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Systemic lupus erythematosus (SLE) is a chronic multisystem inflammatory autoimmune disease that is characterized by a number of immunological abnormalities. Disease onset is triggered by ill‑defined environmental factors in genetically susceptible individuals. C1q plays a key role in apoptotic cell and immune complex removal, and hence it is a very important functional molecule in SLE pathogenesis. Investigation of the relationship between peripheral lymphocyte apoptosis and serum levels of anti‑C1q autoantibodies in SLE patients suggests that increased serum levels of anti‑C1q autoantibodies are responsible for apoptosis and may play a pathogenic role in SLE patients, especially in active disease. Objectives The aim of this study was to measure the serum level of anti‑C1q in SLE patients, and to evaluate the correlation between anti‑C1q and SLE disease activity, especially renal activity. Patients and methods Fifty SLE patients diagnosed according to the Systemic Lupus International Collaborating Clinics classification criteria 2012 and 33 healthy volunteers who were age and sex matched were included in the study. SLE activity was assessed using the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI), and renal activity was assessed using the renal SLEDAI. Anti‑C1q was estimated using enzyme‑linked immunosorbent assay kit. Results Serum anti‑C1q was significantly higher in SLE patients (64.86 ± 27.88 U/ml) compared with healthy controls (30.15 ± 13.93 U/ml) (P 0.000). There was a significantly positive correlation between anti‑C1q and the SLEDAI (P = 0.035, r = 0.299) and the renal SLEDAI (P = 0.025, r = 0.316). Anti‑C1q has a sensitivity and specificity of 92.7 and 66.7%, respectively, a positive predictive value of 92.7%, negative predictive value of 66.7%, and 88.0% accuracy for detecting SLE disease activity, whereas for lupus nephritis diagnosis anti‑C1q has a sensitivity and specificity of 94.12 and 50.0%, respectively, a positive predictive value of 80.0%, negative predictive value of 80.0%, and 80.0% accuracy. Conclusion Our results support the finding that anti‑C1q level might be used as a marker for SLE activity and not lupus nephritis in adult SLE patients.

Systemic lupus erythematosus (SLE) is a chronic multisystem inflammatory autoimmune disease that is characterized by a number of immunological abnormalities. Disease onset is triggered by ill‑defined environmental factors in genetically susceptible individuals. C1q plays a key role in apoptotic cell and immune complex removal, and hence it is a very important functional molecule in SLE pathogenesis. Investigation of the relationship between peripheral lymphocyte apoptosis and serum levels of anti‑C1q autoantibodies in SLE patients suggests that increased serum levels of anti‑C1q autoantibodies are responsible for apoptosis and may play a pathogenic role in SLE patients, especially in active disease. Objectives The aim of this study was to measure the serum level of anti‑C1q in SLE patients, and to evaluate the correlation between anti‑C1q and SLE disease activity, especially renal activity. Patients and methods Fifty SLE patients diagnosed according to the Systemic Lupus International Collaborating Clinics classification criteria 2012 and 33 healthy volunteers who were age and sex matched were included in the study. SLE activity was assessed using the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI), and renal activity was assessed using the renal SLEDAI. Anti‑C1q was estimated using enzyme‑linked immunosorbent assay kit. Results Serum anti‑C1q was significantly higher in SLE patients (64.86 ± 27.88 U/ml) compared with healthy controls (30.15 ± 13.93 U/ml) (P 0.000). There was a significantly positive correlation between anti‑C1q and the SLEDAI (P = 0.035, r = 0.299) and the renal SLEDAI (P = 0.025, r = 0.316). Anti‑C1q has a sensitivity and specificity of 92.7 and 66.7%, respectively, a positive predictive value of 92.7%, negative predictive value of 66.7%, and 88.0% accuracy for detecting SLE disease activity, whereas for lupus nephritis diagnosis anti‑C1q has a sensitivity and specificity of 94.12 and 50.0%, respectively, a positive predictive value of 80.0%, negative predictive value of 80.0%, and 80.0% accuracy. Conclusion Our results support the finding that anti‑C1q level might be used as a marker for SLE activity and not lupus nephritis in adult SLE patients.

