Genome editing: the road of CRISPR/Cas9 from bench to clinic

Molecular scissors engineered for site-specific modification of the genome hold great promise for effective functional analyses of genes, genomes and epigenomes and could improve our understanding of the molecular underpinnings of disease states and facilitate novel therapeutic applications. Several platforms for molecular scissors that enable targeted genome engineering have been developed, including zinc-finger nucleases (ZFNs), transcription activator-like effector nucleases (TALENs) and, most recently, clustered regularly interspaced palindromic repeats (CRISPR)/CRISPR-associated-9 (Cas9). The CRISPR/Cas9 system's simplicity, facile engineering and amenability to multiplexing make it the system of choice for many applications. CRISPR/Cas9 has been used to generate disease models to study genetic diseases. Improvements are urgently needed for various aspects of the CRISPR/Cas9 system, including the system's precision, delivery and control over the outcome of the repair process. Here, we discuss the current status of genome engineering and its implications for the future of biological research and gene therapy.

Qualitative and quantitative coronary angiography in patients with acute coronary syndrome [ACS]

Acute Coronary Syndrome [ACS] encompasses several diseases, previously thought to be separate and defined disease states. In this syndrome, Unstable Angina [UA], Non-ST Elevation Myocardial Infarction [NSTEMI], and ST-Elevation Myocardial Infarctions [STEMI] are all part of this category. The pathogenesis begins with plaque rupture which activates the platelets and coagulation cascade leading to thrombus formation. The thrombus leads to partial or complete coronary artery occlusion leading to various clinical manifestations of ACS. The aim of the present study is to assess the extent of coronary artery disease and characterizes plaque morphology and lesion severity in patients with ACS in comparison with patients with chronic stable ischemic heart disease. To achieve this aim, we studied 100 patients with symptomatic coronary artery disease admitted to Mansoura medical Hospital, where they were subjected to full clinical evaluation; 12 lead electrocardiogram, full laboratory investigations and Coronary angiography was done to every patient, then we analyses the results both qualitative [eye ball description of angiographic lesions] and quantitative [computer-based]. Those patients were classified into two main groups, the first group of patients were those with ACS [50 patients] as a test group while the second one included patients chronic stable ischemic heart disease [50 patients] as a control group. Both groups were comparable and no significant difference was present as regard age, sex, diabetes mellitus, hypertension, smoking, left ventricular function, prior PTCA, prior CHF and angina class while, prior MI more frequent among test group. One hundred, forty-seven lesions [66 in test group and 81 in control group] were available for detailed qualitative angiographic analysis. Out of seven criteria analyzed only presence of lumen irregularity and thrombus were more frequent among patient who presented with ACS [17 [26%] vs. 2 [2.5%] p < 0.05; 9 [13.6%] vs. 0 [0%] p < 0.05] respectively], and this represents the main finding in the current study. No significant difference was present in Quantitative Coronary angiographic characteristics in both groups. The qualitative angiographic assessment represents an essential tool in the evaluation and risk stratification of patients with ACS, through the demonstration of the presence of thrombus and lumen irregularity that correlated more with ACS than the other studded criteria. In addition, QCA although added accurate assessment of the degree of luminal narrowing, thus helping in assessment of the severity of the disease

Determinants of maternal adaptation to mentally disabled children in El Minia, Egypt

This study was carried out in a governmental school for mentally disabled children in El Minia. We assessed maternal adaptation and the relationship between maternal sociodemographic factors and adaptation as well as examining maternal distress. All 100 mothers with children aged 6-18 years attending the school were recruited in the study. Three tools were used: demographic data sheet, adaptation scale to assess the nature of mothers' interaction and patterns of psychosocial adaptation and depression scale to detect the presence of psychiatric disorders among the mothers. Only 35.0% of the mothers adapted positively to their child's condition; 62.9% of those had female children. Negatively adapted mothers were slightly older than positively adapted mothers and had more children. Maternal education and occupation were significantly associated with psychosocial adaptation. Knowledge of mothers about their child's condition significantly affected adaptation as well as the dependency of children in eating, drinking and sleeping. Two-thirds of mothers had high levels of psychopathology

