Heavy Metals Biosorption from Aqueous Solution by Endophytic Drechslera hawaiiensis of Morus alba L. Derived from Heavy Metals Habitats

The ability of dead cells of endophytic Drechslera hawaiiensis of Morus alba L. grown in heavy metals habitats for bioremoval of cadmium (Cd²⁺), copper (Cu²⁺), and lead (Pb²⁺) in aqueous solution was evaluated under different conditions. Whereas the highest extent of Cd²⁺ and Cu²⁺ removal and uptake occurred at pH 8 as well as Pb²⁺ occurred at neutral pH (6–7) after equilibrium time 10 min. Initial concentration 30 mg/L of Cd²⁺ for 10 min contact time and 50 to 90 mg/L of Pb²⁺ and Cu²⁺ supported the highest biosorption after optimal contact time of 30 min achieved with biomass dose equal to 5 mg of dried died biomass of D. hawaiiensis. The maximum removal of Cd²⁺, Cu²⁺, and Pb²⁺ equal to 100%, 100%, and 99.6% with uptake capacity estimated to be 0.28, 2.33, and 9.63 mg/g from real industrial wastewater, respectively were achieved within 3 hr contact time at pH 7.0, 7.0, and 6.0, respectively by using the dead biomass of D. hawaiiensis compared to 94.7%, 98%, and 99.26% removal with uptake equal to 0.264, 2.3, and 9.58 mg/g of Cd²⁺, Cu²⁺, and Pb²⁺, respectively with the living cells of the strain under the same conditions. The biosorbent was analyzed by Fourier Transformer Infrared Spectroscopy (FT-IR) analysis to identify the various functional groups contributing in the sorption process. From FT-IR spectra analysis, hydroxyl and amides were the major functional groups contributed in biosorption process. It was concluded that endophytic D. hawaiiensis biomass can be used potentially as biosorbent for removing Cd²⁺, Cu²⁺, and Pb²⁺ in aqueous solutions.

Production of a novel halophilic dextranase from a honey isolate, bacillus subtilis NRC-B233 under solid-state fermentation

A GRAM-POSITIVE, sporulating halophilic bacteria, designated NRC-B233, was isolated from the honey produced in Saudi Arabia. It was identified by the 16-23S intergenic region as Bacillus subtilis NRC-B233. Screening of the wastes and agro-products for dextranase production under solid state fermentation showed that corn flour was the best substrate [61.323 U/g]. The optimum conditions for dextranase productions were 37°C, pH 9, 32 hr incubation period, and 200% moisture content. The most favorable nitrogen and carbon sources for enzyme production were 2% peptone and 5% starch [1076.768, 1553.364 U/g]. respectively. A unique character of this isolate is its ability to continuously produce dextranase in the absence and presence of NaCl 5-20 g/l. The addition of 0.175 Mm CrCl[3] increased the dextranase production about 4.5 fold. The enzyme has been partially purified about 112-fold from crude extract by only two purification steps involving ultra-filtration. The purified dextranase showed its maximum activity at pH 9.2 and 70°C. It retained fill activity [100%] at 75°C for one hour. Dextranase activity increased about four fold in the presence of 10% NaCl. On the other hand, CaCl[2] [0.050M], EDTA [0.100M], and KCI [0.100M] had great influence in enzyme activity. The enzyme showed variable degradation effects on different types of dextran and its derivatives. These results suggest that the dextranase secreted by Bacillus subtilis NRC-B233 is industrially important from the perspectives of its activity at across pH range [5.0-100], its thermo-activity in addition to its halophilic character and its ability to degrade different types of alpha-1,4 and alpha-1,6 glycosidic linkages

Growth and yield responses of tomato [lycopersicon esculentum] grown under soilless cultivation to application of azospirillum, azotobacter and nitrogen

