Electrophysiological changes in type I diabetes without retinopathy

To assess early functional retinal changes in type I diabetic children and adolescents with no ophthalmoscopically detectable retinopathy. Oscillatory potentials [OP's], scotopic and photopic electoretinogram [ERG] were studied. To study the relationship between ERG and systemic risk factors of retinopathy. Recognition of these early neurosensory defects will enhance our understanding of the pathophysiological basis of diabetic retinopathy. Eighty six type 1 diabetic children and adolescents without ophthalmoscopically detectable retinopathy were evaluated and thirty normal subjects were served as control. Flash ERG examination was carried out using Nihon Kohden Neuopack 2 [Japan]. The stimulator used was a flash stimulator [Xenon tube]: SLS-3100 [Nihon Kohden]. Performing the oscillatory potentials [OPs], scotopic and photopic responses recording its amplitude in micro V and peak implicit time in msec. The differences between control subjects and diabetics were assessed. Serum lipid profile, HbA1c% and screening for microalbuminuria were performed. Oscillatory potentials were delayed. Significantly reduced amplitudes and component-specific delayed peak implicit times were found in the diabetic group compared with the data from the controls. Similar results were obtained in the photopic and scotopic electroretinogram. ERG findings were correlated with poor glycemic control and dyslipidemia. From these findings, we concluded that retinal dysfunction is already present in type 1 diabetics without ophthalmological evidence of retinopathy after a mean duration of diabetes of 7.5 years

Doppler echocardiographic assessment of aortic stiffness and myocardial performance index in insulin dependent diabetics

Type I diabetes is characterized by diffuse arterial wall stiffening and thickening which progress with the severity of the disease but could be detected also in the absence of any diabetic-related complications. The stiffening of aorta and other central arteries is a potential risk factor for increased cardiovascular morbidity and mortality. In this study, we aimed to assess the aortic stiffness index, aortic strain, aortic pulse wave velocity [PWV] and myocardial performance index [MPI] in insulin dependent diabetic children and adolescents non invasively using Doppler echocardiography, correlating it with disease duration, state of glycemic control, and lipid profile. Thirty normotensive insulin dependent diabetics and 33 healthy control group were studied. 2D, M-mode and Doppler echocardiography was performed. Calculation of aortic strain, aortic stiffness index and MPI were done. Measurement of glycosylated hemoglobin [HbA1c] and microalbuminuria were performed. The results proved that the aortic stiffness index and aortic strain were significantly higher in diabetics than in the control group [p=0.02] and [p=0.001] respectively. Aortic strain correlated positively with HbA1c [p=0.05, r=0.4]. Aortic PWV and MPI were significantly higher in the cases [p=0.0001] and [p=0.003] respectively

Conclusion: Insulin dependent diabetic children and adolescents had stiffer aortic arteries than control subjects, Aortic strain correlated positively with state of glycemic control. Myocardial performance index was significantly higher in the cases in spite of the normal ejection fraction that may denote an early sign of left ventricular systolic dysfunction

Changes in insulin like growth factor-1 [IGF-1] and insulin like growth factor binding protein 3 [IGFBP-3] in relation to age and pubertal development in children

The present study was carried out to determine the changes in the values of both insulin like growth factor-1 [IGF-1] and insulin like growth factor binding protein 3 [IGFBP-3] in healthy children and adolescents in different ages and in both sexes. The results of the present study revealed that IGF-1 and IGFBP-3 concentrations increased slowly with age with a steep increase near the age of puberty. No difference was observed for IGF-1 and IGFBP-3 levels between males and females in the studied age groups. A significant increase in both IGF-1 and IGFBP-3 was noted with an advancement in the pubertal stage. A significant positive correlation was noted between age and both IGF-1 and IGFBP-3 as well as between both analytes and body mass index [BMI]. A significant correlation was encountered between IGF-1 and IGFBP-3 suggesting a common regulatory mechanism

Serum lead level in exclusively breast-fed Egyptian infants

Breast milk is the ideal nutrient for the newborn, but unfortunately also a route of excretion for some toxic substances including lead, mercury and cadmium. Very little attention has been paid to breast milk as a source of exposure to these elements. This work aims to determine the blood lead level in exclusively breast fed infants and in their maternal blood and maternal breast milk levels correlating these parameters with possible environmental sources of exposure to lead. Seventy one [71] exclusively breast fed infants were involved and subjected to clinical examination, questionnaire for possible environmental exposure, complete blood count, measurement of lead level in the infants, maternal blood and expressed breast milk spectrophotometricaliy. The mean infant blood lead level was 22.6 +/- 11 micro g/dl. The mean level of breast milk lead was 14.9 +/- 9 micro g/dl and the mean lead level in maternal blood was 21 +/- 12microg/dl. The infant blood lead level was high in 87.3 % of the cases with ' no correlation with maternal blood or breast milk lead levels, or environmental sources of lead exposure

Conclusion: Blood lead level is still considerably high in spite of use of lead free gasoline and new lead free paints. Care should be given to nutritional status of the exclusively breast-fed infants particularly iron status and vitamin supplementation [vitamin C and D] to reduce their absorption of lead. Calcium supplementation to the pregnant and lactating mothers' is mandatory to reduce lead mobilization from bone