Factors affecting albuminuria in diabetic patients at King Fahad Hospital in Almadinah Almunawwarah

To identify factors associated with development of albuminuria in diabetic patients. A hospital based case control study. Fifty diabetic nephropathy patients were compared with 100 diabetic patients without nephropathy. Data were collected using an interview questionnaire. Frequencies, percentages and mean were calculated. Chi-square test, T-test and Univariate logistic regression analysis were used. P < 0.05 was considered significant. An Univariate logistic regression analysis has shown significant associated factors including old age [OR = 8.1] [95%CI = 2.2-30.1], sex [male] [OR = 2.4] [95%CI = 1.18-4.99], the duration of diabetes mellitus above 10 years OR were 4.23 [95%C = 1.6-15.4], associated mild, moderate, and severe hypertension ORs were 5.2 [95%CI = 2.3-11.7], 5.1 [95%CI = 1.5-16.93] and 15.2 [95%CI = 1.4-158.1], respectively, cardiac disease [OR = 3.77] [95%CI = 1.6-8.7], using Angiotensin-Converting Enzyme Inhibitors [ACEIs] and Angiotensin II Receptor Blockers [ARBs] [OR = 8.1] [95% CI = 3.61-18.2], low triglyceride level [OR = 0.38] [95%CI = 0.10-0.81]. Six factors showed a significant positive relationship to the progression of albuminuria in diabetic patients. Older age and males were found to be predictors of high albuminuria. Also, cardiac disease, poor hypertension control, the use of ACEIs or ARBs were found to be predictors of higher albuminuria. Low triglyceride levels were significantly associated with low albuminuria. Higher levels of HbA1c showed less albuminuria while body mass index, smoking and retinopathy showed no association to the albuminuria

Genotypic detection of enterotoxin producing staphylococcus aureus in food

Staphylococcus aureus is one of the most commonly identified bacteria that cause food poisoning by virtue of its variety of enterotoxins, Nasal and hand carriage of enterotoxigenic Staphylococcus aureus is an important source of staphylococcal food contamination in restaurants, therefore it is important to detect Staphylococcus aureus carriage among foodhandlers to prevent possible food contamination .The objective of the study was to detect prevalence of enterotoxigenic strains of staphylococcus aureus among food handlers in Zagazig City and to evaluate phenotypic [SETRPLA] versus genotypic [multiplex PCR] methods for detection of the staphylococcal enterotoxins. Two hundred and seventy swabs of [nose, hand and axilla] were collected randomly from 90 food workers; 3 swabs from each food worker. The swabs were inoculated on Mannitol Salt agar an incubated aerobically for 24 hours. Any suspected Staphylococcus aureus colonies were systematically identified according to standard methods. Staphylococcus aureus isolates were subjected to SET-RPLA test using SET-RPLA Toxin Detection Kit for phenotypic detection of enterotoxin production and Multiplex-PCR to genetically detect enterotoxigenic strains. Carriage rate among the food handlers was 55.5% representing 50 Staphylococcal aureus isolates from 90 food handler, the proportion of contaminated samples among 270 swabs was 18.5% [50/270]. 38[76%] out of 50 isolates were found to be enterotoxigenic by SET-RPLA and 42 [84%] out of 50 staphylococcal isolates were found to be enterotoxigenic genotypically by multiplex PCR. The number of isolates was significantly higher in nasal swabs than in hand or axillary swabs [?[2] =36.87 and p=0.0000]. Using REPLA, the number of enterotoxin producing organisms was significantly higher in nasal swabs [91.2%] than in hand [38.5%] or axillary swabs [66.6%][?[2] = = 14.48 and p = 0.0007]. Type A enterotoxin was the most common type [48%] followed by type D [18%], then type C [6%] while the least type was type A+B [4%]. It also shows that type A+B was isolated only from nasal swabs [2.9%] and type D was not found in axillary swabs. Using Multiplex PCR, gene type a was the most common type [48%] followed by gene type d [22%] then gene type c [6%] while the least type was genes type a+ b [4%]. It also shows that gene types a+b and b+d were isolated only from nasal swabs [5.9% each]. Compared with multiplex PCR, specificity and positive predictive value of RPLA were 100%, while sensitivity was 90.48% and negative predictive value was 66.67%. This study concluded that nasal and hand carriage of enterotoxigenic S.aureus by food handlers is an important source of staphylococcal food contamination in restaurants and fast food outlets so it is important to detect S.aureus carriage among food handlers to prevent possible food contamination by them resulting in food poisoning.It also concluded that multiplex PCR is reliable and valuable method in detection of enterotoxigenic S.aureus strains and it is more sensitive and specific than SET-RPLA. This study recommended health education of food handlers to decrease contamination of their hands, settings training courses for food handlers to learn them the proper hand washing technique and frequent examination of food handler to find and treat. It also recommends screening food workers to identify staphylococcus aureas carriers and referring them to the appropriate health authorities for decolonization

