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Objective(s):  This study compared the antimicrobial efficacy of nanographene (NG) particles with chlorhexidine (CHX) and calcium hydroxide (Ca(OH) 2 ) against Enterococcus faecalis ., Materials and Methods:  Forty extracted human mandibular premolar teeth were cleaned using a scaler, and the middle-third of the root (6 mm) was decoronated using a rotary diamond disk. The inner diameter of the teeth was made consistent using Gates Glidden Drills #3, treated with ethylene diamine tetra-acetic acid and sodium hypochlorite before sterilization. The samples were then contaminated with E. faecalis grown in Tryptic soy broth for 21 days. Tooth samples were then randomly divided into four groups: Group I (Control), untreated saline; Group II, Ca(OH) 2 ; Group III, CHX; and Group IV, NG. The assessment of bacterial growth was carried out by harvesting dentin chips at the end of 1, 3, and 7 days. The colonies were physically counted and tabulated after 24 hours from seeding. Statistical analysis of the collected data was performed with analysis of variance and Tukey's post hoc test using SPSS Version 20.0., Results:  The contaminated dentine blocks irrigated with NG (0.5 µg) and CHX (0 ± 0; p  < 0.001) had no growth of E. faecalis colonies compared to blocks of Ca(OH) 2 (10 ± 21) and saline (927 ± 455). All concentrations of NG (0.5 and 1.0 µg) showed effectiveness higher ( p  < 0.001) than 2% CHX when measured by the zone of inhibition against E. faecalis. CONCLUSION:  It may be concluded that NG is effective against growth of E. faecalis and may be used as a promising antimicrobial agent during root canal treatment. However, further studies should be done to investigate the effect of NG against other dental pathogens., Competing Interests: None declared., (The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).)

Inappropriate disposal of plastic wastes and their durability in nature cause uncontrolled accumulation of plastic in land/marine ecosystems, also causing destructive effects by bioaccumulating along the food chain. Microplastics may cause chronic inflammation in relation to their permanent structures, especially through oxidative stress and cytotoxic cellular damage, which could increase the risk of cancer development. The accumulation of microplastics in the liver is a major concern, and therefore, the identification of the mechanisms of their hepatotoxic effects is of great importance. Polymethyl methacrylate (PMMA) is a widely used thermoplastic. It has been determined that PMMA disrupts lipid metabolism in the liver in various aquatic organisms and causes reproductive and developmental toxicity. PMMA-induced hepatotoxic effects in humans have not yet been clarified. In our study, the toxic effects of PMMA (in the range of 3-10 μm) on the human liver were investigated using the HepG2/THP-1 macrophage co-culture model, which is a sensitive immune-mediated liver injury model. Cellular uptake of micro-sized PMMA in the cells was done by transmission electron microscopy. Determination of its effects on cell viability and inflammatory response, oxidative stress, along with gene and protein expression levels that play a role in the mechanism pathways underlying the effects were investigated. The results concluded that inflammation, oxidative stress, and disruptions in lipid metabolism should be the focus of attention as important underlying causes of PMMA-induced hepatotoxicity. Our study, which points out the potential adverse effects of microplastics on human health, supports the literature information on the subject., (© 2024. The Author(s).)

