Effect of helicobacter pylori infection on lipid profile in type II diabetic patients

The aim of this study is to investigate a possible relationship between H. pylori infection and dyslipidemia in diabetic patients. the study included twenty type 2 diabetic patients classified into two equal groups based on the presence of H. pylon infection [Gl] and its absence [G2]. Ten non-diabetic cases with H. pylori infection were also included [G3] and ten age matched nondiabetic and non H. pylori infected subjects were taken as controls [G4]. All patients and controls were subjected to history taking clinical examination and laboratory studies including fasting and post prandial blood glucose glycosylated hemoglubin, s. total cholesterol, s. triglyceride, HDL- cholesterol and LDL-cholesterol. H. pylori infection was diagnosed by the highely sensitive C13 urea breath test. Lipid profile is more atherogenic in H. pylori positive diabetic patients [G1] than H. pylori negative diabetic [G2].-The results revealed a statistically significant increase in trigleceride cholesterol LDL-cholesterol [G1>G2>G3>G4] versus a statistically significant decreas in HDL- cholesterol [GKG2 < G3 < G4. we concluded that there is a possible assoication between chronic H. pylori infection and atherogenic lipid profile and this assoication is higher among diabetic patients. The importance of this link is highlighted by the possibility of an effective intervention against H. pylori infection in type 2 diabetic patients as a preventable risk factor

lnterleukine-6 and acute phase response in chronic renal failure

The mortality rate is high among chronic renal failure [CRF] patients, and recent evidences suggest that this may be linked to chronic inflammation. IL-6, the main pro-inflammatory cytokine, promotes inflammatory events through, the activation of lymphocytes and the induction of acute phase protein response in the liver. In vitro and in vivo studies have suggested that markers of acute phase response such as serum CRP and serum albumin are both known as important predictors for the progression of CRF. The aim of this study is to investigate the IL-6 serum levels and its relation to acute phase reactants [CRP and albumin] in both dialyzed and non-dialyzed CRF patients in compare with normal healthy subjects. Our results show an enhanced production of IL-6 in the CRF non-dialyzed and dialyzed patients, as compared to controls. A strong impact of plasma IL-6 levels on the acute phase reactants were demonstrated by its significant statistical correlation with CRP and albumin. In conclusion an increase of IL-6 and CRP inversely related with creatinine clearance has been evidenced in our results. The possibility that IL-6 causes an activated acute phase response is claimed. A negative correlation between CRP and serum albumin was found confirming the link between chronic inflammation and malnutrition in CRF patients, this was confirmed the decreased cholesterol levels in CRF patients. These data provided evidence of the activation of mechanisms known to contribute to the increased morbidity and mortality in CRF patients

Topical capsaicin-curcumin combination: an effective therapy for chronic painful distal symmetric polyneuropathy in diabetic patients

Chronic distal symmetric polyneuropathy [CDP] is the most common form of diabetic neuropathy. In chronic [lasting>12 months] painful CDP, the patient suffers from paresthesia and pain, that may lead to disability with daily activities and even sleep. In this work, evaluation of the efficacy of topical application of a curcumin cream formula [0.05%], as a novel indication for treatment of CDP, was guarantied. The efficacy of a capsaicin-curcumin combination [CCC] cream was also tested. Subjects and This study included 120 known diabetic patients coming for follow up, aged 23-63 years, 37 with type 1 and 83 with type 2 DM. The patients were randomly allocated into 4 groups: group 1 applied topical cream base and served as controls. Group 2 applied topical 0.075% capsaicin cream. Group 3 applied topical 0.05% curcumin cream and group 4 applied topical cream containing 0.075% capsaicin plus 0.05% curcumin [combination]. All groups were given the medication as water washable cream, applied topically, 4 times daily for 2 months. The two cream formulas showed a remarkable relief of CDP associated symptoms. As compared to a standard capsaicin cream [0.075%] and a cream base that served as placebo. At the end of study period of 2 months, the overall percentage of patients showing improved and 89.3% for placebo, capsaicin, curcumin and neuropathic symptoms was 20.7%, 70%, 78.5% curcumin-capsaicin combination, respectively [P<0.0001]. The percentage of patients without neuropathic symptoms was 3.4%, 20%, 26% and 42.9% for the four groups, respectively [P<0.0001]. Moreover, pain score declined from 4.2 +/- 0.5, 4. 3 +/- 0.3, 3.9 +/- 0.6 and 4.2 +/- 0.4 [P>0.05] before treatment to 4.0 +/- 0.5, 3.1 +/- 0.3, 2.9 +/- 0.5 and 1.2 +/- 0.3 [P<0.0001] after treatment with placebo, capsaicin, curcumin or their combination, respectively. The onset of gaining pain relief was evident from the first week of treatment, with the highest number of patients reporting pain relief with the combination therapy. Conclusions: Our clinical observations report, for the first time, that topical application of curcumin cream [0.05%] has a beneficial effect in alleviating symptoms associated with CDP. The clinical observations also suggest that a cream containing a combination of 0.075% capsaicin plus 0.05% curcumin is an effective, noninvasive treatment modality for the management of CDP

