Clinical usefulness of cystatin C concentration as a marker of early renal dysfunction in patients with cirrhosis of the liver

As preventive and renoprotective interventions are available, early identification of nephropathy is crucial, and there is a growing demand for a clinically convenient and reliable marker of renal function. Diagnosis of impaired renal function is of particular importance in patients with cirrhosis of the liver. Moderately reduced renal function may be missed by the conventional parameters. Cystatin C is an endogenous marker of glomerular filtration rate independent of muscle mass. Therefore, the aim of this study was to investigate the value of serum cystatin C concentration for the detection of moderately impaired renal function in patients with different stages of cirrhosis in comparison with the conventional methods. Eighty seven patients with cirrhosis were included in this study; All cases in this work had been examined clinically and they are scored according to Child-Pugh score. Calculation of creatinine clearance [CrCl] by determining its concentration in timed urine collections and simultaneously in blood were done for all the patients. All blood samples were obtained on the day of urine collection for CBC, LFTs, pro-thrombin time, serum electrolyte, creatinine, urea, creatinine clearance and Cystatin C concentrations. The patients then divided into two groups depending upon the results creatinine clearance: [groupl] normal creatinine clearance group [creatinine clearance >/= 70 ml/min; n=50] and [group2] reduced creatinine clearance group [creatinine clearance 40n69 ml/min; n=37]. There was no significant difference in urea concentration between the two groups [30.7] group 2 versus [28.3] mg/100 ml, group 1. While serum Cystatin C concentrations [mean [SD]: 1.32 [0.51] v 1.03 [0.34] mg/1 [p=0.008] and creatinine concentrations 1.03 [0.52] v 0.86 [0.22] mg/100 ml [p=0.03] were higher in group 2 than in group 1. To confirm the diagnostic advantage of Cystatin C over creatinine and urea. Receiver-operator characteristics [ROC] shows at equal specificity, the sensitivity of cystatin C was increased almost throughout the ROC plot. At cut off concentrations of 1.0 mg [Cystatin C], 0.8 mg/100 ml [creatinine] and 27 mg/100 ml [urea],cystatin C exhibited significantly higher sensitivity than creatinine and urea [70%, 45.2%, and 43.9%; respectively p<0.05], Specificity and efficiency were not significantly different between parameters. The sensitivity of Cystatin C [88.5%] tended to be higher than that of creatinine [62.0%] and urea [55.3%] at equal specificity of [60%] in Child-Pugh class C patients. The results demonstrated that the diagnostic accuracy of plasma Cystatin C was better than plasma creatinine in identifying liver cirrhotic patients with reduced glomerular filtration rate. particularly with Child-Pugh class C patients, for early diagnosis of renal dysfunction

Correlations between C-reactive protein as an inflammatory component of atherosclerotic process and variable lipid parameters in type 2 diabetic and hyperlipidemic patients

The study aimed to prove any correlations between CRP and different lipid parameters in patients with type 2 diabetes mellitus and hyperlipidemia. The study was conducted on 210 subjects, that were subdivided into three groups [Diabetic group, hyperlipidemic group, appearently healthy controls], each was 70 in number. Measuring of different parameters [serum concentrations of CRP, TC. HDL-C and LDL-C], were done according to standardized enzymatic assay methods. A positive correlations between CRP serum concentrations and that of TC [r = 0.37 and 0.38, P<0.05] and LDL-C [r = 0.39 and 0.35, P<0.05] respectivly in diabetic and hyperlipidemic male patients and the same results in female patients, and an inverse relationship was obtained between CRP serum levels and HDL-C serum concentrations in the diabetic and hyperlipidemic male patients, but statistically was non-significant. Serum CRP concentrations of diabetic and hyperlipidemic patients were significanty higher in both males and females than normal controls. This increase in CRP coincides a significant increase in TC, TG and LDL-C. These results may reflect that a variety of features of the metabolic syndrome are associated with a systemic inflammatory response. The higher CRP concentration in serum could reflect the inflammatory component of the atherosclerotic process that is so prelevant among patients with diabetes and hyperlipidemia

