Role of school teachers in identifying attention deficit hyperactivity disorder among primary school children in Mansoura, Egypt

There is a knowledge gap in primary school teachers that affects their ability to detect attention deficit hyperactivity disorder [ADHD]. This study measured primary school teachers' knowledge about ADHD, and implemented a training programme to improve early detection of ADHD. The prevalence and risk factors of ADHD were also studied. The training programme was implemented through a 2-day workshop for 39 primary school teachers who completed a validated Arabic version of the ADHD Rating Scale for 873 primary school children. The children's parents completed the questionnaire to explore ADHD risk factors. The teachers' pre-training knowledge scores of ADHD ranged from 17.9 to 46.2%. Post-training, their scores improved significantly to 69.2-94.9%. Prevalence rate of ADHD was 12.60%. On logistic regression, independent predictors of ADHD were female gender, unemployed fathers and rural residence. In conclusion, ADHD is a significant health problem among primary school children in Mansoura, Egypt. Efforts should be made to improve teachers' knowledge about ADHD and control modifiable risk factors

Does routine histopathological examination of gallbladder after simple cholecystectomy add additional value?

Cholecystectomy for gallbladder stone disease is a common surgical procedure. Gallbladder carcinoma is a rare malignancy with poor prognosis, which has been linked in some studies to pre-existing gall stone disease. The current practice is to send all gallbladder specimens after cholecystectomy for histopathological examination. This adds additional workload on the pathologists. To determine the necessity of routine histopathological examination of gallbladder specimens following simple cholecystectomy. Aseer Central Hospital, Abha, Saudi Arabia. Retrospective cohort study. Patients who had cholecystectomy for gallstone disease from April 2010 to March 2012 were included. Operative notes, histopathological reports and final diagnoses were reviewed. The study included 803 patients who had simple cholecystectomy. Three of these patients were found to have gallbladder carcinoma, two females and one male. Dense adhesions were encountered in all malignant cases necessitating conversion from laparoscopic to open cholecystectomy in one case. Macroscopic examination revealed a thickened gallbladder in all three patients; two patients had mucosal papillary lesions and one patient had polypoidal projection and mucosal ulcerations. These findings were confirmed by the pathologist. On microscopic examination, two patients had adenocarcinoma while one patient had neuroendocrine tumor. Selective approach for sending gallbladder specimens after cholecystectomy seems justifiable with no compromise on detection of incidental gallbladder cancer. This approach would lead to a reduction of workload on the pathologist.

Gross Motor Development of low birth weight infants with the history of being in Aliasghar hospital corrected aged 8 to 12 months

The aim of this study was to compare the gross motor development between Low Birth Weight [LEW] infants and Normal Birth Weight infants [NBW] at the age of 8-12 months by using the Peabody Developmental Motor Scale-2 [PDMS-2]. This was a non experimental and cross sectional study which was conducted on 18 LBW infants with the history of being in Aliasghar hospital and 14 infants with the history of normal birth weight as a control group. Gathering the information was done by completing Questioner and then by using the Peabody Developmental Motor Scale-2 [PDMS-2]. Finally the scores of the motor quotients were analyzed by independent T test statistical method. There was a significant difference [p= 0.002] between the mean gross motor quotient of LBW [90.83] and NBW [106.78]. This study showed that LBW infants attain low scores of gross motor skills in comparison with normal weight infants. It indicated that the LBW infants are more prone to motor development difficulties

Ventilator associated pneumonia in critically-ill neonates admitted to neonatal intensive care unit, Zagazig university hospitals

