Outcome of children with Hodgkin's disease. A 10-year experience from a single institution in Kuwait

To evaluate the outcome of children with Hodgkin's disease over a period of Loyrs from a Single instituhon in Kuwait Sixty-three children with previously untreated Hodgkin's disease, who were diagnosed at the Pediatric Oncology Unit of Kuwait Cancer Control Centre, Shuwaikh, Kuwait from January 1998 to December 2007 were included in the study. All cases were proved by histopathology, and staging was carried out according to the Ann Arbor system. Our series included 37 [59%] males and 26 [41%] females with a median age of 10 years [range 3-15 years]. B symptoms were present in 20 [32%] children. Bulky disease was noted in 28 [44%] children, with stages III in 8 [13%] and IV in 12 [19%] children. Chemotherapy was administered as a primary treatment in 63 children. The median number of chemotherapy cycles given was 6 [range 2-8]. Radiotherapy was used in 40 [63%] children. Grade III hematological toxicity was observed in 23[37%] and grade IV in 14 [22%] children. Hypothyroidism was observed in 20 [32%] children. Fifty-five children achieved a complete remission [87%] and 2 children achieved a partial remission [3%] with an overall response rate of 90%. Three children achieved a progressive disease [5%] and response could not be evaluated in 3 [5%] children. At a median follow-up of 67 months [5.5 years], the overall survival was 91%. With moderate toxicity, combined modality therapy is effective in the treatment of childhood Hodgkin's disease

Plasma adiponectin and resistin levels in type 2 diabetic obese female patients with and without hypertension and retinopathy

In the past, adipose tissue was largely regarded as a depot for fuel storage in the form of triglyceride. However, adipose tissue is an active endocrine organ that secretes a variety of metabolically important substances including adipokines. The adipocyte is now known to secrete a variety of proteins such as tumour necrosis factor [TNF]-alpha, adipsin, plasminogen activator inhibitor-1, leptin, resistin, and adiponectin. Adipose tissue regulates insulin sensitivity via the circulating adipocytokines, resistin and adiponectin. These factors affect insulin sensitivity and may represent a link between obesity, insulin resistance and type 2 diabetes [DM]. The objective of this study was to compare the levels of resistin and adiponectin in type 2 diabetic obese female patients with and without hypertension and retinopathy. In this study the plasma adiponectin and resistin concentrations were investigated, in 20 control obese non-diabetic females and 40 obese female patients with type 2 diabetes mellitus. The diabetic females were divided into 2 groups. G[I] included 20 controlled uncomplicated diabetics and GII included 20 diabetic patients with hypertension and retinopathy. The plasma concentration of adiponectin was significantly lower [P< 0.01] in diabetic females in G[I] and G[II] than non-diabetic control females. In diabetic patients with hypertension and retinopathy [G[II]] there was a significant decrease in plasma adiponectin levels [P< 0.01] as compared to their levels in diabetic females in G and control females. Our results also show that there were non-significant changes in plasma resistin in diabetic patients in both groups G[I] and G[II] as compared to their levels in control group. These results suggest that adiponectin may play a key role in pathophysiology of type 2 diabetes mellitus and its microangiopathy and macrovascular complications

Assessment of anticardiolipin antibodies, circulating lupus anticoagulant, protein C, protein S, antithrombin III and activated protein C resistance and their relation to thomboembolic and other clinical manifestations in Behcet's disease

Venous and arterial thrombosis occurs in patients with Behcet's disease and is associated with significant morbidity and mortality. Studies on a possible association between the occurrence of thrombosis and thrombophilia in patients with this disease have been controversial. The objective of this study was to assess the frequency and clinical relevance of anticardiolipin antibodies [aCL] and other thrombophilic factors and their relationship to thromboembolic and clinical manifestations in Behcet's disease [BD]. IgG, IgM and IgA anticardiolipin antibodies [aCL] isotypes, presence of circulating lupus anticoagulant [LAC], protein C, protein S, antithrombin III and activated protein C resistance were investigated in 25 patients with BD and 25 patients with various rheumatic diseases not known to be associated with venous or arterial thromboembolic phenomena served as controls. Twelve of the patients with BD [48%] had either deep vein thrombosis [8 patients], arterial thromboembolic phenomena [4 patients], or both [2 patients]. The IgA aCL elevated in14 [56%] patients with BD compared with one [4%] patient in the control group [P<0.01]. IgG aCL levels were elevated in 13 [52%] patients with Behcet's disease [BD] compared with one [4%] patient in the control group [P<0.01].Also patients with BD do not have decreased protein S, or antithrombin III activity, activated protein C resistance, circulating lupus anticoagulant [LAC], or elevated LgM aCL. No significant differences were found between any variable in both groups. No association between elevated IgMaCL levels and venous or arterial thrombosis and no statistical correlation was found between any factor and clinical manifestations of the disease. A significant number of patients have elevated levels of IgA and IgG aCL but they are not associated with venous or arterial thrombosis. These results do not suggest a primary role for aCL in BD and do not support the role of coagulation abnormalities in the pathogenesis of thromboembolic complications of Behcet's disease but suggest vascular inflammation as the main pathogenetic event in the vascular lesions in Behcet's disease