Drug-induced liver injury (DILI) is one of the widespread causes of liver injury and immune system plays important role. Abemaciclib (ABE) is a cyclin-dependent kinase inhibitor used as monotherapy or combination therapy in the treatment of breast cancer. Like other kinase inhibitors, the underlying mechanisms of ABE-induced hepatotoxicity are not completely known yet. In the current study, hepatotoxicity of ABE was evaluated with HepG2/THP-1 co-culture model which has been developed in recent years for the evaluation of DILI potential. Following ABE treatment, oxidative stress, mitochondrial damage, cytokine secretion levels, apoptotic/necrotic cell death were determined. According to our results, ROS production along with GSH depletion was observed in HepG2 cells after ABE treatment. ABE promoted secretion of pro-inflammatory mediators (TNF-α and MCP-1) and declined anti-inflammatory cytokine IL-10 release. Besides, NF K β and JNK1 protein expression levels increased following ABE treatment. ABE enhanced intracellular calcium levels, induced early apoptotic and necrotic cell deaths in HepG2 cells. Furthermore, the changes in some mitochondrial parameters including a reducement in intracellular ATP levels and complex V activity; hyperpolarized mitochondrial membrane potential and enhanced mitochondrial ROS levels were observed, whereas mitochondrial mass did not show any differences after ABE treatments. Therefore, ABE-induced hepatotoxic effects is probably via oxidative stress, inflammatory response and necrotic cell death rather than direct mitochondrial toxicity. In conclusion; the study makes a significant contribution to strengthening the infrastructure we have on in vitro toxicity mechanism evaluations, which are the basis of preclinical toxicity studies., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Ripretinib is a multikinase inhibitor drug approved in 2020 by the FDA and in 2021 by EMA for use in the treatment of advanced gastrointestinal stromal tumors (GIST) which have not adequately responded to previous treatments with kinase inhibitors. The most common side effects of the drug are myalgia and fatigue, which likely causes interruption of the treatment or reduction of the dose. Skeletal muscle cells highly depend on ATP to perform their functions and mitochondrial damage may play a role in skeletal muscle toxicity induced by kinase inhibitors. However, the molecular mechanism has not been clearly identified in the literature yet. In this study, it has been aimed to elucidate the role of mitochondria in the toxic effect of ripretinib on skeletal muscle using the mouse C2C12 myoblast-derived myotubes. The myotubes were exposed to ripretinib at the range of 1-20 μM concentrations for 24 h. To determine the potential role of mitochondrial impairment in ripretinib-induced skeletal muscle toxicity, intracellular ATP level, mitochondrial membrane potential (MMP), mitochondrial ROS production (mtROS), mitochondrial DNA (mtDNA) copy number, and mitochondrial mass were examined after ripretinib treatment. Furthermore, changes in PGC 1α/NRF 1/NRF 2 expression levels that play a role in mitochondrial biogenesis and mitophagy were investigated. Additionally, the mitochondrial electron transport chain (ETC) enzyme activities were evaluated. Lastly, a molecular docking study was done to see ripretinib's possible interaction with DNA polymerase gamma (POLG) which is important for DNA replication in the mitochondria. According to the findings, ripretinib decreases the ATP level and mtDNA copy number, induces loss of MMP, and reduces mitochondrial mass. The activities of the ETC complexes were inhibited with ripretinib exposure which is in line with the observed ATP depletion and MMP loss. The molecular docking study revealed that ripretinib has inhibitory potential against POLG which supports the observed inhibition of mtDNA. The expression of PGC 1α was reduced in the nuclear fraction indicating that PGC-1α was not activated since the NRF 1 expression was reduced and NRF 2 level did not show significant change. Consequently, mtROS production increased in all treatment groups and mitophagy-related gene expressions and Parkin protein expression level were up-regulated at high doses. In conclusion, mitochondrial damage/loss can be one of the underlying causes of ripretinib-induced skeletal muscle toxicity. However, further studies are needed to confirm the results in vivo., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

In this study, the biotransformation of carvone and camphor by Aspergillus flavus and the products were investigated. The biotransformation reaction of carvone by A. flavus resulted in the production of neodihydrocarveol, dihydrocarvone, 2-cyclohexene-1-one,2-methyl-5-(1-methylethenyl), limonene-1,2-diol, trans-p-mentha-1(7),8-dien-2-ol, p-menth-8(10)-ene-2,9-diol, and the biotransformation reaction of camphor resulted in the production of 2 -campholenic acid, 2-cyclohexene-1-one,2-hydroxy-4,4,6,6-tetramethyl, α-campholene aldehyde. The naturally produced essential oils by biotransformation of carvone and camphor were observed to be cytotoxic to breast cancer cells while no significant inhibition was seen in the healthy cell line. Additionally, biotransformation products had the highest inhibition (74%) against aflatoxin B1. The bioactivities of biotransformation products are promising, and they can be further investigated for their therapeutic potential as active agents.

