Effect of blood transfusion versus erythropoietin injection on peripheral erythropoietin response in burnt patients

Twenty-seven adult burned patients [burn size 20-40% of total body surface area] were included in this study. The studied patients were blindly and randomly assigned into two groups: Group A [15 patients] received blood transfusion according to their need, while group B [12 patients] received 4000 units of r-HuEPO twice weekly for one month. Blood transfusion was given to both groups when haemoglobin level decreased to less than 8 g/dl. The effect of administered blood transfusion or r-HuEPO was evaluated through clinical response, blood count, reticulocytic count, serum iron and transferrin and erythropoietin level. The mean values of hemoglobin, packed red cell volume and RBCs count of both groups were progressively decreased, especially in the 3rd post burn day. Despite the progressive decrease of all the previous hematological values in both groups, they had elevated serum erythropoietin level allover the post burn period, which was significantly higher in group B. Moreover, significant reticulocytosis was observed, especially in group B. Before the administration of either blood transfusion or r-HuEPO, iron levels were within the normal range, then rapidly reached extremely low levels and remained low throughout the study periods in group B. On the contrary, in group A, serum iron levels were rapidly increased and reached high levels and remained high throughout the study periods. Moreover, serum ferritin levels were rapidly reaching supernormal values and remained higher allover the study, but the level of transferrin was low in the follow up period compared with that of the first days. The study concluded that recombinant human erythropoietin [r-HuEPO] is capable of enhancing erythropoiesis and has lower risk of iron overload than frequent blood transfusions in burned patients

Evaluation of the peripheral nervous system in patients with chronic respiratory insufficiency and hypoxaemia

Evaluation of peripheral nervous system was studied in 15 male patients with chronic respiratory insufficiency and hypxaemia in addition to 15 healthy individuals. They were selected to be non smoker and had no possible causes of peripheral neuropathy. Neurological examination and electro diagnostic tests in the form of motor and sensory conduction velocities and terminal latencies were done. The results of neurological examination revealed the presence of at least one of the clinical signs of peripheral neuropathy in 10 patients [67%]. Nerve conduction tests showed marked conduction impairment in at least one peripheral nerve in all patients. So nerve conduction studies were of value in identifying subclinical neuropathy in 33% of our patients. A statistically significant of both sensory and motor conduction velocities and latencies of all the studied nerves was found when compared to the normal control groups. These findings reveal that peripheral sensorimotor neuropathy commonly occurs in association with chronic respiratory insujfficiency and chronic hypoxaemia

Effect of antibiotic therapy on serum levels of some elements

Changes in the serum concentrations and metabolic behavior of iron [Fe], Zinc [Zn] and copper [Cu] have been reported during the course of several infectious disease; this was attributed to the effect of illness besides the effect of antibiotic therapy. In this work, the effect of ampicillin and tetracycline on the serum levels of these elements as well as on calcium [Ca] Magnesium [Mg] and Manganese [Mn] was studied. Twenty patients [10 males and 10 females] ranging in age from 12 to 65 years [with a mean + SD of 33.5 ' 16.5 years] and receiving either ampicillin or tetracycline capsules 500 mg/6 hours for infections including bronchitis, pneumonia or urinary tract infection were studied. Twenty, age and sex matched normal subjects served as controls. Ten of the patients were given ampicillin and the other ten tetracycline. Serum levels of the aforementioned elements and total iron binding capacity [TIBC] were measured before and after treatment using colourimetric and atomic absorption methods. Results showed that both ampicillin and tetracycline have similar lowering effects on the serum levels of Ca and Mg. Changes in serum levels of Cu and Zn remain throughout the study and seem to be normal under the therapeutic effect of both types of antibiotics. Mn, Fe and TIBC, were slightly affected during the study