Role of C-peptide and NA[+], K[+] atpase in the pathology of diabetic micro-vascular complications

The purpose of this study is aiming to find out the correlation between erythrocytes membrane Na[+], K[+] ATPase activity, duration of diabetes, C-peptide level, hyperglycemic control and micro-vascular complications. This study was carried out on the following groups: [Group I control group]: included [n = 10] normal healthy subjects, [Group II]: included [n = 30] diabetic patients without complications, 10 of these patients were insulin dependent diabetics [IDD], 10 were non-insulin dependent diabetics [NIDD] treated with insulin and 10 were non-insulin dependent diabetics [NIDD] treated with oral hypoglycemic drugs, [Group III] [n = 30] diabetic patients with neuropathy, 10 of these patients were insulin dependent diabetics [IDD], 10 were non-insulin dependent diabetics [NIDD] treated with insulin and 10 were non-insulin dependent diabetics [NIDD] treated with oral hypoglycemic drugs, [Group IV] [n = 30] diabetic patients with nephropathy, 10 of these patients were insulin dependent diabetics [IDD], 10 were non-insulin dependent diabetics [NIDD] treated with insulin and 10 were non-insulin dependent diabetics [NIDD] treated with oral hypoglycemic drugs. Beside careful history taking, full clinical examination and routine investigations, all the studied groups were subjected to the following estimations, fasting blood glucose level, Glycosylated Hb level, Na[+] K[+] ATPase activity and serum C-peptide level. The mean values of the duration of diagnosis of diabetes were significantly higher in diabetics with complications [neuropathy and nephropathy] when compared to the diabetics without complications [P < 0.001] but no significant differences were present when diabetics with complications [neuropathy and nephropathy] were compared with each other [P > 0.05]. The mean values of the fasting blood glucose level were significantly higher in all diabetic groups when compared to the control group [P < 0.001] but no significant differences were present when diabetic groups compared with each other [P > 0.05]. The mean values of glycosylated hemoglobin levels were significantly higher in all diabetic groups when compared to the control group [P < 0.001] but there were no significant differences when diabetic groups compared with each other [P < 0.05]. The mean values of C-peptide levels were significantly lower in all diabetic groups when compared to the control group [P < 0.001], but no significant differences when diabetic groups compared with each other [P > 0.05]. The mean values of erythrocytes membrane Na[+], K[+] ATPase activity were significantly lower in IDD patients and NIDD patients with insulin therapy of all groups when compared with control group [P < 0.001] and it were significantly lower in NIDD patients with oral hypoglycemic therapy of complicated groups [neuropathy and nephropathy] when compared with control group [P < 0.01], but there were no significant difference between NIDD patients with oral hypoglycemic therapy of non-complicated group and control group [P > 0.05]. Also, It was found that the activity was significantly lower in diabetics with neuropathy and nephropathy when compared with diabetics without complications [P < 0.001], but no significant differences were present between diabetics with nephropathy and diabetics with neuropathy when compared with each other [P > 0.05], there is no significant correlation between Na[+], K[+] ATPase with duration, fasting blood glucose and glycosylated hemoglobin, but, there was sign positive correlation between Na[+], K[+] ATPase and C-peptide. Also, non significant correlation was present between C-peptide with duration, fasting blood glucose and glycosylated hemoglobin. Decrease in erythrocytes membrane Na[+], K[+] ATPase activity in diabetic patients occurs when serum C-peptide level is low, these two factors have a role in the development of diabetic complications, and there is no relation with duration of diabetes or hyperglycemic control. C-peptide and insulin stimulate the activity of Na[+], K[+] ATPase, but there is still strong argument for the physiological role of C-peptide in humans. This finding needs to be confirmed by more studies on patients with diabetes to establish if C-Peptide together with insulin could be beneficial in restoring Na[+], K[+] ATPase activity and improvement of diabetic complications

Predictability of neonatal infection in cases of preterm premature rupture of membranes by interleukin-6 estimation: antenatal bed side test from vaginal fluid versus neonatal serum testing at birth and after 24 hours