The liver and the kidney are one of the vital organs of body. Drug-induced toxicity is one of the most common problems encountered by these organs. The search for an effective medicine to treat this toxicity without any side effects has led to the use of traditional-based medicine. This study evaluated the effect of ethanolic extract of Moringa oleifera seed oil on hepatic and renal markers in dimethyl 2, 2-dichlorovinyl phosphate (DDVP, known as dichlorvos)-exposed Wistar rats. Twenty-one male Wistar rats were randomly divided into three groups of seven animals each. Group A served as the negative control and were not exposed to dichlorvos. Group B served as the positive control and were exposed to dichlorvos for 2 minutes but received no extract. Group C animals were exposed to the dichlorvos and received 300mg/kg of extract (Moringa oleifera seed oil) for 7days before and 21days after exposure. Exposure to DDVP led to a significant increase in hepatic & renal markers, inflammatory markers, decrease in plasma protein and alteration of plasma electrolyte. Moringa oleifera seed oil regulated and significantly enhanced plasma protein, reduced elevated levels of hepatic & renal markers, inflammatory markers in the study sample. In addition, histopathology observation showed that Moringa seed oil was able to regenerate the hepatorenal damage on exposure to dichlorvos. Conclusion: Moringa oleifera seed oil exhibited hepato-protective, nephroprotective properties and could be explored in nutrition and health.

This systematic review aims to evaluate the antimicrobial activity of α-mangostin derived from Garcinia mangostana against different microbes. A literature search was performed using PubMed and Science Direct until March 2022. The research question was developed based on a PICO (Population, Intervention, Control and Outcomes) model. In this study, the population of interest was microbes, α-mangostin extracted from Garcinia mangostana was used as exposure while antibiotics were used as control, followed by the outcome which is determined by the antimicrobial activity of α-mangostin against studied microbes. Two reviewers independently performed the comprehensive literature search following the predetermined inclusion and exclusion criteria. A methodological quality assessment was carried out using a scoring protocol and the risk of bias in the studies was analyzed. Reward screening was performed among the selected articles to perform a meta-analysis based on the pre-determined criteria. Case groups where α-mangostin extracted from Garcinia mangostana was incorporated were compared to groups using different antibiotics or antiseptic agents (control) to evaluate their effectiveness. A total of 30 studies were included; they were heterogeneous in their study design and the risk of bias was moderate. The results showed a reduction in microbial counts after the incorporation of α-mangostin, which resulted in better disinfection and effectiveness against multiple microbes. Additionally, the meta-analysis result revealed no significant difference (p > 0.05) in their effectiveness when α-mangostin was compared to commercially available antibiotics. α-mangostin worked effectively against the tested microbes and was shown to have inhibitory effects on microbes with antibiotic resistance.

Stigma against mental disability within the medical field continues to impose significant barriers on physicians and trainees. Here, we examine several implications of this stigma and propose steps toward greater inclusion of persons with mental disabilities in the physician workforce.

Objective: To investigate the current and future teaching of posterior composite restorations in undergraduate curricula in Malaysian dental schools., Methods: A 24-item validated questionnaire including closed and open questions on the teaching of posterior composites was emailed to faculty members in all 13 Dental Schools in Malaysia. Responses were compiled on Excel and analysed., Results: All 13 dental schools responded to the survey yielding a 100 % response. All schools indicated the use of posterior composites for 2- and 3-surface cavities in premolars and molars. The didactic teaching time devoted to composites was greater than for amalgam (38 h vs 29 h). Clinically, most posterior restorations placed by students were composites (average 74.1 %, range 10 %-100 %); the remaining 25.9 % were amalgams (range, 0 %-50 %). Slot-type cavities were the preparation techniques most commonly taught (n = 11,84.6 %). The use of rubber dam for moisture control was mandatory in most schools (n = 11, 84.6 %). History of adverse reaction to composites was found to be the most common contraindication to composite placement. The phase down of teaching and use of amalgam in Malaysia is expected to occur within the next six years., Conclusion: The trend to increase the teaching of posterior composites reported for other countries is confirmed by the findings from Malaysian dental schools. Notwithstanding this trend, the use of amalgam is still taught, and future studies are required to investigate the implications of the phase down of amalgam in favour of posterior composites., Clinical Significance: Notwithstanding the increase in the teaching of posterior composites there is a pressing need to update and refine clinical guidelines for the teaching of posterior composites globally., (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Competing Interests: Competing interests: None declared.

