Urinary markers for early detection of Diabetic Nephropathy in type 1 Diabetes Mellitus

Background: diabetic nephropathy [DN] is a serious complication of diabetic mellitus associated with increased risk of morbidity and mortality. Diagnostic markers to detect DN at early stage are important as early intervention can slow loss of kidney functions and improve patient outcomes. N-acetyl Beta d-glucosaminidase [NAG] is a lysosomal enzyme, present in high concentrations in renal proximal tubular cells, Gamma-glutamyltransferase [GGT] is an enzyme which located along the proximal tubular brush border, Malondialdehyde [MDA] is a highly toxic product, formed in part by lipid oxidation derived free radicals, Reactive carbonyl derivatives [RCD[S]] is an oxidative stress marker in urine, as a measure of the oxidative modification of proteins and beta-2-microglobulin is filtered by the glomerulus, absorbed and catabolized by the proximal tubules. The aim of this study is to investigate the urinary outcome of these markers as early detectors of diabetic nephropathy in type 1 diabetic children

Subjects and methods: This case-control study included 67 children with type 1 diabetes mellitus [33 male; 34 female], age [11.03 +/- 1.05 years] and thirty one age [10.58 +/- 1.11 years] and sex [13 male; 18 female] matched healthy children [13 male; 18 female]. Type 1 diabetic children were further subdivided into microalbuminuric and normoalbuminuric subgroups according to microalbuminuria concentration [30 mg/ g creatinine]. Age, sex, diabetic duration and the current daily insulin dose, and family history of diabetes, weight, height, body mass index, systolic and diastolic blood pressure were recorded. Fasting plasma glucose, glycated hemoglobin, blood urea nitrogen, plasma creatinine, urinary creatinine, micoalbumin, N-acetyl-B-D glucosaminidase [NAG], Gama glutamyl transferase [GGT], Beta-2-microglobulin, Malondialdehyde [MDA] and Reactive carbonyl groups [RCDS[S]] were measured in all subjects

Results: a significant increase in tubular injury markers of diabetes [NAG, GGT, beta-2-microglobulin] and oxidative stress parameters [MDA, RCDS[S]] as compared to control subjects was found. Microalbuminuric subjects showed a significant elevatation in the urinary markers including NAG, GGT, beta-2-microglobulin, MDA, RCDS[S] as compared to normoalbuminuric subjects. The studied urinary tubular enzymes [NAG, GGT], oxidative stress markers [MDA, RCDS[S]] and Beta-2- microglobulin showed positive correlations with one another

Conclusion: The results of this study introduced the possibility of depending on tubular enzymes [NAG, GGT], oxidative stress markers [MDA, RCDS[S]] and Beta2 microglobulin as early, reliable, and sensitive predictors for diabetic nephropathy. The NAG activity index proved to be the most sensitive biomarker, then beta-2- microglobulin for early discovering the tubule cells damage

Causes and presentation of traumatic brain injury [TBI] in Khartoum- Sudan

To study the causes and pattern of presentation of traumatic brain injury [TBI]. This is a prospective hospital based study. It includes 459 patients who presented to the National Center of Neurological Sciences [NCNS] in Shaab Teaching Hospital in Khartoum, Sudan, with TBI in a period of six months. Some questionnaires prepared beforehand were filled for all patients. The collected data was analyzed using the SPSS computer program. The chi-square [Chi [2]] test and the RHO value were used for statistical significance. TBI was found to affect different age groups from one day to ninety years with a mean age of 27.53 +/- 16.92 years mainly young adults. Male to female ratio was 4:1; most of them were either of working or studying groups. The most common causes of TBI are Road Traffic Accidents 179 [39.0%], followed by assaults 143 [31.2%] and falls 71 [15.5%]. The presenting symptoms were mainly loss of consciousness 410 [89.3%], scalp and face lacerations in 223 [48.6%] and headache in 160 [34.9%]. TBI affects the productive population. It is caused mainly following motor vehicle accidents and presented mainly by variable degree and duration of disturbance of consciousness

Polymerase chain reaction for rapid diagnosis of a recent lumpy skin disease virus incursion to Egypt

In early 2006, a lumpy skin disease [LSD] outbreak has invaded cattle in different localities of Egypt, exerting severe economic losses to livestock industry. Representative specimens [skin biopsies] were collected form nodular skin lesions of infected foreign [imported from Ethiopia, at Ismailia private quarantine] and local cattle [at Fayoum, Menofia and Sharquia governorates]. A polymerase chain reaction [PCR] assay was used, as a basic step, for rapid diagnosis of the causative agent in clinical specimens to control spread of infection in the rest of Egypt. The PCR assay, utilizing a LSDV P32 based primer set, could identify LSDV in all outbreak clinical specimens. The specific PCR amplification products [amplicons] were purified and subjected to direct nucleotide sequencing. Blast search, multiple alignments and phylogenetic analyses of the nucleotide sequence data revealed that outbreak LSDV is closely related to other capripoxviruses of LSD, sheep pox and goat pox. Selection and processing of clinical specimens, methods of DNA isolation, and PCR assay applied in this endeavor, presented a reliable laboratory diagnostic tool for LSDV