Quantification of Hypoxia in Human Glioblastoma using PET with 18F-FMISO / 대한핵의학회잡지

Purpose@#This study aimed to investigate the results of compartmental modeling (CM) and spectral analysis (SA) generated with dynamic 18F-FMISO tumor images. Besides, the regular tissue-to-blood ratio (TBR) images were derived and compared with the dynamic models. @*Methods@#Nine subjects with glioblastoma underwent PET/CT imaging with the 18F-FMISO tracer. The protocol for PET imaging began with 15 min in dynamic mode and two 10-min duration static images at 120 min and 180 min post-injection. We used the two-tissue compartmental model for CM at the voxel basis, and we conducted SA to estimate the 18F-FMISO accumulation within each voxel. We also investigated the usual tumor-to-blood ratio (TBR) for comparison. @*Results@#The images of the tumor showed different patterns of hypoxia and necrosis as a function of PET scanning times, while CM and SA methods based on dynamic PET imaging equally located tumor hypoxia. The mean correlation of Ki images of all subjects between CM and SA was 0.63 ± 0.19 (0.24-0.86). CM produced less noisy Ki images than SA, and, in the contrary, SA produced accumulation component images more clear than with CM. CM-Ki and SA-Ki images were correlated with TBR images (r = 0.72 ± 0.20 and 0.56 ± 0.26, respectively). In the only subject having a continuously increasing tumor time-activity curve, the K3 image showed a high uptake in the necrosis region which was not apparent in TBR or Ki images. @*Conclusion@#Based on these results, the combination of CM and SA approaches was found more appropriate in generating voxelbased hypoxia images.

Efficacy of Fluid Administration Followed by Lung Sonography in Hemodynamic Assessment in Acute Circulatory Failure in Critically Ill Patients

Background:Early recognition and appropriate treatment of shock have been shown to decrease mortality. Incorporation of bedside ultrasound in patients with undifferentiated shock allows for rapid evaluation ofreversible causes of shock and improves accurate diagnosis in undifferentiated hypotension. The aim of the present study was to evaluate efficacy of fluid administration followed by lung sonography in hemodynamic assessment in acute circulatory failure in critically ill patients.Materials and Methods: This prospective cohort controlled randomized study was carried out on 50 Critically ill Patients who had acute circulatory failure in intensive care unit Tanta university hospital Critically ill patients of either sex aged 21-60 years when mean blood pressure was below 65 mmHg were included. Patients have been uniformly distributed in2 categories, The patients assigned either to the Control Group (group I) or to the FALLS (fluid administration limited by lung sonography) protocol group (group II)Results:Comparison between two groups revealed that, the heart rate showed that heart rate is lower in group II in comparison to group I .Comparison between two groups revealed that, the mean arterial blood pressure changes showed that it is higher in group II in comparison to group I .Comparison between two groups revealed that, the Central venous pressure showed that no significant difference in the base line .Intensive care unit stay in group I rangedbetween 5 –11 days while in group II ranged between 3 –8 days .Survival analysis (Kaplan Mier curve), Mortality at 28 days found in group I mean 21.28 days with SE 1.898 and in group II mean 24 days with SE 1.64 with no significant difference in time but there was significant difference in number of mortalities as discussed before.Conclusion:We conclude from this study that bedside Lung Ultrasound has a good accuracy and superiority in assessment over other traditionally used methods for detecting early signs of pulmonary congestion and thus guides the fluid administration in shock management to decrease complications, mortality and intensive care stay

Polypose naso-sinusienne et intolérance à l'aspirine: particularités cliniques et résultats du traitement chirurgical

: Comparer le tableau clinique et les résultats thérapeutiques du traitement chirurgical de la polypose nasosinusienne entre deux groupes de patients porteurs et non d'une intolérance à l'aspirine.PATIENTS ET MÉTHODES : Etude rétrospective sur une période de 13 ans [2002-2014] comparant deux groupes de patients opérés d'une polypose naso-sinusienne. Dix-huit patients étaient porteurs d'une maladie de Widal et 54 autres présentaient une polypose nasosinusienne associée ou non à un asthme mais sans intolérance aux anti-inflammatoires non stéroïdiens. RESULTATS : La symptomatologie clinique était jugée plus sévère chez les patients porteurs d'une maladie de Widal. Le taux d'échec fonctionnel était plus élevé en cas de maladie de Widal (55% versus 4% (p=0,001)). Les récidives étaient plus fréquentes et plus extensives dans cette population (100% VS 42% (p=0,00)).CONCLUSION : La maladie de Widal était associée à un taux d'échec fonctionnel et anatomique plus élevé

