Effect of erythromycin and azithromycin on simvastatin - induced myositis in rats

Inhibitors of cytochrome P 3A4 are known to increase serum concentration of simvastatin and enhance its toxicity. This study is designed to evaluate the effects and compare erythromycin and azithromycin in their interaction with simvastatin. Sixty rats were used distributed equally to 6 groups. Control groups comprised a negative control [1[st] group], erythromycin [2[nd] group], azithromycin [3[rd] group] and simvastatin [4[th] group]. Simvastatin and erythromycin were concomitantly given to the 5th group while simvastatin azithromycin combination served as the 6[th] group. The drugs were orally administered at therapeutic doses of 18 mg/kg b.w. of erythromycin 9 mg/kg b.w. of azithromycin and 3.24 mg/kg b.w. of simvastatin. The drugs were given as single daily dose for 10 days. Assessment of serum creatinine, creatinine phosphokinase [CPK], aspartate aminotransferase [SGOT] and alanine aminotransferase [SGPT] was supplemented by skeletal muscle histopathology of rectus abdominis and quadriceps muscles of the thigh. A significant elevation of CPK was evident in all groups receiving simvastatin either alone or in combination with erythromycin or azithromycin. Compared with all other groups, the group of rats receiving erythromycin and simvastatin combination manifested a more significant elevation of CPK, SGOT, SGPT and serum creatinine. Biochemical results were supplemented with an evident myositis, degeneration and necrosis demonstrated at a higher rate in the simvatatin erythromycin combination group. No significant biochemical or pathologic change was noticed between simvastatin and azithromycin simvastatin combination group. As shown from this study azthromycin greatly enhanced the simvastatin - induced muscles toxicity, an interaction not demonstrated when azithromycin was co-administered with simvastatin. Erythromycin considered as an inhibitor to the cytochrome P 3A4, should be omitted and replaced by azithromycin whenever necessary in patients treated with simvastatin

Serum uric acid in primary nocturnal enuresis

A case control study was conducted on 41 cases of primary nocturnal enuresis and 20 controls in order to evaluate the implications of serum uric acid in the pathogenesis of primary nocturnal enuresis. Serum uric acid level was significantly lower in cases when compared with controls. No significant difference was detected in serum uric acid level between enuretic children with or without behavioral disturbance. Also, no difference was detected between those considered deep sleepers by their parents or not. This relatively lower level of serum uric acid in children suffering from primary nocturnal enuresis may be a possible factor in the pathogenesis of this problem

Risk factors for hyperlipidemia in children 6-12 years in an urban neighborhood in Cairo

This study was conducted to assess dietary, familial and environmental factors that may lead to hyperlipidemia in children. The studied factors were family history of cardiovascular risk factors, dietary intake, blood pressure, anthropometric measurements and physical exercises. It was concluded that in young children [6 - 12 years old] higher serum levels of TC, LDLC and TG are associated with higher systolic and diastolic blood pressure, overweight for age and less physical exercises which are all considered risk factors for premature cardiovascular diseases in later life