IL-6 and IGFII in normal ovulatory; anovulatory pcos and controlled ovarian hyperstimulation cycles

Cytokine interleukin-6 [IL-6] and insulin like growth factor II [IGF-II] are polyfunctional regulatory peptides. They have a wide variety of biological activities including ovulation regulation of gonadal steroid secretion by the ovaries, corpus luteum function and embryo implantation. To investigate their role in normal ovulation, polycystic ovary syndrome [PCOS] and controlled ovarian hyperstimulation [COH] this study is conducted. Department of Obstetrics and Gynecology and Clinical Pathology, Assiut University Hospital, Assiut, Egypt. Sixty women were included in this study from 3 groups of patients; 20 women in each group. First group includes women with normal ovulatory cycle and a second group includes women with anovulatory PCOS cycle and a third group of women prepared for assisted reproduction by [ICSI]. Three blood samples from each women were obtained at day 3 of the cycle day 12 or day of ovum pick up and day 22 of the cycle. Follicular Fluid [FF]collected at the day of ovum pick up from women undergoing [ICSI]. Blood and FFsamples were assayed for IL-6 and IGF-II as well as E2, FSH, LH and P, using [ELISA] technique. The mean values of IL-6 level in the early follicular phase in normal ovulatory, PCOS and COH groups were 12.93 +/- 0.77, 101.99 +/- 32.04 and 12.86 +/- 0.88 [pg/ml], respectively. There is highly significant increase in PCOS group in comparison to normal ovulatory and COH groups. IL-6 significantly increased in patients with increased number of follicles than those of low number of follicles in COH group. The mean values of IL-6 in late follicular phase were 11.4 +/- 0.88, 99.7 +/- 4.0, 27.3 +/- 8.0 in the three groups, respectively. The level is only significanlly increased in those patients with COH than the level in early follicular phase inside each group. The mean values of IL-6 in the mid luteal phase were 176.6 +/- 29.7 and 68.7 +/- 52.3 [pg/ml] in normal ovulatory and PCOS groups. There was highly significant increase in the ovulatory than the anvulatory cycle. There was a significant increase of IL-6 in FF at the time of ovum pick up over the serum samples taken at the same time. The mean values of IGF-II level in late follicular phase were 589.97 +/- 22.58, 466.4 +/.- 41.74 and 770.7 +/- 79.38 [ng/ml] in normal ovulatory, PCOS and COH group, respectively. The increase of IGF-II in cases of COH than normal ovulatory cycle shows its significant role in steroidogenesis which is important for the elevated E2 level in this group. IL-6 may be an early predictor for the ovarian responce and the development of ovarian Hyper stimulation syndrome [OHSS] with the othor hormonal and US parameters. IL-6 may be taken in consideration as a maker for corpus luteum function in conjunction with progesterone in day 22. The elevation of IL-6 in day 3 in PCOS patients than in the normal ovulatory cycle may partially explain the increased liability to OHSS in these patients. The significant reduction in IGF-II in cases of PCOS may play a role in anovulation

Effect of midazolam/fentanyl infusion on haemodynamic and metabolic responses during short surgical procedures

Midazolam was used in combination with fentanyl as total intravenous anesthesia for twenty patients undergoing short surgical procedures; fentanyl [1.5 ug/kg] was given intravenously. Three minutes later, midazolam was administered started by bolus dose of 0.3 mg/kg, followed by drip infusion of 0.25 mg/kg/h. Patients were oxygenated by 100% O2 face mask during the procedures. The hemodynamics and metabolic responses [serum cortisol, lactate, pyruvate and blood glucose changes] were followed preoperatively, intra and postoperatively. Although the hemodynamic parameters [systolic, diastolic and mean blood pressure, heart rate and rate pressure product] showed significant changes, they were not of apparent importance. Insignificant increase in blood glucose concentration was seen following incision; but maximum significant concentration was measured after two hours. From induction in the early postoperative period, serum cortisol concentration significantly increased after induction and during surgery then after 24 hours serum cortisol and glucose returned to pre-induction values. Serum lactate significantly decreased until 24 hours after induction, but serum pyruvate increased significantly at skin incision and during operation; but after 24 hours it returned to pre-induction values. In all patients, good operating conditions were produced and patient's acceptance was high. It was concluded that midazolam infusion in combination with fentanyl may be useful technique in short procedures without inhibiting adrenal steroid release or producing cardiorespiratory instability

Genetic blood markers of the population in Aswan Governorate Egypt

A population sample of Aswan governorate in Egypt has been studied for hemoglobin variant, blood grouping, Rh. D. factor and G.6-PD deficiency. No hemoglobin variant was detected. With the exception of blood group [0] there was a statistically significant in distribution of various blood groups among. Aswan and Nubians population. Rh.D factor was negative in 0.7% in Aswanese and 1.7% in Nubians, the difference was statistically significant. G6-PD deficiency was 0.7% among males Aswanese and 1% among males Nubians

Sickle cell anemia in western Saudi Arabia

25 Saudi and Yemeni Arabs with sickle cell anemia from western Saudi Arabia aged between 5 and 30 years were studied. The mean study state haemoglobin concentration of 8 g/dl was lower than that of 10.7 g/dl reported previously for sickle cell anemia in Western Saudi Arabia. 14 patient had [HbF] of 10% or below [SSLF] while 11 patients had [HbF] above 10% [SSHF] No significant differences were found in the hemoglobin concentration and indices of the two groups. SSLF patients were significantly more prone to infection [P < 0.01], there was an overall high incidence of hepatomegaly [72%] and splenomegaly [60%]. Hepatomegaly was more common in the SSLF group [78.6%]. Saudi Arabian sickle cell anemia, even in patients with raised haemoglobin F levels, may be as clinically severe as in African patients

Serum lipoprotein-cholesterol in hypertensive patients

A study was performed on a group of 38 hypertensive subjects [25 Females and 13 males] and compared the results to another group of 17 matched controls [6 females and 11 males] for assessment of the hazards of lipoproteins cholesterol in hypertensive patients. Hypertensive patients studied showed significant elevation of serum triglycerides, VLDL-C. Significant elevation of total serum cholesterol and LDL-C. in moderate hypertensive patients. Significant reduction of HDL-C. in severe hypertensive patients as compared to the control group. Significant reduction in the ratio of total serum cholesterol to serum triglycerides, and in the ratio of HDL-C. to total serum cholesterol in moderate hypertension. Significant reduction in severe hypertensive patients in the ratio of total serum cholesterol to serum triglycerides. This effect of hypertension was similar to other vascular diseases [coronary, cerebral and peripheral]