Background The link between Vitamin-D deficiency and type 2 diabetes (T2D) is well-established. Since prediabetic obese populations have the greatest risk to develop to T2D, it was important in our study to examine serum 25(OH) D3 concentration among prediabetic obese patients and to evaluate the correlation between serum levelofvitaminDandBMI,FBS,HOMAIRandHbA1camongprediabetespatients. Methods A multicenter case control study was carried out among 101 prediabetic persons & 50 controls, after obtaining consent from subjects and clearance from institutional ethics committee. Serum vitamin D level, Plasma levels of glycosylated hemoglobin (HbA1c) and fasting insulin levels were measured by ELISA in bothgroupsenrolledinthestudy. Results The prevalence of vitamin-D deficiency/insufficiency was (73.3%) (n=74) among 101 prediabetic obese individuals. Also, A significant inverse correlation was observed between vitamin D levels & body mass index(r=- 0.28, P=0.004); fasting blood sugar (r=- 0.22, P=0.002); HOMA insulin resistance (r=0.25P=0.01);HbA1C(r=-0.2, 0.004). Conclusions High prevalence of vitamin D deficiency exists among obese prediabetic individuals and there is significantinversecorrelationbetweenBMI,FBS,HOMAIR,HbA1candvitaminDlevel

ABSTRACT Introduction: The liver has an important role in carbohydrate metabolism since it is responsible for the balance of blood glucose levels by means of glycogenogenesis and glycogenolysis. Aim of the Study: Evaluation of the effect of the single and combined administration of insulin and N-acetyl cysteine on glucose metabolism in hepatotoxic rats. Materials and Methods: This study enrolling 5 groups of adult male albino rats. Hepatotoxicity was induced in group II, III, IV &V using carbon tetrachloride, while group I was left as control. Group II received no treatment, group III received N-acetyl cysteine, group IV received insulin while group V received insulin and N-acetyl cysteine. Samples were taken and measured liver function tests, insulin, glucose and adiponectin level as well as histopathological studies analysis of the liver specimens were measured and nonparametric multicomparison test was applied. Results: Liver function tests, group II and group IV showed higher significant statistical difference than group I and III. Also group II showed higher significant statistical difference than other groups as regarding blood glucose level and adiponectin level. The histopathological results revealed that the untreated group showed significant liver damage when compared to the control group, while treatment with NAC alone and treated with insulin and NAC showed significant reduction of all histopathological changes, whereas treatment with insulin alone significantly reduced all the histopathological changes except lobular inflammation. Conclusion: Good control of carbohydrate metabolism including insulin level, insulin resistance and adiponectin level helped in improving the prognosis of liver dysfuction diseases.

ABSTRACT Introduction: The liver has an important role in carbohydrate metabolism since it is responsible for the balance of blood glucose levels by means of glycogenogenesis and glycogenolysis. Aim of the Study: Evaluation of the effect of the single and combined administration of insulin and N-acetyl cysteine on glucose metabolism in hepatotoxic rats. Materials and Methods: This study enrolling 5 groups of adult male albino rats. Hepatotoxicity was induced in group II, III, IV &V using carbon tetrachloride, while group I was left as control. Group II received no treatment, group III received N-acetyl cysteine, group IV received insulin while group V received insulin and N-acetyl cysteine. Samples were taken and measured liver function tests, insulin, glucose and adiponectin level as well as histopathological studies analysis of the liver specimens were measured and nonparametric multicomparison test was applied. Results: Liver function tests, group II and group IV showed higher significant statistical difference than group I and III. Also group II showed higher significant statistical difference than other groups as regarding blood glucose level and adiponectin level. The histopathological results revealed that the untreated group showed significant liver damage when compared to the control group, while treatment with NAC alone and treated with insulin and NAC showed significant reduction of all histopathological changes, whereas treatment with insulin alone significantly reduced all the histopathological changes except lobular inflammation. Conclusion: Good control of carbohydrate metabolism including insulin level, insulin resistance and adiponectin level helped in improving the prognosis of liver dysfuction diseases.

