Role of soluble P-selectin among type 2 diabetic patients with and without coronary heart disease

Type 2 diabetes mellitus [T2DM] is associated with a marked increase in the risk of coronary heart disease. Platelets play a significant role in coronary artery disease [CAD]. P-selectin is a component of the platelet granule membrane that is expressed on the platelet surface membrane and shed into the plasma as sP-selection on platelet activation. The current study was performed to investigate the association of soluble P-selection with inflammatory marker high sensitivity C-reactive protein [hsCRP], lipid profile and glycemic control among type 2 diabetic patients with and without coronary heart disease. This study included 31 diabetic patients with coronary artery disease [group I], 29 healthy subjects as control group [group II], and 28 diabetic patients without coronary artery disease [group III]. The age and sex of diabetic groups were matched with normal control group. Glucose, HbAlc, lipid profile, hsCRP and sP-selectin were measured. The levels of glucose, HbAlc, total cholesterol, triacylglycerol. LDL-c, hsCRP and sP-selectin level were significantly higher in the diabetic group with coronary artery disease than in the control group and the diabetic group without coronary artery disease. The level of HDL-c was significantly lower in the diabetic group with coronary artery disease than in the control group and the diabetic group without coronary artery disease. There was a significant positive correlation between level of sP-selectin and duration of CAD diabetic patients with coronary artery disease. Also there was a significant positive correlation between sP-selectin and duration of diabetes mellitus in both diabetic groups with and without coronary artery disease. ROC curve analysis for hsCRP and sP-selectin indicated that, sP-selectin had higher sensitivity and specificity than hsCRP in diabetic patient with coronary artery disease. In conclusion, measurement of soluble P-selectin seems more helpful marker of impending coronary artery insult in diabetic patients and had higher diagnostic value than hsCRP in diabetic patient with coronary artery disease

Effects of L-carnitine on inducible nitric oxide synthase, insulin like growth factor-1 gene expression and insulin receptor substrate-1 in kidney tissues of insulin resistant rats induced by high fructose feeding

Metabolism of high dietary fructose induces insulin resistance and metabolic adaptation including changes in gene expression. The present study was designed to elucidate the effects of L-Carnitine [CA] on the renal alterations as well as gene expression such as inducible Nitric Oxide Synthase [iNOS]. Insulin-like Growth Factor-1 [IGF-1], insulin receptor substrate-1 [IRS-1] in kidney tissues of rats fed on high fructose diet. 24 male Wister rats of body weight 120-160 g were divided into 3 groups of 8 rats each. Group 1 received control diet, while group 2 and 3, rats received high fructose diet [60 g/100 g diet]. Group 3, after 2 weeks of fructose feeding animals were treated with CAR [300 mg/kg body weight/day i.p]. At the end of the experimental period [30 days], serum levels of glucose, insulin, Triacylglycerol [TG] and cholesterol were determined. Renal contents of cholesterol, triacylglycerol, Malondialdehyde [MDA] and nitric oxide products were determined. Gene expressions of iNOS, IGF-1 as well as IRS-1 were also assayed in kidney tissues of the experimental rats feed on high fructose diet. Rats fed on high fructose diet showed disturbance in insulin action and formed an animal model of insulin resistance. Fructose fed rats showed increase in renal gene expression of iNOS and decrease in both IGF-1 mRNA and IRS-1 receptor compared to control rats. The administration of CA to rat model of insulin resistance, mitigated the adverse effects of fructose load. Thus the observed abnormalities in gene expression associated with fructose feeding were brought to near-normal levels as compared with untreated rats. L-carnitine normalized the serum and renal lipid alterations as well as gene expression [iNOS, IGF-1] and IRS-1 in this nutritional experimental model

Biochemical alterations of amino acids, neurotransmitters and hepatic functions after thermal injury in rats