Acute effects of cigarette smoking on the cardiac diastolic functions

Smoking is an independent risk factor for coronary heart diseases and it increases all causes of cardiovascular morbidity and mortality. To assess the acute effect of cigarette smoking on ventricular diastolic functions [LV and RV] in healthy, young, and slim smokers. Thirty volunteers who had recently commenced smoking [less than one year] and who smoked 1-2 cigarettes per day, underwent ECG, 2D and M-mode echocardiography, standard Doppler echocardiography, pulsed TDI [tissue Doppler imaging] on septal and lateral side of mitral annulus and lateral tricuspid annulus. Vp values were measured. The investigator asked them to hold smoking for at least two days after which echocardiographic examination was conducted before smoking one cigarette and the second examination conducted immediately after smoking one cigarette containing at least 0.4 mg of nicotine. Doppler findings over the mitral valve showed the E wave was significantly reduced from 82.7 +/- 10.4 to 74.6 +/- 10.4 after smoking; the A wave increased; the E/A ratio was reduced from 1.5 +/- 0.3 to 1.2 +/- 0.2; the E' septal significantly decreased [15.3 +/- 2.4 vs. 11.2 +/- 1.1] after smoking, and the E/E' ratio increased from 5.5 +/- 1.1 to 6.7 +/- 1.1. Doppler findings over the tricuspid valve showed the E wave was reduced from 60.6 +/- 9.7 to 52.7 +/- 9.6; the A wave increased from 42.2 +/- 6.5 to 50.1 +/- 6.6; and the E/A ratio decreased [1.45 +/- 0.25 vs. 1.06 +/- 0.19]. The E' significantly decreased from 14.1 +/- 1.8 to 10.9 +/- 2.4, while the A' increased [10.2 +/- 2.4 vs. 12.7 +/- 3.6] after smoking; and the IVRT of the RV was significantly prolonged from 62.9 +/- 7.5 to 68.7 +/- 7.9 after smoking. The Vp was markedly reduced from 67.8 +/- 8 to 55.2 +/- 3.5 after smoking. These findings reflected on the LV filling pressure [LVFvp] which increased from 9.8 +/- 1.4 to 10.5 +/- 1.3 after smoking. All changes were statistically significant at P < 0.001. Our study reveals that cigarette smoking can result in significant acute alteration in the diastolic functions of both ventricles

End stage chronic kidney disease in Saudi Arabia. A rapidly changing scene

There have been a marked rise in the prevalence and incidence of end stage chronic kidney disease [CKD] in Saudi Arabia over the last 3 decades. This rise exceeds those reported from many countries. The enormous and rapid changes in lifestyle, high population growth, and fast increase in life expectancy, and massive urbanization that has occurred over the last 3 decades combined to make the current CKD status different to what it was. The 2 major factors that influence the CKD status are the very high rate of diabetic nephropathy and shift in age demographics

Portal vein thrombosis and haematemesis in chronic liver disease. Are P-selectin and PSGL-1 clues?