Effect of Bone Marrow-Derived Mesenchymal Stem Cells on Ischaemic-Reperfused Hearts in Adult Rats with Established Chronic Kidney Disease

BACKGROUND AND OBJECTIVES: Bone marrow-derived mesenchymal stem cells (BM-MSCs) are adult multipotent non-haematopoietic stem cells that have regeneration potential. The current study aimed to detect the ability of BM-MSCs to improve kidney and cardiac functions in adult rats with established chronic kidney disease. METHODS: Rats were divided into sham-operated control, untreated sub totally nephrectomised and treated sub totally nephrectomised groups. Body weight, kidney and cardiac tissue weights, plasma creatinine and urea levels and arterial blood pressure were measured. ECG was recorded, and an in vitro isolated heart study was performed. Results: Stem cell treatment decreased the elevated plasma creatinine and urea levels and decreased systolic, diastolic and mean arterial blood pressure values. These changes were accompanied by a decrease in glomerular hypertrophy with apparent normal renal parenchyma. Additionally, BM-MSCs shortened Q-To and Q-Tc intervals, all time to peak tension values, the half relaxation value at 30 min of reperfusion and the contraction time at 15 and 30 min of reperfusion. Moreover, stem cell treatment significantly increased the heart rate, QRS voltage, the peak tension at the 15- and 30-min reperfusion time points and the peak tension per left ventricle at the 30-min reperfusion time point compared to the pre-ischaemia baseline. BM-MSCs resolve inter muscular oedema and lead to the re-appearance of normal cardiomyocytes. This improvement occurs with the observations of BM-MSCs in renal and heart tissues. CONCLUSIONS: BM-MSCs can attenuate chronic kidney disease progression and the associated cardiac electrophysiological and inotropic dysfunction.

L'otite sereuse chez l'adulte : demarche diagnostique et therapeutique

L'otite seromuqueuse (OSM) de l'adulte est une situation regulierement rencontree en consultation ORL. Le but de notre travail est de dicter a travers notre serie et une revue de la litterature une demarche diagnostique et therapeutique en presence d'une otite seromuqueuse de l'adulte. Patients et Methodes : Nous avons mene une etude retrospective sur une periode de 10 ans allant de 2002 a 2011. Ont ete inclus les patients de plus de 18 ans chez qui a ete porte le diagnostic d'otite seromuqueuse avec un suivi minimum de un an. Resultats : Notre population etait constituee de 53 patients. 60 des patients avaient des antecedents de traitement par radiotherapie du massif facial. Vingt patients etaient suivis pour rhinite chronique. Tous les patients ont eu un examen ORL complet et un scanner des rocher dans tous les cas. 62 des patients ont eu un traitement medical. 92 de nos patients ont ete operes; 17 patients ont eu une regression complete et persistante dans le temps. Discussion : le diagnostique etiologique d'une otite seromuqueuse chronique de l'adulte passe par un examen ORL complet; suivi d'un scanner injecte des rocher. Le traitement n'est pas clairement codifie