Thermal injury in human and animals models may be complicated by dysfunction to organs distant from the original burn wound. The physiopathological events following thermal injury are not limited to the surface effects of heat but are also related to an acute inflammatory reaction with increased muscle protein breakdown. The aim of the present study was to investigate the biochemical alterations of some amino acids, brain neurotransmitters and hepatic functions during postburn stage in scalded rats. Male Wistar rats inflicted by 30% total body surface area [TBSA] were employed as the model and were randomly divided into 5 groups; normal sham control, 1,3,5 and 7 days postburn groups, with 8 rats in each groups. Serum levels of IL-6 was estimated by ELISA method. Serum concentrations of amino acids were determined by amino acid analyzer. Levels of homocystein and glutathione were estimated by HPLC method. At the sametime, brain neurotransmitters, serum ALT, AST, ALP and gamma-GT levels were also assayed. There was a decreasing tendency in varying degrees in serum concentrations of most amino acids at each time points. Serum homocysteine level in all scalding groups were markedly lower than that in sham control group at all postburn time points. GSH concentration was significantly decreased at D5 and D7, however, the concentration of GSSG was increased at D1, D3 and D7 and GSH/GSSG ratio was decreased at D1, D3, D5 and D7 postburn when compared to the sham control. There was increasing tendency in brain concentration of norepinephrine and dopamine, while the level of brain serotonin showed a pronounced decrease after one day following burn injury and 3 and 5 days postburn its levels increased significantly when compared to sham group. At the seventh day following burn, serotonin level was found to be replenished back to that of the sham control group. The serum levels of ALT, AST, ALP and gamma-GT were increased obviously at all postbum time points. In conclusion, we found that, there were significant changes in serum contents of amino acids and brain neurotransmitters during postbum stage in scalded rats, which might be related to the early excessive release of inflammatory mediators, enhanced degradation of skeletal muscle and impairment of hepatic function

Some biochemical changes in postmenopausal women with and without metabolic syndrome

Women with the metabolic syndrome are known to be at especially high risk for cardiovascular disease [CVD]. The prevalence of metabolic syndrome increases dramatically with menopause and may partially explain the apparent increase CVD after menopause. This study was performed to investigate the relationships between metabolic syndrome [MS] related parameters and the cardiovascular risk factors in Saudi postmenopausal women. Subjects with MS had significantly higher plasma levels of glucose, uric acid, TC, LDL-c, triacylglycerol and atherogenic index, and lower levels of HDL-c and zinc compared to subjects without MS. Also, the subjects with MS had significantly higher levels of plasma ALT, AST, transferrin, TIBC and ferritin in comparison to those without MS. Postmenopausal women with MS had significantly higher levels of plasma iron compared with control group and premenopausal women with MS. Plasma ALT was positively correlated with ferritin level, waist circumference, body mass index, iron, and AST in postmenopausal women with MS. On other hand, ferritin level was associated with the variables of metabolic syndrome [positive correlation with systolic blood pressure, triacylglycerol, LDL-c], and also was positively correlated with iron, and ALT. In conclusion, there is an association between postmenopausal status, MS and cardiovascular risk. Furthermore, levels of plasma ferritin are correlated with the levels of LDL-c, ALT and AST as well as with the components of metabolic syndrome in Saudi postmenopausal women. Because of the severe implications of cardiovascular diseases, counseling programs directed towards high-risk populations should be endorsed

Study of various epidemiological and metabolic criteria in diabetic children and adolescence attending pediatric outpatient clinic of NIDE