Difficult intubation management in a child with I-cell disease

I-cell disease [mucolipidosis II] is a rare metabolic disorder resulting from the deficiency of a specific lysosomal enzyme, N-acetylglucosamine-1-phosphotransferease. Developmental delay and growth failure are common presentations of I-cell disease. Psychomotor deterioration is rapid and progressive. Some physical signs such as hip dislocations, inguinal hernia, hepatomegaly, joint limitation, and skin changes may be present at birth. Coarse facial features and skeletal abnormalities become more conspicuous with time. The life expectancy of children with this condition is poor, with death usually occurring around the fifth year. A case report of the anesthetic management of gingivectomy with multiple dental extractions in a 5-year-old Omani female with I-cell disease is presented. The problems faced and their management during anesthesia are described

Anaesthetic management of congenital laryngeal web presenting with acute upper airway obstruction

This is a case of failed intubation in a child of 15 months due to presence of laryngeal web. The airway was maintained by Cole Neonatal tube size 2 mm held at the available orifice of the glottis with maintenance of spontaneous respiration under general anesthesia till emergency tracheostomy was performed

Combined use of remifentanil and propofol to limit patient movement during retinal detachment surgery under local anesthesia

One of the drawbacks of performing ophthalmic surgery under local anesthesia is patient movement, which might affect optimal surgical outcome. The study aims to evaluate the efficacy of the combined use of propofol and remifentanil as a sedative technique in comparison with the use of propofol alone to limit patient discomfort and movement during local anesthesia for vitreo-retinal surgery lasting for more than two hours. A total of 140 patients scheduled for vitreo-retinal surgery under local anesthesia, with an expected surgical time of more than two hours, were included in the study. Patients were divided randomly into two equal groups: group I where patients were given propofol and remifentanil by continuous infusion and group II where patients were given propofol alone by continuous infusion. The two groups were comparable with regard to age, weight, gender, ASA physical status and duration of surgery. There was a significant decrease in heart rate and mean arterial blood pressure [MABP] in each group 10 minutes after the start of sedation compared with pre-sedation data and continued all through the procedure. There was an insignificant difference between the two groups with regard to changes in heart rate and MABP all through surgical procedure. There was no significant difference between the two groups with regard to the incidence of complications except for an increased incidence of breakthrough pain and discomfort which necessitated the use of fentanyl as a rescue treatment in the propofol group P<0.001. There were no instances of movements with a major effect on the surgical field, which could have affected surgical outcome, in the two groups. The number of patients who did not move was significantly higher, 56 [80%], in group I compared with 38 [54.29%] in group II with P<0.001. The ophthalmologist satisfaction scale was significantly higher in group I [4.5 +/- 0.63] compared with group II [3.7 +/- 1.04] with P=0.0016. The combined use of propofol and remifentanil as a continuous infusion before performance of the block and during lengthy vitreo-retinal surgery was associated with a lower incidence of patient discomfort, breakthrough pain, and patient movement along with high degree of surgeons' satisfaction and hemodynamic stability

Optimization of the sensitivity of the forced swimming technique for evaluating the antidepressant effect of drugs

Biphenyl Dimethyl Dicarboxylate [DDB] is attracting a growing attention for its pharmacotherapeutic properties as a protector against viral and chemical hepatotoxicity, and possibly as an immunomodulator. It has been also shown to possess some neurobehavioral effects on laboratory animals. Thus, the rising wide spread use of DDB, together with the demonstration of its neurobehavioral potential; have stimulated our interest to investigate its effect on the state of depression. The present work was designed to study the effect of combination of tail suspension and forced swimming techniques on the state of depression, and to compare the effect of fluoxetine and DDB on the combined technique. In addition, serotonin [5-HT], dopamine [DA] and norepinephrine [NE] contents were assayed in the whole brain in each case. The study was carried out on adult male mice. Fluoxetine was administered as a single dose [15 mg/kg, i.p.] and DDB was administered daily for 7 consecutive days [100 mg/kg/day, p.o.]. The obtained results showed that DDB exerted similar effect on immobility time as fluoxetine. However, it produced different neurochemical effects

study of the possible influence of biphenyl dimethyl dicarboxylate [DDB] on the social behavior developed by the sensory contact model in mice