Tuberculose lymphonodale cervicale chez les enfants vaccines par le BCG

La tuberculose ganglionnaire cervicale est une localisation extrapulmonaire relativement frequente chez l'enfant. Elle pose essentiellement des difficultes de prevention. L'objectif de ce travail est d'etudier les particularites diagnostiques et therapeutiques chez des enfants vaccines par le BCG. Materiel et methodes: Notre etude retrospective porte sur 23 cas de tuberculose ganglionnaire chez des enfants vaccines; colliges sur une periode de 10 ans allant de 2002 a 2011. Resultats : La moyenne d'age des enfants etait de 8 ans. Le delai de consultation etait en moyenne de 1 mois. Seize enfants presentaient une polyadenopathie cervicale bilaterale. L'echographie cervicale a objective une necrose intra ganglionnaire dans 17 cas. Le diagnostic de tuberculose ganglionnaire a ete confirme par l'examen anatomopathologique d'une piece d'adenectomie dans tous les cas. Aucun des enfants n'a presente de forme grave ou compliquee. Un traitement antituberculeux selon le schema national a ete instaure dans tous les cas. L'evolution a ete favorable dans tous les cas. Conclusion : Malgre tous les efforts deployes par notre pays pour la lutte contre la tuberculose; cette derniere sevit toujours a l'etat endemique. La vaccination par le BCG a permis de diminuer considerablement le nombre des formes graves mais ne protege pas parfaitement contre cette maladie

Relation between smoking and cognition in egyptian elderly

In spite of numerous studies published in the past few years on the topic, the effectof smoking on Alzheimer's disease and dementia remains uncertain. Case-control studies havelargely suggested that smoking lowers the risk of AD, whereas prospective studies have shownthat smoking increases this risk or has no effect on the probability of developing AD. The aim of this study is to compare the prevalence of Smoking in elderly withcognitive impairment and elderly with non-cognitive impairment. A Case control 88 participants aged 60 years and above. They wereselected from Ain Shams University Hospital from inpatient wards and outpatient clinics. Thestudied sample was divided into 3 groups: Group A [32 elderly patients with Alzheimer's disease],Group B [32 elderly patients with Mild cognitive impairment] and Group C [24 controls withnormal cognitive function].Comprehensive geriatric assessment, including detailed history, physicalexamination, and also cognitive assessment using Montreal Cognitive Assessment [MOCA] andMini mental status examination [MMSE].As regards smoking there was a highly statistical significant difference between the 3groups as non-smokers were more prevalent in Alzheimer's diseaseand Mild cognitiveimpairment groups in comparison to control group with [p-value= 0.001]. There was a highly significant negative association between smoking and cognitiveimpairment

Phenolic content, antioxidant potential and Aedes aegyptii ecological friend larvicidal activity of some selected Egyptian plants

Polyphenols constitute a distinct group of natural compounds of medicinal importance exhibiting wide range of physiological activities as antioxidant, immune-stimulant, antitumor and antiparasitic. Yellow fever and dengue fever are mosquito-borne infectious diseases transmitted by Aedes aegyptii, the presence of yellow fever in Sudan and dengue fever in Saudi Arabia are threats to Egypt with the re-emerging of Ae. aegyptii in Southern Egypt, larvae control is feasible than flying adults. This work was conducted targeting estimation of the relative levels of total phenolic content, antioxidant potential and larvicidal activity of 110 selected Egyptian plants. The highest total phenolic contents were estimated in aqueous extracts of Coronilla scorpioides L., Forsskaolea tenacissima L, Crataegus sinaica Boiss., Pistacia khinjuk Boiss. and Loranthus acacia Benth.; they were 916.70 +/- 4.80, 813.70 +/- 4.16,'744.90 +/- 4.93, 549.00 +/- 3.93 and 460.80 +/- 4.02 mg% while those of methanol extracts were estimated in Coronilla scorpioides, Forsskaolea tenacissima, Crataegus sinaica, Loranthus acacia and Pistacia khinjuk; they were 915.60 +/- 4.86, 664.60 +/- 4.16, 659.30 +/- 4.80, 590.80 +/- 4.49 and 588.00 +/- 3.85 mg% respectively. Investigation of the antioxidant potentials revealed that the most potent plants were Coronilla scorpioides, Forsskaolea tenacissima, Crataegus sinaica, Pistacia khinjuk and Loranthus acacia with calculated values of 454.80 +/- 4.83, 418.4+/-4.16, 399.10 +/- 4.90, 342.5 +/- 2.72 and 239.7 +/- 2.91% for aqueous extracts and 452.9 +/- 4.94, 389.6 +/- 4.6, 378.48 +/- 3.84, 352.3 +/- 3.06 and 346.5 +/- 2.98% for methanol extracts respectively while screening of larvicidal activity proved that Coronilla scorpioides, Forsskaolea tenacissima, Crataegus sinaica, Pistacia khinjuk and Loranthus acacia exhibited highest potency calculated as 22.53 +/- 2.01, 23.85 +/- 2.07, 28.17 +/- 2.06, 31.60 +/- 2.93 and 39.73 +/- 4.58 mg% aqueous extracts and 18.53 +/- 1.95, 18.8 +/- 1.67, 20.17 +/- 1.85, 23.28 +/- 2.7 and 28.48 +/- 3.9 mg% methanol ones respectively

