Nautral coagulation inhibitors in coronary heart disease [CHD]

Haemostasis may be implicated in the pathogenesis of various thrombotic disease. Assay of natural coagulation inhibitors [AT III and PC] in coronary heart diseases may be informative in such cases. In this work, AT III and PC were assayed for 23 patients with coronary ischaemia and infarction besides 12 controls. A highly significant reduction in AT III had been observed in patient groups which had been attributed to an activated coagulation mechanism with consequent consumption of AT III. On the other hand, a significant increase in PC activity had been observed in both studied groups. This rise may be a body attempt to overcome hypercoagulability in those patients. We recommend a trial to use AT III and recombinant APC as therapeutic lines in patients with coronary heart diseases

Some observations on golucosylated hemoglobin in chronic renal failure and the influence of hemodialysis

Glucosylated Hb is a model of non enzymatic postsynthetic protein modification proportionate with blood glucose level. Its role in uremia is however unclear. Moreover, the effect of uremia on Hb glucosylation was shown to be more complicated. Therefore, the aim of this study was to clarify the reflection of uremia on glucosylated Hb level. The material of this study included 30 patients with CRF and CRF diabetics besides 5 non uremic diabetics and 10 healthy controls. Glucosylated Hb was assayed in all subjects and was reported after in uremic cases. We concluded that the level of glucosylated Hb has been significantly reduced in CRF which could be due to shortened red cell survival while in CRF diabetics it was higher due to their high blood glucose. More over, hemodialysis resulted in elevation of glucosylated Hb due to the proved red cell survival. A positive correlation has been revealed between glucosylated Hb and serum creatinne, a finding that may aid in diagnosis and follow up of CRF particularly in doubtful cases

Assessment of serum iron, TIBC and serum ferritin in end stage renal disease and the effect of hemodialysis

Because of the variability in the pathogenesis of anemia in CRF and the accepted usage of iron supplmentation, we attempted to evaluate the importance of blood indices, serum iron and serum ferritin in such conditions as serum ferritin is generally considered as the best indirect index of body iron stores. This work included 52 uremic patients besides 6 control subjects. The patients were grouped into predialysis and dialysis groups.The later were further subdivided into 3 subgroups according to the duration of dialysis. Biochemical tests, complete hemogram including erythrocyte indices, serum iron, TIBC and serum ferritin had been carried out for all subjects. All uremic patientsúirrespective of dialysis were suffering from microcytic hypochromic anemia with marked iron deficiency and low serum ferritin. There was a statigtically insignificant change of iron status in dialysis groups irrespective the variable duration of dialysis. We came to the conclusion that evaluation of serum ferritin is essential to assess the body iron stores and to evaluate the indication of iron supplementation in CRF and [dialysis patients because the hematological indices alone can not point to the actual iron stores. Reevaluation of the adequacy of hemodialysis procedure can be garanteed with the improvement of iron parameters. Moreover, iron supplementation in CRF should be cautiously used after investigating the iron status in such patients. An extension of this work could be suggested to investigate the erythrocyte ferritin, bone marrow iron in CRF and a trial to use RHuEpo in those patients

Effect of diuretics on some respiratory function tests in bilharzial patients with and without ascites

This work comprised 20 male bilharzial patients, devided into 2 groups, 10 bilharzial patients without ascites, 10 patients with ascites and in addition, 10 healthy subjects as a control group. All cases were subjected to thorough history taking, complete clinical examination and the following investigations: urine and stool analysis, blood urea, serum creatinine, x-ray chest, electrocardiography and ventilatory function tests particulary 1C, ERV, FVC, FEV[1], MVV, FMEF, FMEFT, FEF and AVI. Percutaneous transsplenic portal manometry was done for nonascetic and ascitic group, and the intraperitoneal presure was measured for ascitic group only. Bilharzial patients without ascites have obstructive ventilary defect only, while patients with ascitis has combined obstructive and restrictive defects, and diuretics improved these defects. There is negative correlation between portal venous pressure and intraperitoneal pressure and all ventilatory function tests except FMEFT where the correlation is positive. From the preceeding we can see that diuretics are of value in improving organ funciton not only in the ascitic bilharzial patients but also in the non ascitic cases and wherever oedema is interferring with function i.e. interference with digestion in patients with portal hypertension or ascites, and interference with ventilation due to oedema of the bronchial mucosa

Combined drug therapy of intestinal bilharziasis with and without polyposis

In endemic areas treatment of intestimal schistosomiasis, especially when complicated with polyposis, is a major medical problem. In the past few years introduction of new drugs gave hope for treatment of such cases. These drugs were mainly niridazole and oxamniquine. Niridazole has to be given repeatedly at two months intervals over a period up to one year. Oxamniquine provides the advantage of short term therapy over 3 days but the cure rate was much lower than niridazole. The two drugs are different pharmacolozically and this encourages us to give both drugs in succession, then simultaneously without accentnation of the side or toxic effects than when either drug was given alone. In this study 493 patients of intestinal bilharziasis, 39 of them with bilharzial colonic polyposis were included, using different schedules of therapy. Niridazole in a dose 4 mg/ kg. B. W. daily for 20 days and oxamniquine 60 mg/kg. B.W. as a total dose divided over 3 days. The best results were obtained when both drugs were given simaltaneously. The cure rate in non polypotic bilharzial cases was 96.5% and in patients with plyposis 64.3%, while the cure rate using oxamniquine alone or using the two drugs in succession starting by either of them gave much less cure rate, [not more than 40%]. We can conchude that the best treatment of intestinal schistosomiasis with or without polyposis is the simultaneous administration of oxamniquine and niridazole in the above mentioned dosage schedule