Diagnostic and prognostic roles of miRNA and dielectric parameters in HCV Egyptian patients

Hepatic C virus (HCV) infection is a special case in Egypt due to its historical aspects, epidemiology, risk factors, andgenotype. Therefore, an urgent need arose to assess the HCV progression and efficacy of the used antiviral drugs. Thisstudy aimed to evaluate the role of different miRNAs types and blood dielectric measurements in the early diagnosisand prognosis of HCV in Egyptian patients. The study was carried out on a total of 80 blood samples. Twenty of theseblood samples were withdrawn from healthy volunteers and were served as the control group (G1). Sixty HCV patientsamples were divided according to the received treatment into four groups (15 for each). The second group (G2)included HCV patient samples, who did not receive any treatment. The third (G3), fourth (G4), and fifth (G5) groupsincluded the samples of HCV patients who were treated with Sovaldi (400mg) for 1, 2, and 3 months, respectively. G3,G4, and G5 were simultaneously administered Ribavirin (200 mg) and Daclatasvir (60mg) daily for 3 months. Theobtained results demonstrated the upregulation of miR-21, miR-155, and miR-205 and downregulation of miR-122and miR-133a in all HCV patients. HCV patients who did not receive any treatment showed a lower conductivity dueto the action of the virus; either the free charges on the surface of the red blood cells (RBCs) or membrane deformationor alterations were reduced. Noticeable improvement reached to nearly normal values in different miRNA expressionsand RBC dielectric relaxations was achieved by Sovaldi treatment.

Volatile Compounds in the Skin Essential Oil of Moroccan Feijoa sellowiana

The oil of Feijoa skin (Feijoa sellowiana, family Myrtaceae) was isolated by hydrodistillation in a Clevenger-type apparatus and analyzed by GC-MS analysis. As a result, 76 components were isolated. Among 19 peaks identified which three were reported for the first time in this plant (Elixene, Linalylanthranilate and Farnesol). The sesquiterpene group was predominant, accounting for 97.8% of the total oil. Of which Caryophyllene was the most abundant 17.7%, followed by Germacrene D14.4%, Humulene 10.5%, Ledene 14%, Spathulenol 8.5%, Cadina-3,9-diene 8.3%, Farnesol 8%, Linalylanthranite 5.6%, β-elemene 4.8%, α-Cubebene 2.7%. Other constituents were also present in oil such as Octanone 5.3%, D limoneme 0.17%, Ocimene 1.6%, Benzoicacidmethylester 1.1%.

Calcium in the management of atonic postpartum hemorrhage

Objective: was to compare the role of methergine, misoprostol and calcium in the management of atonic postpartum hemorrhage

Design: randomized Controlled Trial

Setting: this study was conducted in obstetrics and gynecology department of Al-azhar University Hospital, Assiut

Patients: 300 women with PPH were included in the study

Intervention: 300 women, each received 5 IU of oxytocin as prophylaxis then divided into three groups: Group A [N=100]: women with atonic PPH took methergine, Group B [N=100]: women with atonic PPH took misoprostol and Group C [N=100]: women with atonic PPH took calcium

Outcome measures: the primary outcome was change in hemoglobin concentration before and after intervention

Results: there was no significant difference between the three study groups as regard mean hemoglobin level before and after treatment. However, a significant difference was present as regard mean change [drop] in hemoglobin level after treatment, with misoprostol group showing the highest drop in Hb% [2.07 +/-0.8] compared to calcium group [1.7 +/-0.8] and methergine group [1.3 +/-0.5]

Conclusion: methergine is more effective in controlling the amount of blood loss during delivery giving a better chance in treatment of atonic postpartum hemorrhage followed with calcium then misoprostol. Although of that calcium is good alternative to methergine with low side effects so can be used safely and effectively when methergine is contriandicated

Occult hepatitis C virus infection in haemodialysis unit: a single-center experience

