Serum tryptophan, insulin, and serotonin in type 2 diabetic patients: A pilot study

Introduction and Aim: T2DM being a most prevalent metabolic disorder globally and is mainly triggered by two important factors: decreased insulin secretion by pancreatic beta-cells and the defective insulin-sensitivity of tissues. Recent studies found that other factors influence insulin release are amino acids, fatty acids, incretins, certain neurotransmitters, and some of the pituitary hormones. Higher levels of peripheral serotonin in diabetic people have drawn attention to the involvement of metabolic homeostasis and cellular sensors. Thus, the aim of this study is to screen the association of tryptophan, serotonin, and insulin in T2DM. Materials and Methods: Serum samples from T2DM patients (n=80) were divided into 2 groups depending on HbA1C levels having good to moderate (6.5-8) and poor (>8) glycemic control to study the levels of tryptophan, serotonin, and insulin.   Results: A boarderline statistically significant increase was observed in Serotonin levels in group 2 when compared with group 1. Statistical analysis showed a negative correlation between insulin and serotonin in group 1, whereas in group 2 a negative correlation has observed between HbA1C and insulin.   Conclusion: The study report shows an increase in serum serotonin levels with increase in insulin levels and hyperglycemia.

Microbiota milieu and mechanisms of intestinal Toll Like Receptors (TLRs) involved in chemotherapy induced mucositis

Gut is not only of digestive but also of immunological importance because of the residing microbiota milieu. Pathological or certain therapeutic condition may modify the normal commensal microflora. Mucositis, the most common untoward effect of chemotherapy, can also lead to this microbiotic imbalance. This shift leads to various molecular cascades which in turn trigger the action of Pattern Recognition Receptors (PRR’s). Toll like receptor (TLR) is one such pattern recognition receptor. In the human body there are about 13 types of TLRs out of which TLR-2, TLR-4, TLR-5 and TLR-9 are intestinal specific. They respond through ligands such as bacterial derivatives like flagellin, Lipoteichoic acid, Lipopolysaccharides, microbial antigen or genetic material of the viru. In turn via adaptor molecules, TLRs alter the signalling mechanisms and further induct the activation of pro or anti-inflammatory cytokines based on the immunological need. Several of the studies have described the involvement of under twined mechanisms of TLRs during chemotherapy. Therefore, agonists and/or antagonists of these strategic molecules may play a key role in pathological and therapeutic aspects. Thus, this review is an attempt to focus on the involvement of TLRs and microbiota to different chemotherapeutic agents and thereby track the available mechanisms of functionality.

Vitamin B status and its impact in post-menopausal women: A review

Menopause is an age-related naturally occurring phenomenon in women. Women generally attain menopause between the 40-58 years of age, during which they undergo several physiological changes that have an impact on their daily activities. The deficiency of B vitamins occurs mainly due to the dietary pattern, absorption and blood loss which may leads to health problems such as cognitive decline, osteoporosis, physical and mental imbalance.  This review evaluated the published evidence on the vitamin B status and its impact in post-menopausal women. Selected data sources were searched for relevant literature (2010-2020) and included as per the set criteria using Prisma guidelines. The NIH quality questionnaire tool was used to rate the articles. Finally eleven articles were included for full length review having reports on the impact of B vitamins on bone loss, cognitive decline and physical activity. Existing evidences show that there is no association between B vitamins and bone loss. Very few studies are available which concluded association of B vitamin with cognitive decline and physical health.  More studies are required to address this research gap.

Correlation of CA 19-9 with HbA1c in prediabetic and diabetic groups

Introduction and Aim: Carbohydrate antigen19-9 (CA 19-9) is a marker of pancreatic cancer. In diabetics, pancreatic beta cell dysfunction can lead to elevated serum CA19-9 level. This study was designed for estimation of CA19-9 in diabetes and its correlation with glucose levels and glycosylated hemoglobin.   Materials and Methods: The includes diabetic, pre diabetic with no history of malignancies and healthy normal subjects (n=50 each). Ca19-9 was estimated using ELISA, HbA1c by D10-Biorad variant turbo and the Lipid profile in Roche COBAs 6000 auto analyzer. Statistical analysis was done by Statistical Package for Social Sciences software version17 (SPSS 17). P <0.05 was considered significant.   Results: Serum CA19-9 level was high in diabetics compared to normal, (p=0.38) however it was decreased in pre diabetic group (P=0.06). There was significant difference in comparison of CA19-9 levels between pre diabetic and diabetics(p=0.001). A significant increase in triglycerides was observed both in diabetics (p<0.01) and pre-diabetics(p=0.04). There was a significant positive correlation of CA19-9 with TC/HDL (p=0.022) and non-HDL(p) in control group.    Conclusion: CA19-9 levels can be influenced by glycemic status, hence assessment of pancreatic cancer in diabetic patients must be interpreted carefully in consideration with CA19-9 levels. CA19-9 level was decreased in prediabetics when compared to normal and diabetics. This is a novel finding, the cause for which must ascertained, and this will open further avenues for research.  

