ORIGINAL_ARTICLE
Predictability of at-admission Plasma Neutrophil Gelatinase– associated Lipocalin (NGAL) Level for Acute Kidney Injury in Patients admitted to Surgical Intensive Care Unit
Objectives: To determine the frequency of acute kidney injury (AKI) among patientsadmitted to surgical intensive care unit (ICU) for variant indications and todetermine the predictability of at admission AKI biomarkers levels for the possibilityof AKI development. Patients & Methods: The study included 168 patients with meanage of 53±6.7 years; 97 postoperative patients, 55 trauma patients and 16 patientshad other causes. Patients’ data were collected and disease severity was evaluatedusing the Acute Physiology and Chronic Health Evaluation (APACHE II) and thesimplified Therapeutic Intervention Scoring System (TISS-28). Development of AKIwithin the first 48 hours after ICU admission was defined according to the AcuteKidney Injury Network (AKIN) criteria using serum creatinine (sCr). Blood sampleswere obtained for ELISA estimation of at admission sCr and serum Cystatin C (CysC)and plasma Neutrophil gelatinase-associated lipocalin (NGAL) levels. Another bloodsample was obtained at 48 hours of ICU admission for colorimetric estimation of sCrand then patients’ categorization. Results: Estimated sCr at 48-hr after admissiondefined 62 patients developed AKI (36.9%); 39 patients AKI stage-1 (23.2%) and 23patients AKI stage-2 (13.7%). At admission plasma NGAL levels were significantlyhigher in patients compared to controls, however, AKI-free patients showed nonsignificantlyhigher plasma NGAL levels compared to controls. Patients developedAKI had significantly higher plasma NGAL levels compared to AKI-free patients withsignificantly higher levels in patients developed AKI-2 compared to those developedAKI-1. At admission serum CysC levels were significantly higher in patientscompared to controls and in patients developed AKI-2 compared to AKI-free andAKI-1 patients. Regression and Receiver operating characteristic (ROC) analysis ofat admission clinical and laboratory data as predictors for development of AKI,defined at admission plasma NGAL and serum CysC, and TISS-28 injury severityscore as the significant specific predictors for possibility of development of AKI.Conclusion: Patients admitted to surgical ICU had a risk of 36.9% for AKIdevelopment and combined high TISS-28 severity score and high at admission plasmaNGAL levels could early predict the possibility of AKI development with significantlyhigh specificity.
https://besps.journals.ekb.eg/article_34883_a414f33c2502962dd2da82b0b2bef86a.pdf
2013-06-01
1
16
10.21608/besps.2013.34883
Neutrophil gelatinase-associated lipocalin
Cystatin C
Acute kidney injury
Surgical ICU patients
Mohamed
Alrabiey
1
Department of Anesthesia & ICU , Faculty of Medicine, Benha University
LEAD_AUTHOR
Mamdouh
Abadier
2
Department of Medical Biochemistry , Faculty of Medicine, Benha University
AUTHOR
Omminea
Alsaied
3
Department of Medical Biochemistry , Faculty of Medicine, Benha University
AUTHOR
Ibraheim
Rageh
4
Department of Clinical Pathology , Faculty of Medicine, Benha University
AUTHOR
ORIGINAL_ARTICLE
Study of Some Biomarkers Changes in Patients with Lupus Nephritis and Their Correlation with Disease Activity and Progression
Background: Systemic lupus erythematosus (SLE) is a chronic multisystemautoimmune disease characterized by complex clinical manifestations and chronicinflammatory processes with failure of immunoregulatory mechanisms. Kidney is oneof the most commonly affected organs. Considering the morbidity associated withSLE and particularly with lupus nephritis (LN), it is important to identify novelbiomarkers of disease activity which could aid in the detection and assessment offlares and degree of activity. At present, activity of SLE is assessed based on clinicalsymptoms and biochemical parameters such as autoantibody (e.g antinuclearantibody (ANA)) and serum complement. However, these biomarkers are not specificfor evaluating renal activity. Renal biopsy is the gold standard for assessment ofkidney damage and disease activity, but its usage is restricted as it is an invasiveprocedure. Aim of the work: In the present study, plasma level of advanced oxidationprotein products (AOPPs) and peripheral blood mononuclear cells nuclear factor-κB(PBMCs NF-κB) level as well as serum levels of fetuin-A, 25-hydroxyvitamin D(25OHD), calcium (Ca), inorganic phosphate were studied as novel biomarkers of LNactivity