Ventilator associated pneumonia [VAP] is defined as nosocomial pneumonia in mechanically ventilated patients. It is considered to be most important cause of infection-related death in intensive care unit We studied the characteristics and risk factors of VAP in critically-ill neonates. Fifty six consecutive neonates with different diagnosis admitted from January to October 2010 to neonatal intensive care unit [NICU], Zagazig University Hospitals who needed mechanical ventilation were included in the study. There were 32 neonates, 18 males and 14 females with proven diagnosis of VAP, and 24 neonates, 11 males and 13 females without VAP served as control group. All studied neonates were subjected to history taking, clinical examination, routine investigations [Complete blood count, C-reactive protein, arterial blood gases, blood culture and liver and kidney function tests], and chest X-ray daily as well as non-bronchoscopic alveolar lavage culture for VAP group only. Of 56 neonates who needed mechanical ventilation, 57.1% developed VAP. Prematurity, low birth weight and prolonged duration of mechanical ventilation were risk factors for developing VAP. Increased total leucocytic count, CRP and hypoalbuminemia were significantly presented in VAP-group. There were significant differences between VAP and non-VAP groups regarding hypothermia, mucopurulent endotracheal tube secretion, PaCO[2] and PaO[2]. Microorganisms associated with blood stream infection in VAP diagnosed group were Klebsiella [15.6%], S. aureus [12.5%], Pseudomonas [9.4%], E. coli [6.2%], Candida [3.1%]; 53.1% of obtained blood cultures were sterile. Of non-bronchoscopic alveolar lavage cultures obtained from VAP patients, 68.6% showed gram negative infection, 21.8% showed gram positive organisms and 9.3% revealed Candida infection. The most important risk factors of VAP are prematurity, low birth weight, prolonged I duration of mechanical ventilation, enteral nutrition and umbilical catheterization

Diabetes mellitus and sensorineural hearing loss among non-elderly people

One of the known complications of diabetes is hearing impairment. This comparative study in Tehran, Islamic Republic of Iran, aimed to evaluate the association of diabetes mellitus and sensorineural hearing loss [SNHL] among a non-elderly population. Among 160 subjects aged < 60 years with no history of occupational noise exposure [80 diabetics and 80 age- and sex-matched non-diabetic controls], 45% of diabetic patients and 20% of controls had SNHL [OR 3.5, 95% CI: 1.6-6.6]. Age at onset and duration of diabetes were associated with SNHL. Diabetes mellitus may be a risk factor for hearing loss regardless of age and smoking. Determining the cause of SNHL in diabetic patients may lead to development of better treatment options

Incidence of anaemia in female breast cancer patients attending the national cancer institute, Wad Medani

Anaeia is a public health problem that affects populations in both rich and poor countries. Although the primary cause is iron deficiency, it is seldom present in isolation. More frequently it coexists with a number of other causes, such as malaria, parasitic infection, nutritional deficiencies and haemoglobin apathies. That was the people and female in Sudan suffered from it. Anaemia has a high prevalence in patients with cancer. The aim of this study was to find the incidence of anaemia in new cases of Sudanese female breast cancer patients attending the National Cancer Institute [NCI], Gazira State, Sudan. The study was performed on 250 female breast cancer patients mean age 45.99 +/- 0.82 [age range between 15-70 years]. The study period was from May 2005 to June 2007. The haemoglobin level for anaemia was measured by SYSMEX-KX21M. It was found that 144 [58.8%] of the female breast cancer patients presented with anaemia, 65[26.4%] of them were in the child-bearing age group 15-40. The degree of anaemia varied between moderate to severe [grade II to grade IV]. In this study, it was also found that a considerable number of cases 200[80.0%] were from the rural area. 44[17.6%] of the patients were found to be underweight, 31 of them were anaemic. While 105[42%] of patients were overweight and obese, 52 of them were anaemic. It is concluded that the incidence of anaemia in newly diagnosed Sudanese female breast cancer patients presented at NCI is association presentation with advanced disease stage. It is also related to the age, state of nutrition and social economical factors. Early cancer detection which leads to effective treatment and reduced complication of diseases included anaemia is recommended

Circulating interleukin-6 and tumor necrosis factor receptor-1 predict resistance to therapy of typhoidal salmonellosis

