|dc.contributor.author||Mohan, Sudesh B||
|dc.description.abstract||Various parameters were measured for two control
groups; the African Medical students and the matched controls
for the disease Endomyocardial Fibrosis (EMF). Many differences
were observed in these two populations, attributable
perhaps to the environments these groups are exposed to:
e students live in a healthier environment and are on a
balanced diet unlike the local population.
The results form the control groups were used to
compare the data obtained for the diseased groups studied:
EMF and the related disorder Rhematic Heart Disease (RHD).
1. Serum Proteins:
Significantly lower total protein and
albuminj levels were observed in the matched control group as compared
to the Student group. The y-globulin level was similar
in the two groups.
When compared with the matched controls,
the EMF group revealed higher total protein and Y- globulin
but low albumin levels. This raised y-globulin level
suggests that an immunological factor is involved in EMF.
RHD group sh~d similar pattern to EMF.
The follow up studies did not reveal any
consistent changes in serum protein patterns as the disease
2. Immunoglobulins. High IgG level was observed in the matched
controls as compared to the student group. IgA and
IgM levels were similar.The higher IgG level in the matched
controls could be because of the more frequent exposure of
this group to antigenic stimulation by fungal,viral and
Higher IgM levels were observed in both EMF and RHD
groups as compared to the matched controls, again suggesting
an abnormal immunological response in EMF Que to IgM
antibodies. This is an important observation because malarial antibodies
have been located in IgM immunoglobulins. Hence the
etiology of EMF may be related to malaria. The IgM level
was not significantly different in EMF and RHD groups;
the two disorders are therefore similar in their immunological
Tribal analysis of the patients with high IgG and
Igm levels indicated that mostly the immigrant populations
fell in this group.
The follow up study of the patients revealed a
gradual decrease in IgM as the disease progressed.
3. Lactate dehydrogenase (LDH) No significant differences
were observed in total LDH or HBDH levels in the two control
groups. However, lower LDH-1 and higher LDH-4 and LDH-5 were
observed in the control group as compared to the student
When compared with the matched controls, the EMF group
showed higher LDH-1 and similar LDH-2 levels but lower
LDH-3 and LDH-4 levels. LDH-5 was usually not detected in
the EMF patients. This isoenzyme pattern shows a shift of
towards the cardiac tissue pattern and hence demonstrates
the presence of cardiac muscle damage in EMF.
Significantly lower LDH-1 level was observed in RHD
as compared to EMF suggesting greater myocardial damage
No myocardial involvement could be shown in either
pyomyositis or parotid abscess patients.The total LDH
levels in the ofrmer group were higher than the latter
but similar to the EMF group.
Follow up studies showed a gradual decrease in LDH
activity as the disease progressed. In some patients a
gradual decrease in LDH-1 and LDH-2 was also observed.
4. Glucose-6.phospaate dehldrogenase (G6PDH) and sickle
cell haemoglobin (HbS).
The samples studied for these two parameters were small,
hence not much information was obtained from these.
Raised G6PDH levels were obtained for both the EMF and
the RHD groups. Similar incidence of enzyme deficiency was
observed in the student, the matched control and EMF groups
No enzyme deficiency was obtained in the RHD group.
The incidence of sickle cell trait was again similar
in the student, the matched control and the EMF groups
RHD group had a high incidence of the trait.||en
|dc.title||Enzymes and proteins in tropical diseases||en
Department of Psychiatry, University of Nairobi, ; bDepartment of Mental Health, School of Medicine,
Moi University, Eldoret, Kenya||