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  Citation statistics : Table of Contents
   2014| January-March  | Volume 26 | Issue 1  
    Online since May 21, 2014

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Impact of hepcidin, interleukin 6, and other inflammatory markers with respect to erythropoietin on anemia in chronic hemodialysis patients
Ihab A. Ibrahim, Usama M. Mohamad, Hatem A. Darweesh, Amal M. Rashad
January-March 2014, 26(1):6-14
Background/objective Hepcidin is a peptide hormone produced by the liver and appears to be the master regulator of iron homeostasis. This peptide is upregulated in inflammatory conditions, including uremia. Hepcidin functions to regulate (inhibit) iron transport across the gut mucosa, thereby preventing excess iron absorption and maintaining normal iron levels within the body. In this study, we aimed to investigate hepcidin levels and their relationship with the parameters of iron status, inflammation, anemia therapy, and parameters of dialysis efficiency in hemodialysis patients. Patients and methods Plasma hepcidin-25, inflammatory markers (high-sensitivity C-reactive protein and interleukin 6), and peripheral iron indices (serum iron, total iron-binding capacity, transferrin saturation and serum ferritin) were measured before hemodialysis in 40 end-stage renal disease (ESRD) patients treated with regular hemodialysis in a single dialysis unit as well as in 20 healthy individuals matched for age and sex serving as the control group. Results Plasma levels of hepcidin-25 were significantly higher in hemodialysis patients compared with controls. In a simple correlation analysis, plasma hepcidin levels were positively correlated with ferritin, transferrin saturation, CRP, and interleukin 6; however, it was negatively correlated with hemoglobin, dose of epoitin-α, and dose of iron. Conclusion Serum hepcidin levels were associated with iron status and inflammation in maintenance hemodialysis patients, and the high hepcidin serum levels, found in hemodialysis (HD) patients, are dependent on the magnitude of the inflammatory process and on recombinant human erythropoietin doses. Hepcidin and its regulatory pathways are potential therapeutic targets, which could lead to effective treatment of anemia in chronic hemodialysis.
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A rare case of reversible paraplegia due to extramedullary hematopoiesis in a patient with thalassemia intermedia
Aysha I.Z. Badawi, Mona I. Nabih, Noha K.H.M. Khalil, Mohamed A.A. ELnady, Sarra A. Hassan
January-March 2014, 26(1):27-29
30 yrs old man is known to have thalassemia intermedia presented with bilateral lower limb weakness and sphincteric troubles with loss of deep sensations, the motor power of the muscles and precipitancy of urine improved after blood transfusion, laboratory investigations and MRI dorsolumbar spine confirm the diagnosis of extramedullary haematopoiesis.
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Genotypic analysis of Asp299Gly and Thr399Ile polymorphisms of TLR4 in Egyptian patients with rheumatoid arthritis and systemic lupus
Hanan A. Taha, Rania E. Sheir, Sanaa S Abdel Shafy, Lamya M. Mohamed
January-March 2014, 26(1):15-20
Background Toll-like receptors (TLRs) are essential molecules of the innate immune system that stimulate numerous inflammatory pathways and harmonize systemic defense against a wide array of pathogens. TLRs may also recognize a number of self-proteins and endogenous nucleic acids. Inappropriate stimulation of the TLR pathway by endogenous or exogenous ligands or as a consequence of mutation in the TLR genes may lead to induction and/or prolongation of autoimmune response and tissue injury. This study was designed to detect the TLR4 (Asp299Gly and Thr399Ile) gene polymorphism in Egyptian patients with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) as well as its correlation with disease activity. Participants and methods This study enrolled 50 patients who were attending the internal medicine and immunology out-patient clinic of Beni-Suef University Hospital. They were classified into three groups: 20 patients with RA, 20 patients with SLE, and 10 healthy controls. All studied persons were subjected to complete clinical evaluation, laboratory investigations, and detection of mutation in the TLR4 (Asp299Gly and Thr399Ile) gene by PCR technique. Results No individual in the RA patients group, the SLE patients group, or control population was identified carrying the Asp299Gly and Thr399Ile polymorphisms; in other words, all RA patients, SLE patients, and controls were with the same wild genotype. Conclusion The similarity in genotype between the patients group and control population concluded that these two missense polymorphisms do not contribute to RA and SLE in a group of Egyptian population.
  - 1,676 164
Influence of admission blood glucose and hemoglobin A1c on outcome of acute myocardial infarction
Hanan E. Zaghla, Mahmoud A. Elbadry, Alaa M. Ashour, Mohamed M. Abdelfatah
January-March 2014, 26(1):21-26
Introduction Patients either with or without a prior history of diabetes mellitus may present with hyperglycemia during acute myocardial infarction (AMI); it is uncertain whether hyperglycemia upon admission, irrespective of the diagnosis of diabetes, remains an independent predictor of in-hospital morbidity and mortality. Aim of the study We aimed in this study to assess the impact of admission blood glucose level on the hospital course and outcome in patients presenting with AMI in ICU. Patients and methods We included 50 patients with AMI divided into two groups: group I included 30 patients with admission blood glucose level less than 180 mg/dl and group II included 20 patients with admission blood glucose level 180 mg/dl or more. Group I was subdivided into group IA including 16 patients with HbA1c less than 6% and group IB including 14 patients with HbA1c of 6% or more. All patients were subjected to complete history taking and complete clinical examination; 12-lead ECG was performed for every patient and routine laboratory investigations including cardiac enzymes, admission blood glucose level, and HbA1c were estimated at the time of admission of the patients. Results There was significant correlation between admission blood glucose level and history of diabetes mellitus and history of smoking (P = 0.000 and 0.008, respectively). There was also significant correlation between admission blood glucose level and complications of myocardial infarction including sinus tachycardia, arrhythmia, and ICU length of stay (P = 0.008, 0.002, and 0.000, respectively). However, HbA1c level was not found to be correlated with any of the previous parameters. Conclusion We concluded that elevated admission glucose level is a strong predictor of short-term adverse outcome in patients with AMIs. However, the prognostic value of diabetic control (i.e. hemoglobin A1c levels) in patients with AMI is still undefined.
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Questions and guide to answers
Amany M Maqsoud
January-March 2014, 26(1):30-34
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Nicotinic acid: a lipid-lowering agent with unrealized potential
Samar H. Aboulsoud
January-March 2014, 26(1):1-5
Nicotinic acid is a well-known treatment for dyslipidemia in adults. This review article explored not only the role of nicotinic acid in dyslipidemia but also its role in hypertension and as a cardioprotective agent. Adverse effects in association with nicotinic acid use are described with a focus on flushing, the major reason for the discontinuation of nicotinic acid therapy. The role of nicotinic acid receptor in mediating its metabolic and vascular effects is also reviewed.
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