Detection of hepatitis C virus RNA in peripheral blood mononuclear cells [PBMC] and/or hepatocytes in the absence of HCV RNA in serum, designated as 'occult HCV infection', has been a matter of controversy in the recent years. Occult hepatitis C virus [HCV] infection has not been investigated in haemodialysis patients. We investigated for the first time the prevalence of occult HCV infection in large cohorts of chronic hemodialysis [CHD] patients in a single heamodialysis center at Al-Taif, KSA. We enrolled 84 CHD patients, whose sera are negative for HCV markers. HCV RNA was tested in PBMC using a sensitive commercial real time assay. In this study, real-time PCR was used to test for the presence of genomic HCV-RNA in peripheral blood mononuclear cells of all of these patients. For comparison, 20 patients on HD with evidence of chronic hepatitis C virus infection were included as a control group. In CHD patients, occult HCV infection, determined by the presence of genomic HCV-RNA in peripheral blood mononuclear cells [PBMNCs], was found in 13.4 % of the patients; 83 % of these patients had ongoing HCV replication, indicated by the presence of HCV-RNA. Patients with occult HCV infection had spent a significantly longer time on heamodialysis and had significantly higher mean alanine aminotransferase levels during the 3 months before study entry. Compared to CHCV patients, those with occult HCV have less elevated bilirubin, AST and ALT. The prevalence of occult HCV infection was moderate in our CHD patients, and it did not appear to be clinically relevant. Further studies in other geographic populations with high HCV endemicity are required to clarify the significance of occult HCV infection in these patient groups

Effects of some antidiabetic medicinal plants on pancreas and liver of diabetic albino rats

Diabetes is a chronic metabolic disease which affects large number of population all over the world. More than 400 traditional medicinal plants have been recorded for helping in controlling such disease. This study investigated effects of some plants used in Saudi Arabia and some other Arab countries as antidiabetic agents. One hundred fifty adult male Albino rats were divided into six experimental groups each consist of twenty five rats. The first group was considered as a control group. The rest of groups were affected by induction of experimental diabetes by subcutaneous injection of Alloxan. The second group consisted of diabetic rats without any treatment. The third group was treated by the aqueous extract of mixture contains Foenugreek, Nigella and Termis seeds. The fourth group was treated with the aqueous extract of Nigella sativa seeds, while the fifth group was treated with the aqueous extract of Foenugreek seeds. The sixth one was treated with the aqueous extract of Termis seeds with the administered dose of the plant extracts [100 mg/kg body weight].After four weeks of treatment, different biochemical parameters were performed including estimation of blood sugar level and serum insulin level. Pancreatic and liver samples were obtained and processed for microscopic and quantitative evaluation after staining the prepared sections with both heamatoxylin and eosin as well as a special stain for demonstration of the different pancreatic cells in the Islet of Langerhans. The usage of the mixture or each plant alone corrected the glucose level and insulin level. Microscopically there was definite decrease in the number and diameter of beta pancreatic cells in the diabetic group, while the other pancreatic cells were not affected [alpha and delta cells]. The use of medicinal plants in the different groups of this study greatly improved such cellular changes and the level of blood sugar level was corrected. The present results showed that the activity of the mixture was the best when compared with Nigella, Foenugreek and Termis seeds. The water extract of the mixture is the most powerful in amelioration hyperglycemia and most of all damage effects of Alloxan on the liver and texture, hematological parameters, and lipid profile. So it is advised to use the plant mixture as an antidiabetic agent rather than the use of each plant separately. Repeating such study with the use of variable doses may be helpful in better evaluation for the required doses

changing pattern of upper gastro-lntestinal lesions in southern Saudi Arabia: an endoscopic study