THIS STUDY was undertaken to investigate the possibility of using Azospirillum bras/lease and Azotobacter chroococcum applied with inorganic nitrogen to enhance tomato [Lycopersicon escnlentum, Mill] production in soilless systems. The effect of inoculation with A. brasilense and / or Azoto. chroococcum with the application of 75% [of the recommended dose] of N[2] on certain tomato growth parameters [shoot height, number of leaves, and fresh and dry weights of plants] after 30, 60 and 90 days of transplanting were determined. In addition, total yield, mean fruit weight and number of fruits per plant were evaluated in plants inoculated with the two bacteria [separately or in combination] with 75% N[2], and plants inoculated with 75% N[2] [control 1] and 100% N[2] [control 2], Plants inoculated with a mixed inoculum of A. bras/lease and Azoto. chroococcum with 75% N[2] gave the highest values of the growth parameters tested while plants inoculated with 75% N[2] [control 1] gave the lowest. The same treatment also resulted in the highest tomato yield, mean weight and number of fruits per plant followed by plants treated with A. brasilense and 75% N[2]. The responses to the tested biofertilizers on nitrogen, phosphorous and potassium [NPK] uptake, population of diazotrophic bacteria and nitrogenase and dehydrogenase activity of the tested bacteria on the rhizosphere of tomato showed that the mixed inoculum of A. brasilense and Azoto. chroococcum with 75% N[2] gave the highest NPK uptake levels after 30, 60 and 90 days of transplanting. The same treatment gave the highest population of diazotrophic bacteria and dehydrogenase and nitrogenase activity of the tested bacteria compared with the plants inoculated with a single organism or controls. In contrast, control 1 gave the least values among all treatments. This study shows that inoculation of tomato plants with Azospirillum brasilense and Azolobacter chroococcum have a significantly beneficial effect on tomato yield under soilless cultivation

Validation of TIMI and GRACE acute coronary risk scores in Alexandria governorate and their role in the comparison of quality of care between hospitals

Risk stratification in acute coronary syndrome [ACS] aims to identify those patients who might benefit prognostically from further investigation and treatment. In addition, risk stratification models have been used by health authorities and hospitals in quality management activities. The present study aimed at validating the Thrombolysis in Myocardial Infarction [TIMI] and The Global Registry of Acute Coronary Events [GRACE] risk scores for prediction of mortality in patients with ACS in Alexandria governorate. In addition, the study aimed also at using one of the validated risk scores to compare risk adjusted mortality among participating hospitals. The study was conducted at hospitals belonging to 3 different health care organizations in Alexandria. All admitted patients with the diagnosis of ACS throughout a period of 6 months were included in the study [n=606]. Discriminatory capacity and calibration of the TIMI and GRACE risk scores for detection of in-hospital mortality and mortality within six months of index admission were assessed. The study showed that both TIMI and GRACE risk scores had high c statistics of 0.70 or higher. GRACE scores showed equal or higher c statistics than TIMI scores denoting better discriminatory capacity. TIMI risk score showed good calibration while GRACE risk score showed lower calibration capacity with certain patient categories. The GRACE risk score was used to calculate the standardized in-hospital mortality ratio which was higher than 1 for all participating hospitals indicating higher than expected mortality for ACS patients in these hospitals. GRACE risk score showed good discriminatory capacity, suggesting that it is suitable for clinical use among ACS patients in Alexandria governorate. It was recommended to use GRACE risk score for risk adjustment in quality management activities

Hepatitis C virus infection among paediatric patients attending University of Assiut Hospital, Egypt

Few studies have evaluated the epidemiology and risk factors of hepatitis C virus [HCV] infection in children in Egypt. This study of 465 children attending Assiut University Hospital measured the rates of anti-HCV positivity by 3rd-generation ELISA test and of HCV-RNA positivity by PCR, with analysis of some relevant risk factors. The rate of HCV-RNA positivity among ELISA-positive cases [n = 121] was 72.2% overall: 100% in the subgroup with hepatitis, 70.8% in those with a history of multiple transfusions and 58.3% in those without hepatitis or multiple transfusions. History of blood transfusions, frequent injections, hospitalization or surgical procedures were significant risk factors for anti-HCV positivity by ELISA

Autosomal dominant genetic disorders among patients attending the genetic clinic of medical research institute

