Inverse relationship of serum IL-17 with type-II diabetes retinopathy.

BACKGROUND: Diabetes mellitus (DM) is a health concern because it leads to complications such as retinopathy. Pakistan has 6.9 million DM affected people that will double by 2025. A study was designed to determine the level of IL-17 in the serum of Pakistani type 2 diabetes mellitus (T2DM) patients. METHODS: It was a cross-sectional case-control study that included 212 subjects. Subjects without diabetes were labeled as Group-I (30 healthy volunteers), Group-II (30 T2DM without retinopathy), and Group-III (152 T2DM with retinopathy). The serum level of IL-17 was determined by ELISA technique. Data was analysed using SPSS 17.0 and one way ANOVA to observe group mean differences. RESULTS: More females were in Group-II (83%) and Group-III (66%) compared to Group-I (30%). The age of subjects was higher in Group-III (50 years) and Group-II (49 years) compared to Group-I (34 years). Group-III had longer mean duration of disease (10.51 years) than Group-II (7.76 years). Group-I had increased levels of IL-17 followed by Group-II and Group-III. On comparison, statistically significant differences were observed among the three groups, and between Group-I and Group-III, but there was no significant difference between Group-I and Group-II, nor between Group-II and Group-III. Further, on comparison of age, gender, and duration of disease there were significant differences while there was no significant difference between the percentages of HbA1c. CONCLUSIONS: Age, gender, and duration of diabetes may contribute in the development of T2DM retinopathy while serum level of IL-17 was inversely associated with T2DM and retinopathy.

Gated spect myocardial perfusion scintigraphy for identifying septal perfusion artifacts in left bundle branch block.

OBJECTIVE: To determine the role of gated Single Photon Emission Computed Tomography (SPECT) for accurate assessment of myocardial perfusion scintigraphy (MPS) of patients with left bundle branch block (LBBB). DESIGN: Analytical study. PLACE AND DURATION OF STUDY: Punjab Institute of Nuclear Medicine (PINUM), Faisalabad, Pakistan, from June 2002 to April 2003. PATIENTS AND METHODS: MPS data of patients with LBBB was analyzed. Resting gated SPECT MPS was performed after an injection of 740 MBq 99mTc-MIBI in 10 normal and 25 subjects with LBBB (with low probability of coronary artery disease). Visual and quantitative analyses were done on non-gated (NG), end diastolic (ED), end systolic (ES) images. Calculations included septal to lateral wall ratio (SLR), myocardial thickening (MT=% increase in counts during systole) at end systolic phase and myocardial thickening at peak level (% peak MT). RESULTS: Septal hypoperfusion was noted in 19 (76%) patients on NG images and in only 1 (4%) patient on gated SPECT ED images. On NG images of LBBB group, SLR was lower than in controls (0.68+/-0.07 vs. 0.87+/-0.05, p<0.001). SLR of LBBB patients approached to that of control group in gated SPECT ED data (0.86+/-0.06 vs 0.88+/-0.06, p=ns). Myocardial thickening at ES for septum was markedly lower in LBBB group than in controls (21.83%+/-10.86 vs. 66.32%+/-20.15, p<0.001). CONCLUSION: In patients with LBBB, reduced septal thickening results in artifactual septal perfusion defects. Gating the perfusion scintigraphy and reporting perfusion status on end diastolic frames in LBBB patients can eliminate these artifacts.

Anti-nucleosome antibodies as a disease activity marker in patients with systemic lupus erythematosus.

AIM: To measure the level of anti-nucleosome antibodies in systemic lupus erythematosus (SLE) patients, to determine the sensitivity and the specificity of these antibodies in the diagnosis of the disease and to evaluate the relationship between the levels of anti-nucleosome antibodies, anti-dsDNA (double-stranded DNA) and SLE disease activity. METHODS: A cross-sectional study was conducted. All patients attended either a medical specialist clinic or were admitted to the medical wards of Hospital Universiti Sains Malaysia with the diagnosis of SLE (n = 90), other connective tissue diseases (n = 45) or were normal controls (n = 90) within the period from July 2004 until September 2005. They were tested for anti-nucleosome antibodies by enzyme-linked immunosorbent assay and anti-DNA antibodies by immunofluorescence. SLE disease activity was evaluated by SLE disease activity index (SLEDAI) score. RESULTS: Out of 90 SLE patients, anti-nucleosome antibodies were positive in 47 (52.2%) patients, whereas these antibodies were positive in three (6.7%) patients with other connective tissue diseases. Anti-dsDNA antibodies were positive in 33 (36.7%) SLE patients, whereas these antibodies were positive in four (8.9%) patients with other connective tissue diseases. Anti-nucleosome antibodies were positive in 40 (97.6%) patients with active SLE, whereas these antibodies were positive in seven (14.3%) patients with inactive SLE. Anti-nucleosome antibodies had a stronger correlation than anti-dsDNA antibodies with SLEDAI score. There was a significant association between anti-nucleosome antibodies and disease activity. CONCLUSION: Anti-nucleosome antibodies test is highly sensitive and specific for the diagnosis of SLE, especially when the anti-dsDNA antibodies are absent. They are additional disease activity markers in the assessment of SLE disease activity.