Bone disease in upper Egyptian transfusion dependent pediatric B-thalassemia major

Thalassemia and the blood transfusion complications associated with it predispose children to poor bone health. This study was conducted to determine the prevalence of bone-related abnormalities within this population. Forty two transfusion-dependent beta thalassemic subjects 5-19 years old in Assiut, Egypt, participated in this cross-sectional study. Medical history by interview and review of medical records, physical examinations including anthropometric measures and puberty assessment, and bone densitometry using DEXA and height adjustment were performed. The incidence of underweight and short stature was 73.8% and 69%, respectively, which were indicators of malnutrition among thalassemic subjects in this study. Low bone density [BMD Z-scores < -2] was detected in the lumbar spine and femoral region in 54.7% and 95.2% of subjects, respectively. But after height adjustment they became 11.9% and 64.3%, respectively. Forty-seven percent of patients had a history of fractures and the cumulative risk for which increased almost with age. Seventy-eight percent of patients reported bone pain, whilst back/hip pain was present in 69% of thalassemic children and adolescents. Genu valgus deformity and scoliosis were seen in 40.5% and 11.9% of patients. High incidence of low bone density and deficit in other aspects of bone health among thalassemia patients makes routine bone health assessment necessary for this vulnerable group. Considering influencing factors, dietary counseling and preventive supplementation therapy for this high risk group of children and adolescents may be necessary, although this should be assessed by intervention studies

Effect of chronic exposure to sulphur dioxide vapour and sulphur related compounds on serum levels of insulin, glucose, C-peptid, and zinc

Sulphur dioxide is emitted from the superphosphate factory in mankabad, Assiut province, Egypt with the possibility of environmental pollution, 28 male workers exposed to sulphur dioxide were included in the study, their ages ranged between 26 and 55years,the control insulin, C-peptide, Zinc levels and alkaline phosphatase. Workers of the exposed group had fasting blood glucose, insulin, C-peptide, serum zinc and alkaline phosphatase, level that were higher than control. Exposed group has hyperglycemina. Hyperglycemina, although their insulin levels and C-peptide are within the international rang

Identification and estimation of leucine aminopeptidase activity in the serum and ascitic fluid of patients with schistosomiasis

The activity and electrophoretic mobility or leucine aminopeptidase [LAP] were assessed in the sera of 100 patients with different clinical stages of Schistosoma hacmatobium infestation as well as in 20 sample of ascctic fluids obtained from patients with bilharzial hepatosplenomegaly associated with ascites matched with 20 healthy adult males sample as control. Generally LAP activity was significantly higher in all patients. The activity of serum LAP showed a progressive rise with the advance in the clinical condition. The highest level was encountered in the sera of patients with bladder carcinoma and liver metastasis, leucine aminopeptidase was considerably found in the ascetic fluid. The ratio of the activity or LAP in the ascetic fluid to its activity in the serum of the same patients was 1:4.5 where the enzyme diffuses from the blood to the ascetic fluid. The enzyme detected by electrophoresis, in serum or ascetic fluid LAP migrated as a single component in the alpha1 -globulin faction. The results are discussed and compared with those in the literature

role of tumour necrosis factor-alpha [TNF-[alpha]] , interleukin-6 [IL-6] and caspase-3 in lung diseases of cement factory workers in Assiut

Respiratory tract disease represents the most important group of occupational disease in the cement industry. Inhalation of silica dust leads to silicosis, the alveolar macrophage plays a key role in the onset and development of inflammatory and fibrogenic lung disease through their ability to release potent inflammatory and fibrogenic mediators. The present study aimed to measure the levels of TNF-alpha and IL-6, in order to determine a possible relationship between the presence of silica particles, cytokine production, and pulmonary dysfunction in workers exposed to cement dust for less and more than 10 years. Also, to test the hypothesis that silica-induced apoptosis of human AM may involve the activation of ICE, we determine the activity of caspase-3 in these workers. The correlations between these previously mentioned bioindices and pulmonary function tests were investigated. . The study consisted of forty male patients workers engaged in cement production and a control group of 40 normal healthy males. The exposed workers were divided according to the duration of the exposure time into two groups: 22 workers were exposed to cement dusts for less than I0 years and 18 workers for more than 10 years

Determination of TNF-alpha and IL-6 in plasma of exposed workers enzyme linked immunosorbant assay [ELISA] and caspase-3 activity in white blood cells of exposed workers by colorimetric methods. The results of the current study showed that pulmonary function tests were significantly lower in exposed workers for more than 10 years than those with less than 10 years. Moreover; in exposed workers for more than I0 years, the plasma levels of TNF-alpha and IL-6 were significantly increased compared to those revels in exposed workers to cement dusts for less than I0 years [P<0.001 for each]. Besides, in this group of workers, caspase-3 activity levels were significantly higher than that of controls [P < 0.001]. However, there was no significant difference in caspme-3 activity levels between both groups of workers. Significant correlations were also found between TNF-alpha IL-6, caspase-3 activity levels and pulmonary function tests. In conclusion, the results of the present study showed that prolonged exposure to silica stimulates AM to produce significant increased levels of TNF-alpha and IL-6 compared to those of controls. Moreover, increased caspase-3 activity was also observed in exposed workers. These changes were associated with a significant reduction in pulmonary functions of these workers

