Could the MMR vaccine replace the measles vaccine at one year of age in Egypt?

This cross-sectional study evaluated the immune status of non-vaccinated healthy infants to determine if it is possible to replace both measles vaccine [at 9 months] and measles, mumps and rubella [MMR] vaccine [at 18 months] with a single dose of MMR at 12 months. Serum samples from 566 children in Alexandria, Egypt showed a significant decrease in the seropositive rate to the 3 viral diseases with increasing age, but a significant increase in the seropositive rate among infants who were ranked 1st or 2nd in their family, full-term or born to mothers with no history of hypertension during pregnancy. We recommend administration of the first dose of MMR vaccine between 9 and 12 months of age, and a booster dose of MMR vaccine at 4 years of age

Somatotrophic hormone in elderly diabetic and nondiabetic subjects

This study was designed to evaluate the basal and postprandial growth hormone levels in elderly diabetic and nondiabetic subjects in relation to their glycemic state. Ten elderly diabetic patients [group I], ten elderly nondiabetic subjects [group II] together with ten adult healthy volunteers [group III] as a control group were included in the study. The glycemic state was evaluated by estimation of fasting and postprandial blood glucose level for all cases as well as by estimation of glycosylated hemoglobin [HbA1c] for elderly diabetic and nondiabetic subjects. Basal and postprandial growth hormone [GH] levels were estimated for all subjects by radio- immunoassay method. The results showed significant increase in basal [GH] level in group I as compared to groups II and III. No correlation was observed between HbA1c and basal GH level in elderly diabetic patients. However, there was a significant positive correlation between postprandial blood glucose level and postprandial [GH] in elderly diabetic patients. It is suggested that increase in GH level in elderly diabetic patients is metabolic in origin rather than being an independent factor in the pathogenesis of diabetics

Serum testosterone and fasting serum C-peptide level in obese diabetic males and females

This study investigated the relationship between obesity, hyperinsulinemia and testosterone in obese diabetic patients. Ten obese non-insulin dependent diabetic [NIDDM] males [group A] and ten obese [NIDDM] females [group B], together with ten normally healthy male and female subjects served as controls [group C] were included in the study. Fasting serum C-peptide, total serum testosterone, sex hormone binding globulin [SHBG] were estimated by radioimmunoassay. Free androgen index [FAI] was also calculated. The results showed that body mass index [BMI] and fasting serum C- peptide were significantly higher in group A and B than in group C, in association with significant positive correlation between BMI and fasting serum C-peptic in group A and B as well as between fasting blood glucose and serum C-peptide in obese diabetic patients. Significant negative correlation was observed between BMI serum testosterone as well as between BMI and SHBG in obese diabetic patients. Moreover, a significant negative correlation was found between fasting serum C-peptide and SHBG in both groups A and B. The mean calculated free androgen index was significantly higher in obese diabetics than in control subjects. However, insignificant positive correlation was found between FAI, BMI and fasting serum C- peptide in obese diabetic males. This correlation was significant in obese diabetic females. It was concluded that SHBG estimation might be considered as a screening test of the hyperinsulinemic states, which is considered as a risk factor in developing diabetes

Hepatogenous diabetes chronic active hepatitis

In order to study the possibility and mechanism of occurrence of diabetes in cases of chronic active hepatitis [CAH], 15 patients with this disease were divided into group [A] in which CAH occurred on top of normal liver and group [B] in which the disease occurred on top of bilharzial hepatic fibrosis [BHF]. Ten healthy volunteers of matched age, sex were included as a control group. Liver function tests, LE cells, fasting and postpr and ial blood glucose level, HBsAg, IgG and IgM, glycosylated hemoglobin, radioimmunoassay of fasting and postpr and ial C-peptide and insulin were done. The results showed high incidence of CAH in patients with BHF. Normal fasting insulin level was present in 66.6% of all studied cases. Fasting hyperinsulinemia was present in 26.6% of cases. Postpr and ial immunocreative insulin [IRI] showed significant difference between patients and control cases, there was significant increase in postpr and ial IRI in group A. No positive correlation between fasting C-peptide and fasting IRI was detected, but postpr and ial C-peptide showed positive correlation in relation to postpr and ial IRI. The significance and explanation of these results were included in the text

C-peptide and glycaemic state in obese and non-obese type II diabetes

This study was carried out on 60 obese patients with type II diabetes and 57 non-obese patients with type II diabetes. Estimation of body mass index was significantly higher in group I [31. +/- 3.3 kg/m[2]] than in group II [22.8 +/- 3 kg/m[2]]. Studying of the glycaemic state in both groups by measuring fasting blood glucose and glycosylated hemoglobin did not reveal any significant changes. While estimation of plasma C-peptide level showed significantly higher level in group I [3.37 +/- 1.5 ng/ml] than in group II [2.25. +/- 1.3 ng/ml]. This increase in plasma C-peptide in group 1 is explained by the presence of insulin resistance in obese patients. Discussion of etiology of these results is mentioned

