Infants of diabetic mothers a cohort study

To determine the outcome of infants born to diabetic mothers at Security Forces Hospital, Riyadh, Saudi Arabia, and compare the complications seen in these infants with infants of non-diabetic mothers. This is a concurrent prospective cohort study of a population of newborn infants delivered at Security Forces Hospital, Riyadh, Saudi Arabia for diabetic mothers between January 2011 and November 2011. A total of 601 infants were enrolled in the study consisting of 319 infants of non-diabetic mothers, and 282 infants of diabetic mothers. Infants of diabetic mothers showed significantly higher rates of associated complications and prolonged hospital stay reflected in their admission to the neonatal intensive care when compared with infants of non-diabetic mothers. There was no difference in rate of complications between infants of gestational diabetics and pre-gestational diabetics. Our study showed that diabetic pregnancies are associated with an increased incidence of neonatal complications. These seem to be related to the degree of maternal glycemic control. The higher rates of complications among our infants of diabetic mothers, particularly major congenital malformations call for those involved in the care of diabetic mothers to consolidate their efforts to facilitate early booking in specialist clinics

Outpatient blind percutaneous liver biopsy in infants and children: is it safe?

We aim to investigate the safety of outpatient blind percutaneous liver biopsy [BPLB] in infants and children with chronic liver disease [CLD]. BPLB was performed as an outpatient procedure using the aspiration Menghini technique in 80 infants and children, aged 2 months to 14 yrs, for diagnosis of their CLD. Patients were divided into three groups: Group 1 [<1 year], group 2 [1-6 yrs], and group 3 [6-14 yrs]. The vital signs were closely monitored 1 hr before biopsy, and then 1, 2, 6, and 24 hrs after biopsy. Twenty-four hours pre-and post-biopsy complete blood counts, liver enzymes, prothrombin time [PT], and abdominal ultrasonography, searching for a biopsy-induced hematoma, were done for all patients. No mortality or major morbidities were encountered after BPLB. The rate of minor complications was 17.5% including irritability or "pain" requiring analgesia in 10%, mild fever in 5%, and drowsiness for>6 hrs due to oversedation in 2.5%. There was a statistically significant rise in the 1-hr post-biopsy mean heart and respiratory rates, but the rise was non-significant at 6 and 24 hrs except for group 2 where heart rate and respiratory rates significantly dropped at 24 hrs. No statistically significant difference was noted between the mean pre-biopsy and the 1, 6, and 24-hrs post-biopsy values of blood pressure in all groups. The 24-hrs post-biopsy mean hemoglobin and hematocrit showed a significant decrease, while the 24-hrs post-biopsy mean total leucocyte and platelet counts showed non-significant changes. The 24-hrs post-biopsy mean liver enzymes were non-significantly changed except the 24-hrs post-biopsy mean PT which was found to be significantly prolonged, for a yet unknown reason[s]. Outpatient BPLB performed by the Menghini technique is safe and well tolerated even in infants and young children. Frequent, close monitoring of patients is strongly recommended to achieve optimal patient safety and avoid potential complications

Batch and flow injection potentiometric monitoring of ceftriaxone sodium in pharmaceutical reparations using two novel membrane sensors

Two novel potentiometric sensors are prepared, characterized and successfully used for static and continuous determination of ceftriaxone sodium [CRXN]. Both sensors are based on the use of plasticized PVC matrix membranes incorporating tetradodecylmethyl ammonium bromide [TDMAB], ortridodecylmethyl ammonium chloride [TDMAC] ion-exchangers and used for quantitative determination of CRXN at concentration level down to 29 micro M using both sensors with a good accuracy. Both sensors offer the advantages of fast response, reasonable selectivity, elimination of drug pre-treatment or separation steps, low cost and possible interfacings with computerized and automated systems. The use of plasticized membrane electrodes were used for continuous monitoring of CRXN offers the advantages of simple design, ease of construction and possible applications to small volumes of drug solutions with little manipulation and without pre-treatment. Both detectors display a wide dynamic measurement range of the drug under continuous mode of operation with a flow rate of 2.0 ml.min[-1] and used for quantitative determination of CRXN. The developed sensors were utilized in static continuous modes successfully for the determination of CRXN in pure powders and in dosage forms. It is worth noting that the developed membrane electrodes exhibited good selectivity toward CRXN over other cephalosporins such as; cefradine, ceftazidime, cefadroxil, cefaclor and cefoperazone, as well as other additives found in the pharmaceutical preparations such as; glucose, fructose and maltose

