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Biomedical subjects

M Labib

Publications and source records attributed to M Labib.

At least 19 recordsLinked to original sources

acp Best Practice No 168. The investigation and management of obesity.

Obesity is a chronic condition characterised by an excess of body fat. It is a complex disorder of appetite regulation and energy metabolism controlled by specific biological factors. In the past 10 years, great progress has been made in the scientific understanding of the pathophysiology of obesity and the interactions between genetic predisposition to weight gain and the environment. This article will review the current understanding of the pathophysiology and the approach to the investigation and management of obesity.

Anti-Obesity Agents↗

Severe hypokalaemia and weakness due to Nurofen misuse.

Nephrotoxicity from non-steroidal anti-inflammatory drugs (NSAID) is well recognized. We report a case of severe hypokalaemia and weakness due to renal tubular acidosis in a young woman who was taking 40-60 tablets per day of Nurofen Plus (ibuprofen 200 mg and codeine phosphate 12.8 mg). Proprietary brands of ibuprofen are freely available to the public and those containing codeine may be potentially subject to abuse. This case highlights the need to be aware of this potential and of the life-threatening electrolyte and acid-base disturbances that might be encountered with the widespread availability of these types of NSAID.

Acidosis, Renal Tubular↗

The postoperative inflammatory response to injury following laparoscopic assisted vaginal hysterectomy versus abdominal hysterectomy.

The magnitude of the inflammatory response to surgery depends on the degree of injury during surgical procedures. Laparoscopic techniques are generally associated with less postoperative pain and shorter hospital stay compared with open procedures, presumably due to less tissue injury and reduced inflammatory response. However, no study has been done, to our knowledge, to assess the inflammatory response to surgical trauma following laparoscopic assisted vaginal hysterectomy. We have, therefore, compared the magnitude of the inflammatory response to injury after laparoscopically assisted vaginal hysterectomy (11 patients) and abdominal hysterectomy (11 patients) by measuring serum C-reactive protein (CRP) and interleukin-6 (IL-6) on admission, and at 24 and 48 hours after the operation. Postoperatively, serum CRP rose significantly in both groups but levels in patients who underwent laparoscopically assisted vaginal hysterectomy were significantly lower than in those who underwent abdominal hysterectomy. Serum IL-6 rose significantly after abdominal hysterectomy but not after laparoscopically assisted vaginal hysterectomy. Our results show that the inflammatory response to surgical trauma was significantly less after laparoscopically assisted vaginal hysterectomy than after abdominal hysterectomy confirming that the laparoscopic procedure causes less tissue damage than the abdominal procedure.

Adult↗

[Myocardial infarction in a pregnant woman during salbutamol therapy].

The authors report the case of a 31 year old woman at 30 weeks' gestation who developed a non-Q wave postero-lateral myocardial infarction during treatment with salbutamol. There were no complications and delivery took place at term normally. Coronary angiography was performed 3 months post-partum and was normal: the Methergin test was negative. Myocardial ischaemia occurring during treatment with a beta-2 mimetic in pregnancy is rare and hardly ever progresses to myocardial infarction. The usual mechanism of ischaemia is an imbalance of myocardial oxygen demand and supply. Myocardial oxygen consumption is naturally increased during pregnancy and excess intracellular calcium secondary to the beta-1 stimulation occurring with the use of beta-2 mimetic drugs further aggravates matters. This hypothesis raises the question of the value of calcium inhibitors in these forms of myocardial ischaemia.

Abortion, Threatened↗

A simple HPLC method for the separation of amphetamine isomers in urine and its application in differentiating between 'street' amphetamine and prescribed D-amphetamine.

D-amphetamine has been increasingly prescribed to treat amphetamine abusers. Prescribing D-amphetamine requires laboratory evidence or confirmation of current use of 'street' amphetamine, using a method which should be capable of differentiating between 'street' amphetamine and prescribed D-amphetamine. We have developed a simple high-performance liquid chromatography (HPLC) method for the separation of the two isomers of amphetamine in urine and have assessed its use in differentiating between 'street' amphetamine and prescribed D-amphetamine. The method is reproducible, free from interference and has a detection limit of 0.1 microgram/mL for each isomer. Urine from patients prescribed D-amphetamine contained only a trace amount of L-amphetamine (less than 4%) whereas urine from those taking 'street' amphetamine contained more than 50% L-amphetamine. The method is applicable to confirmation of 'street' amphetamine misuse and for monitoring patient compliance with treatment. The presence of 4% or less L-amphetamine in urine would suggest that the patient is only taking prescribed D-amphetamine whereas the presence of L-amphetamine in higher concentrations suggests that the patient is taking 'street' amphetamine, with or without prescribed D-amphetamine.

Amphetamines↗

Neopterin levels in alcohol-dependent patients.

Chronic alcohol exposure appears to suppress cell-mediated immunity which may contribute to the high incidence of infections among alcohol-dependent patients. We measured serum neopterin, as a marker of macrophage function and T-lymphocyte activation, in 26 alcohol-dependent patients. The mean serum neopterin in these patients was significantly lower than the mean serum neopterin in matched controls. In those who abstained, the mean serum neopterin at 3 weeks rose and was no longer significantly different from controls. Our findings suggest that alcohol-dependent patients have suppressed macrophage function which may be reversible within 3 weeks of abstention.

Adult↗

Insulin-like growth factor 1 in patients with hypoglycaemia.

Plasma insulin-like growth factor 1 (IGF-1) concentrations were measured in a group of patients with hypoglycaemia due to endogenous hyperinsulinism, and compared with those in a group of patients matched for age and sex with hypoglycaemia and appropriately suppressed insulin levels. Insulin-like growth factor 1 concentrations were significantly higher in the hyperinsulinaemic hypoglycaemic group than in either the hypoinsulinaemic hypoglycaemia group or a group of euglycaemic control subjects. These data provide further evidence that insulin promotes IGF-1 production and release from the liver.

Adolescent↗