Sixteen new thalidomide analogs were synthesized. The new candidates showed potent in vitro antiproliferative activities against three human cancer cell lines, namely hepatocellular carcinoma (HepG-2), prostate cancer (PC3), and breast cancer (MCF-7). It was found that compounds XII, XIIIa, XIIIb, XIIIc, XIIId, XIVa, XIVb, and XIVc showed IC₅₀ values ranging from 2.03 to 13.39 µg/mL, exhibiting higher activities than thalidomide against all tested cancer cell lines. Compound XIIIa was the most potent candidate, with an IC₅₀ of 2.03 ± 0.11, 2.51 ± 0.2, and 0.82 ± 0.02 µg/mL compared to 11.26 ± 0.54, 14.58 ± 0.57, and 16.87 ± 0.7 µg/mL for thalidomide against HepG-2, PC3, and MCF-7 cells, respectively. Furthermore, compound XIVc reduced the expression of NFκB P65 levels in HepG-2 cells from 278.1 pg/mL to 63.1 pg/mL compared to 110.5 pg/mL for thalidomide. Moreover, compound XIVc induced an eightfold increase in caspase-8 levels with a simultaneous decrease in TNF-α and VEGF levels in HepG-2 cells. Additionally, compound XIVc induced apoptosis and cell cycle arrest. Our results reveal that the new candidates are potential anticancer candidates, particularly XIIIa and XIVc. Consequently, they should be considered for further evaluation for the development of new anticancer drugs.

In aluminium phosphide (AlP) poisoning, death is mainly due to acute heart failure. There is some evidence showing that N-acetylcysteine (NAC) and coenzyme Q10 have antioxidant and cardioprotective effects. This study investigated a new approach for treating acute AlP poisoning by using NAC and Co-Q10 as adjuvant therapy. The study design was a retrospective-prospective study. It was conducted in the poisoning unit of Kafer Eldwar General Hospital. Sixty patients with acute aluminium phosphide poisoning were included. The patients were divided into two groups. The first group (standard protocol) considered the control group received the standard supportive care, and their data were collected from the medical records. The second group (new protocol) in addition to the standard supportive care received the NAC and CoQ10 regimen, and all data were collected in a specially designed sheet. The results showed that the highest percentage of patients in both groups were aged 18–25, followed by those under 18, and females outnumbered the males. The systolic (SBP) and diastolic (DBP) blood pressure showed significant improvement in the new protocol group. A significant statistical difference was found between the two groups regarding mechanical ventilation (p = 0.015), where mechanical ventilation was used in 20 % of patients in the new protocol group and 50 % in the standard group. Regarding the outcome of patients, the survival rate reached 73.3 % upon using the new protocol, compared to 50 % who received the standard protocol. The data imply that further investigation in using the NAC and CoQ10 regimen is warranted. It gave an improvement of the survival rate and decrease the need for mechanical ventilation in AlP

Tocilizumab, an interleukin-6 receptor antagonist, has been utilized as a treatment for severe COVID-19 cases due to its anti-inflammatory properties. However, its effectiveness in critically ill patients remains controversial. This retrospective cohort study aimed to evaluate the effectiveness of tocilizumab in reducing mortality and improving clinical outcomes in severe or critically ill COVID-19 patients. Data from 320 patients were reviewed, with 105 meeting the inclusion criteria. Patients were divided into two groups: 72 received the standard COVID-19 treatment protocol, and 33 received tocilizumab. The tocilizumab group had a lower mortality rate (63.6%) compared to the standard protocol group (79.2%), although this difference was not statistically significant (risk difference: 15.6%; 95% CI: –4.3 to 35.5; p = 0.091). The length of hospital stay was significantly longer in the tocilizumab group (median: 11 days, IQR: 7–17) compared to the standard treatment group (median: 7.5 days, IQR: 5–12; 95% CI: 0.014–0.019; p = 0.016). Kaplan–Meier survival analysis demonstrated a statistically significant trend in favor of the tocilizumab group (p = 0.021), despite the non-significant difference in overall mortality rates. These findings suggest that tocilizumab may offer a potential survival advantage in severe COVID-19 patients, although further studies are needed to confirm its effectiveness.

Background: Gut microbiota modulators (GMMs), including probiotics, prebiotics, and synbiotics, play a crucial role in maintaining gut health and influencing immunity, metabolism, and the gut–brain axis. Recently, these agents have gained interest for their potential to be repurposed beyond gastrointestinal disorders to target neurological, metabolic, and immune-related diseases. Main body: Emerging evidence highlights the therapeutic versatility of GMMs. They exhibit protective effects against gastrointestinal infections such as Salmonella and Clostridioides difficile by enhancing mucosal immunity and suppressing pathogens. In neurological disorders, GMMs mitigate neuroinflammation and oxidative stress, showing potential benefits in Alzheimer’s and Parkinson’s diseases. Their role in modulating neurotransmitter balance also supports applications in autism spectrum disorder and attention-deficit hyperactivity disorder. Furthermore, integrating GMMs into drug delivery systems improves targeted therapeutic delivery and minimizes adverse effects. Conclusion: Repurposing GMMs represents an innovative and sustainable approach for precision medicine. By modulating gut microbial composition and signaling pathways, GMMs may extend therapeutic benefits to a range of systemic diseases. However, large-scale clinical trials are still required to validate efficacy, establish standardized protocols, and clarify safety concerns.