Spondias pinnata bark extract- an ameliorator of inflammatory derangement in etoposide induced mucositis: An experimental approach

Background and Aim:

Mucositis, one of the vulnerabilities of chemotherapy, affects the physiological activities and therapeutic strategies of patients because it can affect the normal cell population. Etoposide is a commonly used chemotherapeutic agent for cancers such as oral, lung, and gastrointestinal. In addition to the abnormal metabolic processes in the body caused by tumorigenesis, new metabolic alterations can occur, such as oxidative stress, antioxidant imbalance, and inflammatory reactions, all of which can contribute to existing patient vulnerability. Therapeutic adjuvants can help overcome these toxic effects. Spondias pinnata is a tropical tree omnipresent in the coastal and Western Ghat section of India that is used for culinary purposes and as a local analgesic. Therefore, we aimed to study the anti-inflammatory effects of S. pinnata in an etoposide-induced mucositis rat model.

Materials and Methods:

Small intestinal tissue homogenates from albino Wistar rats were used to estimate the levels of glutathione (GSH) and nitric oxide (NO), and activities of total antioxidant (TAO), myeloperoxidase (MPO) and Na⁺-K⁺ ATPase. The animals were grouped into: (1) normal control, (2) etoposide-induced mucositis (65 mg/kg bodyweight, single IP dose), (3) S. pinnata control group, and (4) etoposide followed by S. pinnata bark extract (200 mg/kg bodyweight, once in a day). Animals were sacrificed after 24, 48, 72, and 96 h and compared with that of the normal control group (n=6). Statistical analysis was performed using EZR software.

Results:

We observed a significant decrease in the TAO and GSH levels with a marked increase in NO, MPO, and Na⁺-K⁺ ATPase activity in the mucositis group. A tendency to recover from the decreased TAO and GSH levels existed in the treated group, showing the protective effects of S. pinnata bark extract against mucositis. In addition, this extract also showed anti-inflammatory effects as reflected by the recovery in MPO levels at the end of 96 h. Maintenance of Na⁺-K⁺ ATPase activity in the treated group demonstrates the protective effects of the extract against the increased levels observed in the etoposide-induced mucositis group.

Conclusion:

This study revealed the protective effects of S. pinnata bark extract against the oxidative and inflammatory changes that occurred during the development ofmucositis. This would decrease the pathological burden during chemotherapy and prevent any hurdles in therapeutic modalities.

Effect of L-tryptophan on intestinal glucagon like peptide-1(GLP-1) in streptozotocin (stz) induced diabetic rat model

Introduction and Aim: The management of diabetes is a great challenge in this era due to several factors. The financial burden of the medications and the complications of diabetes create management demanding especially in the Indian population. A high protein-rich diet is beneficial in controlling hyperglycemia in diabetic patients. Different amino acids play roles in reducing blood glucose levels in diabetes. Certain amino acids trigger hypoglycemia in diabetes by inducing the gut hormone, Glucagon-like peptide -1(GLP-1) secretion. L-tryptophan is one among them and is present in many of the food items like poultry, beans, seeds, nuts, etc., This study using albino rats focuses on the effect of L-tryptophan on intestinal GLP-1 secretion in diabetic rats by evaluating the blood glucose level, intestinal GLP-1, and intestinal histology of diabetic rats after tryptophan administration.Materials and Methods: Single dose of intraperitoneal injection of STZ (50mg/kg) used to develop diabetic model and orogastric gavage of tryptophan (50mg/kg) was done. Intestinal GLP-1 and blood glucose assay and intestinal histology were the parameters studied.Results: The results showed a significant reduction in blood glucose level and an increased secretion of intestinal GLP-1(p=0.001) in diabetic rats by tryptophan administration and recovery was seen in intestinal histology. In conclusion, in our study, the administration of L- tryptophan in diabetic rats induced a hypoglycemic effect by GLP-1 secretion and restored normal histology.Conclusion: Tryptophan administration showed hypoglycemic effect on diabetic rats as the blood glucose level was reverted to normal and the hypoglycemic effect of L-tryptophan in diabetic rats could be due to increased GLP-1 secretion.