Systemic lupus erythematosus (SLE) is a chronic multisystem inflammatory autoimmune disease that is characterized by a number of immunological abnormalities. Disease onset is triggered by ill‑defined environmental factors in genetically susceptible individuals. C1q plays a key role in apoptotic cell and immune complex removal, and hence it is a very important functional molecule in SLE pathogenesis. Investigation of the relationship between peripheral lymphocyte apoptosis and serum levels of anti‑C1q autoantibodies in SLE patients suggests that increased serum levels of anti‑C1q autoantibodies are responsible for apoptosis and may play a pathogenic role in SLE patients, especially in active disease. Objectives The aim of this study was to measure the serum level of anti‑C1q in SLE patients, and to evaluate the correlation between anti‑C1q and SLE disease activity, especially renal activity. Patients and methods Fifty SLE patients diagnosed according to the Systemic Lupus International Collaborating Clinics classification criteria 2012 and 33 healthy volunteers who were age and sex matched were included in the study. SLE activity was assessed using the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI), and renal activity was assessed using the renal SLEDAI. Anti‑C1q was estimated using enzyme‑linked immunosorbent assay kit. Results Serum anti‑C1q was significantly higher in SLE patients (64.86 ± 27.88 U/ml) compared with healthy controls (30.15 ± 13.93 U/ml) (P 0.000). There was a significantly positive correlation between anti‑C1q and the SLEDAI (P = 0.035, r = 0.299) and the renal SLEDAI (P = 0.025, r = 0.316). Anti‑C1q has a sensitivity and specificity of 92.7 and 66.7%, respectively, a positive predictive value of 92.7%, negative predictive value of 66.7%, and 88.0% accuracy for detecting SLE disease activity, whereas for lupus nephritis diagnosis anti‑C1q has a sensitivity and specificity of 94.12 and 50.0%, respectively, a positive predictive value of 80.0%, negative predictive value of 80.0%, and 80.0% accuracy. Conclusion Our results support the finding that anti‑C1q level might be used as a marker for SLE activity and not lupus nephritis in adult SLE patients.

Systemic lupus erythematosus (SLE) is a chronic multisystem inflammatory autoimmune disease that is characterized by a number of immunological abnormalities. Disease onset is triggered by ill‑defined environmental factors in genetically susceptible individuals. C1q plays a key role in apoptotic cell and immune complex removal, and hence it is a very important functional molecule in SLE pathogenesis. Investigation of the relationship between peripheral lymphocyte apoptosis and serum levels of anti‑C1q autoantibodies in SLE patients suggests that increased serum levels of anti‑C1q autoantibodies are responsible for apoptosis and may play a pathogenic role in SLE patients, especially in active disease. Objectives The aim of this study was to measure the serum level of anti‑C1q in SLE patients, and to evaluate the correlation between anti‑C1q and SLE disease activity, especially renal activity. Patients and methods Fifty SLE patients diagnosed according to the Systemic Lupus International Collaborating Clinics classification criteria 2012 and 33 healthy volunteers who were age and sex matched were included in the study. SLE activity was assessed using the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI), and renal activity was assessed using the renal SLEDAI. Anti‑C1q was estimated using enzyme‑linked immunosorbent assay kit. Results Serum anti‑C1q was significantly higher in SLE patients (64.86 ± 27.88 U/ml) compared with healthy controls (30.15 ± 13.93 U/ml) (P 0.000). There was a significantly positive correlation between anti‑C1q and the SLEDAI (P = 0.035, r = 0.299) and the renal SLEDAI (P = 0.025, r = 0.316). Anti‑C1q has a sensitivity and specificity of 92.7 and 66.7%, respectively, a positive predictive value of 92.7%, negative predictive value of 66.7%, and 88.0% accuracy for detecting SLE disease activity, whereas for lupus nephritis diagnosis anti‑C1q has a sensitivity and specificity of 94.12 and 50.0%, respectively, a positive predictive value of 80.0%, negative predictive value of 80.0%, and 80.0% accuracy. Conclusion Our results support the finding that anti‑C1q level might be used as a marker for SLE activity and not lupus nephritis in adult SLE patients.

ABSTRACT Introduction: Saliva has hundreds of components that may serve to detect systemic diseases or as evidence of exposure to various harmful substances, as well as provide biomarkers of health and disease status. Pilocarpine has effects on serum urea, creatinine and phosphorus in patients with chronic kidney disease (CKD) and patients with End Stage Renal Disease (ESRD) on hemodialysis. Pilocarpine is a parasympathomimetic drug used to induce hypersalivation. Parasympathetic stimulation leads to acetylcholine (ACh) release into the salivary acinar cells. ACh causes the salivary gland to release kallikrein, an enzyme that converts kininogen to lysyl-bradykinin. Lysyl-bradykinin acts upon blood vessels and capillaries of the salivary gland to generate vasodilation and increased capillary permeability respectively. The resulting increased blood flow to the acini allows production of more saliva. Aim of work: To determine the effects of expelling induced hyper salivation on serum Phosphorus, urea and creatinine levels in CKD and ESRD patients. Materials and Methods: It is a case control study which included 80 patients divided into Group A: 40 patients with End Stage Renal Disease on Hemodialysis for at least six months in Assiut University Hospital and Group B: 40 patients with Chronic Kidney Disease (stage 3,4) on conservative medical treatment. Both groups were complaining of hyperphosphatemia. Their ages ranged from 18 to 60 years old with mean age ± SD (51 ± 11), pilocarpine mouth washer (4% concentration, 5 ml pilocarpine which equals 13 mg, three times daily) is given for two months. Results: After pilocarpine intake; there was a decrease in serum phosphorus level in CKD patients (33%) than those with ESRD (30%). But there was a decrease in serum creatinine level in ESRD patients (23%) than those with CKD patients (15%). The two groups had the same percentage of decrease in blood urea level (40%). In salivary measures after pilocarpine intake; one hundred percent increase in phosphorus excretion in both group but patients with ESRD showed more creatinine excretion compared to patients with CKD (84% vs. 60%). CKD patients had more urea excretion in saliva versus to patients with ESRD (100% and 55%) respectively. Conclusion: Pilocarpine has a role in improving hyperphosphatemia in CKD patients and ESRD patients, also pilocarpine led to decrease in serum urea and creatinine levels so it can be used as an adjuvant therapy in CKD and ESRD patients.

