ABSTRACT
Many Adverse pregnancy outcome have been reported in pregnant women with thyroid dysfunction. The prevalence of thyroid dysfunction and its relation to pregnancy outcome had not been studied in our locality. To assess the magnitude of thyroid disorders during pregnancy and their relation to pregnancy outcome. A prospective clinical observational study. Subjects and One-hundred-fifty four, pregnant women attending the Ante-natal Care Unit, Mansoura University Hospital. Clinical examination was undertaken. Laboratory evaluation utilizing the highly sensitive chemiluminscent serum TSH assay was performed, together with estimation of serum total T3 and total T4. Cases with abnormal TSH levels were subjected to free T4 estimation to confirm the state of thyroid dysfunction. Urine examination, blood count, liver function tests, kidney function tests and plasma glucose were carried out. Thyroid and abdominal ultrasound were performed. The studied cases were classified into two groups; group 1; 12 women having different antenatal complications and group II; 42 women having no pregnancy complications. The studied cases were also grouped into rural and urban groups, according to their residence in villages or Mansoura town respectively No hyperthyroid cases were detected in either groups. The clinical manifestations of hypothyroidism were not fulfilled, but utilizing serum TSH and FT4 testing, forty five cases out of the 154 studied cases revealed subclincial hypothyroidism [29.2%] being significantly higher among the complicated pregnancy group [33.9%] than the non complicated group [16.7%] and significantly more frequent among the rural cases than the urban group [p<0.001]. Subclincial hypothyroidism has a tendency to increase with increasing gestational age. The most prevalent complications were severe preeclamptic toxemia in 73.7% and second trimester abortion in 15.8% of cases. Subclinical hypothyroidism is common, especially in rural localities. TSH screening of pregnant women in each trimester is suggested
Subject(s)
Humans , Female , Thyroid Function Tests/blood , Thyroxine , Triiodothyronine , Thyronines , Urban Population , Rural Population , Pregnancy OutcomeABSTRACT
Background: there is a controversy about the role of beta-endorphin in the pathogenesis of psoriasis, some reports demonstrated elevated circulating beta-endorphin in psoriatic patients especially with actively spreading plaques while lesion-free patients showed reduction of this neuropeptide. On the other hand, the here is published data denoting that circulating beta endorphin has no primary importance in the manifestation of the psoriasis and that inflammation in psoriatic skin lesions is probably not mediated directly by circulating P-endorphin
Objective: to measure plasma beta-endorphin levels in psoriatic patients and demonstrate whether there are any changes of its peripheral blood levels correlating with the clinical improvement. This in order to determine whether and to which limit this neuropeptide is involved in psoriasis
Subjects and Methods: we measured plasma beta-endorphin concentration by enzyme immunoassay in 46 patients with psoriasis both during the presence of lesions and in symptom Free State. Then compared it with that of 18 non-psoriatic patients with T cell mediated inflammatory diseases [10 atopic dermatitis and 8 systemic sclerosis patients] as control. While 24 age and sex matched, healthy individuals were studied as a negative control
Results: the mean 8- endorphin level of psoriatic patients, atopic dermatitis and systemic sclerosis was significantly higher than healthy controls. After treatment, when the skin lesions cleared in the psoriatic patients there was statistically significant reduction of plasma beta-endorphin level. Significant elevation of beta endorphin was found in patients with long lasting lesions. However, there was no significant difference in P-endorphin levels among patients with and without pruritus, nor in those with and without history of major stress. No significant difference between wide and localized spread lesion. Similarly there was no significant difference between those with high and low PASI scores
Conclusion: beta-endorphin is involved in the pathogenesis of psoriasis. Elevated plasma beta-endorphin levels occurs in psoriasis and decline in these levels parallel to clinical improvement and clearance of psoriatic skin lesions. The increased P-endorphin level in psoriasis is not the results of activation of pituitary-adrenal axis by chronic stress, but is produced in psoriatic skin lesions by inflammatory cells. We hope that in the near future neuropeptides will represent a new approach to skin therapy
ABSTRACT