Typhoid fever, a food-borne disease caused by salmonella species, is a worldwide prevalent disease. In endemic areas, children are at highest risk owing to weaning from passively acquired maternal antibody and lack of acquired immunity. Several studies have been done to clarify the pathogenesis and underlying immune aspects of typhoid fever. Study the changes of some proinflammatory cytokines in plasma of children with typhoid fever. Thirty consecutive children admitted to Zagazig Fever Hospital with proven diagnosis of typhoid fever were included in the study. They were 20 males and 10 females, of ages ranging from 3 to 13 years. In addition, 10 age and sex matched healthy children served as a control group. A verbal consent was obtained from parent[s] of each child before inclusion to the study. All children were subjected to history taking, clinical examination, and routine investigations [CBC, ESR, CRP, Widal test and stool culture], as well as determination of serum interleukin-6 [IL-6] and tumor necrosis factor receptor-1 [TNF-R1], before and 5 days after start of treatment [for patients]. Twenty patients [66.7%] were responsive to therapy and 10 patients [33.3%] were resistant. Toxic look, constipation, high fever, splenomegaly, increased CRP and ESR were significantly presented in patients who displayed resistance to drug therapy. Both IL-6 and TNF-R1 plasma levels were significantly higher in patients than in control children, and in resistant cases than in responsive cases [before and 5 days after treatment]. ESR and S. typhi H agglutination titre correlated significantly with plasma levels of IL-6 and TNF-R1, whereas S. typhi O agglutination titre and total leucocytic count did not. patients with typhoid fever resistant to combined therapy with chloramphenicol and co-trimoxazole have higher plasma levels of IL-6 and TNF-R1. Toxic look, constipation and splenomegaly may be considered as indicators of drug resistance

Vitamin D and LL-37 in children with pneumonia

Vitamin D is involved in the regulation of about1000 human genes. Recent studies suggest that vitamin D may have other actions outside of its classic functions related to bone and calcium homeostasis. The only human cathelicidin, LL 37, enhances microbial killing against a broad range of respiratory pathogens and has a defined vitamin D- dependent mechanism. evaluate the association between vitamin D status and plasma LL-37 levels in children with pneumonia. Forty consecutive children admitted to the chest unit of the Pediatric Department of Zagazig University Hospital with proven diagnosis of pneumonia were included in the study. They were 22 males and 18 females, of ages ranging from 2 to 5 years. In addition, 40 age and sex matched apparently healthy children served as a control group. A verbal consent was obtained from parent[s] of each child before inclusion to the study. All children were subjected to history taking, clinical examination, routine investigations [CBC, CRP and ESR] and chest X-ray done for patients only, as well as determination of serum 25-OH vitamin D and plasma LL-37. The study revealed a highly significant increase of WBCs, ESR and CRP and a highly significant decrease in hemoglobin of patients. Absence of history of sun exposure, increased WBCs counts and low levels of vitamin D and LL-37 were considered as risk factors for pneumonia while site of residence, hemoglobin level and platelets count were not. Both vitamin D and LL-37 were significantly lower in patients than controls [P<0.001]. There were significant positive correlations between vitamin D and LL-37 in studied groups. Appropriate concentrations of vitamin D facilitate the ability of immune system to defend against respiratory tract infections through enhancing LL-37 production

Echocardiographic abnormalities in children with sickle cell disease

Sickle cell disease [SCD] is an inherited disorder associated with significant morbidity, characterized by the presence of abnormal hemoglobin within the red blood cells. The cardiovascular system is stressed by chronic anemia, small pulmonary artery occlusions and myocardial hemosiderosis that cause multiple anatomical and functional changes. Anatomical and functional assessment of the heart through M mode, 2 dimension and doppler echocardiography in pediatric patients with sickle cell anemia [SCA]. Twenty-five children with SCA [mean age 10 +/- 3.4 years], 14 males and 11 females were prospectively studied in a comparison with 25 ages and sex matched healthy children. All of them underwent clinical and laboratory evaluation, M mode, 2 dimension and doppler echocardiography. Patients with SCD had higher left ventricular end diastolic dimension, left atrial dimension, stroke volume and left ventricular mass. Mild pulmonary hypertension with mean pulmonary artery systolic pressure [PASP] 30 +/- 5.40 mmHg. Chamber dilatation, left ventricular hypertrophy with increased left ventricular mass associated with left ventricular diastolic dysfunction secondary to chronic anemia with volume overload and sickle cell cardiomyopathy confirm the evidence of the literature in characterizing a sickle cell disease in pediatrics

polybasic acid-assisted sol-gel route to silica and ag-doped silica nanoparticies