Bleeding and thrombotic complications are common problems in patients with chronic liver disease [CLD]. The aim of the present study was to evaluate the level of soluble P [sP]-selectin, and P-selectin glycoprotein ligand-1 [PSGL-1] [CD162] expression on neutrophils among patients with CLD and to clarify the role of their interaction, by measuring the platelet leucocyte aggregates, on the clinical outcome of the haemostatic balance in those patients. We also investigated the hypothesis that the balance between platelet activation and endothelial biological function is impaired. sP-selectin and thrombomodulin [TM] levels were measured by enzyme-linked immunosorbent assay [ELISA] and flowcytometric detection of CD162 was performed. Platelet-leucocyte aggregation [PLA] in whole blood was measured as positive for CD41a and CD45 in 66 CLD patients divided into the portal vein thrombosis group [PVT] [n = 25], the haematemesis group [n = 21] and the haemostatically stable group [n = 20]. sP-selectin was significantly elevated in all patient groups. Decreased surface expression of CD162 on neutrophils was detected in all patients' groups. PLA was statistically significantly increased in the PVT group. TM was statistically significantly increased in the PVT, haematemesis and haemostatically stable groups. PLA may play a role in the unique PVT outcome of the haemostatic balance in a group of patients whose credentials of hyperdynamic portal circulation predispose them to bleeding rather than thrombosis. Consequently, P-selectin-targeted therapy may be used to prevent this complication

Epidemiological pattern and management of pediatric asthma review of Ain Shams pediatric hospital chest clinic data Cairo, Egypt 1995-2004

Pediatric asthma is the leading cause of chronic illness in childhood and has an impact on child's quality of life. To describe the epidemiological and clinical data of asthmatic children followed up in the Pediatric Chest Clinic Am Shams University during a 10 year period. Files of asthmatic children attending the Clinic in the period from1995 to 2004 were selected. Relevant data were extracted and analyzed. Out of 1006 recorded cases, a total of 691 [68.7%] were asthmatic. The proportion of asthmatics among all chest patients attending the clinic was lowest in 2002 being 51.6% and highest in 1995, being 78.3%. Male to female ratio was] .6:1, mean age was 5.27yrs [SD +/- 3.65], mean age of onset of disease was 1.84 yrs [SD +/- 2.78]. Persistent asthma was significantly more prevalent in males p<0.01. Severe asthma; using the American Thoracic Society Classification, was found in 151 [41.1%] of cases. From 2002, using GINA Guidelines Classification, severe persistent asthma accounted for 13.5%. Episodic attacks were reported by 270 [39%] of patients, nocturnal attacks by 302 of patients [43.7%] and exercise induced asthma in 97 [14%] of patients. Exacerbations occurred in 300 [43.4%] patients after respiratory infections, in 275 [39.8%] on exposure to smoke, in 139 [20%] with special food, in 91 [13.2%] following allergen exposure and 51 [7.4%] on exposure to inhaler sprays. Half of the patients were treated by combination of drugs [49.2%], corticosteroid inhalers in 32.1%, and beta agonists [short acting] in 31.4%. Asthma constitutes a main problem in the Pediatric Chest Clinic. Respiratory infection and environmental factors are major exacerbating factors. Better documentation of patient's data and complete record in the files is needed

Joint affection in chronic active hepatitis c with correlation to liver biopsy and cryoglobulinemia

This study was carried out to map, in a cohort of consecutive patients with chronic HCV infection, joint affection with correlation to cryoglobulinemia and with viral activity detected through liver biopsy done for those patients. Thirty three patients with hepatitis C infection were recruited for the study. Laboratory investigations involved determination of erythrocyte sedimentation rate [ESR], IgM rheumatoid factor [RF] and its titer, serum aminotransferases, and alkaline phosphatase concentrations. Cryoglobulines detection was done in their blood. State of viral activity and degree of hepatic fibrosis were detected by doing liver biopsy through [Metavir score]. Thirty three hepatitis C patients [15 males and 18 females] with mean age [SD] 43.5 [10.5] with mean disease duration [SD] of 50.8 [24.1] months were recruited for the study. Three patients were found to fulfill at least 4 out of the 7 ACR classification criteria for rheumatoid arthritis. They were excluded from the study. There is highly significant strong positive correlation between arthritis and cryogolbulinemia. There is non significant week negative correlation between arthritis and Metavir score -A liver biopsy. There is significant difference between cryoglobulins-positive and -negative patients as regard arthritis. Rheumatological manifestations constitute part of the extra hepatic manifestations of hepatitis C infection, so that sector of patients may have criteria sufficient for RA classification. Cryoglobulinemia plays an important role in association of arthritis/arthralgia in HCV infection patients. HCV, Hepatitis C virus ; MC, mixed cryoglobulinemia ; ALT, alanine aminotransferase; RTPCR, reverse transcriptase-polymerase chain reaction ; RF, rheumatoid factor; RA rheumatoid arthritis; ACR, American College of Rheumatology; ESR, erythrocyte sedimentation rate; SD, slandered deviation

