Antibody mediated immune response in sickle disease variants

Sickle cell anemia, a hemoglobinopathy with serious impacts, represents a health challenge in the developing world. Patients are particularly susceptible to repeated infection that may endanger their lives. In this study, 83 adults and 30 children were included. Cross-sectionally, serum immunoglobulins [IgG, IgA, IgM] and complement factors [C3 and C4] were assessed. All subjects prospectively were immunized by hepatitis B vaccine [recombinant hepatitis B virus surface antigen]. The immune response was evaluated and followed up by antibodies to the selected antigen. IgA was significantly elevated in sickle disease patients and serum IgM was significantly lower in sickle disease children, while C3 and C4 did not show significant differences between groups. The immune response to immunization did no show difference in rate of response between various age matched groups, responders were over 80% in all groups after seven months from the first dose of vaccination in those who completed the study. However, the results denoted a quantitative difference in the level of hepatitis B surface antibody. Further studies to delineate the implicated mechanisms in the immunodeficiency are suggested. Meanwhile, chemoprophylaxis and immunoprophylaxis are recommended in sickle cell anemia

Leukotrienes excretion in acute myocardial ischemia

The role of leukotrienes, released at the site of myocardial ischemia, in attraction of neutrophils and contribution in cardiac dysfunction were suggested. Leukotrienes, having rapid metabolism and excretion, are difficultly measured in blood, their major metabolite leukotriene E4 [LTE4] detected in urine is a sensitive index for their production. In this study, the evaluation of the role of LTE4 measured in urine as an index for acute myocardial ischemia. Patients admitted to ICU complaining of acute myocardial ischemia were subdivided into group 1 [15 patients with acute myocardial infraction], group 2 [10 patients with unstable angina], control group [4 patients with chronic stable myocardial ischemia and 5 normal controls]. All patients and controls were subjected to clinical, ECG and echocardiographic examination, together with laboratory measurement of serum cardiac enzymes and urinary ITE4 by ELISA technique. The results demonstrated higher concentration of LTE4 in urine samples from AMI subjects 8 +/- 2 hours after infarction compared with samples collected two days later. A similar significant increase in LTE4 was observed in acute angina group. Two patients were given omega 3 fatty acids [EPA] for one month in a trial to lower urinary LTE4. The results were equivocal

Intraperitoneal lidocaine [xylocaine] during laparoscopic cholecystectomy: a preliminary study

The aim of this study is to assess the possibility and the efficiency of using intraperitoneal xylocaine during laparoscopic cholecystectomy to provide analgesia both intraoperatively and after operation. Forty-five patients undergoing laparoscopic cholecystectomy were randomly assigned to three grous [15 patients each]: one to receive 40 ml xylocaine 1% intra-peritoneally, the second received 1-2 micro g-Kg[-1] fentanyl intravenously. Patients of the third group received the same anaesthetic technique without either intraperitoneal xylocaine or intravenous opioid. Insufflation of the peritoneum was accompanied by an increases in MAP, plasma cortisol level and blood glucose concentration in the three studied groups. A significant differences was found between the first group and the other two groups. Post-operatively, all patients of the first group had s satisfactory pain relief score and did not need analgesia for 2.1 +/- 0.51 [mean +/- S.D. hours. We conclude that intraperitoneal xylocaine during laparoscopic cholecystectomy shoud be considered as a simple, safe and effective method for relieving pain both intraoperatively and after operation

Capgras syndrome in a patient with systemic lupus erythematosus treated by steroids

Capgras syndrome, the delusion of doubles, is usually seen in psychiatric disorders as schizophrenia, certain organic brain syndromes, and some metabolic and endocrine encephalopathies. In this report, we describe a patient with lupus nephritis who developed the syndrome as a result of steroid therapy. The patient, a fifteen year-old girl, was followed up for a couple of years during which her renal functions steadily deteriorated, with several remissions and exacerbations of lupus activity. Considerable variations were noticed in the severity of the patient's delusions, which were quatitated according to a conventional score of points. Out of many clinical, biochemical and therapeutic variables, only steroid therapy had any relation to the patient's psychiatric symptomatology. There was a statistically significant correlation between the severity of symptoms and steroid doses, suggestive of a cause-and effect relationship. This case seems to be the first documented report on steroid-linked capgras