Markers of cardiovascular disease in women with subclinical hypothyroidism

The relationship between sublinical hypothyroidism and astherogenic lipid profile is still controversial. This study evaluate some of the risk markers of cardiovascular disease in a group of women with subclinical hypothroidism, including biochemical and inflammatory markers as well as echocardiographic study. Twenty-three patients were compared with thirteen euothyriod. TSH, FT4, FT3, total cholesterol, low- density lipoprotein, high- density lipoprotein, triglycerides, CRP and IL-6 were done as well as echocardiographic examination.Significant increase in total cholesterol [P < 0.01], LDL-c [P < 0.01] and TG [P=0.0025] in subclinical hypothyroidism [SCH] patients versus control group. CRP and IL-6 were positively correlated with abnor malities in LV morphology and mass in SCH versus control group. A significant, diastolic dysfunction indicated by Significant. Prolongation of the isovolumic relaxation time [P < 0.001] and Significant. Reduction of the early diastolic mitral flow velocity/ late diastolic mitral flow velocity ratio [P < 0.001]. Serum total cholesterol, low- density liporpotein cholesterol, triglycerides, CRP and IL-6 are increase in women with subclinical hypothyroidism. Echocardiographic findings suggest that subclinical hypothyrodism causes diastolic dysfunction

Immunological and pathological prognostic markers of relapse in ulcerative colitis

Patients with quiescent ulcerative colitis [UC] need satisfactory biochemical, immunological and pathological markers to detect relapse which may influence optimal mangment and to detect relation of these markers to the degree and extent of the disease. Patients and twenty eight patients with UC in remission, were followed for 12 months, we had done:ESR, CRP, microalbuminuria, interleukin 1-B [IL-B], Interleukin 2[IL-2], and colonic mucosal biopsies at the start of the study, at the time of clinical relapse and at the end of the study. Results Patients with active UC had higher microalbuminuria compared with those in remission [p<0.001], also, significantly higher concentration of microalbuminuria were detected in extensive disease compared with left sided disease [p<0.05]. In relapsing UC there are significant increase in IL-1B and in IL-2, also there is a significant correlation between IL-1B and CRP. Over the period of the study 38% relapsed, the relapse was not related to the duration or extent of the disease. In relapse acute inflammatory infiltrate was present in 40% and crypt abscesses in 60%. Microalbuminuria as well IL-1B and IL-2 are prognostic indicators of activity in UC. Also acute inflammatory infiltrate and crypt abscesses are considered indices of active colonic inflammation

Predicting ulcer disease in dyspeptic patients by H. Pylori testing rather than endoscopy

To validate accuracy of the Rapid Blood Test [RBT] in predicting peptic ulcer disease in dyspeptic patients. Rationale: Most patients with dyspepsia have no pathology at endoscopy, thus are exposed to unjustified risk, cost, and inconvenience associated with this invasive assessment. Setting: Medical World Polyclinic and Dar Al-Shefa Hospital, Riyadh, KSA. Patients: One hundred patients with ulcer- like dyspepsia. All patients underwent a RBT followed by endoscopy with antral biopsies for histology and urease slide test [CLO test]. Sixty-five% of the patients were "gold standard" H. pylori positive [positive CLO test, positive histology], 30% were "gold standard" negative [negative CLO test, negative histology], and 5% had conflicting CLO test and histology results. Patients with peptic ulcer disease included 31% of all dyspeptic patients, 42% of H pylori-infected patients, and 7% of non-infected individuals. RBT could determine H. pylori status with a sensitivity of 91% and specificity of 77%. Positive and negative predictive values of the test were 89% and 79% respectively. In predicting peptic ulcer disease, RBT was sensitive in 93% of patients and specific in 41%. Positive and negative predictive values of the test were 41% and 93% respectively. Conclusions: RBT is reliable in determining H. pylori status. However, we cannot predict the development of peptic ulcer disease merely on the presence or absence of H. pylori

Prevalence and predictors of bone mineral density in inflammatory bowel disease

Osteoporosis is established in inflammatory bowel disease [IBD] but the mechanisms underlying this disorder has not been well defined. The aim of this study was to assess bone mineral density [BMD] in inflammatory bowel disease [IBD] and evaluate any potential differences between crohn s disease [CD] and ulcerative colitis [UC]. Also we will try to define biochemical markers that predict the changes in BMD. Twenty six patients with recently diagnosed [3-6 months] crohn s disease [9 patients] and ulcerative colitis [17 patients] and 15 age and gender matched healthy controls were enrolled in the study. IBD is diagnosed on clinical, radiological and colonoscopic basis. BMD of lumbar spines, femur and radius were assessed using dual energy x-ray absorptiometry within 3 months after establishing the diagnosis. Laboratory work included: serum calcium, phosphate, alkaline phosphatase and free osteocalcin. Results showed that, BMD is significantly decreased in IBD in comparison to control group [P- value <0.001], with femur more affected than vertebra [P<0.05]. BMD is more affected in CD patients than those with UC: 65% [CD]. 55% [UC] ate osteopenic and 35% [CD], 17% [UC] are osteoporotic. In CD femur T-score shows significant inverse correlation to the-disease duration [r= - 0.72] and in UC patients spine T- score is inversely related to the age [r= - 0.58] and femur T-score is significantly related to sex [more negative in males]. Serum calcium, phosphorous and alkaline phosphatase are not associated with significant difference between patients and control group [P<0.05] and there is an inverse correlation between osteocalcin and lumbar spine BMD [r=0.37, P<0.05]. In conclusion, IBD patients have significant lower BMD value and BMD is more affected in CD patients than those with UC. Osteopenia is related to disease duration in CD, while it is related to age and male sex in UC. Free osteocalcin is an independent risk factor for low BMD of lumbar spines