The aim of the present study was to determine the relation of uremic hyperinsulinemia, hyperparathyroidism and hypocalcitriolemia to hyper triglyceridemia in nonobese nondiabetic, predialyzed CRF men. The present study was conducted on thirty nonobese nondiabetic male subjects suffering from CRF due to different intrinsic renal causes. They were not yet performing dialysis. The patients were categorized according to their fasting serum triglyceride [TG] levels into two groups: a hypertriglyceridemic and a normotriglyceridemic, each comprised 15 patients. In addition ten clinically healthy male subjects matched in age and body mass index were enrolled as a reference group. Overnight fasting serum triglycerides [enzymatic], insulin [ELISA], 1,25 [OH]2Da [radioimmunoassay], and plasma parathyroid hormone [chemiluminecence immunoenzymo- metric assay] were carried out for all subjects. There was significant increase in serum insulin [P<0.001] and plasma PTH [P<0.001] values in CRF hypertriglyceridemic group than the corresponding values of CRF nor-motriglyceridemic group which in turn was significantly higher compared to the controls. Alternatively there was significant increase in serum total triglycerides levels in both hyperinsulinemic and severe hyperparathyroid CRF subgroups in comparison with normoinsulinemic and mild hyperparathyroid CRF subgroups [all patients showed secondary hyperparathyroidism] respectively. At the same time there was significant positive correlation between serum triglycerides levels and serum insulin and PTH levels [P<0.05, P<0.02 respectively]. On the other hand, there was significant reduction in serum calcitriol levels in CRF compared to controls with insignificant correlation between serum triglycerides and calcitriol levels in uremic. In conclusion, unlike calcitriol, reactive hyperinsulinemia and secondary hyperparathyroidism in CRF patients might contribute to hypertriglyceridemia in CRF. The mode of such action would be complex, but most probably through changes in the activity of lipases in the uremic milieu
ABSTRACT
Background: defective gall bladder [GB] contractility has been proposed as a possible pathogen etic factor to explain the increased prevalence of gallstones in chronic liver diseases. However, GB contractility in bilharzial hepatic fibrosis has not been adequately studied
Aim of the work: to study the changes in GB contractility and plasma cholecystokinin [CCK] levels in patients with bilharzial hepatic fibrosis with and without gallstones. Also, the impact of portal hypertension on GB contractility was evaluated
Subjects and Methods: thirty-six patients suffering from bilharzial hepatic fibrosis [17 male, 19 female; aged 43.97+/-9.48 years] and 15 healthy control subjects matched in age and sex with the patients group were included in the study. All studied subjects were subjected to thorough medical examination and liver function tests. Fasting and postprandial CCK were assayed using radioimmunoassay. Fasting and residual GB volumes and GB ejection fraction were determined by ultrasonography as measures of GB contractility. Congestion index was estimated as a measure of portal hypertension
Results: patients with bilharzial hepatic fibrosis had significantly higher values of fasting and residual GB volumes and significantly lower values of GB ejection fraction than did control subjects [40.97+/-14.77ml Vs 24.4+/-5.87ml, P<0.001; 18.72+/-10.5ml Vs 7+/-2.33ml, P<0.001; 57.08%+/-13.78 Vs 71.26%+/-6.66, P<0.001, respectively]. There were significant increase in fasting and postprandial total CCK values in patients compared to control subjects. Bilharzial hepatic patients with gallstones exhibited significantly larger fasting and residual GB volumes and significantly reduced GB ejection fraction, in comparison to those without gall stones. Bilharzial hepatic patients with gallstones had significantly higher values of portal vein diameter and congestion index than did those without gallstones. For fasting and postprandial CCK, patients harboring gallstones had significantly higher levels than those without gallstones. GB ejection fraction correlated positively with serum albumin [r = 0.56, Pc0.001]. Postprandial CCK correlated positively with residual GB volume [r = 0.77, P<0.001] and negatively with GB ejection fraction [r = -0.58, P0.001]. Fasting and residual GB volumes correlated positively with both portal vein diameter and congestion index. GB ejection fraction correlated negatively with portal vein diameter [r= -0.47, P = 0.003] and congestion index [r = -0.56, P<0.001]
Conclusion: our study provides an objective evidence of impaired GB contractility in patients with bilharzial hepatic fibrosis in spite of higher CCK values especially in those harboring gallstones. Also, bilharzial hepatic patients with gallstones had significantly higher measures of portal hypertension than those without gall stones. The GB hypo contractility correlated to measures of portal hypertension. Therefore, our results suggest that defective GB contractility might contribute to the increased frequency of gallstones in patients with bilharzial hepatic fibrosis. Portal hypertension per se may have a role in the increased genesis of gallstones. Further researches are recommended to study whether portal decompressive drugs could decrease the incidence of gallstones in patients with bilharzial hepatic fibrosis
ABSTRACT
A cross sectional survey was conducted in two Egyptian villages [El- Shoara Village, which is famous for obesity and Alexandria Village, where obesity was not so prevalent] including 2000 subjects aged 20 years screened by an estimation of body mass index [BMI]. A case control study was adopted. The study included 201 obese cases from the El-Shoara and 201 non-obese ones from Alexandria Village. Both cases and controls were subjected to a questionnaire interview covering the sociodemographic data and KAP about obesity. Dietary data were collected by a standardized 24-hour dietary recall and a dietary assessment was carried out by the software program World Food Dietary Assessment Version 2.0. History taking, thorough clinical examination and blood analysis for lipid profile were done. The levels of total physical activity were assessed