effect of weight reduction versus reduction mammoplasty on the pulmonary function parameters and leptin level in obese-macromazia subjects

Background: Obese subjects with breast hypertrophy are suffering not only from cosmetic aspects but also negatively affecting the quality of their life so, the aim of this study was to evaluate the effect of weight reduction versus reduction-mammoplasty on pulmonary function parameters and serum-leptin level

Subjects and methods: Forty females with obesity and macromazia were enrolled into the study. They were classified into two groups, group [1] twenty females who were seeking reduction mammoplasty, and group [2] twenty females who refused surgery and were seeking diet-control regimen. Both groups were matched as regards age and body mass index [BMI]. Pulmonary function parameters [FVC%, FEV[1]%, FEV[1]/FVC and PEFR%] and serum leptin level were measured before starting the intervention in both groups and after starting it by three months

Results: Reduction mammoplasty significantly increases FVC% with non-significant improvement regarding BMI and serum leptin level. On the other hand, diet control regimen improves FEV[1]%, FVC%, FEV[1]/FVC and PEFR% with a significant reduction of BMI and serum leptin levels

Conclusion: Reduction mammoplasty can play a role in improving restrictive pulmonary function parameters while diet control regimen has a more significant improvement in both obstructive and restrictive pulmonary function parameters and in the reduction of BMI and serum leptin level in obese subjects with macromazia

Bacteriological and immunological study in diabetic foot

Background: Diabetes mellitus is increasing rapidly through the world, so the diabetic foot syndrome become more and more important as a major diabetic complication

Objectives: The aim of study was to determine the association between the up-regulation of circulating level ofIL-6 in diabetic patients with foot ulcer compared with diabetic patients without foot ulcer

Subjects and methods: The study included 60 subjects, they were divided into three groups; group I included 20 diabetic patients without foot ulcer syndrome, group II included 20 diabetic patients with diabetic foot ulcer syndrome [DFUS] and group HI included 20 apparently healthy subjects as a control. All subjects were subjected to clinical assessment, routine laboratory investigations and specific investigations including assay of glycosylated haemoglobin, serum IL-6 and bacteriological culture and sensitivity for ulcer

Results: There is no significant difference among the three studied groups regarding the gender, age, duration of the disease and type of treatment. There was significant difference between group I and other groups regarding hypertension [p<0.02]. There was no significant difference between the three studied groups regarding WBC. There was a significant difference between the three studied groups as regards neutrophils and platelets counts f [p=0.009] nd [p=0.03] respectively. There was a highly significant difference between the three studied groups as regards Hb concentration [p<0.001]. There was a highly significant difference [p<0.00l] between group II and both group I and group III as regards ESR [43 +/- 77.2, 13+/-3.9, 11+/-3], random blood sugar [RBS] [319.7+/-47, 238+/-47.8, 92.5+/-10.8], glycosylated haemoglobin [HbAlc] [9.93+/-1.35, 8.83+/-1.4, 4.6+/-0.6], Urea [49.9+/-37, 52.5+/-41, 20.6+/-2.4] and IL-6 [18.9+/-5.6, 4.9+/-2.7, 2,77+/-I].There was positive significant correlations [p<0.001] between IL-6 and levels of RBS [r=0.72], and HbAlc [r=0.62], respectively. Also, a positive significant correlation between IL-6 and neutrophils% [r=0.35, p<0.005] was found The most common isolated microorganisms from foot culture were mixed gram + ve cocci and gram -ve bacilli representing 60% and lonely gram + ve cocci and gram -ve bacilli were 20% respectively. Also, it was found that the most gram +ve organism was Staphylococcus aureus and the most gram -ve organism was E. coll and the most effective antibiotic was Ampicillin-Sulbactam 70% followed by Imipenem 30%

Conclusion: Diabetic patients with foot ulcer were found to have higher IL-6 level than diabetic patients without foot ulcer and they were prone to complications or mortality. This assay could facilitate early and accurate diagnosis and greatly aid timely institution of appropriate treatment