The sensory contact model allows forming different psychopathological states produced by repeated agonistic interactions in male mice. It gives the opportunity of using animals with behavioral pathology to investigate the action of novel [along with widely used] psychotropic drugs and to conduct their screening in the simulated clinical conditions. Due to wide use of Biphenyl Dimethyl Dicarboxylate [DDB] together with its neurobehavioral effect, the present work aimed to investigate the possible effects of DDB on social behavior by studying its protective and medicative effects on the process of transformation to aggressive and submissive behaviors using the sensory contact model. Besides, measuring behavioral changes [using the open field test and the elevated plus maze test], neurotransmitters [serotonin, norepinephrine, and dopamine] and immunological changes [total leucocyte count, differential leucocytic count, and evaluation of bone marrow lymphocytes count and viability assessment] were evaluated. The work was conducted using adult male Swiss mice. DDB was administered orally in a dose of 100 mg/kg/day for two weeks and in two regimens. First as a protective treatment: it was applied for two weeks from the fifth day to the last day of the sensory contact model. Second, as a medicative treatment: DDP was administered after the end of the sensory contact model where the animals were kept in comfortable housing condition without daily interaction and received the treatment for two weeks. The present results concluded that, administration of DDB to the sensory contact model involved animals was showen to be associated with significant impacts on the animals' behavior, brain contents of neurotransmitters as well as the examined immunity related parameters. The produced effects were developed on the frame of DDB administration, whether it is administred as a possible protective agent or as a possible medicative one

Assessment of needle stick injuries and related knowledge among health care workers participating in an infection control-training program at El Minia University Hospital

Needle stick injuries are an important and continuing cause of exposure to serious and fatal diseases among health care workers [HCWs] who suffer daily accidental occupational exposure to needle stick injuries during the course of their role of caring for patients to determine the burden of needle stick injuries, its causes and knowledge related to it among HCW participating in an infection control training program at Minia University Hospital [MUH]. A well-structured pre- and post-training questionnaires about general infection control knowledge was used and included also 10 basic knowledge questions and inquiries about incidents of needle sticks, its frequency and cause, and history of hepatitis B vaccination. A total of 278 physicians and 56 dentists participated in this study. Dentists were younger than physicians, and had a slightly higher knowledge score than physicians. We found that 63.2% of the participating physicians and dentists experienced at lease one needle stick during their practice. About 61% and 71.4% of the physicians and dentists experienced at lease one needle stick during their practice, respectively, suggesting that dentists were more likely to be exposed to needle stick injuries than physicians. The overall mean of needle stick injuries per year among the participants was 4.42 [ +/- 1.83]. However, the average numbers of sticks were 4.51 [ +/- 1.87] and 4.03 [ +/- 1.77] among the participating physicians and dentists, respectively. Self-inflicting injuries during bending or recapping of a used needle was the most frequent cause of needle sticks [41% for physicians and 59% for dentists]. Nearly 72% of the participants were categorized as excellent in basic knowledge regarding infection control. Also, knowledge of needle stick management significantly improved by 63.3% and 7.8% post-training among dentists and physicians, respectively. Importantly, as the knowledge score increases, the liability to be injured by needles decreased. On the other hand, physicians were three times more likely to be vaccinated against Hepatitis B virus [HBV] than dentists although the overall vaccination rate was very low [15.2% vs. 4.2% among physicians and dentists, respectively]. needle stick injuries are common among HCW of MUH and recapping and bending of needles are prevalent inappropriate practices that increase the likelihood of needle sticks. Ensuring that HCW are properly trained on safe use and disposal of sharps will make this practice safer

Fluvastatin increases insulin-like growth factor-1 gene expression in rat model of metabolic syndrome