Thyroid stimulating immunoglobulin in hyperthyroidism

This study was carried out on 20 patients with hyperthyroidism. The diagnosis of hyperthyroidism was based on clinical, biochemical and isotopic studies. Sixteen patients were diagnosed as Gravs' disease and four patients as toxic nodular goiter [two had solitary hot nodule and two had multinodular goiter], Thyroid stimulating immunoglobulin estimation revealed normal levels in all patients with toxic nodular goiter; while-13-patients [81%] with Gravs' disease showed high level of thyroid stimulating immunoglobulin. Six months after radioactive iodine therapy, all patients with previously high levels of thyroid stimulating immunoglobulin showed reduction in their serum levels to reach a normal value in 6 of them [46%] and levels above normal range in 7 [54%]. This finding suggests that radioactive iodine therapy may have an immunoregulatory effect in cases of Gravs' disease

Glycosylated hemoglobin in relation to serum immunoreactive insulin and plasma glucose in patients with chronic renal failure on maintenance hemodialysis

The present study was carried out on 20 patients with chronic renal failure undergoing maintenance hemodialysis and six healthy non-hospitalized control individuals. The aim of this work was to study, the glycosylated hemoglobin in relation to serum immunoreactive insulin and plasma glucose levels in patients with chronic renal failure and the effect of one month regular hemodialysis on these value. Before hemodialysis glycosylated hemoglobin is elevated in uremic patients, but cannot be used as an indicator of carbohydrate metabolism because it declines to normal level with improvement of uremic state with hemodialysis. Also, fasting serum insulin level is high in uremic patients, but hemodialysis and improvement of azotemia reduced basal serum insulin level

Pharmacotherapeutics of a calcium antagonist [verapamil] in simple goitre

The present work was carried out to study the possible beneficial effect of verapamil in cases of simple goiter. Verapamil was administered orally in doses of 240 mg daily [80 mg t.d.s] for three months. The body weight, T3, T4 and TSH levels were measured before and after the drug intake. Verapamil had a significant inhibitory effect on TSH release and serum T3 levels, whereas no significant effect on serum T4 level could be detected. It might be suggested that verapamil may be of some value in cases of simple goiter dependent on increased serum TSH level and probably also in cases of post thyroidectomy thyrotoxicosis due to increased TSH level

Effect of non-selective beta blocker on insulin sensitivity in insulin dependent diabetic patients

Insulin sensitivity test has been performed before and after propranolol administration in 15 insulin dependent diabetic patient and 10 control subjects of matched age and sex. Recovery from hypoglycaemia was delayed after propranolol administration with a significant lowering of the plasma glucose level all through, the test period in all patients and control subjects. Tachycardia was replaced by bradycardia at the lowest hypoglycaemic level after propranolol in 13 patients and all controls. One patient developed heart block and another patient developed clinical as well as ECG manifestations of myocardial ischaemia at the lowest hypoglycaemic level after propranolol. Systolic blood pressure was elevated at the same level before while both systolic and diastolic pressures were elevated after propranolol administration at the lowest hypoglycaemic level. All these findings were discussed. It is concluded that hypoglycaemia is hazardous in diabetic patients on propranolol for cardiovascular diabetic complications, not only because of elucidation of subclinical myocardial ischaemia or conduction abnormalities, but also for the masked hypoglycaemic manifestations experienced before by the patient

Changes in serum immunoglobulins and complement in non bilharzial chronic liver diseased patients

This work was performed on 32 patients with non Bilharzial chronic liver disease [11 patients with alcoholic cirrhosis, 8 patients with primary biliary cirrhosis, 5 patients with chronic hepatitis and 8 patients with cryptogenic cirrhosis]. The diagnosis was confirmed by liver biopsy. The serum immunoglobulins [IgG, IgA and IgM], complement components [C[4] and C[3], the whole complement titre [CH[50]] and liver functions were investigated in all studied cases. The results revealed high incidence of increased serum IgG, IgA, IgM, C[4], C[3] levels and low CH[50]] titre in most studied groups of patients. These findings in association with the absence of any relationship with the liver function tests suggested that the changes in the studied parameters was dependent on the immune reactions and immune mechanisms [whether hepatic or extrahepatic] rather than on the hepatic pathological changes or the function of the remaining liver tissue. Moreover the results were favouring increased hepatic and or extrahepatic synthesis more than decreased catabolism of these immunoglobulins and complement components

Glucagon infusion test in hypothyroidism before and after T[3] therapy

T twenty primary hypothyroid patients and ten control subjects were studied. They were all subjected to: intravenous glucagon infusion test to study the response of their blood glucose. Also I.V. lgucose tolerance test was performed to estimate the glucose disappearance rate [Kg. value]. The same tests were repeated in hypo thyroid patients after triiodothyronine [T[3]] therapy. A supernormal response of blood glucose level was observed in hypothyroid patients before treatment. This finding was attributed to increased tissue glucose utilisation. Decreased secretion and increased glucagon degradation were also suggested. The response to glucagon infusion and the tissue glucose utilisation were normalised after T[3] therapy