Flying bullets and speeding cars: analysis of child injury deaths in the Palestinian Territory

Despite the fact that children account for over half the Palestinian population, little attention has been paid to the problem of child injuries. We examined the types of injury mortality in children aged 0-19 years in the West Bank and Gaza Strip [Palestinian Territory] and compared these with similar data for children in Israel and England and Wales. We used data from death certificates covering 2001-2003. Death rates per 100 000 children per year were estimated. The leading cause of injury mortality in Palestinian children was accidents caused by firearms missiles [9.6]. In comparison, transport accidents were the leading cause of death in children in both Israel [5.0] and England and Wales [3.5]

clinical significance of methylenetetrahydrofolate reductase [MTHFR] polymorphisms in acute lymphoblastic leukaemia

Acute lymphoblastic leukemia [ALL] is lie most common pediatric cancer. Genetic polymorphisms in the folate metabolic pathway may contribote to the susceptibility to childhood ALL because they affect the DNA synthesis, methylation and repair. The most common two polymorphisms are methylenetetrahydrofolate reductase [MTHFR] C677T and A1298C. We studied their effect on 30 ALL patients and 30 healthy controls regarding the incidence, toxicity and response to treatment using polymerase chain reaction-restriction fragment length polymorphism [PCR-RFLP]. MTHFR 1298 AC showed a decrease in incidence of ALL [OR=0.5; 95% CI=0.28-0.8; p=0.01] .Treatment toxicity with MTHFR C677T polymorphism was seen in the form of a decreased platelet Count [p=0.03] and with A 1298C in the form of liver toxicity [p=0.03]. No significant association could be found between the polymorphisms and the response to treatment

Nocturnal attacks, emergency room visits and ICU admission of pediatric asthma: frequency and associated factors

Asthma is the most frequent cause of chronic illness in childhood and emergency department visits. This study aims to determine the frequency of emergency room [ER] visits, intensive care unit [ICU] admission, and nocturnal attacks among asthmatic children and to identify associated factors. Records of asthmatic children in the pediatric chest clinic, Ain Shams University during 1995-2004 were reviewed. Asthmatic children with documents of ER visits, ICU admission, or nocturnal attacks were compared with asthmatic children without previously mentioned events. Out of 691 asthmatic patients, 302 [43.7%] had nocturnal attacks, 258 [37.3%] had emergency room visits, 39 [5.6%] were admitted to ICU, and 249 [36%] had no reports of previous events. ER visits and nocturnal attacks were more in children above 4 years. ER visits and ICU admission were higher among those with positive family history of asthma [p< 0.01], those exposed to environmental tobacco smoke [ETS] [p< 0.01], and those who had previous respiratory infections [p< 0.05]. Attacks of nocturnal asthma were associated with the previous factors in addition to animal contact [p<0. 01] and living in bad housing conditions [p<0.05]. Logistic regression showed that family history [OR= 2.87, CI= 1.9-4.1] and bad housing conditions [OR= 2.65, CI= 1.3-5.3] were the significant factors for ER visits, while respiratory infections [OR= 5.24, CI= 2.1-12.0] and family history [OR= 3.48 CI, 1.3-9.2] were the significant factors for ICU admission. For nocturnal attacks, all factors were significant. Control of respiratory infections, limitation of ETS exposure and good housing conditions are needed to limit severe asthmatic attacks

Methylenetetrahydrofolate reductase gene is determinant of hyperhomocysteinemia in epileptic patients