Ventilator associated pneumonia in critically-ill neonates admitted to neonatal intensive care unit, Zagazig university hospitals

Ventilator associated pneumonia [VAP] is defined as nosocomial pneumonia in mechanically ventilated patients. It is considered to be most important cause of infection-related death in intensive care unit We studied the characteristics and risk factors of VAP in critically-ill neonates. Fifty six consecutive neonates with different diagnosis admitted from January to October 2010 to neonatal intensive care unit [NICU], Zagazig University Hospitals who needed mechanical ventilation were included in the study. There were 32 neonates, 18 males and 14 females with proven diagnosis of VAP, and 24 neonates, 11 males and 13 females without VAP served as control group. All studied neonates were subjected to history taking, clinical examination, routine investigations [Complete blood count, C-reactive protein, arterial blood gases, blood culture and liver and kidney function tests], and chest X-ray daily as well as non-bronchoscopic alveolar lavage culture for VAP group only. Of 56 neonates who needed mechanical ventilation, 57.1% developed VAP. Prematurity, low birth weight and prolonged duration of mechanical ventilation were risk factors for developing VAP. Increased total leucocytic count, CRP and hypoalbuminemia were significantly presented in VAP-group. There were significant differences between VAP and non-VAP groups regarding hypothermia, mucopurulent endotracheal tube secretion, PaCO[2] and PaO[2]. Microorganisms associated with blood stream infection in VAP diagnosed group were Klebsiella [15.6%], S. aureus [12.5%], Pseudomonas [9.4%], E. coli [6.2%], Candida [3.1%]; 53.1% of obtained blood cultures were sterile. Of non-bronchoscopic alveolar lavage cultures obtained from VAP patients, 68.6% showed gram negative infection, 21.8% showed gram positive organisms and 9.3% revealed Candida infection. The most important risk factors of VAP are prematurity, low birth weight, prolonged I duration of mechanical ventilation, enteral nutrition and umbilical catheterization

Clinical and laboratory studies on experimentally induced acute ruminal lactic acidosis in male goats

Acute ruminal acidosis was experimentally induced in six mixed breed of male goats, [15-18 months old and 27-38 kg body weight], by wheat flour, 50 g/kg BW, infused intraruminally through a surgically prepared ruminal cannula. Ruminal fluid and blood samples were obtained at 0, 12, 24 and 36 hours to evaluate ruminal fluid contents, serum biochemical changes and complete blood picture. Severe clinical signs of ruminal acidosis were evident by12 hours represented by depression, recumbency, diarrhea, grinding over the teeth, trembling, ruminal stasis, dehydration, polypnea and tachycardia. Sharp drop in ruminal fluid pH with parallel sharp increase in ruminal lactate and glucose levels were recorded. Ruminal protozoa completely disappeared following induction. Significant decrease in venous blood pH and a significant increase of serum levels of lactate, total protein, albumin, Gamma glutamyl transferase [GGT], urea and creatinine were obtained. Significant increase in hematocrit value, total leukocytic count, neutrophil and a significant decrease in lymphocyte were also recorded. Post mortum and histopathological examination were performed to confirm the disease