Protective potentials of Annona muricata fruit pulp on etoposide-induced gastrointestinal toxicity in Wistar rats

BACKGROUND:

Mucositis, one of the devastating consequences of chemotherapy and also limits the efficacy of the treatment. At present, there are no antimucositic agents without side effects. Hence, there is a need for better adjuvant therapy using plant or food sources. Here, we have made an attempt to study the effect of Annona muricata (AM) fruit pulp on etoposide-induced mucositis.

MATERIALS AND METHODS:

The study was conducted at Central Research Laboratory, Kasturba Medical College, Mangalore. The effect of AM fruit pulp (100 mg and 200 mg/kg body weight) on etoposide-induced mucositis was studied in Wistar rats (n = 36) in comparison with normal and AM controls. Intestinal tissue was collected for histology and estimation of total antioxidants (TAO), glutathione (GSH), myeloperoxidase (MPO), and nitric oxide (NO) levels along with histological changes were studied. Statistical analysis was performed by one-way analysis of variance.

RESULTS:

TAO and GSH levels were found to be significantly high in the rats which received 200 mg of AM/kg body weight than 100 mg of AM/kg body weight when compared with etoposide control. The levels of inflammatory markers - MPO and NO - were found to be decreased (P < 0.001) in the animals received 200 mg/kg body weight of AM in comparison with etoposide group and lower dosage of AM pulp. Histology of intestine also showed a protective effect of AM (200 mg/kg body weight) against etoposide toxicity.

CONCLUSION:

The results show that AM fruit pulp has the capacity to act as antimucositic agent and also reduced inflammation.

Plasma antioxidant vitamins and lipid peroxidation products in pregnancy induced hypertension

It has been suggested that antioxidant systems are impaired in pregnancy induced hypertension and hence patients are exposed to oxidative stress. In order to investigate the relationship between lipid peroxidation and certain antioxidant parameters in blood of pregnancy induced hypertension (PIH) cases, 25 normotensive and 23 PIH samples were studied. In the present study, thiobarbituric acid reactive substances showed a tendency to increase, however the increase remained statistically insignificant. Plasma ascorbic acid level remained unaltered and Vitamin E showed a tendency to increase in the study group. The findings implicate oxidative stress in the disease and cite the biochemical rationale for clinical trials of antioxidants to prevent and treat pregnancy induced hypertension.

Neuroprotective effect of resveratrol against prenatal stress induced cognitive impairment and possible involvement of Na(+), K(+)-ATPase activity

Resveratrol, an active ingredient of red wine extracts, has been shown to exhibit neuroprotective effects in several experimental models. Hence in the present study, the protective effects of resveratrol on cognitive deficits induced by prenatal stress were evaluated in offspring, and the possible involvement of Na(+), K(+)-ATPase in learning deficits were explored. Pregnant rats were subjected to restraint stress during early or late gestational period. Another set of rats received resveratrol during the entire gestational period along with early or late gestational stress. The study parameters included various behavioral tests like open field test and Morris water maze test. At the end of the behavioral tests (on 40th postnatal day), the offspring were sacrificed, and their brain homogenate was subjected to Na(+), K(+)-ATPase estimation. Early and late gestational stress affected spatial learning and memory and prenatal resveratrol has reversed these cognitive deficits. The Na(+), K(+)-ATPase activity in the offspring brain homogenate was reduced in the late gestational stress group; however prenatal resveratrol treatment has not affected this activity. These data suggest the neuroprotective efficacy of resveratrol against prenatal stress induced cognitive impairment. Though late gestational stress involves Na(+), K(+)-ATPase activity in rat brain homogenate, this would not be the primary cause in prenatal stress-induced cognitive dysfunction.

Undergraduate medical education in the Gulf Cooperation Council: a multi-countries study (Part 1)

BACKGROUND

The Gulf Cooperation Council (GCC) countries have witnessed over the last 40 years a rapid and major social, cultural, and economic transformation. The development of medical education in the region is relatively new, dating from the late 1960s. An important goal among the medical colleges in the region is to graduate national physicians who can populate the healthcare service of each country.