Aim: With disabled patients, clinicians are often mechanistically oriented, limiting goals to bodily improvements of perceived deficits back to species-typical functioning. Psychological goals, when present at all, are often pessimistically narrow, or phenomenologically shallow. Recent research on fourth wave psychotherapies helps broaden clinical concepts of healing and treatment beyond mere deficit remediation, and helps match clinical goals with the richness of human flourishing and the layered complexity of the patient's evolving experience of meaning. Method: This article draws from first-hand accounts of the experience of disability and adjustment to impairment, along with a synthesis of recent theoretical and experimental work in clinical psychology and psychotherapy, to present recommendations for more accurate and ethical notions of rehabilitation for clinical practice. Results: We explain the clinical value of "flourishing": the psychological, social, cultural, existential, moral, spiritual and religious dimensions of the patient in the context of their dynamic narrative existence in meaningful relationship and ritual formation. This approach allows clinicians to personalize and humanize caregiving in line with human strengths, move beyond an aim of mere recovery, more accurately characterize perceived impairments, goals of care, and successful treatment outcomes. These more capacious and experientially-attuned clinical concepts and aims help the clinician accompany and empower patients by understanding what is at stake throughout the illness experience. Conclusions: This flourishing model helps to reimagine the clinician-patient relationship, and the methods and entire purpose of rehabilitation medicine, and clinical medicine more broadly. The condition of blindness is presented as an illustrative case.Implications for rehabilitationAmidst vast medical and technological advances in diagnosis and treatment of disabilities, modern health systems often still approach rehabilitation of disability via species-typical standards of bodily or mental homeostasis as the standard of sound health, without considering the perspectives and experiences of flourishing that are unique to the individual who is sufferingPsychological, social scientific, and religious traditions uniquely explore the inner experiences of individuals and their relationships, and can be used to help patients find individualized paths to recovery, healing, and flourishingFourth-wave psychotherapies, utilizing existential, humanistic, and spiritual/religious philosophies, have resources clinicians can use to help patients aim beyond mere recovery, and allow for the possibility of "ultrabilitation"Attention to the psychological, social, cultural, existential, moral, spiritual, and religious dimensions of the patient in the context of their dynamic existence can promote ultrabilitationDedicated focus on compassion, virtue, dignity, gratitude, contemplative wisdom, and transcendence can enable one to conceptualize flourishing in a way independent or complementary to bodily outcomes in recovery, and sometimes even when illness or disability persists.

Introduction: Suicide is a global problem and accurate assessment of risk for self-harm is critical. Even morally principled clinicians can manifest bias when assessing self-harm in patients with physical disabilities such as spinal cord injury (SCI). Assessment of self-harm is an obligation for health care clinicians and overestimating or underestimating risk may undermine a patient's trust in their care, possibly leading to less engagement, increased apathy about having an interest in living, and less adherence to healthy treatment options., Case Presentation: Introduces readers to three biases that can impact decision-making regarding a patient with a disability when assessing the patient's risk for self-harm: (1) ineffectual bias, (2) fragile friendliness bias, and (3) catastrophe bias. These preconceptions are derived from a mix of paternalism, projection, low expectations, pity, and infantilization. In this paper, we explain how each bias can affect clinical decision-making regarding diagnosis, treatment, prognosis, and prevention for patients with SCI within a common case scenario. Readers can employ personal reflection and potential self-application when they encounter individuals with SCI in and outside clinical settings., Discussion: Unchecked biases toward the disabled and patients with SCI can undermine ethical caregiving. Biases are habits of mind and thoughtful clinical and education interventions can improve clinical practice. The literature on health care bias with other minority groups is instructive for investigating biases related to patients with disabilities, and especially for clinicians outside of rehabilitation medicine.

The aim of the present systematic review was to evaluate the effectiveness of technology-enhanced learning (TEL) in the field of Endodontics to improve educational outcomes compared to traditional learning methods. Randomized controlled studies published in English were identified from two electronic databases (PubMed and Scopus) up to May 2018. Two authors independently performed study selection, data extraction and assessed the risk of bias (ROB). Any teaching method using TEL was considered as the intervention, and this was compared to traditional methods. The outcome measuring the effectiveness of learning activities was evaluated by Kirkpatrick's four-level training evaluation model. The four levels of training outcomes are as follows: Reaction, Learning, Behaviour and Results. A meta-analysis was performed to estimate the standardized mean difference (SMD) by the random effects model. In total, 13 studies were included in the systematic review. Only three studies were assessed as 'low' ROB. A meta-analysis could not be performed in the domains of Reaction and Behaviour. No significant difference was observed in knowledge gain (Learning domain) between TEL and traditional methods (SMD, 0.14 (95% CI -0.10 to 0.39) I 2  = 62.7%). Similarly, no difference was observed in performance (Behaviour domain). A variable response was found in attitude (Reaction domain). From the available evidence, it can be concluded that TEL is equally as effective as traditional learning methods., (© 2018 International Endodontic Journal. Published by John Wiley & Sons Ltd.)