193 nm ArF excimer laser induced changes in aqueous humor of rabbit's eyes

The changes in aqueous humor of rabbits' eyes after land 4 weeks of corneal photoablation with 193 nm argon fluoride [ArF] excimer laser with two different intensities [300 mJ/cm[2] and 500 mJ/cm[2]] were investigated. In the 1[st] group the right eyes were submitted to 300 mJ/cm[2] and left for one week, the 2[nd] group was submitted to 300 mJ/cm[2] and left for 4 weeks, the 3[rd] group was submitted to 500 mJ/cm[2] and left for one week and finally the 4[th] group was submitted to 500 mJ/cm[2] and left for 4 weeks. The left eyes from each group were used as control. Measurements of the total protein content, the refractive index [RI], sodium dodecyle sulfate polyacrylamide gel electrophoresis [SDS PAGE], column chromatography and ultraviolet spectroscopy profiles for aqueous humor were carried out. Non significant changes in the protein content and the refractive index [RI] were observed after 1 week of treatment with 300 mJ/cm[2]. All measurements detected significant changes after 4 weeks of treatment with 300 mJ/cm[2] and after 1 and 4 weeks of laser treatment with 500 mJ/cm[2]. The ultraviolet absorption spectrum revealed apparent depletion in ascorbic acid concentration. It was concluded that, ArF excimer laser [193 nm] leads to change in aqueous humor and formation of new protein with different molecular weights accompanied with a loss and oxidation of ascorbic acid and formation of dehydroascorbic acid

Prevalence and risk factors of gallstone disease in a high altitude Saudi population

To study the prevalence of gallstone disease and related risk factors in a Saudi Arabian population a cross-sectional community-based study was made of 291 people from Abha district, Asir region. A structured interview collected background data and all participants had upper abdominal ultrasonography to detect gallstones. The overall prevalence of gallstone disease was 11.7%. Using logistic regression multivariate analysis, the following were significant risk factors for gallstone disease: female sex, family history of gallstone disease and past history of pancreatitis. Age, education, blood pressure, smoking, coffee intake, overweight, diabetes mellitus, number of pregnancies and use of oral contraceptives were not significant risk factors. Discriminant analysis of symptoms showed that only right hypochondrium pain was significantly associated with gallstone disease

study into the expression of the tumor suppressor gene p53 and the oncogene bcl-2 in human breast cancer

In this study, the protein expression of the mutant tumor suppressor gene p53, and oncogene bcl-2 was evaluated in 50 female breast cancer patients using two different techniques, ELISA and western blotting, the relation between these two techniques in relation to protein expression was detected, and the correlations between the expression of these two proteins and the different prognostic parameters of cancer breast were studied. The mean value of bcl-2 in breast cancer patients was statistically significantly higher than those of normal healthy controls using both ELISA and western blotting techniques. A significant positive correlation was found between bcl-2 and both the tumor size and the stage of the tumor which signifies its important role as a prognostic factor in breast cancer. Also over-expression of mutant p53 was detected using both ELISA and western blotting techniques when compared to the normal healthy controls. The only statistically significant correlation between mutant p53 expression and the different prognostic parameters of breast cancer was found to be between p53 the stage of the tumor. When taking predictive cut off levels of bcl-2 at 75U/ml, and mutant p53 at 2.16U/ml, bcl-2 showed the highest sensitivity, specificity anti diagnostic accuracy of [88%, 90%, and 90%] respectively, while mutant P53 showed its highest sensitivity, specificity and diagnostic accuracy [80%, 100%, and 85.7%] at the chosen cut offs. When done in either abnormal and both abnormal double combinations with the same cut offs, the sensitivity, specificity and diagnostic accuracy in the either abnormal combination have improved than either parameter singly, [92%, 100% and 94.29%] respectively, while in both abnormal combination the sensitivity, specificity, and diagnostic accuracy are [64%, 90% and 71.43] respectively. When studying the correlation between the 2 techniques [ELISA and western blotting] used in determination of bcl-2 and P53 expression in breast cancer patients all samples which showed over-expression for mutant P53 and bcl-2 using ELISA technique, also demonstrated over-expression using western blotting technique. The percent of positive expression the mutant P53 and the bcl-2 proteins were higher [76%] and [88%] respectively using western blotting technique when compared to ELISA technique [70%] and [80%] respectively. The results of both techniques were statistically significantly correlated for both P53 and bcl-2. Although western blotting technique has a higher sensitivity compared to ELISA, it has many disadvantages as cost, reproducibility, time consumption and the requirement for high skills

