Primary prevention of non insulin dependent diabetes mellitus

This work was conducted aiming at early prediction of individual at high risk of development of type 2 diabetes mellitus and evaluation of the efficacy of primary prevention of type 2 DM in such individual by diet control and /or metformin therapy. It was conducted on 100 individuals at high risk of development of type 2DM. Subjects were classified into 3 groups: Group I [Individuals with positive family history of DM], 30 cases, subdivided into two equal subgroups, Group la used as control and left without diet control and Group Ib were on diet control. Group II [individuals with upper body segment obesity], 40 cases, subdivided into 3 subgroups: Group II a, 10 cases, left without neither diet control nor metformin therapy, Group II b, 15 cases, were on diet control only while Group IIC, 15 cases, were on both diet control and metformin treatment. The third group [Group III] were females with history of gestational diabetes, 30 cases, subdivided into two equal subgroups, Group IIIa used as control and left without diet control, while Group IIIb were on diet control. All cases were subjected to through history taking, complete physical examination, liver function tests, renal function tests, fasting and two hours post-pr and ial plasma glucose estimation, glycosylated haemoglobin [Hb A[1]c] and complete lipid profile. Results showed that individuals with family history of DM had a significant decrease of both FPG and 2HPG together with highly significant decrease in Hb A[1]C after one year of diet control together with significant decrease in total cholesterol, TG and LDL-cholesterol with increase in HDL-cholesterol levels compared to those individuals on free diet reigmen. As regard those with upper body segment obesity, there were significant decreases in both FPG, 2HPG and highly significant decrease in Hb A[1]c in those on diet control and those on both diet control and metformin therapy together with decrease in BMI after one year of follow up compared to those obese with free diet reigmen. This study also showed that females with history of gestational diabetes are more prone to develop type 2DM if left without any diet control since there were significant decrease of both FPG, 2HPG and HbA[1]c levels after one year of follow up. The results of this study showed that diet control has a significant role in preventing or at least delaying the occurrence of type 2DM in those studied high risk groups. Similar effect was obtained by metformin therapy on subjects with upper body segment obesity in preventing the development of type 2DM. Nevertheless, this role need large scale research for long term follow up period to be cleared. The results of this study showed also that, diet control and /or metformin therapy have a significant effect on modification of the different parameters of lipid profile in those individuals which may subsequently have a beneficial effect on reducing or delaying the appearance of the diabetic vascular complications

Some neutrophilic functions in pediatric poststreptococcal glomerulonephritis

Poststreptococcal glomerulonephritis [PSGN] is the most common form of glomerulonephritis in children. Leucocytes play a role in mediating glomerular injury. Assessment of neutrophil functions [chemotaxis and phagocytic activity] was studied in 20 cases diagnosed as having PSGN [case group] and 10 age and sex matched healthy children [control group]. There was a statistically significant decrease in chemotaxis and phagocytosis of neutrophil leucocytes in index patients. There was a positive significant correlation between polymorphonuclear leucocyte functions - age and female sex. Meanwhile, there was nonsignificant correlation between antistreptolysin titer [ASOT] and chemotaxis [index and difference], while there was nonsignificant negative correlation between ASOT and phagocytosis [index and percentage]. There was a significant positive correlation between total leucocytic count and both chemotaxis and phagocytosis in case group. Also, there was a highly significant positive correlation between chemotaxis and phagocytosis of polymorphonuclear leucocyte functions in case group. This study revealed a defect in neutrophil functions as chemotaxis and phagocytosis in poststreptococcal glomerulonephritis, so this may play a significant role in increasing infection among such children

Can increased platelet turnover predict progressive hypertensive disease in pregnancy?

Platelet activation was assessed in third trimester patients with preeclampsia [n = 12] or chronic hypertensive superimposed with preeclampsia [n = 8] and in healthy pregnant women [n = 8] as control group, by measuring plasma B-thromboglobulin [BTG] in both plasma and urine by [RIA]. The plasma BTG levels differed significantly between patient with preeclampsia [50.1 +/- 10.83 ng/ml. P < 0.01] or chronic hypertension superimposed with preeclampsia [47.6 +/- 11.3 P < 0.01] and the control group [22.5 +/- 4.53 ng/m]. The urinary BTG level increased significantly in preeclamptic patients [33.02 +/- 5.25 ng/ml, P < 0.001] or in chronic hypertensive patients superimposed with preeclampsia [30.1 +/- 4.1 ng/ml, P < 0.001], when compared to control [8.7 +/- 2.48 ng/m]. Plasma BTG in patients with preeclampsia, but not chronic hypertension superimposed with preeclampsia, correlated directly with 24 hours urinary protein loss [r = 0.93, P < 0.01] and serum creatinine levels [r = 0.62, P < 0.05] and inversely with creatinine clearance [r 0.60, P < = 0.05]. This finding may reflect the renal] involvement in preeclamptic patients, the turnover of platelets may be increased which lead to increased BTG, levels in both plasma and urine and the more increase in BTG, level the more sever of kidney involvement

Effects of endogenous sex hormones on serum lipids, lipoproteins in women during reproductive age

Forty women of reproductive age were included in this study with aim of establishing the variation in serum lipids and lipoprotein are influenced by endogenous hormonal changes. Total cholesterol, triglycerides and phosholipids were determined in whole serum and in following lipoprotein fractions: very low density lipoproteins [VLDL] low density lipoproteins [LDL] and high density lipoproteins [HDL] obtained by ultracentrifugation. A significant decrease was found in total cholesterol [P < 0.01] and phospholipids [P < 0.01] during the late luteal phase. The LDL cholesterol decrease during the luteal phase and VLDL cholesterol decrease during the luteal phase and VLDL cholesterol increased in early and mild luteal phases. The LDL phospho-lipids and VLDL triglycerides also showed a significant decrease during the luteal phase [P < 0.01]