Effect of alpha I adrenergic receptor inhibitors on lipid pattern in hypertensive patients

In a trial to evaluate the effect of the selective post synaptic alpha I adrenergic inhibitor [Doxazosin] on lipid profile, this study was conducted on 50 patients with essential hypertension 35 females and 15 males. Our results showed a highly statistically significant drop of total lipids, total cholesterol, total triglyceride and VLDLc levels. The mean High Density Lipoprotein cholesterol HDLc level at the end of our trial unexpectedly showed statistically non significant drop. However, on comparing the HDLc total cholesterol ratio before and after the selective post synaptic alpha I adrenergic inhibitor, there was a statistically significant increase. Also the total cholesterol/ HDLc ratio [risk factor I] showed a statistically highly significant drop after the use the selective post synaptic alpha I adrenergic inhibitor. LDLc/ HDLc ratio [risk factor II] showed also a statistically highly significant drop after therapy with the same drug. A possible explanation for the lack of increase in HDL cholesterol level in this study may be the short duration of the trial

Splenic volume measured by sonography as a new better index for diagnosis of splenomegaly

Since the introduction of sonography as a mean for diagnosis of splenic abnormalities, the traditional method to diagnose splenomegaly was essentiaIIy dependant upon estimating its log axis. A new [original] method was used in this study to determine the splenic size [volume] as a more accurate assessment of splenic enlargement in borderline cases with a long axis of 10-12 cm. The calculation of splenic volume was possible depending upon a built in function of the sonographic device Sonoline [Siemens] with the B-mode sector and liner transducer [3.5 M.Hz.]. This work was conducted on two groups of cases:1. First group without clinical splenomegaly: A. A spleen with a long axis less than 10 cm. as determined sonographically [101] cases. B. Another sub-group with a long axis more than 10. cm but less than 12 cm [65 cases] .2 Second group of cases included patients with definite splenomegaly as detected clinically and/or long axis of more than 12 cm. as determined sonographically [15 cases]. All cases were subjected to full history, physical examination and necessary laboratory tests to diagnose the etiology of splenomegaly. All cases were studied sonographically for the long axis of the spleen and splenic volume. A value of l53.36 cm +/- 58.29 was found to be a measure of normal splenic volume. In borderline cases with a long axis of 10-12 cm where splenomegaly was not diagnosed sonographically with the traditional method, the splenic volume was found significantly bigger than normal value of splenic volume obtained in this study and it was concluded that this measurement is a more accurate diagnostic tool for diagnosis of splenomegaly in cases where sonographic splenomegaly is doubtful

Study of standard leukocytic count in Egyptian adults

Although leucocytic count. whether total or differential, has been given figures in all textbooks, yet variations are known to occur with race, age and sex. This work aimed at shedding some light on the standard leucocyte values of Egyptian adults, while comparing those of males and females. To achieve this aim, 240 apparently normal Egyptian adults were studied and subdivided into 2 equal groups, the first including 120 males and the second 120 females. Total and differential leucocytic count was done for each member of each group, and the results were tabulated and statistically analysed .It was concluded that the mean total leucocytic count in Egyptian adults was lower than that of Europeans, and close to that observed in Orientals, yet higher than that of Negroes. The mean neutrophil count showed similar results. Comparing both groups, the total leucocytic count was significantly higher in females than in males due to a highly significant difference in the neutrophil count. It is hoped that a more extensive study be performed covering different age groups and socioeconomic standards and extending to rural and suburban areas to screen a larger sector of the population in order to deduce more precise normal Egyptian values

Study of the effect of exercise and alpha adrenergic blockers on lipids and lipo-pattern in normals and hypertensive patients