Clinical and ultrasonographic prediction of Oesophageal varices in liver cirrhosis

Since bleeding from oesophageal varices is a major complication of chronic liver diseases among Egyptians, early diagnosis of portal hypertension and varices may prevent and control bleeding. 139 patients with chronic liver disease of different grades were classified and investigated. 89 with no varices, 27 with small and 23 with large varices. Clinical examination, liver functions, blood picture, hepatitis markers, rectal snips for bilharzial ova, upper gastrointestinal endoscopy and abdominal ultrasonography with Doppler study of portal vein, splenic vein and hepatic artery were done for every patient. The results showed significant relation between presence of oesophageal varices and hepatic coma, spider navi, ascites and increased score of child classification. There was significant positive relation between splenic size and negative relation of liver size and presence or grading of varices. A significant positive relation was found between presence of varices and post hepatitic cirrhosis. A significant increase in total bilirubin, AST, ALT, ALKphos., and decrease in serum albumin and prothlrombin concentration in patients with varices as well as a significant decrease in R.B.Cs, W.B.Cs, Platelets and HP% in the group with varices. Doppler study revealed increase in P. V.D, P. V.C.A, and decrease in P. V.C.I and P. V.M. V in patients with varices. Doppler study on hepatic artery showed good correlation of H .A. P.I, L V.I but not H.A.M. V and the presence of varices. No parameter was found to differentiate small from large varices except splenic size and ascites. This leads to the conclusion that clinical, ultrasonic and Doppler examinations of hepatic patients may suggest the presence of varices without, need for endoscopic examination of every patient

Distribution of P53 and mdm2 genes in patients with hepatocellular carcinoma

50 patients with hepatocellular carcinoma, 36 males and 14 females 14-73 years old were studied in this work. Abnormal values of s.. bilirubin. AST, ALT and alkaline phosphatase were found in 52, 64 and 76% of cases respectively. 70%of cases had AFP levels between 50 and 150ng/dl while 6/had levels below 10ng/dl. 46.had stage 1:36 stage II and 18/had stage III disease. P53 was overexpressed in 46% of cases not related to age or sex. A statistically significant relationship was found between mdm2 overexpression and the stage of the tumor. 42% of cases were P53 positive and mdm2 negative and 24% of cases were P53 negative and mdm2 positive that may indicate that mdm2 overexpression and P53 mutation represent alternative mechanisms for inactivating the same regulatory pathway for suppressing cell growth. Concomitant overexpression of either P53 or mdm2 or both was found to have statistically significant relation with tumour stage indicating that P53 mutation and mdm2 overexpression are alternative mechanisms for inactivating the same pathway for suppressing cell growth. It can be concluded that P53 in activation may be involved in the molecular pathogenesis of HCC and its mutation is late in HCC and its frequency is related to tumour progression mdm2 overexpression has the same significance. Tumors with mdm2 overexpression were devoid of P53 mutations and vice verca; indicating that they represent alternative mechanisms for inactivating the same regulatory pathway for suppressing cell growth