Laboratory screening for rhabdomyolysis among beginners practicing vigorous exercises

The objectives of this study were: screening for cases of exertional rhabdomyolysis among beginners in practicing vigorous exercises, and finding out reference laboratory values for the students who will exercise for the first time. The study was conducted in Assuit university hospital on 222 male students of first year of faculty of sports, who practiced vigorous exercises for one hour with maximal load, for the first time, and 20 apparently healthy subjects as a control group [GI]. Twenty four hours after vigorous exercise [24hs AVE], blood samples were collected and the students were classified according to [CK] levels into two groups, group II [GII] :125 students, with total CK<183U/L[cut off value] and group III [GIII]: 97 students, with total CK>183U/L. One month after vigorous exercises [I m AVE], blood samples were collected from [GIII] which represent the follow up group [GIV, baseline]. All participants were subjected to medical history, clinical examination including body mass index [BMI], and quadriceps circumferences. Laboratory investigations included peripheral haemogram, kidney and liver function tests, blood minerals, and specific tests including: total CK, CK-MB and CK-MM isoenzymes, LDH, and serum myoglobin. This study revealed statistically highly significant elevation of total CK, CK-MM, CK-MB, AST and serum myoglobin when comparing [GIII] with each of [GI] and [GII] while a high significant reduction was found when comparing [GIV] with [GIII]. No significant difference could be detected when [GIV] compared with [GI] and [GII] compared with [GI]. There was a significant reduction in serum Na+ and serum Ca+ + level and highly significant elevation in serum K+ and phosphorus in GIII when compared with GI. No statistical significance in [BMI] was detected. Twenty four hours after vigorous exercises, 16 students [7.2%] showed total CK level more than 5 times the cut off value [183 U/L]. These students showed no signs and symptoms of rhabdomyolysis except muscle pain. The participant students who showed total CK values five times or more than the cut off value [183 U/L], are considered by some authors to be suspicious of having rhabdomyolysis. Laboratory values of the students who did not show rhabdomyolysis, could be taken as reference values for students and untrained persons who will practice exercise vigorously for the first time

Pulmonary tuberculous children and the Euthyroid Sick Syndrome.

This study was designed to investigate changes in the thyroid hormones in children with active pulmonary tuberculosis [TB] before and three months after starting antituberculous therapy. It was observed that the mean hemoglobin level was significant and lower in patients than controls. The mean serum albumin level was significantly lower in cases before treatment than three months after treatment and the control group. The mean serum level of AST and ALT was significantly higher in patients after treatment than before treatment and the control group. It was observed that the mean serum level of T3 was significantly lower in patients before treatment than after three months of antituberculous treatment or the control group. There were no significant differences in the serum levels of T4 or TSH between the control group and cases before and three months after starting antituberculous treatment. Cases with decreased serum T3 level had more severe clinical manifestations than those with normal serum T3 level

Late onset involuntary movements, clinical and laboratory study

This study aimed to find the relative frequency of movement disorders, its etiology and presentation in relation to other neuropsychiatric illnesses throughout a period of 12 months. This study revealed that over a period of one year about 3100 patients aged 40 years and more with neuropsychiatric illness attended out patients clinic of neuropsychiatry, Assiut University Hospital. Ceruloplasmin and total thiol were significantly diminished in all groups of patients with movements disorders compared with the control. Lipid peroxide was significantly increased in all studied groups compared with control. These biochemical indices indicated the important role of increased oxidant stress in the etiopathogenesis of movements disorders

approach to the role of nitric oxide in hyperdynamic circulation in liver cirrhosis