Acut organ failure in septic patients with or without shock

Sepsis and septic shock are life threatening complications of infections with a high incidence and mortality rates. Death is strongly related to types and number of systems failure, beside other risk factors. Aiming to identify the incidence of acute organ failure in relation to presence or absence of shock, retrospective evaluation was done for 170 patients admitted to Intensive Care Unit in a seven months period during 2005-2006. Patients with septic shock had a significantly higher age, APACHE II score [31.39 +/- 09.76 versus 18.6 +/- 5.73, P<0.005], SOFA score [8.42 +/- 3.70 versus 3.73 +/- 2.36, p< 0.0005], and a higher mortality rate [67.08% versus 25.27%, p< 0.0005] compared to those with severe sepsis. The percentage of acute organ failure in septic patients with shock versus those without shock was: pulmonary [86.83% versus 51.65%], renal [59.49% vr 23.07%, P<0.005], hepatic [49.37% vr 25.27%, P<0.005], haematological [54.43% vr 30.77%, P<0.005] and central nervous system [13.92% vr 10.98%, P=NS] respectively. Septic shock patients were more likely to have significantly higher mean SOFA score and a higher mortality rate than non-shocked cases. Mortality increases significantly with age, APACHE II and SOFA scores

Neurotoxicity of the commenest volatile substances abused in El-Minia Governorate: clinical and experimental study

The current study was. performed to investigate the possible neurotoxic effects of chronic solvent abuse of some of the commonest abused substances in El-Minia governorate, namely, acetone and diethyl ether, and whether these changes, if present, are reversible or not. It was carried out as 2 parts: 1[st] part; 50 male persons aging between 20-45 were divided into 5 groups of 10 subjects each: group I; a normal volunteer control group, group II exposed daily to acetone for 1-2 year[s], group III: exposed daily to acetone for 8-10 year[s], group IV: exposed daily to diethyl ether for 1-2 year[s], group IV: exposed daily to diethyl ether for 8-10 year[s]. All subjects were examined thoroughly for any neuropsychiatric disorders 3 times 3 months apart. The 2[nd] part; 180 albino rats divided into 9 groups of 20 rats each as follows: group I: a control group received a daily oral dose of 1.5 ml of physiological saline for 1 month, group II: exposed to a daily dose of acetone [1250 ppm. / 30 min.] for 1 month, then examined immediately, group III: exposed to a daily dose of acetone [1250 ppm. / 30 min.] for 1 month, left for 1 month without any medical intervention, then examined, group IV: exposed to a daily dose of acetone [1250 ppm. / 30 min.] for 3 months, then examined immediately, group V: exposed to a daily dose of acetone [1250 ppm. / 30 min.] for 3 months, left for 1 month without any medical intervention, then examined, group VI: exposed to a daily dose of diethyl ether [2000 ppm. / 30 min.] 1 month, then examined immediately, group VII: exposed to a daily dose of diethyl ether [2000 ppm. / 30 min.] 1 month, left for I month without any medical intervention, then examined, group VIII: exposed to a daily dose of diethyl ether [2000 ppm. / 30 min.] for 3 months, then examined immediately, and group IX: exposed to a daily dose of diethyl ether [2000 ppm. / 30 min.] for 3 months, left without any medical intervention for 1 month, then examined. The results of the 1[st] part of the current study revealed that persons of the groups II and IV had mild neuropsychyatric disorders and that these changes were much more severe in the persons of group III and V as well as the appearance of another serious disorders including parkinsonism, cerebellar dysfunction, and cranial nerve affection. The results of the 2[nd] part revealed that animals of groups II and VI showed profound pathological changes of the cerebral cortex and cerebellum ranging from mild to moderate degrees with higher incidence towards the mild one. In addition, the animals of groups IV and VIII showed similar changes with increased incidence of the moderate degree. Moreover, animals of groups III and VII showed a mild improvement of the reported pathological changes when compared to those examined immediately after the last dose. On the other hand, animals of groups V and IX showed no improvement and nearly were the same when compared to those of groups IV and VIII. It could be concluded that volatile substance abuse induces serious neuropsychiatric and pathological changes, and that severity of the pathological changes increases with the increase of period of abuse, while reversibility becomes less likely

Will recombinant bovine somatotropin and/or PMSG can be used to dissolve the problem of delayed breeding in heifers and post partum cows