AIM

The aim of this study is to provide understanding of undergraduate medical education in each of the six GCC countries and the challenges that each face.

METHODS

This is a descriptive cross-sectional study. Fourteen senior medical faculty were requested to submit information about undergraduate medical education in their own countries, focusing on its historical background, student selection, curriculum, faculty, and challenges.

RESULTS

The information provided was about 27 medical colleges: 16 from the Kingdom of Saudi Arabia (KSA), five from the United Arab Emirates (UAE), two from the Kingdom of Bahrain, two from Sultanate of Oman, one from Kuwait, and one from the State of Qatar. It was found that older colleges are reviewing their curriculum while new colleges are developing their programs following current trends in medical education, particularly problem-based learning and integrated curricula. The programs as described 'on paper' look good but what needs to be evaluated is the curriculum 'in action'. Faculty development in medical education is taking place in most of the region's medical colleges.

CONCLUSION

The challenges reported were mainly related to shortages of faculty, availability of clinical training facilities and the need to more integration with the National Health Care services. Attention to quality, standards, and accreditation is considered essential by all colleges.

Undergraduate medical education in the Gulf Cooperation Council: a multi-countries study (Part 2)

BACKGROUND

The Gulf Cooperation Council (GCC) countries have witnessed over the last 40 years a rapid and major social, cultural, and economic transformation. The development of medical education in the region is relatively new, dating from the late 1960s. An important goal among the medical colleges in the region is to graduate national physicians who can populate the healthcare service of each country.

AIM

The aim of this study is to provide understanding of undergraduate medical education in each of the six GCC countries and the challenges that each face.

METHODS

This is a descriptive cross-sectional study. Fourteen senior medical faculty were requested to submit information about undergraduate medical education in their own countries, focusing on its historical background, student selection, curriculum, faculty, and challenges.

RESULTS

The information provided was about 27 medical colleges: 16 from the Kingdom of Saudi Arabia (KSA), five from the United Arab Emirates, two from the Kingdom of Bahrain, two from Sultanate of Oman, one from Kuwait and one from the State of Qatar. It was found that older colleges are reviewing their curriculum while new colleges are developing their programs following current trends in medical education particularly problem-based learning and integrated curricula. The programs as described 'on paper' look good but what needs to be evaluated is the curriculum 'in action'. Faculty development in medical education is taking place in most of the region's medical colleges.

CONCLUSION

The challenges reported were mainly related to shortages of faculty, availability of clinical training facilities, and the need to more integration with the National Health Care services. Attention to quality, standards, and accreditation is considered essential by all colleges.

Advanced oxidation protein products and total antioxidant activity in colorectal carcinoma

The present study was designed to assess the levels of advanced oxidation protein products (AOPP) and percent hemolysis (that indirectly indicates the degree of membrane damage secondary to lipid peroxidation) in colorectal carcinoma. Glutathione (GSH), total thiols and albumin were measured to determine the antioxidant status. Considering the dynamic interaction between various antioxidants in the body, we measured the total antioxidant activity (AOA). Globulin was measured to assess the inflammatory response secondary to oxidative stress. Investigations were conducted in 45 cases of recently diagnosed primary colorectal adenocarcinoma. As control, 45 age and sex matched healthy persons were chosen. GSH was estimated in whole blood, percent hemolysis in RBC suspension and other parameters in plasma. We observed a very high significant increase (P<0.001) in AOPP, percent hemolysis and a highly significant increase (P<0.01) in globulin in colorectal carcinoma. We observed a very high significant decrease (P<0.001) in whole blood GSH, total thiols, albumin, AOA and a significant decrease (P<0.05) in plasma GSH in colorectal carcinoma. A very high significant negative correlation between percent hemolysis and AOA and an apparent negative correlation between total thiols and AOPP was seen in colorectal carcinoma. This demonstrated oxidative stress, decreased antioxidant status and secondary inflammatory response in colorectal carcinoma.