Effect of different growth conditions on certain biochemical parameters of different cyanobacterial strains

Aims: Variation in the traditional growth medium conditions to enhance the production of lipids, carbohydrates, protein and the free amino acids content of three cyanobacterial species. Methodology and Results: Three species of cyanobacteria (Anabaena laxa, Anabaena fertilissima and Nostoc muscorum) were collected from the culture collection of Soils, Water and Environment Research Institute, Agriculture Research Center, Giza, Egypt, to investigate their biochemical composition under different growth conditions, using BG110 (nitrogen free) as growth medium. These conditions were represented by control medium, static glucose medium with (1%, w/v), aerated medium (aerated by bubbling technique depending on CO2 normally existed in air with a concentration of 0.03%), molasses medium (0.7%, v/v) and aerated medium enriched with glucose (1%, w/v). Lipid content, total carbohydrates, soluble proteins and free amino acids were determined at the previous conditions. Glucose at 0.7% (w/v) was the most favorable for lipid production in A. laxa, where it exhibited the highest lipid content (427 μg/g fresh wt.). Increasing molasses concentration up to 0.7% (v/v) produced an increase in lipid contents of the tested cyanobacterial strains. The highest lipid content of both N. muscorum (366.2 μg/g fresh wt.) and A. laxa (357.4 μg/g fresh wt.) were recorded at molasses concentrations of 0.1 and 0.7% (v/v), respectively. A. laxa expressed high significant values for both proteins (31.6 μg/mL) and free amino acids (40.5 mg/g dry wt.) after 6 days of incubation period under aerated enriched glucose condition (1%, w/v). Also, at the same growth conditions, A. fertilissima exhibited high significant values for carbohydrates at 4th day (876.8 mg/g dry wt.). Conclusion, significance and impact of study: Aerated enriched glucose medium (1%, w/v) was the best growth medium condition used in the present study.

Evaluation of serum nitrate levels in infants and children with congenital heart diseases

This study was carried out on 100 patients having congenital heart disease [CHO], 63 males and 37 females, their age ranged from 4 months to 12.5 years. In addition, 20 apparently healthy children were taken as a control group. This study was done at AI-Azhar University Hospital on patients attending the cardiology and pediatric cardiology outpatient clinic as well as children admitted to the inpatient department. The CHO patients were divided into groups according to: pulmonary artery systolic pressure [PASP] [normal PASP, mild, moderate or severe pulmonary hypertension], presence or absence of heart failure [HF]: [patients with or without heart failure], correction of the cardiac defect: [patients with or without surgical correction] and cyanosis [cyanotic or non-cyanotic CHO]. All patients were subjected to the following: full history taking, complete physical examination [general and cardiac], plain x-ray chest and heart, electrocardiography, echo cardiography and measurement of serum nitrate levels. Our results showed statistically significant differences in serum nitrate levels particulary between patients with severe pulmonary hypertension and those without and between patients with heart failure and those without. The levels were higher in the HF group compared to non-HF group and the control group. No statistically significant differences in serum nitrate levels were found between patients who previously underwent operations for correction of the cardiac defects and those who did not nor between cyanotic and non-cyanotic groups

[ prophylaxis of the thromboembolic disease in the head trauma]