Quasi regular silica nanoparticles are synthesized and post-treated for a facile homogeneous doping with metallic silver. The nanoparticles are obtained through a simple alkali-mediated sol-gel route in presence of tartaric acid and conventional ultrasonic agitation. Gelation in presence of both mechanical agitation and ultrasonic dispersion has lead to the formation of well-dispersed silica nanoparticles having an average particle size of less than 10 nm. In addition, tartaric acid was used to interfere in the hydrolysis stage that has lead to the formation of silica nanocubes probably by forming templates at the early stages of formation of the amorphous hydrous silica colloid. Unlike the acid hydrolysis route that produces irregular-shape grains or micro-sized agglomerates. TEM images in this study show that the combined application of tartaric acid template and ultrasonic agitation during gelation enhanced the formation of well dispersed silica nanocubes. XRD measurements showed that post-treatment of silica wet gel with metallic silver into the silica grains by sonication in silver ion solution and later reduction has successfully loaded the silica particles with silver to a good extent on the expense of regularity and dispersion of obtained nanoparticles. Samples were also characterized by FT-IR

Alkoxide-based sol-gel synthesis of MgO-ZrO2- SiO2 compositions

Using acetylacetone-complexed zirconium alkoxide and tetracthylsilane. the sol-gel technique was followed to prepare five different compositions within the MgO-ZrOr SiO2 system, primarily as amorphous powders. XRD analysis showed the formation enstatitc and zirconia on mild thermal treatment. The results of XRD and Raman spectra indicated that the obtained zirconia powders are of tetragonal phase at room temperature and was thermally stable over the temperature range of 1000-1300 °C. The powders showed aggregates of nanosize zirconia crystallites as shown by some SEM photos

effect of short time telephone follow-up on physical conditions and quality of life in patients after pacemaker implantation

Cardiac arrhythmia is one of the most common cardio-vascular diseases. Pacemaker as one of the curative methods in treating patients with arrhythmia can reduce most of their problems. In spite of its benefits, it may cause some physical and psychological problems and affect on patients quality of life. Thus, following up is necessary for these patients. Telephone follow up may be useful as a cheap and effective method for this purpose. The aim of this study was to evaluate the effects of telephone follow up by nurse on the quality of life in patients with pacemaker. In this clinical-trial study, 60 patients with pacemaker were divided into two groups. Case group was followed up by telephone and control group was followed up by routine procedure. The quality of life [QOL] was assessed using AQOL and sf-36 questionnaires for duration of one month. Data were analyzed using independent and paired-t tests. No significant difference was found between case and control group for the quality of life scores before starting the study. At the end of the study, mean quality of life scores was significantly higher in case group compared to the control group. Paired t-test also showed a significant difference between the mean of quality of life scores in case group before and after the study [P<0.001]. Telephone following-up can be used as a cheap and effective method for improving the quality of life in patients with pacemaker after discharge