Twenty eight Holstein cows [16 heifers and 12 multiparous cows] were used. Heifers were weighed 350-380 kg, and failed to conceive till 2.5 years old. Multiparous cows calved since about 5-6 months and showed no any oestrus signs and low plasma progesterone. Heifers were assigned to three treatment groups in a randomized design. Eleven heifers were treated with a single injection per heifer of rb ST [Somatech]. Two days post injection, all heifers were rectally examined to ensure ovarian activity and follicular development. Seven days later, six of these rbST-treated heifers were injected PMSG. Third group were kept as control. Multiparous postpartum cows were assigned to two groups. First group [n=7] received bST, and second one [n=5] were treated with both rbST and PMSG injections according to the same procedure of heifers. Two weeks before treatment, blood samples were collected from all experimental animals once weekly, and then once daily on day 2, 3, 7 and 12 post injection for determinations of IGF-1 and insulin concentrations. Oestrus was detected in heifers and cows by usual observation and progesterone profile. All heifers and cows that detected in oestrus were artificially inseminated. First-service conception rates and pregnancy percentages were obtained. Postpartum cows were milked twice daily and average daily milk production was calculated before and after injection of bST. Plasma concentrations of IGF-1 and insulin showed significant increases in bST-treated heifers. However, IGF-1 concentrations were decreased after bST injection, and plasma insulin concentrations did not significantly affected in postpartum cows. Treatment with bST caused improving of the reproductive performance of heifers and postpartum cows

Effect of short term dietary supplementation with full fat flaxseed before breeding on fertility of local baladi ewes

This study was conducted to evaluate the effect of short term supplementation of flaxseed on some plasma metabolites and hormones, rumen metabolic profile, and fertility of local Baladi ewes at the late anoestrus season. Twenty non-pregnant, non-lactating mature Baladi ewes of 2.5- 3 years age were randomly assigned to one of two groups from mid September. Ten ewes served as controls fed a maintenance ration [500g concentrate] and received no supplement, and the remainder ewes supplemented with 100g full fat flaxseed per animal daily. After one month, ovarian status had been assessed in all females thorough ultrasonography. All females were then left with mature fertile bucks. Conception rate was recorded and confirmed by lambing. Blood samples were collected and plasma was frozen at 20 C pending analysis. Two hours before feeding, samples of rumen Contents were taken from either control and treated groups for determinations of ammonia N production and volatile fatiy acids, total and individual. Plasma values of urea, total lipids, and glucose were significantly higher due to flaxseed supplementation, while Plasma total Protein, albumin, triglyceride and cholesterol concentrations did not differ significantly between groups. Dietary flaxseed caused an increase in plasma insulin and estradiol values, but did not influence IGF-l. All measured parameters of rumen metabolic profile showed no significant variation. Ultrasonograms of the ovaries that revealed folIicular number and size was included in the paper. In spite of stimulatory effect on the ovaries, dietary flaxseed reduced conception rate indicating its estrogenic effect

Possible effects of supplementation with Nigella sativa cake on reproductive performance, ovarian response, and embryo recovery of female baladi goats

This study is one of many recent attempts that search for economic feed resources with the aim to improve reproductive efficiency of the local breeds of farm animals in Egypt. Thirty female Baladi goats were used in two experiments. In experiment 1, 12 immature females weighed 8-11 kg and aged 4-5 months were allotted into two groups: Control [n=4] fed on basal control ration and NSc group [n=8] fed on the same basal ration supplemented with 100 g Nigella sativa cake. All females were fed till maturity and run continuously with fertile bucks. Jagular blood samples were collected twice weekly for progesterone assay to detect sexual maturity, ovarian cyclicity, conception and pregnancy. The parameters of the reproductive characteristics in the pattern of continuous/total, lambed/continuous, conception, fertility and prolificacy were calculated. Initial and final body weights were individually recorded and body weight gain was calculated

Reproductive consequenes and plasma thyroid hormone status of postpartum cows treated with bovine somatotropin

