Methylenetetrahydrofolate reductase gene polymorphism in coronary artery disease patients

Coronary artery disease occurs with the interact ion between environmental influences and genetic factors. Genetic susceptibility may be caused by mutations and polymorphisms in a variety of genes mainly involved in blood coagulation, metabolism of lipids, homocysteine and or iron. The most common form of genetic hyperhomocysteinemia results from the production of a thermolabile variant of methylene tetrahydrofolate reductase [MTHFR] with reduced enzymatic activity. This study was performed on ninety individuals selected with normal serum glucose, kidney, liver, and thyroid function test and lipid profile. They classified into: Group I: 27 apparently healthy persons as control group. Group II: 3 apparently healthy persons with elevated homocysteine level. Group III: 27 CAD patients with normal coronary angiography. Group IV: 33 CAD patients with abnormal coronary angiography. The following specific investigations were done for all the studied persons:- Serum homocysteine [Hcy], serum folic acid [FA] and MTHFR genotyping by PCR-RFLP

Results: In group III three patients had elevated Hey [11.1%]. There was significant elevation of Hey level in group IV compared to group I [P<0. 05].however there were insignificance differences in mean value of folic acid of the studied groups compared to each other. As regard the relation between the MTHFR polymorphisam and hey and FA levels, in group I there was significant elevation of serum Hey level in carriers of CT genotype compared to carriers of CC genotype [P<0.05]. Homocysteine level was highly elevated in patients had TT genotype in group III and group IV when compared to CC and CT genotypes and this was statistically highly significant [<0.000] in group IV, but insignificant elevation in group III Folic acid level was not differing between patients had TT genotype when compared to CC and CT genotype in all studied groups and that was statistically insignificant. When we study the severity of CAD in group IV there was insignificant elevation of serum Hey level in group of one vessel affection compared to group of two vessel and multi vessel affection, there was Significant elevation of serum Hey level in group of >/= 90% stenosis compared to group of >50-75% stenosis and 75-90% stenosis. However there was insignificant difference in serum FA between the groups compared to each other. Homozygous TT was detected in group of one vessel affection and with >90% stenosis. Carriers of TT genotypes in group of one vessel affection and in>/= 90% stenosis had highly significant elevation [P<0.000] of serum homocysteine compared to CC and CT genotypes in the same group

Conclusion: Our findings support that homozygous MTHFR TT genotype is a genetic risk factor for CAD

Epidemiology of intractable epilepsy in Al-Kharga district; new valley; [Egypt]

Drug-resistant epilepsy, despite the advancement in epilepsy treatment, continues to be a major clinical problem with devastating consequences. Identification of the prevalence of intractable epilepsy, as well as causes of intractability. Total population of 62,583 persons were screened through door to door survey, including every door. All suspected cases of epilepsy were subjected to complete history taking, meticulous examination, conventional EEG, and Stanford-Binnet intelligence scale. Monitoring of serum level of AEDs was done for those with possible intractable seizures to ensure adequate dose compliance. Patients have an average seizure frequency of one or more per month during the last 6 months despite optimal and suitable use of AED were considered truly intractable Ohtsuka et al [2001]. They were subjected to video monitoring EEG, and brain MRI. In this study, 437 epileptic patients were identified with a life time prevalence rate of epilepsy 6.98/1000, out of whom, 11.4% [n = 50/134] of patients were intractable with a prevalence rate 0.8/1000. Possible aetiology of intractable epilepsy was determined among 46% of cases [Remote symptomatic], while 58% of cases had unknown causes [idiopathic and cryptogenic]. Symptomatic and cryptogenic causes had signicantly lower IQ than idiopathic group Perinatal complications should be better avoided and/or managed to avoid a large sector of intractable epilepsy

Skin granuloma on a clinical background [histopathological]

This study was done on 80 cases of granulomatous diseases of the skin. These patients were subjected to full history, clinical examination and elliptical skin biopsy for histopathological examination by light microscopy using hematoxylin-eosin stain and special stains. Special stains were done for confirmation of the diagnosis in some cases as follow: Ziehl-Neelsen stain for tuberculosis, modified Ziehl-Neelsen stain for leprosy, Giemsa stain for leishmaniasis, periodic acid- Schiff and Grocott-Gomori stains for deep fungus, and reticulin stain for sarcoidosis. Leprosy represented the commonest type of skin granulomas [25%] of the cases. The age group between 30 - 40 years represented the highest incidence in most cases of skin granuloma, while cutaneous tuberculosis is more in younger age group [mean age 25.5 years]

Comparative study of verapamil, isradipine and cimetidine on the gastric changes induced by stress or indomethacin

