Plasma met-enkephalin, beta-endorphin and leu-enkephalin levels in human hepatic encephalopathy

To address the role of the opioid system in the pathogenesis of hepatic encephalopathy [HE] we measured plasma met- enkephalin, beta -endorphin and leu- enkephalin in patients with different grades of HE compared to control subjects and patients with cirrhosis. Plasma met- enkephalin levels were significantly higher in patients with cirrhosis and all grades of HE than controls. Plasma beta levels were similar in the 3 groups. Plasma leu- enkephalin levels were significantly higher -endorphin in HE grades II, III and IV than in controls, patients with cirrhosis and HE grade I patients. Our results support data on the involvement of met- enkephalin and leu- enkephalin in the pathogenesis of HE and provide a rationale for the use of opioid receptor antagonists in the treatment of HE

Serum levels of astroglial S100-beta and neuron-specific enolase in hepatic encephalopathy patients

To find a reliable, noninvasive method for the diagnosis of cognitive impairment in patients with hepatic cirrhosis we measured serum levels of astroglial S100beta and neuron-specific enolase in cirrhotic patients with and without hepatic encephalopathy [HE]. S100beta levels showed a significant increase in groups with HE stage 1 and 2 compared to both control and cirrhosis patients. However serum neuron-specific enolase levels were not significantly different between the studied groups. S100beta levels had a specificity of 91.3% and sensitivity of 51.7% for detection of HE from cirrhosis. Serum S100beta may be a useful surrogate marker for the diagnosis of mild cognitive impairment in cirrhotic patients before they progress to more advanced stages of HE

Influence of rotating shift work on pregnancy stability and fetal well being among medical field pregnant workers

Inherent in all rotating shift schedules are the requirements that the worker regularly changes sleep, meal and work times. This conflicts with the dictates of the internal biological clock system, which in humans has evolved to a very unique diurnal orientation. This study aimed to evaluate stability of pregnancy course in rotating shift pregnant workers in hospitals and to investigate the fetal well being. A clinical prospective study was done in The Special Care unit for Fetus, Ain Shams Maternity Hospital. The study group included 60 pregnant workers in hospital environment and we also examined 20 pregnant housewives as a control group. The study group was subdivided into two subgroups: 1st subgroup comprised those who had fixed day work [regular schedule], while the 2nd subgroup comprised those with rotating shift work [irregular schedule]. The study population was subjected to functional evaluation of uterine contractility by external [abdominal] tocography using a cardiotocography machine which evaluates also external fetal heart rate. Abdominal ultrasonography was done with real time ultrasound probe 3.5 MHz using full bladder technique. The study revealed that there was a highly significant difference [P<0.001] between pregnant workers and housewives as regards the complications during pregnancy, with a higher incidence of complications among doctors, and nurses and technicians compared to employees; also there was a significantly higher incidence of congenital fetal malformation among doctors and technicians. Therefore, the study recommended that working women should be warned that if any complications arise they should be able to leave work so as to lessen foetal jeopardy and have a good

Hyperviscosity determinants in infants of diabetic mothers

Thirty newborn infants of diabetic mothers [IDMS] [15 males and 15 females] with mean gestational age of 38.56 +/- 2.6 weeks were enrolled in this study. They were divided into three clinical groups: 10 infants of gestationally diabetic mothers [GDMs], 12 infants of insulin dependent diabetic mothers [IDDMs] and 8 infants of non insulin dependent diabetic mothers [NIDDMs], Fifteen cohort full-term healthy newborn infants were chosen to serve as controls. Cord blood was obtained from all study subjects for assessment of complete blood count, platelet aggregation, RBC filterability, whole blood and plasma viscosity, plasma fibrinogen as well as protein and lipoprotein electrophoresis. Whole blood viscosity was significantly elevated in infants of IDDMs and NIDDMs when compared to IGDMs and controls at different shear rates. However plasma viscosity was not statistically different among all groups, The infants of IDDMs and NIDDMs similarly showed significant increase in mean levels of hemoglobin, packed cell volume, RBCs count, platelet aggregability, total plasma lipids and pre-beta lipoprotein and decrease of RBCs filterability in comparison to IGDMs and controls. However IGDMs did not show any significant differences regarding all the studied parameters compared to controls. Therefore this study emphasizes the impact of the type of maternal diabetes on the increase of whole blood viscosity in IDMs, mainly through disturbed cellular factors, rather than plasma ones. Hence it is recommend that early diabetic control is mandatory to lessen the incidence of hyperviscosity syndrome among IDMs. Resides, therapeutic modalities should be dirtected toward correction of both quantitative and qualitative cellular abnormalities

Comparative evaluation of combined endoscopic variceal ligation together with low volume sclerotherapy versus sclerotherapy or band ligation alone for bleeding esophageal varices