Dyspepsia is a common gastrointestinal disorder and is the most common indication for upper gastrointestinal endoscopy [UGIE]. In recent years, it has been observed in several centers that there is a change in the causes of dyspepsia as revealed by UGIE. Our main objectives were: [1] To study the pattern of upper gastrointestinal pathology in patients with dyspepsia undergoing upper endoscopy; [2] Compare that with the pattern seen 10-15 years earlier in different areas of KSA. Retrospective study of all UGI endoscopies performed at Aseer Central Hospital, Abha, Southern Saudi Arabia during the years 2005-2007 on patients above 13 years of age. Patients who underwent UGIE for reasons other than dyspepsia were excluded. The analysis was performed using the SPSS 14 statistical package. A total of 1, 607 patients underwent UGI endoscopy during the three-year study period [age range, 15-100]. There were 907 males [56.4%] and 700 female [43.6%]. Normal findings were reported on 215 patients [14%] and the majority had gastritis [676 = 42%], of whom 344 had gastritis with ulcer disease. Moreover, 242 patients [15%] had gastro-esophageal reflux [GERD], with or without esophagitis or hiatus hernia. Also, a total of 243 patients had duodenal ulcer [DU] [15%] while only 12 had gastric ulcer [0.7%]. There is clear change in the frequency of UGIE lesions detected recently compared to a decade ago with an increasing prevalence of reflux esophagitis and hiatus hernia. This could be attributed to changes in lifestyle and dietary habits such as more consumption of fat and fast food, increased prevalence of obesity, and smoking. These problems should be addressed in order to minimize the serious complications of esophageal diseases

Predictive factors for success and failure of pegylated interferon/ribavirin therapy in chronic hepatitis C patients

The aim of this study was to determine the clinical, biological, virological and histological predictive factors for success and failure of pegylated interferon/Ribavirin therapy among Egyptian patients infected by hepatitis C virus [HCV]. This retrospective study included 100 patients with HCV infection who underwent clinical, biochemical and virological assessments before treatment and at 12, 24 and 48 weeks from the start of treatment. The selected patients were divided equally into two groups according to the seroconversion state after receiving a course of pegylated interferon and ribavirin. Group I: 50 patients with CHC who show seroconversion after 12, 24 and 48 weeks of treatment. Group II: 50 patients with CHC who did not show good virological response after 12 and 24 weeks of treatment and they further divided into two groups: Group II A: 25 patients who stop treatment at 12 weeks due to absence of virological response [S 2 log decline in HCV RNA by Quantitative PCR] and Group II B: 25 patients who siop treatment at 24 weeks due to presence of detected HCV RNA by Qualitative PCR. At the end of this study we found that the best positive predictor factors that associated with good virological response before treatment are male sex, younger patients, low BMI, low APP, low viremia and low grade of activity and fibrosis in liver biopsy. The positive predictive factors that associated with good virological response after 12 weeks of treatment are low liver enzymes low viremia and early virological response

use of intraperitoneal mersilene in the management of large ventral hernias

Large ventral hernias usually require prosthesis for a successful repair. Many prosthetic techniques have been described with extra-fascial, sub-fascial, and intra-peritoneal positioning. The present study was conducted to asses the value of Mersilene mesh intra-peritoneal placement in the management of large ventral hernias. This study included 15 female patients with large ventral hernias [myo-apponeurotic defect >/= 10cm in diameter]. Their ages ranged from 30 to 62 years with a mean of 42.8 years. Twelve patients had an incisional hernia, following midline incision [n=6], right subcostal incision [n=3], paramedian incision [n=2], and Mc Burney's incision [n=1]. Three patients had a huge paraumblical hernia. All patients were clinically evaluated, investigated and had their respiratory function tests assessed both pre-and post-operatively. Hernias were repaired using the intra-peritoneal technique of mesh [30x30 cm Mersilene] positioning with placement of the greater omentum between the mesh and the bowel whenever possible. Patients were followed-up for a mean of 11.5 months [range 8-18 months]. The size of the hernia defect at surgery ranged from 10x13 cm to 22x25 cm with a mean of 13x14 cm. The mean hospital stay was 8.5 days [range 7-10 days]. Post-operatively, one patient developed superficial wound infection and another developed a seroma. Both resolved spontaneously on conservative measures. None of the patients developed post-operative respiratory distress. No recurrence was encountered during the follow-up period. The technique of intra-peritoneal Mersilene mesh fixation in the treatment of large ventral hernias a'ppears to be simple, adequate and safe. It does not cause post-operative respiratory distress and does not necessitate dissection of the intermediate planes thus minimizing hematoma and seroma formation and the risk of sepsis