and progression. Methods: The study included 30 SLE female patients, 15without nephritis (group II) and 15 with nephritis (group III), in addition to 15 agematchedhealthy controls (group I). Overnight fasting blood was collected from allsubjects for measurement of plasma AOPPs level, PBMCs NF-κB level and serumfetuin-A level, 25OHD level, Ca and inorganic phosphate levels as well as calculationof calcification risk index (CRI). Results: Plasma AOPPs, PBMCs NF-κB, seruminorganic phosphate levels and CRI were significantly higher in SLE patients (groupII) than age-matched healthy controls (group I) (p<0.05) with the highest level inpatients with LN (group III) meanwhile, serum fetuin-A and 25OHD levels weresignificantly lower in SLE patients than age-matched healthy controls (p<0.05) withthe lowest level in LN patient group. In addition plasma AOPPs, PBMCs NF-κBlevels and CRI showed significantly positive correlation meanwhile, fetuin-A and25OHD levels showed significantly negative correlation with serum creatinine, 24hours urinary albumin, erythrocyte sedimentation rate (ESR), C reactive protein(CRP), ANA, anti double stranded DNA (Anti- dsDNA) antibodies levels and SLEdisease activity index (SLEDAI). Conclusions: In SLE patients, high PBMCs NF-κBand plasma AOPPs levels as well as CRI while low levels of fetuin-A and 25OHDwere related to disease activity and progression.
https://besps.journals.ekb.eg/article_34884_b3efc33d54b5e3656438ee5f6853cc29.pdf
2013-06-01
17
34
10.21608/besps.2013.34884
Systemic lupus erythematosus (SLE)
lupus nephritis (LN)
Advanced oxidation protein products (AOPPs)
Peripheral blood mononuclear cells nuclear factor-κB (PBMCs NF-κB)
Fetuin-A
25-hydroxyvitamin D (25OHD)
Calcification risk index (CRI)
Walaa
Keshk
1
Department of Medical Biochemistry, Faculty of Medicine, Tanta University
LEAD_AUTHOR
Nema
Soliman
2
Department of Medical Biochemistry, Faculty of Medicine, Tanta University
AUTHOR
Noha
Esheba
3
Department of Internal Medicine, Faculty of Medicine, Tanta University
AUTHOR
ORIGINAL_ARTICLE
Study of Galectin 3 and Matrix Metalloproteinase -9 as Prognostic Markers in Colon Cancer
Objectives: The present study was carried out to evaluate the diagnostic role ofgalectin 3 and matrix metalloproteinase 9 in 50 consecutive newly diagnosed coloncancer patients, who presented to the Outpatient Clinic of the NCI over the period2011-2012 and to compare their serum levels before treatment with those of 15benign colon lesions patients, 15 normal controls subjects, and in 16 patients of thecancer colon group after treatment. Also, to compare these studied markers withCEA, CA 19.9 and some prognostic factors of cancer colon. Methods: Serumconcentration of CEA and CA19.9 were evaluated using Axsym and MMP9 andGalectin 3 antigen were assessed using ELISA technique. Results: Serum levels ofMMP9, CEA ,and CA 19.9 showed highest results in the malignant group beforetreatment, followed by the patient group with benign lesion, then the malignant groupafter treatment and lastly comes the control group. While galectin 3 showed thehighest results in the malignant group, followed by the benign then the control andlastly comes the after treatment group. Diagnostic performance of all the studiedmarkers at the chosen cutoffs, CEA (21 ng/ml), CA19.9 (58 U /ml), MMP9 (90.9ng/ml) and galectin 3 (4.8 ng/ml),galectin 3 showed the highest sensitivity, followedby CEA, and then CA19.9 and lastly MMP9 (96.9%, 92.3%, 81.5% and 75.4%respectively). As regards specificity % CEA, CA19.9 and MMP9 showed 100%specificity each, while galectin 3 showed relatively lower specificity % (90.3%).Galectin 3 and CEA showed comparable high diagnostic accuracy (94.8%) followedby CA19.9 (87.5%) then MMP9 (83.3%). On comparing diagnostic performance forthe studied tumor markers in double combinations, the best sensitivity (98.5 %) wasobtained when combining galectin 3 & CA19.9 at cut offs (4.8 ng/ml - 58 U /ml)respectively and galectin 3 & MMP9 at cutoffs (4.8 ng/ml – 90.9ng/m) respectively.As regards specificity, the double combination between CEA & CA19.9 at cut offs (21ng/ml - 58 U /ml)) respectively and MMP9 & CA19.9 at cut offs (90.9 ng/ml - 58 U/ml) respectively showed the highest specificity of 100% each, on studying thecorrelation between all the studied tumor markers, there were significant positivecorrelations between CEA & CA19.9 , CEA & Galectin 3, CEA & MMP9, CA19.9 &Galectin 3, CA19.9 & MMP9 and MMP9 & Galectin 3 (p=0.0001) each.