The effect of administration of bovine somatotropin [bST] on plasma thyroid hormones [T3 and T4] and postpartum reproductive performance was studied in lactating dairy cows. Fifty cows [25 heifers and 25 multiparous cows], each were alloted into three groups: five cows as control, ten cows injected with 500 mg bST [Somatech] at the 9[th] week post calving then every 14 days, and the third ten cows were given only half dose [250 mg]. Blood samples were collected during treatment and plasma T3 and T4 were determined by RIA technique. All cows were observed twice daily for detection of oestrus signs and allowed to conceive naturally by fertile bull. Conception was confirmed based on last service and the to calving. Plasma concentrations of T3 and T4 were significantly increased in heifers, but decreased in multiparous cows supplemented with 250 mg bST, which might be due to the effect of parity and milk yield. High dose of bST [500mg] did not affect the T4 value either in heifers or multiparous cows. Supplementation with bST improved the conception rate in heifers, while the interval from calving to conception was not affected. Conception rate showed slight bST-related difference in multiparous cows .however, days open was increased from 5 months in control to 9 months in bST-treated cows. Pregnancy rates showed significant lower values in multiparous cows comparing to heifers. In controls, higher values of T3 and T4 meet either lower values of conception rate and longer interval from calving to conception in multiparous cows, and vise versus in heifers, indicating a negative relationship between plasma concentration of T3 and T4 and postpartum reproductive performance

Reproductive response of two laying strains subjected to force molting either by feed withdrawal or oral administration of antiestrogenic drug, tamoxifen

The anti-estrogenic drug, Tamoxifen, was evaluated as a molt inducer in two strains of Hy-line laying hens. Birds were divided equally into four groups as follows: group one in which birds received daily oral administration of Tamoxifen [20 mg/kg body weight] for 5 days, group two in which birds received the same dose as in group one for 10 days, group three in which birds were fasted for 7 days, gorup four in which birds served as a control group. Body weights were recorded at the beginning and the end of treatments. Pre and postmolt egg production were recorded daily. Blood samples were taken at the end of treatment for determination of plasma calcium [Ca], inorganic phosphorus [Pi], total protein [TP], albumin [AL], Urea [U], total lipids [TL], triacylglycerol [TG], Alanine aminotransferase [ALT], Aspartate aminotransferase [AST], progesterone [P[4]], and triiodothyronine [T[3]]. Brids treated with Tamoxifen lost less body weight compared to feed removal birds. Post-molt rates of lay were not significantly different for Tamoxifen and fasted birds. Plasma levels of Ca, TG, TL, and P[4] were reduced in the force molting groups. Plasma levels of T[3] were reduced in feed removal group while elevated in Tamoxifen group comapred to the control. It can be concluded that Tamoxifen maybe a useful agent for molt induction

Studies on pregnancy failure in rabbits possibly due to aflatoxicosis

New Zeal and pregnant rabbit does were used in two trials to investigate the effects possibly due to aflatoxins on the reproductive performance and blood metabolites as well as the accompanying histopathological changes. Criteria of pregnancy and mortalities were recorded. Blood samples were obtained for determination of plasma total protein, albumin, urea, creatinine, glucose, cholesterol, total lipids, activities of ALT and AST as well as plasma progesterone. Hopeless cases were subjected to postmortem examination, and specimens from liver, kidney, ovaries and uterus were collected for histopathological examination. All does that received aflatoxin contaminated ration either after mating or during mid pregnancy failed to complete pregnancy. Plasma concentrations of albumin, urea, and the activities of ALT and AST showed significant variations due to aflatoxin administration. Postmortem examination of rabbits fed aflatoxin diet showed liver shrinkage, enlargement of gallbladder and kidney which showed white necrotic foci. Gross hemorrhages on many parts, especially heart, lungs, and intestine, were seen. Moreover, the presence of implantation sites in the uterine horns indicated early fetal resorption. Histopathology of the liver, kidney, ovaries, and uterus of [AF] rabbits revealed severe pathological changes

Possible effects of two levels of dietary fat addition on performance and reproductive potentials during puberty and post-parturition in rabbit does

The rabbit performance and reproductive efficiency as influenced by the addition of two levels of dietary fat during puberty and post-parturition were included in this paper. Three groups of eighteen immature female New Zealand rabbits were given control basal diet [CD] or that supplemented with 5% and 10% sunflower oil to formulate moderate [MFD] and high fat [HFD] diets. In puberty study, fat addition increased feed intake and energy intake, while the values of body weight, feed conversion, and plasma metabolites were not affected in growing rabbits during prepubertal period. Fat supplementation also hastened puberty, where the rabbits firstly accepted the meals at 56.0 +/- 3.51, 23.0 +/- 4.7, and 21.0 +/- 3.8 days for [CD], [MFD], and [HFD] groups respectively. Moreover, high percentage [83.3%] of conceived does was observed in [HFD] group if compared to [CD] and [MFD] groups [33.3%]. In post-parturition study, pups from mothers among [HFD] group were heavier in weight and grew more rapidly throughout 5 weeks [till weaning] than those of [CD] and [MFD] groups. Fat addition increased prolificacy and improved fertility of the does during post-parturition, however it did not affect feed intake or energy intake of lactating does. This study clarified the positive responses of performance and reproduction to fat addition, and supported the recommendation to include 10% dietary fat for growing and breeding rabbit does

