Comparative study between the concentration of interleukin-6 in peritoneal fluid and in serum of patients with endometriosis

Our purpose was to compare the level of interleukin- 6 in peritoneal fluid with that in serum in patients with and without endometriosis undergoing laparoscopic procedures and to set a value for Interleukin 6 as a marker for endometriosis in the serum and peritoneal fluid of patients diagnosed laparoscopically to have endometriosis and correlate it with the stage of the disease. The present study was conducted at the period starting from March 2002 to October 2003 in the laparoscopy unit, Ain Shams University Maternity hospital. Fifty patients underwent laparoscopy were recruited in this case control cross-sectional study. These patients were divided into two groups. Group I included thirty patients diagnosed to have endometriotic lesions by means of laparoscopy and histopathologic confirmation. Group II included twenty patients diagnosed laparoscopically to have no visible gynecological lesions [e.g. women undergoing laparoscopic tubal ligation]. These patients were subjected to full history taking with special regard to symptoms suggestive of endometriosis, full general, abdominal and local examination for signs of endometriosis, laparoscopic visualization and staging of endometriosis according to the criteria of the revised American Fertility Society classification system, testing for serum and peritoneal fluid Interleukin-6 using the BioSource International ELISA. [Enzyme linked immunosorbent assay], and histopathologic confirmation of peritoneal endometriotic lesions. Interleukin- 6 was significantly higher among female patients diagnosed to have endometriosis than in control patients both in serum and peritoneal fluid. Also, our study revealed a highly significant direct correlation between the level of serum and peritoneal fluid IL-6 among women with endometriosis. A significant direct correlation between the level of IL-6 with the grade of endometriosis among cases was found both in serum and peritoneal fluid IL-6. However, no significant correlation was found between the grade of endometriosis and pain among the cases group. Increased peritoneal fluid levels of interleukin-6 in patients with active red endometriosis may relate to endometriosis-associated infertility and to the pathogenesis of endometriosis

Pain relief after operative laparoscopy

This study is aimed to evaluate the effect of infiltration analgesics with intrapenitoneal Lidocaine and intraincisional bupivacain on postoperative pain relief after operative laparoscopy. For this study 40 patients needing operative laparoscopy for various indications were chosen. 20 cases received infiltration analgesics and 20 patients taken as control received no additional drug after general anaesthesia. At the complain of surgery, 20 ml of 0.5% Lidocaine were instilled intraperitoneally and 5 ml of 0.5% bupivacaine intraincisional before suturing of entry sites. McGill present pain intensity scores for pain, and narcotics use in the recovery room were less in the first two hours after operation for those patients who received the infiltration analgesics but there was no difference between the two groups 6 hours postoperative. It is concluded from this study that intraperitoneal Lidocain and intraincisional bupivacain are effective in relieving pain in the first two hours after operative laparoscopy

Chemotherapeutic agents in tuberculosis and cellmediated immune response an in-vitro study

To estimate the potential adverse sequence of PAS, INH, ethionamide, ethambutol and rifampin therapy on cell mediated immune response in tuberculosis, we measured the in vitro lymphocyte resposes to PHA in the presence of these chemotherapeutic agents in varying concentrations per ml. lymphocytes were collected on Ficol-Hypaque gradient from the heparinized blood from normal adult male blood donors. The degree of incorporation of tritiated thymidine into the lymphocytes in the presence and absence of the chemotherapeutic agents were measured by a B, scintillation counter as cpm. The stimulation indices were calculated. PAS, INH and ethionamide were found to have no adverse effect on lymphocytes in any of the concentrations used. Rifampin at the concentration of 50 micro g/ml and ethambutol at the concentration of 300 micro g/ml were significantly depressant to lymphocytes