ABSTRACT Introduction: The liver has an important role in carbohydrate metabolism since it is responsible for the balance of blood glucose levels by means of glycogenogenesis and glycogenolysis. Aim of the Study: Evaluation of the effect of the single and combined administration of insulin and N-acetyl cysteine on glucose metabolism in hepatotoxic rats. Materials and Methods: This study enrolling 5 groups of adult male albino rats. Hepatotoxicity was induced in group II, III, IV &V using carbon tetrachloride, while group I was left as control. Group II received no treatment, group III received N-acetyl cysteine, group IV received insulin while group V received insulin and N-acetyl cysteine. Samples were taken and measured liver function tests, insulin, glucose and adiponectin level as well as histopathological studies analysis of the liver specimens were measured and nonparametric multicomparison test was applied. Results: Liver function tests, group II and group IV showed higher significant statistical difference than group I and III. Also group II showed higher significant statistical difference than other groups as regarding blood glucose level and adiponectin level. The histopathological results revealed that the untreated group showed significant liver damage when compared to the control group, while treatment with NAC alone and treated with insulin and NAC showed significant reduction of all histopathological changes, whereas treatment with insulin alone significantly reduced all the histopathological changes except lobular inflammation. Conclusion: Good control of carbohydrate metabolism including insulin level, insulin resistance and adiponectin level helped in improving the prognosis of liver dysfuction diseases.

ABSTRACT Introduction: The liver has an important role in carbohydrate metabolism since it is responsible for the balance of blood glucose levels by means of glycogenogenesis and glycogenolysis. Aim of the Study: Evaluation of the effect of the single and combined administration of insulin and N-acetyl cysteine on glucose metabolism in hepatotoxic rats. Materials and Methods: This study enrolling 5 groups of adult male albino rats. Hepatotoxicity was induced in group II, III, IV &V using carbon tetrachloride, while group I was left as control. Group II received no treatment, group III received N-acetyl cysteine, group IV received insulin while group V received insulin and N-acetyl cysteine. Samples were taken and measured liver function tests, insulin, glucose and adiponectin level as well as histopathological studies analysis of the liver specimens were measured and nonparametric multicomparison test was applied. Results: Liver function tests, group II and group IV showed higher significant statistical difference than group I and III. Also group II showed higher significant statistical difference than other groups as regarding blood glucose level and adiponectin level. The histopathological results revealed that the untreated group showed significant liver damage when compared to the control group, while treatment with NAC alone and treated with insulin and NAC showed significant reduction of all histopathological changes, whereas treatment with insulin alone significantly reduced all the histopathological changes except lobular inflammation. Conclusion: Good control of carbohydrate metabolism including insulin level, insulin resistance and adiponectin level helped in improving the prognosis of liver dysfuction diseases.

ABSTRACT Introduction: Mirabegron is a novel β3-adrenergic receptor agonist that recently approved for the management of overactive urinary bladder disease. Reactive oxygen species (ROS) have a major role in the pathogenesis of gentamicin nephrotoxicity. The aim of the present study was to investigate the renoprotective effect of mirabegron alone and in combination with N-acetylcysteine (NAC) in cases of nephrotoxicity induced by gentamicin in rats. Materials and Methods: 40 Wistar rats were divided into 5 groups. Group 1; treated with NaCl 0.2 ml i.p. Group 2; received 100 mg/kg of gentamicin i.p. for 8 days for induction of nephrotoxicity. Group 3; treated with gentamicin + NAC (500 mg/kg i.p.for 8 days). Group 4; treated with gentamicin + mirabegron (10 mg/kg orally for 8 days). Group 5; treated with gentamicin + NAC + mirabegron. After 8 days, blood samples were used for assessment of renal function. Serum nitric oxide, renal malondialdehyde (MDA) and glutathione (GSH) levels were measured. Results: Gentamicin caused a significant elevation of serum creatinine, urea, uric acid and nitric oxide with significant elevation of kidney MDA with reduction of GSH. Treatment with both of NAC and mirabegron each alone or in combination with each other caused restoration of renal function parameters and caused significant decrease in serum nitric oxide and MAD and increase in GSH. These changes were more marked with combination of NAC and mirabegron. Conclusion: Mirabegron has a modest antioxidant activity which may be responsible for its protective effect against nephrotoxicity induced by gentamicin.

