Study the relationship of erythropoietin and chronic obstructive pulomonary disease

It has long been known that COPD causes polycythemia secondary to erythrocytosis caused by hypoxia present in advanced cases of COPD. However, it was shown in several studies that some COPD patients had anemia rather than erythrocytosis. Revealing the changes which occur in erythropoiesis in response to COPD was the aim of the current study. 41 COPD patients of different groups according to the inclusion and exclusion criteria and ten healthy control subjects age and sex matched were enrolled in the study. For all, history taking and full Clinical exam were performed, also ABGs, PFT [spirometry], routine labs [CBC, liver and renal function] and determination of EPO should be performed on human serum by ELISA. Showed that the erythropoietin level was 15.24 +/- 2.6 in stage 1, 22.61 +/- 5.68 in stage 2, 33.59 +/- 4, in stage 3, then 17.9 +/- 3.3 in stage 4. Also the total percentage of anemia in COPD patients was 46.3% [19/41], in comparison to 51.3% [21/41] non anemic and 2.4% [1/41] polycythemic. And that the percentage of anemia was 27.3% in stage 1, followed by 38.0% in stage 2, 100% in stage 3 then dropped to 58.33% in stage 4 with emergence of polycythemia in 8.33% of cases. Although COPD was thought to cause polycythemia, the current study showed that almost half of patients have anemia, and polycythemia occurred only in the advanced stages. It also appeared that response to erythropoietin in COPD is probably blunted especially with increased severity of the condition. This might be considered as a contributing factor in the development of anemia in COPD which is considered as anemia of chronic disease

Prevalence characteristics of COPD in never smokers

Chronic obstructive pulmonary disease [COPD] is currently the 4th leading cause of death all over the world. Smoking is by far the most important documented [and preventable] cause for COPD. However, COPD can still be recorded among a good percentage of non smoker patients, due to other different causes. This study was performed in the Chest Department, Menoufiya University, in the period from April 2009 to August 2011, on randomly selected 300 COPD patients, 230 patients [76.66%] were men and 70 patients [23.34%] were women. The mean age of the patients was 60.7 +/- 5.35 years [range 42-83 years], and all patients were diagnosed as having COPD [FEV1/FVC < 70%], with the use of spirometry [prebronchodilator and postbronchodilator inhalation], according to the GOLD criteria. For each patient, the personal history [including his or her education level], smoking history, health status, and exposure to risk factors for COPD, were assessed according to a prewritten questionnaire. Out of the 300 COPD patients included in this study, 120 [40%] were never smokers and 180 [60%] were ever smokers. Women made up 41.7% of the never smokers [50 of 120] and 11% of the ever smokers [20 of 180]. Never smokers were significantly older than smokers [65.08 +/- 5.03 years vs 56.33 +/- 5.67 years [P < 0.001]] and were more likely to be women [41.7% vs 11% [P < 0.001]]. Never smokers made up to 40% [120/300] of all COPD cases: 78% [70/90] of all GOLD stage II cases, 45.5% [50/110] of all GOLD stage III cases. Among never smokers, 58.3% [70/120] fulfilled the criteria for GOLD stage II and 41.7% [50/120] fulfilled the criteria for GOLD stage III and no patients fulfilled the criteria of either GOLD stage I or GOLD stage IV. Never smokers were shown to have more occupational exposure to organic and inorganic dust and irritant gases at work place [41.7% [50/120] vs 27.7% [50/180], P < 0.05], more biomass exposure [41.7% [50/120] vs 0% [0/180], P < 0.001], less education [41.7% [50/120] vs 72.2% [130/180], P < 0.001], more exposure to passive smoking [75% [90/120] vs 22.2% [40/180], P < 0.001]. When compared with never smoker patients with moderate COPD [GOLD stage II], never smokers with severe COPD [GOLD stage III] were older in age [70.6 +/- 2.44 years vs 61.14 +/- 1.25 years, P < 0.001], have a higher female percentage [60% vs 28.6%, P < 0.001], lower BMI [21.2 +/- 0.76 vs 26.14 +/- 2.43, P < 0.001], more occupational exposure [27.5 +/- 2.56 years vs 13.33 +/- 2.39 years, P < 0.001], more biomass exposure [35 +/- 4.15 years vs 20 +/- 10 years, P < 0.001], less education [0% vs 71.4 educated, P < 0.001], more exposure to passive smoking [29 +/- 2.02 years vs 13.75 +/- 4.19 years, P < 0.001]. This study revealed that never smokers constitute a significant proportion of the Egyptian COPD patients. When dealing with COPD management, clinicians must be oriented with the different risk factors, other than tobacco smoke, that play a key role in the development and pathogenesis of COPD, because despite smoking is the most important risk factor, its absence doesn't exclude COPD diagnosis