A total number of 1600 patients referred to the Genetic Clinic, Medical Research Institute, Alexandria University, were assessed to determine the frequency of autosomal dominant disorders. It was found that 5.25% [84 patients] had autosomal dominant disorders. Bone dysphasia/short stature were the most common disorders 47.60% [40/84], where half of them were achondroplasia cases. Osteogenesis imperfect a type I was detected in 10 cases. Dysmorphic autosomal dominant syndromes were observed in 35.70% [30/4]. Syndromes with craniosynostosis were more frequent [26/84]. Encountered in this study also, 9 cases [10.70%] with Hamartoses [6 cases had Neurofibromatosis type I and II and 3 with Tuberous Sclerosis]. Skin disorders were reported in 6.0% cases [5/84]. Positive family history were observed among cases with Achondroplasia, Apert, Crouzon, Albright hereditary osteodystrophy, Neurofibromatosis type II and Waardenburg syndrome. The remainder was sporadic due to fresh mutations especially in cases with older paternal age mainly in achondroplasia, Aped and Crouzon syndromes. The chronic nature of genetic disorders requires life long medical attention, expensive supportive and symptomatic therapy, and specialized care

Genetic study of patients with proportionate growth deficiency referred to human genetics clinic, in Alexandria

Growth deficiency is the term that describes a growth rate below the appropriate growth velocity for age. Normal stature varies widely among ethnic groups and within each ethnic group approximating a normal distribution. Short stature may be proportionate or disproportionate. Children with proportionate short stature may have more generalized disorders. The aim of the present work was to study the phenotypic variations in patients with proportionate growth deficiency, and to evaluate the diagnosis to provide accurate genetic counseling. The study included 53 patients with proportionate growth deficiency from those attending the Human Genetics Clinic, Medical Research Institute, Alexandria University, during a four years period. They were subjected to a complete genetic and family history, pedigree analysis, complete genetic examination, ant hropometric measurements, cytogentic analysis and others investigations when needed. The results showed that group I consisted of 17 cases [32.07%] with chromosomal anomalies [7 cases with numerical aberrations and 10 cases had structural anomalies], group II included 21 patients [39.62%] with single gene disorders [11 patient had autosomal dominant disorders. 9 cases with autosomal recessive diseases and only I case with X-linked recessive disorder]. Group Ill consisted of the sporadic syndromes [11 cases; 20.75%] and the last group had disorders due to teratogens [4 cases; 7.56%]. It is essential that a specific diagnosis should be made because there are hundreds of causes for growth deficiency that have differing prognoses, complications and responses to treatments

LMNA gene polymorphism [1908/CT] and indices of obesity in a sample of Egyptian females

Nuclear Lamins A and C are encoded by LMNA gene and present in terminally differentiated cells. The LMNA gene polymorphism [1908C/T] has been reported to be associated with adipose tissue metabolism and obesity indices in some populations, suggesting that this polymorphism may increase the risk of obesity. This study was conducted to estimate the C and T allele frequencies of LMNA gene polymorphism [1908], and to investigate the association of T-allele with obesity in a sample of Egyptian obese females. One hundred and forty Iwo obese females [BMI>30Kg/m[3]] and 100 age matched non obese females [BMI