Insulin-like growth factor- 1 [IGF-1] was found to have a role in both glucose homeostasis and cardiovascular diseases. The present study was designed to compare the effects of fluvastatin and metformin on IGF- 1 mRNA expression within the liver and on other individual components of the metabolic syndrome induced in rats by high fructose feeding. Rats fed 60% fructose in diet for 6 weeks were treated daily with fluvastatin [3.75mg/kg/day] or metformin [200mg/kg/day] during the last 2 weeks and were compared with untreated fructose fed group. Fasting levels of plasma cholesterol, triglyceride, glucose, insulin, nitric oxide products, IGF- 1 and IGF- 1 mRNA within the liver as well as systolic blood pressure and body weight were determined. Compared to control rats, the fructose fed group developed hypertension, hyperlipidemia, hyperinsulinemia, hyperglycemia and endothelial dysfunction as well as decreased levels of plasma IGF- 1 and its mRNA within the liver. Fructose fed rats treated with fluvastatin or metformin for 2 weeks showed significant decrease in plasma cholesterol, triglyceride, insulin and glucose levels compared to untreated fructose fed group. Also, both drugs increased significantly plasma levels of nitric oxide products and IGF-1 together with significant increase in IGF-1 mRNA within the liver. However, only metformin treated rats showed significant decrease in systolic blood pressure compared to fructose fed group. This study showed that in a rat model of insulin resistance, fluvastatin improves the metabolic profile and increases plasma level of IGF-1 and its gene expression as effective as metformin

Comparing three clinical screening tools in identification of geriatric depression in a rural community setting

With the demographic transition, the elderly population is growing all over the world. Depression, currently considered as the 'disease of the century' ranks among the most significant health problems in older adults causing substantial morbidity, disability, functional decline, and mortality. Depression is reported in 13% of elderly community dwelling, and 24% of older medical outpatients, but there is a consensus that geriatric depression is underestimated. This is because older people in the community may not have contact with health services and because physicians may not screen for depression using the too lengthy tools leading to compounding of the depression problem. Efforts are needed to locate and identify those at risk and to provide care relevant to their needs. The Geriatric Depression Scale [GDS] is a screening instrument for depression in the elderly. Using a shortened GDS can greatly facilitate identification and assessment of depression in clinical and community settings. Determining the toll of depression among geriatric rural population in El Minia as well as to assess the value of application of the shorter version of geriatric depression scale and two-questions from PRIME-MD for screening of depression. The 15-item GDS, 5-items GDS and two-questions from PRIME-MD completed by all participants during community visit. 165 community dwellers aged 60 years and older were chosen randomly to be participated in the study and subjected to interview questionnaire administered to them at their household in Tehna Elgabal village, El Minia Governorate. ROC curve analyses showed .good agreement between 15-GDS, five-GDS and two-items PRIME-MD screener. Using GDS 15, it was found that nearly 30% of the participated geriatric rural populations in El Minia were moderately to severely depressed, while as 37.6% of them were categorized as so using GDS 5. Two items PRIME-MD screening categorized 24.2% as moderately- to- severely depressed. GDS was found to have a good specificity [0.85] in a representative sample of community-dwelling oldest old for the presence of major depression. This scale was developed as a basic screening measure for depression in older adults. 15-GDS is correlated to 5-GDS and Two items-PRIME-MD screener [r = 0.53, P < .000, r = 0.44, P =0.000] respectively.ROC curve analyses showed good agreement between 15-GDS and the 5-GDS as well as the Two-items PRIME-MD screener. It was found that 2 items [measuring depressed mood and anhedonia over the past month] demonstrated good sensitivity [88%] but only modest specificity [60%] compared with the 15-GDS. It was found that 5-GDS demonstrated excellent sensitivity [92%] but only fair specificity [50%] compared with the 15-GDS Interview Schedule. Nearly one fourth of community geriatric participated in the this study were found to be moderately to severely depressed using the 2-item PRIME-MD depression screening questionnaire which was found to be an efficient and effective way of separating patients with milder levels of depression from those with moderate to severe impairment. It was found that the short forms were adequate substitute for the long form and tends to be more suitable to be incorporated and widely used in primary care and community setting