Predictors of mortality in mechanically ventilated COPD patients

Patients with chronic obstructive pulmonary disease [COPD] commonly require hospitalization and admission to intensive care unit. It is useful to identify patients at the time of admission who are likely to have poor outcome. This study was carried out to define the predictors of mortality in mechanically ventilated COPD patients and to advice a scoring system using the baseline physiological variables for prognosticating these patients. This study comprised 220 patients with acute respiratory failure [ARF] secondary to COPD, requiring mechanical ventilation [MV] and admitted to the intensive care unit [ICU] of Menoufiya Chest Department over a two-year period. Clinical and demographic data including APACHE III [Acute Physiology and Chronic Health Status Evaluation] score and Charlson co-morbidity score were recorded on MV, at the time of admission to the ICU. In addition, the acid base status, renal and liver functions, serum electrolytes, LDH, CRP and albumin were recorded at the time of presentation. The length of stay in-hospital, in the ICU, and mechanical ventilation were also recorded. The mean serum albumin level was 2.77 +/- 0.39 gm/dL and 2.11 +/- 0.19 for survivors and non-survivors, respectively [p < 0.05]. As regards ABGs; the mean PaCO2 was 54.8 +/- 6.39 mmHg and 76.1 +/- 11.1, PaO2 was 54.8 +/- 7.1 mmHg and 50.2 +/- 4.9, and HCO3 was 34.7 +/- 4.2 mEq/L and 41.6 +/- 4.8 in survivors and non-survivors, respectively [p < 0.05]. Charlson co-morbidity index demonstrated a cut off value of 1.4 +/- 0.3 and 2.6 +/- 0.6 and APACHE III score off value was 45.2 +/- 12.62 and 80.9 +/- 15, for survivors and non-survivors, respectively with statistically significant correlation for both indices [p < 0.05]. The present results indicate that the severity scores, like Charlson co-morbidity and APACHE III scores, are useful and reliable tools for predicting mortality in COPD patients requiring MV. Serum albumin level, renal functions as well as the oxygenation and ventilation parameters can also, predict mortality

Treatment outcomes among patients with multi-drug resistant tuberculosis in Abbasia chest Hospital from July 2006 to June 2010

Tuberculosis despite being treatable and preventable disease, it continues to be a major health challenge in many parts of the world. The emergence of drug-resistant tuberculosis has made the current epidemic worse. This retrospective study included 200 MDR-TB patients admitted to Abbassia Chest Hospital in the period between July 2006 and June 2010. Their files had been analyzed including medical history, chest examination and investigations. Drug regimens of resistance used for treatment and the fate of treatment were reported. Patients were 148 males [74%] and 52 females [26%]. Their ages ranged from 15 to 76 years [37.83 +/- 12.78 years]. 81.5% of them lived in rural areas, 2.5% were tobacco smokers and were diabetics. Defaulters were 44.5%, treatment failure patients were 44%, relapse patients were 4%, and new cases constituted 7.5% of the studied patients. Acquired resistance was 92.5% and primary resistance was 7.5%. The duration for sputum conversion ranged from 2 to 9 months [4.19 +/- 1.28 months]. The fate of MDR-TB treatment was favorable outcome in 132 cases [66%] and unfavorable in 68 cases [34%] [28 patients were defaulters [14%], 21 patients died [10.5%] and 19 patients had treatment failure [9.5%]]. The prevalence of defaulter patients was significantly higher among unfavorable outcome patients while the prevalence of treatment failure patients was significantly higher among favorable outcome. Successful treatment could be achieved in 66% of MDR-TB patients treated in Abbassia Chest Hospital between July 2006 and June 2010