Expression of adhesion molecule CD44V6 in salivary gland tumors

Salivary gland tumors are a morphologically and clinically diverse group of neoplasms which may present significant diagnostic and management challenges. Cell adhesion molecules [CAMs] are glyco-proteins that are present on the external surface of the cell membrane. CD44 is a cell adhesion molecule belonging to systemic IgCAMs family, and is remarkable for its ability to generate alternatively spliced forms, many of which differ in their activities. This remarkable flexibility has led to speculation that CD44, via its changing nature, plays a role in some of the methods that tumor cells use to progress successfully through growth and metastasis. To investigate the expression of CD44v6 in different types of salivary glands tumors and to correlate the results with some established prognostic factors. Sixty cases were studied. 21 were pleomorphic adenomas,, 9 Warthin's tumors, 6 monomorphic adenomas, 9 mucoepidermoid carcinomas, five adenoid cystic carcinomas, in addition to 10 normal controls. Clinical data were obtained from the referring clinical departments. The biopsy specimens were obtained by excision, true cut needle biopsy, or punch biopsy. Cases were selected by reviewing the hematoxylin and eosin [H and E] stained slides. Immunohistochemistry was done using the CD44v6 mouse monoclonal antibody raised against human species. CD44v6 was +ve in 46/60 [76, 7%] of salivary gland tumors studied; 35/40 [87.5%] benign salivary glands tumors and 11/20 [55%] malignant salivary gland tumors and this difference was statistically significant [P < 0.01]. CD44v6 was +ve in 16/21 [76%] of pleomorphic adenoma, in 9/9 [100%] of Warthin's tumors and in 6/6 of monomorphic adenoma. CD44v6 was +ve in 5/ 9 of mucoepidermoid carcinoma; 4/5 [80%] of low and intermediate grade mucoepidermoid carcinoma and in 1/4 [25%] of high grade malignant mucoepidermoid carcinoma. The 4 studied high grade malignant mucoepidermoid carcinoma were lymph node metastasis +ve. CD44V6 was +ve in 4/5 [80%] of adenoid cystic carcinoma. There was a statistically significant decrease in CD44v6 positivity [P < 0.03] in high grade malignant salivary gland tumors compared to low and intermediate grade tumors. There was also a statistically significant decrease in CD44v6 positivity [P < 0.01] in malignant salivary gland tumors received with lymph node metastasis compared with those lymph node metastasis negative cases. 1] Down regulation of CD44v6 plays an important role in malignant transformation of salivary gland tumors. 2] The degree of down-regulation is correlated, with progression towards higher grades and also with lymph node metastasis

Mental retardation among children born with birth defects

Mental retardation [MB] is a major health problem affecting 3% of the population. It results from the interaction of many genes and non-genetic factors. However, in up to 60% of patients the aetiology remains unclear. The aim of the study is to examine the association of birth defects and MB, taking into consideration the type of birth detect, level of MB, co-occurrence of MB with other developmental disabilities, genetic and biological risk factors. A case control study was conducted on 300 children with MR from December 2006 to December 2007. They were referred to the Human Genetics Department, Medical Research Institute, University of Alexandria, for diagnosis and genetic counseling. For comparison, 506 normal control groups were randomly selected. The cases were 156 males [54%] and 135 females [46%], the difference was not statistically significant. Out of 300 studied cases, 72 children [24%] had various chromosomal aberrations, while the remaining 228 [76%] had single gene disorder. From these groups 66 children had another coexisting DDS [25 with CP, 15 had VL, 10 with autism; 10 HL and 6 had epilepsy]. Mild MB [MMR] was more prevalent among all the studied cases than severe MR [SMR], there was significant association between 8MB and birth defects [OR = 1.65, Cl: 1.05-3.27]. Birth defects occurred in 180 children [40 children with Down syndrome, 1 with sex chromosomal defect, 3 with other chromosomal anomalies, and the remaining 136 with non-chromosomal abnormalities]. There was significant association between children with Down syndrome and birth defects [OR=10; Cl: 1-242.25]. Birth defects were present in 41 children with MR and other coexisting DDs. Also, it was found that all children with different birth defects had significant association with MB, [OR = 87.21 Cl: 40.38-196.31]. These MR risks tended to be the largest among infants born with heart and central nervous system defects. There was significant association between low birth weight [OR = 3.57; Cl: 1.91-6.65], preterm [OR = 9.63; Cl: 2.21-47.84], and parental consanguinity [OR = 4.19; Cl: 2.9-6.06] and the occurrence of MR. This study high-lights the role of prenatal factors in the origin of many DDS especially MR and suggests that a sizable proportion of DDS may be caused by insults occurring early in embryologic development