The prophylaxis of the thromboembolic disease in the severe head trauma remains a controversy. In this study, we are interested to the determination of under groups of patients for whom the advantages of the prophylaxis of the thromboembolic disease [TED] are higher than its disadvantages. We proceeded to a retrospective study based on patient medical records ranging from March 2003 until March 2004, enrolling 56 consecutive patients. The data collected related to the age, the gender, past medical history, the type of trauma, results of age, the gender, past medical history, the type of trauma, results of the initial CT scan, the treatment, appearance or not of the thromboembolic disease and its prophylaxis therapy. The average age was of 36 +/- 19 years. 76.8% did not have significant past medical history. All the patients profited from an elastic compression stocking. The LMWH were used among 15 patients victim of severe head trauma associated with other injuries and 72 hours after stabilization of hemorrhagic attacks. A thromboembolic disease diagnosis was based clinical or biological assumptions. Among 56 patients, 4 of them showed a TED with an incidence of 7.1 including 3 DVT and one case of pulmonary embolism. The 4 patients sustain severe multiple trauma; 3 of them received an early anti-coagulation therapy. In the group of patients with TED, the OMEGA scores and IGS are high; all of them are multiple traumatized patients with shock requiring a blood transfusion in 75 of the cases. Only the blood transfusion is correlated at the risk of TED, statistically established. The risk to develop a thromboembolic complication in the traumatic patients with head injury is high particularly in case of associated muscleskeletal injuries. Elastic compression technique is not always effective but considered as an interesting alternative to the pharmacological prevention of thrombosis. The use of the anticoagulants therapy must be careful. It is contra-indicated in case of cerebral haemorrhage in progress and must be considered upon individual case of each patient

Subclinical cardiac involvement in systemic lupus erythematosus

Cardiovascular lesions are commonly found in children and adolescents with systemic lupus erythematosus [SLE] with relevant implication in mortality and morbidity. The purpose of the study was to verify whether there is any sign of cardiovascular involvement in childhood SLE without clinical manifestations using electrocardiography [ECG] and echocardiography [ECHO]. The study was carried out on 40 children with SLE who attended the outpatient clinics of Rheumatology, Pediatrics, Cardiology and Internal Medicine departments of Assiut and AI-Azhar universities. They were free of any clinically evident cardiac manifestations such as dyspnea, orthopnea and edema of the lower limbs. In addition, twenty apparently healthy children were taken as a control group. All subjects underwent complete history and physical examinations, x ray chest, ECG and two dimensional,M mode, continuous wave [CW], pulse wave [PW] and color flow Doppler examinations .The following investigations were done: complete blood count [CBc], erythrocyte sedimentation rate[ESR], antistreptolysin O titre [A SOT], C reactive protein[CRP], C[3] complement, rheumatoid factor[RF],anfinuclear antibodies[ANA] and anti double strand DNA[anti ds DNA]. Minor ECG changes were detected in 15% of patients. ECHO showed pericarditis with effusion, aortic insufficiency, mitral regurgitation, mild tricuspid regurgitation and mild pulmonary hypertension in 15%, 20%, 25%, 15% and 20% of patients with SLE respectively. A significant reduction of ejection fraction [EF] and fraction shortening [FS] was found in our patients .Significant diastolic dys functions were manifested by decreased early diastolic flow velocity [E], early diastolic flow velocity/late diastolic flow velocity [E/A] ratio and increased E deceleration time [Edt], left ventricular posterior wall diameter in diastole [LVPWd], interventricular septum in diastole[.lVSd] and pulmonary artery systolic pressure [PASP]. Cardiovascular involvement in childhood SLE is Regular cardiac evaluation using [ECG] and [ECHO] is recommended to detect subclinical cardiac involvement

Potential role of interleukins-12 and 18 as predictors in infection induced premature rupture of membranes whether full term or preterm

Acute bacterial intraamniotic infections are by far the most important cause of perinatal morbidity and death. Although early diagnosis and aggressive treatment to decrease the ill effects of intra amniotic infection, this goal is frequently difficult to achieve because the infection may not be clinically apparent before delivery in all patients. In this respect, the current study was designed to asses the potential role of interleukins [1L]-12 and or 18 as a predictor of infection induced rupture membrane whether term or preterm. 75 pregnant women at labor were the subjects of the study. 25 preterm with premature rupture of membranes [PROM] were gp 1, 25 full term PROM were gp 2 and 25 full term with intact membranes were gp 3 [controls]. Bacterial cultures, Chlamydia, Mycoplasma and Ureaplasma were detected among the high vaginal swabs taken at the time of delivery. IL-12 and 18 were quantitated by commercial enzyme linked immu-nosorbant assay [ELISA] from cell culture supernates of milogcn stimulated whole peripheral blood obtained from all subjects at time of delivery. Results revealed a significant association of bacterial infections and IL-12 and 18 with PROM deliveries [whether preterm or term] compared to the controls. A significant increase in IL-12 and 18 were observed among preterm cases than full term ones and among positive bacterial culture cases compared to negative culture ones. The highest interleukin values were with ordinary bacterial infections and the least were with mycoplasmal and ureaplasmal ones. IL-18 values were significantly higher than IL-12 levels. So, we can conclude that IL-18 measurement could be a marker of infection induced PROM