Pleurodesis using different agents in malignant pleural effusion

Malignant pleural effusions [MPE] are characterized by rapid reaccumulation, after tapping, and many symptoms related. Pleurodesis, for the management of MPE, is intended to achieve symphysis between parietal and visceral pleura, and to prevent relapse of pleural effusion. Many chemical agents are tried to induce abrasion and damage of the pleural mesothelial layer to achieve this symphysis. The aim of this study is to compare the results of medical pleurodesis, using 4 different chemical agents in these cases, to reach an efficient one with minimal complications. Between July 2010 and July 2012, 40 patients with MPE, divided into 4 groups, underwent medical pleurodesis using 4 chemical agents in comparison: bleomycin, doxycycline, povidone iodine and 5-fluorouracil. Immediately and for 3 months after the procedure, the results of pleurodesis were assessed and the final reported success rates were 70% for bleomycin, 80% for doxycycline and 80% for povidone iodine, while 5 fluorouracil had the lowest success rate [50%] [P-value < 0.05]. Bleomycin, doxycycline and povidone iodine are nearly equally effective and safe pleurodetic agents when used in the optimal dose, while 5-fluorouracil had a much higher failure rate. Although povidone iodine and doxycycline are as effective and safe as bleomycin, they are cheaper alternatives and more available chemical agents for pleurodesis in cases with MPE

Prophylaxis of retained fetal membranes in dairy cattle

This study aimed to evaluate the effect of usage some drugs to avoid retention of placenta [fetal membranes] in dairy cattle. This study was carried out in private dairy farm. The age of cows ranged between 2-5 years. The animals were divided randomly into 2 groups. First group [20 cows] to study the effect of vitamin E and Selenium injection for [re-partum prophylaxis of RFM. Second group [30 cows] to study the effect of Oxytocin or Methyl ergometrine injection for post-partum prophylaxis of RFM. The results indicated that using vitamin E and Selenium injection pre-partum reduced the incidence percentage of retention of fetal membranes also the usage of Methergin or Oxytocin injection immediately post-partum reduced the incidence of retention of fetal membranes and improved the reproductive performance in dairy cattle

Prevalence of intestinal parasitosis in a rural population in Egypt, and its relation to socio-demographic characteristics

A cross-sectional study was conducted in a village in Menoufia Governorate, Egypt where the majority of people had individual trenches in the houses for sewage disposal with absence of public sewage system. Out of 2292 stool samples 47.8% had at least a single infection. Multiple infections occurred in 14.9%. Entamoeba histolytica was 20%, E. coli 10%, Giardia lamblia 10%, Ascaris lumbricoides 27.31%, Hymenolepis nana 2.96%, Schistosoma mansoni 2.45% and Ancylostoma duodenale 2.23%. Males were significantly infected with S. mansoni than females. Younger age groups were significantly infected by H. nana than older ones. Working in agriculture was significantly at risk with S. mansoni and A. duodenale infections. On multiple logistic regression analysis; the risk factor most strongly associated with infection was the presence of another infected family member

Epidemiologic pattern of falls among inpatients in Ain Shams University Hospitals in Cairo, Egypt