The influence of the calcium channel blockers verapamil and isradipine on gastric ulceration and glandular wall mast cell count in rats was investigated and compared with that of cimetidine [H2 antagonist]. Two different models for induction of experimental gastric ulcer were performed; cold restraint stress ulcer and indomethacin - induced gastric ulcer. Restraint at 4°C for 1 h or single bolus dose of indomethacin 30 mg/kg p.o, produced a marked gastric mucosal ulceration in saline pretreated controls. The pretreatment with single I.P injection. of either cimetidine [100 mg/ kg], verapamil [4 mg/kg] or isradipine [0.5 mg/kg] 30 minutes before cold restraint or indomethacin administration produced a significant reduction in mean gastric ulcer severity score and reduced incidence of ulceration in both macroscopic and microscopic examinations of stomachs of different groups. Both verapamil and isradipine are more or less equally effective in reducing gastric damage produced by either stress or indomethacin, however, cimetidine produced significant greater protective action. Cold restraint produced a marked decrease in mucosal mast cell count. This degranulating action of stress was prevented with verapamil or isradipine but cimetidine did not produce any significant effect. It is possible that decreased amine release [Histamine and 5 HT.] from mast cell may be responsible for the antiulcer effect of Ca channel blockers, since mast cell degranulation seems to play an important role in pathogenesis of stress gastric ulcers. Other suggested anti-ulcer mechanisms of Ca[++] channel blockers are discussed in the light of the available literature, including decreased stomach wall motility, reduced gastric acidity, peripheral and central interference with vagal overactivity, stimulation of gastric PG, synthesis and/or antioxidant action that counteract stimulation of gastric lipid peroxidation produced by stress or indomethacin. This study proved the potential value of Ca" channel blockers in the management of two different models of experimental gastric ulcers, however, a controlled clinical study is needed before any attempt to extrapolate ulcer therapy in rats to ulcer therapy in man

Comparative study of the effects of natural honey and antacid [aluminium phosphate] on the anti-inflammatory and ulcerogenic activity of indomethacin

The effects of concurrent administration of either honey of aluminium phosphate with indomethacin on the anti-inflammatory activity, ulcerogenic activity and plasma level of indomethacin in rats were investigated in this study. Natural honey [3 mg/kg orally] caused a significant decrease of ulcerogenic activity of indomethacin [30 mg/kg orally] as indicated by the gross lesion score and hitopathological examination This effect induced by honey is comparable to that produced by colloidal aluminium phosphate [3 gm/kg orally] also honey caused a marked decrease of indomethacin-induced gastric acid secretion that was not significantly different from that produced by aluminium phosphate Both indomethacin-honey and indomethacin-aluminium phosphate combinations caused a decrease of anti-inflammatory activity and plasma level of indomethacin but the reduction produced by the first combination was found to be significantly less than that produced by the second combination. These data may justify the use of honey concurrently with indomethacin to suppress its deleterious effect on the gastric mucosa with less disturbance of its plasma level and anti-inflammatory activity than its concomitant use with antacid

HBV serological markers versus clinico-biochmical, and histopathological evidence of activity in the evaluation of cirrhotic patients group A Child's Classification with hematemesis and/or melena

One hundred and five [105] patients with bilhazial hepatic fibrosis and/or cirrhosis fullfiling the criteria of group A child's classification were subjected to thorough clinical examination, biochemical investigation and serological determination of Hepatitis B virus markers. Moreover an upper GIT endoscopy and liver biopsy were done for every patient in the studied group. From the present work hepatitis B serologic markers alone or in combination were present in 86/105[81.9%] of cirrhotic patients group A child's classification The prevalence of each hepatitis B virus serological markers among this group of patients was:HBs AG 18/105 [17.1%], anti-HBs 26/105 [24.8%], anti -HBC IgM 1/105[22.9%] None of the hepatitis Bvirus serological markers was detected in 19/105[18.1%]. HBV serological markers profile of past infection was detected in 21/105 [20%], HBV serological markers profile of chronic current infection in 56/105 [53.3%] and HBV serological markers profile of a recent current infection in 9/105 [8.6%] of cases. Pure bilharzial hepatic fibrosis accounted for 17/105[16.2%] of cases only, mixed cirrhosis for 26/105[24.8%], pure posthepatitic, most likely, due HBV infection in 53/105[50.5%], and undetermined etiology in 9/105[8.6%], of cases. According to the accepted criteria of active cirrhosis, 16.26[61.5%] patients with mixed cirrhosis and 10/53[18.7%] patients with pure cirrhosis showed biochemical and histopathological evidence of active cirrhosis thus we have assured a total incidence of active cirrhosis in 26/105[24.8%] of this group of patients