Developing a disease-specific tool for assessment of quality of life of patients with hepatitis C virus associated chronic liver disease

To develop an Egyptian disease-specific instrument to assess the health related quality of life [HRQoL] in patients with chronic hepatitis C [CRC], and to assess the HRQoL in CHC patients according to this instrument. Based on responses from 100 patients, 5 liver experts, and from reviewing previous studies and other disease-specific instruments, items affecting the HRQoL of CRC patients were selected. Responses from 100 patients were used for determining and maximizing the questionnaire's internal consistency reliability [ICR] and construct validity. Retained items were scaled and the final questionnaire was pretested in 20 patients. Using this instrument, the HRQoL was assessed in 126 subjects distributed into three equal groups, one healthy and two groups of patients having chronic liver disease [CLD] with and without hepatitis C antibodies [CLD HC+ve, CLD HC-ve respectively]. Sixty seven items were identified in the item selection process, and 33 were retained at the end of the process of maximizing ICR and construct validity. In pretesting, five items were combined into two, and three questions for assessing the general health perception [GHP] were added. Patients found the final 33 questionnaire clear and easy to complete in 15 minutes. The developed instrument proved gradients among CHC patients, CLD HC-ve controls and normal controls, and among patients with different grades of liver disease severity. Certain domains did better than others in discriminating among the three groups and in comparing different grades of disease severity. The specific questionnaire has acceptable reliability, good construct validity, and correlates with disease severity. Further researches were needed for investigating its usefulness in clinical practice and for supporting the findings of the major decrements in HRQoL domains

Schistosome/mollusk: genetic compatibility

Schistosomiasis remains one of the most prevalent parasitic infections and has significant economic and public health consequences in many developing countries. Economic development and improvement in standard of living in these countries are dependent on the elimination of this odious disease. For the control of Schistosomiasis, understanding the host/parasite association is important, since the host parasite relationship is often complex and since questions remain concerning the susceptibility of snails to infection by respective trematodes and their specificity and suitability as hosts for continued parasite development. Thus, the long term aim of this research is to learn more about the genetic basis of the snail/parasite relationship with the hope of finding novel ways to disrupt the transmission of this disease. In the current research, genetic variability among susceptible and resistant strains within and between Biomphalaria glabrata and B. tenagophila was investigated using RAPD-PCR. The results indicate great genetic variations within the two snail species using three different primers (intrapopulational variations), while specimens from the same snail species showed few individual differences between the susceptible and resistant strains (interpopulational variation).

Leptin, osteocalcin and bone mineral density in liver cirrhosis

The pathophysiology of osteoporosis in complicated liver cirrhosis is unknown. Some studies have found leptin to be a potent inhibitor of bone formation. The study was performed to investigate the relationship between leptin, osteocalcin and bone mineral density in liver cirrhosis. Sixty patients with liver cirrhosis classified into 3 groups were included in this study. Group I included 20 premenopausal females, group II included 20 postmenopausal females and group III included 20 males. 30 healthy subjects with age and sex matched [10 for each group] were the control of this study. The patients and controls were subjected to history, clinical examination and measurements of body mass index [BMI]. The following investigations were performed; serum osteocalcin, leptin and intact parathyroid hormone in addition to liver function tests, liver biopsies, HBs-AG, HCV-Ab, serum phosphorus, and calcium and measurements of bone mineral density [BMD] by Calcaneal ultrasound. BMD was below normal in 86.6% of patients as a whole, their values were significantly lower in each group when compared to their controls [p<0.01, for all] and significantly lower in-group I than group II and in-group III than group II [p<0.01, for all]. Serum levels of leptin were significantly increased in each group when compared to their controls [p<0.01, for all] and significantly lower in-group III [males] than other groups [females] [p<0.01]. Serum osteocalcin levels were significantly lower in each group when compared to their controls [p<0.01, for all], but no significant differences were found among all three groups. Serum iPTH levels were elevated above normal range in 55% of patients but there was no significant difference between patient groups and their controls, and their levels were significantly lower in-group I when compared to other groups [p<0.01, for all]. There were no significant differences in serum levels of calcium and phosphorus between patient groups and their controls and among patient groups. In Child-Pugh's classification, BMD and serum osteocalcin were significantly lower in grade C than grade B [p<0.01], while serum leptin was significantly higher in grade C than grade B [p<0.01], but no significant differences in serum levels of iPTH, calcium and phosphorous were found between grade C and grade B. Serum levels of osteocalcin correlated with iPTH [r= -0.530], serum leptin [r=-0.654], BMD [r=0.580], serum calcium [r=0.530] and serum albumin [r=0.547]. Serum leptin correlated with osteocalcin [r=-0.654], BMD [r=-0.586] and serum albumin [r=-0.560].Serum leptin was elevated in cirrhotic patients in both genders, but it is higher in females than males. There were inverse relationship between serum leptin and BMD and osteocalcin. Leptin may have a role in the pathogenesis of osteoporosis in liver cirrhosis

