October 6 University

Background Naringenin has shown attractive neuroprotective effects; however, it is characterized by low oral bioavailability. Naringenin-loaded nanoparticles (Nar-NPs) were prepared for enhanced delivery, and their effects in scopolamine-induced cholinergic hypofunction model were tested, either alone or in combination with donepezil. Methods Nar-NPs were developed via solvent evaporation with Span-80/Tween-80 and then characterized for morphological characteristics (TEM), hydrodynamic size/PDI, and zeta potential (DLS/ELS). Encapsulation efficiency (EE%), drug loading (DL%), and stability in simulated physiological buffer were also determined. Three different batches were used to evaluate the reproducibility of the formulation. Male mice were injected with scopolamine (3 mg/kg, i.p.) and orally administered Nar-NPs (37.75 mg/kg) or Nar-NPs combined with donepezil (10 mg/kg). Results were evaluated as Morris Water Maze, oxidative stress and inflammatory markers, lipid profile, qRT-PCR, and histopathology. Molecular docking analyses examined possible bonds of naringenin interaction with GABRA5α and GSK-3β as hypothesis-generating results. Results Nar-NPs were spherical in shape (~ 95 nm), of monodisperse size (PDI < 0.2) and negatively charged (ζ ≈ -28.5mV). The formulation showed high encapsulation efficiency (EE% = 89.2 ± 3.1%), demonstrated good colloidal stability in phosphate buffer (pH 7.4) over 24 h, and exhibited a sustained drug release profile as well with sustained release profile (Korsmeyer-Peppas, n ≈ 0.56). The batch-to-batch reproducibility of ζ was high (− 28.47, -28.71, − 28.52mV; mean = − 28.57 ± 0.13mV; CV% ≈ 0.44%). In vivo, Nar-NP attenuated scopolamine-induced deficits as evidenced by the amelioration of acquisition and probe trial performance, normalization in levels of antioxidant defenses, reduction in neuroinflammatory mediators, and reinforcement of hippocampal architecture. The combination with donepezil produced effects greater than either monotherapy alone, suggesting potential additive or synergistic interaction. Docking indicated reasonable binding to GABRA5α and GSK-3β, but this is exploratory and needs validation ex vivo/in vivo for the mechanism of action. Conclusions Nar-NPs are a predictable, stable, and bioavailable formulation with multidomain neuroprotective potential in a cholinergic impairment model. Since the reversible model we use mimics acute cholinergic dysfunction with associated oxidative and inflammatory sequelae rather than the progressive proteinopathies (amyloid-β accumulation, tau hyperphosphorylation) and chronic neurodegeneration seen in Alzheimer’s disease, the current findings ought to be interpreted as an example of symptom-relevant rather than disease-modifying neuroprotection. As such, the multi-domain therapeutic potential implied by our molecular and histopathological endpoints must be tested stringently in chronic, pathology-induced models (e.g., transgenic APP/PS1 or 3xTg-AD mice) for determining translational relevance to Alzheimer’s disease.

Background/Objectives: Pulmonary fibrosis is a chronic, progressive lung disease marked by scarring and inflammation, leading to impaired respiratory function. This study aimed to investigate the combined therapeutic effects of pirfenidone (PFD), metformin (MET), and bone marrow-derived mesenchymal stem cells (BM-MSCs) on bleomycin (BLM)-induced pulmonary fibrosis in rats. Methods: Forty-eight Western Albino rats were divided into six groups: normal control, BLM-positive control, and four treatment groups receiving PFD, MET, BM-MSCs, and their combination. Treatments were administered for four weeks starting on day 21 post-BLM instillation. Lung tissues were analyzed for oxidative stress markers, inflammatory cytokines, apoptotic markers, and fibrogenic gene expression. Histopathological changes were assessed using hematoxylin and eosin (H&E) and Masson's trichrome staining. Results: The combination therapy significantly reduced oxidative stress and inflammatory markers while enhancing antioxidant capacity. It decreased pro-apoptotic Bcl-2-associated X protein (BAX) and increased anti-apoptotic B-cell lymphoma 2 (Bcl-2) levels. Additionally, anti-inflammatory interleukin-10 (IL-10) was elevated, while tumor necrosis factor-alpha (TNF-α) and transforming growth factor-beta 1 (TGF-β1) levels were markedly lowered. Gene expression analysis showed a significant downregulation of matrix metalloproteinase-9 (MMP-9) and collagen type 1 alpha 1 (Col1α1). Histologically, the combination treatment group exhibited minimal fibrosis and inflammation, closely resembling normal lung tissue. Conclusions: The combination of PFD, MET, and BM-MSCs offered superior therapeutic efficacy in treating BLM-induced pulmonary fibrosis compared to individual treatments. This multimodal approach effectively targets oxidative stress, inflammation, apoptosis, and fibrosis, suggesting strong potential for future clinical application.