Estimation of tissue hypothyroidism in patients with overt and subclinical hypothoidism

The clinical score, and tests that reflect tissue hypothyroidism [ankle reflex relaxation time, serum cholesterol level] were reevaluated in the high of the modern laboratory tests of thyroid function. We analyzed 95 female subjects: 40 overt hypothyroid patients, 25 sub clinical hypothyroidism [SCH], and 30 euthyroid control subjects. The clinical score was defined as the sum of the 2 best discriminating signs and symptom. Beside TSH and thyroid hormones, we measured parameters known to reflect tissue manifestations of hypothyroidism, such as ankle reflex relaxation time and total serum cholesterol. So Classical signs and symptoms of hypothyroidism were present only in patients with sever overt hypothyroidism with low T3, It has been found that the clinical score, showed an excellent correlation with ankle reflex relaxation time p < 0.01 and serum cholesterol level p < 0.001, and CK p < 0.01 but not correlated with serum TSH in patient group with overt hypothyroidism. While in subclinical hypothyrodism the clinical score correlate significantly with ankle reflex relaxation time p < 0.01 with fT4 p < 0.01 with serum TSH p < 0.01 but not correlated other parameters It could be concluded That Scoring of symptoms and signs of hypothyroidism with the new clinical score and measurement of ankle reflex relaxation time in addition to routine thyroid function tests is very useful for the individual assessment of thyroid failure and monitoring of treatment

Release of phosphorus from rock phosphate through composting using organic materials and its effect on corn growth

The use of natural forms of minerals such as rock phosphate as an alternative source to synthetic fertilizers partially or totally is receiving renewed attention worldwide. Apart from nutritional effects, application of such minerals is effective in reducing the cost of crop production and maintaining the natural fertility of soil. Since the solubility of rock phosphate is generally low, it does not always give satisfactory results when directly applied. The present study was therefore, undertaken to explore the possibility of increasing the release of P from rock phosphate at different rates through composting using rice straw and the effect of P-charged compost on the yield and P uptake by corn plants. The concentration of total P significantly enhanced in the final product with all treatments as organic materials decreased during composting compared to control where no P was added. Phosphorus from rock phosphate was solubilized and transformed into available forms during composting. Application of rock phosphate had no effect on degradation of rice straw up to 20% but at higher rates, the degradation decreased. The water soluble P decreased with the addition of rock phosphate to composted materials. The soluble P in 2% citric acid increased dramatically on composting with rock phosphate and the maximum increase was observed with 30% rock phosphate. This fraction is presumed to be available to plant uptake. Release of P from rock phosphate was decreased by addition of [NH[4]] [2] SO[4], but increased by the addition of urea. It is concluded that urea hydrolyzes the organic matter within the period of composting and that the products of hydrolysis chelate Ca[2]+ ions and so increased the release of P from the rock phosphate. The response of corn plants to addition of compost that included rock phosphate was considerable when added in sandy soil. The P-charged compost containing 6.75% total P was comparable to super phosphate or better when combined with phosphate dissolving bacteria in increasing dry matter yield and P uptake. Rice straw compost prepared without rock phosphate did not give significant increase in corn yield

Respiratory syncytial virus infection in patients visiting King Khalid University Hospital

Respiratory syncytial virus [RSV] is a leading cause of lower respiratory tract infections in infants and young children worldwide. The involvement of lower respiratory tract, manifest clinically as bronchiolitis or pneumonia is the hallmark of severe RSV disease. This study aimed to assess the prevalence of RSV among patients visiting King Khalid University Hospital, King Saud University, Riyadh. Nasopharyngeal aspirate samples were obtained from patients with acute respiratory symptoms visiting King Khalid University Hospital in the period between 1999 and 2003. Samples were sent to the virology unit for detection of RSV hntigens using direct immunofluorescence test. 19.3% of the nasopharyngeal aspirate samples were positive for RSV. Most of the cases were in the age group 0-6 months [58.9%], followed by age group > 6- 12 months [19.8%]. Seasonal variation showed that most of the RSV cases were predominant during winter and early spring months. Infections with RSV are a common cause of morbidity and mortality among Saudi patients. A better understanding of the epidemiology of RSV infections may be used for timely, specific antiviral therapy and prophylaxis