Association of obesity and hyperandrogenemia in peripubertal girls: obesity as a risk factor for postpubertal hyperandrogenism

The objective of the present work was to assess the degree of hyperandrogenemia across puberty in obese girls. A cross-sectional analysis of data obtained at Out Patients Clinics. Fasting blood samples were extracted from 56 obese [body mass index [BMI] for age >/= 95%] and 55 normal-weight [BMI for age,<85%] peripubertal girls to assess [testosterone T, sex hormone binding globulin SHBG, free testosterone FT. insulin, blood glucose, LH, FSH and dehydroepiandrosterone sulfate DHEAS]. BMI and BMI percentile for age were calculated and correlated with these hormones in each stage of puberty. BMI was found to be correlated with total testosterone [T] [rs 0.81], SHBG [rs=-0.93], and free T [rs=0.74]; free T was 3.9 times as great in obese girls compared with normal-weight girls [p<0.001 for all]. BMI correlated with insulin [rs=-0.93]; both insulin and LH correlated with free T [rs=0.71 and 0.70, respectively; p<0.0001 for all]. When analyzing early pubertal girls [pubertal stages 1-3; n=41] alone, BMI correlated with total T [rs=0.97], SHBG [rs=-0.89], and free T [rs=0.96]; free T was 5.2 times as great in obese early-pubertal girls [p<0.001]. BMI correlated with insulin [rs 0.87], and insulin correlated with free T [rs=0.87, p<0.0001 for both]. BMI correlated with free T [rs=0.96, p<0.0001]. In conclusion, peripubertal obesity is associated with marked hyperandrogenemia, which is especially pronounced in early puberty

Clinical evaluation and follow up of autoimmune thyroiditis in children and adolescents [a retrospective study]

The objective of the present study was to assess the clinical manifestations of autoimmune thyroiditis [AlT] in children and adolescents, in addition to disease course and long-term outcome. A retrospective analysis of data obtained at pediatric endocrinology outpatients clinic, Saudi German Hospital, Jeddah, Saudi Arabia. Fifty three children, 11 boys and 42 girls, with diagnosis of autoimmune thyroiditis and with the age of 12.33 +/- 1.58 years at presentation were included in the study and followed-up in pediatric endocrinology clinic for two years. Clinical characteristics at presentation, reasons for referral, treatment and outcome; by thyroid and pubertal status were recorded. Noticeable goitre was found in 37.75%at time of presentation. Other reasons for referral were clinical symptoms of hypothyroidism [28.3%] and findings on work-up for an unrelated problem [20.7%] or for high-risk groups [13.2%]. Thirteen patients [24.5%] were euthyroid, 18 [34%] had sub-clinical hypothyroidism, and 22 [41.5%] had overt hypothyroidism. The concordance of anti-thyroid peroxidase [anti-TPO] high titers was found in 83%of subjects, while 75.4%of the cases had anti thyroglobulin [ATg] positive titer and both titers were positive in 71.6%. Treatment was initiated shortly after diagnosis in all 22 hypothyroid patients and in 12/18 compensated hypothyroid patients, and within 12 months in two euthyroid patients. Indications for treatment of euthyroid patients were further thyroid enlargement during follow-up, significant increase in TSH concentration, or development of one or more symptoms compatible with hypothyroidism. Ht-SDS at last follow-up was significantly lower than at diagnosis for the entire study group [-0.02 +/- 0.38 vs-0.14 +/- 0.30], p<0.01] but both were within normal Puberty was normal in the studied patients. Forty two [79.2%] had reached their final height by the last follow-up visit [mean Ht-SDS-0.13[0.31] and their final height was within the normal range. There was no significant difference in body mass index SDS at referral by thyroid status. In conclusion, although goitre is the main symptom leading to diagnosis of AlT, it is still often overlooked, underscoring the need for thorough thyroid evaluation on routine physical examination. Acquired hypothyroidism is not often associated with obesity, and ultrasound usually has no added diagnostic value. Adequate treatment in this age group leads to normal growth, puberty and final height

