PAIgG and PAIgM levels in secondary dengue virus infections lead to thrombocytopenia in patients from KP, Pakistan

Objective: To understand the impact of platelet associated immunoglobulin G (PAIgG)/platelet associated immunoglobulin M (PAIgM) on severity of dengue virus infection leading to thrombocytopenia. Methods: In this study we examined a total of 52 patients who were having secondary infection of dengue in acute phase by using competitive ELISA. Results: A decrease in the platelet count was observed at the acute phase of infection while all along the recovery stage the count of platelet was significantly increased. A significant decrease was observed in PAIgG and PAIgM in these subjects. Inverse correlation was found between platelets count and PAIgG/PAIgM among the subjects studied. In the platelets elution from ten subjects, anti-dengue virus immunoglobulin G and immunoglobulin M were observed. PAIgG and PAIgM with inclined levels were higher in dengue hemorrhagic fever than the classical dengue fever. In the development of dengue hemorrhagic fever PAIgM inclined level was independently associated with high specificity, showing a possible indication of dengue hemorrhagic fever. Conclusions: This study suggests that in secondary dengue virus infection, the PAIgG and PAIgM levels, and the activity of anti-dengue virus play key roles, both in the development and severity of the disease.

Blood lead levels and Occupational Hazards in child labour in Peshawar

To determine blood lead level, calcium and haemoglobin in children involved in auto labour at Peshawar. A total of 150 children; 30 control and 120 working in auto-mobile workshops for 8-10 hours daily without any safety measures, were investigated. We observed that low-income families generally encouraged their children to learn some professional skills at early age. Besides, the nature of work in automobile workshops was hazardous and the long working hours were stressful for the children. Eighty Seven percent of the children were not willing to do the job and 100% were un-aware of the safety measure. As compared to controls, the subject group have had high blood lead levels with a mean +/- 42.4 g/dl [p<0.001]; low haemoglobin +/- 11.2 g/dl [p<0.01] and decreased calcium +/- 8.6 mg/dl [P<0.01] concentration. Furthermore, the younger age group had comparatively raised lead level than old age group. Sixty eight percent children of the study group have had abnormalities like headaches, raised hearing threshold, memory loss and generalized body pain. It is concluded that the high level of blood lead affects the health of children; and poor children specially are at more risk because of inadequate nutrition. Besides, the present study suggests the need of awareness, implementation of laws for child's rights, effective family planning facilities and finally various organizations should play an effective role in child labour prevention programmes

Study of bile composition and antinucleating activity of bile in Egyptian patients with mixed gall stones

This study included two groups, one group of ten control subjects and a second group of ten patients suffering from mixed gall stones. The bile of all subjects was analyzed for glycoproteins, total bile acids, cholesterol, bicarbonate, total and ionized calcium, pH and antinucleating activity. The biochemical parameters studied except for bile acids were significantly increased in bile from patients with mixed gall stones as compared to normal bile. No statistical correlation was found between the decreased level of bile acids and the level of any of the studied parameters. The antinucleating activity of calculus bile was significantly decreased in those patients when compared to normal bile. It was concluded that calculus nucleation and growth is not caused by a single factor, but is mostly caused by a combination of multiple different factors whose roles are sharing in stone formation and in some way are connected. However, the relative role played by each factor in the nucleation and growth of stones can be deduced

Diuresis versus therapeutic abdominal paracentesis: effects on ascitic fluid interleukin-1, opsonic activity and complement

Twenty-four patients were randomly allocated to two groups: Group A included 12 patients treated with spironolactone [200-400 mg/day] and group B included 12 patients treated twice weekly with 34 l paracentesis for two weeks. Ascitic fluid samples from all patients were analyzed for total protein and albumin concentrations. C3 and IL-1 beta levels and OA at the beginning and two weeks after treatment. The results indicated that IL-1 beta, an immunoregulatory cytokine that stimulates a variety of cells that function as effector of immune response towards antigens, was significantly decreased following paracentesis, while it remained almost stable among the diuretic treated patients. The ascitic fluid OA and C3 concentrations increased significantly in diuretic treated patients [P <0.05]; while, patients treated with paracentesis had significantly decreased C3 concentration, and their ascitic fluid OA remained stable