Changing pattern of childhood blindness in Saudi Arabia

We studied 187 patients attending special educational institutions in Saudi Arabia who were blind before the age of 14. All patients underwent complete ophthalmological evaluation. The visual acuity in 31% of the patients was no light perception and in 58% light perception to counting fingers at 3 feet [1 m]. 70% were blind before age 2. Prior to 1962 acquired diseases led to blindness in 75% of the patients. From 1962 onwards genetically determined diseases accounted for 84% of childhood blindness. 56% of this group were the product of consanguineous marriages. On the other hand in the group who acquired blindness only 14% were from cosanguineous marriages [p<0.0001]. We here describe guidelines for the prevention of childhood blindness in Saudi Arabia

Changing patterns of visual loss in the eastern province, Kingdom of Saudi Arabia

Considerable attention has been given to the problems of prevention of blindness and trachoma in the Eastern Province of Saudi Arabia over the past 40 years. It was reported in the 1960s that trachoma prevalence in Eastern Province preschool children was in excess of 90% in villages and 70% in towns, leading to a high incidence of blindness. Unpublished data from the Kig Khaled Eye Specialist Hospital 1984 G/ 1404 Hnational Survey of Eye Disease and Visual Loss demonstrated that, according to World Health Organization criteria, the prevalence of blindness in the Eastern Province was 3.3% and the prevalence of active trachoma was 11.3%. Recent socioeconomic improvement, including the health services, prompted a new survey in order to assess the current situation. From a stratified geographic cluster sample, 4819 persons were registered and 4340 were examined. Results from this 1990 survey are compared with the 1984 data. Blindness was reduced from 3.3% to 1.5%, and cataract remains the major cause of blindness [37.5%]. Trachoma is responsible for 9.4% of the causes of blindness in 1990, in comparison to 27.3% in 1984. Active trachoma has decreased to a level where it can no longer be considered a major health hazard [1%]; however, total elimination of the disease, and protection of families at risk is recommended

Open palomo technique versus laparoscopic varicocelectomy

Aim: is to compare varicocelectomy by conventional open high ligation [palomo] and the laparscopic technique. Patients and Between June 2000 and December 2002; forty patients suffering from varicocele in Surgery Department, Menoufiya University Hospital; 20 of those patients treated by palomo operation [GPI]. The other 20 patients treated by laparoscopic varicocelectomy [GPII]; pre-operative semen analysis; Doppler examination, Dupler u/s., Blood picture, liver function, urine and stool analysis. Post-operative seminogram was also performed; follow up period 6 +/- 3 and 3 +/- 2.5 months for GPI and II, respectively. 40 patients suffering of 69 varicocels of various grades: -Group I: 12 cases [32.4%] grade III, 15 cases [40.5%] grade II and 10 cases [27%] grade I. -Group II: 10 cases [31.2%] grade III, 20 cases [62.5%] grade II and 12 patient [6.25%] grade I. Primary infertility was detected in 8 patients [40%] of group I and in 5 patients [25%] of group II; secondary infertility was detected in 3 patient [15%] of group I, and in 3 patient [15%] out of group II. In these cases pre-operative seminogram showed oligoasthenoteratospermia. Post-operative seminogram showed significant increase in the number and motility after treatment in both groups in addition to reduction of abnormal forms. Again, the large varicocele showed greater post-operative semen quality improvement. Shorter mean operative time and less cost in group I and higher recurrence rate in group II [P<0.05]. The open palomo technnnique is a safe, simple minimally invasive, short time and less cost consuming but laparoscopic varicocelectomy is suitable for bilateral cases

[Bilateral pulmonary embolism secondary to the venous thrombosis in child nephrotic syndrome]