https://besps.journals.ekb.eg/article_34888_f10811c335ae6c197f0cb2cc98c1984e.pdf
2013-06-01
35
52
10.21608/besps.2013.34888
galectin 3
MMP9
Colon cancer
tumor marker
Mohamed
Badawy
1
Department of Clinical pathology, Faculty of Science - Cairo University, Egypt
LEAD_AUTHOR
Iman
Abdelgawad
2
Department of Clinical pathology, Faculty of Science - Cairo University, Egypt
AUTHOR
Asmaa
Abdelgawad
3
Department of NCI, Biochemistry, Faculty of Science - Cairo University, Egypt
AUTHOR
ORIGINAL_ARTICLE
Leptin and Angiogenesis
Leptin is a 16 KDa protein, consists of 167 amino acid residues. It has manyfunctions including angiogenesis. Leptin either induces angiogenesis itself orinfluences the levels of other angiogenic factors. The aim of the present investigationwas to study the effect of leptin on the levels of the angiogenic factors: vascularendothelial growth factor (VEGF) and thymidine phosphorylase (TP) enzyme activityin prepubertal female albino rats. Twenty prebubertal female albino rats were dividedrandomly into two groups; 1st group (group I); rats were injected intraperitoneallywith saline alone and considered as control group. The 2nd group (group II); its ratswere daily intraperitoneally injected with leptin (recombinant rat leptin (L5073),Sigma-Aldrich) in a dose of 3 μg/g. body weight in 100 μl saline for 10 days.Obtained results revealed that leptin increased significantly the serum levels of bothVEGF levels and TP activity. In addition, there was a positive correlation betweenVEGF levels and TP activity.
https://besps.journals.ekb.eg/article_34892_23ab8abe23fa1b6bfc214204b394f828.pdf
2013-06-01
53
60
10.21608/besps.2013.34892
Hoda
Moghazy
hodamoghazy@yahoo.com
1
Physiology Department, Faculty of Medicine, Sohag University
AUTHOR
Aida
Mahmoud
2
Biochemistry Department Faculty of Medicine, Sohag University
AUTHOR
ORIGINAL_ARTICLE
Effect of New Synthesized Copper Complex of 4-azomalononitrile antipyrine with Superoxide Dismutase Activity on Ehrlich Ascites Carcinoma in Mice
Background: A number of Cu(II) chelate complexes that exhibit cytotoxic activitythrough cell apoptosis or enzyme inhibition was reported to have numerous biologicactivities including antibacterial, antifungal, antiviral and anti-tumor properties. Thepresent work aimed to study the effect of new synthesized Cu complex of 4-azomalononitrile antipyrine [CuL(OH)(ClO4)] which exhibits superoxide dismutase(SOD)-mimetic activity on tumor in mice induced by Ehrlich ascites carcinoma (EAC)cell line. Results: The administration of 10 mg/kg body weight [CuL(OH)(ClO4)] 24hours after intraperitoneal injection of EAC, effectively inhibited tumor growth andthe proliferation of EAC cells. Cu complex ameliorated the increase in serumaspartate transaminase (AST) and alanine transaminase (ALT) activities afterimplantation of EAC cells. On the other hand, the level of creatinine was increased.Moreover, Cu complex of 4-azomalononitrile antipyrine significantly improved thehepatic and erythrocytes SOD and GRX activities. The glutathione content of hepatictissues and erythrocytes was restored in EAC tumor bearing mice. Furthermore, italso, inhibited the formation of nitric oxide and lipid peroxidation products(thiobarbituric acid reactive substance, TBARS) in EAC tumor bearing mice. Thiseffect was associated with inhibition of cell cycle progression and induction ofapoptosis. Administration of [CuL(OH)(ClO4)] complex 24 hours after injection ofEAC for 3 weeks arrested cells in G0/G1 phase and resulted in a decrease in theviability. Conclusions: Cu complex [CuL(OH)(ClO4)] has a strong inhibitory activityagainst growth of tumors. The anti-tumor mechanism may be mediated by preventingoxidative damage and induction of apoptosis.