Maternal plasma leptin concentration in pre eclampsia and its correlation with fetal cord concentration

Leptin is a 16KD a polypeptide hormone originally assumed to be produced only by adipose cells. It has an important role in reproduction. During pregnancy, maternal serum leptin concentrations are greater than those non pregnant women. Pre eclampsia is a serious complication diagnosed by hypertension, proteinuria and edema, Pre eclampsia is associated with dramatically enhanced plasma leptin, In this study that was carried out in Al Azhar University Maternal Hospital on 40 pregnant women that were classified into 2 groups: Pre eclampsia and Normal control pregnant women. The 2 groups are matched to each other with respect to gestational age of the fetus at sampling, and BMI. The study showed that there was no significance difference between 2 groups with respect to either BMI or gestational age but with great significant statistical difference in birth weight between the infants of women with pre eclampsia [2718,75 +/- 117.74 gms] and those of normal pregnant women [3376.0 +/- 130,72 gms]. There were significance statistical difference of maternal plasma leptin-between 2 groups before delivery [44.99 +/- 10.0 ng/ml in pre eclamptic group and 34,9 +/- 9.34 ng/ml in normal pregnant group]. The leptin concentration was [5.5 +/- 1.7 ng/ml] [NV 2.5 - 8.5] in cord blood infants of the women with pre eclampsia but its concentration was 6.6 4/- 2.04 ng/ml] [NV 3.2 - 9.5 ng/ml] for normal pregnant women. There was strong positive correlation between maternal leptin and cord leptin concentration for women with pre eclampsia but not for normal pregnant women, in conclusion, the study has shown that, independent of the maternal BMI, the maternal leptin concentration increases in pre eclampsia and positively correlates with the cord blood leptin concentration

sE-selectin, glycated haemoglobin [HbA[1c]] and Microalbuminuria as markers for diabetic retinopathy

Diabetes mellitus [DM] is a group of metabolic diseases characterized by hyperglycaemia, defects in insulin secretion or both. Diabetic retinopathy [DR] is a one of the late complications of DM. Adhesion molecules [including sE-selectin] may have a role in the pathogenesis of diabetic retinopathy [DR] E-selectin are extracellular matrix proteins that attract leucocytes from the circulation, expressed on the cell surface and are shed into the plasma. Thus, sE-selectin plasma concentration may representative for endothelial activation, damage and turnover. Thus, the aim of this study was to evaluate the concentration of sE-seleclin in typel DM patients with or without retinopathy and to evaluate the relationship between sE-selectin and Glycated haemoglobin [HbA1c] and microalbuminuria and also, with correlation to duration and control of DM. Study was performed on 80 individuals divided into 4 groups: G1; 20 healthy control, G2; 20 patients with [IDDM]. With no DR: G3; 20 patients [IDDM] with NPDR and G4; 20 Patients [IDDM] with PDR. The study results showed the following findings: increased FBS, Glycated haemoglobin [HbA1c], microalbuminuria in diabetic patients [more in NPDR, PDR] than those control group and those without DR sE-selectin were raised in diabetic patients than control group. Also, sE-selectin were raised in diabetic patients with DR compared to those without DR Also, sE-selectin appeared to be related HbA1c levels

Plasma homocysteine in relation to myocardial infarction and cerebrovascular stroke

This study included an acute myocardial infarction group [AMI] including 30 patients with age [mean +/- SD of 47 +/- 6.31 years]; cerebrovascular stroke group [CVS] including 30 patients with age [mean +/- SD of 47.5 +/- 7.3 years] as well as a control group including 30 apparently healthy subjects with age [mean +/- SD of 48.23 +/- 9.1 years]. None of them had diabetes, renal, hepatic disease or hypertension. The sera from all subjects were assayed for fasting blood sugar, serum creatinine, triglycerides, total cholesterol, high density lipoprotein cholesterol and the plasma samples were used to measure homocysteine [Hcy]. Low density lipoprotein was obtained by calculation using Friedwald formula. The results of this study suggested that the prevalence of hyperhomocysteinemia in the Egyptian patients with AMI and CVS is similar to and possibly slightly higher than that recorded in western studies. Also, this may add a further evidence to the hypothesis that plasma homocysteine is an important independent risk factor for atherosclerotic vascular diseases