Nephrotic syndrome is known to be associated with thrombosis in child. These complications are severe. The authors reported a case of a 4 year-old boy who was hospitalized for a corticoresistant nephrotic syndrome. He has developed a bilateral pulmonary embolism secondary to the extension of the thrombosis of the superior vena cava. The treatment consisted in the association of a low molecular weight heparin and vitamin K antagonists for 8 months. The outcome was good after 18 months without sequealea, and the remission of nephrotic syndrome was obtained after using cyclosporine

Helicobacter pylori infection among school children in Alexandria: Possible association with intestinal parasitic infections

This study was conducted on 170 pupils of a primary school in Backos area of Alexandria, Egypt. A complete clinical examination was undertaken together with a thorough past and family history taking. The children completed a pre-designed questionnaire regarding some socioeconomic data and past medical history. A stool examination was carried out to detect different parasitic infections. Helicobacter pylori infection was diagnosed immunologically by the detection of anti-H. Pylori IgG antibodies in salivary samples using the enzyme linked immunosorbent assay [ELISA]. The results revealed that the prevalence of H. Pylori among the examined pupils was 27.1%. Boys were more infected than girls [32.5% vs. 22.2%]; however, the gender effect was not statistically significant. Age was more important as an epidemiologic determinant and H. Pylori infection increased significantly with age. Of the socioeconomic factors investigated, the education of parents, especially mothers, was the most important and H. Pylori infection increased significantly with the decrease of the level of mother's education. A degree of association, which was not statistically significant, was found between H. pylori infection and intestinal parasitic infections, especially helminths as Ascaris, Trichuris, Hymenolepis and Fasciola sp. Suggesting the fecal-oral route of transmission, role of food and the effect of household environment and food hygiene

Insulin, endothelin-1, homocysteine, plasminogen activator inhibitor-1 and C-reactive protein as novel brisk factors for systemic atherosclerosis in diabetic patients

Aim: The aim of the present study was to find out the contributing role of ET-1, PAI-1, homocysteine, and CRP [C- reactive protein] with regard to the increasing risk for the development of atherosclerosis in diabetic patients. The study included 30 metabolically-controlled diabetics, 15 of them belonged to type 1, and 15 type 2 diabetics. Blood glucose levels, HbAIc, lipid profile, plasma C- peptide, homocysteine, CRP, and fibrinogen were assayed basally, whereas ET-1 and PAI-1 levels were assayed both basally and at 120 and 180 minutes during the euglycemic hyperinsulinemic clamp technique. Basal levels of homocysteine, C- reactive protein and fibrinogen were within normal range in both types of diabetes. There was a significant increase in the mean basal levels of ET-1 and PAI-1 in type 2 diabetics when compared to their mean basal levels in type 1 diabetes. Moreover, ET-1 and PAI-1 levels were significantly higher at 120 and 180 minutes when compared to their basal levels. Also, ET-1 and PAI-1 levels at 120 and 180 minutes were significantly higher in type 2 diabetics when compared to their levels in type 1 diabetics. There was a significant positive correlation between the daily dose of exogenous insulin and basal levels of ET-1 and PAI-1 in type 1 diabetes, and between the mean basal C- peptide level and the mean basal ET-1 and PAI-1 levels in type 2 diabetics. Conclusions: Insulin stimulates ET-1 expression in patients with diabetes. The plasma ET-1 concentration is related to endogenous insulin secretion and therefore to insulin resistance. As a consequence of higher endogenous insulin secretion, patients with type 2 diabetes have higher levels of plasma ET-1 than patients with type 1 diabetes. This level was maintained significantly higher at 120 and 180 minutes in type 2 diabetics when compared to its level in type 1 diabetes. Moreover, patients with type 2 diabetes have significantly higher levels of PAI-1 than patients with type 1 diabetes. Therefore, in diabetics, the impairment of fibrinolytic system may affect the development and progression of atherosclerosis

Thyroid gland status and type 1 diabetes mellitus in relation to serum vascular endothelial growth factor levels