Type 1 diabetes mellitus is one of the greatest challenges in public health and one of the most frequent chronic diseases in the pediatric age. The aim of this study was to study the epidemiological and metabolic criteria of 398 diabetic children who attended the outpatient pediatric clinic with determination of beta cell function of theses patients. Study of the age of onset of diabetes, sex distribution, residency, with other epidemiological factors among diabetic patients, attended the outpatient clinic of NIDE during year 2008, who accepted to participate in this study. All patients were subjected to full history taking, thorough clinical examination and full laboratory investigations including: CBC, liver enzymes, s. creatinine, lipid profile, including total cholesterol LDL-cholesterol, HDL-cholesterol and triglycerides, fasting c-peptide, Glycated HbA1c, and estimation of microalbuminuria. There was positive correlations between: Age [mean = 10.34 +/- 12.7 y.] and BMI [mean = 27.79 +/- 8.66 kg/m2], systolic B.P. [105.23 + 6.86 mmHg.] and total cholesterol [mean = 175.74 +/- 38.09 mg/dl] and systolic B.P. and triglycerides [mean = 83.88 +/- 47.46 mg/dl], and a highly positive correlations as regarding age [mean = 10.34 +/- 12.7 y.] and glycated HbA1c [mean = 9.79 +/- 2.38%]. There were no significant difference between diabetic group with c-peptide < 1 ng/ml and group with preserved beta cell function with c-peptide> 1 ng/ml as regards: Glycated HbA1c, s. cholesterol, s. cholesterol LDL, microalbuminuria, BMI and age. While there was a positive statistical difference between both groups as regards s. triglycerides [mean=75.27+31.17mg/ dl and 102.27+49.6 mg/dl]. There was no significant difference as regarding sex distribution as the female percentage was 51% while male represented 49%. The family history of diabetes was positive in 6.7% as regards father, 5.2% as regards mother, 4% as regards siblings. The study of beta cell function was done through estimation of fasting c-peptide levels. 93.7% were with fasting c-peptide level < 1 ng/ml, while 6.3% were preserved beta cell function as fasting c-peptide levels were > 1 ng/ml. Only 34.8% of the patients were doing continues home blood glucose monitoring with glucose sensors, 25.8% were doing the monitoring only with visual strips, while 39.4% of the diabetic children did not doing any home blood glucose monitoring. The glycated HbA1c was <7% in 31%, 7-8% in 22%, > 8-9% in 14% and >9% in 33%. The study of BMI of the patients showed that 56% were not overweight, [BMI <25], 27% started to be overweight, [BMI 25-30], 14% were obese, [BMI 30-<40] while 3% only were with severe obesity [BMI >40]. According to the definition of metabolic syndrome criteria, the study of the metabolic criteria of the study group showed that 112, [28.1%] patients were with positive one metabolic criteria, 56 patients, [14%] with 2 positive metabolic criteria and 36 patients, [9%] with 3 positive metabolic criteria. So, in addition to the presence of hyperglycemia, 23% of the young diabetic patients fulfilled the criteria of metabolic syndrome

Antioxidants and lipid peroxidation status in patients with rheumatoid arthritis

This study was designed to investigate whether increased ROS production may affect antioxidant enzymes in erythrocyte, major components of antioxidant defense system, and antioxidant vitamins in plasma as well as malondialdehyde [MDA] as an index of lipid peroxidation resulting from oxidative damage, in plasma and erythrocyte. Patients and The study included 20 patients of rheumatoid arthritis [RA] and 20 age-and sex- matched normal individuals constituted the control group. Blood samples of controls and patients were collected at the time of presentation and analyzed for ESR,CRP, RF and antioxidant enzymes [SOD, GSH-Px and catalase] as well as MDA, also antioxidant vitamins A, beta -carotene, C and E. Patients with RA have high levels of ESR, CRP, erythrocyte SOD, plasma MDA and erythrocyte MDA and lower level of erythrocyte GSH-Px and catalase activities. There was a statistically significant decrease in the concentrations of antioxidant vitamins. The erythrocyte MDA was positively correlated with erythrocyte SOD, plasma CRP, and ESR, also a significant positive correlations were observed between erythrocyte SOD and both of CRP and ESR, whereas, there were a significant inverse correlations between plasma vitamin A and ESR, plasma vitamin C and CRP and plasma vitamin E and CRP. The present study suggested that the increased production of ROS in RA, as reflected by higher plasma and erythrocyte MDA levels, may impair erythrocyte membrane integrity and also may lead to the alterations in erythrocyte antioxidant defense system, as reflected by higher SOD and lower GSH-Px and catalase activities in erythrocytes. These results are consistent with the underlying hypothesis that there is an imbalance between ROS production and the antioxidant defense system in rheumatoid arthritis disease. Rheumatologists treating this disease may consider incorporating antioxidant therapeutics in their prescriptions to support the antioxidant defense mechanisms of these patients

Beta thalassemia trait carrier state diagnosis by allele specific oligonucleotid hybridization Polymerase chain reaction based method

