Serum miRNA-1 as a novel biomarker for acute myocardial infarction and unstable angina

Background: Coronary artery diseases are the predominant cause of morbidity and mortality in developed and developing countries. Thus, extraordinary efforts have been directed to determine the molecular and pathological characteristics of the diseased heart in order to develop novel diagnostic and therapeutic strategies miRNAs are class of abundant, non-coding RNAs that attracted scientists' attention for their promising role as diagnostic and prognostic biomarkers in cardiovascular diseases

Aim of the work: To identify whether miRNA-1 is a dependable biomarker for diagnosis of acute myocardial infarction or not

Subjects and Methods: 69 patients with coronary artery disease were included in this study; 36 patients with AMI and 33 patients with unstable angina. Those patients were admitted to coronary care unit, Assuit University Hospital during the period of March to October 2014. In addition 22 apparently healthy subjects were included as a control group. Cardiac troponin I and miRNA-1 was done for all subjects

Results: In patients with AMI the results of miRNA-1 ranged from 28.3 - 6763.9 fold changes above the control level. In those with UA, miRNA-1 result ranged from 1.74 - 144.37 fold changes above the control level [when the control group is one fold]. Comparison between different cups regarding results of miRNA-1 revealed that there was a highly significant difference [P<0.001] between different groups. There was a highly significant increase in patients with AMI when compared with the control group, also a statistically significant increase [P<0.001] in patients with UA when compared with the control group and a statistically significant increase [P<0.001] in patients with AMI when compared with those of UA

Conclusion: miRNA-1 is a novel dependable biomarker in patients with acute coronary syndrome. It shows significant upregulation in patients with AMI, but this upregulation is far from that of UA

JAK2 V617F mutation in myeloproliferative neoplasms

Myeloproliferative neoplasms [MPNs] are clonal hematopoietic stem cell Malignancies characterized by excessive production of blood cell :they include polycythemia vera [PV],essential thrombocythemia [ET],Myelofibrosis [MF] and chronic inyeloid leukemia [CML].A somatic mutation in the Janus Kinase gene on chromosome 9: a guanine to thymine point mutation at nucleotide 1849 in exon 14,results in substitution of valine to phenylalanine atfcodon 617 this mutation contributes to the expansion of the MPN clone by increasing tyrosine phosphorylation activity providing hematopoietic [dh with a proliferative and survival advantage. The present work aimed to study the expression of JAK2 V617 F mutation by Real time PCR in myeloproliferative neoplasms patients. This study included /5 MPNs patients ;19 cases were diagnosed as PV 10 cases were diagnosed as ET16 cases were diagnosed as MF .20 age and sex matched individuals were also included as a control group. In MPNs patients,JAK2 mutation was expressed in 62%, in P V, ET an d MF patients 79%, 60% and 44% of cases had JAK2 mutation respectively. There was highly significant relationship between JAk2 mutation expression and patients' laboratory findings as regards hemoglobin level, total leucocytic count in PV positive JAK2 mutation patients and platelets count in ET positive JAK2 mutation patients. JAK2, mutation expression was associated with increased risk of MPNs .We concluded from this study that JAK2 mutation plays a fundamental role in the palhogenesis and development of MPNs ,and its detection is very useful to confirm the diagnosis and help in treatment and follow up of MPNs patients

Hepatitis B virus escape mutants after vaccination

Vaccine escape mutant may develop after immune prophylaxis with universal HBV vaccination. Aim of the study: to detect the frequency of HBsAg escape mutant among the patients with previous HBV infection and patients with HCV infection after full dose of HBV vaccination. A hospital control based study included 68 person. Twenty six with previous HBV infection patients, 25 chronic hepatitis C patients, and 17 apparently healthy persons as controls. Vaccination were carried out for all patients and control group. All patients and control groups were negative for HBs Ag before enrollment in this study. HBsAg, HbcAb, HBeAg and HBsAb were enrollment performed by micro particle immunoassay. HBV DNA and HBsAg mutants were performed by real time polymerase reaction [RT-PCR]. HBV DNA was detected in 10[38.5%] in HBV patients with previous infection and after full dose of vaccination. HBsAg mutants were detected in 8[30.8%] of them. In HCV patients with negative surface antigenemia HBV DNA was detected in 5 [20%] and HBsAg mutants were detected in 3[12%] of them. The frequency and levels of HBsAb in HBV patients with previous infection and after full dose of vaccination were significantly decreased when compared to those with HCV infection and healthy control group after dose of vaccination. From this study we concluded that the presence of HBsAg mutants in HBV and HCV patients with negative surface antigenemia after full dose vaccination .the measurement of HBV DNA by sensitive quantitative technique plays an important role in detection either with mutants in surface antigen or occult HBV infection [OBI]. Lower immune response was markedly observed after prophylactic vaccination of patients with previous HBV infection with and to lesser extent in those with HCV infection. HBcAb and or HBV DNA testing should be considered before HBV vaccination to avoid the vaccine induced pressure which may lead to development of HBV surface antigen mutations

