Diuretic therapy in hypertension, and its effects on lipoprotein pattern

In this work, 19 hypertensive patients were thoroughly examined, and divided into 3 groups according to the diuretics used. The first group comprised 5 diabetic patients given spironolactone, the second contained 6 diabetics given ethacrynic acid, but the third group consisted of 8 non diabetic patients given frusemide. Investigations were done for every case e.g. urine and stool analyses, X-ray chest, E.C.G., blood sugarlevel and serum creatinine, in addition after treatment. In group I, we found insignificant increase in cholesterol triglycerides and total lipids but in group II, inspite of insignificant increase in triglycerides and total lipids, the cholesterol was decreased insignificantly. In the third group there were significant increase in triglycerides and ongly insignificant increase in both cholesterol and total lipids

Effect of diuretics on some respiratory function tests in bilharzial patients with and without ascites

This work comprised 20 male bilharzial patients, devided into 2 groups, 10 bilharzial patients without ascites, 10 patients with ascites and in addition, 10 healthy subjects as a control group. All cases were subjected to thorough history taking, complete clinical examination and the following investigations: urine and stool analysis, blood urea, serum creatinine, x-ray chest, electrocardiography and ventilatory function tests particulary 1C, ERV, FVC, FEV[1], MVV, FMEF, FMEFT, FEF and AVI. Percutaneous transsplenic portal manometry was done for nonascetic and ascitic group, and the intraperitoneal presure was measured for ascitic group only. Bilharzial patients without ascites have obstructive ventilary defect only, while patients with ascitis has combined obstructive and restrictive defects, and diuretics improved these defects. There is negative correlation between portal venous pressure and intraperitoneal pressure and all ventilatory function tests except FMEFT where the correlation is positive. From the preceeding we can see that diuretics are of value in improving organ funciton not only in the ascitic bilharzial patients but also in the non ascitic cases and wherever oedema is interferring with function i.e. interference with digestion in patients with portal hypertension or ascites, and interference with ventilation due to oedema of the bronchial mucosa

Some platelet functions in patients with diabetes mellitus and hepatosplenic bilharziasis

Our aim was to study platelet count, adhesiveness and aggregation in patients with hepatosplenic bilharziasis and diabetes mellitus. Our material comprised 10 non-ascitic patients with hepatosplenic bilharziasis, 7 uncomplicated diabetes mellitus and 8 patients with hepatosplenic bilharziasis and diabetes mellitus. 5 apparently normal subjects were taken as a control group. All groups were subjected to through history taking, clinical examination, urine and stool analysis blood picture, bleeding and coagulation times, serum creatinine, serum bilirubin, serum glutamic pyruvic tranaminase, fasting blood sugar; platelet count, adhesiveness and aggregation. Platelet count, adhesiveness and aggregation were decreased in patients with hepatosplenic bilharziasis, increased in patients with diabetes mellitus while they were non significantly, changed in patients with hepatosplenic bilharziasis plus diabetes mellitus. So, while diabetic patients should receive antiplatelet drugs like aspirin and dipyridamole; such drugs are contraindicated in patients with hapatosplenic bilharziasis for fear of bleeding and they are not recommended in cases with combined diabetes mellitus and hepatosplenic bilharziasis

Combined drug therapy of intestinal bilharziasis with and without polyposis

In endemic areas treatment of intestimal schistosomiasis, especially when complicated with polyposis, is a major medical problem. In the past few years introduction of new drugs gave hope for treatment of such cases. These drugs were mainly niridazole and oxamniquine. Niridazole has to be given repeatedly at two months intervals over a period up to one year. Oxamniquine provides the advantage of short term therapy over 3 days but the cure rate was much lower than niridazole. The two drugs are different pharmacolozically and this encourages us to give both drugs in succession, then simultaneously without accentnation of the side or toxic effects than when either drug was given alone. In this study 493 patients of intestinal bilharziasis, 39 of them with bilharzial colonic polyposis were included, using different schedules of therapy. Niridazole in a dose 4 mg/ kg. B. W. daily for 20 days and oxamniquine 60 mg/kg. B.W. as a total dose divided over 3 days. The best results were obtained when both drugs were given simaltaneously. The cure rate in non polypotic bilharzial cases was 96.5% and in patients with plyposis 64.3%, while the cure rate using oxamniquine alone or using the two drugs in succession starting by either of them gave much less cure rate, [not more than 40%]. We can conchude that the best treatment of intestinal schistosomiasis with or without polyposis is the simultaneous administration of oxamniquine and niridazole in the above mentioned dosage schedule

