Hepatocytic hemostatic dysfunction in hepatitis-B and hepatitis-C cariers [blood donors]

The liver being the main site of formation of the coagulation factors, as well as the main site for clearance of activated coagulation factors and plasminogen activators, is expected to influence the hemostatic mechanism even in apparently normal individuals, who have minimal liver derangement. In this study 2502 apparently normal blood donors were screened for hepatitis-B and hepatitis- C markers as well as other body system check-up. Only 100 hepatitis patients were found suitable for the study, having free body systems, and are symptomless. They were compared with an equal age, sex, and environment matched group of individuals [n=20]. Factors 11, V, VII, IX and X were assayed in all cases. Twenty one HBsAg positive blood donors and 79 anti-HCV positive blood donors showed statistically significant reduction in the level of all the above coagulation factors when compared to control group. Alanine transferase [ALT] and aspartate transferase [AST] did not show any statistical variation in both groups in relation to the control subjects. Factors II and VII activity assay proved to be the most sensitive indicators for the subtil liver derangement as liver enzymes, ALT and AST levels were within normal values in all the above studied cases

role of sialic acid in the development of anemia in chronic renal failure

Shortened life span of erythrocytes has been suggested as one of the causes of anemia in chronic renal failure. Decreased sialic acid content of erythrocytes lead to their rapid removal from the circulation. Abnormalities in metabolism of this substance with increased neuraminidase activity in sera of these patients may be responsible for this phenomenon. To clarify this hypothesis, sera of 50 patients with end stage renal failure were examined before and after dialysis for neuraminidase activity by assessing their effect on desialylation of erythrocytes of healthy subjects, matched for blood group and of fetuin [substrate rich in sialic acid] together with determination of total and lipid bound sialic acid content of their RBCs. The results were compared with corresponding values of 20 controls. The study showed a significantly enhanced neuraminidase like activity in sera of patients with chronic renal failure in comparison with sera of healthy controls [P<0.001] associated with significant decrease of total and lipid bound sialic acid of RBCs. The present data are indicating that increased neuraminidase activity in sera of patients with chronic renal failure could be a contributing factor involved in the mechanism of producing the marked anemia in uremic subjects by acting on erythrocytes, rendering them more liable to be cleared faster by the liver and spleen, shortening their life span, moreover, it could act on erythropoietin depriving it from its sialic acid content, shortening its life span therefore reevaluation of the therapeutic modalities of anemia in these patients whether blood transfusion or erythropoietin is needed

Some markers to elucidate the pathophysiology in early diabetic nephropathy

Diabetic nephropathy is one of the microvascular complications of diabetes mellitus, microalbuminuria is considered as an important predictor for the onset of diabetic nephropathy. The goal of this study is to search for other markers in the hope of enhancing the sensitivity and specificity of screening for this life threatening complication. In the present study, 82 diabetic patients [26 insulin dependent and 56 non insulin dependent] aged from 21-69 years, [57 males and 25 females], together with 18 apparently healthy control of matchable age and sex were subjected to estimation of serum levels of Interlukin-1B [IL-1B], N-acetyl-13-glucosaminidase [NAG], fructosamine, random blood glucose, urinary levels of NAG, B[2]-microglobulin [B[2]-MG] and creatinine. The study showed that all the parameters studied were significantly higher in diabetics compared to the control group and their levels were significantly higher in diabetics with longer duration of diabetes and serum IL-1B, NAG, urinary B[2]-MG/mg creatinine, and NAG/mg creatinine were significantly higher in non-insulin dependent compared to insulin dependent. No significant correlation could be observed between any of the parameters studied and random blood glucose or fructosamine. Serum IL-1B, urinary B[2]-MG and urinary and serum NAG may be considered a good markers in detecting early diabetic nephropathy