sICAM-1 AND beta[2]microglobulin as markers of disease activity in psoriasis

Background: PASI score is used in evaluating the extent and severity of psoriasis. However, it is a subjective method with several limitations. Attention have been recently focused on some systemic immunological and inflammatory parameters useful in monitoring of psoriasis activity

Aim of work: was to detect whether the level of sICAM-1 and serum Beta 2 microglobulin could be useful parameters in monitoring the activity of psoriasis or not

Patients and Methods: This study included 40 psoriatic patients and 20 healthy controls. The patients were classified into two groups: The first group: Consisted of 20 patients in active phase of psoriasis, 10 of them were erythrodermic psoriasis and the other 10 were psoriasis vulgaris. The second group consisted of 20 patients in remission phase of psoriasis. The patients were submitted to detailed history taking, complete clinical and dermatological examinations, detection of the extent and severity of psoriatic lesions using PASI score, estimation of serum ICAM-1 and B[2]microglobulin levels by ELISA, and statistical analysis of the results was done

Results: Statistically significant elevation of sICAM-1 and P-, microglobulin levels was found in all psoriatic patients [active and remission] when compared to those of the normal control group. Statistical significant increase was found in sICAM-1 and B[2]microglobulin of patients in active psoriasis compared to those in remission phase. Statistical significant increase in sICAM-1 of active psoriasis vulgaris was found when compared to that of patients in remission phase and sICAM-1 of erythrodermic psoriasis compared to that of patients in remission phase. Statistical significant increase was found in P[2]microglobulin of patients with erythrodermic psoriasis compared to that of patients in remission phase but no statistical significant difference in B[2]microglobulin was found between patients with active psoriasis vulgaris compared to that of patients in remission phase. There was a statistical significant positive correlation between PASI score and sICAM-1 level, between PASI score and beta[2] microglobulin level and between sICAM-1 and B[2]microglobulin levels in all patients

Conclusion: sICAM-1 and 2 microglobulin are useful markers in monitoring the activity of psoriasis

Campylobacter jejuni in acute diarrhoea in infancy and its relation to faecal leucocytic count

A prospective study was carried out to identify the relative risk of Campylobacter jejuni infection in 50 infants with acute diarrhoea, 24 infants with acute resistant diarrhoea and 25 healthy normal infants as a matching control group. Faecal samples were collected from the three groups and were cultured on both selective media for Campylobacter and other media for isolation of other organisms. Direct stool smears, stained with methylene blue, were examined for detection of faecal leucocyte in all samples. Campylobacter jejuni were isolated from 4 cases [8.0%] of the acute diarrhoeal group and 4 cases [16.6%] of acute resistant diarrhoeal group. The other bacterial pathogens isolated from our cases were Salmonella, Shigella, E.Coli, Proteus mirabilis, Vibrio Parahaemolyticus, Klebsiella, Streptococcus faecalis and Candida albicans. All cases from whom Campylobacter was isolated were bottle fed and their ages were below 6 months. Smears for faecal leucocytes were positive in 100% of Campylobacter isolated cases, 60% of Salmonella, 50% of Shigella, 14% of E.Coli and 100% were negative in all other cases. Thus it can be recommended that any case presenting with acute diarrhoea should be initially screened by faecal leucocytic counting, positive cases should be cultured for Campylobacter jejuni detection in addition to cultures for other organisms detection

Some biochemical indices in cholestasis of pregnancy

This study Includes 29 pregnant women at their 36-39 weeks of pregnancy, 14 of them were suffering from itching of unknown cause and diagnosed as [cholestatic group] by the obstetrician and the physician, the other 15 were apparently healthy normal pregnant women and considered to be [control group]. Serum alanine aminotransferase [ALT], Aspartate aminotransferase [AST], Alkaline phosphatase [AP], Garnma-glutamy1 transferse [gamma gT], Cholic acid [CA], Chenodeoxy cholic acid [CDCA], prolactin and specific beta glycoprotein [Sp1] were estimated in the two studied groups. The results obtained showed that ALT, AST, CA and CDCA were significantly increased, on the otherhand Sp1 was significantly decreased, while AP, gamma gT and prolactin showed nonsignificant changes. In the cholestatic group compared to the normal control group. In the cholestatic group ALT, AST, AP and gamma gT were over the mean values of the control group in 71.4, 57.1, 25.7 and 42.9% of cases respectively, while CA and CDCA in 85.7 and 71.4% of cases respectively. Thus it appears that serum CA is a sensitive indicator of cholestasis in pregnancy. Fetal and maternal morbidity demonstrated in the 14 cholestatic pregnant women were; premature deliveries in 2 cases, postpartum haemorrhage in 4 cases, meconium stained amniotic ftuid in 6 cases, low birth weight in 3 cases and bad Apgarscore at 5 minutes in 2 cases. It is concluded that consideration should be given to the measurement of serum bile acids particularly [CA] in all pregnant women with unexplained pruritus. Those with high levels should be subjected to a more intensive follow up

Anaemias in pregnant Egyptian women and its effect on hormonal placental function

This study was done on 35 pregnant women in the last three weeks of gestation, 10 of them with normal haemoglobin concentration [Hb conc.] [Group I] and 25 with Hb. concentration less than 8 gm/ dl [Group II]. The following laboratory tests were done to them: Hb concentration, estimation of serum iron, total iron binding capacity, ferritin, vitamin B12, folate, aestriol and human placental lactogen HPL. Fetal birth weight and placental weight were recorded. There was significant decrease in Hb conc., serum iron and ferritin in Group II as compared to Group I [P < 0.001]. On the other hand, significant increase in serum total iron binding capacity was detected in Group II as compared to Group I [P < 0.01]. There was significant decrease in serum folate [P < 0.01] and insignificant decrease in serum vitamin B 12 in Group II compared to group I. 56% of the anaemic cases were due to iron deficiency anaemia, 28% were mixed iron deficiency and megaloblastic anaemia, and 16% with megaloblastic anaemia due to folate deficiency. There was significant increase in serum HPL and significant decrease in serum aestriol level [P < 0.001] in Group II compared to Group I. There was also significant decrease in fetal birth weight [P < 0.05] and significant increase in placental weight [P < 0.01]. Although, it has been accepted that serum HPL and aestriol level are a good index of feto- placental wellbeing. It is important for obstetrician to be cautious in using HPL and aestriol values as a test of good placental function in anaemic pregnant women