Could the MMR vaccine replace the measles vaccine at one year of age in Egypt?

This cross-sectional study evaluated the immune status of non-vaccinated healthy infants to determine if it is possible to replace both measles vaccine [at 9 months] and measles, mumps and rubella [MMR] vaccine [at 18 months] with a single dose of MMR at 12 months. Serum samples from 566 children in Alexandria, Egypt showed a significant decrease in the seropositive rate to the 3 viral diseases with increasing age, but a significant increase in the seropositive rate among infants who were ranked 1st or 2nd in their family, full-term or born to mothers with no history of hypertension during pregnancy. We recommend administration of the first dose of MMR vaccine between 9 and 12 months of age, and a booster dose of MMR vaccine at 4 years of age

Study of pro-hepcidin level and renal functions in nephrotic syndrome, chronic renal failure and hemodialysis patients

Anemia is associated with worse outcomes in patients with chronic kidney disease [CKD]. Hepcidin is a recently discovered protein produced mainly by the hepatocytes as a pre-prohormone, pre-prohepcidin. It is a key regulator of iron metabolism in different iron disorders. To study serum pro-hepcidin levels in nephrotic syndrome [NS], chronic renal failure [CRF], and hemodialysis [HD] patients. The study included 4 groups. Group I: 20 patients with NS, group II: 20 patients with CRF on conservative treatment, group III: 20 patients on regular HD, and group IV: 20 healthy subjects as a control group. All groups were age and sex matched, and subjected to physical examination, abdominal ultrasound, and laboratory investigations including: Complete blood cell count, serum iron, iron indices, serum pro-hepcidin, serum high sensitivity C-reactive protein [hs-CRP], renal functions, liver functions, and other necessary tests. CRF and HD patients had a statistically significant higher mean serum pro-hepcidin than NS patients and controls [P <0.001], with no statistically significant difference between the NS and control groups. All patient groups had a statistically significant higher serum hs-CRP, and a significantly lower hemoglobin concentration, serum iron, and transferrin saturation compared with controls [P<0.001]. The mean serum ferritin was statistically significantly increased in the HD group only [P <0.001]. Serum pro-hepcidin showed a statistically significant positive correlation with serum hs-CRP [a marker of inflammation], serum ferritin, blood urea and serum creatinine in all patient groups, with serum uric acid in NS and CRE patients, and with serum albumin only in NS patients. It showed a statistically significant inverse correlation with serum iron and transferrin saturation in all patient groups, with hemoglobin concentration and creatinine clearance in NS and CRF patients [HD patients were anuric], and with urinary albumin excretion only in NS patients probably due to increased pro-hepcidin loss with the proteinuria. In patients with CKD, the presence of a chronic inflammatory status offsets the inhibitory effect of anemia on pro-hepcidin production with a net increase in serum pro-hepcidin levels. This inflammation related dysregulation of pro-hepcidin might result in a functional iron deficiency, thus aggravating the anemia. Pro-hepcidin is unlikely to be beneficial in monitoring anemia of CKD. However, it could be a future therapeutic target in managing anemia in these patients

Insecticidal, acaricidal and synergistic effects of Socian, pancreatinum maritima extracts and constituents