Angiogenic modulators in chronic obstructive pulmonary diseases

Angiogenesis or formation of new blood vessels out of pre-existing capillaries is a sequence of events that is fundamental to many physiologic and pathologic processes such as COPD. With the identification of several proangiogenic molecules such as VEGF and bFGF and the recent description of specific inhibitors of angiogenesis such as angiostatin and endostatin. The current study included 76 COPD patients of 5 grades according to postbronchodilator FEV1: -Grade zero: Included 14 male patients who were already diagnosed as COPD grade zero. - Grade 1: Included 10 male patients who were already diagnosed as COPD grade 1. -Grade II a: Include 4 male patients who were already diagnosed as COPD grade II a. -Grade II b: Included 12 male patients who were diagnosed as COPD grade II b. Grade III: Included 36 male patients, who were already diagnosed as COPD grade III. The patients were recruited before treatment administration among the attendants of chest and internal medicine departments, Assiut University Hospital. The study also included 20 healthy male subjects as a control group who were matched in age to the patients [mean age was 63 years old]. For each of the patients and control group the following items were done 1- History 2- Clinical examination 3- Spirometry: to measure the following pulmonary function test. 4- Arterial blood samples for blood gases [PO@, PCO2] analysis. 5- Venous blood sample, the sera were removed for estimation bFGF, VEGF, NO, Lipid peroxide, Copper, Zinc and total iron. The result reveal that serum bFGF, VEGF, serum NO, Lipid peroxide and Serum copper levels were significantly higher in patients with COPD compared to healthy controls [p. value

Some markers to elucidate the pathophysiology in early diabetic nephropathy

Diabetic nephropathy is one of the microvascular complications of diabetes mellitus, microalbuminuria is considered as an important predictor for the onset of diabetic nephropathy. The goal of this study is to search for other markers in the hope of enhancing the sensitivity and specificity of screening for this life threatening complication. In the present study, 82 diabetic patients [26 insulin dependent and 56 non insulin dependent] aged from 21-69 years, [57 males and 25 females], together with 18 apparently healthy control of matchable age and sex were subjected to estimation of serum levels of Interlukin-1B [IL-1B], N-acetyl-13-glucosaminidase [NAG], fructosamine, random blood glucose, urinary levels of NAG, B[2]-microglobulin [B[2]-MG] and creatinine. The study showed that all the parameters studied were significantly higher in diabetics compared to the control group and their levels were significantly higher in diabetics with longer duration of diabetes and serum IL-1B, NAG, urinary B[2]-MG/mg creatinine, and NAG/mg creatinine were significantly higher in non-insulin dependent compared to insulin dependent. No significant correlation could be observed between any of the parameters studied and random blood glucose or fructosamine. Serum IL-1B, urinary B[2]-MG and urinary and serum NAG may be considered a good markers in detecting early diabetic nephropathy

Circulating angiogenic factors in patients with chronic liver diseases

Platelet-derived endothelial cell growth Factor [PD-ECGF], basic fibroblast growth factor [b-FGF], gangliosides [Gs] and nitric oxide [NO] are angiogenic factors expressed in various cancer tissues as well as non malignant tissues. Little is known about the role of these factors in patients with chronic liver diseases such as chronic hepatitis [CH], cirrhosis, and hepatocellular carcinoma [HCC] with cirrhosis. The levels of these factors were determined in 28 patients with chronic hepatitis, 43 with cirrhosis and 29 patients with HCC. The study also included 18 normal individuals who are comparable to patients in age as a control group. The study revealed that the levels of these angiogenic factors are significantly increased in patients with HCC in comparison with either patients with hepatitis or liver cirrhosis. Moreover, both Gs and NO are also increased in patients with cirrhosis in comparison with controls. In HCC the levels of angiogenic factors reflected tumor burden where they were significantly increased in higher burden. These angiogenic factors are derived from HCC cells as well as inflammatory cells. In cirrhosis the elevation of these factors might be related to the extent of inflammation and angiogenesis in the cirrhotic liver. These factors showed significant positive correlations with liver enzymes in HCC. Assessment of the angiogenic factors in patients with chronic liver diseases would help to follow progression of liver affection. The expression of PD-ECGF in HCC would predict its chemosensitivity

Urolithiasis in Saudi Arabia

A Study comprising 140 males and 30 females carried out regarding urolithiasis in Saudi Arabia showed that calcium oxalate were the commonest. No relation was found between serum calcium, uric acid, phosphorus and stone formation. On the other hand, urinary excretion of calcium, uric acid, phosphorus go hand in hand with the corresponding stone formation. 11.8% of the patients suffered from urinary infection, 10% due to escherichia coli and 1.8% due to Klebsiella aerogens

Correlation between biochemical findings and ultrasonography in acute pancreatitis in a community hospital in Al-Kharj area Kingdom of Saudi Arabia