Predictors of disability among elderly population in Rural Minia

A key measure of functional independence in elderly is the ability to do activities of daily living [ADL] without the assistance of another person. 506 rural population in El Minia, aged 60-80 yrs were subjected to interview questionnaire, where daily living [ADL] and self-rated health were assessed. Katz's ADL items of disability [bathing, dressing, transfer, toileting, and eating] were used to construct a three-level five-item ADL scale: not disabled [no disabilities], moderately disabled [1-2 disabilities], severely disabled [3-5 disabilities]. household based cross sectional study using an interview questionnaire.To assess the functional capacity and self-rated health of rural aging. Nearly 10% of the participants can be categorized as being disable with variable levels of severity. Either moderate or severe disability was found to be more prevalent among females where nearly 67% and 54% of those who classified as moderately or severely disable respectively were females. Female elders were more likely to report poor health status than males. The results of this study revealed that the most common causes of disability were DM [22%], Osteoarthritis and fracture [20%] followed by COPD [16%], eye problems [8%] and CVDs [6%]. Osteoarthritis and diabetes mellitus were significantly contributing to the occurrence of disability. About 68% of the participants had a positive history of health problems, 30% were bed ridden and about 24% were hospitalized for various reasons at some time during the last year. Almost 7% and 48% were self-rated their health as poor and fair respectively. Mean number of days staying at bed or admitted to hospital as inpatients during the last year were significantly more among elders with disability than their counterparts without disability [142 and 14.5 days vs. 22.2 days and 14.3 days] respectively. Rural Elderly population experiencing disabilities were significantly belonging to lower socioeconomic class. Unmarried status was found to be significantly related to both occurrence of disability and poor health status, where nearly up to 54% of either moderately or severely disabled were unmarried and about 66% rated their health as poor. Disability in ADL and poor health were prevalent among nearly 10% and 7% of elderly population in rural Minia respectively. Diabetes and Osteoarthritis were more prevalent among disable and were contributing significantly to it. Disability was also associated with age, low income, female gender, and single status. develop adequate responses to the problem of disability

Study of emergence time and recovery of psycho-motor function after propofol-alfentanil anaesthesia

We have investigated the emergence time and the postoperative recovery of psychomotor function after minimally invasive procedures carried out under total intravenous anaesthesia using propofol and alfantanil. The study was carried out on 60 patients categorized into two equal groups: group I [elderly patients>65 years] and group II [younger patients < 40 years]. The emergence time was assessed by detecting the awaking time [eye opening on verbal commands], time to orientation, and Aldrete Recovery score. The recovery of psychomotor function was assessed using the speed of information processing [simple visual reaction time and simple auditory reaction time] and memory function test. These tests were performed before surgery and, 30 min, 1h, 2h, and one day after it. The results showed that the emergence time was similar in both groups, however, the psychomotor function recovered completely 2h after surgery in the elderly group compared to 1h in the younger group. These findings emphasize that the emergence time after minimally invasive surgery under propofol-alfentanil anaesthesia was comparable in both groups and the delay in recovery of psychomotor function in the elderly patients compared to younger patients was short lasting and improved within 2h after surgery

Serum interleukin-6 and lactic dehydrogenase levels in hematologic malignancies

Objective: to assess the prognostic value of serum IL-6 and LDH in chronic lymphocytic leukemia [CLL] and acute myclogenous leukemia [AML] and to investigate whether the two markers correlated with other known prognostic factors such as Beta- macroglobulin

Patients and Methods: this study included 25 leukemia patients, in addition to 10 healthy subjects matched for age and sex [controls]. Total leucocytic count, absolute lymphocytic count and blast cell count were performed by flow-cytometry based haematology analyzer. Serum interleukin-6 [IL-6] was determined by enzyme immunoassay. Serum lactate dehydrogenase and albumin were measured by colorimetric methods. Beta2-microglobulin [Beta2- MG] and C-reactive protein [CRP] were measured by AXSYM[TM] system

Results: the levels of IL-6, LDH, Beta[2]- MG and CRP were significantly increased in both CLL and AML compared to controls [p<0.001 for IL-6 and LDH p < 0.0001 for CRP and Beta2- MG in CLL patients. p < 0.0001 for IL-6. LDH and CRP, p<0.0026 for beta[2]- MG in AML patients], whereas serum albumin levels in both diseases were decreased significantly than that of controls [p<0.0001 for each]. Total leucocytic and absolute lymphocytic count were increased significantly in CLL patients compared to control [p

Conclusion: results demonstrated that serum IL-6 and LDH may be used as reliable markers for monitoring the disease activity and were found to have prognostic significance for disease stage and outcome

Trace elements and antioxidants status in the development of vascular complications in type II diabetes mellitus