Anterior abdominal wall fistula: a clinicopathological challenge

Aim of the work was to study the anterior abdominal wall fistulae connected to the gut from etiological, clinical and therapeutic aspects regarding their incidence, presentations, response to conservative or surgical treatment and final outcome. This study was carried out on 30 patients with external fistulae connecting the anterior abdominal wall and Originating from the intestine, biliary radicles and the pancreas. All patients were admitted to Department of Surgery, Main Alexandria University Hospital There were 18 males and 12 females, the age ranged from 12 to 65 years with a mean value of 48.15 +/- 3.24 years. Eleven patients [36.7%] were of high output fistulae, 4 patients [13.3%] were of moderate output fistulae and 15 patients [50%] were of low output fistulae. The complications were sepsis in 10 patients [33. 3%], fever in 10 patients [33.3%], electrolyte depletion and weight loss in 4 patients [13.3%] and skin complications in 22 patients [73.3%]. Abdominal ultrasound and CT scans were done in all cases and revealed internal collection in 7 patients [23.3%], fistulogram was done in 7 cases [23.3%] and endoscopic retrograde cholangiopancreatography [ERCP] in one case. The origin of fistulae was the small intestine In 10 patients [33.3%], the colon in l6 patients [53.3%], from biliary- enteric anastomosis in 3 patients [10%] and from pancreatic duct in one patient [3.3%]. The etiological factors were gut carcinoma in 8 patients [26.7%], hernia repair in 10 patients [33.3%], neglected appendicitis in 3 patients [10%], post Whipple operation in 3 patients [10%], post pancreatic necrosectomy in one case [3.3%], iatrogenic trauma to sigmoid colon during gynaecological surgery in 2 cases [6.7%], rupture sigmoid diverticulitis in 2 patients [6.7%] and one case [3.3%] following typhoid perforation. Spontaneous closure was achieved in 25 patients [83.3%] by conservative treatment which included total parenteral nutrition, enteral nutrition, somatostatin analogue and antibiotics. Surgical intervention was required in spatients [16.7%] in the form of resection of the fistula- bearing segment and anastomosis of the two healthy ends. Five fistulae [16.7%] closed between 2 and 4 weeks, 8 fistulae [26.67%] between 4 and 8 weeks, 9 fistulae [30%] between 6 and 8 weeks and 8 fistulae [26.7%] closed after more than 8 weeks. Only one patient [3.3%] died from sepsis and multiple organ failure. spontaneous closure is depending on a number of factors which include anatomical site, distal obstruction, presence of inter current disease and whether or not the fistulous track is simple or complex. Sepsis in the peritoneal cavity is the major cause of mortality. The use of octreotide is highly recommended as It definitely converts high output to low output fistulae. The enterocutaneous fistulae that fail to resolve within 4 to 6 weeks under conservative treatment require surgical intervention

role of CT guided fine needle aspiration biopsy in the management of intra-abdominal masses