In assessing the pesticidal activity of soosan, P. maritimum, the bulbs and leaves were extracted using acetone/ethanol and ethanol as solvents and mosquito larvae C. pipiens, as a test organism. The acetone/ethanol extract of bulbs was more toxic [LC50, 25 ppm] than that of the leaves [LC50, 75 ppm]. Crude alkaloids, lycorine, terpenes and sterols and fixed oil were isolated from soosan bulb. Their percentages were 0.193, 0.02, 0.13 and 3.3%, respectively. The acetone/ethanol extract showed a strong aphicidal activity to Aphis gossypii with LC50 of 0.028% followed by lycorine, soosan oil and crude alkaloids with LC50 values of 0.07, 0.28 and 0.3%, respectively. Also, the acetone/ethanol extract showed high toxicity to Spodoptera littoralis 4th instar larvae, with LD50 value of 2 mg/larva. In addition, the crude alkaloids ethanol extract and the oil of soosan bulbs showed acaricidal activity against the two spotted spider mite, Tetranychus urticae with LC50 values of 0.2, 0.36, and 1.5%, respectively. Synergism studies on the A. gosspii indicated that lycorine, the principal alkaloid of soosan bulbs, strongly synergized, the OP insecticide cyanophos and reducing its LC50 values from 120 to 48 ppm. On the other hand, the aqueous extract of soosan bulbs synergized the toxicity of Actellic and Permethrin in Tribolium castaneum which reduced their LC50 values from 80 to 46 ppm and from 1000 to 550 ppm, respectively. Also, ethanol and petroleum ether extracts synergized the toxicity of Reldan and Permethrin, respectively, in the same insect

Somatotrophic hormone in elderly diabetic and nondiabetic subjects

This study was designed to evaluate the basal and postprandial growth hormone levels in elderly diabetic and nondiabetic subjects in relation to their glycemic state. Ten elderly diabetic patients [group I], ten elderly nondiabetic subjects [group II] together with ten adult healthy volunteers [group III] as a control group were included in the study. The glycemic state was evaluated by estimation of fasting and postprandial blood glucose level for all cases as well as by estimation of glycosylated hemoglobin [HbA1c] for elderly diabetic and nondiabetic subjects. Basal and postprandial growth hormone [GH] levels were estimated for all subjects by radio- immunoassay method. The results showed significant increase in basal [GH] level in group I as compared to groups II and III. No correlation was observed between HbA1c and basal GH level in elderly diabetic patients. However, there was a significant positive correlation between postprandial blood glucose level and postprandial [GH] in elderly diabetic patients. It is suggested that increase in GH level in elderly diabetic patients is metabolic in origin rather than being an independent factor in the pathogenesis of diabetics

Serum testosterone and fasting serum C-peptide level in obese diabetic males and females

This study investigated the relationship between obesity, hyperinsulinemia and testosterone in obese diabetic patients. Ten obese non-insulin dependent diabetic [NIDDM] males [group A] and ten obese [NIDDM] females [group B], together with ten normally healthy male and female subjects served as controls [group C] were included in the study. Fasting serum C-peptide, total serum testosterone, sex hormone binding globulin [SHBG] were estimated by radioimmunoassay. Free androgen index [FAI] was also calculated. The results showed that body mass index [BMI] and fasting serum C- peptide were significantly higher in group A and B than in group C, in association with significant positive correlation between BMI and fasting serum C-peptic in group A and B as well as between fasting blood glucose and serum C-peptide in obese diabetic patients. Significant negative correlation was observed between BMI serum testosterone as well as between BMI and SHBG in obese diabetic patients. Moreover, a significant negative correlation was found between fasting serum C-peptide and SHBG in both groups A and B. The mean calculated free androgen index was significantly higher in obese diabetics than in control subjects. However, insignificant positive correlation was found between FAI, BMI and fasting serum C- peptide in obese diabetic males. This correlation was significant in obese diabetic females. It was concluded that SHBG estimation might be considered as a screening test of the hyperinsulinemic states, which is considered as a risk factor in developing diabetes

Sperm autoimmunity and abnormal semen parameters in insulin-dependent diabetic men

To evaluate sperm autoimmunity in IDDM, 20 men with IDDM [mean age 30 +/- 7.1 years] and ten healthy fertile men of comparable age, were studied. Fasting blood glucose, serum fructosamine, LH, FSH, testosterone and insulin were measured. Complete semen analysis was performed. Insulin was also measured in seminal plasma. The presence of antisperm antibodies was detected in both blood serum and seminal plasma using the slide agglutination method. Antisperm antibodies were detected in serum and seminal plasma in 60% and 50% of men with IDDM, respectively, and in none of healthy men. The presence of these antibodies did not correlate with the degree of metabolic control. In diabetic men, the volume of the ejaculate and the sperm motility were reduced, while the abnormal forms of sperms were more common in comparison to healthy subjects. None of these abnormalities correlated with the presence of sperm antibodies, with the degree of metabolic control, or with the level of seminal plasma insulin which was lower than normal in diabetics. Serum LH, FSH and testosterone were normal in diabetic men, thus sperm autoimmunity is in association with IDDM

