Serum ferritin: a noval coronary artery disease risk factor

Strong epidemiological evidence is available that iron is an important factor in the process of atherosclerosis. Therefore, it has been hypothesized that the assessment of novel markers help to identify persons prone to premature CAD. The aim of the study is to assess the potential role of ferritin as an independent risk factor promoting atherosclerosis. 45 patients with CAD were studied and subdivided into 3 main groups; group 1: patients with chronic., stable angina group 2: patients with unstable angina, group 3: patients with acute myocardial infarction and additional group 4 of 15 subjects as a control. All patients and control were subjected to accurate history taking, clinical examination and a variety of laboratory investigations in association with s. ferritin and plasma malondialdehyde level [MDA]. It was found that patients with CAD whether chronic stable angina, unstable angina, or acute myocardial infarction had a significant higher serum ferritin level than the control subjects: mean s. ferritin: 702.46 +/- 211.36 ng/L versus 195.66 +/- 41.46 ng/L, P-value 0.001 also the CAD patients had a higher oxidative stress represented by lipid proxidation product MDA [Malondialdehyde]: mean MDA in umol/L 0.780 +/- 0.213 versus 0.375+0.198/umol/L for the control subjects, P-value 0.01. Serum ferritin could be considered a novel, and independent CAD risk factor associated with increased oxidative stress in th n of increased lipid peroxidation and hence MDA

Glucagon like peptide-I [GLP-I] and type 2 diabetes mellitus in the elderly

The most common type of diabetes in the elderly is type 2 diabetes which has a hereditary association and is aggravated by obesity and diabetogenic drugs; its prevalence increase with aging from 6% among those aged 45-54 years to more than 20% among those aged 75 years or older. Glucagon like peptide-I [GLP-I] is a hormone secreted from gut endocrine cells in response to nutrient ingestion and plays multiple roles in metabolic homeostasis as stimulation of glucose-dependent insulin secretion and insulin biosynthesis, inhibition of glucagon secretion and gastric emptying and inhibition of food intake. The objective of this study is to compare between the levels of GLP-I in diabetics and non diabetic elderly and to predict the possible role of GLP-I in the development of type 2 diabetes mellitus in the elderly. The presentawork assessed the postprandial serum level of GLP=I in 30 elderly patients with type 2 diabetes mellitus 15 males and 15 females Their age'ranged between 65-74 years. Their mean age is 68.27 years in comparison to 30 control non-diabetic elderly of matched age and sex. The radioimmunoassay of GLP-I is based upon the competition between labeled I 125 peptide and unlabeled peptide binding to a limited quantity of GLP-I antibody, as the concentration of standard or unknown in the reaction increases the amount of I 125 peptide able to bind to the antibody decrease. By measuring the amount of I 125 peptide bound as a fraction of the concentration of the unlabeled peptide in standard reaction mixture the standard curve is constructed and from which the concentration of the peptide in the samples can be determined. Serum GLP-I shows a statistically marked significant decrease in diabetic elderly group when compared to the control group with mean value of [7.56 ng/ml] in diabetic group versus [16.99 ng/ml] in control group P value <0.001 with no gender difference in the diabetic group with mean value of [8.24 ng/ml] in males diabetic versus [6.88 ng/ml] in females diabetic with P value 0.20. Also there is a highly significant negative correlation between GLP-I and insulin and glucagon levels in diabetic group with P value <0.001. These results indicate that GLP-I decrease in elderly type 2 diabetics and this decrease may be a cause of the high prevalence of type 2 diabetes in the elderly population

Evaluation of saphenoperitoneal shunt in hepatic patients with intractable ascites

Portal hypertension is a leading cause of chronic illness in Egypt. It is responsible for a significant proportion of lost days from work and refractory ascites is the most frequent admitting diagnosis in the medicine and hepatology departments. To evaluate the saphenoperitoneal shunt [SPS] in the management of hepatic patients with intractable ascites. Prospective study. Mansoura University Hospital, Department [8], General Surgery. Hepatic patients with intractable ascites. For 15 patients with intractable ascites the great saphenous vein is reversed to form saphenoperitoneal shunt under spinal anaesthesia. Patients morbidity and mortality as reflected by patients outcome, clinical follow up, laboratory follow up [kidney functions - liver functions] Child-Pugh grade and the therapeutic follow up. There was significant relief of symptoms in [86.6%] of patients, shunt stenosis in a single case and partial thrombosis in 2 cases, significant reduction of patients weight, abdominal girth and increased blood pressure, improved liver and kidney functions and upgraded patients scoring with less requirments for diuretics. The saphenoperitoneal anastomosis [SPS] has a wide range safety, cost effective, favorable outcome, less morbidity and mortality. So, it is a definitive treatment but not a palliative one