Hormonal dysfunction in patients with chronic obstructive pulmonary disease

Systemic response to chronic disease in COPD patients might cause hormonal imbalance which in turn affects the severity of the disease. The severity of hypoxia in COPD patients causes alterations in thyroid function tests and IGF-1 levels. This work was carried on 50 COPD patients diagnosed and classified according to GOLD criteria and 20 healthy controlled subjects. All subjected to full clinical history, examination, chest X-ray and spirometry. Levels of TT3, TT4, FT3, FT4, IGF-1 and insulin were measured. TT4, FT3, FT4, TSH, and insulin levels were normal in all COPD. Despite the TT3 hormone level were normal in all stages of COPD, there is reduction in hormone levels in stage III and stage IV than control subjects. There is also reduction in TT3/TT4 ratio in severe COPD and there is correlation between TT3/TT4 ratio and PaO2 in stage III and stage IV but no correlation between TT3/TT4 ratio and PaO2 in stage I and stage II. IGF-1 hormone levels were variable among different stages of COPD. There is was no significant difference between some hormonal levels in COPD and in controls, accordingly hormonal replacement therapy in these patients is doubtful

Comparison of magnetic resonansc cholangiography percutaneous transhepatic cholangiography and endoscopic retrograde cholangiopancreaticography in evaluation of bile duct obstruction

Background: Percutaneous transhepatic cholangiography [PTC] has been the preferred investigation to delineate the anatomy of biliary tract in patients with bile duct obstruction, whether iatrogenic obstruction or obstruction due to stone or malignant lesion. Then ERCP has been described to evaluate and to manage the obstructed common bile duct whether by papillotomy and stone retrival or by biliary stenting. Both PTC and ERCP are invasive technique and may be associated with serious complication as cholangitis and biliary injury, recently magnetic resonance cholangiography [MRC] has been described to evaluate the obstructed biliary tract and considered as a diagnostic tool superior to PTC and ERCP as its non invasive and non operator dependent technique

Methods: This was prospective study of 21 patients who had surgery for bile duct obstruction due to any cause [stone or malignant lesion or iatrogenic injury]. The patients divided into three equal groups. 7 patients underwent ERCP, 7 patients underwent PTC and 7 patients underwent MRC. The results of which were compared with the intra operative findings

Results: Both PTC, MRC and ERCP were comparable with regard to image quality, detection of intrahepatic bile duct dilatation, assessment of level of injury and detection of abnormalities such as intraduct calculi, cholangetic liver abscess and atrophy of liver lobe. MRC provided additional information including detection of associated fluid collection and portal hypertension in addition its non invasive non operator dependent technique. In three patients more than one puncture had to be performed during percutaneous trans- hepatic cholangiography to delineate the complete anatomy in addition its an invasive method to delineate and decompress the bile ducts. ERCP failed in two patients and MRC done to delineate the biliary tree but ERCP provided additional benefit about anatomy of bile ducts below level of obstruction and solve the problem completely by endoscopic papillotomy and stone retrieval or by stenting of common bile duct

Conclusion: MRC is an accurate and non invasive imaging procedure for preoperative evaluation of patients with a bile duct obstruction and is capable of providing additional information which may not be available with PTC and ERCP. But ERCP considered superior to MRC as a therapeutic procedure in spite of that PTC may be essential in some patient when ERCP failure has occurred to decompress the biliary tracts

Plasma C3c level in patients with type II diabetes mellitus with microabluminuria

The study included 10 NIDDM patients with microalbuminuria, 10 NIDDM patients and 10 age matched normal controls. All were subjected to clinical examination, E.C.G., biochemical assessment for blood sugar, total serum cholesterol, serum creatinine, and serum C3c. Results revealed significant lowering of serum C3c in diabetic patients with microalbuminuria than controls [M. 76.43 +/- 15 and 95.75 + 22.23, respectively] [p < 0.036] and non significant reduction in diabetic patients without microalbuminuria [M. 87.327 = 21.22 mg/dl] [p < 0.398]. There was an inverse correlation between plasma level of C3c and each of total serum cholesterol [p < 0.001], degree of microalbuminuria [p < 0.0001] and ischemic heart disease [p < 0.002]

Age related changes of myeloperoxidase and lysozyme activities of neutrophils

The myeloperoxidase and lysozyme activities of neutrophils were studied in a number of healthy individuals representing a wide range of age 24 to 89 years. Each person was subjected to full clinical examination and laboratory investigation. Those persons shown to suffer from any disorder known to affect host defence system, were excluded. According to age, they were classified into three groups. GROUP I from 24-38 years, group II from 41-57 years and group III from 60-89 years. A high significant age-related reduction of myeloperoxidase activity of neutrophils was demonstrated. Despite no significant age related difference of lysozyme activity was declared, a significant negative, correlation between age and neutrophil lysozyme activity was found in group III. We concluded that myeloperoxidase activity of neutrophils do decline with age. This finding could result in a functional neutropenia in the aged people

Viral hepatitis B among pregnant women in Ketour village [Gharbia Governorate]

Prevalence of hepatitis B surface antigen [HBsAg] was found to be 18.18% among bilharzial pregnant women without splenectomy, 4.55% among bilharzial pregnant women with splenectomy and 3.03% among non bilharzial group of women. There was a tendency of HBsAg to decrease with the increase of age. Parenteral therapy [50.00%] and blood transfusion [29.41%] constituted the main routes for viral hepatitis transmission. Out of 34 HBsAg +ve pregnant women, one case died before delivery with a case fatality rate of 2.94%. Fetal complications included still births [5.88%], neonatal deaths [8.82%] low birth weight infants [17.65%] and congenital malformations [2.49%]. Recommendations included routine screening of all pregnant women for HBsAg and giving immunoprophylaxis to all infants borne to HBsAg positive mothers in rural areas

Serum fructosamine concentration in diabetes mellitus

The present study was designed to assess the sensitivity of fructosamine test, its correlation with blood sugar. Twenty healthy subjects [controls], and 48 uncontrolled as well as 28 controlled diabetic patients constituted the material in this study. All subjects were subjected to through clinical examination; estimation of fasting plasma glucose levels and two hours after 75 grams glucose oral load as well as serum albumin and serum fructosamine levels. Our results revealed that serum fructosamine levels in uncontrolled diabetics were significantly higher than in control subjects, while its level in controlled diabetics is not significantly different from controls. Serum fructosamine levels showed no significant correlation with sex age. However, there is significant positive correlation between serum fructosamine levels and fasting plasma glucose levels. Therefore, serum fructosamine level is a reliable alternative as an indicator of glycemic control