Risk factors for coronary artery disease among young Egyptian [under 35 years]

Despite impressive strides in diagnosis and management over the last three decades, coronary artery disease continues to be a major public health problem. We observed that the incidence of coronary artery disease is increasing among young patients [below 35 years of age]. To study the pattern of risk factors for CAD among young Egyptians. 50 patients under 35 years of age were included in the study. Another 50 healthy persons matched by age and sex were included in the study as a control group. Patients were selected from the CCU unit of the NHI. Full history taking, complete general and local examination of the heart was done, resting twelve leads ECG, clinical exercise testing, lipid profile, blood sugar, uric acid, liver and kidney function, echocardiography and thallium stress test was done to all patients. Also psychiatric assessment questionnaire was taken from them to determine the type of personality, exposure to stress and for determining the social, economic status and exposure to pollution. 50 patients under 35 years of age were included in the study, they were 40 males [80%] and 10 females [20%]. Their age ranged between 23 to 34 years with a mean of 29.67 +/- 4.86 years. 20 patients [40%] had ant. MI, 15 patients [30%] had inf. MI, 10 patients had extensive ant. MI and 5 patients had non-Q wave MI. The age of the controls ranged between 21 to 35 years with a mean of 28.5 +/- 5.45. 8 of them [16%] were diabetic, 12 [24%] were hypertensive, dyslipidemia was found in 24 [48%] of them, 14 [28%] were smokers and 14 [28%] had +ve family history for CAD. Type A personality was found in 37 patients [74%], 30 patients [60%] were exposed to psychosocial stress. 39 patients [78%] were living in polluted areas [near factories and in crowded areas]. Exposure to pollution, type of personality, and exposure to psychosocial stress was found to be the most prevalent risk factors for coronary artery disease among young Egyptians. So, attention should be paid to these risk factors especially pollution and extensive studies should be done to find out the role of pollution in CAD

study of glycosaminoglycans and some lysosomal enzymes in the serum and synovial fluid in osteoarthritis

The study was done on 25 patients with osteoarthritis as well as 25 healthy persons as a control group. Determination of serum beta-glucuronidase, beta-galactosidase and aryl sulfatase activities as well as serum concentration of glycosaminogylcans and glucuronic acid were done in both groups. The same parameters were determined in the synovial fluid of the patients only. There were significant increase of serum beta-glucuronidase activities, aryl sulfatase activities and glucuronic acid concentration in osteoarthritic patients as compared to control group. There was a significant decrease of serum glycosaminoglycan in osteoarthritic patients as compared to control group. But there was no significant change of beta-glactosidase activities

study of some hormones and minerals in cases of rheumatoid arthritis

The present study was carried out on 50 subjects classified as follows: 20 patients with adult rheumatoid arthritis, 10 patients with juvenile rheumatoid arthritis and 10 healthy subjects with matched age and sex as a control group for each of the previous two groups. The results of the present work revealed that both serum GH and cortisol levels showed insignificant difference in cases of RA and JRA as compared to their control groups; so, they have no role as a cause of growth retardation in children with JRA. Significant changes were detected regarding thyroid hormones in cases of RA. Low serum T[3] levels associated with high T[4], levels were observed in these patients as compared to their adult control group. It was suggested that low serum T[3]-levels may result from decreased neogenesis secondary to inhibition of iodothyronine 5 mono deiodinase by the excess liberation of free radicals. High serum T[4], levels might be due to increased glandular secretion or to increased thyroxine-binding globulin concentration that may result as a consequence of low androgen concentration in RA patients. No significant changes in serum T[3] and T[4], levels were detected in JRA patients. So, hypothyroidism can not be claimed as a cause of growth retardation in these patients. As regards nutritional parameters; insignificant changes in total proteins were detected in both RA and JRA groups in this study. However, protein deficiency can not be excluded as a cause of nutritional growth retardation since hypoalbumine-mia'was previously reported in rheumatoid disease. Significant low serum zinc concentration was found both in RA and JRA groups as compared to their control group. This deficiency may play a role in the etiology of growth retardation in cases of JRA. Significant high copper and ceruloplasmin concentrations in both RA and JRA groups as compared to their control group, role out the possibility of their engagement in the etiology of short stature in JRA We can conclude that the growth failure seen in children with JRA might be of nutritional origin and that nutritional deficiency can lead to the decreased somatomedin concentrations previously reported in JRA patients. However, it is recommended to assess in the future the exact thyroid function state by radioiodine uptake test. Also, to estimate TBG concentration in patients with rheumatoid disease Newly discovered cases were achieved to exclude the effect of any medication on T[3]- or T[4], levels

Adrenal function in depression

Urinary excretions [24 hours] of vanillyl-mandelic acid [VMA], epinephrine and norepinephrine and total catecholamines "ere found to be significantly elevated in depressed patients [10 patients with endogenous depression and 10 patients with reactive depression] as compared to healthy control subjects [10 persons]. Also, there were significant higher levels of serum cortisol and urinary free cortisol in both depressed groups as compared to control group