Hepatogenous diabetes chronic active hepatitis

In order to study the possibility and mechanism of occurrence of diabetes in cases of chronic active hepatitis [CAH], 15 patients with this disease were divided into group [A] in which CAH occurred on top of normal liver and group [B] in which the disease occurred on top of bilharzial hepatic fibrosis [BHF]. Ten healthy volunteers of matched age, sex were included as a control group. Liver function tests, LE cells, fasting and postpr and ial blood glucose level, HBsAg, IgG and IgM, glycosylated hemoglobin, radioimmunoassay of fasting and postpr and ial C-peptide and insulin were done. The results showed high incidence of CAH in patients with BHF. Normal fasting insulin level was present in 66.6% of all studied cases. Fasting hyperinsulinemia was present in 26.6% of cases. Postpr and ial immunocreative insulin [IRI] showed significant difference between patients and control cases, there was significant increase in postpr and ial IRI in group A. No positive correlation between fasting C-peptide and fasting IRI was detected, but postpr and ial C-peptide showed positive correlation in relation to postpr and ial IRI. The significance and explanation of these results were included in the text

Predictive value of hyperinsulinaemia in subjects with and without coronary heart disease

To determine the predictive value of hyperinsulinaemia and associated other cardiovascular risk factors, this study was carried out on two groups of subjects aged between 40 and 65 years, group I [20 subjects with CHD] and group II [20 subjects without CHD]. All cases were subjected to determination of body mass index, ECG, fasting blood glucose and uric acid, complete lipid metabolism parameters and fasting serum insulin concentration by RIA. More than 80% of group I have significant raised levels of serum fasting insulin [30 +/- 15.32 uU/ml]. cholesterol, LDL cholesterol and triglycerides, while low level of HDL Obesity and raised BP [160/95] was more prevalent in group I. From prevalences and sensitivity percentage of these risk factors, we concluded that, hyperinsulinaemia [i.e insulin resistance] is the major predictive risk factor for increased incidence of CHD, the best of lipid parameters is HDL cholesterol and the poorest is triglyceride value, while other different risk factors are of variable importance

C-peptide and glycaemic state in obese and non-obese type II diabetes

This study was carried out on 60 obese patients with type II diabetes and 57 non-obese patients with type II diabetes. Estimation of body mass index was significantly higher in group I [31. +/- 3.3 kg/m[2]] than in group II [22.8 +/- 3 kg/m[2]]. Studying of the glycaemic state in both groups by measuring fasting blood glucose and glycosylated hemoglobin did not reveal any significant changes. While estimation of plasma C-peptide level showed significantly higher level in group I [3.37 +/- 1.5 ng/ml] than in group II [2.25. +/- 1.3 ng/ml]. This increase in plasma C-peptide in group 1 is explained by the presence of insulin resistance in obese patients. Discussion of etiology of these results is mentioned

Scintigraphic study of patients with hyperthyroidism before and after radioactive iodine therapy

This study was carried out on 20 patients with hyperthyroidism. The diagnosis was based on clinical, laboratory, isotopic study and thyroid scan. Thyroid scanning was done at two stages; one before radioactive iodine therapy and one 6 months after treatment. Thyroid scintigraphy before treatment revealed that 16 patients had Gravs' disease [80%] and four patients had toxic nodular goiter [20%]; two patients had hot nodules and two had toxic multinodular goiter. It was useful for calculating the dose of radioactive iodine as it helps in estimation of gland size. After treatment 19 patients showed normal trace uptake accumulation, while one patient still had an increase trace uptake indicating persistent hyperthyroid scintigraphic picture and this was confirmed by clinical manifestations and laboratory tests. Two patients with normal trace uptake had hypothyroid manifestations as confirmed by clinical and laboratory findings. Accordingly, our conclusion is that thyroid scintigraphy is a helpful tool for diagnosis, verification of the type of hyperthyroidism and for estimation of the therapeutic dose of radioactive iodine but not for follow up after treatment