Plantar fasciitis (PF) is a common cause of heel pain that affects the health-related quality of life of many individuals and has various treatment options. Two effective interventions are corticosteroid (CS) injections and dextrose prolotherapy (DP). This study aimed to compare the efficacy and safety of DP and CS in patients with PF systematically. Relevant studies, including those comparing DP and CS for treating PF, were identified by searching electronic databases until August 2025. The visual analog scale (VAS) pain score, foot function index (FFI), and plantar fascia thickness (PFT) were compared between the groups in the short term (0.5-1month) and mid-term (3months). Statistical analyses were performed via RevMan 4.5.1, and p<0.05 was considered statistically significant. Five RCTs and two cohort studies, with a total of 567 patients, were included in the meta-analysis. The analysis revealed that at the short-term follow-up (1month), corticosteroid injections were more effective at reducing the VAS pain scores than dextrose prolotherapy for general VAS score (MD=1.85, 95% CI [0.05, 3.64], p=0.04), the VAS score at the first step in the morning (MD=1.26, 95% CI [0.49, 2.02], p=0.001), and the VAS score for pain while walking (MD=1.85, 95% CI [0.68, 3.02], p=0.002). Similarly, at the short-term follow-up (1month), the analysis revealed a significantly greater reduction in the FFI score (MD=18.81, 95% CI [0.06, 37.55]) and PFT (MD=0.26mm, 95% CI [0.07, 0.45]) in the CS group than in the DP group. At 3months, the analysis revealed a significant decrease in the FFI score (p=0.003) in the DP group compared with the CS group, whereas no significant difference was observed in the VAS scores or PFT. In patients with plantar fasciitis, CS injections had greater efficacy than DP did in the short term; however, their efficacy became similar in the mid-term follow-up, with DP outperforming CS in terms of foot function. Further trials with standardized protocols and long-term follow-ups are needed to address potential biases.

Skeletal muscle (SkM) accounts for 30%-40% of body mass. SkM is required for body movement, energy metabolism, and material metabolism, all of which directly impact human quality of life. This review traces the key medicinal plants used for alleviating skeletal muscle disorders (SkMDs), with a focus on lifestyle modifications and exercise. A comprehensive literature search was conducted using databases such as Google Scholar, Elsevier, Springer Nature, Wiley, PubMed, and EKB. SkMDs are a broad category of conditions that affect the muscles, bones, joints, and connective tissues, resulting in major impairments in movement, function, and quality of life. SkMDs affect more than 1.3 billion people worldwide and are a major cause of disability and economic hardship. Conventional therapy approaches, such as pharmaceutical interventions and surgical procedures, are typically limited by undesirable side effects, extended recovery times, and patient dissatisfaction, especially when focusing only on symptom relief. In response, complementary and alternative medicine, particularly medicinal herbs, has grown in popularity to improve SkMD management. Medicinal plants have a diverse range of pharmacologically active compounds with anti-inflammatory, analgesic, and antioxidant effects, making them promising additions to traditional treatments. Berberine, curcumin, resveratrol, quercetin, (-)-epicatechin, and ginsenosides have been reported to have potential in SkMDs. These compounds exert their effects through multiple mechanisms, such as enhancing muscle protein synthesis, reducing inflammation, and modulating hormones that influence muscle mass. Overall, the study emphasizes the ability of natural supplementation approaches to improve clinical outcomes, improve patient well-being, and provide a more sustainable model for treating SkMDs.

Deverra tortuosa and Deverra triradiata are desert perennial shrubs growing extensively in Egypt. We aimed to assess the antioxidant, antiaging, and skin-whitening activities of the aqueous MeOH extract of their roots and flowers, as well as their phenolic content, using HPLC-MS-MS. D. triradiata contained higher phenolic content than D. tortuosa. Phenolic acids and flavonoids account for a significant portion of their extracts. All extracts demonstrated antioxidant activity and inhibited the enzymes elastase, collagenase, and tyrosinase. Compounds 3, 13, 14, and 19 exhibited promising binding to the three enzymes. They displayed the highest affinity to collagenase with binding energies of -9.1, -9.0, -8.4, and -9.2 kcal mol-1, respectively. In conclusion, the two Deverra species are rich in polyphenols and can be used for controlling free radicals and skin aging-related disorders.