Oxidative stress and low dose ionizing radiation

The field of radiation biochemistry has provided tremendous impact in recent years as extensive research on free radicals has implicated them in radiation damage. An important offshoot of this field is the branch dealing with radiological protection in medical applications like diagnostic radiology. Hence, we decided to investigate the relationship between oxidative stress and low dose ionizing radiation (x-rays) in the work environment of x-ray technicians (radiographers), by comparing their RBC malondialdehyde, % hemolysis, catalase and plasma vitamin E levels with those of controls. There was a significant increase in the susceptibility of RBCs to hemolysis in radiographers compared to controls. Malondialdehyde and catalase levels were slightly increased in the radiographers, but this did not disturb the steady state concentration of their plasma vitamin E. These findings go in favour of theories stating that exposure to low dose ionizing radiation does cause a greater amount of oxidative stress, than that caused during normal routine metabolic processes.

Effect of extract of Benincasa hispida on oxidative stress in rats with indomethacin induced gastric ulcers

This study was undertaken to determine the healing of ulcers induced by indomethacin due to antioxidant role of fruit extract of Benincasa hispida (Ashgourd) on ulcers in rats. Malondialdehyde (MDA) in RBC and antral homogenate was determined to measure tissue oxidation. Superoxide dismutase (SOD) in RBC and antral homogenate, plasma and homogenate vitamin C were estimated as measures of antioxidant defense. On induction of gastric ulcer, there was significant increase in SOD in RBC and homogenate levels and vitamin C in plasma. There was an apparent decrease in ulcer index in animals treated with fruit extract. There was significant decrease in MDA with concomitant decrease in SOD and vitamin C levels in the treated rats when compared to those not treated with fruit extract. Benincasa hispida has been shown to contain certain active principles like terpenes, flavanoid C--glycosides and sterols which have antioxidant effects. These probably inhibit gastric mucosal injury by scavenging the free radicals and repress production of SOD and vitamin C in these rats.

Plasma antioxidant vitamins in brain tumors

Plasma levels of vitamins A, E and C were analyzed in 102 patients with different types of brain tumors. A follow-up study was done with 27 postoperative patients. On comparison with plasma from normal individuals, vitamin A and E were decreased, but the decrease was statistically insignificant. Vitamin C levels remained in the normal range. In a comparative study of preoperative and postoperative cases, plasma vitamin A levels in postoperative glioma patients were significantly higher than those in the pre-operative state. There was no significant difference in the plasma level of vitamins C and E. The results of the present study suggest that the plasma antioxidant vitamins are not altered effectively in brain tumor cases.

Primary hypertrophic colonopathy

We report a 45-year-old man and a 60-year-old woman who presented with features of intermittent intestinal obstruction. Barium enema revealed narrowing at the pelvic-rectal junction in the man, and from the pelvic colon to the anal verge in the woman. Histology of the resected sections showed marked hypertrophy of the muscularis propria in both cases, with normal mucosa, submucosa and myenteric plexus. Both patients are asymptomatic at 4 years' and 2 years' follow up. This entity of primary hypertrophic colonopathy may be a variant of primary visceral myopathy.

Role of antioxidant enzymes in brain tumours

Erythrocyte antioxidant enzymes were analysed in 100 patients with intracranial neoplasm and in 47 controls. There was a significant decrease in RBC glutathione reductase (GRx) and superoxide dismutase (SOD) activity in most types of brain tumor cases. Patients with acoustic neurinoma showed a significant reduction in selenium-dependent glutathione peroxidase (Se-GPx) activity. A decrease in catalase (CT) activity was seen in most of the brain tumor patients but remained statistically insignificant when compared to controls. A significant increase in plasma ceruloplasmin concentration was observed in patients with glioma. These enzymes were also studied in 27 post-treatment cases. GRx activity returned to normal levels in these patients. RBC SOD and plasma ceruloplasmin levels showed a tendency to return to normal. Hence, a marked decrease in the antioxidant enzymes may have a role in the genesis of considerable oxidative stress in patients with brain tumors.

Primary melanocarcinoma of stomach

Melanomas of the gastrointestinal tract are infrequent. Among primary melanomas, melanoma of the stomach is a rarity. We report a patient with primary melanocarcinoma of the stomach.

Marked perisplenitis in gastric carcinoma

We report a patient with gastric carcinoma with marked perisplentis, on gross appearance resembling secondary deposit. On sectioning, the spleen showed a solitary metastasis in the red pulp.

