Activated proten C. resistance in contraceptive pill users with deep vein thrombosis: relation to other risk factors and pill type

The relative risk and mechanism of thrombosis induced by different preparations of oral contraceptives is a mater of debate. The phenomenon of activated protein C [APC] resistance was recently described as a possible mechanism for thrombosis in hypercoagulable states. We investigated the prevalence of APC resistance, using an APC-[DVT] on oral contraceptive pills [group I]. Also included were 30 age matched women on oral contraceptives without evidence of DVT [group II] and 20 healthy control subjects of comparable age who never used oral contraceptives [group III]. Our results showed a significant increase in the percentage of APC-resistance positive cases among contraceptive Pill users with DVT [Group I] compared to pill users without DVT [group II] and the control [group III] [26.67% vs 6.67 and 5% respectively]. Among other risk factors positive family history [F.H.] of thrombosis and body mass index [BMI] were significantly higher in group I compared to groups II and III [30% vs 6.7% respectively for F.H. of thrombosis] and 39.21 +/- 6.09 vs 30.33 +/- 6.60 and 31.42 +/- 5.04 respectively for BMI]. APC-SR correlated negatively with BMI but did not correlate with age, serum cholesterol, serum triglycerides, duration of contraceptive use and platelet count. Users of second generation contraceptives had a higher incidence of DVT compared to users of third generation contraceptives with lower oestrogen concentration [56.41% vs 38.09% respectively] but APC-SR was not significantly different in the two groups [2.09 +/- 0.56 vs 2.70+/= 0.18 respectively]. We conclude that APC-resistance is more frequent in contraceptive pill users with thrombosis complications. Other risk factors include positive F.H. of thrombosis and higher BMI. The risk of thrombosis is higher among users of second generation cattraceptives. It is justified to screen women for APC resistance before prescribing oral contraceptives specially when obese or with positive family history of thrombosis

Polymerase chain reaction in the diagnosis of mycoplasma pneumonia: comparison with culture and serology resdults

Results of classic specific diagnostic tests for Mycoplama pneumonia [M. Pneumonia] are not promptly available to assist therapeutic decisions and new rapid diagnostic tests are becoming increasingly used. This study was designed to compare the different diagnostic tests for M. pneumania. Eighty-six 86 patients presenting with symptoms of respiratory infection and not responding to empiric treatment with B-lactam antibioties were included. Paired and single serum micro particle agglutination [MAG] assay, culture and direct polymerase chain reaction [PCR] for the diagnosis of M. pneumonia were used. Direct PCR was positive in 67 cases [77.9%] while serology gave positive results in 41 cases [47.7%] and only 33 cases [38.4%] gave positive culture results. Furthermore serology results were less sensitive in the older age groups [40 -<60 years and >/= 60 years] compared to the younger groups [< 20 years and 20- <40 years] with positive result in [26.7% and 21.4% vs 57.1% and 62.1%] respectively. Positive serology results were also less in the diabetic compared to the non-diabetic and the older age groups. The combination of direct PCR and serology may be important to differentiate clinical cases from carrier states

Interleukin-2 inducible cytotoxic activity of peripheral blood mononuclear cells from patients with type 2 diabetes mellitus

The ability of peripheral blood mononuclear cells [PBMNC] from 36 patients with type 2 diabetes and 26 healthy control subjects to acquire cytotoxic properties after in vitro incubation with interleukin-2 [IL-2] was examined. Cytotoxic activity of IL-2 activated PBMNC was measured by 51Cr-release assay from radiolabeled Burkitt lymphoma cells. The percentage of cytotoxicity of PBMNC from diabetic patients was not different from the control group when incubated with medium alone or with IL-2 at a concentration of 0.1 u/ml. Cytotoxic activity of IL-2 activated MNC was similar in all age groups in diabetic as well as controls. The kinetics of MNC activation by IL-2 were similar in the two groups with comparable degrees of activation in response to increasing concentrations of IL-2 and similar time course for activation reaching a maximum after 4-5 days of incubation and gradually decreased

Diabetes mellitus among a group of farmers in Sharkia Governorate: an epidemiological study

To study the magnitude, trends and determinant factors of diabetes mellitus [D.M] in a rural area, this study was carried out upon 500 farmers, selected randomly from a village in Sharkia Governorate during the year 1990. For detection of diabetic cases, an examination protocol was used which include: personal interview, medical examinations and determination of glucose in urine and capillary blood by using simple methods suitable for field screening. The main findings of this study were as follows: the prevalence of D.M. was 3.4% [4.14% males and 2.71% femals]. D.M. was more prevalent among age group > 30 years [765%] and among obese than non obese subjects [8.33% vs 1.23%]. 28.6% of diabetic persons reported a history of bilharzial infestation, while 14.3% had previous viral infection. In view of these results, mass screening for detection of missed diabetic cases in various sectors of population should be done in an out reach health programmes. Further studies should be devoted to investigate the role of bilharzial infestation and other infection in development of diabetes in susceptible subjects, and to study the impact of agricultural total environment upon D.M. as a multifactorial disease