Objective: to determine the levels of trace elements and antioxidants in type II diabetic patients with and without vascular complications

Subjects: the study was carried out on 30 patients with type II diabetes mellitus and were divided into two groups according to fundus examination either with and without vascular complications. Fifteen healthy voluntary subjects were chosen as controls

Setting: department of Biochemistry, Faculty of Science. Ain Shams University and Clinical Pathology Department, Maadi Armed Forces Hospital, Cairo, Egypt

Patients and Methods: sera of control and diabetic patients were analyzed for determination of trace elements by Inductively Coupled Plasma Mass Spectrometry [ICP-MS], a very powerful and reliable analytical method for trace elements determination. Blood samples were used for determination of glutathione [GSH], superoxide dismutase [SOD]. Plasma samples were used for determination of nitric oxide [NO] and ascorbic acid [vitamin C] using spectrophotometer

Results: serum trace elements levels [Zn, Cr, Se and Mn] in type II diabetic patients with and without vascular complications were significantly decreased when compared to the corresponding levels of controls. Significant reductions in the levels of SOD, GSH and NO were encountered in diabetic patients with and without vascular complications as compared to controls. Serum vitamin C levels were markedly decreased in the two diabetic groups and the decrease was more pronounced in patients with vascular complications. There were negative correlations between serum Zn and SOD as well as Cr and NO in type II non vascular diabetic patients without vascular complications, whereas positive correlation was found between serum Se and vitamin C in type II diabetic patients with vascular complications

Conclusion: the decrease of antioxidants and trace elements may indicate that diabetic patients a e subjected to oxidative injury. Antioxidant supplies may helpful to protect against vascular complications of diabetes mellitus

Perception of violence against women by El Minia University female students

Violence against women [VAW] represents a staggering public health problem which refers to many types of harmful behavior directed at women and girls because of their sex in forms ranging from verbal abuse to homicide throughout the life cycle and derives essentially from some cultural patterns that perpetuate the lower status accorded to women in the family, the workplace, the community and society. Obviously, VAW is considered a profound health problem which may cause a range of bad outcomes as adverse mental health conditions, such as depression, anxiety, and low self-esteem, poor physical health consequences, such as gynecological complications, Physical injuries, chronic headaches, sleep disturbances, nausea, behavioral problems that further damage their health or risk their lives, such as substance abuse, alcoholism, and increased risk of suicide attempts and increased use of health services up to homicide. In Arab and Islamic countries, domestic violence has an increasing frequency and serious consequences. Surveys in Egypt, Palestine, and Tunisia show that at least one out of three women is beaten by her husband. Knowledge about VAW causes, consequences, and protective measures are needed to be studied. To examine awareness of University female students about violence, and to explore their knowledge and attitude towards VAW. A cross sectional study of a total of 152 students from education and nursing faculties completed a self administered questionnaire including Sociodemoraphic characteristics of respondents; parents, knowledge perception, attitudes of causes of violence, history of self experience to violence; friends and/or relatives exposure to a violence. Their believes about what causes violence and their opinions regarding methods to prevent it. Out of 152, 68.4% of the students agreed that cirumcision is a type of violence and 80% of them reported that it causes physical, psychic and sexual harm. Almost 85% of the sample considered early marriage, as a form of violence, and about 88% stated that low education is another form of violence against women. The majority of the respondants 94.7% and 98% agreed that physical abuse and rape respectively are forms of violence. About half of these students are exposed to some sort of violence [53.7%]. More than half of these females beileved that the most common reason for violence is low socioeconomic level [62%]. Nearly half of the female students [52.%] believed that VAW is on the rise [upward trend] than before. About 39.5% of study sample believed that female work, low socioeconomic status, weak religious belief, TV drama and addiction, altogether, are the causes of this increase. The police were informed about violence experienced by others by only 19.8% of the sample. Nearly all these students [95.4%] believed that protection from VAW can effecetively be done through religious institutions and increase female education [90.8%]. Most female university students in El-Minia University are aware about most types of VAW. About half of these students are exposed to some sort of violence [53.7%]. Women work, low socioeconomic level, weak religious belief, different media and addiction are the causes of increased VAW. Educating girls to their fullest potential, victims of violence need reliable counseling and support programmes, women should be educated about their human rights and empowered to protect their own safety