https://besps.journals.ekb.eg/article_34896_c1280ea08a954cc6de44a2abfa711ab7.pdf
2013-06-01
61
72
10.21608/besps.2013.34896
antitumor activity
Copper complex
Oxidative Stress
Flow cytometry
Ehrlich ascites carcinoma cells
Omali
El-Khawaga
1
Chemistry Department, Faculty of Science, Mansoura University,
AUTHOR
I.
El-sayed
2
Molecular Biology Department, Genetic Engineering and Biotechnology Institute, Minufia University, Sadat City, Egypt.
AUTHOR
ORIGINAL_ARTICLE
Serum Levels of Soluble Fractalkine in Patients with Systemic Lupus Erythematosus
Background: Fractalkine (Fkn)/CX3CL1 which is a unique member of the CX3Cchemokine subfamily, and expressed on inflamed endothelium appears to possessimmunoregulatory properties that affect inflammatory/immune cell interactions andinflammatory responses at sites of inflammation. Objective: The purpose of thepresent study was to determine the Fractalkine/CX3CL1 level in SLE patients andcorrelates that level with indices of disease activity and damage, trying to disclose itsrole in the pathogenesis of SLE. Methods: The study was carried on forty SLEpatients (classified into 15 active and 25 inactive by using clinical and the BILAGdisease activity index assessment), thirty patients with rheumatoid arthritis (RA) asdisease control group and twenty healthy as control group. Levels of soluble Fknwere measured by enzyme-linked immunosorbent assay. Expression of Fkn /CX3CL1was quantified by real-time polymerase chain reaction. Results: Both serum sFknlevels and mRNA expression of Fkn /CX3CL1 were significantly higher in patientswith SLE compared with RA patients and healthy controls (P<0.05) and weresignificantly higher in SLE patients with active disease than in those with inactivedisease. Also, serum levels of sFkn were positively correlated with disease activity,organ damage, anti–double-stranded DNA (anti-dsDNA) antibody titers, anti-Smantibody titers, immune complex C1q levels, anti-phospholipid, anti-RNP and ESRlevel and negatively correlated with total hemolytic complement activity (CH50).Conclusion: sFkn and CX3CL1 mRNA expression play crucial roles in thepathogenesis of SLE and that sFkn may serve as a serologic inflammatory marker ofdisease activity and organ damage.
https://besps.journals.ekb.eg/article_35098_287274989764fdb1fa439c287dc22698.pdf
2013-06-01
73
84
10.21608/besps.2013.35098
Soluble Fractalkine (sFkn)
Fractalkine (Fkn)/CX3CL1
SLE
disease activity
Dalia
Shaheen
1
Medical Biochemistry Department, Faculty of Medicine, Mansoura University
LEAD_AUTHOR
Hisham
Habib
2
Rheumatology and Rehabilitation, Faculty of Medicine, Mansoura University.
AUTHOR
Doaa
Shahin
3
Clinical Pathology Departments, Faculty of Medicine, Mansoura University.
AUTHOR
ORIGINAL_ARTICLE
Molecular Detection of Monocyte Chemotactic Protein-1 gene Polymorphism in Patients with Spontaneous Bacterial Peritonitis
Backgrounds and Aim: Patients with cirrhosis and ascites show a higher susceptibilityto bacterial infections,Monocyte Chemotactic Protein-1(MCP-1) secretion is upregulatedduring chronic hepatitis and correlates with the severity of hepaticinflammation. We thought to confirm the association of the functional MCP-1 promoterpolymorphism (A-2518G) with spontaneous bacterial peritonitis (SBP). Methods: 50patients with post-hepatitis C virus liver cirrhosis and ascites categorized into twogroups, group I: 25 patients with SBP, group II: 25 patients free from SBP, in additiona group of 20 healthy volunteers were included. We assessed the MCP-1 genepolymorphism in blood. Results: Significant MCP-1 gene polymorphism was detectedin group I & II (p-value=0.001 & 0.02 respectively), group I was significantlyassociated with AG genotype, group II with GG genotype when compared to healthyvolunteers (p-value=0.002 & 0.001 respectively), and G allele was significantly higherin both groups (I & II) (p-value 0.005 & 0.001 respectively). Conclusion: MCP-1 GGgenotype and G allele in HCV infected patients may be associated with more advancedstage of the disease. AG genotype may increase the susceptibility to spontaneousbacterial peritonitis.
