Serum and tissue levels of zinc, copper and metallothionein as prognostic factors in patients with HCV-related liver diseases

The relationship between chronic hepatitis and trace metals has not been understood clearly. Serum metal levels such as those of zinc and copper have been reported to be highly sensitive in the diagnosis of chronic liver diseases. Metallothioneins [MT] are family of low molecular weight cysteine rich proteins which are widely distributed in various species. They are thought to be involved in heavy metal detoxification, intracellular trace elements storage and scavenging free radicals. The aim of this work was to study the serum and liver tissue levels of zinc, copper and metallothionein in patients with chronic hepatitis, liver cirrhosis and HCC, and to clarify their role in the progression of liver disease. This study was carried out on 40 patients with chronic liver disease, divided into three groups: Group I: Included 15 patients with chronic hepatitis C, Group II: Included 10 patients with liver cirrhosis [histologically diagnosed cirrhosis from patients subjected to biopsy for grading of chronic hepatitis or diagnosis of suspicious nodule], and Group III: Included 15 patients with hepatocellular carcinoma. All patients were subjected to liver function tests, viral hepatitis markers, alpha-fetoprotein, abdominal ultrasonography, and estimation of zinc, copper and metallothionein in serum and liver tissue. The results of the present study revealed that serum and liver tissue levels of zinc were significantly lower in patients with HCC than patients with chronic hepatitis and cirrhosis. On the other hand, serum and tissue levels of copper and metallothionein were significantly higher in patients with HCC than patients with chronic hepatitis and cirrhosis. Also, the present study showed a positive correlation between serum and liver tissue levels of zinc, copper and metallothionein. So, monitoring the serum level of Zn, Cu and MT can limit the need for liver biopsy for detection of their tissue level. We can conclude that serum levels of zinc, copper and metallothionein may be useful as prognostic markers for chronic liver diseases especially with the development of HCC. Future studies are encouraged to evaluate potential therapeutic role of these findings to delay the progression of chronic liver disease in HCV patients

Clinical patterns of scorpions stings at El-Quawayah general hospital, Riyadh region, Saudi Arabia

To study the clinical symptoms and signs of scorpion venom sting. Between May and October 1993, 48 cases of scorpion stings were seen. The following data were recorded for each patient: age, sex, nationality, time and site of sting, type of scorpion and physical examination. EI-Quawayah General Hospital, Riyadh region, Saudi Arabia. This study involved 26 males and 22 females; 20 of the patients were children. Main outcome measures: The following investigations were done for every patient: leucocyte count, serum creatinine, serum aspartate aminotransferase, serum alanine aminotransferase and serum lactate dehydrogenase. The scorpions encountered as mentioned by the patients were 27 yellow scorpions [Leiurus quinquestriatus], 19 black scorpions [Androctonus crassicauda], and two unknown. Thirty-eight [79.1%] stings occurred between 6 a.m. and 9 p.m. The lower extremity was the most common sting site. Local pain was the most common symptom while tachycardia was the most common sign encountered. Forty-three [89.5%] patients were given scorpion antivenom. Scorpion stings are not always safe. They are associated with manifestations of envenoming which include: severe local pain, tachycardia, vomiting, hypertension, pulmonary oedema and priapism and these manifestations are more commonly seen in children than adults. The mortality rate among children was 10%