The goal of thalassemia trait [Carrier states] screening is the identification, prior to conception or birth of an affected child of couples where both partners are the thalassemic carriers. The target is the risk family to detect the carrier member to be genetic counseling. The measurement of HbA2 level is affected by many factors, mainly Iron deficiency anemia and coinheritance of alpha thalassemia. So, the genetic study is the only way to confirm that by detection of gene mutation. In this study, we investigated the risk families that have a thalassemic patient retrospectively to determine the carrier states in these families. This study was conducted upon 10 families, which have a thalassemic case. The gene mutation detected by Allele Specific Oligonucleotid [ASO] Hybridization of DNA amplified by Polymerase Chain Reaction [PCR]. We were selected eight probes, which are most common among Mediterranean population. Five of them appeared to be prevalent in Egypt [IVS 1 - 110 [G - A], Codon 39 [C - T], IVS 1- 6 [T - C], IVS 1- 1 [G - A] and IVS 2 - 745 [C - G]]. Our results revealed that the conventional methods of carrier detection [MC V and HbA2] are not reliable. We noted that HbA2 is normal in four subjects [17.39%], whom diagnosed by genetic study as a carrier. Also we noted that MCV was low in 2 subjects of the normal group as diagnosed later by genetic study. Recommendation, We recommended that a program of carrier detection by genetic study at least among the families at risk and premarital genetic counseling is the corner stone in prevention and control of thalassemia disease

Ct of non lymphomatous metastatic neoplasms of the kidney

Due to the widespread use of CT for tumor staging and diagnostic work up, the discovery of metastatic neoplasms to the kidney has become a more frequent occurrence. Fifteen patients with non lymphomatous metastatic carcinoma to the kidney were studied by CT including eight by sonography. Carcinoma of the lung was the primary tumor in six patients. Bilateral renal involvement was seen in three cases. CT features of these cases with the differential diagnosis were included. This study indicated that CT is useful for distinguishing these clinically important tumors, thus unnecessary biopsies may be avoided

Evaluation of the cardiac functions in Kwashiorkor before and after treatment

The present study revealed that 83.3% of KWO patients showed small cardiac shadow and 16.7% showed cardiomegaly due to pericardial effusion as reported by echocardiography. ECG showed tachycardia, low voltage of QRS complex as well as T wave were found in all KWO patients. After recovery there was significant improvement of ECG changes. Echocardiographic results before treatment revealed that, left ventricular internal dimensions in KWO were significantly smaller when compared with control group. Also, the end-diastolic and the end- systolic posterior wall and septal thickness were significantly diminished in KWO cases. The left ventricular mass was significantly smaller and the heart rate showed significant increase in KWO were significantly smaller when compared with control group. Also, the end- diastolic and the end-systolic posterior wall and septal thickness were significantly diminished in KWO cases. The left ventricular mass was significantly smaller and the heart rate showed significant increase in KWO cases. Left atrial, aortic root, and right ventricular dimensions were significantly smaller in KWO cases. As regards the echocardiographic findings of 14 KWO cases, after treatment and recovery, evidences of improvement of cardiac function and left ventricular performances were detected in these cases. It was revealed that there were significant improvement and increase in left ventricular dimensions and left ventricular mass. The stroke volume and the cardiac output increased significantly. The ejection fraction, the circumferential shortening of the left ventricle [fraction] and the fractional shortening [%] were significantly higher after recovery compared with the results before treatment. The end-diastolic, the end-systolic and the percent of systolic septal thickness showed significant increase. The left atrial, aortic root and right ventricular dimensions showed significant increase after treatment. It was observed that pericardial effusion resolved with recovery of KWO itself

Pharmacological closure of ductus arteriosus in very low birth weight in prevention of respiratory distress syndrome

P.D.A. is a major problem among premature infants. In the present work a trial to determine whether early pharmacological treatment with indomethacin would alter morbidity and decreases incidence of R.D.S. in premature infants with asymptomatic P.D.A. Among 40 premature infants weighing < 1750 gm. who had sub-clinical P.D.A., 20 infants had received two doses of endomethacin in the first 24 hours of life, the initial dose was 0.2 mg/kg body weight and the second dose was 0.1 mg/kg. Each infant was subjected to clinical examination including weight, gestational age, respiratory rate, heart rate, evaluation of murmur, Echocardiography, doppler and chest X-ray film. Detection of R.D.S. depended on clinical observation, respiratory rate and laboratory tests of blood gases analysis. Among the 20 infants who had received indomethacin, 6 infants developed R.D.S., four of them died and 14 infants did not develop R.D.S. [5 infants died from pneumonia and heart failure]. Among the 20 infants who did not receive indomethacin, 9 infants developed R.D.S. [6 infants of them died] and 11 infants did not develop R.D.S. [7 infants died from heart failure and aspiration pneumonia]. Several principles have emerged from this work: - Permanent closure of P.DA. is more better in premature infants within the first 10 hours of life by indomethacin. - Extremely immature infants are less likely to respond to indomethacin treatment. - Indomethacin treatment with total dose of 0.3 mg/kg/day is safe. - Indomethacin treatment is effective in prevention and decreased mortality in premature infants but further researches are needed