Aim: Investigation of the relationship of thyroid gland status in type 1 diabetes mellitus and serum vascular endothelial growth factor [VEGF] level. Subjects and Twenty type 1 male diabetic subjects, and ten matched control normal subjects. Serum VEGF concentrations, FT3, FT4, serum TSH and anti-GAD were tested for all subjects. None of the subjects ever had any concomitant metabolic and/or autoimmune diseases. Diabetic patients demonstrated a significant reduction in FT3 and a significant increase in both TSH and VEGF as compared to the control group. There was no significant difference between the two groups regarding FT4. Sixty five percent of type 1 diabetic patients showed +ve autoantibodies against glutamic acid decarboxylase [anti-GAD], whereas all the controls were -ve for anti-GAD. Conclusions: There is a close association between type 1 diabetes with anti-GAD, and the presence of thyroid dysfunction. Moreover, the increased serum levels of VEGF in type 1 diabetics with hypothyroid function could be the stimulus for the increase in intrathyroidal angiogenesis

Relation between insulin sensitivity and plasma tumour necrosis factor alpha in subjects with impaired glucose tolerance

The aim of the present study has been to search for a possible relation between insulin resistance and plasma tumour necrosis factor-a [TNF-alpha] in a group of subjects with impaired glucose tolerance [IGT]. Forty adult men with IGT [Group I] and twenty matched control subjects with no family history of diabetes mellitus [Group II] were included. Insulin resistance was assessed by measurement of Insulin Sensitivity Index [ISI]. Plasma TNF-alpha levels were measured using enzyme linked immunosorbant assay. The insulin sensitivity indices were significantly lower and plasma TNF-alpha was significantly higher in IGT subjects [Group I] as compared to normal controls [Group II]. There was a negative correlation between insulin sensitivity indices and plasma TNF-alpha concentrations in IGT subjects. TNF-alpha was significantly correlated to BMI, fasting blood glucose, serum triglyceride levels and inversely correlated to HDL- cholesterol. These results indicate that TNF- alpha is an important mediator of insulin resistance syndrome and may be involved in the pathogenesis of impaired glucose tolerance and type 2 diabetes mellitus

Effect of insulin-induced hypoglycaemia on plasma pancreatic polypeptide and glucagon levels in conscious dogs

The aim of the present study has been to identify the role of nitric oxide [NO] in mediating pancreatic endocrine responses to severe hypoglycaemia [2.0 nmol/kg insulin I.V.] in conscious dogs. The experiments were carried out on 18 apparently healthy adult male conscious dogs divided into three groups: Group I: Six dogs sacrificed as control group. Group II: Six dogs subjected to severe hypoglycaemia in the absence of L-NAME [NOS blocker] and sodium nitroprusside [NO donor]. Group III: Six dogs subjected to severe hypoglycaemia in the presence of L-NAME [100 mg/kg I.A.] and sodium nitroprusside [2-4 micro g/min/kg I.V.].Glucose was measured by means of a Mark 2 Beckman Glucose Analyser, Glucagon and PP were easured by radioimmunoassay. Determination of cGMP levels was studied using pancreatic tissues from the three studied groups. Administration of L-NAME effectively produced a significantly reduced plasma pancreatic polypeptide [PP] response. In contrast, the glucagon response was not significantly affected. Moreover, plasma glucagon values were consistently higher in group III [with L- NAME] when compared to group II [without L-NAME] at 30 and 120 min. intervals, [t = 5.36, P < 0.001, and t = 6.32, P< 0.001 respectively]. One can conclude that, in the absence of L-NAME, production of NO may contribute to the PP response, but not to the glucagon response to hypoglycaemia in this species under physiological conditions, in this study, there was a significant increase in pancreatic tissue cGMP in the studied dogs without L-NAME and sodium nitroprusside as compared to both control dogs [t= 11.6, P < 0.001], and those receiving L-NAME and sodium nitroprusside [t = 8.25, P < 0.05]. This explains a possible rote of cGMP in the process of PP release through NO gas. Conclusions. Administration of NOS blocker has produced a significantly reduced plasma pancreatic polypeptide [PP] response with no significant effect on glucagon secretion during insulin-induced severe hypoglycaemia in conscious dogs. cGMP has been found to play a possible role in the process of PP release through NO gas