https://besps.journals.ekb.eg/article_35178_4fee8191d21d88a14e806481fbc34197.pdf
2013-06-01
85
92
10.21608/besps.2013.35178
genotype
allele
ascites
Liver cirrhosis
Gene expression
Maysa
Salama
1
Medical Biochemistry and Molecular Biology, Faculty of Medicine, Cairo University
LEAD_AUTHOR
Dina
Sabry
2
Medical Biochemistry and Molecular Biology, Faculty of Medicine, Cairo University
AUTHOR
Rasha
Ahmed
3
Department of Tropical Medicine, Faculty of Medicine, Cairo University
AUTHOR
Fatma
Taha
4
Medical Biochemistry and Molecular Biology, Faculty of Medicine, Cairo University
AUTHOR
Miriam
Wadie
5
Medical Biochemistry and Molecular Biology, Faculty of Medicine, Cairo University
AUTHOR
ORIGINAL_ARTICLE
Circulating Retinol Binding Protein-4 and Total Thiols In Generalized and Abdominal Obesity Regarding; Monitors Of Cardiovascular Disease
Background: Retinol-binding protein 4 (RBP4) is an adipocyte-secreted hormoneconsidered to link obesity with cardiovascular complications. The oxidative stresscaused by overproduction of reactive oxygen species (ROS)) has been concerned inthe pathophysiology of obesity. We evaluated serum RBP-4 and plasma total thiols(TT) in generalized obesity (GO) and abdominal obesity (AO) as regard tocardiovascular risk factors. Glycated hemoglobin (HbA1c), C- reactive protein (CRP)and lipid profile were also evaluated. Subjects and Methods: Sixty obese subjectswere recruited [30 abdominally obese (AO) subjects (15 males and 15 females); theirmean± SD of age was 49.5±5.5 years. Their waist circumference (WC) was > 102 cmfor men or > 88 cm for women) and waist/hip ratio (WC divided by that of the hips of> 0.9 for men and > 0.85 for women)] and [30 generalized obese (GO) subjects (22males and 8 females; their mean± SD of age was 42.5± 8 years), their body massindex (BMI) was ≥ 30-34.9 kg/m2, with normal WC]. Serum levels of RBP-4 weremeasured by ELISA, serum levels of TT were measured by colorimetric methods,blood HbA1c%, lipid profiles and CRP were also determined. Subjects with AO hadsignificantly higher circulating RBP-4 and CRP levels compared to GO (p< 0.05 foreach). Total thiols levels were significantly lower in AO subjects compared to GO(p< 0.05). Total serum cholesterol, triglycerides and HbA 1c% increased with BMI,WC and waist/hip ratio (WHR), but the relations were statistically insignificant.Conclusion: The study revealed that RBP-4 is autonomously related to visceral fataccumulations and cardiovascular diseases. The study also revealed the beneficialeffect of TT against obesity and cardiovascular disease and the potential clinicalapplicability of RBP4 and total thiols in cardiovascular diseases.