Patient falls and injuries during hospitalization is a good quality indicator of safety of inpatients. Data on inpatients falls are deficient in Egyptian hospitals. Ain Shams university hospitals do not have any recording system for falls. This study aimed at estimating the incidence density of falls and describing pattern and risk factors contributing to falls in Ain shams university hospitals. A prospective follow up study was conducted on inpatients admitted to Ain Shams university hospitals. Patients were followed up for a maximum of two weeks for the occurrence of fall. An interview questionnaire addressed to in-patients was designed to investigate the incident of fall. Type of fall, provisional cause, consequences, night or day timing of fall, walking condition in hospital and past history of fall were among the factors investigated in the incident of fall. Questionnaire assessing the basic and instrumental daily activities for the elderly [>/= 60 years] was completed. 1779 patients were included in the study in eight different wards with a mean age of 41 .8 years. The incidence density of falls was 9 per 1000 patient days. Logistic regression analysis identified male gender, walking difficulties in-hospital and history of falls before hospitalization as independent risk factors for falls among below 60 years patients. While diabetes mellitus, walking difficulties in-hospital, medical [non-surgical] conditions and dependency [as assessed by basic and instrumental daily activities] were the independent risk factors of falls among elderly. Incidence of falls is relatively high among the studied university hospitals. Identified risk factors differed among adults compared to elderly. Measuring, monitoring and assessing fall rates are strongly recommended using a valid and reliable tool to improve quality of health services

Neuroprotective effect of melatonin against ethanol-induced damage in rat brain stem

Chronic ethanol administration has been found to have neuronal damaging effect through free radical generation. The aim of this study is to determine the possible neuroprotective effect of melatonin [MLT] against ethanol induced neuronal damage in the brain stem of male albino rats. Rats were randomly divided into 3 groups: control group, 35% ethanol-treated group and melatonin [l0mg/kg I. P. for 7 consecutive days] pre-treated ethanol group. Administration of ethanol [35%] orally in drinking water for 30 consecutive days decreased glutathione [GSH], dopamine [DA], norepinephrine [NE] and serotonin [5-HT] contents and superoxide dismutase [SOD] activity. The maximal percentage of decrease was 44%, 34%, 41%, 29% and 40%, respectively. On the other hand; there was a progressive increase in malondialdehyde [MDA] level and DNA fragmentation by 128% and 53%, respectively. Melatonin administration prior to ethanol significantly increased. GSH, DA, 5-HT, and NE contents in brain stem by 53%, 30%, 33%, 33% respectively and SOD activity by 35%. MDA level and DNA fragmentation were markedly reduced by 36% and 30%, respectively. Our data suggest that melatonin is capable of at least partially preventing ethanol -induced neurodegeneration in the brain stem of rats. This effect might be attributed to direct free radical scavenging properties and regulation of antioxidative enzyme activity of melatonin

Prevalence of S. mansoni and intestinal parasites in a rural population in Egypt, and its relation to socio-demographic characteristics

A cross-sectional study was conducted in a village in Menoufia Governorate in Egypt where the majority of people had individual trenches in the houses for sewage disposal with absence of public sewage system. Out of 2292 stool samples 47.8% had at least a single infection. Multiple infections occurred in 14.9%. Entamoeba histolytica was 20%, E. coli 10%, Giardia lamblia 10%, Ascaris lumbricoides 27.31%, Hymenolepis nana 2.96%, Schistosoma mansoni 2.45% and Ancylostoma duodenale 2.23%. Males were significantly infected with S. mansoni than females. Younger age groups were significantly infected by H. nana than older ones. Working in agriculture was significantly at risk with S. mansoni and A. duodenale infections. On multiple logistic regression analysis, the risk factor most strongly associated with infection was the presence of another infected family member. We recommend screening all family members of positive cases

Bacteriological quality of some dairy products [Kariesh cheese and ice cream] in Alexandria