Females with gonadal dysgenesis: cytogenetic and molecular analysis

Gonadal dysgenesis [GD] is a congenital defect in gonadal development related to abnormalities of genes controlling sexual differentiation and includes a wide spectrum of patients with variable phenotypes and chromosomal constitutions. This study aimed at studying the spectrum of chromosomal abnormalities as related to the phenotypic variability of GD cases and to detect the presence of Y-ctiromosome specific sequences in these patients by using molecular techniques in order to allow, early prophylactic management. Seventy females presenting with female GD were referred to the Human genetic clinic, National Research Center for cytogenetic analysis and genetic counseling. Patients were subjected to clinical examination, pedigree construction, cytogenetic and molecular analysis. Hormonal studies, pelvic ultrasonogrophy, Laparoscopy and gonadal biopsy were performed whenever possible. Patients were classified according to their Karyotypes into 9 groups. The most frequent Karyotype, was 45, X [34.3%]. The association of 45, X with other cell lines were found at a rate of 28.6%. The age of studied cases ranged between 15 days to 31.07 years [mean=14:0.9 years]. The total parental consanguinity rate reached 44.3%. Gonadal dysgenesis and short stature are the two cardinal signs in these patients. Skeletal features were detected among all studied groups with highest scores in patients having complete X monosomy [44.6%]. Neck webbing was a characteristic sign of patients with non-mosaic 45, X karyotype. Dysmorphic features were detected in all groups with the exception of groups with 46, XX and 46, XY Karyotypes. Hirsutism and other virilizing signs were not commonly detected among the studied cases. Gonadoblastoma was detected in only one case among the 5 cases examined by Laparoscopic biopsy. Unidentified sex chromosomes markers constituted 35% of all our 45, X mosaic patterns. Molecular analysis of the markers using PCR technique proved the presence of Y specific sequences, SRY, in three cases. The over all rate of Y chromosomal material detected among these patients either by cytogenetic or molecular methods was 14, 3%

Angiotensinogen gene [M235T] variant and pre-eclampsia in Egyptian pregnant women

Association between the angiotensinogen gene [M235T] and pre-eclampsia has been confirmed in recent studies. Pre-eclampsia is a complication of pregnancy characterized by increased vascular resistance, higher blood pressure, proteinuria and oedema that appear in the second and third trimester of pregnancy. This study aimed at investigating the relationship between M235T gene polymorphism and pregnant women with different forms of pre-eclampsia. One hundred and fifteen pre-eclamptic women and 100 normal control group were recruited and evaluated for the frequency of M235T mutation using polymerase chain reaction-restriction fragment length polymorphism [PCR-RFLP]. A positive association was found between maternal age over 35 years [OR = 6.67; CI: 2.09-23.59], previous family history of hypertension [OR = 3.01; CI: 1.18-7.66], previous pre-eclampsia [OR = 7.44; CI: 2.47-22.42], history of reproductive losses [OR = 53.98; CI: 3.23-90.88], fetal anomalies [OR = 8.4; CI: 1.06-180.33], and pre-eclampsia. The frequency of heterozygous carriers of M235T mutation in pre-eclampsia [19.1%] was higher than that in control [14%] but the difference was statistically non-significant. Also, the frequency of M235T mutation was higher in mild pre-eclampsia women [63.6%] compared to women with severe pre-eclampsia [36.4%], however this was statistically non-significant. This study revealed that the frequency of M235T mutation was higher within women with mild pre-eclampsia

Prolongation of action of bupivacaine in caudal block in pediatrics: comparative study between addition of ketamine, clonidine and adrenaline

Regional anesthesia is considered an effective method for providing analgesia both intraoperatively and postoperatively and also decreases the total amount of general anesthesia required for surgery, provides more rapid recovery and faster wake up times. Caudal block is the most useful and common pediatric regional block as it is widely applicable and technically simple. Many factors influence the activity of caudally administrated local anesthetic solutions as dosage, addition of a vasoconstrictor e.g. epinephrine and addition of drugs as Ketamine and Clonidine. In this study, we compared the analgesic efficacy and side effects of Bupivacaine alone, Bupivacaine + Epinephrine, Bupivacaine + Clonidine and Bupivacaine + Ketamine. In the current study the addition of drugs to Bupivacaine has significantly extended the duration of caudal analgesia more than Bupivacaine alone especially with Ketamine and Clonidine