Leucocytic margination in typhoid and hepatosplenic bilharziasis

Adrenaline injection induced a significant blood cellular changes, which were more at phase I than at phase II except a reverse pattern occurs to platelets, phase II of adrenaline response is not to stimulation of pituitary adrenal axis, the total leucocytic counts were positively correlated with neutrophils and lymphocytes. In bilharzial cases, the maximum adrenaline induced increase of the formed blood elements was larger than in normal persons, negative correlation between grades of splenomegaly and base line level of all formed blood cells, positive correlation between grades of splenomegaly and the maximum adrenalin test can be used a diagnostic of cellular sequenstration in grades II and III bilharzial splenomegaly. Marginal bool of noutrophils is increased and positively correlated with the grades splenomegly and the maximum increase of lymphocytes after adrenaline test was larger than that of neutrophils. A suggestion for lymphocytes margination and was positively correlated with the grade of splenomegaly. In enterica, neutrpenia is due to increase of their marginal pool, relative lymphocytosis may b due to decrease of their margination. The maximum increase of lymphocytes after adrenaline injection was lower than of neutrophils

Immunoglobulin E in some intestinal parasitic infections

48 patients and 10 control subjects were studied. Their ages ranged from 6.5-60 years. 15 patients were bilharzial; 10 non ascitic and 5 ascitic; 9 patients with ascariasis; 6 patients with oxyuris, 6 withgiradiasis; 6 with H. nana and 6 patients with trichostrongyloides. The control group consisted of 10 apparently normal subjects. All cases were subjected ta thorough history taking, clinical examination, urine and stool analyses, sigmoidoscopy and mucosal biopsy, complete blood picture, ESR and immunoglobin E estimation. There was significant increase in IgE levels in all parasitic infections except in H. nana group. The highly significant elevation was found in ascariasis and bilharzial group [specially the non ascitic cases]. The triad of anemia, raised ESR and high level of IgE may be a feature of some parasitic infections; namely bilharziasrs, ascariasis, oxyuriasis and trichostrongyloides. IgE estimation may be a useful parameter in the diagnosis and follow up of cases with bilharziasis as well as other parasites, higher levels being obtained with ascariasis [which can be excluded by stool analysis] and bilharzial cases where diagnosis is sometimes difficult. As individual parasitic infections were found to raise IgE level, it is expected that mixed parasitic infestations may raise IgE and this may be of diagnostic value and usefulness in follow up of these infections

Neutrqphils phagocytic power in chronic asthmatic bronchitis and pulmonary tuberculosis

This work comprised 16 and 14 tuberculous patients in addition to 16 healthy control subjects. All cases were submitted to full history taking, thorugh clinical examination, x-ray chest, laboratory investigations including: urine analysis, stool analysis, blood picture, E.S.R., serum creatinine and post prandial .blood sugar. Sputum smear with Ziehl Neelsens and sputum culture and sensitivty test. Estimation of serum IgA, G, Mi and C[3], and determination of the phagocytic power of neutrophils. The asthmatic and control groups were subjected to pulmonary function tests. The results revealed: mild anaemia with normal leucocytic count in both groups. The phagocytic power of neutrophils was markedly depressed in all patients which is mainly due to cellular defect, rather than humoral as there is normal serum IgA and C[3] and elevated IgM and IgG. The only specification in tuberculous group is elevation of C[3] with no difference in phagocytic power among sputum positive and negative subgroups

Serum, ascitic fluid and urinary biochemical changes in bilharzial patients with refractory ascites