Leptin, osteocalcin, and bone mineral density in post-hepatitic liver cirrhosis

The pathophysiology of osteoporosis complicating chronic liver disease is unknown. Some studies have found leptin to be a potent inhibitor of bone formation. The aim of this study is to investigate the relationship between leptin, osteocalcin and bone mineral density [BMD] in liver cirrhosis. Sixty patients with post-hepatitic liver cirrhosis were classified into three groups: group I, 20 pre-menopausal females; group II, 20 post-menopausal females; and group III, 20 males. In addition, 21 age- and sex-matched healthy subjects [seven for each group] were included as control subjects. Patients were classified according to Child-Pugh classification into grade A [n = 0], grade B [n = 38] and grade C [n = 22]. Serum osteocalcin, leptin and parathyroid hormone [PTH], in addition to liver functions test, hepatitis B surface antigen [HBsAg], anti-hepatitis C virus [HCV], serum phosphorus and calcium were measured. Bone mineral density [BMD] was measured by calcaneal ultrasound. Leptin was elevated in all groups [I, II and III] when compared with their control groups [p < 0.01, p < 0.001 and p < 0.01, respectively]. Further, it was high in female groups [I and II] compared to males [group III], [p < 0.01 each]. BMD and serum osteocalcin decreased in each group compared with the respective control [p < 0.001; p < 0.01 in group I, p < 0.05; p < 0.001 in group II and p < 0.001; p < 0.001 in group III, respectively]. In the Child-Pugh grade C group, BMD and osteocalcin were low [p < 0.001, p < 0.05, respectively], while serum leptin was elevated [p < 0.05], when compared with grade B group. Leptin correlated negatively with serum osteocalcin [r = -0.553; p < 0.001], BMD [r = -0.229; p < 0.05], albumin [r = -0.449; p < 0.001] and albumin/globulin [A/G] ratio [r = -0.661; p < 0.001], while positively correlated with both aspartate transaminase [AST] [r = 0.462; p < 0.001], and alanine transaminase [ALT] [r = 0.483; p < 0.001]. Osteocalcin negatively correlated with intact iPTH [r = -0.370, p < 0.001], while positively correlated with BMD [r = 0.418; p < 0.001], albumin [r = 0.659; p < 0.001] and A/G ratio [r = 0.444; p < 0.001]. Serum leptin was elevated in cirrhotic patients and may have a role in the pathogenesis of osteoporosis in liver cirrhosis

Laboratory screening for rhabdomyolysis among beginners practicing vigorous exercises

The objectives of this study were: screening for cases of exertional rhabdomyolysis among beginners in practicing vigorous exercises, and finding out reference laboratory values for the students who will exercise for the first time. The study was conducted in Assuit university hospital on 222 male students of first year of faculty of sports, who practiced vigorous exercises for one hour with maximal load, for the first time, and 20 apparently healthy subjects as a control group [GI]. Twenty four hours after vigorous exercise [24hs AVE], blood samples were collected and the students were classified according to [CK] levels into two groups, group II [GII] :125 students, with total CK<183U/L[cut off value] and group III [GIII]: 97 students, with total CK>183U/L. One month after vigorous exercises [I m AVE], blood samples were collected from [GIII] which represent the follow up group [GIV, baseline]. All participants were subjected to medical history, clinical examination including body mass index [BMI], and quadriceps circumferences. Laboratory investigations included peripheral haemogram, kidney and liver function tests, blood minerals, and specific tests including: total CK, CK-MB and CK-MM isoenzymes, LDH, and serum myoglobin. This study revealed statistically highly significant elevation of total CK, CK-MM, CK-MB, AST and serum myoglobin when comparing [GIII] with each of [GI] and [GII] while a high significant reduction was found when comparing [GIV] with [GIII]. No significant difference could be detected when [GIV] compared with [GI] and [GII] compared with [GI]. There was a significant reduction in serum Na+ and serum Ca+ + level and highly significant elevation in serum K+ and phosphorus in GIII when compared with GI. No statistical significance in [BMI] was detected. Twenty four hours after vigorous exercises, 16 students [7.2%] showed total CK level more than 5 times the cut off value [183 U/L]. These students showed no signs and symptoms of rhabdomyolysis except muscle pain. The participant students who showed total CK values five times or more than the cut off value [183 U/L], are considered by some authors to be suspicious of having rhabdomyolysis. Laboratory values of the students who did not show rhabdomyolysis, could be taken as reference values for students and untrained persons who will practice exercise vigorously for the first time

use of gated cardiac single photon emission computed tomography [SPECT] in healthy smokers