Recent evidences mount that homocysteine level significantly increased in epileptic patients particularly those taking anticonvulsant drugs. Several previous studies revealed that a 677C T transition in the methylenetetrahydrofolate reductase [MTHFR] gene is related to Hyperhomocysteinemia and might increase risk of vascular occlusive pathology. However other publications negate this relationship. This study aimed to determine the prevalence of hyperhomocysteinemia, [MTHFR] gene 677C [right arrow] T mutations and whether this mutation is related to elevated homocysteine concentrations in epileptic patients and to determine the possible relationship between clinical data with elevated Hcy levels and genetic mutations. Twenty five epileptic patients [13 males, 12 females], their mean age is 15.08 +/- 13.7 divided into two groups according to medications: Group 1: Newly diagnosed patients who did not receive medications yet. They were 16 patients, Group 2: Patients who received valproate. They were 9 patients. Fifteen healthy sex- and age-matched controls were recruited. After through neurological evaluation and EEG study, plasma total homocysteine [tHcy] level was determined by specific immunoassays [IMX, Abbott Laboratories]. MTHFR 677 C[right arrow]T mutation using a polymerase chain reaction [PCR] and restriction fragment length polymorphism analysis with HinfI digestion were investigated. The prevalence of hyperhomocysteinemia [>/= 11.4micromol/L, 90[th] percentile of control group] was significantly higher in the epileptic patients than in the controls [15 patients [60%] V one volunteer [6.6%] p<0.05]. The mean of homocysteine level was significantly higher in the epileptic patients than in the controls [10.23 +/- 5.9 V 5.35 +/- 1.64, p<0.05]. No significant correlation was found between clinical data [Age, sex, age of onset, seizure type, seizure frequency, duration and valproate medication] and homocysteine level. The homozygosity for the 677 C[right arrow]>T mutation of MTHFR was associated with elevated tHcy levels. The magnitude of hyperhomocysteinemia in MTHFR CT heterozygotes was more pronounced in epileptic patients than in controls [12.64 +/- 6.64 V 7.9 +/- 2.54 micromol/L, p<0.05]. Statistically significant differences is noticed between hetero mutant patients and patients with normal gene as regard mean homocysteine level [12.64 +/- 6.64 V 8.50 +/- 4.68 in p value <0.01]. The epileptic patients are at a higher risk of hyperhomocysteinemia. The C677T mutation in MTHFR gene contributes to hyperhomocysteinemia in epileptic patients. So measuring homocysteine in epileptic patients is recommended as early management of hyperhomocysteinemia help to avoid its devastating consequences

Distal airways bacterial colonization and inflammatory pattern in children with different chronic lung diseases: a bronchoscopic study

Children with chronic lung diseases are vulnerable to develop bacterial colonization of their distal airways. However, this diagnosis is based usually on nonspecific samples, such as gastric lavage or sputum cultures. The aim of this study was to assess applicability of fibro-optic bronchoscope technique to determine distal airway microbial colonization and inflammation in children with chronic lung diseases compared to conventional methods. Bronchoscopic bronchoalveolar lavage fluid [BALF], sputum and blood samples were collected from 10 healthy children and 30 patients with chronic lung diseases [with different diagnoses]. All samples were subjected to microbiological assessment [direct films, cultures, and antibiogram test], cytology assessment and biochemical assessment of Lactic dehydrogenase enzyme [LDH] and Alkaline phosphatase enzyme [ALP] levels as indicators for ongoing pulmonary damage. Distal airway bacterial colonization by potentially pathogenic microorganisms [PPMs] was defined in 73% of children with the most common organism Staphylococcus aureus followed by E. coli, Pseudomonas aeruginosa, and Citrobacter freundii. BALF analysis was superior to sputum [OR=5.5; 95%CI: 1.6-19.7, P=0.004] and blood samples [OR=38.5; 95%CI: 6.4-302, P=0.0001] analyses as they missed detection of many organisms. Antibiogram analysis revealed that most of gram negative organisms were highly sensitive to imepenem, tobramycin, ceftriaxone, garamycin, and amikin. Most of gram positive organisms were highly sensitive to vancomycin, dalacin and oxacillin. All patients [even if not colonized] visualized ongoing distal airways inflammation and had higher levels of inflammatory markers and cellular loads in comparison to healthy controls. BAL fluid sampling is a safe, technically simple procedure in children and has a significant diagnostic value compared to sputum or blood markers for distal airways bacterial colonization and inflammation