Respiratory effects of occupational exposure to asbestos

Ventilatory capacities of 73 Libyan men working in the Asbestos-Cement Pipe factory in Jenzur, a residential area near Tripoli, Libya and those of 73 age-matched healthy Libyan men unexposed to asbestos were determined. The mean values of forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) for men unexposed to asbestos were 3.89 +/- 0.084 and 3.64 +/- 0.082 liters respectively. The respective values for men exposed to asbestos were 3.62 +/- 0.082 and 3.29 +/- 0.097 liters. Thus, there has been a significant decrease in the ventilatory function of the men exposed to asbestos as compared with age-matched unexposed counterparts.

Oxytocin induces intimate behaviors

After decades of classic research on its secretion from the neurohypophysis and its potential effects in the uterus and the gland, oxytocin has, in the last 15 years, been proven to be centrally distributed neuropeptide with a broad spectrum of behavioral effects. Of particular interest are reports of potent effects of oxytocin on many reproductive and social behaviors such as maternal behavior, female sexual receptivity (lordosis), penile erection, male mounting behavior and side by side contact. The nonapeptides promote a large number of key behavioral interactions between conspecifics than any other class of neuropeptides. Nonapeptides may trigger the appropriate intraspecific affiliative behavior under broad range of reproductive and social conditions.

Blood pressure levels in diabetes mellitus

Levels of fasting plasma glucose, body mass index, serum total lipids, serum total cholesterol, serum triglycerides and blood pressure of 177 Libyan diabetic patients were determined. The respective mean values were 212.4 +/- 5.6 mg/dl, 26.6 +/- 0.45 kg/m2, 825.7 +/- 20.5 mg/dl, 176.4 mg/dl, 144 +/- 5.8 mg/dl and 135.3 +/- 1.7/83 +/- 0.89 mm Hg. The mean levels of all variables except plasma glucose are significantly higher in the female patients than their male counterparts. Correlations were present between blood pressure levels and age/body mass index/serum total lipids. There was a significant correlation between systolic pressure levels and the duration of diabetes. Serum cholesterol and serum triglyceride levels correlated with diastolic blood pressure levels only.

Serum electrolytes and osmolality in diabetes mellitus

Fasting plasma glucose levels, serum osmolality and serum concentrations of sodium and potassium were determined in 73 Libyan diabetic patients attending the outpatient clinic of the Diabetes Hospital, Tripoli, Libya. The respective mean values were 234.8 +/- 9.7 mg.dl-1, 288.5 +/- 2 m0sm.L-1, 134.7 +/- 0.8 mEq.L-1 and 4.2 +/- 0.07 mEq.L-1. Statistically significant correlations were present between fasting plasma glucose and serum osmolality as well as the concentrations of serum sodium and potassium. There is is an increase in osmolality and levels of sodium and potassium concentration with an increase in plasma glucose concentration.

Diabetes mellitus in Libya: a retrospective study

The records of the Diabetes Hospital, Tripoli, Libya for the years 1961-1983 were examined and the available particulars relating to 24,962 diabetic patients (12,486 males + 12,476 females) registered during this period were obtained. The highest number of male and female diabetic patients were in the age group 40-50 years and the highest number of obese diabetic patients also belong to this age group. There was a gradual increase in the number of diabetic patients visiting the Diabetes Hospital with the highest number in 1983. The increase has been both in the type I and type II patients. In 1983, 15% of the diabetic patients belong to type I diabetes. Family history of diabetes appears to be an important factor in the onset and manifestation of type II diabetes. Patients with diabetes in the family have a lower mean body mass index and fasting blood glucose level as compared with those of patients without known case of diabetes in the family. This may be due to greater alertness, early diagnosis of the disease and steps taken to control blood glucose levels and body weight in the case of patients with family history of diabetes.

Respiratory effects of occupational exposure to tobacco dust

The ventilatory capacities of 195 tobacco factory workers exposed to tobacco dust and 190 Libyan men not exposed to tobacco dust were measured. In both groups, the forced vital capacity (FVC) and forced expiratory volume in 1 s were found to be correlated with age, stature, sitting height and body surface area. Those exposed to tobacco dust have decreased ventilatory capacity values as compared with age-matched unexposed workers. The duration of exposure to tobacco dust does not appear to have any significant effect on the ventilatory function. There was no significant difference in the lung function test values between the smokers and nonsmokers in both groups. The flow-volume curves were constructed for the unexposed and exposed groups of workers. At 25% FVC, in the group exposed to tobacco dust, there was a decrease in air flow by 20.8% as compared to age-matched normal unexposed Libyans. This indicates that the small airways are affected by exposure to tobacco dust. Flow-volume curves are useful in the assessment of lung function status.

