus ( S. aureus ) and Pseudomonas aeruginosa ( Ps. aeruginosa ). MEO exhibited a better activity with > 99.999% killing of both tested strains after 2 h contact time. MEO was tested using the same technique against four multidrug resistant isolates: S. aureus (MRSA, sputum), Escherichia coli ( E. coli , urine), Ps. aeruginosa (wound) and Klebsiella pneumonia ( K. pneumonia , sputum). Highest bactericidal activity was observed against Ps. aeruginosa while lowest was against K. pneumonia (99.59 and 54.04% killing, respectively after 2 h contact time). A cream and mouthwash were formulated using 5% v/v MEO. The cream showed a better activity against Ps. aeruginosa than S. aureus (95.11 and 86.76% killing, respectively after 2 h contact time). The in vitro treatment of ca 10 7  CFU/ml S. aureus cells suspended in 10% saliva with the mouthwash produced ca 46% killing within the first 15 min reaching ca 99.999% after 30 min. Cytotoxic studies of both the essential oil and hexane extract on human liver cancer (Hep G2), human breast cancer (MCF-7) and colon cancer cell lines (HCT-116) revealed a promising in vitro activity. Highest activity was recorded for the essential oil on MCF-7 with IC 50 10.93 ± 0.32 μg/ml. GC/MS analysis allowed the identification of 17 and 9 compounds representing 92.01 and 99.99% of the hexane extract and essential oil, respectively. Furano-eudesma-1,3-diene (15.99%) and 2-acetoxy-furano-diene (26.82%) were the major identified compounds in the hexane extract and essential oil, respectively. These results indicate that Myrrh essential oil is a promising antibacterial and cytotoxic agent that can be formulated in suitable dosage forms.

Purpose To compare 10-MHz and 15-MHz B-scan probes regarding the detection and localization of retinal detachment (RD) in silicone-oil-filled eyes. Methods This cross-sectional observational study included 100 eyes (98 patients) -having media opacity precluding fundus examination- scheduled for silicone-oil removal. Patients were examined in the sitting-position using both frequencies one week preoperatively. Longitudinal and transverse scans were taken in primary-gaze, inferior, inferonasal, and inferotemporal positions to detect the presence/absence and extent of RD. Patients were sub-grouped according to axial lengths (AXLs), state of silicone emulsification, and globe filling. Agreement between sonographic and intraoperative observations was compared. Results No statistically significant differences were found between 15-MHz and intra-operative findings regarding RD detection ( P  = 0.752) and accurate localization of inferior, inferonasal, and inferotemporal RD ( P  = 0.279, 0.606, and 0.599). There were statistically significant differences between 10-MHz and intra-operative findings regarding RD detection and localization ( P  < 0.001). The 15-MHz probe was superior to 10-MHz probe regarding the accuracy of RD detection and localization (94% and 47%, respectively). The accuracy of 15-MHz probe was 88%, 83%, and 85% in detecting and localizing inferior, inferonasal, and inferotemporal RD compared to 45%, 60%, and 62% with 10-MHz probe. The 15-MHz probe showed better sensitivity while 10-MHz probe showed better accuracy in eyes with short AXLs. The 10-MHz probe showed better sensitivity in patients with sonographic emulsification while15-MHz probe had better sensitivity in detecting vitreoretinal-interface disorders. Conclusion The 15-MHz B-scan probe is more accurate in detecting and localizing recurrent RD in silicone-oil-filled globes with higher sensitivity in detecting vitreoretinal-interface disorders.

Purpose: The aim of this study was to evaluate the macular and peri-papillary blood vessel density following uncomplicated phacoemulsification in diabetics using optical coherence tomography angiography (OCT-A). Methods: An observational case-control study was conducted on 60 patients eligible for phacoemulsification, divided equally into diabetic and control groups. Both study groups were matching in sex, age, and axial length. We excluded diabetic patients of any form of macular edema or treatment history for macular edema. All study participants were subjected to preoperative OCT and OCT-A, which was repeated for all study population 1 month postoperatively. Results: We had a mean age of 54.5 ± 6.34 years in the non-diabetic group and 57.2 ± 4.09 years in the diabetic group (P = 0.06). There was a significant increase in the mean value of the macular blood vessels density in the nasal area in both study groups (P = 0.047 in non-diabetic group, P = 0.002 in the diabetic group). The percentage of the radial peripapillary capillary plexus vessel density (RPCP VD) change was non-significant on comparing the results for the diabetic group (mean preoperative value = 52.8 ± 4.47, postoperative = 52.0 ± 4.59, P = 0.204, D is the preoperative-postoperative value = 0.8), and also was non-significant for the non-diabetic group (mean preoperative value = 50.9 ± 4.89, postoperative = 52.1 ± 4.89, P = 0. 0.090, D = -1.3). On comparing the results of the diabetic and nondiabetic groups, the RPCP VD D was significantly different (P = 0.034). Conclusion: Uncomplicated phacoemulsification results in increase of the nasal macular blood vessel density in the normal population and in diabetic patients without retinopathy.