The evaluation of deep non-palpable abdominal masses or focal lesion is often difficult. Distinction between malignant and non-malignant lesions and particularly inflammatory lesions is vital for patient management, and is often suspected from imaging techniques; the diagnosis requires confirmation by biopsy. Fine needle aspiration cytology [FNAC] is a well established diagnostic technique. This study aimed at evaluation of CT guided FNAB in diagnosis of intra-abdominal masses and its impact on treatment planning. The study was conducted on thirty patients with intra-abdominal masses [clinically or radiologically diagnosed] admitted to the Department of Surgery, Faculty of Medicine, the Main University Hospital. FNAs were performed at the Radiology unit in the Main University Hospital with the pathologists assistance. Patients were subjected to surgical exploration according to the findings, aiming at resection of the mass. The impacts of CT and FNAB on the surgical decision were recorded The pathological findings of FNAB were compared with the final histo-pathological findings of the specimen. The study was carried but on 30 patients who had abdominal mass or masses. Each patient was subjected to CT guided FNAC. The age of the patients ranged between 18-70 years, with a mean of 48.57 +/- 13.69 years. with a male to female ratio 1:1. The Sensitivity for CT was 76% and for FNAB was 89%. Specificity for CT was 100% and for ENAB was 100%. Positive predictive value for CT was 90% while it was 95% for FNAB. Negative predictive value was 18% for CT and 40% for FNAB. CT guided FNAB is a relatively painless procedure. It is a safe method for obtaining a pathologic diagnosis. The overall accuracy of the CT guided FNA in intra-abdominal masses was 73.3%. CT guided FNAB helped in avoiding surgery in patients with metastatic or irresectable tumors. The accuracy was 100% in hepatic, pancreatic and pelvic masses. while it was less accurate in retroperitoneal and gastrointestinal masses. This accuracy increased with adenocarcinomas and benign tumors, but decreased with lymphomas, smooth muscle tumors, inflammatory and fibrotic lesions

INF-gamma, IL-5 and IGE profiles in chronic schistosomiasis mansoni Egyptian patients with or without hepatitis C infection

The immune response against clinical forms of chronic schistosomiasis mansoni patients with or without HCV infection was evaluated by assays the serum levels of IFN-gamma and IL- 5 for estimate the cell mediated immunity and IgE level to estimate the humoral immunity. This study included three patient groups. G.I included 25 patients with intestinal schistosomiasis, G.II included 15 patients with hepatosplenic schistosomiasis and G.III included 40 patients hepatosplenic schistosomiasis co-infected with HCV. Control G.IV included 15 healthy persons with matched age and sex. The intestinal group had high IFN-gamma [92%], normal level of IL-5 and IgE. The immune response was mainly 100% Th-1 response. The hepatosplenic patients had high IFN-gamma [26.7%], IL-5 [86.7%] and IgE [73.3%]. The immune response was 73.4% Th-0, 13.3% Th-l and 13.3% Th-2. The co-infected group had high IFN-gamma [62.7%], IL-5 [100%] and IgE [92.5%]. The immune response was 62.5% Th-0 and 37.5% Th-2 immunity. The shift to Th-0 and Th-2 immunity as well as associated depression of Th-1 in mixed group of patients may be playing a role in the persistence and severity of both diseases. Such immunity defects add to decrease challenge against HCV clearance

Genetic markers between Biomphalaria glabrata snails susceptible and resistant to Schistosoma mansoni infection

The analysis of the genetic variability related to susceptibility to Schistosoma mansoni infection in the vector of the genus Biomphalaria is important in terms of a better understanding of the epidemiology of schistosomiasis itself, the possible pathological implications of this interaction in vertebrate hosts, and the formulation of new strategies and approaches for disease control. In the present study, the genetic variability of B. glabrata strains found to be resistant or susceptible to S. mansoni infection was investigated using DNA amplification by random amplified polymorphic DNA-polymerase chain reaction (RAPD-PCR). The amplification products were analyzed on 8 percent polyacrylamide gel and stained with silver. We selected 10 primers, since they have previously been useful to detect polymorphism among B. glabrata and/or B. tenagophila. The results showed polymorphisms with 5 primers. Polymorphic bands observed only in the susceptible strain. The RAPD-PCR methodology represents an adequate approach for the analysis of genetic polymorphisms. The understanding of the genetic polymorphisms associated to resistance may contribute to the future identification of genomic sequences related to the resistance/susceptibility of Biomphalaria to the larval forms of S. mansoni and to the development of new strategies for the control of schistosomiasis