Circulatory abnormalities arising in cirrhosis increased cardiac output and, possibly, heart rate coupled with reduced systemic vascular resistance, and possibly arterial pressure could result from peripheral vasodilatation. The locally acting vasodilator nitric oxide has recently been implicated as a possible mediator in the vasodilatation observed in cirrhosis. To investigate this hypothesis, total of 51 patients with liver cirrhosis were recruited in the present investigation, 14 had hyperdynamic circulation [HDC] and 37 had no manifestations of HDC the study also included 20 completely healthy controls. In each participant, serum and urinary nitric oxide [NO], urinary cyclic guanosine monophosphate [cGMP] excretions, serum endotoxin and C-reactive protein were determined. The study revealed significantly increased levels of serum NO, endotoxin and C-reactive protein as well as urinary excretions of NO and cGMP in patients with cirrhosis compared with controls. Patients with HDC had significant increase of all bioindices expcept C-reactive protein. Significant positive correlation existed between urinary CGMP, urinary NO, serum NO, endotoxin C-reactive protein. These findings would indicate that bacterial endotoxin rather than cytokines induce NO synthase expression in vessel walls with sustained NO release. The released NO through activation of guanylate cyclase, leads to increased intracellular cGMP concentrations and induces vasodilatation and hypotension. Inhibition of NO synthesis in these patients could be achieved by reduction of endotoxaemia through sterilization of the intestine. This would result in restoration of sensitivity to vasoconstrictors and reverse the haemodynamic abnormalities in liver cirrhosis

relation between ABO groups and some coagulation factors

The study was carried out on 200 blood donors at Minia and Assiut university Hospitals. It was found that the level of fibrinogen, factor II and VIII were significantly higher in group A when compared with group O, also factor II, VIII and cholesterol was found increased when compared with group B. Fibrinogen, factor II, and IX of group B were significantly higher when compared with group 0. Serum cholesterol and factor II of group AB were significantly increased when compared with B. No other differences between the blood group reached statistical significant

Plasma histamine in asthmatic children in relation to plasma IgE level

This study included 35 asthmatic children and 10 controls. Ages of patients and controls ranged from 4-8 years. They were recruited from the out-patients clinic of the pediatric Departement, Assiut University Hospital. The following investigations were done for both patients and controls: Plasma IgE level, plasma histamine level, total and differential white blood cell count, urine and stool examination. Plasma histamine level was significantly elevated in asthmatic than in control children. At the same time plasma histamine level was significantly elevated in asthmatic children with normal plasma IgE than in asthmatics with raised plasma IgE. Absolute blood esinophil count was significantly elevated in asthmatic children with elevated plasma IgE than both controls and asthmatics with normal plasma IgE. No significant difference could be found in the absolute blood basophil count could be found between asthmatics children and controls. It appears from this study that histamine may be an important mediator of bronchial asthma in children irrespective of the plasma IgE level

Study B-endorphin and plasma cortisol in stress of anesthesia and during surgery

Propofol [a short acting intravenous anesthetic agent] was used in two different infusion rates; 50-65 ug /kg/min. [group I] and 100-130 ug/kg.min. [group II], in twenty male patients scheduled for moderate surgical procedures, in a trial to study the effect of propofol on plasma cortisol and B-endorphin [B-EP] levels. The concentration of cortisol and B-endorphin in plasma showed a significant rise during anesthesia, during surgery and 2 hours postoperatively, [p 0.01-0.001] being greater in group I. In both groups B-EP level showed a significant decline six hours postoperatively. There is a positive significant correlation between serum cortisol and B-endorphin levels in most of the samples

state of serum iron and proteins in infantile rickets

Forty children with rickets aged 10-24 months and 10 controls of comparable age, sex and socioeconomic status were included in the present study. Serum iron, iron binding capacity, serum albumin, serum calcium, serum phosphorus and serum alkaline phosphatase were measured. A roentgenogram to the lower end of radius and ulna was done for all rachitic children. Iron deficiency anemia was found in 40% of the rachitic children. In the rachitic group a significantly positive correlation was found between serum iron and each of serum calcium and serum phosphorus. A significantly negative correlation was found between serum iron and serum alkaline phosphatae in rachitic in rachitic cases. Iron status was poorer in cases with active rickets than in both controls and cases with healing rickets. Hypoalbuminumia-was found in 25% of rachitic children. A significantly positive correlation was found between serum iron and serum albumin level in cases with rickets. Rachitic children with either hypocalcemia olr hypoalbuminemia showed a significantly lower serum iron and percent of transferrin saturation and a significantly higher iron binding capacity than rachitic children with normal serum calcium and serum albumin levels