https://besps.journals.ekb.eg/article_35184_872b749066872a7d85d7bd3e01e96c0a.pdf
2013-06-01
93
106
10.21608/besps.2013.35184
Retinol binding protein4-abdominal
obesity-generalized
obesity cardiovascular disease
Salwa
Dimitry
1
Cardiology Department, Faculty of Medicine, Assuit University
LEAD_AUTHOR
Naglaa
Idriss
2
Medical Biochemsitry Department, Faculty of Medicine, Assuit University
AUTHOR
Ahmed
Ahmed
3
Cardiology Department, Faculty of Medicine, Assuit University
AUTHOR
Eman
Abdel Aal
4
Cardiology Department, Faculty of Medicine, Assuit University
AUTHOR
ORIGINAL_ARTICLE
Lead Levels in Maternal and Newborns Blood and Hair and Their Impact on Neonatal Anthropometric Measurements
Lead is a toxicant heavy metal which cross the placenta and accumulate in the fetaltissues. Prenatal exposure to lead poses a health threat and causes adverse effects onintrauterine growth and neurodevelopment. The present study aimed to: 1) Determinematernal as well as fetal blood and hair lead levels. 2) Evaluate the correlationbetween maternal and fetal levels of lead. 3) Study the possible effects of maternalblood lead levels on the anthropometric measurements of their neonates. The studywas carried out on 38 pregnant women and their fetuses. All blood and hair samplesof the mothers and their fetuses were analyzed for estimation of lead concentrationusing atomic absorption Spectrophotometer. The results showed significant increasein maternal and fetal blood as well as hair lead. There was statistically significantcorrelation between maternal and fetal blood lead and maternal and fetal hair lead.The high levels of maternal blood lead affect the anthropometric measurement of thefetus. The affection of dimension of infant growth at level ≥ 10 μg/dl was more thanlow levels. Also, there was significant negative correlation between maternal bloodlead levels and birth weight, fetal length, head circumference, chest circumferenceand mid-arm circumference. In conclusion, there was highly statistically significantrelation between maternal and fetal blood lead levels, hair help in the determinationof level of lead exposure as there was significant relation between fetal blood andhair lead levels. Also, lead levels in maternal blood affect neonatal anthropometricmeasurements. Simple preventive measures may play a role in decreasing maternalblood lead and thereby decreasing trans-placental transfer of lead to the fetus andprotect the fetus from adverse effect of lead.
https://besps.journals.ekb.eg/article_35188_9598f92e7594fe7ba49b848705d04e42.pdf
2013-06-01
107
122
10.21608/besps.2013.35188
Lead
maternal lead
fetal lead
birth weight
Head circumference
Sahar
El-DeeK
1
Medical Biochemistry Department, Faculty of Medicine,Assiut University, Assiut, Egypt
LEAD_AUTHOR
Zaghloul
Mohammed
2
Forensic Medicine and Clinical Toxicology, Department, Faculty of Medicine, Assiut University, Assiut, Egypt
AUTHOR
Hala
Fathy
3
Forensic Medicine and Clinical Toxicology, Department, Faculty of Medicine, Assiut University, Assiut, Egypt
AUTHOR
Safwat
Mohamed
4
Obstetric and Gynecology Department, Faculty of Medicine, Assiut University, Assiut, Egypt
AUTHOR
ORIGINAL_ARTICLE
Prevalence of Thyroid Dysfunction in Systemic Lupus Erythematosus of Bahraini Patients
Background: Controversy about the prevalence of thyroid dysfunction in systemiclupus erythematosus (SLE) patients has been reported. As no previous studyevaluated thyroid status in SLE Bahraini (BSLE) patients, so, the current study aimedto evaluate the prevalence of thyroid dysfunction among those patients compared toan age and sex matched healthy control group. Methods: Retrospective laboratorydata of the thyroid function in forty-three SLE Bahraini patients who were recentlydiagnosed and fulfilling four criteria of the American College of Rheumatology(ACR) criteria were evaluated. One hundred-fifty matched healthy controls wereselected from the general population laboratory records for thyroid functionscreening or routine annual checkup. Results: The overall thyroid dysfunction amongBSLE patients was 32.5% VS 12.6% in the control group (P<0.002). The mostprevalent thyroid dysfunction in SLE patient was the subclinical form compared to thecontrol group, the prevalence of subclinical hypothyroidism was significantly higher(P<0.002) whereas, subclinical hyperthyroidism was insignificantly different.Laboratory data did not reveal any overt thyroid dysfunction among patients andcontrols. Conclusion: Subclinical hypothyroidism was significantly higher amongBSLE patients than in healthy controls. Physician during follow up of SLE patientsshould be alert for the development of overt thyroid dysfunction in high risk groupespecially the female gender.
https://besps.journals.ekb.eg/article_35194_4b3153b1427a9390f1fb45810e6190ce.pdf
2013-06-01
123
130
10.21608/besps.2013.35194
subclinical hypothyroidism
subclinical hyperthyroidism
Thyroid dysfunction
Systemic lupus erythematosus
Bahraini
Ola
ElSegai
1
Department of Medical Biochemistry , Salmanya Medical Complex, Ministry of Health, Kingdom of Bahrain
LEAD_AUTHOR
Eman
Farid
2
Department of Medical Biochemistry , Salmanya Medical Complex, Ministry of Health, Kingdom of Bahrain
AUTHOR
Reda
Ebrahim
3
Department of Internal Medicine, Salmanya Medical Complex, Ministry of Health, Kingdom of Bahrain
AUTHOR