Evaluation of zinc status as a liver function test in patients with schistosomal hepatic fibrosis

The association between schistosomiasis and Zinc [Zn] deficiency had been attributed to many causes including malabsorption, hepatic malfunction or reduction in its binding proteins [albumin and a[2] rnacroglobulins]. The present work aimed at the study of the relation between zinc status and the functional reserve capacity of the liver in patients with schistosomal hepatic fibrosis. For this purpose the study included 60 subjects; 15 healthy persons as a control group and 45 patients with schistosomal hepatic fibrosis divided into three equal groups [A, B and C] according to the severity of their liver affection using modified child's classification. It was found that zinc levels in plasma, polymorphonuclear leukocytes and erythrocytes are significantly low in all Schistosomal patients as compared to the control group and usually the more severe the dysfunction is, the more the Zn deficiency. This indicates Zn depletion in both extra and intracellular compartments can be mainly explained by the defective synthesis of plasma proteins by the liver, mainly albumin and a2 macroglobulins that act as carriers of Plasma Zn. However, the hyperzincuria found in these patients may share in the chronic Zn deficiency and it is mostly due to increased diffusible fraction of Zn as a result of hypoalbuminemia

Study of mucosal and submucosal vasculature, helicobacter pylori and protective capacity of gastric mucosa in portal hypertension

This study was conducted to assess the behaviour of mucosal and submucosal vasculature, protective capacity of gastric mucosa and the presumed aggressive factor, Helicobacter pylori in two well matched groups of patients. Group I included 40 patients with portal hypertension subdivided into: group IA, 20 patients with endoscopic evidence of portal hypertensive gas tropathy and group IB, 20 patients without gastropathy. Group II comprised of 20 control patients with gastritis, not associated with chronic liver disease or portal hypertension. Morphometric study revealed statistically significant increase in the mean value of mucosal and submucosal capillary cross sectional areas in both groups IA and IB as compared to group II, while no statistically significant difference was observed between these two subgroups, although the degree of mucosal and submucosal capillary ectasia was noticed to be more prominent in patients with gastropathy [group IA]. The biochemical studies of the gastric mucus secretion revealed a statistically significant decrease in mucin content, protein component and N-acetyl-neuraminic acid in portal hypertensive patients [group I] as compared to those of gastritis patients [group II]. Helicobacter pylori was found to be a significant aggressive factor in group II patients as compared to group I, it was present in 70% of this group, compared to 35% in group I, 45% in group IA and 25% in group IB. Thus the mechanisms of gastric mucosal changes in portal hypertension are multiple, entailing characteristically gastric mucosal and submucosal capillary ectasia, as well as decreased protective capacity of the gastric mucosa

Study of respiratory center drive, respiratory muscle performance and breathing patterns of some extrathoracic disorders

The present study was carried out on 40 subjects divided into four equal groups [G]. GI included 10 obese subjects, GII included 10 patients of upper airway obstruction, GIII included 10 patients with tense ascites and GIV included 10 normal persons as a control. Obese subjects showed significant increase in respiratory center discharge, respiratory frequency and minute ventilation associated with a degree of respiratory muscle dysfunction and shortening of the inspiratory time [Ti]. Patients of GII showed significant increase in respiratory center drive associated with significant reduction in their tidal volume. Also, there was a degree of respiratory muscle dysfunction. The significant findings in patients with ascites [GIII] were increased respiratory drive and respiratory frequency with subsequent shortening of Ti. Possible explanations for these results were discussed

Left ventricular function in cholestatic jaundice

Left ventricular functions were studied in 10 normal healthy controls and 57 patients with cholestatic jaundice of more than 6-week duration. The QS2 interval was insignificantly increased, the LVET was significantly shortened and PEP was significantly prolonged. These findings pointed to the impaired left ventricular performance in cholestatic jaundice. Direct myocardial depression by bile salts or decreased sympathetic drive were incriminated for the impaired left ventricular function