Recently, multiple culprits-in addition to melanocytes-have been implicated in the pathogenesis of vitiligo. Among those factors are fibroblasts. However, their exact role has not been clearly elucidated. The aim of the study was to evaluate the possible role played by fibroblasts in vitiligo via studying the expression Tenascin C and DKK1 in acral versus non-acral vitiligo lesions. This case-control study included 19 non-segmental vitiligo patients and ten controls. All patients were subjected to thorough clinical evaluation. Both Tenascin C and DKK1 were measured in lesional and peri-lesional skin of acral and non-acral lesions using ELISA technique. The measured levels of Tenascin C and DKK1 were significantly higher in the vitiligo group when compared to controls in all assessed sites (P < 0.05). Tenascin C was found to be significantly higher in lesional areas compared to peri-lesional ones only in the acral sites. DKK1 was significantly higher in lesional areas in all assessed sites (P < 0.05). The current work suggests a malfunction of fibroblasts in vitiligo, through demonstrating significant up-regulation of two melanogenesis inhibitory products (Tenascin C and DKK1) in patients compared to controls. Larger scale studies are warranted to detect the possible implications of such findings on vitiligo treatment.

Introduction: The aim of this systematic review (SR) was to evaluate the quality of SRs and meta-analyses (MAs) in endodontics., Methods: A comprehensive literature search was conducted to identify relevant articles in the electronic databases from January 2000 to June 2017. Two reviewers independently assessed the articles for eligibility and data extraction. SRs and MAs on interventional studies with a minimum of 2 therapeutic strategies in endodontics were included in this SR. Methodologic and reporting quality were assessed using A Measurement Tool to Assess Systematic Reviews (AMSTAR) and Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA), respectively. The interobserver reliability was calculated using the Cohen kappa statistic. Statistical analysis with the level of significance at P < .05 was performed using Kruskal-Wallis tests and simple linear regression analysis., Results: A total of 30 articles were selected for the current SR. Using AMSTAR, the item related to the scientific quality of studies used in conclusion was adhered by less than 40% of studies. Using PRISMA, 3 items were reported by less than 40% of studies, which were on objectives, protocol registration, and funding. No association was evident comparing the number of authors and country with quality. Statistical significance was observed when quality was compared among journals, with studies published as Cochrane reviews superior to those published in other journals. AMSTAR and PRISMA scores were significantly related., Conclusions: SRs in endodontics showed variability in both methodologic and reporting quality., (Copyright © 2018 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Research on human cooperation has concentrated on the puzzle of altruism, in which 1 actor incurs a cost to benefit another, and the psychology of reciprocity, which evolved to solve this problem. We examine the complementary puzzle of mutualism, in which actors can benefit each other simultaneously, and the psychology of coordination, which ensures such benefits. Coordination is facilitated by common knowledge: the recursive belief state in which A knows X, B knows X, A knows that B knows X, B knows that A knows X, ad infinitum. We test whether people are sensitive to common knowledge when deciding whether to engage in risky coordination. Participants decided between working alone for a certain profit and working together for a potentially higher profit that they would receive only if their partner made the same choice. Results showed that more participants attempted risky coordination when they and their prospective partner had common knowledge of the payoffs (broadcast over a loudspeaker) than when they had only shared knowledge (conveyed to both by a messenger) or private knowledge (revealed to each partner separately). These results support the hypothesis that people represent common knowledge as a distinct cognitive category that licenses them to coordinate with others for mutual gain. We discuss how this hypothesis can provide a unified explanation for diverse phenomena in human social life, including recursive mentalizing, performative speech acts, public protests, hypocrisy, and self-conscious emotional expressions., (2014 APA, all rights reserved)

Dehumanization is endemic in medical practice. This article discusses the psychology of dehumanization resulting from inherent features of medical settings, the doctor-patient relationship, and the deployment of routine clinical practices. First, we identify six major causes of dehumanization in medical settings (deindividuating practices, impaired patient agency, dissimilarity, mechanization, empathy reduction, and moral disengagement). Next, we propose six fixes for these problems (individuation, agency reorientation, promoting similarity, personification and humanizing procedures, empathic balance and physician selection, and moral engagement). Finally, we discuss when dehumanization in medical practice is potentially functional and when it is not. Appreciating the multiple psychological causes of dehumanization in hospitals allows for a deeper understanding of how to diminish detrimental instances of dehumanization in the medical environment., (© The Author(s) 2012.)

