[Metabolic profile of Tunisian obese adult]

obesity is associated with multiple comorbidities such us metabolic and cardiovascular diseases. Evaluate metabolic profile and to determinate the frequency of metabolic syndrome in Tunisian obese adult. It's a prospective study realized in the unit of obesity research in the national institute of nutrition between April 2003 and March 2005 .This study concerned two groups of subjects aged between 20 and 60 years old: Group 1 [n = 100]obese [BMI >/= 30 kg/m[2] and group 2 [n= 60] controls with normal weight [BMI between 18.5 and 24.9 kg/m[2]. Mean number of metabolic complications is significantly higher [P < 10[-3]] in obese [3.28 +/- 2] than in controls [1.16 +/- 1.2]. Impaired fasting glucose and type 2 diabetes mellitus are respectively more frequent in obese [37% and 16%] than in non obese [5% et 1.7%]. Hyperinsulinemia is significantly [P<10[-3]] more frequent in obese. hypertriglyceridemia, hypercholesterolemia and hyperapolipoproteinaemia B are significantly [P = 0.01, P < 10[-3] et P < 10[-3] more frequent in obese than in no overweight subjects. The prevalence of hyperuricemia increased significantly [P = 0.01] in overweight subjects than in normal weight subjects. Metabolic syndrome is significantly more frequent [P < 10[-3]] in obese [48%] than in control [1.7%]. Obesity, especially visceral obesity, is associated with a cluster of metabolic complications increasing the risk of coronary heart disease. We stresson the importance of primary prevention and early management of obesity

[Pathologic assessment of Meckel's diverticulum specimens; a ten year study]

Meckel's diverticulum is one of the most common congenital anomalies of gastrointestinal tract. Our aim was to study pathologic features of surgical specimens of the diverticulum and to assess the type of lining mucosa, presence of Helicobacter pylori and inflammatory changes. We studied patients' medical records and pathology files of the years 1994 through 2004, of the patients who underwent surgery with the diagnosis of Meckel's diverticulum in Children's Medical Center, Tehran. Pathologic features such as length and lining of the diverticulum and other variables such as age, gender and clinical signs were studied. We found 45 specimens in this period [80% male 20% female]. The mean age was 3.8 years [25 days to 11 years] and most of the patients were between 2 to 4 years old [33.6%]. Most common clinical symptoms were abdominal pain [17] and hematochesis [4]; 20 patients had combined symptoms such as abdominal pain and melena. Only 9 patients with lower gastrointestinal bleeding had Technetium scan and all of them were positive. Associated findings during surgery included appendicitis and invagination. Twenty diverticulae were inflamed in pathologic report, 8 with gangrene and 5 with perforation. Pathologic examination of specimens revealed a mean diameter of 2 cm [range: 0.4-4.5] and a mean length of 3.8 cm [range: 1-10]. Lining was of intestinal type in 27 [60%], gastric in 10 [22.2%] and combined in 8 specimens [17.8%]. 11 specimens from 18 that were lined by gastric type of mucosa showed no Helicobacter pylori in Giemsa stain [2 had mucosal necrosis]. Clinical findings of Meckel's diverticulum in our study were rather the same as in literature. The most efficient way of diagnosis was Technetium scan. Pathologic examination of specimens revealed that most diverticulae were lined by intestinal type of mucosa. None of those with gastric type of mucosa showed Helicobacter Pylori infection

[Intestinal biopsy and anti endomyosial serologic test in children suspicious for celiac disease: a comparative study in children medical center]

Celiac is one the most common causes of malabsorption and is an autoimmune disorder resulting in damage to intestinal epithelial cells by self T lymphocytes. The main culprit is gluten. The aim of our study was to assess the histopathologic findings of patients suspicious to have celiac disease in their first admission and compare them with serologic findings [endomyosial antibody test: EMA]. The study is a prospective descriptional type and 95 patients suspicious to have celiac disease were included who went under upper endoscopy and sampling and also serologic studies. Histopathologic findings were grouped by Marsh classification. Specimens in Marsh stage 0 and 1 were also stained for leukocyte common antigen by immunohistochemistry. Ninety five patients, 49 males and 46 females, ranging from 9 months to 17 years [mean: 6.3 ys] were included in the study The most common complaint was abdominal pain. EMA test was positive in 43 patients. Most specimens were categorized as Marsh stage IIIA [51 cases] by histopatholgic examination, which can be seen in many other conditions. Only 16 patients were categorized as Marsh stage IIIB and IIIC, which are seen in established celiac patients No significant correlation was found between histopathologic and serologic findings. No difference was found between H and E staining and immunohistochemical staining in counting of intra- epithelial lymphocytes. Most of our patients had mild partial villous atrophy which is also seen in many other disorders and also EMA test was negative in this group. It appears that current assessment of celiac disease has many drawbacks and necessity of more specific methods is highly appreciated