Peripheral neuropathy in patients with polyarteritis nodosa clinical and electrophysiological study

The aim of this study was to investigate the clinical and electrophysiological characteristics of peripheral neuropathy in patients with systemic polyarteritis nodosa. Thirteen patients with peripheral neuropathy and evidence of systemic vasculitis of polyarteritis nodosa type were included in this study. Eight patients presented with mononeuropathy multiplex. Three patients were presented with asymmetrical sensorimotor neuropathy. The remaining two patients presented with distal symmetrical polyneuropathy. Ulnar peroneal and sural nerves are the most common nerves affected in polyarteritis nodosa. The findings showed acute or subacute neuropathy. EMG and nerve conduction studies showed an evidence of axonal neuropathy with a significant reduction of the motor nerve action potential amplitudes

Prevalence and pathophysiology of osteopenia in type 1 diabetes mellitus patients

Prevalence and severity of osteopenia were evaluated in 50 patients with uncoinplicated type 1 diabetes mellitus with mean age [39.9 +/- 14.8] and mean disease duration [12.3 +/- 4.2]. Bone mineral density was measured by quantitative ultrasonometry . In addition , markers of bone formation [plasma insuline - like growth factor [IGF-1], serum alkaline phosphatase [ALP] and serum osteocalcin] and markers of bone resoiption [urinary execretion of calcium and of cross-linked N-telopeptide of type 1 collagen , both corrected for the execretion of creatinine] were measured in diabetic patients and in 20 healthy controls , matched for sex , age , height, weight and body mass index.Osteopenia was found in 62% of type 1 diabetic patients [P< 0.001] compared with controls who showed no osteopenia . in the whole group of diabetic patients, the mean plasma IGF-1 level tend to be lowered compared with that in the controls [P<0.05]. Also, the serum level of osteocalcin was lowered in diabetic patients compared with that in the controls [P<0.01] . There were no differences between the mean serum ALP levels in both diabetic patients and control groups. As regard to the bone resorption markers, there was significant increase in urinary level of cross- linked N- telopeptide of type 1 collagen compared with that in thecontrols [P<0.001]. However, urinary calcium level was similar in both groups bone mineral density did not correlated with plasma level of glycosylated hemoglobin and not related to any of bone resorption markers.Our data demonstrate that in male patients with type 1 diabetes mellitus, osteopenia is the consequance of lowered bone formation and increased bone resorption

Assessment of Serum Tumor Necrosis Factor-alpha and alpha-fetoprotein in HCV-related chronic liver disease patients

This study included two groups of HCV-related chronic liver disease [CLD] patients, 30 patients with compensated CLD, 30 patients with decompensated CLD in addition to 20 apparently healthy individuals who served as controls. For all the subjects, the following tests were done; complete history, clinical examination hemoglobin concentration and platelet count, liver function tests [LFTs], TNF-alpha and AFP. TNF-alpha and AFP measurement was done employing state-of-the-art solid-phase two-site chemiluminescent enzyme immunometric assay automated analyzer [immulite]. The study showed that there was significant elevation of TNF-alpha level in HCV-related CLD group in comparison to control subjects. However, no significant differences were observed between compensated and decompensate CLD groups. There was also a significant elevation of serum AFP levels in HCV-related CLD groups in comparison to control subjects. However, no significant differences were observed between compensated and decompensate CLD groups. A significant inverse correlation was found between serum albumin and serum TNF-alpha in compensated CLD group, also a significant direct correlation was found between serum ALP and serum TNF-alpha in decompensate CLD group. However, no correlation was found between serum TNF-alpha and any other assayed parameters including AFP