The present study estimated the total viable bacterial density, total and faecal coliforms, and E. coli in Kariesh cheese and ice cream. The study included 160 ice cream and Kariesh cheese samples [80 samples each]. Ice cream samples were 47 packed [33 cup and 14 stick] and 33 open samples while Kariesh cheese samples were 62 open, 18 packed samples [8 of known brand and 10 of unknown brand]. Samples were collected from supermarkets, shops and street vendors. All samples were analyzed for enumeration of total viable heterotrophic bacteria using standard pour plate method, and for the determination of the total coliforms, fecal coliforms and E. coli using multiple tube dilution method. Ice cream samples, showed that the total bacterial count was >/= 1.5x105 cfu/g in 26 [32.5%] samples, total coliforms were >/= 10 MPN/g in 36 [45.0%] samples, fecal coliforms were detected in 45 [56.3%] samples, and E. coli was detected in 34 [42.5%]. Kariesh cheese samples, showed a total coliforms of >/= 10 MPN/g in 54 [67.5%] samples, while fecal coliforms were detected in 64 [80%] samples, and E. coli was detected in 60 [75%]. It is recommended to use and implement immediate regulatory measures like good manufacturing practices as well as distribution and retail storage practices for ensuring microbiological safety of ice cream and Kariesh cheese

Aging is an inevitable risk factor for insulin resistance

The present work looks into the different aspects of glucose homeostasis in the elderly patients in comparison to healthy younger subjects and patients with type 2 diabetes mellitus, relying on intravenous glucose tolerance test. A clinicobiochemical study was carried out comprising forty apparently healthy non-diabetic non-obese old individuals [mean age 65 +/- 4.8 years]. Forty type 2 diabetic patients compared to thirty healthy young subjects. The senile group had no family history of diabetes. Cases with renal, hepatic, gastrointestinal, or endocrine abnormalities were excluded from the study. Intravenous glucose tolerance test [ivGTT] was done with sampling at 0, 5, 10, 15, 30, 45, and 60 min after glucose load and the following estimations were undertaken: glucose constant decay [KG], glucose and insulin area under the curve, insulnogenic index, first phase insulin response, insulin resistance index and fractional insulin clearance. The senile and diabetic groups, when compared to the control, had non-significantly different fasting plasma glucose in senile group but it was higher in diabetic patients, while fasting serum insulin was significantly higher in the studied groups than in healthy control group. The senile group showed significant reduction in glucose tolerance [KG 1.36 +/- 0.3%/min], decreased insulin sensitivity index [5.19 +/- 1.4 10[-4] min[-1] /[uIU/ml]] and marked reduction of first phase insulin response [2.45 +/- 0.78 uIU/ml per mg/dl], when compared with the control group. However, the degree of glucose intolerance and insulin insensitivity of the senile group was still significantly less than of type 2 diabetic patients. This study revealed that the insulin resistance seems to be characteristic feature of normal aging process and senility could be considered as an inevitable risk factor for glucose intolerance and metabolic syndrome with its accompanying health hazards. Insulin secretion, insulin clearance and interaction between insulin and target tissues are defective in elderly subjects. These functions are intermediate between healthy controls and type 2 diabetic patients and may predispose the elderly population to the risk of impaired glucose tolerance or diabetes mellitus with its attendant macrovascular and microvascular complications

Blood ammonia, S100B and neuron-specific enolase levels in patients with hepatic encephalopathy