BackgroundSpontaneous bacterial peritonitis (SBP) is a common complication in cirrhotic patients with ascites, whereas spontaneous fungal peritonitis (SFP) is a less recognized but serious entity. Data on the frequency and predisposing factors of SFP in cirrhosis remain limited. We aimed to evaluate the prevalence, risk factors, and clinical features of SFP in patients with cirrhotic ascites.MethodsThis multicenter cross-sectional study enrolled 267 Egyptian adults with cirrhotic ascites. All patients underwent history taking, clinical examination, and routine laboratory testing. Ascitic fluid analysis included direct microscopic examination and bacterial and fungal cultures.ResultsThe prevalence of SFP was 2.62%, whereas 56.55% of patients were diagnosed with SBP. Among SFP cases, the most frequent presentations were abdominal distension (42.85%), abdominal pain (42.85%), and abdominal pain with fever (14.28%). Hepatorenal syndrome was present in 28.57% and hepatocellular carcinoma in 14.28% of SFP cases. Most SFP patients (85.71%) had received antibiotics during hospitalization. According to the Child–Pugh classification, 57.1% of patients were class C, and the remainder were class B (42.9%). The mean Model for End-Stage Liver Disease (MELD) score among SFP patients was 18.3 ± 8.99.ConclusionA high index of suspicion for SFP is required in cirrhotic patients with ascites, particularly in those presenting with a higher MELD score and Child–Pugh class C who fail to improve after antibiotic treatment.

Origanum vulgare L. (Lamiaceae) is a widespread flavoring culinary and medicinal herb. The present study aimed at investigating the antimicrobial activity of Origanum vulgare (OV) essential oil (EO) through illustrating its biostatic, biocidal and the dynamics of the biocidal activity against 11 different microorganisms. GC/MS of OV EO allowed the identification of 32 compounds representing 99.94% of the oil. The two major identified compounds were terpinen-4-ol (38.35%) and trans-sabinene hydrate (10.06%). Different methods were employed to illustrate the biostatic activity of OV EO. Results of the biostatic studies on OV EO using agar and broth dilution methods showed that Staphylococcus aureus (S. aureus) was the most sensitive organism; with a Minimum inhibitor concentration (MIC) 1.18 mg/ml. Agar diffusion method showed that the highest activity was observed against Bordetella bronchiseptica (Br. bronchiseptica), Saccharomyces cerevisiae (S. cerevisiae), Bacillus subtilis (B. subtilus) and Staphylococcus epidermidis (S. epidermidis) with inhibition zones 38 ± 1.5, 29.5 ± 0.8, 26.9 ± 0.9 and 26.9 ± 1.1 mm, respectively. Studying the dynamics of 1% v/v OV essential oil emulsion over a period of 6 h revealed that Escherichia coli (E. coli), B. subtilis, S. epidermidis and S. cerevisiae had the fastest response. Also increasing concentrations of OV oil emulsion increased the rate of cell killing and the duration of growth lag phase increased correspondingly. These data indicated that OV EO produces a concentration and time-dependent antimicrobial activity.

Chemotherapy is still the mainstay of treatment for triple-negative breast cancer (TNBC) patients. Yet only 20% of TNBC patients show a pathologic complete response (pCR) after neoadjuvant chemotherapy. 5-Fluorouracil (5-FU) is a stable cornerstone in all recommended chemotherapeutic protocols for TNBC patients. However, TNBC patients’ innate or acquired chemoresistance rate for 5-FU is steeply escalating. This study aims to unravel the mechanism behind the chemoresistance of 5-FU in the aggressive TNBC cell line, MDA-MB-231 cells, to explore further the role of the tumor suppressor microRNAs (miRNAs), miR-1275, miR-615-5p, and Let-7i, in relieving the 5-FU chemoresistance in TNBC, and to finally provide a translational therapeutic approach to co-deliver 5-FU and the respective miRNA oligonucleotides using chitosan-based nanoparticles (CsNPs). In this regard, cellular viability and proliferation were investigated using MTT and BrdU assays, respectively. 5-FU was found to induce JAK/STAT and PI3K/Akt/mTOR pathways in MDA-MB-231 cells with contaminant repression of their upstream regulators miR-1275, miR-615-5p, and Let-7i. Moreover, CsNPs prepared using the ionic gelation method were chosen and studied as nanovectors of 5-FU and a combination of miRNA oligonucleotides targeting TNBC. The average particle sizes, surface charges, and morphologies of the different CsNPs were characterized using dynamic light scattering (DLS) and transmission electron microscopy (TEM), respectively. In addition, the encapsulation efficiency (EE%), drug loading capacity (DLC%), and release manner at two different pH values were assessed. In conclusion, the novel CsNPs co-loaded with 5-FU and the combination of the three miRNA oligonucleotides demonstrated synergistic activity and remarkable repression in cellular viability and proliferation of TNBC cells through alleviating the chemoresistance to 5-FU.