The subjects of this study were forty six patients presenting with upper GI bleeding due to esophageal varices with unstable vital signs or blood transfusion of >/ 2 units. These patients were randomly assigned to intravariceal sclerotherapy [5% ethanolamine oleate], variceal ligation or combined endoscopic variceal ligation and low volume endoscopic sclerotherapy after resuscitation. Patients had therapy at initial endoscopy and then had weekly sessions until obliteration then follow-up at three months interval. The number of sessions, rebleeding, complications, and treatment failure were reported. Control of active bleeding was accomplished by sclerotherapy in 15 of 17 [88.2%], by ligation in 12 of 15 [80%], and by combined modality in 12 of 14 [85.7%]. Recurrent bleeding was insignificantly lower in both ligation and comibned modality groups. The number of sessions needed for variceal obliteration were significantly lower in both ligation and combined modality groups [4.2 +/- 0.5 and 3.2 +/- 0.6 vs. 6.2 +/- 0.7, P <0.05]. Moreover, the complication rate was significantly higher in the sclerotherapy group. It was also concluded that combination endoscopic variceal ligation together with low volume sclerotherapy results in rapid eradication of esophageal varices with low incidence of complications

Prevalence and epidemiology of epilepsy among Egyptian infants and children

Pre-designed questionnaires fulfilling some remarks about epilepsy were distributed among children of 12 primary schools randomly chosen from Abbassia and Heliopolis districts in Cairo. All cases were recruited from the survey as well as those epileptics followed up in the pediatric neurology clinic. They were subjected to history taking and mical examination in addition to intelligence quotient and EEC. computerized tomography [CT] was done for some selected cases. The prevalence of epilepsy was found to be 3.5/1000 with highest prevalence in the group aged 6-9 years. Boys were found to be more affected than girls although statistically insignificant. Primary epilepsy-was more common than secondary cases. Partial seizures were more prevalent than generalized ones and they were found to be significantly associated with secondary etiology. Early onset of seizures, secondary etiology and partial nature of seizures were significantly associated with different neurological deficits. Primary cases especially generalized seizures showed better therapeutic response. CT scan were normal in all primary cases but were positive in all examined secondary cases. To sum up, we can conclude that epilepsy is not uncommon problem among Egyptian school children. There is no significant sex prediction. Response to treatment can be predicted on clinical basis, i.e. primary etiology, generalized nature as well as absence of neurological deficits were the most important predictors of good response to therapy

Behaviour disorders in deaf children

Behaviour disorders were studied in a group of 100 deaf children aged between 6 and 12 years. They were matched with a control group of 100 normal children of the same age, sex and socioeconomic class. Members of both groups were subjected to; a history taking from both parents and teachers, physical examination, psychiatric interview and I.Q. testing using good enough draw a person test. The study showed that behaviour disorders were significantly higher among deaf [89 percent] than normal group of children [20 percent]. The common behavioral disorders encountered were: conduct [89 percent], sleep [84 percent], speech [77 percent], psychomotor [55 percent], excretory functions [45 percent] and feeding disorders [42 percent]. The mean I.Q. level was significantly lower among deaf than normal children [P < 0.001]. The percentage frequency of behavioural disorders was significantly increased with the degree of hearing loss. Overprotection was the most common significant family reaction towards their deaf child. Recommendations were put in order to reduce the impact of deafness on the sufferer and on his family

Maternal and cord plasma tocopherol levels in full term and preterm infants

The plasma tocopherol levels in maternal and cord blood samples were estimated in two groups of cases. The first group consisted of thirty full term infants and their mothers. The second group consisted of fifteen preterm infants and their mothers. The plasma tocopherol level was also estimated in ten normal non-pregnant women. The plasma tocopherol level was estimated by the technique described by Baker and Frank in 1968. The study revealed a significant positive correlation between the mean values of the cord and the maternal plasma tocopherol levels. Similarly this linear correlation was found between the mean cord plasma tocopherol level and the gestational age. The mean values of the plasma tocopherol of the preterm infants and their mothers were lower than the mean values of the full term infants and their mothers. The recommendation of vitamin E supplementation during pregnancy will be discussed

Palmar dermatoglyphics among Egyptian idiopathic nephrotic children

This work is a recent study of dermatoglyphic features in a group of Egyptian Children; eighteen male patients aged 6-14 years and twelve female patients aged 6-12 years, suffering from the idiopathic nephrotic syndrome, INS. Palamar dermatoglyphics of nephrotic patients were compared to normal Egyptian Children of matched age and sex. To the best of our knowledge, the present work is the first specified study in Egypt for palmar dermatoglyphics among nephrotics, aiming at using them as a genetic marker. The study showed some important specific findings among nephrotics and different from normals. Hence the significance of using dermatoglyphics to find out individuals who are susceptible to INS