As the prevalence of autism spectrum disorders (ASDs) has increased, attention has shifted toward consideration of ASDs in adolescence and adulthood, as well as public health repercussions for this population. Since the social and emotional deficits within ASDs may be salient during incidents of unintended criminal or violent behavior, one area of focus is involvement of adolescents and young adults with ASD in the criminal justice system. Without a thorough understanding of how and why individuals with ASDs may exhibit criminal behavior, judicial and legislative state systems have begun to develop policies lacking a substantial evidence base. In this article, we attempt to synthesize the literature on one type of ASD (high functioning) and criminal behavior. Three specific deficits characteristic of individuals with ASDs (theory of mind, emotion regulation, and moral reasoning) are examined as potential confluent forces leading to criminal behavior among individuals with ASDs. Legal and policy recommendations are presented.

Private practice physicians in Hawaii were surveyed to better understand their impressions of different insurance plans and their willingness to care for patients with those plans. Physician experiences and perspectives were investigated in regard to reimbursement, formulary limitations, pre-authorizations, specialty referrals, responsiveness to problems, and patient knowledge of their plans. The willingness of physicians to accept new patients from specific insurance company programs clearly correlated with the difficulties and limitations physicians perceive in working with the companies (p<0.0012). Survey results indicate that providers in private practice were much more likely to accept University Health Alliance (UHA) and Hawaii Medical Services Association (HMSA) Commercial insurance than Aloha Care Advantage and Aloha Quest. This was likely related to the more favorable impressions of the services, payments, and lower administrative burden offered by those companies compared with others., (Hawaii Medical Journal Copyright 2011.)

Noise is one of the major problems that hinder an effective texture analysis of disease in medical images, which may cause variability in the reported diagnosis. In this paper seven texture measurement methods (two wavelet, two model and three statistical based) were applied to investigate their susceptibility to subtle noise caused by acquisition and reconstruction deficiencies in computed tomography (CT) images. Features of lung tumours were extracted from two different conventional and contrast enhanced CT image data-sets under filtered and noisy conditions. When measuring the noise in the background open-air region of the analysed CT images, noise of Gaussian and Rayleigh distributions with varying mean and variance was encountered, and Fishers' distance was used to differentiate between an original extracted lung tumour region of interest (ROI) with the filtered and noisy reconstructed versions. It was determined that the wavelet packet (WP) and fractal dimension measures were the least affected, while the Gaussian Markov random field, run-length and co-occurrence matrices were the most affected by noise. Depending on the selected ROI size, it was concluded that texture measures with fewer extracted features can decrease susceptibility to noise, with the WP and the Gabor filter having a stable performance in both filtered and noisy CT versions and for both data-sets. Knowing how robust each texture measure under noise presence is can assist physicians using an automated lung texture classification system in choosing the appropriate feature extraction algorithm for a more accurate diagnosis.

I. viscosa has been used for years in folk medicine for its anti-inflammatory, antipyretic, antiseptic, and paper antiphlogistic activities. In this study, cytotoxic and genotoxic effects of I. viscosa leaf extracts on the root meristem cells of Allium cepa have been examined. Onion bulbs were exposed to 2.5 mg/ml, 5 mg/ml, and 10 mg/ml concentrations of the extracts for macroscopic and microscopic analysis. Tap water has been used as a negative control and Ethyl methanesulfonate (EMS) (2 * 10(-2) M) has been used as a positive control. The test concentrations have been determined according to doses which are recommended for use in alternative medicine. There has been statistically significant (P < .05) inhibition of root growth depending on concentration by the extracts when compared with the control groups. All the tested extracts have been observed to have cytotoxic effects on cell division in A. cepa. I. viscosa leaf extract induces the total number of chromosomal aberrations and micronuclei (MNC) formations in A. cepa root tip cells significantly when compared with control groups. Also, this paper shows for the first time the induction of cell death, ghost cells, cells with membrane damage, and binucleated cells by extract treatment. These results suggest the cytotoxic and genotoxic effects of the I. viscosa leaf extracts on A. cepa.