Study of some metalloenzymes and its related trace elements affecting lipid peroxidation in chronic renal failure

The level of lipid peroxidation is affected and enhanced in chronic renal failure [CRF]. This could be estimated by measurement of malonlydialdehyde [MDA]. This increase in lipid peroxidation could be either increase in free radicals or due to defective antioxidants, e.g. glutathione peroxidase [GSH-Px] and superoxide dismutase [SOD] and its related trace elements. This study was carried out to detect the lipid peroxidation level and the defect in the activity of antioxidants, if present, in chronic renal failure patients both on conservative medical treatment and those on maintenance hemodialysis. Of the present study were divided into 3 group: [I] CRF on maintenance hemodialysis, [II] CRF on conservative medical treatment, and [III] control group. Each group was of 10 patients. The study showed significant increase in serum copper in group I as compared to groups II and III, a significant decrease in serum zinc and selenium in groups I and II when compared to group III and a significant increase in serum zinc and selenium in group I when compared to group II. Erythrocyte MDA was found to be clinically higher in group II when compared to I and III and in group I when compared to III. Erythrocyte SOD was significantly decreased in groups I and II as compared to III. Erythrocyte glutathione peroxidase was normal in group I and II. These results confirm incomplete disturbance in the enzyme system incorporated in free radicals scavenger in CRF patients. It is concluded that dialysis is harmless to the dialyzed patients and imposes no oxidative stress on them

Study of carcinoembryonic antigen and protein-bound sialic acid in prostatic cancer and benign prostatic hyperplasia

In this study, taking prostatic acid phosphatase [PAP] as a reference, two tumor markers [serum carcinoembryonic antigen [CEA] and serum protein bound sialic acid [NANA]] were estimated to evaluate their role in diagnosis, staging as well as monitoring of the therapeutic response of prostatic cancer. The study was carried out on 19 prostatic cancer patients, 10 patients with benign prostatic hyperplasia and 10 healthy males as controls. All of them were subjected to the estimation of serum PAP, CEA and NANA before treatment and one month after treatment [orchiectomy for prostatic cancer patients and transurethral resection of prostate in cases with benign prostatic hyperplasia]. The results of the present study revealed that CEA NANA and PAP were significantly elevated in prostatic cancer patients as compared to both controls and patients with benign prostatic hyperplasia [BPH]. The three tumor markers gave sensitivities of 68.4%, 84.2% and 57.8%, respectively, for the diagnosis of prostatic cancer. This finding showed that serum NANA is the most sensitive of the three markers, an observation that needs further proof in view of the small number of cases studied. The three markers showed specificities of 80%, 80% and 90%, respectively, in diagnosis of prostatic, cancer. So, PAP is proved to be the most specific for prostatic cancer, serum CEA and NANA being only nonspecific markers. The present study revealed also that NANA was significantly increased with the progression of the stage of cancer, while CEA levels showed insignificant increase with the advancement of the cancer stage. This finding was explained by the fact that serum CEA is related to the grade of differentiation of the tumor cells [grading] more than with staging. Serum PAP was found to be increased significantly in the late stages only [stage C and D]. So, serum PAP is considered to be a marker for prostatic cancer with metastasis and that it has a minor importance on early stage [stage A and B]. Although serum PAP was the reference marker in this study, it only showed insignificant decrease in cancer patients following therapy, which may be explained by the small number of cases and the wide range of its levels in these cases. Serum values of CEA and NANA showed significant reduction after treatment in prostatic cancer patients. Serum PAP levels showed a significant positive correlation with serum NANA in prostatic cancer patients before and after treatment. From these previous results, it was concluded that the use of more than one marker cooperatively helps in monitoring the therapeutic response of patients with prostatic cancer

Changes in antigenicity after new administration of semisynthetic human insulin or shifts from conventional insulin

The present study was carried out on 44 insulin-dependent diabetic [IDD] patients divided into three groups: Group 1 comprised 15 uncontrolled IDD patients transferred from conventional insulin therapy to semisynthetic human insulin [SHI], group 2 comprised 14 IDD patients transferred from porcine monocomponent insulin therapy [PMCI] to SHI and group 3 comprised 15 recently diagnosed IDD patients who were given insulin for the first time in the form of SHI. All patients were followed up after one, three, six and twelve months. The daily insulin dose was not allowed to be increased during the study period, but was decreased whenever needed. Group 1 showed significant decrease in serum insulin antibodies throughout the study. There was also significant reduction in oral glucose tolerance sum, denoting better glycemic control, with a subsequent gradual decrease in insulin daily dose. As regards group 2, there was insignificant change in serum insulin antibody levels as well as glycemic levels throughout the study period. In group 3, there was a gradual increase in serum insulin antibody levels during the study period. This increase, although insignificant in the first month, was significant in the third and sixth months of the study, then became insignificant once more by the end of the 12th month. This suggested the presence of autoantibodies which are formed before the onset of SHI therapy and even before the onset of diabetes. This group showed also significant decrease in glucose tolerance sum [GTSo-2 h] values throughout the study. This was simply attributed to the administration of insulin. These results showed the SHI and highly purified porcine insulin do not differ in respect to immunogenicity as well as efficacy in controlling blood glucose concentration