Age-related changes in haemostatic responses to localized cold-induced stress in rats

In the present work, age-related changes in haemostatic responses to localized cold stress in rats were investigated. The role of vitamin E supplementation, on the haemostatic responses of those stressed rats, was also studied. Three different age groups were studied; young mature rats [4 months], middle-age rats [14 months] and old-age rats [24 months]. The animals were subjected either to acute localized cold stress [1 hour] or to chronic localized cold stress [3 hours daily, for 15 days]. Age-matched control rats were maintained under standard conditions of boarding. A group of old rats was injected intramuscularly by vitamin E in a dose of 150 mg/kg-body weight/day, prior to the stress induction [daily, for 15 days]. Exposure to acute localized cold stress produced a significant elevation in the mean arterial blood pressure in the three different age groups of rats, compared to their age matched controls. On the other hand, chronic exposure to localized cold stress resulted in significant elevation in the mean arterial blood pressure [MAP] and plasma malondialdehyde [MDA] level, with an increase in platelet aggregation, and a decrease in platelet count. In addition, there were shortening in prothrombin and partial thromboplastin times, as well as a reduction in antithrombin III activity and an increase in the levels of plasma fibrinogen and fibrin degradation products in all stressed rat groups, compared to their age matched unstressed controls. These platelet hyperaggregability and blood hypercoagulability states observed in stressed rats raise the risk of thrombo-embolic manifestations. Vitamin E supplementation in old rats subjected to chronic localized cold stress produced a significant decrease in MAP and plasma MDA level, as well as inhibited the activated coagulation system induced by cold exposure in old age, evidenced by decreased platelet aggregation in response to ADP and plasma fibrinogen level, in concurrence with prolonged PTT and stimulated AT-III activity compared to stressed old rats. Further, the value of all these parameters were corrected to near normal levels, being non significantly different from the corresponding values in the normal old rats. Therefore, the therapeutic intervention with vitamin E might improve the stress- induced derangement in the haemostatic profile

Age-related changes in haemostatic responses to oxidative stress

Altered haemostatic mechanisms are known to occur in stressful situations, yet the pathophysiology of stress related dyshaemostasis is still poorly understood. In the present work, age-related changes in haemostatic responses to oxidative stress in rats with different ages were investigated. Also, the effects of vitamin E supplementation, prior to stress induction, on the haemostatic responses of those stressed rats were evaluated. Three different age groups were studied, young mature rats [4 months], middle age [14 months] and old rats [24 months]. The animals were subjected to oxidative stress by adding H[2]O[2] solution to their drinking water, in a final concentration of 3%, daily, for 21 days. The age-matched control rats drink normal tap water. A group of old rats was injected intramuscularly by vitamin E in a dose of 150 mg/kg body weight, prior to the stress induction, daily, for 21 days.Results obtained in this study demonstrated an elevation in mean arterial blood pressure, plasma malondialdehyde, and plasma fibrinogen concentrations, and fibrin degradation products, in addition to shortened prothrombin and partial thromboplastin times and inhibited antithrombin III activity, in the young and old rats subjected to H[2]O[2]-induced oxidative stress, being statistically significant compared to their age matched controls. Moreover, there were an increase in platelet aggregation and a decrease in platelet count in the stressed young and old groups, but they were statistically significant only in old rats, compared to their age matched controls. However, stressed middle-age rats showed non-significant changes in the studied parameters, except for the mean arterial blood pressure that was significantly elevated, compared to their age matched controls. From these results, it is clear that the changes in the haemostatic responses to stress were more manifest in the young and old rats, with more marked responses in the older ones. On the other hand, vitamin E supplementation in old rats, prior to the stress induction, produced a decrease in mean arterial blood pressure, platelet aggregation, plasma fibrinogen concentration and fibrin degradation products, as well as increase in platelet count and antithrombin III activity. All these changes were statistically significant compared to the vitamin E-unsupplemented stressed old rats, but they were non significantly changed from the normal controls. It is concluded that vitamin E injection, prior to stress induction, produces marvelous effects on the stress-induced derangement of the haemostatic system