Study of N-acetyl-beta-D-glucosaminidase in elderly patients with iron deficiency anaemia

Little is known about renal tubular function in elderly patients with iron deficiency anaemia. To investigate renal tubular function in these patients. To achieve this aim, we compared renal tubular function in 30 asymptomatic non smoker elderly patients [over 65 years] having iron deficiency anaemia [group I] with 15 healthy age and sex matched controls [group II]. Based on their ages, group I patients were subdivided into 2 subgroups; group Ia consisted of 15 iron deficiency anaemia patients >/= 65 - 70 years while group Ib consisted of 15 iron deficiency anaemia patients above the age of 70 years. These patients were diagnosed during routine check up. Patients with known cardiac, hepatic, or renal diseases as well as cancer or other comorbid conditions were excluded from the study. Blood and urine samples were obtained for haematological and biochemical analysis. Urinary N-acetyl-beta-D-glucosaminidase [NAG], as an index of renal tubular function, was estimated by spectrophotometry. Mean urinary NAG levels were significantly higher in iron deficiency anaemia patients of both age groups than in controls [F=85. 77, p<0.001] with significantly higher mean values observed in group Ib than in group Ia patients. No statistically significant difference was observed between mean urinary NAG values in males [19 patients] and females [11 patients] [t= 0.56, p= 0.46]. In elderly iron deficiency anaemia patients of both age groups, urinary NAG values showed statistically significant negative correlation with haemoglobin levels [r=-0.673 and -0.811 at p=0.006 and <0.001 for groups Ia and Ib respectively] and were positively correlated with age [r=0.838 and 0.780 at p<0.001 and <0.001 for groups Ia and Ib respectively]. No correlation was detected between urinary NAG and haemoglobin values in either males or females [r=-0.433, p=0.064 for males and r=-0.077, p=0.821 for females]. There was no correlation between urinary NAG and serum iron, total iron binding capacity [TIBC] or serum ferritin in elderly iron deficiency anaemia patients of both age groups [r=-0.136, 0.328 and -0.070 at p=0.63, 0.232 and 0.805 respectively for group Ia] and [r=-0.229, -0.333 and 0.107 at p=0.414, 0.225 and 0.704 respectively for group Ib]. Elderly patients even with asymptomatic iron deficiency anaemia have impaired renal tubular function. Anaemia may be a contributing factor for renal impairment in such patients that is why it should be early diagnosed and treated even if no clinical disease is immediately apparent

Serum uric acid in smokers

To demonstrate the possible effect of smoking on serum uric acid. Subjects enrolled in study were divided into two groups; nonsmokers and smokers, each with 60 male volunteers of the same social class and dietary habit without history of alcohol consumption, diabetes mellitus, hyperuricemia and gout, renal, joint, lung or heart diseases. Fasting blood and random urine samples were obtained from both groups for measurement of uric acid and creatinine. Calculation of both urine uric acid/urine creatinine ratio and fraction excretion of uric acid were done. The results were statistically evaluated by standard statistical methods. No significant differences in the age, serum creatinine, spot urine uric acid/urine creatinine ratio and fraction excretion of uric acid between the two groups, serum uric acid was significantly lower in smokers. In smokers there was significant negative correlation of smoking status [average number of cigarette smoked/day, duration of smoking and cumulative amount of smoking] with serum uric acid. After exclusion of other factors affecting uric acid level, the significant low serum uric acid level in smokers was attributed to reduce endogenous production as a result of chronic exposure to cigarette smoke that is a significant source of oxidative stress. As this reduction is proportionate with smoking status and predisposes to cardiovascular disease, it is, therefore, recommended for smokers to stop or reduce smoking and introduce serum uric acid estimation as routine test since its cheap and simple to reflect their antioxidant level