Aims The aims of this study are to (a) detect the effect of different types of heart diseases [ischemic, cardiomyopathy, hypertensive heart failure (HF)] on the association with sleep disorders, and to (b) identify the relationship between Cheyne–Stokes respiration (CSR) and left ventricular dysfunction. Materials and methods In a cross-sectional study involving 100 HF patients, we performed echocardiography and a fullnight attended polysomnography for all patients. Results In all, 47.9% of patients with ischemic heart disease had obstructive sleep apnea (OSA), whereas 37.5% had central sleep apnea (CSA). OSA was highly prevalent in patients with hypertensive heart disease (79.2%). On the other hand, 50.0% patients with dilated cardiomyopathy (DCM) had CSA, whereas 39.3% had OSA. Patients with DCM had a significant increase in the central apnea index (11.05±9.19 events/h), as well cycle length of CSR (68.14 ±13.26 s), as compared with other groups. There was an inverse increase of cycle length with reduction in left ventricular ejection fraction (LVEF) (LVEF≥50% had a cycle length of 41.55±10.84 s, whereas those with LVEF≤30% had a longer mean cycle length of 69.23±18.09 s). Conclusion Sleep-disordered breathing is a common disorder in different groups of HF. OSA was prevalent in ischemic and hypertensive heart disease, whereas CSA was prevalent in DCM. There was a significant increase in cycle length of CSR with a reduction in LVEF.

Background Heart failure (HF) is characterized by its high mortality, frequent hospitalizations, and reduced quality of life. Sleep-disordered breathing (SDB), one of the common comorbidities, accelerates the progression of HF. Objectives The objectives of the study were (a) to investigate the prevalence and type of SDB in HF patients and (b) to determine the predictors of SDB. Materials and methods In a cross-sectional analytic study, all eligible patients of Assiut Chest and Cardiology Department admitted (100 patients) during the period from August 2015 to March 2016 were included in this study. Clinical assessment, full-night attended polysomnography, and echocardiography were recorded and compared between patients with (SDB) (85 patients) and those without SDB (15 patients). Results SDB was found in 85% of patients [53% had obstructive sleep apnea (OSA) and 32% had central sleep apnea (CSA)]. OSA patients are characterized by higher BMI and neck and waist circumference. There was a higher prevalence of hypertension, as well as mean blood pressure, systolic blood pressure, diastolic blood pressure, in OSA patients. Loud snoring was the only clinical symptom associated with OSA as compared with CSA. CSA patients had a significant reduction in PaCO2. OSA patients showed a significant increase in desaturation index and time spent with oxygen saturation less than 90%. Maximum heart rate and brady/tachy index were significantly increased in OSA. Cycle length was significantly increased in CSA. Conclusion The prevalence of sleep apnea was high in patients with stable HF (85%). OSA was the predominant type (53%). The predictors of SDB were BMI (≥30), systemic hypertension, neck circumference more than 40 cm, waist circumference more than 110 cm, and e

Background: Injury is a growing public health problem worldwide. Deaths due to injuries account for 10% of the world’s mortality. More than 90% of the world’s injury deaths occur in low and middle income countries. In Egypt, injury is a hidden epidemic and its related deaths are misclassified due to lack of accurate national data. Furthermore, as a research problem it has also been largely ignored in developing countries. Objectives: To determine the pattern and trend of injury from January 2002 to December 2009 among attendants at trauma unit in Assiut university hospital in Upper Egypt. Patients and Methods: A descriptive retrospective study was conducted at the trauma unit in Assiut university hospital in Upper Egypt. All registered injuries during January 2002 to December 2009 were included in the study. Results: During January 2002 to December 2009, 213835 injured cases were admitted to the trauma unit. The number of attendants increased every year from 9.3% from the total cases in all study period in 2002 up to 15.3% in 2009 with a statistically significant difference (P = 0.000). Young adults aged 20 - 29 years were the most common group affected by injuries (22.2%). Male to female ratio was 3:1. Falls represent one half of injuries (49.6%) from all attended cases, followed by exposure to inanimate mechanical forces (19.5%) and transport accidents (18.3%). Falls were ranked as the leading cause of injuries, while transport accidents were the second cause in 2007 - 2009. Conclusions: Trauma in Upper Egypt is an under-recognized problem, which requires prioritized attention. Increasing the awareness of community, making policies and establishment of a trauma system are important to decrease the burden of injuries.