Regular follow up of patients with beta thalassemia for detection of iron overload as it affects humeral and cell mediated immunity.

Background: Nephropathy is a significant cause of morbidity and mortality in patients with Diabetes Mellitus (DM). The condition is characterized by persistent albuminuria and may be decline in the Glomerular Filtration Rate (GFR). Urinary cyclophillin A has been proposed as a simple, accurate and rapid endogenous marker for DN. Aim of Study:To assess the value of urinary cyclophillin A anew marker of diabetic nephropathy.Subjects and Methods: Group I: 60 patients with type 2 diabetes mellitus which will be subdivided into: (A) 30 diabetic patients with diabetic nephropathy. (B) 30 diabetic patients without diabetic nephropathy. Group II: 30 healthy persons as a control group.Results: There was significance association between urinary cyclophillin A and serum creatinine, blood urea, 24 h protein collection and ACR.Urinary cyclophilin A found higher in diabetic nephropathy patients than diabetic patients without nephropathy so it is a new marker for diabetic nephropathy. Conclusion:The results of this study suggest that urinary cyclophillin A new marker for diabetic nephropathy.

Background: Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion or insulin action, or both. Diabetes and its complications have become a major public health problem in the world and its prevention has become a public health priority. Hepcidin, a 25-amino-acid antimicrobial peptide, is the central regulator of iron homeostasis. Under normal circumstances, hepcidin expression and subsequent release into plasma prevents further absorption of iron from the duodenal enterocytes by preventing the efflux of iron by ferroportin channels, hence reduced amounts of iron delivery via transferrin to hepatocytes. In response to iron loading, hepcidin expression increased to prevent the further uptake of iron. Conversely, during iron deficiency, hepcidin expression decreased. Aim of the Study: Was to assess the possible changes of serum hepcidin that may occur in patients with type 2 diabetes. Objectives: Was to evaluate changes of serum hepcidin level in type 2 diabetes, assess possible relationships of serum hepcidin, iron status, hepcidin: Ferritin ratio and HOMA-IR in type 2 diabetes patients. Methods: This study consisted of randomized eighty subjects divided into four groups: Group 1: Included 20 patients with impaired glucose tolerance (pre-diabetes), Group 2: Included 20 patients with controlled diabetes, Group 3: 20 patients with uncontrolled diabetes, Group 4: Included 20 healthy volunteers. Results: Hepcidin: Ferritin ratio was statistically high in impaired glucose tolerance and low in uncontrolled diabetes with (p-value <0.001*) and normal in controlled diabetes and healthy volunteers. Significant negative correlation between hepcidin: ferritin ratio and HOMA-IR in impaired glucose tolerance with (p-value=0.009*) was found. Conclusion: Serum hepcidin affected by multiple factors so cannot be used for screening of type 2 diabetes. But hepcidin: Ferritin ratio could be a novel marker for early screening of patients with type 2 diabetes.

Introduction: This study was done to evaluate other oral hypoglycemic medications; especially the new ones in the management of PCOS patients as alternatives to the standard medication used for this purpose Metformin. Patients and Methods: 105 patients were enrolled and randomly distributed into 3 groups according to sequence of computer-generated block-random numbers. Each group included 35 patients. This randomized double blind case controlled study was conducted at Tanta University Hospital from December 1, 2015 to October, 1, 2016. In group A (study group 1) the patients received Pioglitazobe 30 mg once a day for 6 months while in group B (study group 2) the patients received Vildagliptin 50 mg once daily. In Group C (control group) the patients received Metformin 500 mg tds. for 6 months. The clinical outcome measures of the study were the improvement in the regularity of the menstrual cycle, the BMI and the improvement in the modified Ferriman-Gallwey (F-G) score for hirsutism. The biochemical outcome measures will be the change in the Serum Free testosterone, dehydroepiandrosterone (DHEA), fasting insulin level, Glcosylated hemoglobin (Hb A1c) and fasting Low Density Lipoproteins (LDL) levels. Results: Pioglitazobe in the study group 1 patients showed a significant reduction of BMI (p = 0.016), Ferriman-Gallwey score (p = 0.003), free testosterone level (p = 0.003), DHEA level (p = 0.001), fasting insulin level (p = 0.036) and Hb a1c level (p = 0.000), and also significant reduction of menstrual irregularities (p = 0.035). When compared to Metformin in the control group 3, there were significant reduction of BMI (p = 0.010), Ferriman-Gallwey score (p = 0.002), free testosterone level (p = 0.034), Hb a1c (p = 0.000) level and significant reduction of menstrual irregularities (p = 0.004) only. This means that the clinical and metabolic effect of Pioglitazobe is better than Metformin in PCOS patients. On the contrary there were disappointing results of the new drug Vildagliptin in group 2; the patients in this group 118showed significant reduction of BMI (p = 0.001), Ferriman-Gallwey score (p = 0.046) and Hb a1c (p = 0.000) level only. Non significant effect on menstrual irregularities and non significant reduction of LDL level are noticed. But there is elevation of Ferriman-Gallwey score, free testosterone level, DHEA level and fasting insulin level. Conclusion: Pioglitazobe is an effective and safe alternative to Metformin in the management of PCOS patient although further studies including larger number of patients should be done while Vildagliptin should be omitted for use in PCOS patients.

Prominin-1 is a helpful prognostic marker in patients with ALL; therefore, it should be routinely assessed at diagnosis in ALL patients for better prognostic assessment and should be taken in consideration in designing future therapeutic strategies based on patient-specific risk factors.