Detecting depression among open cardiac surgery patients: pre and postoperative evaluation of changes

Objectives: this study aimed at evaluation of changes in the pre- and post-operative depression by simple method among open cardiac surgery patients that may help in further psychiatric intervention to improve outcomes

Methods: it included eighty four patients of those that subjected to open cardiac surgery over one year period. They were evaluated prior to the surgery, at the tenth postoperative day and at three to four months later. Assessments were done using the WHO [Ten] Well-Being Questionnaire, the Major Depression Rating Scale [ICD-10 version], the PCASEE Quality of Life Scale, and the New York Heart Association Functional Classification [NYHA]

Results: high concordance rate in diagnosing de in pression was found in this study between the surgeon and the psychiatrist. More than one third [36%] of patients who subjected to open cardiac surgery had preoperative depression. At the follow up; there were increased levels of depression more than the preoperative stage. Low scores of the quality of life were related in the post-operative stages to the depression in spite of the marked improvement the functional disability

Conclusion: there are decrements in both the quality of life and depressive scores in open cardiac surgery patients even after surgical interference independent of the improvement in the physical functional disabilities that needs further psychiatric intervention to mini mize the further physical consequences of depression

role of computerized tomography in diagnosis of petrous temporal bone lesions

There are various imaging modalities for the lesions of temporal bone, of which computerized tomography stands out as one of the most reliable modalities, The aim of the study is to evaluate the role of computerized tomography of temporal bone in diagnosis of this region. The material comprises 42 patients with age ranging from 2 to 10 years. We used a Siemens Somaton 4 Plus at El-Hussein and G.E. Systec Plus at Sayed Galal University hospitals. The cases are categorized into: Congenital [8 cases], traumatic [10 cases], inflammatory [14 cases], neoplastic [4 cases]. The main value of C.T. in inflammatory lesions, of temporal bone is its ability to show bony erosions or sclerosis associated with these conditions and the spread of inflammation to adjacent structures. An accurate C.T. examination of temporal bone gives the otorhinolaryngology surgeon a detailed preoperative map that avoid ricky situations

Uninary aibumin excretion rate in patients with type 2 diabetes mellitus and retinopathy

To determine whether a relationship between retinopathy and nephropathy in patients with type 2 diabetes mellitus; 47 subjects with type 2 diabetes mellitus and retinopathy, and a control group formed of 65 subjects with type 2 diabetes mellitus but without retinopathy were examined for urinary albumin excretion per 24 hour, fasting blood glucose, 2 hour post prandial blood glucose, glycosylated HbA1c, fasting serum cholesterol, fasting serum triglycerides, blood urea, serum creatinine and glomerular filtration rate The two groups of patients were matched for age and sex. They were above 5 years diabetes duration and had a within normal renal function. Results of this study showed that subjects with diabetic retinopathy had mostly nonprolifertive type [41 [87.23%]] and there was an increase in their urinary albumin excretion per 24 hour [19 [40, 43%]] which was mainly in the form of microalbuminuria. Comparing the frequency and mean values of micro albuminuria and macro albuminuria in the two groups of patients, there was a significant increase in the diabetic subjects with retinopathy. Also, these patients had a significant increase in the mean values of fasting blood glucose, post prandial blood glucose, fasting serum cholesterol, fasting serum triglycerides, glycosylated HbAlc, diabetes duration and both systolic and diastolic blood pressure. For the other studied parameters, there was a non significant increase in the mean values of fasting serum insulin, blood urea, serum creatinine, glomerular filtration rate, body mass index and age of the patients in the diabetics with retinopathy in comparison to those without retinopathy. These results suggest that patients with type 2 diabetes mellitus and retinopathy have an increase in the rate of urinary albumin excretion and there is a strong association between background retinopathy and microalbuminuria. Consequently microalbuminuria can be considered as a risk factor for diabetic retinopathy as well as fundus examination can be a useful and rapid bed side diagnostic tool for diabetic nephropathy

role of magnesium and calcium ions in atrial natriuretic peptide secretion

For the purpose of examining the role of calcium and magnesium ions in the secretory process of atrial natriuretic peptide [ANP], we studied the effects of hypercalcemia, digitalis "Lanoxine", calcium ion channel blocker "verapamil", hypermagnesemia, potassium ion channel blocker "Glibenclamid", and potassium ion channel opener "cromakalim" on plasma concentration of immunoreactive ANP [ir ANP]. Pentobarbital-anesthetized dogs [n-36] were divided into-6-equal groups [6 each] and treated separately with calcium chloride infusion [0.136 mmol/Kg/min-10 min]. Lanoxine injection [30 micro g/Kg], verapamil injection [300 micro g/Kg], magnesium sulfate infusion [0.168 mmol/Kg/min-10 min] after an initial bolus dose of 1.5 mmol/Kg, glibenclamid injection [0.3 mg/Kg], and cromakalim injection [10 micro g/Kg]. Plasma ir ANP concentrations, mean arterial pressure [MAP], heart rate [HR] and serum calcium and magnesium concentrations were measured. With calcium chloride and magnesium sulfate infusions, serum calcium and magnesium levels and plasma ir ANP concentrations were significantly increased. Also, lanoxine and K[+] -channel blocker "glibenclamid" caused a significant increase in plasma ir ANP concentration while verapamil and the K[+]-channel opener "cromakalim" resulted in a significant decrease. Neither calcium chloride nor lanoxine produced a significant effect on heart rate, but both significantly increased MAP. In contrast, magnesium sulfate and verapamil produced a significant decrease in MAP and HR while glibenclamid and cromakalim were associated with insignificant changes in both HR and MAP. These results suggest that calcium ions may play a key role in the secretory process of ANP and indicate that magnesium ions may also influence ANP secretion by acting via modulation of K[+] -channels

effect of edge to edge bite in different skeletal classes on the position of the condyle

This study was carried out to evaluate the effect of edge to edge bite on different skeletal classes on the condylar position within the glenoid fossa at centric occlusion. The study was performed on a total sample of 35 subjects [20 control with accepted occlusion, 5 with skeletal Class I, 5 with skeletal Class II and 5 with skeletal Class-III]. Skeletal class I, II and III subjects charactarised by an edge to edge bite. The mean age of the subjects was 24.3 years. Lateral oblique transcranial radiographs for right and left sides of TMJ were carried out. TMJ computer analysis were performed for each subject. This study revealed that the condyle in skeletal Class III subjects was more anteriorly displaced. In skeletal Class II subjects, it was found that the distance between the condyle and the temporal curve was increased