To evaluate circulating blood ammonia [NH3], S 100B and neuron-specific enolase [NSE] levels in patients with liver cirrhosis with or without hepatic encephalopathy [HE] and to choose which of these parameters could be used as a useful marker for early diagnosis of HE. Subjects and The study included 20 patients with liver cirrhosis without HE, 20 patients with sub clinical HE [SHE], 24 patients with HE grades I-IV and 20 matched for age and sex healthy control subjects. Blood levels of NH3, S100B and NSE were determined by calorimetric method for the former and by enzyme immunometric assay [EIA] for the 2 latter. Blood levels of NH3 and S 100B were significantly elevated in patients with cirrhosis, SHE and HE with various grades compared to normal subjects. Serum NSE levels were significantly increased in patients with SHE and HE with various grades compared to normal subjects. These parameters were significantly greater in patients with SHE and HE grades I-IV in comparison to cirrhotic patients. Serum S100B and NSE levels were significantly higher in patients with HE grades I-IV in comparison to SHE cases. Plasma NH3 levels showed no significant difference among patients with different Child-Pugh classes or between patients with different HE grades and SHE. Meanwhile, serum S 100B and NSE showed significant increase in Child class C in comparison to Child class A and B and in patients with different HE grades compared to those in SHE cases. Plasma NH3 level was significantly correlated with serum S100B and NSE levels and significant correlation was found also between S 100B and NSE levels. The 3 parameters exhibited similar sensitivity of 79.50%, but plasma NH3 and serum S 100B showed 100% specificity meanwhile, serum NSE showed 80% specificity for predicting HE in comparison to cirrhotic patients. Serum S100B levels appeared to be a better marker predicting HE than plasma NH3 and serum NSE

Plasma retinol and growth at puberty: relation To glycemic control and nutritional status in type 1 [insulin-dependent] diabetic mellitus

Vitamin A deficiency [VAD] has been shown to have a significant effect on growth and maturation. Subnormal vitamin A intake is one of the etiological factors in delayed pubertal maturation. This study was conducted to assess the nutritional status of Insulin Dependent Diabetic children during the immediate prepubertal period and early puberty. The objective of this study was to examine if there is a relationship between the nutritional status, including growth, body mass index, and plasma retinol level in relation to glycemic control that would possibly influence the onset and progress into puberty. So we tried to assess the effect of glycemic control of IDDM patients on the plasma retinol levels after controlling for renal, hepatic and thyroid functions during puberty. This study included 35 IDDM patients aged 9-14 years including 17 poorly controlled and 18 well controlled matched for age, sex and socioeconomic class with one another and with a group of 18 healthy controls. Full examination and thorough investigation of renal, hepatic and thyroid functions was conducted for all subjects to rule out any disease that may affect plasma retinol levels, There were significant reduction in plasma retinol levels in the poorly controlled diabetic patients [24.44 +/- 3.95 pg/dl] and in the well controlled diabetic group [37.79 +/- 6,81 micro g/dl] when compared with the control group [50.94 +/- 3.67 micro g/dl; p<0.001]. Clinical manifestations of VAD were absent. All poorly controlled diabetics had plasma retinol levels below 30 micro g/dl [3 cases<20 micro g/dl, and 14 between 20-29 micro g/dl]. We found a highly significant negative correlation between plasma retinol levels and glycated hemoglobin [HbAlc], [r=-0.99; p<0.001] and with the duration of diabetes [r=-0.498; p<0.01] indicating marginal impairment in vitamin A status in diabetic children related to poor control. All poorly controlled had stunted growth with delayed puberty and a body mass index far below those of their well controlled counterparts and controls. Plasma retinol was positively correlated to the Body Mass Index [BMI], [r=0.635, p<0.001], probably indicating that plasma retinol levels and delayed growth during puberty could be interrelated in these children. These results demonstrated that diabetics who have poor glycemic control and delayed puberty which is unrelated to thyroid hormone disturbance, may be suffering from marginal vitamin A deficiency. It is suggested that low plasma retinol levels may be implicated in the disturbed glycemic control end poor growth during puberty. It remains to be proven whether supplementation of-vitamin A to these children, together with glycemic control, may be beneficial in improving their pubertal growth and development. The study draws the attention to the importance of routine screening of diabetics for micronutrient deficiencies particularly among poorly controlled diabetics during puberty in areas where vitamin A deficiency is a public health problem

Re-appraisial of the prevalence of obesity, glucose intolerance and hypertension in an Egyptian village in Dakahlia province