Urinary cortisol and minerals excretion in high risk newborns

Twenty four hours urine specimens have been analysed with regard to cortisol, sodium, potassium, calcium and phosphate in 48 Full-term and premature newborns. The mean values of 24 hours urinary cortisol in 10 uncomplicated premature newborns [12.45 +/- 5.8 ug/kg], in 16 complicated premature newborns [24.35 +/- 15.55 ug/kg] and in 12 complicated full-term [14.9 +/- 10.91 ug/kg] were found to be significantly higher than that in 10 uncomplicated full-tern newborns [6.68 +/- 2.76 ug/kg]. Significant negative correlations between cortisol excretion and gestational age were found in the group of normal full-term [r = -0.73, P < 0.02] and in the group of uncomplicated premature newborns [r = 0.81, P < 0.01]. Significantly higher levels of 24 hours sodium, potassium, calcium and phosphate urinary excretion were observed in uncomplicated preterm [2.43 +/- 1.14 m Eq/kg, 1.31 +/- 0.31, 1.65 +/- 0.23 mg/kg and 28.97 +/- 5.4 mg/kg respectively] compared to normal full-term [0.88 +/- 0.17 mEq/kg P < 0.01, 1.01 +/- 0.19 mEq/kg P 0.05, 0.64 +/- 0.1 mg/kg P < 0.01 and 7.27 +/- 1.07 mg/kg P < 0.01 respectively]. Complicated premature newborns excrete significantly higher level of sodium, calcium and phosphate [2.99 +/- 1.30 mEq/kg, 3.02 +/- 1.62 mg/kg and 36.70 +/- 19.15 mg/kg respectively] than the group of normal full-term newborns P < 0.01 for each. Complicated full-term newborns excrete significantly more sodium [2.11 +/- 1.60 mEq/kg] and phosphate [36.65 +/- 7.88 mg/kg] than normal full-term neonates P < 0.05 and P < 0.01 respectively. Significant negative correlations were found between either sodium or phosphate excretion and gestational age in the group of uncomplicated premature newborns [r = 0.78 P < 0.01 and r = -0.80 P < 0.01 respectively]. The results were discussed in the light of the available data

Correlative studies of serum digoxin level, its clinical and electrocardiographic assessment in patients with congestive heart failure

The present work included 28 hospitalized cardiac patients [31 males and 15 females]. Their ages ranged from 17-56 years. Complete clinical examinations were performed. It was found that 16 patients had serum digoxin levels above the normal therapeutic range [2 ng/ml] with a mean + S.D. of 4.3 + 1.45. Seven of these patients showed clinical and ECG evidences of digitalis toxicity. From the 12 patients with normal serum digoxin level [Mean + S.D. 1.58 + 0.43], 2 developed ECG changes suggestive of digitalis toxicity. There was also a significant increase [P <0.05] in the serum digoxin level among hypokalemic patients as compared to normokalemic. All the hypokalemic patients showed ECG evidences of digitalis toxicity. On the other hand, no significant differences could be detected between patients with digitalis toxicity and those without as regard to the age, serum creatinine, serum potassium and digoxin level. The common ECG changes denoting digitalis toxicity were premature ventricular contraction in 66.6% and second degree heart block in 33.4% of patients

Liver affection in lichen planus

58 lichen planus patients with hepatomegaly of unapparent cause subjected to thorough clinical examination, ultrasound screening, liver function tests hepatitis B markers, antinuclear and antimitochondria antibodies were studied. Ultrasound examination showed a fine hyperechoic parenchyma. Abnormal liver function tests in 50% of cases studied in the form of a significant increase in total and direct serum bilirubin, alkaline phosphatase, aspartate transminase and alanine transaminase compared to controls. Hepatitis B markers were positive in 17 patients out of 58 cases studied [29.3%]. Antinuclear antibody was positive in 3 patients [5.1%] while the antimitochondrial antibody was negative in all studied cases. From these data we can say that in our patients with lichen planus, liver affection can be present in the from of hepatitis [viral B or auto immune] in 34.4% of cases studied and not in the form of primary biliary cirrhosis