Changes in plasma lipid concentrations and some coagulation factor activities in insulin dependent diabetics with and without microalbuminuria

This work was carried out to determine the concentration of lipoproteins, apolipoproteins A and B, the clotting factors VII and VIII and antithrombin III in diabetic patients and to investigate the significance of the presence of microalbuminuria in this respect. Forty five insulin dependent diabetic patients of whom 21 were with and 24 were without microalbuminuria and 20 healthy controls, were included in the study. The serum total cholesterol, triglycerides, phospholipids, low density lipoproteins and apoprotein B were significantly higher while the serum HDL/ LDL and apoprotein A/ apoprotein B ratios were significantly lower in diabetic groups. The coagulation factors VII and VIII and antithrombin III were significantly higher in diabetic patients than in controls. The abnormalities in the lipid profile and the coagulation parameters were more marked in microalbuminuric than in normoalbuminuric patients. The work shows that insulin dependent diabetic patients suffer from hyperlipidaemic and hypercoagulability states which are more marked when microalbuminuria is present. These changes might be responsible for macro and microvascular disease with subsequent thromboembolic complications in diabetes. The presence of microalbuminuria should be considered an important warning sign and necessary medical care should start

HBV and HCV among volunteer blood donors

During the period between April 1992 and May 1995, 3576 volunteer blood donors had their sera tested for: HBsAg, HCV [antibodies] by ELISA II and ALT. Sera with high ALT were retested for: ASA, AMA and Anti Bilharzial Antibodies. 80 volunteers were HBsAg positive [2.2%], among them only 3 cases [3.8%] had their ALT elevated. HCV antibodies were +ve in 312 [8.7%] volunteers, among them 39 cases had elevated ALT [12.6%]. 28 cases had their sera positive for both HBsAg and HCV Ab [0.8%], among them 4 cases had elevated ALT [14.3%]. 6 cases had their ALT elevated with all other tests -ve [HBsAg, HCV Ab, ASA, AMA and Anti Bilharzial Ab]. 1. There is significant reduction in the prevalence rate of HBV among Egyptians reflecting a significant increase in the health services. 2. Prevalence rate of HCV among the tested sample is much lower than previously recorded rates and this clarify the urgent need for a national project to estimate the true prevalence of HCV among different communities as it looks that the differences in the prevalence rate of HCV are due to the difference in the tested samples. 3. Most of HCV antibodies positive cases might be either: inactive cases or carriers. 4. ALT testing should not be used as a lone test for blood transfusion safety as most cases with HCV +ve antibodies had their ALT normal. 5. There is a possibility of the presence of Non -B Non-C virus among Egyptian blood donors. HBsAg = Hepatitis B Surface Antigen. HCV = Hepatitis C Virus. ALT = Alanine Amino-Transferase. ASA= Anti-Smooth Muscle Antibodies. AMA = Anti-Mitochondrial Antibodies. Ab = Antibody

Study of T-cell count in uremic patients with HBs antigenemia

This work was carried out on 10 healthy volunteers who served as a control group [Gl]. and 50 patients with chronic renal failure. The uremic patients were divided into 5 groups, each consisted of 10 patients. Group 2 [G2] comprised patients with negative HBsAg. Group 3 [G3] comprised patients treated with conservative measures who are chronic healthy carrier for HBsAg. Group 4 [G4] comprised patients treated with conservative measures who suffered from chronic active hepatitis due to HBV infection. Group 5 [G5] comprised dialyzed patients who are chronic healthy carrier for HBsAg. Group 6 [G6] comprised dialyzed patients who suffered from chronic active hepatitis due to HBV infection. The following laboratory investigations were performed to all subjects: complete blood picture, counting of T-lymphocytes, HBsAg, blood urea, serum creatinine, serum bilirubin and serum transaminases. Diagnosis of chronic active hepatitis was confirmed by liver biopsy. Our study showed that chronic renal failure as well as haemodialysis decreased significantly both total lymphocytic count and absolute T-cell count. Total lymphocytic count and absolute T-cell count showed significant negative correlation with blood urea, serum creatinine, duration of dialysis, and the age of patients. HBsAg positive uremic patients showed siginificant reduction in absolute T-cell count, but didn't show significant change in total lymphocytic count, when compared with HBsAg negative uremlc patients. No significant difference could be found in both total lymphocytic and absolute T-cell count between chronic active hepatitis uremic patients and chronic healthy carrier uremic patients. Finally, no significant correlation was detected between the biochemical parameters of liver function [total serum bilirubin, SGOT and SGPT] and both total lymphocytic count and absolute T-cell count

Plasma fibronectin level in acute myocardial infarction

This study was carried out on twenty patients with acute myocardial infarction [10 had anterior and 10 had inferior infarction] in a trial to find out any relationship between plasma fibronectin level and severity of myocardial infarction. Plasma fibronectin was significantly reduced on the 1 st, 2 nd 3 rd and 8 th postinfarction days and raised by the 20 th day. However Marked diminution was more noticeable in anterior compared to inferior infarction. Plasma fibronectin positively correlated with the ejection fraction and fractional shortening and negatively correlated with the level of cardiac enzymes, with leucocytosis and ESR and with the size of infarction. Therefore, the degree of diminution of plasma fibronectin can be considered as a parameter reflecting the severity of myocardial involvement. On the other hand its rise signifies myocardial healing however, trial for evaluating the therapeutic efficacy of exogenous fibronectin in promoting healing of acute myocardial infarction might be recommended as a future research

Value of C reactive protein determination in bacterial meningitis

This work was carried out on 20 patients with bacterial meningitis in a trial to investigate the value of C reactive protein [CRP] in serum and CSF as a diagnostic and prognosis index in sush disease. Before therapy CRP in serum and CSF was significantly high seven days from the start of therapy CRP dropped significantly in 95% of cases only one patient [5%] who developed facial nerve palsy showed elevated CRP. Therefore early determination of CRP in serum and CSF may be a sensitive and rapid indicator of bacterial meningitis and also may have a prognostic value as it decreases markedly when there is recovery