Secondary diabetic complications and biochemical parameters

The mean values of body mass index, haemoglobin A1, serum protein, total lipids, triglycerides, lactate dehydrogenase, alkaline phosphatase, amylase and beta-glucuronidase and heart rate and blood pressure and blood urea levels of Libyan diabetic patients with secondary complications are significantly higher than those of the patients without secondary complications. However, the mean values of fasting blood glucose, serum cholesterol and beta-N-acetylglucosaminidase of patients without complications are higher than those of the patients with secondary complications. The duration of diabetes in patients with secondary complications was 10.2 +/- 1 years while that of patients without complications was 5.2 +/- 0.65 years. The significance of these results is discussed.

Peak expiratory flow rates in Libyan adolescents

Peak expiratory flow rates of 578 Libyan boys and 527 Libyan girls aged 12 to 21 years were determined. The prediction formulae that best describe the data are as follows: Boys: PEFR = 160 X Stature 1.87 Girls: PEFR = 130 X Stature2.44 Statistically significant correlations were found between peak expiratory flow rate (PEFR) and standing height, sitting height, body mass index, body surface area and age in both sexes. Stature (standing height) is marginally better as an index of body size in explaining the variability of the ventilatory capacity. The relationship between PEFR and age in girls appears to correlate with the relationship between PEFR and body mass index. The difference in the slope for girls when compared with that for boys is attributed to the obesity/over weight of the girls.

Effects of microamperage, medium, and bacterial concentration on iontophoretic killing of bacteria in fluid

Prevention of nosocomial urinary tract infections by iontophoresis is addressed. An iontophoretic generator was used to provide microamperage (10 to 400 microA) to vials containing either synthetic urine or supplemented synthetic urine. Bacteria were added to vials, and parameters of growth, bacterial killing, and multiple electrode materials were examined. Escherichia coli and Proteus species were both inhibited and killed at various microamperages and with several electrode types, the most efficient being gold-gold as the anode-cathode combination. Klebsiella pneumoniae in supplemented synthetic urine was least inhibited in growth, and higher microamperage (200 to 400 microA) was most effective in killing the bacteria. Bacterial growth reduction and killing were directly related to increasing microamperage and were inversely related to bacterial concentration.

Spirometric standards of Libyan boys and girls

Ventilatory capacities of 578 Libyan boys and 527 Libyan girls aged between 12 and 21 years were measured. The data of forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) were analyzed by logarithmic regressions on age, standing height (stature), sitting height, body mass index and body surface area. The prediction formulae for pulmonary function in Libyan boys and girls were calculated. Standing height (stature) appears to be marginally better than sitting height as an index of body size in explaining the variance in ventilatory capacity of Libyan boys and girls. Libyan boys and girls have a greater proportional leg length than their British counterparts. Their mean values of FVC and FEV1 are lower than those of British children by about 13%. About 10% of Libyan boys are smokers. Below 14 years of age, there were no smokers. A steady rise in number of smokers from the age of 14 years reaching 41% at 21 years of age was observed. No smokers were reported from the Libyan girls. There was no statistically significant difference in the mean FVC or FEV1 between the smokers and nonsmokers.

Glycosylated haemoglobin and blood glucose levels in Libyan diabetic patients

Glycosylated haemoglobin (HbA1) and fasting blood glucose levels of 178 Libyan diabetic men were determined. The mean levels respectively were 11.5 +/- 0.4% and 236 +/- 7 mg.dl-1. In this study group, there were 78 patients with insulin-dependent diabetes and 100 with non-insulin-dependent diabetes. The highest percentage of patients belong to the age group 51-60 with the onset of diabetes between 41 and 50 years of age. The highest number of obese patients were in the age group 51-60 indicating the strong association between diabetes and obesity. A statistically significant correlation was found between fasting blood glucose levels and HbA1 concentrations (r = 0.37; P less than 0.001). Correlations between urinary glucose and HbA1 or fasting blood glucose were highly significant. These diabetic patients have a poorly controlled diabetes as indicated by the correlation between HbA1 and duration of diabetes. There was no significant difference in HbA1 levels of patients undergoing insulin administration and those taking oral hypoglycaemic drugs. Glycosylated haemoglobin levels will be a valuable adjunct to blood glucose determinations in epidemiological studies.

