Measurement of axial bone mineral density in postmenopausal females by quantitative computed tomography

Twenty-six postmenopausal females aged 45 or more presented with generalized bone aches were enrolled in this study. They were subjected to clinical assessment, X-ray dorsal and lumbosacral spine and quantitative computed tomography [QCT] of the lumbar spine to measure their bone mineral density [BMD]. The results showed that 19 patients had BMD below normal. The group had BMD of 60.262 [ +/- 17.352] mg/cm3 equivalent of K2HPO2. Their BMD loss expressed as a percentage of deviation from the average matched normal valued was 50.709% [ +/- 14.904]. The results emphasized the extent of this problem and the importance of early measurements of BMD in postmenopausal females

Cerebral magnetic resonance imaging in systemic lupus erythematosus

To detect cerebral lesions in neuropsychiatrically symptomatic or asymptomatic patients with systemic lupus Erythematosus [SLE] and probe the relationship of these lesions to clinical and laboratory variable. Brain magnetic resonance imaging [MRI] was performed on twenty patients with SLE under the age of 50. The patients were inpatients [thirteen were from Kasr El Eini Hospital and seven were from other private hospitals]. The patients [50% of the total number of patients] showed MRI findings in the brain. Four of them [20% of the total] showed abnormal high intensity spots [HIS] on T[2] weighted images and they were neuropsychiatrically asymptomatic. Another four patients [20%] combined abnormal HIS and brain atrophy and these patients were neuropsychiatrically symptomatic. The remaining two patients [10%] with positive MRl findings showed only brain atrophy and they were also neuropsychiatrically symptomatic. Our results suggest MRl as an important technique for detecting the extent of brain injury in cerebral lupus. In addition MRl proved to be a sensitive procedure for detection of the asymptomatic HIS cerebral lesions. A follow up study of these asymptomatic patients with HIS is necessary to clarify their clinical significance

Free fatty acids mobilization under the effect of oral glucose load in NIDDM

Glucose load test [75 gm] was performed on 25 non- obese subjects, 10 were normal as a control group and 15 were non- insulin dependent diabetic patients. Glucose, FFA and insulin levels in plasma were estimated before and after glucose load. The study showed highly significant of both fasting and post prandial blood glucose in the diabetic group [86.9 plus or minus 9.05 versus 170.07 plus or minus 30.72 and 107.8 plus or minus9.99 versus 254.33] respectively. The FFA fasting concentration was 983 plus or minus 281. mu mol / L and the post prandial concentration was 881 plus or minus 220 mu mol/ L and 693 plus or minus 56 mu mol/ L in the control group respectively. The mean of insulin concentration in the fasting state was 35.6 plus or minus 18.24 mu / ml in the diabetics versus 20.4 plus or minus 6.45 mu / ml in the control group. The post prandial insulin concentration was 68.07 plus or minus 13.19 mu / ml in the diabetic group versus 39.5 plus or minus 7.22 mu / ml in the control group with highly significant difference. The elevation of fasting FFA in the diabetic group and the fall of FFA after an oral glucose load but still higher than the normal can be explained by the diminished anti-lipolytic effect of insulin either due to insulin resistance or increased activity of the counter- regulatory hormones

poor response of non-ulcer dyspepsia cases to gastric acid suppression and its implications on the theories of pathogenesis

We conducted a randomized controlled trial on 67 patients with non-ulcer dyspepsia to test the efficacy of both H2-Histamine receptors blockers [cimetidine in this study] and conventional antacids in treating these cases. We found that cimetidine was more effective than antacids and placebo in the first week of treatment. It reduced the number of pain attacks by 28.2% in the first week. These effect were not significant in subsequent weeks. Antacids reduced the pain attacks by 12.7% and increased pain-free days by 10.4% which is not significantly different from placebo [12.9% and 12% respectively]. In subsequent weeks, neither cimetidine nor antacids were more effective than placebo. We conclude that the benefit from cimetidine in treatment of non-ulcer dyspepsia is transient and brief, while antacids are of no benefit in such cases. This shows that the non-uclcer dyspeptic syndrome is not dependent on increased gastric acid secretion

incidence of compylobacter enteritis in adults and isolation of the organism from blood stream

WE included 114 adult patients with enteritis or gastroenteritis in the study which aims to determine the incidence of compylobacter infection among adults having gastroenteritis or enteritis, and the incidence of compylobacter bactermia in such cases. By means of stool culture, we isolated 8 cases caused by compylobacter. Blood cultures for the same organism were taken from all the 8 cases with compylobacter enteritis but only 1 was positive for growth. We concluded that the incidence of compylobacter enteric infections in the group studied was 7%, among them only one case had bactermia. This shows that although the disease is not uncommon in adults, assoicated bacteraemia is rare

hazardous effect of smoking on healing of duodenal ulcers and on their recurrence rate is not dependent on gastric acid oversecretion

In a prospective, randomised study, we examined newly diagnosed cases of duodenal ulceration for the effect of smoking on the healing of ulcers to find out whether a maintenance dose of H2-Histamine blockers may significantly antagonise the harmful effect of smoking on healing, so that we can examine the role of HCI oversecretion in augmenting the harmful effect of smoking. The study included 57 smoking patients with duodenal ulcers diagnosed by gastroscopy and followed for two years. It showed that following initial treatment with Ranitidine, for a course of 8 weeks, the incidence of recurrence after 4 months was 21% in patients maintained on Ranitidine, and 38% in patients maintained on placebo. The difference which is in favour of H2-Histamine blockers maintenance is however statistically insignificant. Recurrence rate 12 months after initiating therapy was 66.6% for Ranitidine vs 74% for placebo maintenance respectively, P = not significant. Six months later, the recurrence rate was 53. 8% for Ranitidine vs 74% for placebo maintenance respectively, P = not significant. Six months later, the recurrence rate was 53.8% for Ranitidine vs 55.5% for placebo maintenance, P = N.S. At the end of the two-year study, the recurrence rate for Ranitidine was 48% vs 51.8% for placebo maintenance group, P = N.S. We conclude that in the first few months after treatment, giving maintenance dose of H2-Histamine to smokers with duodenal ulcers decreased the incidence of recurrence on the short term but not to a satisfactory significant level, while on the medium and long terms [12-24 months], it offers no real benefit. Stopping smoking seems to be an important factor in preventing the recurrence of healed duodenal ulcers, and patients should be advised of that instead of prescribing the drugs that suppress gastric acid