Assessment of tibolone effects on menopausal symptoms and cardiovascular markers

To assess Tibolone effects on menopausal symptoms, lipid profile, serum homocysteine levels, and C-reactive protein. Fifty two healthy post menopausal women, who had been menopausal for at least one year, were recruited in this prospective randomized controlled clinical trial. They were randomly assigned into two groups. The first group received 2.5mg Tibolone tablet [Livial] for 6 month was referred to as "Tibolone group'. The second group received placebo treatment for 6 month and was referred to as "Control group. Menopausal symptoms were assessed upon enrollment and after 6 months using the Greene climacteric scale. All women had an assay of total cholesterol, triglyceride, LDL cholesterol, HDL cholesterol, CRP, and serum homocysteine levels upon enrollment and after 6 months. After 6 months, Tibolone reduced significantly the Greene climacteric scale [median score=10, with score range=2-25] compared to the control group [median score=15, with score range=4-48. p=0.0013]. In the Tibolone group, there was significant decrease in the scale after 6 months compared to baseline. After 6 months, there was no significant difference between the 2 groups regarding the cholesterol, triglycerides, and LDL cholesterol levels. However, there was significant drop in the HDL cholesterol in the Tibolone group compared to the control group [63.33 +/- 15.41 Vs 75.80 +/- 21.11, p=0.016]. By applying the paired t-test and comparing the lipid profile values in the Tibolone group, there was a significant reduction in total cholesterol, triglyceride, and HDL levels after 6 months. There was no significant reduction in LDL cholesterol level. At baseline, there was no significant difference in the homocysteine level between the 2 groups. After 6 months, there was still no significant difference between the 2 groups. Within the Tibolone group, there was a 5.1% reduction in the serum Homocysteine level after 6 months compared to baseline, however, this was also non significant. After 6 months, CRP was significantly higher in the tibolone group compared to the control group [1.99 +/- 0.73 Vs 1.52 +/- 0.76, p<0.05]. Within the tibolone group there was significant rise in CRP level after 6 months. Tibolone is effective in controlling menopausal symptoms. Tibolone had favorable effect on total cholesterol and triglyceride levels, however, it reduced HDL. Tibolone had no effect on homocysteine levels, It was associated with a rise in CRP levels. Further long term clinical trials are needed to verify the cardiovascular effects of tiblone

electro-physiologic study of trigeminal brainstem circuits in migraine

The study aimed at investigating functional changes in the trigeminal and optic nerves brainstem connections in migraine patients. Trigeminal somatosensory evoked potentials [TSER's], electric blink reflex [EBR] and light stimulus evoked blink reflex [LBR] were carried out interictally on 18 patients suffering from migraine without aura and 12 healthy controls. TSER's latencies [N1, P1, N2, and P2], EBR latencies [R1, ipsilateral and contralateral R2] as well as LBR latencies [direct and indirect responses] and their amplitudes were recorded and compared to healthy controls. The ipsilateral and the contralateral R2 components of the EBR [R2i, R2c] showed a highly significant delay as compared to the control group [p<0.000]. N1, P1 and N2 latencies in patients were significantly longer than the control group bilaterally. P1 latencies showed the most significant prolongation of latency [p<0.0000]. The latencies of the LBR direct and indirect responses were significantly prolonged in the patient group [p<0.000] and had a double fold amplitude compared to those of the control group. Migraine patients show a disruption in the central circuits not only at the level of the brainstem but possibly within the higher cerebral regions as well

Bcl-2 as a marker of apoptosis in type 2 diabetes mellitus with vascular complications

Background: vascular complications are the major cause of morbidity and mortality in diabetic patients. Because apoptosis plays a critical role in normal vasculz development and atherosclerosis, we assessed the level of Bcl-2 which is a major anti-apoptotic factor in diabetic patients with and without vascular complications to assess the changes of apoptosis which may occur in diabetic patients

Patients and Methods: this study was conducted on 80 patients divided into 3 groups: Group 1 type 2 diabetics without vascular complications [20 patients, with age rangedfrom 40-65 years with a mean age 52.5+/- 8.0 years], group 2: type 2 diabetics with vascular complications [40 patients with age ranged from 35-80 years with a mean age 57.65+/- 12.75 years], group 3: Healthy non diabetic subjects [20 subjects with age ranged from 35-72 years with a mean age 53.1+/-17.09 years] as a control group. The Bcl-2 ELISA test was used to assess the level of Bcl-2 as a marker of apoptosis. The determination of Bcl-2 was done using a kit supplied by Bender Medsystem Diagnostic Gmbh Rennweg 95 b [USA]

Results: Bcl-2 was found to be significantly lower in the both diabetic groups [with and without vascular complications] in comparison to the control group [p<0.001 and p<0.001 respectively]. It was found to be significantly lower in diabetic patients with vascular complications in comparison to those without vascular complications [p<0.001]. Bcl-2 was negatively correlated to glycated Hb level [p value <0.05], however, it had no correlation to the duration of diabetes in both diabetic groups

Conclusions: Bcl-2 levels are low in diabetic patients especially those with vascular complications indicating a higher rate of apoptosis in those patients. increased apoptosis may have an important pathogenic role in both development and progression of diabetes and its vascular complications

Involvement of interleukin-13 and soluble Inter leukin-2 receptors in the clinico-pathological presentation of pediatric nephrotic syndrome

54 children with nephrotic syndrome and 17 healthy controls were included in the study, among cases studied 40 were males and 14 were females, 36 had history of hypertension and 12 cases had oedema at the time of sampling. Patients were divided into 4 groups, GP 1:10 cases were. steroid responsive in remission, GP 11:12 cases were steroid resistant during activity, GP III:18 cases were steroid dependent of low dose steroids and GP IV:14 cases were steroid dependent on high dose steroids. For all patients' full history, clinical examination and estimation of urinary proteins as well as serum level of IL-13 and sIL-R11 were done. The level of serum JL-13 was significantly lower in cases, compared to control, interquartile range [IQR] was II and 28 respectively [p<0.005] Comparison of the 4 groups revealed a highly significant correlation between groups II and I [p<0.0054]. groups II and IV [p<0.010], there was also a significant difference in serum IL-I 3 level in both sexes but no significant relation to presence of oedema or hypertension. There was a significant negative correlation between IL-13 and serum protein level [r =-0.2686, p<0.05]. On the other hand the serum level of slL-2R was significantly higher in children with NS compared to controls [1Q11=5000, 1244 respectively, p<0.005]. There was a significant difference between patients in GPI vs OP IV [p<0.0 126] and between OP II vs OP Ill [p<0.029] and a highly significant difference between OP II vs OP IV [p<0.0012]. There was no significant difference as regards sex, but a significant difference in children with oedema [p<0.0090] and a highly significant difference in those with hypertension [p<0.0015]. There was also a significant negative correlation between sIL-2R and steroid intake [r =-0.49, 2 0.03]. Results of renal biopsy had no significant correlation with either IL-13 or sIL-2R. In conclusion TL-13 was significantly lower in all studied groups compared to the control, indicating involvement of IL-13 in the pathogenesis of NS. SIL-2R is involved in pathogenic mechanisms involved in activation of NS so it can be used as a clue for disease activity. The exact role of inflammatory cytolcines in pathogenesis of NS in childhood needs further research work to reach proper understanding of the pathogenesis of this syndrome