The Objective of this study was to assess the predictability of interleukin 6[IL-6] for neonatal infection, in women with preterm premature rupture of membranes [PPROM] using a bed side test from vaginal fluid versus neonatal serum testing at birth and after 24 hours. The study was a cross sectional one and enrolled 73 women who were hospitalized for PPROM. The gestational age at study entry ranged between 28 and 35 completed weeks of gestation that was confirmed from history and/or by a first-trimester ultrasonograhy. Maternal routine investigations as serum C reactive protein [CRP] and IL-6 detection in vaginal fluid were done. Neonatal examination and assessment was done. Initial neonatal outcomes as Apgar score, neonatal infections and neonatal cranial ultrasound were assessed. Neonatal CRP and IL-6 were also estimated. The results showed that neonatal infections were more frequent for babies of women with IL-6-positive vaginal samples [29.7% vs 8.3%; P=0.02]. The sensitivity of vaginal testing of IL-6 for predicting neonatal infection was 79%; its specificity was 56%; its positive predictive value was 30%, and its negative predictive value was 92%. The mean neonatal IL-6 at 0 hour was significantly higher in babies of the vaginally positive than the vaginally negative mothers [P<0.01]. The sensitivity of IL-6 at 0 hour for predicting neonatal infection was 99%; specificity was 91.4%; positive predictive value was 57.4%, and negative predictive value was 92%. The sensitivity at 24 hours was 67.4%; specificity was 69.3%; positive predictive value was 50%, and negative predictive value was 63%. Estimation and detection of IL-6 with both the qualitative vaginal secretions bedside test and at birth neonatal serum are of great value in the prediction of neonatal infection in cases of PPROM. This cytokine may reflect the insult that the fetus had been exposed to: hence affection of the fetal brain. Antenatal detection and early at birth estimation are of medico legal importance, which may protect obstetricians and pediatricians from alleged intrapartum or early neonatal mismanagement

Evaluation of the toxic effect of polycyclic aromatic hydrocarbons on semen of infertile workers in diesel and engine workshops: a prospective controlled study

The purpose of this study is to prove the toxic effect of exposure to polycyclic aromatic hydrocarbons [PAHs] on semen of infertile workers in diesel and petrol engine repair workshops. Urine and semen samples from 20 male workers exposed to hydrocarbons in diesel and petrol engines repair workshops for at least 2 years were collected. Urinary excretion of urinary 1-hydroxyrene [1-OHP], the most reliable indicator for PAHs exposure, was measured. Semen analysis and annexin -V bioassay were performed for all workers [during exposure and one year after precaution against exposure] and non-exposures [control] to document the toxic effect of PAHs exposure. PAHs exposed males showed six fold increase in 1-OHP excretions as compared to the control group. While semen volume is the same in both groups, there was significant increase in the percentage of non-aggregated sperms between the exposed and the control groups [45 +/- 26.17 and 11 +/- 7, respectively]. There was significant decrease in sperm count [Million / ml] in the exposed than the control group [44.4 +/- 37.79 and 110 +/- 55, respectively]. Asthenozospermia was found either alone or in combination with other abnormalities in 55% of the ejaculates from exposed workers, whereas, it was found alone in only 15% of the control group. Normal forms of the sperms and semen's viscosity were found significantly lower in the exposed group as compared to control group. The mean value of apoptotic sperm cells that have positive annexin-V was 42.5 +/- 14.09, while; the control group has shown no apoptotic sperm cells. Moreover, necrotic sperm cells were significantly increased in semen of exposed workers when compared to semen of control group [5.5 +/- 3.8 and 1.1 +/- 0.05, respectively]. Workers who had longer duration of exposure to PAHs had higher levels of urinary 1-OHP, percentage of annexin-V cells, lower sperm counts, lower motility, increased percentage of aggregated sperms and decreased percentage of normal sperm [r: 0.48, 0.45, -0.74, -0.79, 0.46, and 0.69, respectively]. On the other hand, after one year of precaution against exposure to PAHs all the above-mentioned parameters were spontaneously improved; level of urinary 1-OHP, ejaculate volume, nonspecific aggregate, sperm count, sperm motility, normal sperm form and sperm vitality [2.4 +/- 0.9, 3.5 +/- 1.6, 15 +/- 9.6, 56.5 +/- 30, 55 +/- 15, 60 +/- 25 and 70 +/- 23, respectively]. This study documented the deleterious toxic effect of PAHs on semen of exposed males in diesel and engine workshops that could be reversed by stoppage of exposures. However a study on a bigger number of patients is required to assess the exposure time to induce changes in semen parameters and the time needed for reversal of the toxic effect of the PAHs. Furthermore, longer follow up is recommended to evaluate the fertility of those workers

Caspase-3 activity as an early marker of lead-induced immunotoxicity

This study included 80 adult males. They were nonsmokers, non- drug abusers and nonalcoholic and not occupationally exposed to lead. They were divided into four equal groups according to residency and workplace. The subjects in group I were living on the highway and working in the city,those in group 2 were living and working in the city, in group 3 were living and working in the villages and group 4 were living in the villages and working in the city. Mean blood lead level was significantly higher in the subjects who were living on the highway and working in the city [23.8 +/- 5.6 g/dl] as compared with all other groups. Caspase-3 activity showed significant increase in the subjects of the first group [0.305 +/- 0.09] when compared with all other groups. However, the study revealed that as the blood lead level increased than 18.35 g/dl, it showed significant positive correlation to lymphocyte caspase-3 activity

