Proteinurea and cerebrovascular stroke in type 2 diabetic patients

Proteinuria is an independent risk factor for cardiovascular disease in patients with NIDDM. The aim of this study was to assess the relationship between proteinuria and ischemic stroke in subjects with NIDDM, and to determine whether proteiuria is an independent risk factor for cerebrovascular stroke also. We performed a study on 20 diabetic patients with first-ever ischemic stroke due to thrombotic arterial occlusion, who were considered cases, and 10 diabetic patients without stroke, matched by gender. age, and diabetes duration, as a control group. WHO criteria for verified definite or possible stroke were used to ascertain the diagnosis of stroke. Proteinuria was higher in diabetics with stroke compared to those without stroke [P < 0.00]. Diabetic patients with stroke and proteinuria compared to those without proteinurea had significantly high duration of diabetes, systolic and diastolic blood pressure. fasting blood glucose, serum cholesterol and triglycerides[P < 0.05, 0.05, 0.001, 0.05, 0.05 and 0.01 respectively. However, proteinurea was not correlated to site, size or severity of stroke. In conclusion proteinurea was strongly associated with stroke in diabetic patients, may be through the presence of associated risk factors mainly hypertension. dyslipidemia and uncontrolled diabetes mellitus

Nitric oxide in gall bladder diseases

Nitric oxide is implicated in the physiological modulation of gastric and gall bladder motility during the inter and postprandial phases.In this study, we have investigated nitric oxide in the sera of 50 individuals, 10 healthy controls [Group I] and 40 randomly selected patients with chronic cholecystitis [Group II]. Patients were subdivided into 3 subgroups, 15 patients with calculous cholecystitis [Group IIa], 15 parients within non-calculous cholecystitis [Group IIb] and 10 cases with biliary sludge [Group llc]. Results of this study have demonstrated high concentrations of serum nitric oxide in patients with chronic cholecystitis particularly those with calculous cholecystitis and those with biliary sludge. These observations may suggest that, the increase in nitric oxide production impair gall bladder emptying leading to gall stasis and hence, together with other factors, may lead to gall stone formation. This study, has also shown that, obesity, smoking and gender don't affect nitric oxide serum level. Further studies are recommended especially on large number of patients to varify the effect of nitric oxide on gall bladder motility. It is recommended also to evaluate the benefits of using nitric oxide synthase inhibitors in high risk groups as obese females and patients using nitric oxide donar medications