Effects of ammoniated aflatoxin contaminated corn in pregnant rabbits

This paper dealt with the effects of ammoniated aflatoxin-contaminated corn under atmospheric pressure [AP], on the biochemical and pathological changes of pregnant rabbits. Two groups of female pregnant rabbits were fed on control diet and ammoniated aflatoxin- contaminated diet throughout pregnancy [trial 1]. Another 2 groups were fed the same diets during the second half of pregnancy [trial 2]. Rabbits fed ammoniated ration in both trials 1 and 2 completed pregnancy accompanied by normal parturition and alive offspring. No mortalities were recorded among treated rabbits. Progesterone hormone was not significantly affected in treated rabbits, while levels of blood metabolites and enzymes showed mild variations. Postmortem examination of sacrificed rabbits revealed mild pathological changes

Effect of monensin on metabolic profile testing in buffalo-heifers

Thirteen prepuberal buffalo-heifers aged 10-14 months were kept on the experimental farm of National Research Center, to investigate the biological effects of monensin on metabolic profile testing in buffalo-heifers. The experimental animals were randomly allotted into two groups: control group of 5 heifers ted on pelleted concentrate, and a group of 8 heifers which received the same coscentrate after milling and mixing was and 100 Monensin/head daily. Blood samples were collected monthly and used for determination of blood haemoglobin and packed cell volume [PCV]. Plasma was separated and used for determination of macroelements [calcium, inorganic phosphorus and magnesium], microelements [copper, iron and zinc], proteins [total and fractions],urea,glucose, sodium.potassium and enzymes [ALT, AST and alkaline phosphatase]. The results indicated that blood haemoglobin and PCV values were not affected significantly by monensin supplementation. Likewise, monensin did not alter plasma glucose level and urea concentration. Monensin administration into heifers did not affect significantly plasma total proteins, fibrinogen, total and fractional globulins, but lowered slightly plasma albumin concentration. The results also recorded that monensin did not alter significantly plasma mineral profile as well as cholesterol in buffalo-heifers. Moreover, monensin elevated plasma activity of alkaline phosphatase and depressed the activity of ALT, but it did not affect plasma activity of AST. In conclusion, monensin administration in daily doses of 100 mg/head was safe and did not affect negatively metabolic profile testing of buffalo-heifers

Monensin effect on rumen metabolic profile, methane production and protozoal population in buffalo-heifers

Thirteen propuberal buffalo-heifers aged 10-14 months were kept on the experimental farm on National Research Center, to investigate the effects of monensin on rumen metabolic profile, mithane production and protozoal population. The experimental animals were radomly allotted into two groups: control group of 5 heifers fed a pelleted concentrate and monensin group of 8 heifers which received the same concentrate after milling and mixing with 100 mg monensin head daily. Rumen samples were taken from buffalo-heifers of both groups 8 and 10 months after the beginning of treatment, before and 2 hours post-feeding. The rumen juice was subjected for determination of pH value, ammonia production, total and individual volatile fatty acids. Methane was also calculated and derect smears from the whole rumen contents were made for detection of protozoal density. pH values were not affected by neither feeding nor monensin and ammonia production was increased significantly by feeding, while monensin administration lowered the amonia production. The values of total volalille fotty avds [TVFAS] were elevated significantly by control feeding regime while monensin had no significant effects on the TVFAS concentrations. The production of acetic acid decreased in the rumen of monensin treated heifers. Monensin supplementation resulted in increasing the propionic acid production. The concentration of butyric acid was not affected by adding monensin. The molar prportions of acitic: propionic: butyric acids were 53.82: 26.34:19.75 under feeding of basal diet, and 41.82: 38.64: 19.53 on monensin administration. Monensin lowered the production of mentane in the rumen. Moreover, the density of protozoal population decreased in the rumen liquor of buffalo-heifers receiving monensin. In conclusion, monensin acts as a propionate enhancer and methane inhibitor. Thus, use of monensin as a feed additive may be profitable and incentive in buffalo production