Gonadotoxicity induced by exposure to polycyclic aromatic hydrocarbons in engine repair workshops

This study has documented the gonadotoxic effect of exposure to hydrocarbons in workers of diesel and petrol engine repair workshops as measured by urinary 1-hydroxypyrene [1-OHP], semen analysis study and annexine-V bioassay. Twenty workers exposed to hydrocarbons in diesel and petrol engine repair workshops were included in this study. They showed nearly six-fold increase in 1-OHP excretion [the most reliable indicator for PAHs exposure] as compared with the control group [20 males of the workers' relatives of matched age and socioeconomic standard]. The study revealed a significant correlation between the relative number of sperm cells that expressed PS [annexine-V positive cells] and duration of exposure to hydrocarbons, low sperm count, diminished motility and the urinary 1-OHP levels of the exposed workers. This study recommended biomonitoring of urinary excretion of 1-OHP in workers exposed to hydrocarbons as a screening test and to use the annexine-V binding assay as an early measure of gonadotoxicity induced by toxic exposure to polycyclic aromatic hydrocarbons

Predictive value of serum CA 125 and beta subunit of human chorionic gonadotropin in theratened abortion

To evaluate the prognostic predictive value of serum beta subunit of human chorionic gonadotropin [beta-hCG] and CA125 in cases with threatened abortion, this study was carried out on twenty women with threatened abortions attending the Obstetrics and Gynecology Department of Tanta University Hospital. Four cases of the twenty patients ended in spontaneous abortion. As regards serum CA125, the mean values were 138.1 +/- 17.79 and 55.5 +/- 4.01 U/ml for spontaneously aborted group [group B] and successful ongoing pregnancy group [group C] respectively, and the mean values of beta-hCG were 22301.9 +/- 2555.1 and 58053.1 +/- 5959.77mIU/ml for group B and group C respectively. There were significant differences between both groups. This study showed that CA125 in more superior to beta-hCG in predicting spontaneous abortion in cases with threatened abortion where its sensitivity and specificity were 100% and 93:75% compared to 75% and 37.5 in beta-hCG. Thus, serum CA125 has a high accuracy in predicting the outcome in early threatened abortion

Effect of steroids on some hemostatic parameters in children with nephrotic syndrome

Disturbances in hemostatic parameters have been investigated in 20 children with minimal change nephrotic syndrome [15 boys and 5 girls], all were steroid sensitive. Studies were performed before remission with steroid [prednisone] treatment and after complete remission. Our aim is to determine the effect of steroids on these hemostatic parameters. Increased platelet count, platelet aggregation, serum fibrinogen and factors VIII and IX. While no changes in prothrombin time and partial thromboplastin time were noted before remission and after remission with steroid therapy. But after remission platelet count, platelet aggregation, serum fibrinogen and factors VIII and IX were significantly decreased. So, the hemostatic parameters showed a tendency toward normality on steroid [prednisone] therapy, The correction of hemostatic parameters by steroid [prednisone] appeared to be indirect one by correction of proteinuria, hypoalbuminemia, hypercholestrolemia and the hemoconcentration through effect of steroids [prednisone] on the affected glomeruli. We advise to give antiplatelet [as aspirin] to decrease platelet aggregation specially in cases with severe hypoalbuminaemia and haemoconcentration to avoid thrombo-embolic complications

ABH grouping of fresh and old dental pulp tissue by elution test

The ABH blood grouping was determined using the pulps of 293 teeth by theelution test. To ascertain whether or not the blood group of the extractedtooth would coincide with the actual blood group of the individual, the bloodgroups of teeth donors were identified by blood examination and used asreference samples. One hundred and twenty seven teeth were examined byelution test in the fresh state immediately after extraction, the remainingteeth [166] were left standing at room temperature and divided according tothe lapse of time after extraction into 3 groups of 49, 51 and 66 teeth to beexamined 1 to 6, 7 to 12 and 13 to 18 months after extraction, respectively. The results revealed that, in all fresh samples, there was completeconcordance between blood grouping results by elution test and those by bloodexamination giving 100% conclusive results. While in dental pulps examinedwithin 18 months after extraction, conclusive results were obtained in 93.9%,92.2% and 97% of samples examined within 6, 12 and 18 months after extraction,respectively

Role of computed tomography in staging of bronchial carcinoma

Thirty patients with biopsy proven bronchial carcinoma were studied by CT to recognize its role in tumor staging. CT enabled gathering lot of information concerning the size, localization and CT features of the tumor masses, their relation to the bronchial tree and major mediastinal nodal involvement and distant metastatic spread. Subsequently, accurate staging of bronchial carcinoma was applied using the TNM classification system of UICC. CT proved to be a highly accurate, safe and noninvasive method in staging bronchial carcinoma allowing better choice of appropriate therapeutic regimen and preduction of prognosis