Obesity is becoming a world - wide problem associated with a multitude of potential risks and complications was to study the prevalence of obesity, glucose intolerance and hypertension and their interaction in a rural community and to compare the rates with those reported in previous studies in / 985 and / 989, all carried out in a El Hasina village in Dakahlia province. 500 individuals, were subjected to thorough history taking and clinical examination. Blood pressure was measured with standard sphygmomanometer and hypertension was diagnosed according to the JNC VI criteria. Body mass index [BMI] was considered as an index of obesity. Fasting and postprandial blood glucose were assayed utilizing a portable reflectance apparatus. The prevalence of obesity in 2002 was found to be 56.2%: of them 28.8% were overweight, 26% were obese and 1.4% had morbid obesity. These figures are higher than those reported in the previous study carried out during 1985 [21.45%]. The increased prevalence of obesity from 1985 to 2002 denotes that obesity is becoming an over-endemic diseases in Egypt and a great challenge to health authorities. The prevalence of DM increased from 5.2% in 1989 to 1/6% in 2002, and the prevalence of IGT increased fro 6.2% in 1989 to 7.4% in 2002: probably indicating that JGT and DM are becoming an endemic problem in Egypt. Both DM and IGT were more common among obese [15.3% and 11.4%, respectively,] than non-obese [6.8% and 2.3%, respectively]. In our study. the total prevalence of HTN among the studied individuals was / 6.4%. Hypertension was found to be more prevalent among obese [24.9%] than non-obese [5.5%] individuals. and Increasing the degree of obesity was associated with an increased prevalence of hypertension

Impact of life style on the nutritional status of medical students at Ain Shams University

This cross sectional study was carried out to assess the nutritional status of medical students and to determine its relation to their life style. The study involved 317 students at, Aim Shams University. Anthropometric measurements such as weight, height, mid-arm circumference, triceps skin fold thickness and body mass index were measured. The students completed a self-administered questionnaire including data about some life style factors and food-frequency consumption. The study revealed that 41.3% of the students were of normal weight while 9.5% of the sample were underweight, 36.9% were overweight and 12.5% were obese. The mean mid upper arm circumference [MUAC] and mid arm muscle circumference [MAMC] of males was significant higher than that of females, while the mean triceps skin fold [TSF] of females was significant higher than that of males. The food frequency questionnaire analysis showed that most of students consume all food groups items faire. There was no statistical significant difference between the body mass index [BMI] of students and different types of food consumption. About two thirds of the students used to practice exercise, 26.9% of the students practiced exercise for less than 2 hours per week, while 33.9% of them for more than 2 hours. There was no statistical significant difference between the BMI of students and different types of exercise. However, there was significant higher percentage of males play sports and practice running [44.7% and 19.4% respectively] compared to [11.7% and 8.1%] of females. Sixty four percent of the students usually have regular meals. About 87.2% of obese compared to 64.9% of normal weight students eat snacks between meals, the difference was statistically significant. Obese individuals eat more during watching television and during feeling of stress compared to non-obese and the difference was statistically significant. The duration of practicing exercise, sports and playing computer was significantly higher in males than females. However, the duration of watching television was significantly higher in females than males. Logistic regression analysis results showed that family history of obesity and some life style factors as duration of computer use, eating more during stress time and snacking between meals were important risk factors for obesity. We concluded that about half of medical students were overweight and obese. The most important life style factors responsible for obesity were longer time spent using computer, eating more during time of stress and snacking between meals. Also, genetic factors played an important role in development of obesity. It is recommended to develop nutritional education and physical activities programs to face the problem of increasing the rate of overweight and obesity among university students