Molecular epidemiology of antibiotic associated diarrhoea due to clostridium dificile and clostridium perfring ensin Ain Shams University Hospitals

As we are Iiving in the era of antibiotic overuse, antibiotic associated dlarrhea [AAD] is considered now a distinct health problem with a need for more attention was to perform a highly specific detection and definition of pathogenic Clostridium perfringens and Clostridium difficile related AAD in children compared to adults and geriatircs. One hundred and fifty patients diagnosed for AAD were included in this study [50 children, 50 adults and 50 geriatric patients]. All of them were subjected to full medical history including complete therapeutic history of antibiotics and collection of stool sample during the attack for detection of Clostridium perfingenes enterotoxin [CPEnt] and Clostridium difficile cytotoxin by [EIA] kit. PCR detection of Clostridium perfingenes epegene [Coding gene for CPEnt] was perfomed as well. Results showed that prevalence of Clostridium difficile cytotoxin was 24% while Clostridium perfingenes enterotoxin was 12% as detected by EIA in faecal specimens as a whole. Detection of epe gene by PCR was positive in 16% of all cases. Children [OR: 4.2, 95% CI: 1.3-14.8, P

Unintended pregnancy in Egypt: evidence from the national study on women giving birth in 1999

The current study aimed to estimate the prevalence and correlates of unintended pregnancy among ever-married women. The study sample was 2349 ever-married women aged 15-49 years who gave birth in 1999. Unintended pregnancy was defined as unwanted and mistimed pregnancies. Of these, 431 [18.5%] women reported unintended pregnancy: 137 were mistimed [5.9%] and 294 were unwanted [12.6%]. Women of older age, living in frontier governorates, with poor knowledge of the ovulatory cycle, having a more than ideal family size, using contraceptive methods and having 4 or more children were at increased odds of reporting unintended pregnancies. Fewer antenatal care visits and low child weight at birth were significantly associated with unintended pregnancy

Serum level of tumor necrosis factor-alpha in patients with hepatic encephalopathy due to chronic liver diseases

Tumor necrosis factor-alpha [TNF-alpha] is involved in many acute and chronic liver disease [CLD]. This work was conducted on 69 patients with CLD [50 patients with overt hepatic encephalopathy [HE] and 19 patients with no evidence of HE] and 13 healthy subjects as a control group. The aim was to assess the serum level TNF-alpha in patients with HE due CLD and to correlate this level with the severity and precipitating factors of HE. All patients and control subjects were subjected to clinical, laboratory and abdominal ultrasonography in addition to measurement of serum level of TNF-alpha. HE was more common in male patients [P<0.002] but not related to the age [P = 0.826]. Serum TNF- alpha level was significantly elevated in patients with CLD in comparison with the control and patients with overt HE than those with no evidence of HE [16.88 pg/ml. 33.85 pg/ml and 78.48 pg/ml] respectively. TNF-alpha was positively correlated to the synthetic liver function but not related to the liver enzyme levels. TNF-alpha was positively related to the severity of liver disease represented by Child-Pugh score [P<0.001] being highest in Child C patients. The serum level of TNF-alpha was significantly correlated to the severity of HE reaching its highest levels in Grade IV. but not related to the precipitating factors of HE. serum level of TNF-alpha was higher in cirrhotic patients with HE and correlates with severity but not the precipitating factors of HE

Correlation between clinical presentation and genotypes of human giardiasis

The aim was to study the genotypes of human giardiasis and its relation to the symptoms of the clinical presentation. 105 patients. with giardiasis In the stool, 61 were symptomatizing and 44 were asymptomatic. and 20 subjects serving as a control group with negative stool examination for giradiasis. all were examined by PCR of stool to detect genotypes of G.L. PCR detected G.L. in 73.3% and failed to detect G.L in 26.7% of cases with G.L. in stool, and was negative in all control subjects. this mean. RCR specificity is 100% and sensitivity 73.3% for G.L. Three genotypes were detected, genotypes I in 36.19%. genotype II in 12.38% and genotype III in 9.52%, and mixed genotypes were detected in 15%, of cases with G.L In the symptomatic patients genotype I was 32.79%, genotype II was 16.39% and genotype III was 9.64%, mixed genotypes infection in 16.39% and undetermined genotypes was 24.59% while in the asymptomatic group. genotype I detected in 40.91% genotype II In 6.82%. genotype II in 9.59% mixed genotypes in 13.64% and undetermined in 29.55%. There was no statistically significant difference between symptomatic and asymptomatic group regarding G.L genotype distribution and the genotype of G.L was not related to symptoms of clinical presentation. the study revealed genetic diversity of G. Lamblia infection in the studied population and the genotypes of G. Lamblia were not related to the symptoms of clinical presentations

