The aim of this study was to confirm if there is a link between the alteration in blood levels of trace elements (chromium, copper, lead, cadmium, and zinc) and dehydroepiandrosterone sulfate (DHEAS) in healthy and diabetic states. This study is the first study to test these parameters in Egyptians. The study included 150 subjects divided into the following four groups: healthy middle-aged, healthy elderly, middle-aged diabetics, and elderly diabetics. Our results revealed a statistically significant decrease in the level of DHEAS in the elderly compared to middle-aged healthy and diabetic groups (p < 0.05). There was a significant difference between the middle-aged groups with respect to zinc, copper, chromium, and cadmium levels. Zinc and copper were lower in the diabetic subjects while chromium and cadmium were higher in the same group in comparison to healthy subjects. In the elderly groups, there were significant increases in chromium and cadmium levels in diabetic subjects rather than healthy ones. There was a significant increase in the thiobarbituric acid reactive substance level in the elderly healthy and diabetic groups and a significant decrease in the glutathione level in the elderly groups. There was no correlation between the levels of trace elements and DHEAS or between the levels of DHEAS, oxidants, and antioxidants in all of the tested groups. In conclusion, only the DHEAS level was correlated with age. There was no difference between the diabetic and healthy groups with respect to the levels of trace elements, with the exception of chromium and cadmium, which suggests the effect of pollution on the pathogenesis of diabetes in Egyptians. No correlation existed between the levels of DHEAS and trace elements, oxidants, and antioxidants. Finally, we believe that there is a large regional variation in the levels of trace elements due to different environmental exposure and nutritional factors which are responsible for contradictory results regarding the pathogenesis of diseases related to alterations in the levels of trace elements.

Background Patients hospitalized in medical ICUs (MICUs) with acute noncardiac illnesses may have underlying cardiovascular abnormalities, especially in Egypt where rheumatic heart disease is still frequently encountered. This may affect the diagnosis and/or plan of management. Routine cardiac examination may not be informative because of the acuteness of the illness and the need for frequent concurrent mechanical ventilation. Purpose The purpose of this study was to utilize transthoracic echocardiography to define cardiac abnormalities, especially rheumatic valve disease that may be present in noncardiac patients. Materials and methods Over a 4-month period, 75 patients without primary cardiac diagnoses admitted to the MICU of Kasr El Ainy hospital underwent transthoracic echocardiography (TTE). The MICU mortality rates and length of stay were compared in patients with and without significant cardiac abnormalities. Results One or more cardiac abnormalities were observed in 61.3% patients of the studied group. Of these abnormalities, 15% were rheumatic in origin. Right atrial and right ventricular dilatation were the most encountered lesions, followed by left ventricular hypertrophy and pulmonary hypertension. Although there was no correlation between the presence of cardiac abnormalities and the length of ICU stay or mortality, the plan of management was affected in 14.67% of patients. Conclusion A significant proportion of patients admitted to the MICU with noncardiac illness had underlying cardiac abnormalities, and this affected the plan of management in a significant number of patients.

BackgroundTumor necrosis factor α (TNF-α) is a type of cytokine produced by macrophages and other cell types in response to various stimuli. Many studies have shown that TNF-α is involved in the development of diabetes. It also has a pivotal role in the inflammatory process of chronic hepatitis C.ObjectivesThis study aimed to examine the hypothesis that TNF is increased in patients infected with hepatitis C virus (HCV) and with diabetes rather than in patients infected with HCV or with diabetes alone.MethodsPatients were divided into 5 groups: patients with diabetes without complications and without HCV infection (group 1), patients with diabetes and complications but without HCV infection (group 2), patients without diabetes but with HCV infection (group 3), patients with diabetes without complications but with HCV infection (group 4), and patients with diabetes and complications and with HCV infection (group 5).ResultsResults revealed an activation of the TNF axis in all tested patients when compared with the level of healthy Egyptians done in previous studies. However, although there was a gradual escalation in the activation of the TNF axis in these groups, the increase did not amount to a statistical difference between them (P > 0.05). However, the trend was toward the higher values in HCV infection with diabetes and its complications. The number of studied patients may be a limitation of this research. There was no correlation between the level of TNF receptor II and the levels of transaminases, albumin, and creatinine in the different groups or the degree of microalbuminuria in the groups of patients with diabetic complications. Also, there was no relation between the hepatic or splenic size and the level of TNF receptor II.ConclusionsThe presence of diabetes and its complications in patients with HCV infection could not be attributed only to the activation of the TNF system at least in Egyptian patients.

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