Study of serum and cerebrospinal fluid level of major and trace elements in chronic renal failure patients associated with nervous system manifestations [part I]

Studies were done on 31 CRF patients, 10 undialysed and 21 patients undergoing haemodialysis including 11 patients with nervous manifestations and the other 10 patients without nervous manifestations. 10 normal subjects were included as a control group. The level of sodium, potassium, magnesium, calcium and phosphorus were estimated in serum and CSF by Atomic Absorption Spectophotometry. There was significant increase in serum and CSF levels of sodium, potassium, magnesium and phosphorus and significant decrease in serum and CSF calcium in CRF patients as compared to control group. The haemodialysed patients showed a significant elevation of serum and CSF potassium, magnesium and phosphorus and insignificant change in serum and CSF sodium and calcium as compared to control group. There was insignificant change of serum and CSF levels of the studied elements in dialysed CRF patients with nervous manifestations as compared to patients without CNS manifestations as compared to patients without CNS manifestations

Study of serum and cerebrospinal fluid level of major and trace elements in chronic renal failure patients associated with nervous system manifestations [part II]

Studies were done on 31 CRF patients, 10 undialysed and 21 patients undergoing haemodialysis including 11 patients with nervous manifestation and the other 10 patient without nervous manifestations, 10 normal subjects were included as a control group. The level of zinc, copper, iron, lead, manganese and aluminium were estimated in serum and CSF by Atomic Absorption Spectrophotometry. There was significant increase in serum and CSF level of lead and aluminium, and insignificant change in serum and CSF copper in CRF patients as compared to control group. The haemodialysed patients showed significant elevation of serum and CSF copper, lead and aluminium, and significant decrease of serum and CSF zinc, iron and manganese as compared to control group. The haemodialysed patients with nervous manifestations showed a significant elevation serum and CSF aluminium and insignificant change of serum and CSF levels of other elements as compared to the patients without nervous manifestations

Biochemical studies on the effect of some schistosomicidal drugs on the production of the bladder carcinogen xanthurenic acid

Male Swiss albino mice were studied to demonstrate the in vitro effect of two antimonial antibilharzial drugs [anthiomaline and Astiban] and two non-antimonial drugs [Vansil and Bilarcil] on the activity of vitamin B-dependent 3-hydroxy kynureninc aminotransferase enzyme. The effect of increasing pyridoxal phosphate concentration on the enzyme activity was also studied. The results revealed that both antimonial and non-antimoial drugs inhibited the B-dependent 3-hydroxy kynurenine aminotransferase in vitro. Increasing the concentration of pyridoxal phosphate could not completely overcome the inhibitory effect of these drugs. Moeover, there was no interaction between the used antibilharzial drugs and pyridoxal phosphate in vitro. Also, the direct interaction of the drugs with the enzyme is not likely. Therefore, the inhibitory efect o the studied anti-bilharzial drugs on the activity of B-dependent 3-hydroxy kynurenine aminotransferase enzyme could lead to the accumulation of the bladder carcinogenic compound 3-hydroxy kynurenine

Urinary catecholamines and serum free fatty acids in acute myocardial infarction

Twenty-one patients with acute myocardial infarction [AMI] were studied, 9 without complications, 7 with bradyarrhythmia, 5 with heart failure and 10 normal subjects as a control group. All were subjected to estimation of total catecholamines in urine, urinary adrenaline, noradrenaline and VMA, and serum free fatty acids [FFA]. Foods containing catecholamine-like compounds were excluded from diet. It was found that urinary VMA showed a significant increase with AMI whether complicated or not. A significant change in the level of adrenaline and noradrenalin in uncomplicated AMI, on the other hand, the increase in adrenaline, noradrenalin and catecholamines occurred in complicated AMI

Study of pericardial fluid in rheumatic heart patients

A study of the biochemical changes of the pericardial fluid of patients of rheumatic fever were done on patients and compared to some control normal subjects. All are subjected to the following estimations: C-reative proteins, latex antistreptolysin O titer, total proteins, lactic dehydrogenase activity, transamination and creative phosphates activities, immunoglobulins, glucose, sodium, potassium, copper, and zinc. Rheumatic cardiac lesions are characterized by their wide distribution in the endocardium and pericardium. Pericardial lesion is the most frequent and most characteristic lesion. Changes in the biochemistry of the effusion fluid were discussed

Study of some trace elements in serum and ascitic fluid in different stages of schistosomal liver disease

Copper, zinc and manganese were estimated in 20 patients of schistosomal hepatic fibrosis [SHF], 10 cases without ascitis and 10 cases with ascitis, and 5 healthy controls. Serum zinc was significantly lower in SHF, with ascitis than control group. Serum copper and manganese were significantly higher in SHF [with or without ascitis] than control group. Zinc concentration [but not copper or manganese] in ascitic fluid showed significant correlation to plasma protein concentration