15 ascites patients with aepatosplenic bilharziasis responding to diuretic therapy were taken as control group. 20 patients with bilharzial hepatosplenic affection and retraciory ascites were the material of the present study. All patients from both groups were subjected to investigations to prove pure bilharzial etiology. In their serum, and serum and ascitic fluid enzymes [GOT, G.P.T., Alkaline phosphatase and L.D.H.], Proteins [Albumin total globulin, Alpha[1], Alpha[2] Beta and Gamma globulin]; glucose, cholestrol, bilirubin [total and direct], B.U.N., creatinine and electrolytes [Phosphorus, calicum, pottassium, sodium and chloride] were assessed. Urinary electrolytes [Phosphorus, calcium, calcium potassium, sodium and chlorid] were also meadured for all. The serum biochemical data of patients with refractory ascites showed that they were in a more advanced stage of hepatocellular damage than patients with non refractory ascitis. The ascitographic picture of biochemical data of both groups showed selective significant differences that can be taken as a parameters to fortell refractoriness of ascites during the follow up of cases in the course of that disease. Selective significant differences in urinary electrolytes of both groups can also be taken as forerunnex to predict refractoriness of ascites. The A/S ratio of different biochemical data in both groups showed selective significant differences that can be taken as a parameters for detection of the impending refractory ascitic stage in the course of bilharzial hepatosplenic affection. The concept of an active role for the peritoneum in ascitogrophic biochemical patterns construction was proposed and discussed

Anaemia in diabetes mellitus

Eighty five patients with diabetes mellitus and 25 normal controls were studied clinically together with evaluation of their red cell values, bone marrow picture, serum iron and liver function tests. Normochromic normocytic anaemia was found to be a characterstic feature of diabetics having chronic complications or infections. Macrocytic normochromic anaemia was present in diabetics having ketoacidosis. Possible underlying mechanisms for the present anaemia was discussed. In non complicated diabetics anaemia was not present and serum iron was within normal limits. Conclusion was reached that the presence of anaemia in a diabetic patient is a sign of diabetic complications

Blood viscosity in diabetes mellitus

Eight five diabetics and 25 normal controls of matched age and sex were studied. Estimation of the whole blood viscosity by using the U-shaped viscometer tube was made. Significantly higher blood viscosity was a constant feature for diabetics. Correlation of viscosity to diabetic complications and type of diabetes was carried out. Hyperlipidemia, hyperfibrinogenaemia, increased alpha[2] and beta globulins showed a linear relation to the blood viscosity. Conclusions were reached that the estimation of blood viscosity in diabetics is a rapid, simple and reliable prognostic test for diabetics especially in complicated cases

Thyroid and male infertility

The functional state of the thyroid gland was evaluated clinically and by PBI for 104 infertile males and 25 normal controls. An euthyroid state was found to be fundamental for spermatogenesis. Hypothroidism was detected in 3 cases and a case record of azoospermic thyrotoxicosis is described with normalization of semen picture after medical control of the hyperthyroid state. Liothyronine therapy [20 ug/day] was very effective among infertile males with hypothyroidism and useless in euthyroidism. Study of the functional state of thyroid gland is essential before T 3 therapy

Reversion of oesophageal acid perfusion test results after paracentesis abdominis in ascitic cases of bilharzial hepatic fibrosis

Twenty six patients with hepatosplemc schistosomiasis and tense ascites, having positive acid perfusion test results, were the candidates of this research. All cases were investigated for brtharzlal aetiology, portal pressure manometry, ascitic fluid volume and pressure estimation and oesophageal acid perfusion test were done before and 10 days after slow paracentesis abdominis. The following results were found: 1. Positive correlation between portal and ascitic fluid pressures before and after paracentesis. 2. Both portal and ascitic fluid pressures were significantly reduced after tapping in all patients. 3. The oesophageal acid perfusion test turned negative in 61.53% of patients 10 days after tapping. 4. The degree of portal and ascitic fluid pressure reduction was more significant in the group showed reversion of oesophageal acid perfusion test. 5. While test reversibility was linked to the portal hypotensive effect of tapping, non reversibility was indicative of inefficient non significant tapping. We can conclude from this work the great value of this simple test in indicating and evaluating the success of tapping in lowering the portal and ascitic fluid pressures in bilharzial ascitic patients