Soluble transferrin receptor: a possible index of body iron status

Erythrocyte microcytosis and hypochromia constitute a haematological problem associating many haematological disorders such as true iron deficiency anemia and anemia complicating chronic diseases. Therefore, the present study has been planned for evaluating the level of soluble transferrin receptor [sTfR] as a differentiating parameter in these conditions. The study included 40 patients with hypochromic microcytic anemia who were classified as a true iron deficiency [IDA] group and a group of anemia of chronic disease [ACD], in addition to a control group of matched age and sex. Serum TfR and conventional iron parameters were evaluated in all included individuals. Soluble TfR was found to be significantly higher in patients with IDA, while in ACD patients, its level showed a non-significant change. Moreover, TfR/Log ferritin ratio [TfR-F index], was shown to be significantly elevated in IDA than either ACD or healthy controls. This ratio was also found to be more convenient, than serum ferntin, in differentiating ACD from that of iron deficiency. In addition, a nonsignificant difference was observed among both anemic groups as regards other parameters of iron status. On the other hand, sTfR was significantly inversely correlated with serum iron, serum ferritin and Hb in both anemic groups. It could be concluded that sTfR may be considered as a possible important parameter for evaluation of body iron status and in differentiation of the true iron deficiency anemia from that of chronic disease

Assessment of Il-8 and TNF-alpha in serum and BAL of patients with COPD and lung cancer

There is an increasing evidence for the role of cytokines, especially interlukin-8 [IL-8] and tumor necrosis factor-alpha [TNF-alpha] in the pathogenesis of many chest diseases especially chronic obstructive pulmonary disease [COPD] and to some extent lung cancer. Tins study was conducted on three groups comprising 70 smoker subjects; 25 patients [21 males and 4 female] with mild to moderate degree of COPD, 25 patients [21 males and 4 females] with lung cancer and 20 asymptomatic control subject [17 males and 3 females], All subjects were subjected to full history taking, clinical examination, radiological assessment, pulmonary function testing, tissue diagnosis of lung cancer, blood sampling and bronchoscopic bronchoalveolar lavage [BAL] for assessment of TNF-alpha and IL-8 levels both in scrum and BAL fluid using the enzyme linked immunosorbant assay [ELISA] method. There was a highly significant [P < 0.05] elevation in both serum and BAL levels of IL-8 in COPD and lung cancer patients compared to the healthy control subjects but the difference between the COPD and lung cancer patients was insignificant [P > 0.05], Also, there was a highly significant elevation in both serum and BAL levels of TNF-alpha in COPD and lung cancer patients compared to the control group and the serum as well as the BAL levels of TNF-alpha were significantly higher in lung cancer patients compared to the COPD ones. The BAL levels of IL-8 and TNF-alpha were always significantly higher than the serum levels of the same cytokine in the same group of patients or control subjects. This study concludes that IL-8 and TNF-a levels are increased both in BAL and serum of COPD and lung cancer patients and their assessment may add to the understanding of the ongoing pathogenic inflammatory processes occurring in the smoker's airways till the development of COPD or lung cancer

Is scrotal exploration necessary for all patients with acute scrotal pain?

Testicular torsion is a surgical emergency. Scrotal exploration is the classical procedure followed by either orchidopexy or orchidectomy. Up to 50% of cases are negative on exploration. The aim of this work was to assess the possibility of avoiding this high rate of negative exploration. Eleven patients are included in this study. Each patient was clinically diagnosed as testicular torsion. Prior to scrotal exploration a color doppler ultrasound and a scrotal scinitigraphy were performed. The surgical findings are corrected to the imaging results. All eleven patients had testicular torsion and all but one testis were saved. The testis has to be fixed on both scrotal sides to prevent recurrence. We found that scrotal scintigraphy is more accurate in the detection of torsion, yet it its exprensive, not widely available and uses ionising radiation. One the other hand color doppler ultrasound is widely available, less costly, uses no ionising radiation but with a success rate of 90.9%. We conclude that neither test should be accepted as the sole discriminator of testicular torsion. Scrotal exploration may not be necessary for all cases of acute scrotal pathology but is definitely safer as regards testicular salvage