Circulating adhesion molecules in type 11 diabetic patients with and without vascular complications

Diabetes mellitus type II is considered to be a risk factor for atherosclerotic diseases. Leucocyte adhesion to arterial endothelial cells is thought to be an important step in development of atherosclerosis. In this study, the concentrations of soluble adhesion molecules [sICAM-l and sVCAM-l] were elevated in patients with type II [Non-insulin dependent] [NIDDM] with [n=27] and without [n=33] vascular complications compared with those of healthy non-diabetic control subjects [n.=13]. However, the mechanisms responsible for elevation of soluble adhesion molecules are poorly understood. The present study was undertaken to investigate the relationships between serum concentrations of soluble adhesion molecules and blood sugar level, insulin resistance and other conventional risk factors in type II diabetes such as some clotting factors and lipid profiles in type II diabetes with and without vascular complications. Pearson's correlations were carried out in this study. It has been found that, in diabetic patients-type II with vascular complications, the concentration of sICAM-l and sVCAM-l were correlated significantly with fasting, postprandial giucose, factor VII, factor VIII and plasminogen activator inhibitor [PAI], while sICAM-l has only marked correlation with triacylglycerol, cholesterol and LDL [r = 0.453, p=/<0.018, r = 0.404, p=/< 0.036 and r = 0.386, p=/< 0.04 respectively] and sVCAM-l was related significantly with insulin resistance [r = 0.445, p=/<0.02] whereas, in diabetic patients type 11 without vascular complications, sICAM-l was correlated significantly with fasting and postprandial glucose, insulin resistance and PAI, while sVCAM-l has relationship with both triacylglycerol and cholesterol levels. Thus, the present study suggested that the levels of soluble adhesion molecules in diabetic patients type II with dyslipidaemic and hypercoagulable state may be a marker of endothelial cell activation or dysfunction, and may be related to the "activity" of multiple cell types in atherosclerotic lesions. Furthermore, they may serve as a tool to monitor the impact of prevention and intervention on vascular damage

Thyroid dysfunction in type 2 diabetes

The association between diabetes mellitus and thyroid disorders was always a matter of medical interest. The explanation of that association is still debatable whether through metabolic, immune, vascular or multifactorial. The aim of the present study was to identify subjects at risk of clinical or subclinical thyroid dysfunction by other investigation modalities in diabetics. Forty seven type 2 diabetic patients 21 men and 26 women with age xx ranging from 40-70 years and 20, age, sex and weight matched healthy control subjects were subjected to: estimation of fasting, postprandial plasma glucose. Estimation of serum free T3 and T4 and TSH by radioimmunoassay. Thyroid scan dynamic and static using technetium[99m]. Thyroid colour coded duplex Doppler study of the inferior thyroid arteries. Exclusion criteria included drugs that interfere with thyroid functions. As regards Technetium thyroid scan: the perfusion index [PERI] was significantly higher in patients compared to control subjects [p-value < 0.009]. A negative correlation was found between the duration of DM and the functional index which was statistically significant in diabetic women [r = -0.4264, p=0.03]. Thirty percent of patients were detected to have dynamic thyroid scan characteristics of thyroiditis with marked increase of the perfusion index, marked decrease of the functional index till zero and replacement of slope II and III with a plateau. As regard duplex Doppler Results: the mean pulsatility [PI] and resistivity [RI] indices were found to be higher in patients with thyroiditis [as evident by thyroid scan]. The peak systolic, diastolic, end diastolic and mean velocities where statistically lower in those patients compared to control. The mean value of pulsatility and resistivity indices were significantly higher in patients with subclinical hypothyroid state than control subjects, whereas, thyroid gland volume, blood flow and blood velocities showed no statistically significant difference. Tc[99m] dynamic thyroid scan and duplex Doppler sonography detected hypofunction and abnormal perfusion while the thyroid hormones were still on the low normal side. So, it is recommended to use these investigation tools in following up patients with long standing diabetes specially in those who show clinical or laboratory evidence of thyroiditis, [such as neck pain, thyroid swelling or elevated ESR]. A condition which is not uncommon in patients with Type 2 diabetes