Background and Aim: The emergence of colistin-resistant strains is considered a great threat for patients with severe infections. Here, we investigate the prevalence and some possible mechanisms of colistin resistance among multidrug-resistant (MDR) and extensively drug-resistant (XDR) Pseudomonas aeruginosa (P. aeruginosa). Methods: Antimicrobial susceptibility was performed using disc diffusion methods while colistin resistance was detected by agar dilution method. Possible mechanisms for colistin resistance were studied by detection of mcr-1 and mcr-2 genes by conventional PCR, detection of efflux mechanisms using Carbonyl Cyanide 3-Chlorophenylhydrazone (CCCP), studying outer membrane protein profile and Lipopolysaccharide (LPS) profile of resistant isolates. Results: It was found that MDR and XDR represented 96% and 87% of the isolated P. aeruginosa, respectively, and colistin resistance represented 21.3%. No isolates were positive for mcr-2 gene while 50% of colistin-resistant isolates were positive for mcr-1. Efflux mechanisms were detected in 3 isolates. Protein profile showed the presence of a band of 21.4 KDa in the resistant strains which may represent OprH while LPS profile showed differences among colistin-resistant mcr-1 negative strains, colistin-resistant mcr-1 positive strains and susceptible strains. Conclusion: The current study reports a high prevalence of colistin resistance and mcr-1 gene in P. aeruginosa strains isolated from Egypt that may result in untreatable infections. Our finding makes it urgent to avoid unnecessary clinical use of colistin.

Background and Aim: The emergence of colistin-resistant strains is considered a great threat for patients with severe infections. Here, we investigate the prevalence and some possible mechanisms of colistin resistance among multidrug-resistant (MDR) and extensively drug-resistant (XDR) Pseudomonas aeruginosa (P. aeruginosa). Methods: Antimicrobial susceptibility was performed using disc diffusion methods while colistin resistance was detected by agar dilution method. Possible mechanisms for colistin resistance were studied by detection of mcr-1 and mcr-2 genes by conventional PCR, detection of efflux mechanisms using Carbonyl Cyanide 3-Chlorophenylhydrazone (CCCP), studying outer membrane protein profile and Lipopolysaccharide (LPS) profile of resistant isolates. Results: It was found that MDR and XDR represented 96% and 87% of the isolated P. aeruginosa, respectively, and colistin resistance represented 21.3%. No isolates were positive for mcr-2 gene while 50% of colistin-resistant isolates were positive for mcr-1. Efflux mechanisms were detected in 3 isolates. Protein profile showed the presence of a band of 21.4 KDa in the resistant strains which may represent OprH while LPS profile showed differences among colistin-resistant mcr-1 negative strains, colistin-resistant mcr-1 positive strains and susceptible strains. Conclusion: The current study reports a high prevalence of colistin resistance and mcr-1 gene in P. aeruginosa strains isolated from Egypt that may result in untreatable infections. Our finding makes it urgent to avoid unnecessary clinical use of colistin.

Antimicrobial susceptibility was performed using disc diffusion methods while colistin resistance was detected by agar dilution method. Possible mechanisms for colistin resistance were studied by detection of mcr-1 and mcr-2 genes by conventional PCR, detection of efflux mechanisms using Carbonyl Cyanide 3-Chlorophenylhydrazone (CCCP), studying outer membrane protein profile and Lipopolysaccharide (LPS) profile of resistant isolates. Results It was found that MDR and XDR represented 96% and 87% of the isolated P. aeruginosa, respectively, and colistin resistance represented 21.3%. No isolates were positive for mcr-2 gene while 50% of colistin-resistant isolates were positive for mcr-1. Efflux mechanisms were detected in 3 isolates. Protein profile showed the presence of a band of 21.4 KDa in the resistant strains which may represent OprH while LPS profile showed differences among colistin

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an emerging coronavirus causing respiratory disease commonly known as COVID-19. This novel coronavirus transmits from human to human and has caused profound morbidity and mortality worldwide leading to the ongoing pandemic. Moreover, disease severity differs considerably from individual to individual. Investigating the virology of COVID-19 and immunological pathways underlying its clinical manifestations will enable the identification and design of effective vaccines and potential therapies. In this review, we explore COVID-19 virology, the contribution of the immune system (innate and adaptive) during infection and control of the virus. Finally, we highlight vaccine development and implications of immune system modulation for potential therapeutic interventions to design better therapeutic strategies to guide future cure.