As cigarette smoking is a major cardiovascular risk factor, this study was designed to find the effect of chronic cigarette smoking on cardiovascular system of apparently healthy subjects by using gated SPECT. This study included 20 healthy young males heavy smokers with smoking index 379 +/- 193.4. Also 10 age and sex matched non smokers volunteers served as controls. Smokers and non smokers persons were subjected to complete history taking, thorough clinical examination, X-ray chest, resting ECG and resting echocardiography to exclude any abnormalities. In addition the following laboratory investigations were done; blood urea, serum creatinine, serum glucose, lipogram and C-reactive protein. Also, stress gated cardiac SPECT using Tc99m MIBI was performed for all subjects. Mean values of serum cholesterol and LDL-c were significantly higher in smokers than non smokers [p <0.001, p <0.05 respectively]. Mean values of HDL-c were significantly lower in smokers than controls [p<0.05]. The percentages of positive CRP were significantly higher in smokers versus non smokers [p<0.05]. The mean values of EF% and SV were insignificantly lower in smokers versus controls at post-stress SPECT. Also, 50% of smokers had diminished myocardial perfusion versus 0% of non smokers [p<0.01] at post stress SPECT. There were also abnormal wall motion and thickness at post stress SPECT. Cigarette smoking is a major risk factor for atherosclerosis in young adult male. Post stress cardiac SPECT may be useful for early detection of cardiovascular events of smoking

Thyroid disorders in systemic lupus erythematosus and rheumatoid arthritis

Aim: Thyroid disorders are not uncommon in systemic lupus erythematosus [SLE] and rheumatoid arthritis [RA]. However, the association between SLE and RA with autoimmune thyroid diseases is conflicting. This study was designed to determine the patterns of thyroid dysfunction in SLE and RA in Assiut University Hospital. Subjects and Twenty patients with SLE and another twenty with RA were studied in addition to 20 healthy age- and sex-matched controls. All patients were subjected to complete history taking, thorough clinical examination and joint examination. All patients and controls were subjected to the following investigations: serum T3, T4, TSH, antithyroglobulin antibodies [ATGAb] and thyroid peroxidase antibodies [TPOAb]. Also, complete blood picture, ESR, RF, ANA, CRP and LE cells were determined. Fifty percent of SLE patients showed thyroid dysfunction compared to 15% of RA [P<0.05]. In SLE group, 20% had euthyroid sick syndrome, 20% had hypothyroidisrn [10% subclinical and 10% overt], and 10% had hyperthyroidism [5% subclinical and 5% overt]. However in RA, 10% had hypothyroidisrn [subclinical] and 5% had subclinical hyperthyroidism. TPOAb was found in 15% of SLE and 5% of RA patients and 10% of controls, but the titre was higher in SLE and RA patients. Also ATGAb was found in 5% of SLE and 30% of RA patients and 10% of controls, but the titre was higher in SLE and RA patients. Conclusions: Thyroid dysfunction was common in SLE [in particular] and RA. Euthyroid sick syndrome and hypothyroidism were the most common thyroid disorders in SLE. In RA hypothyroidism was more common than hyperthyroidism. SLE and RA were associated with antithyroid antibodies [TPOAb in SLE and ATGAb in RA]. We recommend the performance of thyroid function tests in patients with SLE [in particular] and RA as a part of biochemical and immunological profile

Evaluation of clinical significance of prostate specific antigen and other tumor markers in breast cancer

To evaluate the significance of prostate specific antigen [PSA], both total and free, carcinoembroynic antigen [CEA] and carbohydrate antigen 15 -3 [CA15- 3] in breast cancer serum levels of total and free PSA, CEA and CA15-3 were measured in 60 female patients with breast cancer at time of primary diagnosis. The patients were divided into 4 groups according to the stage of breast cancer and the results were compared with those of 25 apparently healthy females as controls. The study revealed that, total PSA was detected in serum of 4% [1/25] of healthy controls and 18% of breast cancer patients. Free PSA is the predominate molecular form of serological PSA in 54% of patients with increased total PSA levels. Free and total PSA, levels were highly significantly increased in advanced stages of breast cancer [III and IV] in comparison to control group, stage I and stage II [P < 0.001]. There was significant negative correlation between PSA [total and free] and age of breast cancer patients [r = 0.285,P< 0.05, r = -0.295, P<0.05 respectively]. There was significant positive correlation between PSA [total and free] and stage of breast cancer [r = + 0.470, P <0.001, r = +0.399, P <0.01 respectively] CEA levels were significantly increased in stage I [P< 0.05], stage II [P < 0.01] stage III and IV [P < 0.001] in comparison with control group. Levels of CEA and CA 15-3 were significantly high in stages III and IV compared with stages I and II [P < 0.001]. There was significant Positive correlation between [CEA, CA15-3] and stage of breast cancer [r = +0.314, P<0.05, r = + 0.547, P <0.01 respectively]. There is a positive correlation between [CEA and CA15-3 [r = +0.597, P<0.001]. In conclusion: Levels of serum PSA and CA 15-3 increased in late stages of breast cancer and so they cannot be used as a screening diagnostic tool for breast cancer. Although CEA increases early in breast cancer, it cannot be trusted as a diagnostic tool for breast cancer as its levels are elevated in a variety of cancers, so it may be used as a screening test. There is a positive correlation between CA 15-3 and CEA, which can be used together for follow up and prognosis of breast cancer