Study of B2-microglobulin in patients with ascites

Beta [2] microglobulin was measured in sera and ascitic fluid of 24 patients with malignant ascites, 24 patients with ascites secondary to bilharzial liver fibrosis, 18 patients with Tuberculous ascites and in sera of 24 healthy volunteer controls by enryme linked immuroassay. Serum beta [2]-microglobulin level were significantly higher in all patients with ascites than controls [1.545 +/- 0.245 mg/L]. Among the ascitic groups, the bilharzial group had the highest serum beta [2] - microglobulin [8.058 +/- 1.135mg/L] followed by the malignant group [6.461 +/- 1.007mg/L] and lastly the Tuberculous group [3.881 +/- 0.223mg/L]. In the ascitic fluid beta [2]-microglobulin was significantly higher in the tuberculous group [7.817 +/- 1.947mg/L] than the bilharzial group [5.145 +/- 0.374 mg/L] and the latter was in turn significantly higher than the malignant group [2.564 +/- 0.398mg/L]. A significant positive correlation between serum and ascitic fluid beta [2]-microglobulin levels was found only in the bilharzial group. Ascitic/serum ratio of beta [2]-microglobulin levels was >1 in Tuberculous group [2.04 +/- 0.56] and < 1 in the bilharzial and malignant groups [0.67 +/- 0.83 and 0.42 +/- 0.10 respectively]. It is concluded that estimation of either serum or ascetic fluid beta [2]-microglobulin alone is not conclusive in diagnosis of the cause of ascites. However the finding of striking rise of ascitic beta [2]-microglobulin level in conjunction with an ascetic serum ratio > 1 is highly suggestive of tuberculosis as a cause of ascites

Effect of metoclopramide on the rectosigmoid activity in some systemic diseases

The pattern of the recto-sigmoidt myoelectrical activity [MEA] before and after I.V. injection of metoclopramide [0.15 mg/kg] was investigated in normal subjects, in patients with diabetes mellitus [DM], chronic renal failure [CRF], systemic lupus erythematosus [SLE] and scleroderma. In addition, the effect of the drug on patients with autonomic neuropathy [AN] due to DM and CRF was also studied. Furthermore, serum gastrin and plasma vasoactive intestinal polypeptide [VIP] were also estimated in all groups. The present study demonstrated that the pattern of rectosigmoid MEA in DM [Type I and II] and CRF under conservative treatment was not significantly different from that of the normal subjects. One the other hand, in patients with CRF under peritoneal dialysis and in patients with SLE there was a special pattern of MEA characterized by slow waves [SW] composed only of high frequency rhythm [HFR] and could be differentiated from each other by the significantly higher amplitude of the SW in CRF. Conversely, the pattern of MEA in patients with scleroderma was composed only of SW of LER [low frequency rhyhm]. The serum gastrin level was significantly increased in both types of DM and CRF patients while the plasma VIP was significantly increased in type 1 DM, CRF and scleroderma. Metoclopramide has uniform effect in various groups despite the presence or absence of AN. This effect is manifested by significant increase of the LER on the expense of the HER, significant increase in the amplitude of the SW. In patients with SLE and scleroderma, metoclopramide decreased the number of spikes minute. It is concluded that systemic disease can produce a constant and reproducible pattern of rectosigmoid MEA. Metoclopramide produces uniform changes in this MEA regardless of the presence or absence of AN denoting effectiveness of its use in such cases

Effect of lactulose and neomycin on plasma level of prostaglandin E in patients with portasystemic encephalopathy

This work aimed at the study of the relation of plasma prostaglandin E [PGE] to the development of chronic portosystemic encephalopathy [PSE] in patients with chronic liver disease and its response to treatment with either lactulose or neomycin. The study included 30 patients with chronic liver disease and PSE and 10 healthy controls. PGE plasma levels were assayed using radioimmunoassay [RIA] at the beginning of the study and 14 days after treatment with either lactulose [15 patients] or neomycin [15 patients]. PGE mean levels were higher in patients with chronic liver disease and PSE in comparison to controls [11.61 +/- 5.2 versus 1.88 +/- 1.16 ng/ml respectively, P < 0.05]. The overall result of treatment with either lactulose or neomycin was a reduction from 11.61 +/- 5.2 to 9.85 +/- 4.42 ng/ml. [P < 0.05]. Ascitic patients had higher PGE levels than non ascitic patients before [14.05 +/- 3.74 vs 8.42 +/- 4.78 respectively] and after treatment [10.99 +/- 3.74 vs 8.92 +/- 4.92]. Neomycin resulted in a decrease in PGE levels only in the ascitic group from 16.2 +/- 3.77 to 11.9 +/- 4.69 ng/ml. [P < 0.05] while lactulose did not significantly alter the PGE level in ascitic or non ascitic patients. It is concluded that PGE levels are increased in patients with PSE and that their level increases more with the degree of hepatic decompensation. Neomycin significantly decreases PGE levels in ascitic patients while lactulose did not significantly influence PGE levels. PGE may not be used as a marker of PSE since all patients showed clinical improvement with either lactulose or neomycin

Evaluation of effect of education of diabetes control in Sharkia governorate

The effect of education on diabetes control and the development of late diabetic complications evaluated in 100 adult diabetics by answering a questionnaire that covers knowledge about various aspects of diabetes. Glycosylated hemoglobin [GHb] [a monitor of long-term control], fasting blood glucose [FBG] and postpr and ial blood glucose [PPBG] as a monitor of short-term control were estimated. Knowledge of the patient was expressed as knowledge score [K.S.]. The most important factor affecting compliance and acceptance of the patient to education programs is the level of his general education as indicated by significantly higher K.S. In diabetics with high educational level and with secondary school than who read and write only and illiterate diabetics. It is concluded that education must be an essential integral part of any diabetes mellitus control program to achieve good metabolic control and to minimize or at least postpone late diabetic. complications

value of fructosamine in monitoring diabetes control in NIDD with different stages of schistosomal liver disease