<ns3:p>Background The incidence of stress and anxiety among nursing students is observed across all academic years of their educational training. Although Objective Structured Clinical Examinations (OSCEs) are helpful in healthcare education, they can be anxiety-inducing. This study aimed to assess the anxiety level among nursing students during the OSCE exams. Methods A descriptive study was carried out on a purposive sample by distributing an online survey among students from an undergraduate nursing program. Anxiety levels were measured using the State-trait anxiety inventory, including the subscales of the state and trait of anxiety. Results A total of 121 students with a mean age of 22.2 years (SD +/-3.6) participated in the study. The majority of the participants, 72.7%, were females, and 27.3% were males. Before attending the OSCE, 58.7% of the participants reported a mild degree of anxiety, 33.1% had a moderate level of anxiety, and only 10.7% had a severe level of trait anxiety. Conclusions The findings highlight the complex interplay between sociodemographic factors, academic performance, work-study balance, and anxiety levels among nursing students preparing for high-stakes assessments like the OSCE. Addressing anxiety levels among nursing students preparing for OSCE assessments requires a multifaceted approach that considers individual characteristics, academic performance, and external stressors.</ns3:p>

This study evaluated the efficacy and safety of misoprostol, letrozole and their combination in first trimester missed miscarriage. This single-blind, randomised controlled trial was conducted between March 2023 and August 2024 among women diagnosed with first trimester missed miscarriage at Kasr Al-Aini Hospital, Cairo, Egypt. Participants were randomly assigned to three groups: misoprostol-only (Group A), letrozole plus misoprostol (Group B) and letrozole-only (Group C). The primary outcome was the rate of complete miscarriage. Secondary outcomes included abortion timing, adverse effects, need for surgical evacuation and the effect of age, body mass index (BMI) and gestational age on success. A total of 225 women were included in this study. Group B had the highest cumulative complete miscarriage rate by day 7 (76.0%) compared with Group A (53.5%) and Group C (62.5%) (P = 0.0005). Early abortion (by day 4) occurred in 68.4% (group B), 46.5% (group A) and 37.5% (group C). Group B also had the highest incidence of adverse effects, particularly bleeding (85.3%) and pain (92.0%), although severe events were rare. Letrozole-only (group C) had the fewest side effects (26.7%) and required no surgical evacuations. Combination therapy proved most effective across subgroups by age, BMI and gestational age. Combining letrozole with misoprostol significantly improves complete miscarriage rates with tolerable safety. Letrozole alone is safer but less effective. Thus, combination therapy may offer an optimal non-surgical strategy for individualised management.

BackgroundThe use of EkoSonic Endovascular System (EKOS) that combines ultrasound technology with catheter-directed thrombolysis has shown promising outcomes in patients with pulmonary embolism (PE) in dissolving clots effectively. This method targets thrombus removal precisely, minimizing systemic exposure to thrombolytic agents and thereby reducing bleeding risks. Given its minimally invasive approach and focused delivery, EKOS offers a safer alternative for intermediate high-risk patients in whom traditional anticoagulation or systemic thrombolysis may pose higher risks of complications. This study compares the safety and effectiveness of EKOS versus intravenous (IV) alteplase infusion in managing acute PE.MethodsA retrospective cohort study was conducted at a tertiary care hospital, examining patient records from 2022 to 2024 according to predefined eligibility criteria. Individuals aged 18 years or older diagnosed with intermediate- to high-risk PE, who showed clinical deterioration after 48 h of anticoagulation, were enrolled, as assessed by the National Early Waning Score (NEWS). Patients were excluded if they had a stable PE or were at a high risk of hemodynamic decompensation at the time of presentation. The primary outcomes were the change in tricuspid annular plane systolic excursion (TAPSE) and right ventricular-to-left ventricular (RV/LV) diameter ratio from baseline to 1-week outpatient follow-up.ResultsOut of 104 eligible patients, 54 received EKOS (EKOS group) and 50 received IV alteplase infusion (control group). The RV/LV diameter ratio significantly decreased, while TAPSE improved significantly in the EKOS and control groups. At the end of follow-up, the incidence of major bleeding events within 72 h was significantly lower in the EKOS group (2 vs. 8; p = 0.03). Although all-cause mortality at 6 months was lower in the EKOS group, the difference was not statistically significant (p = 0.3).ConclusionEKOS showed comparable efficacy to systemic thrombolysis, reducing right heart strain, improving RV function, and minimizing complications in patients with intermediate- to high-risk PE after failed anticoagulation, with deterioration in clinical condition and the need for rescue thrombolysis. In addition, EKOS had a lower incidence of major bleeding within 72 h, making it a safer option for rescue thrombolysis.

**Traffic increases have made road infrastructure construction difficult for transport planners and operators, risking pavement collapse or resource waste. Egyptian roads have deteriorated due to traffic loads, requiring periodic maintenance and reconstruction. Traffic data is scarce in developing countries like Egypt, making these analyses difficult. This study estimates traffic growth rates across the country using 2008–2018 Egyptian data to address traffic forecasting difficulties. Annual average daily traffic (AADT), population density, and other socioeconomic variables are used in regression analysis to estimate traffic increases. The AADT socio-economic relationship was substantial, with adjusted R2 values from 0.74 to 0.99. Comparing predicted traffic to last year's traffic data at each station in the research showed appropriate results for the proposed models. AADT error rates for proposed models and true values were 0.00–0.025. Thus, traffic growth rate data can improve and develop new roads in such regions. These findings enhance planning accuracy for future projects.