Prevalence of thyroid autoantibodies in children, adolescents and young adults with type 1 diabetes in Kuwait

To investigate the prevalence of thyroid autoimmunity among children and adolescents with type 1 diabetes in Kuwait. In a mixed cross-sectional and longitudinal study, anti-thyroid peroxidase [anti-TPO] and anti-thyroglobulin [anti-TG] were measured in 232 subjects [118 males and 114 females] with type 1 diabetes. The mean age of the total study population was 10.9 +/- 3.6 years [range 1-21], and the median diabetes duration was 3.9 years [range 0-16]. At the initial screening, 57 out of 232 [24.6%] patients had positive antibodies, and of the remaining 175 patients, who were antibody negative, 131 [74.3%] were followed up for 4-9 years. 23 out of these 131 [17.7%] patients became antibody positive, with a cumulative prevalence of elevated antibodies of 34.5%. Anti-TPO was present in 34 [14.7%], anti-TG in 23 [9.9%] and both antibodies in 23 [9.9%] patients. Thyroid antibodies presented early within the first 5 years of the onset of diabetes [63.2 vs. 36.8%, p < 0.05]. The prevalence of elevated thyroid antibodies increased after the onset of puberty in both females and males [p < 0.0001]. A total of 58.7% of the patients with positive antibodies were females compared to 41% males [p < 0.0001]. The basal thyroid-stimulating hormone was higher in subjects with positive antibodies [5.1 +/- 10.7 mIU/l] compared to those who were antibody negative [1.79 +/- 0.87 mIU/l, p < 0.001]. Furthermore, 30 out of 232 [12.9%] patients developed thyroid dysfunction. In this study, a high prevalence of thyroid autoimmune antibodies was found in patients either at the onset of type 1 diabetes or within the 4-9 years of follow-up

Non HLA genetic markers association with type-1 diabetes mellitus

The currently available data identified IDDM1 and IDDM2 as 2 susceptibility loci for type 1 diabetes [T1D]. The major histocompatibility complex [MHC]/HLA region referred to as IDDM1 contains several 100 genes known to have a great influence on T1D risk. Within IDDM2, a minisatellite variable number of tandem repeats [VNTR] locus in the insulin gene [INS] promoter region is likely to represent the etiologic polymorphism. The aim of the present work was to study the association between genotypes and susceptibility to T1D among Egyptian diabetic children and their family members. Twenty-five nuclear Egyptian families with 27 children having T1D, aged 3-14 years, their nondiabetic 44 sibs, aged 3-15 years and their parents were included in our study. All studied children were subjected to: detailed history and family pedigree. Thorough clinical examination and anthropometric measurements. Laboratory work up of diabetes including random blood sugar [RBS] and HbA[1]C. Molecular genetics of INS was studied in four steps; nucleic acid purification, amplification, sequencing and haplotyping using flanking single nucleotide polymorphisms [SNPs] as surrogate markers for minisatellite alleles identification. Analysis of variant repeat distribution among Egyptian families combined with flanking haplotypes revealed that all our diabetic children had class I alleles of INS; 9 had class IC+, 9 had class ID+ and 9 had class ID-, while all non-diabetic family members had class III alleles of INS. Therefore the three class I alleles were considered to be equally predisposing to T1D, while class III alleles are dominantly protective. There was significant positive correlations between body mass index [BMI] and both HbA[1]C and AST liver enzyme among diabetic children with class IC+ but not other alleles; indicating that they need close monitoring of their diabetic control and liver functions beside following specific dietary regimens. It can be concluded that all class I alleles [IC+, ID+ and ID-] are equally important susceptibility factors for T1D among Egyptian children, while class III alleles [IIIA and IIIB] are dominantly protective. It is concluded also that our diabetic children with class IC+ are an especially endangered subgroup of diabetics. Genotyping for INS-VNTR alleles is recommended for diabetic children as an important step of diagnostic and follow up regimens and for their non-diabetic family members for family counseling and early identification of potential diabetics. Further studies of INS-VNTR alleles and HLA haplotypes all over Egypt are recommended to define the Egyptian susceptibility loci for T1D and their relations to the clinical and laboratory findings as an important national programs

Detection of sperm DNA fragmentation in IVF-ICSI patients and correlation with sperm quality and treatment outcome

The incidence of DNA fragmentation in the sperm head [DFl] is higher in infertile male population compared to the fertile one. Several methods can be used to detect sperm DNA fragmentation. Among this method TUNEL assay is reported to be the most related to the male fertility potential. The aim of this study is to examine the relationship between sperm DNA fragmentation and the outcome of intracytoplasmic sperm injection [ICSI]. Eighty-five couples undergoing ICSI procedure were recruited to this study. Sperm from the row ejaculate was examined for sperm DFI was using TUNEL assay. There was no relation between the sperm DFI and the conventional WHO semen parameter. There was also no significant difference in the fertilization and cleavage rate between couples with low, moderate or high DFI [<15%, 15-30%, >30% respectively]. Pregnancy rate was significantly lower when sperm DFI was higher than 15% and no pregnancy as achieved when the DFI was higher than 30%. These results demonstrate the negative effect of the DNA fragmentation on the ICSI outcome. This deleterious effect seems to affect later stages of embryonic development

