Silent myocardial ischaemia [SMI] in non-insulin dependent diabetic men and its relation to diabetic autonomic neuropathy

Treadmill exercise test was performed in 100 non-insulin dependent diabetic men not suffering from symptoms of coronary artery disease [asymptomatic Diabetic Group] and 40 none diabetic control subjects [Control Group], to detect the prevalence of SMI in the asymptomatic diabetic group, and to be compared with the control group. Thirty sex% of diabetic patients were found positive for SMI in treadmill test, this is to be compared with only 5% of subjects in the control group, the difference in between was statistically significant [P < 0.05]. When we evaluated autonomic neuropathy in the diabetic group we found that 44% of these patients had diabetic autonomic neuropathy. Also diabetic autonomic neuropathy was found in 69.4% in treadmill positive patients, this is to be compared with 29.7% in treadmill negative patients, the difference in between was statistically significant [P < 0.05]. From this study we concluded that silent myocardial ischaemia in asymptomatic diabetic men occurrs frequently and in association with autonomic neuropathy, suggesting that diabetic autonomic neuropathy may be implicated in the mechanism of silent myocardial ischaemia. We recommend careful screening of diabetic patients with treadmill test to detect SMI for proper management of this risky diabetic complication

Study of T-cell count in uremic patients with HBs antigenemia

This work was carried out on 10 healthy volunteers who served as a control group [Gl]. and 50 patients with chronic renal failure. The uremic patients were divided into 5 groups, each consisted of 10 patients. Group 2 [G2] comprised patients with negative HBsAg. Group 3 [G3] comprised patients treated with conservative measures who are chronic healthy carrier for HBsAg. Group 4 [G4] comprised patients treated with conservative measures who suffered from chronic active hepatitis due to HBV infection. Group 5 [G5] comprised dialyzed patients who are chronic healthy carrier for HBsAg. Group 6 [G6] comprised dialyzed patients who suffered from chronic active hepatitis due to HBV infection. The following laboratory investigations were performed to all subjects: complete blood picture, counting of T-lymphocytes, HBsAg, blood urea, serum creatinine, serum bilirubin and serum transaminases. Diagnosis of chronic active hepatitis was confirmed by liver biopsy. Our study showed that chronic renal failure as well as haemodialysis decreased significantly both total lymphocytic count and absolute T-cell count. Total lymphocytic count and absolute T-cell count showed significant negative correlation with blood urea, serum creatinine, duration of dialysis, and the age of patients. HBsAg positive uremic patients showed siginificant reduction in absolute T-cell count, but didn't show significant change in total lymphocytic count, when compared with HBsAg negative uremlc patients. No significant difference could be found in both total lymphocytic and absolute T-cell count between chronic active hepatitis uremic patients and chronic healthy carrier uremic patients. Finally, no significant correlation was detected between the biochemical parameters of liver function [total serum bilirubin, SGOT and SGPT] and both total lymphocytic count and absolute T-cell count

Post transplant diabetes in kidney transplant recipients

This study was carried out on 300 renal transplant recipients in order to evaluate post transplant diabetes in such patients. The incidence of post transplant diabetes was 12%. No correlation could be elicited between post transplant diabetes and either age or cumulative dose of steriod therapy. There was a correlation between post transplant diabetes and positive diabetic family history. A higher incidence of HLA A3, A28 and B16 was observed among post transplant diabetics. However, the outcome of patients and graft is not affected by post transplant diabetes. Therefore, diabetes in renal transplant recepients is usually mild and there is no good reason to consider such patients at higher risk for diabetic complications