Neurophysiologic and psychometric changes in patients with liver cirrhosis

Because of its prognostic and socioeconomic relevance, interest has focused on SHE, which describes a poorly defined syndrome found in the grey zone between normality and manifest HE. the aim was to study the neurophysiologic and nero psychologic changes in chronic liver diseases to diagnoses subclinical heptic encephalopathy [SHE]. Sixty patients with chronic liver disease 30 had cirrhosis due to chronic HCV [group 1], and 30 patients had liver fibrosis due to Schistosomiasis [alone or with hepatitis] [group2]. and 20 healthy subjects as control [group 3], all were subjected to, clinical examination, assessment of liver function, routine tab., investigations, Abd, US. and EEG and psychometric assessment by [NCT] and symbol [SDT]. NCT abnormal score was found in 46.7% group2. ranging from 42.3% to 75% in Child-Pugh grade A, B respectively, however the control group had normal NCT score. Positive EEG changes were in [60%]and [50%] ranging from [47.05% to 76.92%] and from [46.15% to 75.0%], in group 1 and group 2 in Child-Pugh grade A and B, respectively, while in group 3 EEG was normal in [90%] and non specific changes found in[10%]. EEC changes and psychometric defects were detected in considerable percentage of cirrhotic patients and were related to the severity of liver cirrhosis, so psychometric tests and EEG may be suitable tools for diagnosis of SHE

Serum proiactin concentrations in female patients with systemic lupus erythmatosus

Elevated serum PRL levels have been reported in SLE patients and its role in the pathogenesis of SLE is controversial. To assess frequency of hyperprolactinemia in patients with SLE and evaluate its possible clinical significant with the disease activity. The basal level of PRL is determined in a 23 female patients with SLE by radiommunometric assay. For every patient the systemic lupus disease activity index [SLEDAI] CBC, liver functions, serum creatinine, urine analysis, ESR, ANA, anti ds DNA, C3 and C4 were determined by standard technique. Any patients who had other conditions known to be associated with hyperprolactemia were excluded. Correlations between PRL concentrations and SLE clinical and serological activity were evaluated. The mean age of the studied population was 28.9 +/- 7SD years [range 19-46] and the mean duration was 3.3 +/- 6SD years [rang from 0 or new case to 11 years]

effect of beclomethasone inhalation and oral montelukast sodium on serum IgE levels and clinical parameters in asthmatic children

IgE is considered to play a crucial role in allergic immune responses. Inhaled steroids and anti- leukotrienes are anti-asthmatic drugs which down regulate the immune responses. The present study was conducted to determine and compare the effects of a 6-months treatment with 600 mcg of inhaled beclomethasone and 5 mg of oral montelukast sodium on serum IgE, forced expiratory volume in 1[s] [FEV1] and clinical asthma scores in children with mild to moderate bronchial asthma. Sixty children with mild to moderate persistent asthma and sensitive to house-dust mites were randomly allocated to receive beclomethasone 600 mcg or montelukast 5 mg for 6 months. The level of serum total IgE, clinical parameters and FEV1 were measured before and after treatment. The results proved that, after 6 months of treatment, inhaled beclomethasone and montelukast, significantly decreased serum levels of total IgE, clinical asthma scores and FEV1 [P<0.01, P<0.01 and P<0.05 respectively]. There were no significant differences between inhaled beclomehtasone and oral montelukast in changes of all clinical parameters, FEV1 and serum total IgE levels. Both inhaled beclomethasone and oral montelukast decreased the serum IgE levels and improved the clinical parameters and pulmonary function in asthmatic children