Thyroid stimulating immunoglobulin in hyperthyroidism

This study was carried out on 20 patients with hyperthyroidism. The diagnosis of hyperthyroidism was based on clinical, biochemical and isotopic studies. Sixteen patients were diagnosed as Gravs' disease and four patients as toxic nodular goiter [two had solitary hot nodule and two had multinodular goiter], Thyroid stimulating immunoglobulin estimation revealed normal levels in all patients with toxic nodular goiter; while-13-patients [81%] with Gravs' disease showed high level of thyroid stimulating immunoglobulin. Six months after radioactive iodine therapy, all patients with previously high levels of thyroid stimulating immunoglobulin showed reduction in their serum levels to reach a normal value in 6 of them [46%] and levels above normal range in 7 [54%]. This finding suggests that radioactive iodine therapy may have an immunoregulatory effect in cases of Gravs' disease

Side effects of environmental toxicants: VI-effects of the organophosphorus insecticide sulprofos on serum enzymes and liver of white rats

The acute toxicity in white rats to sulprofos is moderate. The LD50 was 103.3 mg/kg b. wt. for male rats. Degenerative changes, lymphocytic aggregation, hemorrhages and perivascular edema were seen in the liver of sulprofos-treated rats. The clinical biochemistry of serum indicated significant change from control values in the activities of glutamic pyruvic transaminase [GPT], glutamic oxalacetic transaminase [GOT], acid phosphatase, alkaline phosphatase, alpha- naphthyl esterase and cholinesterase [CHE]

Glycosylated hemoglobin in relation to serum immunoreactive insulin and plasma glucose in patients with chronic renal failure on maintenance hemodialysis

The present study was carried out on 20 patients with chronic renal failure undergoing maintenance hemodialysis and six healthy non-hospitalized control individuals. The aim of this work was to study, the glycosylated hemoglobin in relation to serum immunoreactive insulin and plasma glucose levels in patients with chronic renal failure and the effect of one month regular hemodialysis on these value. Before hemodialysis glycosylated hemoglobin is elevated in uremic patients, but cannot be used as an indicator of carbohydrate metabolism because it declines to normal level with improvement of uremic state with hemodialysis. Also, fasting serum insulin level is high in uremic patients, but hemodialysis and improvement of azotemia reduced basal serum insulin level

Pharmacotherapeutics of a calcium antagonist [verapamil] in simple goitre

The present work was carried out to study the possible beneficial effect of verapamil in cases of simple goiter. Verapamil was administered orally in doses of 240 mg daily [80 mg t.d.s] for three months. The body weight, T3, T4 and TSH levels were measured before and after the drug intake. Verapamil had a significant inhibitory effect on TSH release and serum T3 levels, whereas no significant effect on serum T4 level could be detected. It might be suggested that verapamil may be of some value in cases of simple goiter dependent on increased serum TSH level and probably also in cases of post thyroidectomy thyrotoxicosis due to increased TSH level

Antithrombin III in relation to other coagulation disorders in cases of diabetic ketoacidosis before and after treatment

This work was done on 20 patients with diabetic ketoacidosis. Coagulation studies were done to every patient before and after treatment including prothrombin time, partial thromboplastin time, antithrombin III, fibrin degradation products. It was found that the partial thromboplastin increased significantly after control of the ketotic state, the antithrombin III decreased significantly after treatment, no change was found in prothrombin time and platelet count