Nasolahial flap in reconstruction of oral defects after ablative surgery in patients with oral cancer

This study highlights technical aspects and outcome of different types of nasolabial flap in reconstruction of oral cavity defects, following extirpation of mouth cancer. This is a prospective study, included 14 patients who had been treated surgically for oral cancerous lesions and reconstruction was performed by 16 nasolabial flaps in the period from June 2002 and December 2005 in Sohag University Hospital. Inferiorly based flaps were 10 unilateral and 1 bilateral, and superiorly based flaps were 2 unilateral and 1 bilateral. All flaps were for immediate reconstruction of the defects except in 2 cases. Perioperative complications were recorded. Functional outcome in terms of speech; chewing; swallowing; and cosmetic appearance were evaluated preoperatively and at 6 months postoperative. Patients were 10 men and 4 women and their average age was 63.8 years [45-82 years]. The commonest histology was squamous cell carcinoma [12/14] and presentation was early in stage I [6/14] and II [5/14]. The majority of patients were ASA grade II [5/14] and III [6/14]. Neck lymph nodes dissection with facial artery ligation was done in 8 patients without affecting the outcome. As complications, we noted one case with postoperative wound dehiscence and another case with minimal infection. On the other hand, we, found it technically feasible, versatile, and with satisfactory functional and acceptable cosmetic outcome. The nasolabial flap for replacement of soft tissue in the oral cavity is easy to harvest, with minimal morbidity. It represents a functional and aesthetically satisfactory alternative to reconstruction by other flaps in cases with small and medium sized defects, especially in elderly, medically compromised patients who are therefore of poorer surgical risk

possible cytoprotective effect of vitamin E in aluminium-induced liver damage in rats

The aim of the present work was to assess the possible pro-oxidant effects of Al on rat liver, as well as the possible protective role of exogenous vitamin E. 40 male Sprague Dawley rats were divided into 4 groups each including ten animals: group I served as a control, group II treated with Al alone, group ill treated with Al and vitamin E, and group IV treated with vitamin E alone. For 4 weeks, Al and vitamin E were given in a dose of 20 mg/kg body weight. After 4 weeks, blood samples were collected for estimation of Al, vitamin E, and liver enzymes ALT and AST. Liver tissue homogenates were used for determining ROS and All. After 4 weeks of Al administration, Al levels increased in both plasma and liver. Treatment with Al alone significantly increased plasma levels of liver enzymes AST and ALT. On the other hand, the presence of vitamin E with Al caused a decrease in these elevated plasma liver enzymes yet it did not reach the control value. ROS was increased in liver homogenates from rats treated with Al compared to controls. This effect was attenuated by exogenous vitamin E administration. Oxidative stress clearly played a key role in Al-induced liver pathogenesis .Moreover; vitamin E supplementation alleviated the harmful effects of Al on all the measured parameters and improved liver functions

Sevoflurane versus halothane and isoflurane in children with mitochondrial disorders undergoing surgery for muscle biopsy

Children with mitochondrial disorders may have an increased risk for cardio respiratory and neurological complications from anesthesia. With inhalation anesthesia, standard preoperative assessment monitoring and anesthesia management, there were no major preoperative and postoperative anesthesia related complications. The aim of this study was to determine the incidence of preoperative complications and adverse events with inhalation anesthesia in children with mitochondrial disorders

Continuous epidural infusion of midazolam for postoperative analgesia in major gynaecological surgery: comparative study with ropivacaine

The study was conducted on 60 female patients who underwent major gynaecological operations. Postoperative analgesia was managed by epidural infusion of Ropivacaine 0.2% [Group R], Midazolam 0.02% [Group M] or a combination of Ropivacaine 0.2% + Midazolam 0.02% [Group RM] in a total infusion rate of 5mL/hour for 48 hours. Visual analogue scale, respiratory rate, heart rate, blood pressure, sedation score, SPO[2], PCO[2] and blood glucose level were monitored. Results showed that group RM had significant lower VAS value and lower need for rescue analgesics. Sedation was more pronounced in RM Group than the other ones with no respiratory adverse effects. In conclusion, adding Midazolam to continuous epidural infusion of Ropivacaine provides a great analgesic and sedative effect with no side effects

