Derangement of Basic Amino Acids and Nitric Oxide Levels in Patients Undergoing Cardiothoracic Surgery

Research Abstract

Background: A cyclic relationship exists, between; arginine, citrulline, and ornithine. Arginase is a specific enzyme that plays a role in this relationship. This study aimed to elucidate the role of surgical trauma and anesthesia on plasma levels of the previous acids and nitric oxide (NO) and to determine whether the changes in these levels can be correlated to the duration of surgery and anesthesia exposure. Patients and methods: The study included: group A 41 patients who underwent coronary bypasses and group B 17 patients who underwent lung cancer surgery. The amino acid analyzer was used for the detection of amino acids, while NO was estimated by a Spectro-photometric method. Results: The study revealed a significant decrease in the intra-operative levels of arginine, citrulline, ornithine, and NO compared to their pre-operative levels in both groups. Conclusion: Depletion of these basic amino acids is possibly multifunctional and can be associated with an increase in arginase, surgical trauma, anesthesia, and stress.

 

Research Authors
Ahmed Farouk, Rasha Hamed, Nashwa Farouk Abd El Hafez, Rania Abdalla, Farag Moftah, Fify Alfy Gabra, Tahia Saleem
Research Date
Research Department
Department of  Anesthesia and Intensive Care
Research Member
Nashwa Farouk Abd Elhafez

Measuring the Systemic Inflammatory Response to On and Off Pump Coronary Artery Bypass Graft (CABG) Surgeries Using the Tryptophan/Kynurenine Pathway

Research Abstract

Background: Cardiac surgeries induce many inflammatory responses with remarkable clinical implications. Tryptophan (Trp) is a precursor for serotonin, melatonin and kynurenine (Kyn). Plasma kynurenic acid (Kyna) and Kyn concentrations are thought to be related to the severity of inflammation. Plasma Trp/Kyn ratio is used to measure inflammatory cytokine activity.

Methods: We performed the current longitudinal study in a tertiary care center and included 62 patients divided into two groups; group A (on-pump CABG patients) and group B (off-pump CABG patients). Plasma Trp and Kyn were measured using the high-performance liquid chromatography (HPLC) technique. Serum interlukin-6 (IL-6) and white blood cells (WBCs) were measured using ELISA and routine blood count, respectively.

Results: The present study revealed that the intraoperative levels of plasma Kyn, IL-6 and WBCs were significantly increased while the plasma Trp/Kyn ratio was significantly decreased in both the groups; however, the changes were more significant in the on-pump CABG group. Moreover, the levels in both the groups returned to preoperative levels 72 h postoperative. Our study has shown that WBCs is positively correlated with IL-6, but has negative correlation with Trp/Kyn ratio.

Conclusions: Kyn and Trp/Kyn ratio might be utilized as markers of the severity of inflammation in major surgery. In addition, off-pump CABG might be more preferable than on-pump CABG regarding stress and release of inflammatory markers.

Research Authors
Ahmed Farouk, Rasha A Hamed, Saeid Elsawy, Nashwa F Abd El Hafez, Farag M Moftah, Muammar AY Nassar, Fify Alfy Gabra, Tahia H Saleem
Research Date
Research Department
Department of  Anesthesia and Intensive Care
Research Journal
Journal of Investigative Surgery
Research Member
Nashwa Farouk Abd Elhafez
Research Year
2022

Platelet Indices as a Predictor in patients with Aplastic anemia and Immune Thrombocytopenic purpura“A retrospective case-control study”

Research Abstract

Background & Objectives: platelet indices are widely available and relatively cheap platelet parameters. The critical objective of this study is to assess the reliability of platelet indices as biomarkers for diagnosis and prognosis in adult thrombocytopenic patients.

Methods: A retrospective case-control study, including 81 immune thrombocytopenia (ITP) cases, 50 aplastic anemia (AA) cases, and 150 participants as a control group. This study included patients admitted from 2016 to 2021 to the Clinical Hematology Unit, Department of Internal Medicine, University Hospital. The collected data included Socio-demographic information, clinical data, laboratory data, and an assessment of the therapeutic response in the studied groups.

Results:For the diagnosis of adult thrombocytopenic patients, platelet distribution width (PDW) showed the best diagnostic accuracy (85% for ITP and 91.9% for AA) at cutoff points of 14.9% and 17.2%, respectively. This was followed by mean platelet volume (MPV) with diagnostic accuracies of 77% for ITP and 89.3% for AA at a cutoff point of 9.4 fl. Platelet large cell ratio (PLCR) demonstrated insignificant accuracy in diagnosing either ITP or AA. Conclusion Platelet indices can play a crucial influence in the diagnosis, not the prognosis, of adult thrombocytopenia.

Keywords: immune thrombocytopenic purpura, aplastic anemia, mean platelet volume; platelet distribution width, platelet large cell ratio

Ethical approval number:(IRB No:17101645).

Clinical trial ID: NCT05116033

https://classic.clinicaltrials.gov/ct2/show/NCT05116033

Research Authors
Mahynour Z. Abdel hi¹, Safaa A. A. Khaled², Dalia G Mahran³, Mai M. Aly ²
Research Date
Research Department
Family Medicine
Research Member
Mahy nour Zoghby Abd elhi

Announcement regarding the provision of a free linguistic proofreading service for research from the Scientific Documentation Office at the College of Medicine

Announcement regarding the provision of a free linguistic proofreading service for research from the Scientific Documentation Office at the College of Medicine

Announcement regarding the provision of a free linguistic proofreading service for research from the Scientific Documentation Office at the College of Medicine

Ahmed, O. G., Mahmoud, G. S., Samy, S. S., Sayed, S. a. J. I. J. O. P., Pathophysiology & Pharmacology 2023. The protective effect of melatonin on chronic paradoxical sleep deprivation induced metabolic and memory deficit in rats. 15, 56.

Research Member
Slevia Saber Samy
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