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Background During the last few decades, patients worldwide have been interested in using alternative medicine in treating diseases to avoid the increased side effects of chemical medications. Green coffee is unroasted coffee seeds that have higher amounts of chlorogenic acid compared to roasted coffee. Green coffee was successfully used to protect against obesity, Alzheimer disease, high blood pressure and bacterial infection. Methods This study aimed to investigate the probable protective activity of the green coffee methanolic extract, silymarin and their combination on CCl4-induced liver toxicity in male rats. Thirty Sprague – Dawley male albino rats were divided into 5 groups; control negative (G1) just got the vehicle (olive oil) and the other four groups received CCl4 dissolved in olive oil through an intraperitoneal injection and were divided into untreated control positive group (G2), the third group (G3) was treated with green coffee methanolic extract, the fourth group (G4) was treated with silymarin, and the fifth group (G5) was treated with a combination of green coffee methanolic extract and silymarin. Results In the positive control group treated with CCl4 (G2), the CCl4-induced toxicity increased lipid peroxidation, IL-6, kidney function parameters, liver function enzymes, total cholesterol, triglycerides and low-density lipoproteins, and decreased irisin, antioxidants, CYP450 and high-density lipoprotein levels. Hepatic tissues were also injured. However, treating the injured rats in G3, G4 and G5 significantly improved the altered parameters and hepatic tissues. Conclusions Green coffee methanolic extract, silymarin, and their combination succeeded in protecting the male rats against CCl4 hepatotoxicity due to their antioxidant activity. Effect of green coffee methanolic extract mixed with silymarin in G5 was more efficient than that of green coffee methanolic extract in G3 or silymarin in G4.

Introduction: Diabetic nephropathy (DN) is one of most prevalent diabetic complication. It remains unclear whether the anti-inflammatory Hydroxytyrosol (HT) has beneficial effects on biogenesis of diabetic renal changes. So, we aimed to find out the relationship between inflammation, apoptosis, oxidative stress and the progression of DN. Also, try to assess the possible effects of HT on diabetic renal tissue. Materials and Methods: Rats were divided into: non-diabetic rats (group I) and rats with induced type II diabetes that were subdivided into: group II non-treated DM, group III treated with HT, group IV treated with glyclazide and group V treated with combined treatment. Treatments were supplied for eight weeks. Results: Administration of HT alone or with GLY significantly lowered blood glucose levels and ameliorated kidney hypertrophy index together with improving renal dysfunction parameters including creatinine in serum and urine, blood urea nitrogen, serum and urinary albumin, together with the tissue oxidative markers and inflammatory cytokines activities compared to diabetic group. These effects of HT were also reflected on histologic evaluation and Nrf2- Keap1 system expression. Conclusion: This study discovers the renoprotective effect of HT in diabetic rats. Hence, this study recommended an addition of antioxidants like HT to the management of diabetes.

BACKGROUND: Many factors have been implicated in the pathogenesis of unexplained recurrent spontaneous miscarriage (URSM). METHODS: The objective of this preliminary clinical study was to verify whether intravaginal sildenafil citrate tablets (25 mg intravaginally 4 times/day for 24 days) are effective as a novel treatment of threatened miscarriage in patients with a history of URSM (n=4). We also evaluated changes in the concentrations of some antioxidants the percent expression of cells positive for tumor necrosis factor-alpha (TNF-alpha) CD56+T-cells [CD3+CD56+ natural killer cells (NKT cells) (cluster differentiation 3 56 NKT cells)] which express one of the NK cell markers and uterine artery pulsatility index (PI). We compared these results with healthy women in their first trimester of pregnancy (FTP n=4). RESULTS: Sildenafil improved the measured antioxidants concentrations [total antioxidant capacity (TAC) glutathione S-transferase (GSH-S-T) and catalase (CAT) superoxide dismutase (SOD)] and improved oxidative stress by reducing malondialdehyde (MDA) and nitric oxide (NO) in the four patients under investigation. The improvement in antioxidants was close to concentrations seen in women in their FTP. The four patients had progressed to their third trimester of pregnancy using this novel application. The percentage of [CD3+CD56+ NKT cells] and TNF-alpha in peripheral blood was higher in URSM patients compared to women in their FTP. However concentrations were greatly reduced and improved after sildenafil administration. We demonstrated that intravaginal sildenafil citrate tablets can reduce vasoconstriction by increasing blood flow through relaxation of uterine arteries as indicated from measured PI in URSM patients. CONCLUSIONS: We conclude that intravaginal sildenafil citrate tablets used as suppositories might be a novel interesting safe antiabortive option in the treatment of threatened miscarriage in patients with a history of URSM. We are the first to report this novel clinical application in four case reports in Egypt.

Many factors have been implicated in the pathogenesis of unexplained recurrent spontaneous abortion (URSA). The current study was conducted to determine the possible role of antioxidant status and tumor necrosis factor-alpha (TNF-alpha) in URSA.Reduced glutathione (GSH), glutathione reductase (GSH-R), glutathione peroxidase (GSH-PX), catalase (CAT), superoxide dismutase (SOD), nitric oxide (NO), malondialdehyde (MDA) and TNF-alpha were assayed in women suffering unexplained first-trimester abortions. Two groups were included, the first represented by 24 women with URSA (number of abortions 3-5) and the second included 16 women with URSA (number of abortions5). The control group included 20 women within their first trimester of pregnancy and 20 non-pregnant healthy females within their follicular phase.We observed that the antioxidant levels measured were significantly lower in URSA groups than in the control group (p0.05 for each comparison). Higher TNF-alpha, MDA and NO production were detected in URSA groups compared to controls (p0.05 for each comparison). URSA 3-5 was associated with significantly higher levels of antioxidants and lower levels of TNF-alpha compared to levels in URSA5.Impaired antioxidant defense and an increase in oxidative reactive species may be responsible for recurrent abortion due to possible damage produced by their generation. In addition, the level of TNF-alpha apparently contributes to the pathogenesis of URSA.