Sohag University

Obesity and diabetes are escalating worldwide health concerns, prompting the use of non-caloric sweeteners such as aspartame and stevia as substitutes for sucrose; however, their long-term physiological and behavioral consequences remain incompletely understood. This work presents a comparative experimental study examining the long-term effects of sucrose, aspartame, and stevia intake on liver, heart, and brain functions in rats, while exploring the capacity of astaxanthin (ASTX) to attenuate the resulting tissue impairments. Seven rat groups-including control, sucrose, aspartame, stevia, and each sweetener combined with ASTX-were treated for 8 weeks to compare the organ-specific toxicity of the sweeteners and assess the protective effects of ASTX. Comprehensive evaluations of liver, heart, and brain were conducted using biochemical, behavioral, and histopathological analyses. All three sweeteners induced hyperglycemia, disrupted lipid metabolism (triglycerides, LDL, HDL), and increased oxidative stress (MDA), suppressing Nrf2/HO-1 antioxidant pathway and activating TLR4/NF-κB-mediated inflammation, leading to apoptosis. Biomarkers revealed liver dysfunction (ALT, AST, ALP), cardiac injury (troponin I, CK-MB, MEF2), and cognitive impairment (amyloid-beta, tau, BDNF), alongside altered monoamine neurotransmitters and Wnt3a/GSK-3β/β-catenin dysregulation. Bax/Bcl-2 ratio indicated enhanced apoptosis, with aspartame exerting the highest toxicity and stevia the least. While ASTX effectively alleviated these biochemical, histological, and functional changes. These findings suggest that aspartame has the strongest negative impact on liver, heart, and brain health, while stevia has the least, and that ASTX may serve as a potential protective agent against these harmful impacts.

Objective: To compare the outcomes of microscopic subinguinal varicocelectomy versus oral antioxidants in managing male infertility associated with isolated teratozoospermia.Methods: This multicenter randomized controlled trial was conducted between January 2022 and January 2024. A total of 81 patients with isolated teratozoospermia and clinical varicoceles completed the study; 40 patients underwent varicocele ligation (group A), and 41 patients received oral antioxidants (L-carnitine, vitamin C, and vitamin E) (group B). Sperm morphology, sperm DNA fragmentation (SDF), and the achievement of natural pregnancy were compared between the two groups. Additionally, predictive factors for improvement were analyzed.Results: All sperm parameters improved significantly following either varicocele ligation or antioxidant treatment. SDF decreased significantly in both groups (p<0.001). The increase in the percentage of normal sperm forms and the reduction in SDF were significantly greater in the varicocele surgery group compared to the antioxidant group (<i>p=0.007 and p=0.013, respectively). The natural pregnancy rate was higher in the varicocele ligation group, with nine patients (22.5%) achieving pregnancy compared to five patients (12.5%) in the antioxidant group. Moreover, the presence of pinpoint and round head abnormalities predicted significantly poorer outcomes following varicocele ligation (p=0.003).Conclusion: Varicocelectomy appears to be more effective than antioxidants in improving sperm morphology, reducing SDF, and enhancing the natural pregnancy rate in male infertility due to isolated teratozoospermia.