Résumé
Background: psoriasis is T cell mediated disorder in which the cytokine network is extremely complex, involving the actions and interactions of multiple cytokines. Psoriasis vulgaris was reported to be associated with T helper cell type 1 [Th1] upregulation and T helper cell type 2 [Th2] downregulation
Objective: this cross section study was aimed to evaluate the changes in serum levels of IFN-gamma and IL4 in psoriasis vulgaris patients and correlate these parameters with psoriasis area severity index score [PASI]
Subjects and methods: this work was achieved through the study of 24 psoriasis vulgaris patients [16 males, 8 females, age ranged from 24 to 62 years] and 12 age and sex matched healthy controls. They were subjected to thorough history taking, general and dermatological examination for patients and controls. PASI score was calculated for every one of psoriatic patients. IFN-gamma and IL4 serum levels were assessed for patients and control by quantitative sandwich enzyme immuneo-assay technique. The patients were classified into three groups according the duration of the disease, a group with duration up to 5 years [6 patients], a group with duration from 5 to 10 years [10 patients] and the third one with duration more than 10 years [8 patients], according to PASI score into two groups a group with PASI score up to 15 [14 patients] and a group with PASI score more than 15 [10 patients]
Results: the serum level of IFN-gamma was significantly higher in psoriasis vulgaris patients compared to controls and serum level of Il-4 was significantly lower in psoriasis vulgaris patients compared to controls. There was highly significant positive correlation between serum level of IFN-gamma and PASI score. There were significant inverse correlation between serum level of IL4 and each of PASI score and serum IFN-gamma. There was significant difference in the serum levels of IFN-gamma and IL4 between groups of psoriatic patients with different PASI scores, while the difference between groups with different duration of the disease was non-significant
Conclusion: psoriasis vulgaris is associated with high serum level of IFN-gamma indicating Th1 upregulation and low serum level of IL-4 indicating Th2 down regulation. These changes in IFN-gamma and IL-4 serum levels were significantly correlated to PASI score
Résumé
Presence of diabetes mellitus during pregnancy has important consequences for both mother and fetus. Study maternal and fetal outcome among pregnant diabetic women in Mansoura University Hospital. Reprospective study was performed in the antenatal care unit, Mansoura University Hospital in the period from September, 2003 to October, 2005. The study group included 215 pregnant diabetic women, in addition to 200 cases with normal pregnancies as control group. The study group included 145 cases with pre-gestational D.M and 70 cases with gestational D.M. The maternal and fetal outcomes were studied and analyzed. In our study, pregnant diabetic patient represent 8.1% of total admission in antenatal care unit, this reflect the high incidence of D.M in Egypt. Maternal complications among pre-gestational D.M were higher than control including high rate of cesarean section 71.7%, pre-eclampsia 24.1%, urinary tract infections 15.1%, polyhydramnios 19.1% and ketoacidosis 2.7%. The most common adverse outcome in gestational D.M group was fetal macrosomia 51.4%. Infant, born to mothers with pregestational D.M were at increased risk of congenital malformations 8.3%, IUFD 5.5%, asphyxia 6.2% and neonatal death 8.3%. We recorded 40% of our study group as being poorly controlled. Early detection of D.M, optimal glycemic control in periconceptional period and throughout pregnancy and adequate fetal surveillance will improve the maternal and fetal outcome in diabetic patients