Assessment of carotid intima media thickness in obese children and adolescents

The objectives of the present study aimed to assess the endothelial function in obese children and adolescents by using a non invasive high resolution ultrasound assessment of the carotid intima media thickness [CIMT]. Case control study was conducted on 49 obese children and adolescents comparing them with 34 healthy sex and age matched control group in the New Pediatric Hospital, Cairo University. For all subjects, the following were done: full history tacking and clinical examination, anthropometric measurements of obesity in the form weight, height, BMI, skin fold thickness [SFT], waist circumference and hip circumference, laboratory investigations in the form of total cholesterol, triglycerides, HDL, LDL, C-peptide, fasting glucose and insulin. Ultrasound measurements of CIMT were done. Positive correlation was found between the CIMT and the anthropometric measurements including: weight, BMI, BMI SDS, waist circumference, hip circumference, triceps SFT, subscapular SFT and with the supra-cristal SFT. Also a positive correlation between the CIMT and the total cholesterol, triglycerides, LDL and fasting insulin were found but there were no significant correlation between the CIMT and fasting glucose or C-peptide, while negative correlation between CIMT and HDL was found. the present study conclude that obese children are at increased risk of having thickened CIMT, especially in relation to weight, BMI, skin fold thickness [SFT], waist circumference, hip circumference, total cholesterol, triglycerides, low-density lipoprotein [LDL] and insulin levels

Effects of garlic on myocardial dysfunction and plasma levels of nitric oxide, C-reactive protein and leptin hormone in diabetic rats

It is now accepted that allocin, the main biologically active compound in garlic, exhibits antioxidant activity. As well, garlic has been well known for its protective effects against cardiovascular disease. Diabetes mellitus is reported to be accompanied by severe oxidative stress. Since heart disease is the leading cause of death in diabetes, this study was carried out to determine the effect of garlic supplementation on cardiac performance as well as. on the cardiac responses to Badrenergic stimulation and on plasma levels of nitric oxide [NO], C-reactive protein [CRP] and leptin hormone in streptozotocin [STZ] diabetic rats. The study was carried out on 58 adult male albino rats, allocated into 4 groups: Group 1 included non-diabetic control rats [n = 12] that received a single i.p. injection of citrate buffer, in a volume equal to that used as solvent for STZ used to induce diabetes in the test groups. Group 2 included nondiabetic garlic-treated rats [n = 14], which were injected i.p. with garlic in a dose of 200 mg/kg/day, 6 days/week, for 1 month. Group 3 included diabetic rats [n = 15], diabetes being induced by a single i.p. injection of STZ in a dose of 40 mg/kg. Group 4 included diabetic garlic-treated rats [n = 17], that received a single dose of STZ as in group: and then treated with garlic in a dose of 200 mg/kg/day, given i.p., 6 days/week for 1 month. On the day of sacrifice, blood samples were taken from the aorta for estimation of plasma glucose, nitrate, CRP and leptin levels. Thereafter, the hearts were excised and subjected to in vitro cardiac studies to demonstrate the response of isolated hearts to isoproterenol [ISU] infusion. Hearts isolated from diabetic rats showed impairment of both intrinsic chronotropic and inotropic functions as shown by the diminished spontaneous beating rate [BR], peak developed tension [PT] and myocardial flow rate [MFR] together with prolonged time to peak tension [TPT]. Their response to the different doses of ISU stimulation was also diminished. Further, diabetes was found to be associated with increased plasma glucose, nitrate and CRP, with non significant change in plasma leptin level. Garlic administration to diabetic rats enhanced chronotropy, evidenced by increased BR, as well as inotropy as shown by the shortening of TPT. Garlic also caused significant reduction in blood glucose levels indicating its hypoglycemic effect, together with reduction of the elevated nitrate and CRP levels, yet no effect on leptin was detected. It can be concluded from the present study that diabetes caused impairment of cardiac functions, both basal and in response to ISU infusion. Moreover, the inflammatory effect of diabetes was manifested by the increase in CRP, whereas the high level of NO could be attributed to the oxidative stress induced iNOS activation. Garlic supplementation antagonized the diabetic adverse effects on cardiac functions through its cardioprotective, hypoglycemic, anti-inflammatory and antioxidant effects