Correlation between serum alkaline phosphatase activity and blood glucose levels

Fasting blood glucose levels and serum alkaline phosphatase activity of age-matched Libyan diabetic men (168) and women (168) were determined. The mean levels of blood glucose of men and women were 227 +/- 6 and 237 +/- 5 mg/dl, respectively. The respective values of serum alkaline phosphatase were 179 +/- 5 and 199 +/- 6 IU/l. The mean serum phosphatase activity of women was significantly higher (p less than 0.001) than that of their male counterparts. A statistically significant positive correlation was found between serum alkaline phosphatase and blood glucose levels of these diabetic patients (r = 0.35; p less than 0.001).

Negative correlation between erythrocyte count and mean corpuscular volume or mean corpuscular haemoglobin in diabetic and non-diabetic subjects

Negative correlation was observed between erythrocyte count (RBC) and mean corpuscular volume (MCV) or mean corpuscular haemoglobin (MCH) in both sexes of diabetic and non-diabetic Libyans. The slopes of regression lines for MCV-RBC and MCH-RBC of diabetic patients were significantly lower (P less than 0.001) than those of their non-diabetic counterparts. Positive correlation was found between MCH and MCV. The slope of the regression line for MCH-MCV of diabetic patients was not significantly different from that of non-diabetic subjects.

Erythrocyte count and hemoglobin levels in diabetic women

Fasting blood glucose, erythrocyte counts hemoglobin levels of 131 Libyan diabetic women of Tripoli , Libya were determined. The respective mean values were 223 +/- 7 mg X dl-1, 4.97 +/- 0.034 X 10(6) X mm-3 and 14.4 +/- 0.127 g X dl-1. Sixty-five percent of these diabetic women were obese. The highest percent of diabetics belong to the age group 46-55 years. The increase in prevalence of diabetes correlates with an increase in obesity. A significant positive correlation was found between body surface area and fasting blood glucose levels (r = 0.65; P less than 0.001). Elevated levels of erythrocyte count and hemoglobin were present in these diabetic patients. Significant correlations were found between body surface area and erythrocyte count, as well as between fasting blood glucose levels and erythrocyte count, indicating the effect of obesity and diabetes on erythrocyte numbers. A significant correlation was found between fasting blood glucose levels and hemoglobin (r = 0.35; P less than 0.001). The elevated levels of hemoglobin present in these patients may be the result of haemoconcentration due to polyuria, which is always present in poorly controlled diabetic patients. The results suggest a close relationship between diabetes and obesity. Regulation of body weight/surface area is an important factor in the control of diabetes. The elevated levels of erythrocyte count and hemoglobin reflect poor control of blood glucose levels in these diabetic patients.

Relationship of obesity to diabetes

In a representative sample of 201 diabetic patients of Tripoli, Libya, 138 were obese. The highest percent of diabetics and obese belong to the age group 41-50 years. In all age groups, there was a parallel increase/decrease in obesity with diabetes. Regulation of body weight should be considered very important in control of diabetes.

Serum cholesterol levels in diabetes

Serum cholesterol levels of 474 Libyan diabetics were determined. The mean levels of diabetic men and women were 236.04 +/- 3.16 and 248 +/- 2.85 mg/100 ml, respectively. A significant correlation was found between serum cholesterol levels and fasting blood glucose in short-term diabetics. A similar correlation was observed in these diabetics between serum cholesterol levels and total body weight. However, in long-term diabetics with disease for more than a year, no such correlations were present.

Effect of genetic diabetes on beta-N-acetylglucosaminidase activity in plasma, conjunctiva, muscle and kidney cortex of mice

The activity of beta-N-acetylglucosaminidase, a lysosomal enzyme concerned with the degradation of glycoproteins and mucopolysaccharides, in plasma, conjunctiva, thigh muscle and kidney cortex of normal Swiss Albino and genetically diabetic KK mice of 20, 40, 70, 180 and 360 days of age was determined. The enzyme activity was significantly lower in the tissues of the KK mice of 180 and/or 360 days of age when compared with age-matched Swiss Albino mice. This lower enzyme activity was considered to be a reflection of the changes in the glycoprotein and basement membrane metabolism of these tissues.

Position-related false-positive renal imaging

A case report of false-positive renal imaging due to anterior displacement of the upper pole of the left kidney with the patient in the prone position is presented. False imaging can be avoided by imaging the kidneys with the patient in the supine position and with the detector behind the patient.