Anesthetic management of congenital insensitivity to pain with anhidrosis: a rare autosomal recessive disorder

Congenital insensitivity to pain with anhidrosis [CIPA] is a rare high risk disease and patients require meticulous pre-medication care, and a continuous accurate monitoring to avoid anesthesia related complications. This is what has been performed throughout the pre-medication, induction, maintenance and recovery periods

Interest of cystatin C as a marker for early impairment of renal function in Egyptian thyroid patients

A randomize prospective study include thirty-two patients [age:30-77 years] of clinical hypo- and hyperthyroidism was planned to evaluate the changes which produced in serum cystatin C compared to creatinine as a sensitive test for early detection of renal failure in patients with thyroid disorders and to determine if significant thyroid hormones disturbance affect cystatin C concentrations. The assays were proposed again when the patients become euthyroid state after treatment. Patients with hyperthyroidism showed significant decrease of cystatin C from 1.0 +/- 0.31 mg/L at time of diagnosis to 0.71 +/- 0.32 mg/L after treatment and significant increase of creatinine from 79.5+26.51 micromol/L to 97.2+26.7 micromol/L in euthyroid state [p<0.001]. In hypothyroid group, it was showed a significant increase in serum cystatin from 0.76 +/- 0.27mg/L to 1.0 +/- 0.21 mg/L in euthyroid state while serum creatinine exhibited significant decrease from 88.4 +/- 26.5micromol/L at time of diagnosis to 70.7 +/- 26.0 micromol/L in euthyroid state [p<0.001]. Our results showed that significant changes in thyroid hormones alternate serum cystatin C concentration so cystatin C should be considered as a sensitive marker for the early prediction of glomerular filtration rate disturbance after thyroid hormones investigations

Outcome of parathyroidectomy for primary hyperparathyroidism in Sohag university hospital in 5 years: retrospective study

Primary hyperparathyroidism [PHPT] is a common endocrine disease treated very effectively by surgery. It is the commonest cause of hypercalcaemia. The majority of cases are caused by adenoma [80% to 85%], whereas approximately 15% have diffuse hyperplasia of all four parathyroidglands. Rarely [1%], parathyroid carcinoma is the cause of hyperparathyroidism. Parathyroid diseases has not been investigated in our community before. This study had been conducted to analyze the outcome of surgical treatment of [PHPT], as regard the success rate, complications and recurrence. Between May 1999 and July 2004, 14 consecutive patients with [PHPT], who had been submitted to surgery in Sohag University Hospital were enrolled in this study. Analysis of clinical presentations, laboratory and imaging studies, surgical approach, intraoperative findings, and outcome assessment m terms of success rate, complications had been done. A total number of 14 patients diagnosed as PHPT, 10 were women and 4 were men. Their age ranged from 25-51 years, with a mean age of 41.2 +/- 6.9 years. Bone affection was the dominant presenting feature [79%]. All cases showed high level of serum calcium [mean 3.13 +/- 0.42 mmol/L] and parathormone hormone [mean 787.4 +/- 256.6 pg/mL]. Accuracy of ultratsound scanning of the neck was 71% in localization of parathyroid lesions, while that of CT and Sestamibi scan were 85% and 87.5% respectively. A single parathyroid adenoma was the commonest lesion [86%]. All patients, but two, had been followed up from 6 months to 18 months with a mean of 11 +/- 4 months. The success rate was achieved in all but one [92.9%], who had been found to be an ectopic parathyroid adenoma in the superior mediastinum. There was one case who died due to the morbid general medical condition. Postoperative temporary hypocalcaemia was observed in two cases. No permanent injury to RLN was reported in our cases. Parathyroid disease is not uncommon problem in our locality. Surgery of PHPT is a very successful operation with minimal morbidity. Early discovery of PHPT gives the best chance of cure and avoid disastrous complications of this disease