study of meningitis in children in Sharkia

The present study comprised 50 patients admitted to Zagazig Fevers Hospital in Sharkia Governorate, suggested to have meningitis. Their ages ranged from below 1 year up to 15 years. Males [64%] outnumbered females [36%]. Neck rigidity was found in 78% of cases, Brudzinski's sign in 48% and Kernig's sign in 30%. In this series, Neisseria meningitidis was isolated from 38% of cases, Haemophilus influenzae [18%], pneumococci [16%], Staphylococcus aureus [2%], and the remaining 16% were of negative culture. It is noticed that pneumococcal meningitis had a higher mortality than either meningococcal meningitis or Haemophilus influenzae meningitis. The highest mortality rate was found in cases with disturbed consciousness

Study on protein energy malnutrition in Zagazig University Hospital

The nutritional unit of Paediatric Department include 16 inpatient beds, small diet kitchen and a washing facility which is limited. The unit has its own medical nursing and dietetic staff. Many children with different degrees of PEM used to come to nutrition unit of Zagazig university Hospital, during inclusive period from May to August 1989, 124 cases of PEM were admitted. A full history, careful examination, assessment of nutritional status and classification of severity of malnutrition were done. Also every case was subjected to many investigation and a regime of treatment was applied.64.5% of our cases were males and their mean age was 12.7 months. According to wellcom's classification, 75.8% were underweight 13.7% were Kwashiorkor and 15.5% as marasmic Kwashiorkor, our study showed that 66.9% of cases improved, 19.4% escaped and 13.7% of cases died. In improved cases the mean period of hospitalization was 15 days. The mean weight gain per day during hospitalizalion was 50 grams in marasmus, versus a weight loss of 21.5 grams in Kwashiokor. Prognosis was more better in underweight and marasmus than Kwashiorkor and marasmic Kwashiorkor, also more better among breast fed and mixed fed infants than artificially fed and weaned cases. Mortality was reported to be due dehydration and pneumonia

Prevalence of poliomyelitis in North Sinai

Poliomyelitis is receiving an increasing attention in the developing counteries as a more serious and a widespread public health problem. In June 1981, a World Health Organization consultant reviewed the epidemiology of poliomyelitis in Egypt to develop recommendations for facilitating poliomyelitis control. Epidemiological data revealed the ex istence of a marked inverse correlation of paralyic poliomyelitis attack rates with socio-economic status. and unusually young age distribution of paralylic cases [16-25%] were under 9 months of age and a clear seasonality in which 53- 69% of acute cases each year occured June through October. recent collected data in three villages in Assiut govenverate showed that one dose of a quadriple inactivated vaccine [D P T-Polio - was more immunogenic than one dose of TOPV and that recipient of three doses of both vaccines provided better seroconversion rates than did three doses of TOPV alone. [Schonberger, 1985]. In a number of well vaccinated counteries no poliomyelitis cases, or only a few cases, have been reported for several years [Fields et al., 1985]. Also, a virtual eradication of wild polio-virus has been reported in some Europian and American counteries. The aim of this work is to examine the epidimiology of paralytic poliomyelitis in North Sinai governorate compairing that with the epidemiology of poliomyelitis in some other Egyptian governorates and other counteries abroad

Precipitating pathology in childhood intussusception: a report of 19 cases from Kuwait and review of the literature

From January 1997 to December 1986, 244 episodes of intussusception in 233 patients were treated in Ibn Sina Hospital, Kuwait. Nineteen patients [7.9%] had a definite pathologic lesion [a " leading point"]. Nine of these 19 patients [47.3%] were over 2 years old as compared to only 16 of 244 [6.6%] in the whole series. No particular leading point occurred more frequently than any other. Fifteen of these leading point were in the small gut and only four in the large gut. Preoperative therapeutic barium enema was attempted and failed in six cases. All 19 patients were operated on. There were 11 ileocolic, four ileoileal, and four colocolic intussusceptions. The postoperative complications were high, and likewise the length of hospitalization. No recurrent intussusception had a leading point