Short term prognostec value of interleukin-10

A role for inflammation has become well established over the past decade or more in theories describing the atherosclerotic disease process. From a pathological viewpoint, all stages, of the atherosclerotic plaque might be considered to be an inflammatory response to injury. Indeed patients with acute coronary syndromes demonstrate elevated levels of systemic markers of inflammation. Yet little is known about the role of anti-inflammatory cytokines in this setting. The aim of this work was to study the serum level of interleukin-10, which is produced by various inflammatory cells and identified as a cytokine synthesis inhibitory factor, in patients of unstable angins using stable angina patients as a control group and its prognostic value during in hospital stay. This study included 60 patients who were admitted for the assessment of angina chest pain. They were classified into 2 groups. Of the 60 patients, 30 had unstable angina [Group I] and 30 had chronic stable angina [Group II]. Samples from those patients were taken under aspirin cover at the time of admission and another ones were collected in the first 48 hours after admission to assess serum interleukin-10 level. According to the serum level of IL- 10, patients of group I [Unstable angina] was arranged into two equal subgroups. Each subgroup includes 15 patients. Group [IA] included patients with low serum IL-b and Group [IB] included patients with high serum IL- 10. We have compared the two subgroups regarding cardiovascular events during in hospital stay and regarding baseline characteristics. Also coronary angiography was carried out and analyzed. We found that, no significant differences between the two groups regarding baseline characteristics. Interleukin-10 was significantly lower in patients of group I compared with patients with group II [t = 8.6, p < 0.05]. Also, Interleukin- 10 was significantly negatively correlated with different types of lesions [P = 0.0004]. IL- 10 was not significantly correlated with the morphology of the lesions in group I [P = 0.065]. Angiographic findings were similar in the two groups except for the number of vessels affected which was significantly higher in the unstable group [P = 0.01]. IL-b was not significantly correlated with type or morphology of the lesions in patients of group II. During hospital stay, there was more poor prognosis among patients of group IA compared to those in group IB

use of doppler - echocardiogiography for the assessment of cardiac functions in children with Iron deficiency anaemia

This study included 30 patients [17 males and 13 females, with an age range from 1 to 12 years with a mean of 5.75 +/- 3.43 years] of those attending pediatric clinic. Detailed retrospective clinical history, complete clinical examination, stool analysis, CBC, hemoglobin concentration, hematocrit value, mean corpuscular volume and mean corpuscular hemoglobin concentration together with the estimation of serum iron and total iron binding capacity [TIBC] were done. Echo-Doppler examination to estimate left ventricular dimensions, septal and posterior wall thickness, ejection fraction and fractional shortening, diastolic ventricular function estimation by mitral valve diastolic flow study were also carried out. It was concluded that iron deficiency anemia leads to a hyperdynamic circulating state with significant left ventricular diastolic dysfunction

Qualitative and quantitative coronary angiography in patients with Q-wave myocardial infarction versus patients with non-Q wave myocardial infarction

The classification of myocardial infarction into transmural and subendocardial types has been based on the presence or absence of abnormal Q-waves in the ECG; it is more appropriate to describe myocardial infarction as Q-wave and non-Q wave infarction. Visual evaluation of CA lesions was associated with inter observer and intraobserver variability of about 30%. In the present study 40 patients [20 patients with Q-wave and 20 patients with non Q-wave myocardial infarction] have been assessed for the presence or absence of significant difference regarding all risk factors for CAD, echocardiographic findings, cardiac enzymes and various QCA [Quantitative Coronary Angiography] variables [percentage of stenosis, plaque area, length of lesion, type of lesion, number of vessels affected and site of lesion]. The distribution of risk factors [age. sex, smoking, hypertension, diabetes, hyperlipmdemia] between both groups revealed no statistically significant difference. The history of previous ischemic insult was significantly higher in group II [40% in group II and 5% in group I]. Echocardiographic findings: Regional wall motions abnormalities [RWMA]: in group 1, 95% of patients have hypokinesia and 5% have akinesia in one or more left ventricular wall segments. In goup 2, 20% of patients have normal wall motions, 65% have hypokinesia and 15% have akinesia in one or more of left ventricular wall segments [P<0.05]. However the ejection fraction, fractional shortening, end-systolic and end-diastolic volumes were not statistically different between the two groups. In evaluation of cardiac enzymes, CPK; ranged from 550 to 2001 IU, in group I. with a mean value of 997 +/- 425 IU, in group 2, it ranges from 220 to 900 IU with a mean value of 451 +/- 149 IU [P<0.001]- LDH; it ranges from 550 IU tol900 IU with a mean value of 1657 +/- 198 IU while in group 2 it ranges from 301 IU to 860 IU with a mean value of 618 +/- 168 IU [P<0.05]. CPK MB fraction; values were ranging from 28 IU to 60 IU with a mean value of 53 +/- 21.7 IU for group I. In group 2 it ranges from 22 to 30 IU with a mean value of 32.9 +/- 9.1 IU [P<0.001]. As regard the parameters of QCA, Percentage stenosis; in group I, it ranges from 61% to 99.6% with a mean value of 87.66 +/- 12.4. In group 2, it ranges from 59% to 99.9% with a mean value of 90 +/- 14.1%, [P>0.05]. Plaque area; in group 1, it range from 1.09 to 16.8 mm2 with a mean value of 5.15 +/- 2.4 mm2. In group 2 it ranges from 0.33 to 21.66 mm2 with a mean value of 7.12 +/- 6.6 mm2 [P>0.05]. Length of lesion; in group 1, it range from 4.42 to 25.75 mm with a mean value of 16.68 +/- 3.7 mm. In group 2. it ranges from 4.72 to 29.3 mm with a mean value of 17.65 +/- 4.6 mm [P>0.05]. Number of vessels affected; in group 1, 60% of patients have single vessel disease, 20% two-vessel disease and 20% multi-vessel disease. In group 2, 50% of patients have single vessel disease, 25% two-vessel disease and 25% multi-vessel disease [P>0.05]. So we concluded that there is no significant difference between Q-wave and non Q-wave myocardial infarction except in the following points: the history of previous myocardiat infarction and ischemia is commoner in non Q-wave myocardial infarction. Regional wall motions abnormalities occur more frequently in patients with Q-wave myocardial infarction. Cardiac enzymes are more elevated in Q-wave myocardial infarction than non Q-wave myocardial infarction. It is clear from the study that the magnitude of myocardial infarction should be judged on the anatomical and functional basis rather than the designation of Q-wave or non Q-wave type of myocardial infarction. It is also apparent that quantitative coronary angiography is an accurate and reproducible method for assessing the coronary artery lesion

Silent myocardial ischemia in patients with coronary heart disease

Silent myocardial ischemia [SMI] is defined as an objective evidence of myocardial ischemia occur in the absence of symptoms in a patient who has documented coronary artery disease. It may result in a silent infraction or a sudden death or other event. The studied group consisted of 30 patients [20 males]. Treadmill exercise test and single photon emission computed tomography [SPECT] perfusion scintigraphy were used to detect signs of myocardial ischemia in angiographically documented presence of a single coronary artery disease. Fourteen patients had only SMI and nine patients had angina pectoris only during stress. The predictive value of SPECT to detect reperfusion defects for all was 83%. The prevalence of SMI in patients with LAD stenosis was higher than those with RCA and/or LCx lesions