Evoluation of some biochemical alterations in neonatal hypoxic ischemic encephalopathy [HIE]

The main objective of this work was to study the evolution of serum L- carnitine and other metabolic derangements that may contribute significantly to the severity of hypoxic ischemic encephalopathy [HIE] including serum aspartate aminotransferase [AST], alanine aminotransferase [ALT], creatinine and electrolyte levels as well as acid-base status. It was conducted on 23 full-term newborns that fulfilled the clinical criteria of hypoxic ischemic encephalopathy in addition to ten healthy full-term newborns of matched weight, gestational and post-natal ages as a control group. It was concluded that L-carnitine may be a useful marker for the severity of HIE. Serum creatinine, AST and ALT levels were significantly increased in all grades of HIE

Occurrence of some food poisoning microorganisms in rabbit carcasses

Fivety random samples of rabbit meat and liver [25 of each] were collected from different rabbit processing plants at Kalyobia Governorate for demonstration of food poisoning microorganisms. The obtained results revealed that the mean values and incidences of microorganisms isolated from rabbit meat and liver were 5.32x10[2] +/- 1.16x10[2] [8%] and 8.78x10[2] +/- 1.90x10[2]/g [16%], 9.11x10[3] +/- 2.63x10[3] /g [48%] and 1.41x10[4] +/- 0.27x10[4] /g [68%], 7.18x10[2] +/- 1.76x10[2] /g [44%] and 4.55x10 +/- 0.83x10 [2]/g [32%] 1.35x10[2]/g +/- 0.24x10[2] [16%] and 2.63x10[2] +/- 0.69x10[2]/g [20%]for E. coli, Staphylococcus aureus, Clostridium perfringens and Bacillus cereus, respectively. Enteropathogenic E. coli isolates isolated from rabbit meat were serologi-cally identified as 0,[111]:K [58] [B14] while O [26]:K[60] [B6] and O[124]:.K[72] [B[17]] these serotypes were isolated from rabbit liver. Moreover, Yersinia enterocolitica was isolated from examined rabbit meat and liver samples 8% and 4%, respectively. However, Salmonella organisms could not be isolated from all examined samples. The public health significance of isolated microorganisms as well as suggestive hygienic measures to improve the quality of rabbit carcasses were discussed

Transfixion ligation of isolated patent ductus arteriosus a safe, easy and effective technique

A series of 110 patients with isolated patent ductus arteriosus have been submitted to surgical transfixion ligation. There were 79 females [71.8%] and 31 males [28.2%]. Age ranged from 5 months to 38 years with a mean age of 5.08 + 1.76 years. Diagnosis was made on clinical basis and confirmed by echocardiography. Surgical ligation of PDA was performed using double silk ligatures on both ends of the ductus together with a transfixion ligation in between. Mortality was 0.9%. Intraoperative bleeding happened in 2.7%. The alive patients have been followed up for variable periods of time, the longest of which was 15 years and no evidence of recanalization appeared till now

Determination of tumor necrosis factor alpha level in cerebrospinal fluid as a differentiating parameter between bacterial and non bacterial meningitis

36 patients [26 males and 10 females with their ages ranged from 4 to 14 years] diagnosed clinically as meningitis were studied for the biochemical, microbiological and the level of tumor necrosis factor alpha [TNF-alpha] in cerebrospinal fluid [CSF]. 16 patients were diagnosed as bacterial meningitis. While 20 patients [55.56%] were diagnosed as non bacterial meningitis. Tumor necrosis factor alpha level is highly elevated in all patients with bacterial meningitis while showing a little rise in non bacterial meningitis and within normal level in control group with a highly significant difference between the 3 groups [P <0.001] indicating that it can be used as a parameter to differentiate bacterial from non bacterial meningitis

Meningitis in an infant due to a relatively penicillin resistant strain of streptococcus pneumoniae

A six months old infant with bacterial meningitis is described. The infection was caused by a strain of S. pneumoniae that showed relative resistance to penicillin with a MIC value of 0.5 micro g/mL The disease ran a complicated course that might have been precipitated by repeated courses of other antibiotics before the correct diagnosis was established. Regular screening of S. pneumoniae with regard to penicillin resistance is emphasised

Cerebrospinal fluid lactate is useful in differentiating viral from bacterial meningitis

Cerebrospinal fluid [CSF] lactate was studied in 63 consecutive infants and; children with suspected bacterial meningitis. Levels of CSF lactate above 3 mmol/1 were present in 14 out of 16 children with culture-proven meningitis, 1 out of 9 infants with viral meningitis, and 2 out of 6 with partially treated meningitis. Thirty-three infants who had their CSF examined to exclude meningitis served as control. None had levels above 2.3 mmol/1. The sensitivity, specificity, and efficiency of the test was 87.5, 97.6 and 94.8, respectively. We conclude that the test is useful, simple and reliable