The value of fructosamine versus glycosylated hemoglobin HbA[1c] in monitoring diabetes control in diabetics with different stages of liver disease was investigated. The study included diabetics without liver disease [[Group I, n = 20], diabetics with compensated hepatosplenic schistosomiasis [HSS] [Group II, n = 20], diabetics with decompensated HSS [Group III, n 20]. Each group included patients who were controlled [n = 10] and others who were uncontrolled [n = 10] for at least 2 months before the stud. Group IV included 10 normal controls, 10 with compensated HSS and 10 with decompensated HSS without diabetes. Both HbA[1c] and fructosamine were determined by quantitative colorimetry. In diabetics without liver disease both fructosamine and HbA[1c] correlated significantly with plasma glucose was well as with each other and so fructosamine which is cheaper can be used alone for monitoring diabetes control in such cases. In the absence of diabetes fructosamine decreased in parallel with the progress of liver disease while HbA[1c] did not change. This illustrates the influence of decreasing albumin in fructosamine levels. Fructosamine was not correlated to HbA[1c] but was correlated to albumin. In diabetics with liver disease, fructosamine and HbA[1c] levels followed the same pattern as in patients without diabetes indicating that fructosamine levels are related more to albumin than the glucose levels. It can be concluded that fructosamine can be used safely for monitoring diabetes control in the absence of liver disease, while HbA[1c] is preferred with liver disease

Humoral response to schistosomiasis in diabetes: its implications on serodiagnosis

The antibody response to schistosomiasis was assessed, using the E.L.I.S.A. technique, in diabetics with active schistosomiasis [positive stools and/or rectal snip for schistosomiasis]. n=20; diabetics with past schistosomiasis [n=15]; non diabetics with active schistosomiasis [n=15]; non diabetics with past schistosomiasis [n=10] and normal controls [n=25]. The antibody response against both soluble egg antigen [SEA] and soluble worm antigen preparation [SWAP] was lower in diabetics with active schistosomiasis and past schistosomiasis compared to the non diabetic groups [P<0.01] regarding both SEA and SWAP. The antibody response was not influenced by the level of plasma glucose, age or type of diabetes but was negatively correlated to the duration of diabetes [r=-0.53; P<0.01 for SEA and r=-046; P<0.01 for SWAP]. The antibody responses to SEA and SWAP were positively correlated in diabetics with active [r=0.64; P<0.01] and past [r=0.79; P<0.01] schistosomiasis. The sensitivity of serodiagnosis of schistosomiasis was higher in non diabetics 93% for SEA and SWAP compared to 70% and 40% [P<0.05 and 0.01] respectively. The specificity was comparable in diabetics and nondiabetics for SEA but was lower for SWAP in diabetics [65.2% v.s. 100% P<0.01]. It is to be concluded that the antibody response to schistosomiasis is decreased in diabetics leading to decreased reliability of serodiagnosis

Captopril versus nifedipine as monotherapeutic modalities in systemic hypertension

In a trial to compare the hypotensive efficacy of captopril [25 mg orally bid for one month] vs nifedipine [10 mg orally tid for one month] in hypertensive patients with and without chronic obstructive pulmonary disease [COPD], as well as the impact of either of these therapeutic modalities on ventilatory function, arterial blood gases [PO[2] and PCO[2]], blood pH, blood urea, serum creatinine, plasma Na and K, and fasting blood glucose [FBG], forty eight patients with mild to moderate essential hypertension [24 with COPD and 24 without] were included in the present work. Captopril insignificantly reduced systolic, diastolic, and mean arterial pressure [S.B.P., D.D.P and M.A.P.] in hypertensive patients without COPD. In those with COPD the latter two were poorly, yet significantly reduced. Nifedipine, however, significantly reduced the three parameters in hypertensive patients with and without COPD. Captopril significantly increased forced expiratory volume in the 1st second [FEV[1]], forced expiratory flow 25% [FEF[25%]], [FEF [50%] in patients without COPD, while FEF[25%] was the only significantly increased parameter in those with COPD. Blood pH, PO[2], and PCO[2] were insignificantly affected by captopril in both groups. On the other hand, nifedipine did not significantly affect either ventilatory function parameters or arterial blood gases in patients without COPD. In those with COPD, it only significantly increased FEV[1] and peak expiratory flow rate [PEFR], and decreased PO[2]. In both hypertensive groups captopril significantly increased plasma Na and K, while nifedipine did not. Blood urea and serum creatinine were not significantly affected by either drug among the studied groups. FBG was significantly elevated in both groups receiving nifedipine, while insignificantly affected in those receiving captopril. It can be concluded that in mild to moderate hypertension captopril [25 mg orally bid for one month] has no or poor effect as a hypotensive drug with at least no deleterious effects on ventilatory function, arterial blood gases, blood pH, blood urea, serum creatinine, and F.B.G., but increases plasma Na and K in patients with or without COPD. Nifedipine [10 mg orally tid for one month] is a potent hypotensive drug with a significant bronchodilating effect in patients with COPD but significantly decreases PO[2] and increases FBG with insignificant effects on blood urea, serum creatinine, and plasma Na or K