This study included 60 adults; 30 normotensive subjects and 30 patients with mild hypertension [diastolic B.P. 95-105 mm Hg] who were free of medical conditions that would contraindicate vigorous exercise and not taking medications that would influence plasma lipids. All participants were instructed to maintain their normal diet and not to change smoking habits, and non of them were alcoholic. Using a fixed dose of 0.5 mg prazosin HCL t.i.d. and standard regular physical exercise program of walking for 30 minutes daily the trial population were divided into 4 groups: Group I and Ill: included 15 normotensive subjects [group I] and other 15 hypertensive patients [group III]. Each participant received prazosin for 3 weeks then exercise program was added for further 3 weeks. Group II and IV; included 15 normotensive subjects [group II] and 15 hypertensive patients [group IV]. Each participant followed the exercise program for 3 weeks then prazosin administration was added for further 3 weeks. In normotensive subjects physical exercise alone showed a significant reduction of TG level and significant elevation of HDLc levels. While prazosin alone could not change their plasma lipids and lipoprotein pattern significantly. On the other hand in hypertensive patients prazosin alone in a dose of 0.5 mg t.i.d. reduced significantly LDLc levels. Also the combination of physical exercise and prazosin administration in normotensive and hypertensive subjects has an additive antiatherogenic effect on plasma lipids and lipoprotein pattern

Effect of propranolol and spironolactone on body weight, extracellular fluid and intracellular fluid sodium, urinary sodium and total urine output per 24 hours in chronic liver diseases

Ascites is one of the most common complications of chronic liver diseases and usually requires frequent and often prolonged hospitalization. Increased renal tubular sodiumreabsorption is the predominant mechanism. Activation of renin - angiotensin - aldosterone system and of the sympathetic nervous system play important roles in this process. Aldosterone would help reabsorption of sodium and water from the distal and collecting tubules. Spironolactone is a known drug that antagonizes the effect of aldosterone in these segments. Activation of the sympathetic nervous system results in reduction of the renal blood flow, glomerular filtration rate, increase in sodium and water reabsorption from the different nephron segments and increase in renal synthesis and release of renin. Propranolol is a non selective beta adrenoreceptor blocking drug that will block the effects of overactive sympathetic nervous system. Again, propranolol will inhibit activation of renin - angiotensin - aldosterone system, added to its known portal hypotensive effect. In this work, the effect of combined therapy of spironolactone and propranolol for 14 days on body weight, daily urine output, urinary sodium was studied on 10 non azotaemic patients with chronic liver disease and ascites. Results of this work showed a highly significant increase in urinary sodium and a significant increase in daily urine output after therapy. The body weight, intracellular sodium and extracellular sodium showed an insignificant change after therapy with spironolactone and propranolol in combination. According to the results obtained in this work, we recommend the usage of spironolactone and propranolol combination with or without other lines of therapy in treating non azotaemic patients with chronic liver disease and ascites

Study of tissue prostaglandins in patients with peptic ulceration

The relationship between tissue prostaglandins and peptic ulcer has been well documented. Its exact nature remains unclear. It has centered on a possible relationship between the cystoprotection of the gastroduodenal mucosa and prostaglandins, and between the increase of HCI secretion, this has not been fully documented. Recent medical experience suggests that an awareness of the association between peptic ulcer and prostaglandins may increase the yield of healing of peptic ulcer. In the present work, prostaglandins [PGE 2, 6-keto PGF 1, and TXB 2] were studied in patients with peptic ulcer. The study was performed on 19 patients with peptic ulcer and 18 control subjects. A biopsy from the edge of the ulcer as well as from the healthy mucous membrane at least 5 cm away from the ulcer was obtained for microscopic examination and for determination of the prostaglandins [PGE 2, 6-keto PGF 1, and TXB 2]. The study showed that PGE 2 was highly increased at the edge of the ulcer than in the mucous membrane 5 cm away from the ulcer and in normal control subjects. This increase of PGE 2 in the edge of the ulcer is to help proliferation of the mucous membrane to cover the ulcer and to protect it from the acidity. In the same study, we found that 6-keto PGF 1 was increased at the edge of the ulcer more than in the healthy tissue. And as it is known, the 6-keto PGF 1 is the stable from of PGI 2 which is secreted from the wall of the blood vessels. This increase of 6-keto PGF 1 will help also in the cytoprotection of the gastric mucosa and its proliferation to cover the ulcer from the attack by HCL. Also in this study, we found that TXB 2, which is produced by the tissue platlets, was less at the edge of the ulcer than in the other healthy tissue. This study showed that there is an important relationship between prostaglandins and peptic ulcer, since the change of the amount of the produced prostaglandins may increase the incidence of peptic ulcer or may help in he healing process of peptic ulcer