179 cases of acute pancreatitis [156 males and 23 females] had been studied in this work using both biochemical and ultrasonographical livestigations. Our results showed that ultrasonography could be helpful only up to 23% of the cases. On the contrary biochemical findings could be useful up to 80% in the diagnosis of the disease. Also, we noted that ultrasonography was not going hand in hand with the majority of cases of acute pancreatitis, specially mild and early moderate cases. Only in the late moderate and severe cases the ultrasonographic findings are useful. On the other hand, the biochemical changes occur very early in the disease process

Hyperuricaemia in a community of modern affluence Al Kharj, Kingdom of Saudi Arabia

Hyperuricaemia was detected in [17.7%] of hospital patients examined for arthritic complaints in a four year period. A male predominance [20.6%] to females [11.8%] was noted. Hyperuricaemia was found to be associating Diabetes and Hyperlipidaemia. The purpose of the Study was to appraise the effect of modern affluent health services in a rural hospital in the Kingdom of Saudi Arabia

Glucose 6 phosphate dehydrogenase deficiency in persistent jaundice

As four year study included 100 cases of persistent jaundice who were screened for G6 PD deficiency as a causative agent. Twenty one% were found to be positive for G6 PD., deficiency. Other causes of jaundice were excluded. All were Saudis of different age groups with a higher incidence found in the 3-12 years old. The purpose of this study is to suggest G6 PD deficiency as a causative agent of persistent jaundice

Protein/creatinine index as a guide for proteinuria it's application in breast cancer patients

Due to the importance of elucidating the relationship of proteinuria and renal disease, 24 hours urinary protein excretion and protein/creatinine index were concurrently studied in a total of 202 referred outpatients. The latter method correlates well with the total 24 hours protein excretion and is an efficient and reliable method. Using this index proteinuria can be classified into 5 classes regarding its severity. Applying this index to breast cancer patients, these patients had increased incidence of proteinuria of pathological significance due to glomerular damage produced by antigen antibody complexes produced especially in patients with III and IV stage breast cancer

Extensive chronic cutaneous leishmaniasis as a stress factor affecting plasma testosterone, cortisol, prolactin and lutenizing hormone levels

Cutaneous leishmaniasis leads to widespread disfiguring scars which cause profound psychological trauma in patients affected with the disease. Stress situations in man are known to alter the serum levels of a number of hormones. Fifty male patients who were subjected to severe chronic stress due to cutaneous leishmaniasis were investigated for their plasma testosterone, cortisol, prolactin, and luteinizing hormone [LH] levels. In comparison to 20 normal subjects, these patients showed significant decrease in plasma testosterone levels and significant increase in plasma cortisol and prolactin levels

Biochemical and radiological changes in Saudia patients with gall stones

A study including 217 patients, 189 females and 28 males, undergoing surgical removal of gall stones at Alkharj Hospital in Saudi Arabia has been carried out. It aimed at screening the diagnostic efficiency of biochemical changes and radiological findings in these patients. There was a significant increase in total cholesterol, triacylglycerol and low density lipoprotein cholesterol [P < 0.001] whereas HDL- cholesterol and phospholipids were significantly decrease [P < 0.001] compared to the control group. On the other hand, total lipids did not show any significant change. Electrophoretically, there was increase in Alpha-lipoproteins. Analysis of the composition of gall stones revealed that cholesterol was the main constituent either alone or present with other compounds in 65% of stones. Radiological findings indicateed that ultrasonography was the method of choice for diagnosis. It could be concluded that gall stone disease in Saudi Arabia is mainly the result of metabolic abnormalities in both lipids and lipoproteins. Infection and hemolytic anemias are other contributing factors

Detection of dyslipoproteinemias among male attendants in a community hospital in Saudi Arabia

The present work was designed to detect incidence of primary hyperlipoproteinenias among males who attend Knig Khalid Hospital, Saudi Arabia, where fasting milky sera were frequently observed. All patients with secondary causes of hyperlipoproteinemias were excluded from the study. Interestingly, hyperlipoproteinemias were present in 24% of these patients. Upon electrophoresis, 33.9% subjects had type II a, 27.7% fitted to type IIb, 24.5% had type III and 13.8% had type IV. Types I and V could not be detected among our group. These individuals are at risk of developing early coronary heart disease, cerebral and peripheral vascular accidents. They should receive suitable treatment and follow up. Hyperlipoproteinemias should be searched out whenevr possible especially among middle aged and young males to prevent their unfavourable sequelae

Biochemical changes in chronic pancreatitis

In order to determine the pattern of derangement of exocrine and endocrine functions of the pancreas in patients suffering from chronic pancreatitis, 43 patients with the disease together with 20 controls were studied in King Khalid Hospital, Alkharj, Saudi Arabia. Serum total proteins, albumin and vitamin B12 were significantly decreased [P < 0.001] while iron, total iron binding capacity and corrected calcium levels were similar to healthy individuals. Blood glucose was significantly [P < 0.001] increased in patients compared to controls but severe diabetes could not be detected. Total fat excretion together with serum and urinary amylase were significantly increased [P < 0.001] in patients. From the present findings we can conclude that in Alkharj area of Saudi Arabia, the pattern of chronic pancreatitis is characterized by a marked derangement of exocrine function with a low incidence of pancreatic calcification