Background Several agricultural or environmental factors affect plants’ chemical and pharmacological properties. Methods In this study, the essential oil of Libyan Satureja thymbra was isolated from plants collected during two successive years at two different altitudes; Wasita (WEO) and Safsaf (SEO), 156 and 661 m above sea level, respectively. Results GC/MS allowed the identification of 21 and 23 compounds, respectively. Thymol prevailed in WEO (26.69%), while carvacrol prevailed in SEO (14.30%). Antimicrobial activity was tested by agar-well diffusion method, and MIC/MLC values were determined by broth dilution method. Values of MIC/MLC were 0.125/0.25 μg/ml for SEO against S. aureus , P. mirabilis and K. pneumonia and for WEO against B. subtilus . It was observed that plants growing at lower altitude in Wasita locality had better antifungal activity, while those growing at higher altitude at Safsaf locality had better antibacterial activity. Both essential oils had a better anthelmintic activity than the standard piperazine citrate against a tested earthworm. However, SEO oil had a significantly higher anthelmintic activity than WEO. Cytotoxicity of the oils tested using SRB assay on human breast cancer (MCF-7) and colon cancer cell lines (HCT-116) showed better activity for SEO, especially against HCT-116 with IC 50 2.45 ± 0.21 μg/ml. Conclusions Thus, altitude is an important factor that should be considered as it affected the yield, composition and biology of the plant extracts.

ObjectivesThe present work was conducted to estimate the prevalence of adult Behçet’s disease (BD) in adult Egyptian and to study the clinical pattern and influence of age at-onset and sex on disease phenotype. Also, we investigated the spectrum of presentation and frequencies along the north-to-south gradient of the country.Patients and methodThe population-based, multicenter, cross-sectional study included 1526 adult BD patients from 26 specialized Egyptian rheumatology centers. Demographic, clinical, and therapeutic data are assessed for all patients.ResultsThe mean age of patients was 35.7 ± 9.84 years, disease duration 6.58 ± 5.25 years, and age at onset 29.37 ± 8.6 years; 91 were juvenile-onset (JoBD). There were 1102 males and 424 females (M:F 2.6:1). Regarding co-morbidities, 19.92% were diabetic, and 26.05% were hypertensive. The mean body mass index was 27.57 ± 5.24 (43.1% overweight; 25.9% obese). The mean BD current activity form was 4.48 ± 4.28. Regarding the medications use, systemic steroid and colchicine were the most common drugs used (947 (90.2%) and 611 (82.7%), respectively). The overall estimated prevalence of BD in Egypt was 3.6/100,000 population being highest in the two main cities: Alexandria (15.27) and Cairo (8.72). Pathergy test was positive in 43.4%. 90.2% were receiving systemic steroids and 8.3%, biologics. Disease characteristics were comparable between JoBD and adult-onset BD cases. Central nervous system (CNS), deep venous thrombosis (DVT), and gastrointestinal (GIT) involvement were significantly higher in males (p = 0.01, p = 0.001, and p = 0.001 respectively) while joint affection (p = 0.001) and disease activity (p = 0.011) were increased in females.ConclusionsThis study provides current prevalence of BD in Egypt; 3.6/100,000 with no remarkable north-to-south gradient. The sex influences the disease phenotype with the CNS, DVT, and GIT involvement are higher in males, while the joint affection and disease activity were increased in females.Key Points• The prevalence and phenotype of Behçet’s disease across Egypt is presented in a multicenter nationwide study.• The potential influence of the age at onset and sex on disease phenotype is highlightened.• A review of the literature worldwide is presented allowing comparisons with studies from other nations.