Effect of calcium channel blockers on the hemodynamic changes of hyperthyroidism

To study the effect of Ca[+2] channel blockers on hemodynamic changes in hyperthyroid patients, 14 patients were classified in to group I [seven patients received verapamil for one month] and group 2 [seven patients received both verapamil and carbimazole for one month]. Verapamil controlled the hemodynamic changes such as pulse rate, hyperkinetic apex and ejection systolic murmur in the majority of patients. The EGG showed positive changes under verapamil therapy alone, but relative to the combined effect with carbimazole, these changes were incomplete. The peripheral blood flow was corrected enermously by verapamil but its combination with carbimazole made the blood flow nearer to the control value than its action alone. Verapamil as a calcium channel blocker, controlled significantly blood pressure, pulse pressure, mean arterial blood pressure and improved many cardiac complications. verapamil also improved the hemodynamic state in one patient who had had a bronchial asthma where propranolol is contraindicated. Verapamil can be regarded as a good therapeutic tool in prevention of cardiac injury secondary to persistent ischaemia reported to be common in thyrotoxicosis

Effect of calcium channel blockers on the metabolic changes of hyperthyroidism

To study the effect of calcium channel blocking agents on hyperthyroidism, 14 patients were studied; Wayne's Clinical Diagnostic Index was used for diagnosis and confirmed by estimation of T3 and T4 serum levels. The patients were classified into two groups; group I [seven patients received verapamil alone for one month] and group II [seven patients received a combination of verapamil and carimazole for one month]. After one month's therapy, Wayne's Clinical Diagnostic Index decreased significantly from 35.4 +/- 4.2 [thyrotoxic value] to 10.7 [normal value: up to 10] in group I and from 36.4 4 +/- 2.5 [thyrotoxic value] to euthyroid state [2.29 +/- . 2.20] in group II. The body weight increased in both groups but it was only significant in group II. Also serum T[3] and T[4] levels decreased significantly in both groups. It is concluded that verapamil by itself does not only improve the clinical course of thyrotoxicosis but also decreases the thyroid hormones level centrally and blunts their action peripherally. The combination therapy of verapamil and carbimazole in a smaller dose than used was found to be an efficient and dependable therapeutic line in the medical management of hyperthyroidism. The reduced carbimazole dose which was used successfully in combination with verapamil could be considered as an advantage to avoid the side effects of thiourea drugs

Role of hormonal changes in the pathogenesis of primary female infertility

Eighteen female patients with primary infertility [after exclusion of any significant gynecological, cause of infertility] had been studied. Their age ranged from 17 to 40 years with regular periods except 3 patients with 2-3 months amenorrhea. All of them had normal healthy potent husbands with normal semen analysis. All patients were selected to be free endocrine, hepatic as well as metabolic disorders which may interfere with their fertility. They were subjected to estimation [using radioinmunoassay i.e. RIA] of all hormones concerned with fertility. According to the results of their hormonal profile they were classified into 5 groups including 4 patients with hyperprolactinaemia, 2 patients with hypoprolactinaemia and hypogonadotrophinaemia, 4 patients with isolated hypogonadotrophinaemia [2 of them with low progesterone and estradiol serum level], 3 patients with LH hypergonadotrophinaemia and 5 patients with normal hormonal profile. The possible role hormonal changes in the pathogenesis of infertility in these patients has been discussed

Effects of calcium channel blocking agents on hypertensive diabetic patients

Twenty non-insulin-dependent hypertensive diabetic patients were treated for four weeks with Ca++ channel blocking agents for the hypertension. They were divided into two groups, each included ten patients of matched age and sex. The first group received verapamil in oral dose of 240 mg in three divided doses and the second group received nifedipine in oral dose of 80 mg divided also into three doses. The results showed that oral verapamil and nifedipine produced significant reduction in both supine and upright heart rate and blood pressure. Serum creatinine was reduced after treatment in both groups. Abnormal fasting and postprandial blood glucose level were significantly reduced after treatment with oral hypoglycemics in association with Ca++ channel blocking agents. Serum lipoproteins and total serum cholesterol did not show any statistical difference after treatment with both drugs