Nautral coagulation inhibitors in coronary heart disease [CHD]

Haemostasis may be implicated in the pathogenesis of various thrombotic disease. Assay of natural coagulation inhibitors [AT III and PC] in coronary heart diseases may be informative in such cases. In this work, AT III and PC were assayed for 23 patients with coronary ischaemia and infarction besides 12 controls. A highly significant reduction in AT III had been observed in patient groups which had been attributed to an activated coagulation mechanism with consequent consumption of AT III. On the other hand, a significant increase in PC activity had been observed in both studied groups. This rise may be a body attempt to overcome hypercoagulability in those patients. We recommend a trial to use AT III and recombinant APC as therapeutic lines in patients with coronary heart diseases

Blood level of vitamin A, ascorbic acid and folate in hemophilic patients

The target of this work was to search for any relation between the nutritional status and haemophilia and whether the disease alters the level of certain vitamins. Therefore, serum vitamin A, plasma ascorbic acid, serum and red cell folate had been determined in 23 haemophilic patients together with 16 normal control persons. From the forementioned discussion, we concluded that there was a significant haemophilics despite their dietary vitamin C intake was in excess of 66% of RAD. Meanwhile, the demands for ascorbic acid needed for tissue repair in haemophilic patients could be reduced with prompt medical care of bleeding episodes and optimal nutritional care. A non significant differences had been observed in the serum vitamin A, red cell and serum folate in haemophilic patients as compared to control subjects

Thyroxin binding globulin [TBG] and prealbumin [TBPA] levels in healthy subjects

This study was carried out on 120 carefully selected normal healthy subjects [56 males and 49 females in addition to 15 newborns]. Their ages ranged from newborn to Geriatric. Estimation of plasma TBG and prealbumin by RIA and immunoturbidimetric methods respectively was performed. Plasma TBG levels were nearly constant in females up to the age of 7.5 years and then showed progressive decrease, together with that of the male group, till the age of 16 years and then showed a slight gradual increase till the age of 65 years. The highest levels of TBG were observed at birth and at the age of 65 years and the lowest one was at age group of 15-18 years [about two thirds the highest levels]. No significant sex difference was encountered in TBC levels among all age groups. Pre albumin levels were nearly constant till the age of 8 years in males and decrease slightly in females. In both sexes, a marked increase was noted from 8-14 years, then the increase was much slower till the age of 24 years. The level started to decline slightly from age 24 to 40 years and markedly till age of 65 years. The highest level of prealbumin was in age of 15-35 years which was two and half folds that obtained for newborns and old age [65 years]. Prealbumin was significantly higher in male than females at the age range 15-50 years. Significant negative correlation was demonstrated between plasma TBC and prealbumin levels in all age groups

High molecular weight kininogens [HMWK] and coagulation factor VII as prognostic landmarks in the prediction of hepatic decompensation

Owing to their delicate nature coagulation proteins could be strongly considered as sensitive parameters in assessment of the hepatic functions, Vierling [1984]. Plasma coagulation factors are very sensitive to liver failure yielding a good indication of terminal liver protein insufficiency. Many investigators studied various coagulation parameters aiming at evaluation of their prognostic value in chronic liver diseases. They reported that no single parameter is by itself a definitive indication for a terminal hepatopathy, Biland et al. [1978]. This problem is still controversial. Vierling [1984] suggested that a prothrombin time eight seconds longer than control values represent an adverse prognostic index hepatic insufficiency. In fact prothrombin time assay does not seem to differentiate between survivors and non survivors when cirrhotic cases were followed. Therefore, a great deal of attention has been given to identify blood coagulation factors that are more sensitive to liver failure to evaluate their prognostic importance. Initial studies suggested that factor VII. a protein of prothrombin complex with a short half life, and HMWK are sensitive indexes of liver damage. Orlando et al [1982] and Cordova et al [1984]. Therefore, the objective of the present study is to further investigate this clinical problem. Therefore, coagulation factor VII and HMWK have been assayed simultaneously in liver cirrhosis and chronic hepatitis in compensated as well as decompensated stages

Some observations on golucosylated hemoglobin in chronic renal failure and the influence of hemodialysis

Glucosylated Hb is a model of non enzymatic postsynthetic protein modification proportionate with blood glucose level. Its role in uremia is however unclear. Moreover, the effect of uremia on Hb glucosylation was shown to be more complicated. Therefore, the aim of this study was to clarify the reflection of uremia on glucosylated Hb level. The material of this study included 30 patients with CRF and CRF diabetics besides 5 non uremic diabetics and 10 healthy controls. Glucosylated Hb was assayed in all subjects and was reported after in uremic cases. We concluded that the level of glucosylated Hb has been significantly reduced in CRF which could be due to shortened red cell survival while in CRF diabetics it was higher due to their high blood glucose. More over, hemodialysis resulted in elevation of glucosylated Hb due to the proved red cell survival. A positive correlation has been revealed between glucosylated Hb and serum creatinne, a finding that may aid in diagnosis and follow up of CRF particularly in doubtful cases

Assessment of serum iron, TIBC and serum ferritin in end stage renal disease and the effect of hemodialysis

Because of the variability in the pathogenesis of anemia in CRF and the accepted usage of iron supplmentation, we attempted to evaluate the importance of blood indices, serum iron and serum ferritin in such conditions as serum ferritin is generally considered as the best indirect index of body iron stores. This work included 52 uremic patients besides 6 control subjects. The patients were grouped into predialysis and dialysis groups.The later were further subdivided into 3 subgroups according to the duration of dialysis. Biochemical tests, complete hemogram including erythrocyte indices, serum iron, TIBC and serum ferritin had been carried out for all subjects. All uremic patientsúirrespective of dialysis were suffering from microcytic hypochromic anemia with marked iron deficiency and low serum ferritin. There was a statigtically insignificant change of iron status in dialysis groups irrespective the variable duration of dialysis. We came to the conclusion that evaluation of serum ferritin is essential to assess the body iron stores and to evaluate the indication of iron supplementation in CRF and [dialysis patients because the hematological indices alone can not point to the actual iron stores. Reevaluation of the adequacy of hemodialysis procedure can be garanteed with the improvement of iron parameters. Moreover, iron supplementation in CRF should be cautiously used after investigating the iron status in such patients. An extension of this work could be suggested to investigate the erythrocyte ferritin, bone marrow iron in CRF and a trial to use RHuEpo in those patients

relevance of protein C and antithrombin III in Diabetes mellitus

Protein C-a natural coagulation inhibitor is activated by thrombin. It cleaves off an NH2 terminal activation peptide. Many investigators reported that PC has been incriminated in hypercoagulability state in diabetic patients. This induced us to study PC activity and AT III concentration in this disease. We investigated 18 diabetic patients. On oral hypoglycemic therapy for PC activity and AT III concentration and compared their results those of 10 selected healthy control subjects. A highly significant reduction was found in both studied parameters in the diabetic group. These findings stress the major role of hyperglycemia in determining PC reduction in diabetics, and suggest that PC reduction probably associated to hyperglycemia enhanced thrombin formation