Developmental toxicity evaluation of oral aluminum in rats

The present study was designed to elucidate the adverse effects of the orally administered aluminum [Al] on the growing fetus and consequently on the animal wealth in our country. This aim has been achieved by studying the teratogenic, perinatal and postnatal effects of aluminum chloride when administered orally at 345 mg/kg body weight to female rats during organogenesis, fetal and/ or lactation periods. The results showed that Al chloride exposure on days 6-15 of gestation produced a significantly higher percentage of postimplantation death, resorptions, morphological, visceral and skeletal anomalies in the obtained fetuses compared to the control group. In addition, the live fetuses' percentage, mean fetal body weight and placental weights were significantly decreased. The obtained data revealed also that Al chloride exposure on 6[th] day of gestation till weaning induced significant increase in the percentage of dams showed delayed birth date and signs of dystocia. In addition, it induced a significant increase in the percentage of postimplantation loss, dead fetuses; fetuses showing neurobehavioral and respiratory symptoms and those born with morphological abnormalities. Moreover, it decreased the live/ birth, survival and viability indices and weight gain of these fetuses compared with control. The Al- induced effects on the obtained fetuses from Al chloride treated dams through lactation period included significant increase in the percentage of postnatal deaths, fetal stunted growth with a significantly increased percentage of nervous and respiratory symptoms prior to death. Consequently, the survival and viability indices were reduced. Moreover, the weight gain during lactation was significantly reduced. Brain examination of the obtained fetuses from all exposed dams throughout this study showed different histopathological changes. It can be concluded that Al chloride exposure of female rats during gestation and/ or lactation periods caused teratogenic, perinatal and postnatal adverse effects on their progeny

Effect of lyophilization on the characteristics and stability of melanin loaded liposomes

The present study was directed to optimize the stability of melanin liposomes utilizing the technique of lyophilization. Two types of cryoprotectants; sucrose and lactose, each in two concentrations of 5% and 10% were used. Lyophilized liposomes [10% lactose] either fresh or stored for one year at 5°C showed no significant changes [P>0.05] in the phase transition temperatures [Tc], structure and shape, and size distribution of the fresh unlyophilized liposomes. The fresh unlyophilized liposomes were unilamellar with Tc of 41.6°C and an average size of 5.21 micro m. The stored unlyophilized liposomes showed a significant [P<0.05] decrease in Tc [32.8°C] and increase in the average size [15.6 micro m] with the formation of onion- like multilamellar vesicles compared with the fresh unlyophilized ones. Lyophilization of melanin liposomes with different cryoprotectants significantly [P<0.001] decreased the rate of leakage of entrapped melanin from the liposomal structure compared with the unlyophilized ones. This cryoprotection effect was significantly [P<0.05] increased by the use of lactose and by increasing the cryoprotectant concentration. The entrapped melanin in lyophilized liposomes with 10% lactose was chemically stable for six months at 5°C as evaluated by mass spectroscopic analysis. As a conclusion, lyophilization with 10% lactose maintained the chemical stability of melanin and significantly improved the physical stability of melanin liposomes

placebo control study of the effect of Nigella sativa fixed oil on the healing rate of recurrent aphthous ulceration

Nigella sativa has an antibacterial effect; it produced also a marked antifungal, anticestodal and antinematodal activity besides its antiarithritic, analgesic, antiseptic, antiviral and too many other activities. To show the effect of Nigella sativa fixed oil on the healing rate of RAU. Forty patients with RAU having no other systemic manifestations were included in this study. Those patients were divided into two groups of 20 patients each. The first group was treated by Nigella sativa fixed oil 10% in glycerin 3 times daily, the second group was treated with glycerin 3 times daily. All those patients were assessed by Oral Clinical Manifestation Index [OCMI]. Patients treated with Nigella sativa showed 100% cure after five days of treatment. Nigella sativa fixed oil is a new effective topical agent for promotion of healing of recurrent oral ulceration

mode of feeding and its impact on visual and neural maturation at 6 months of age

The role of polyunsaturated fatty acids in the function of the brain and retina is an area of active research. Docosahexaenoic acid was reported to exert a beneficial effect on neuronal maturation and visual development in breastfed infants. The formation of long-chain polyunsaturated fatty acids [LC-PUFAs] from the parent essential patty acids in early life is limited, thus infants are dependent on the exogenous provision of LC-PUFAs from human milk or supplemented formula. The objective of this analytical cross sectional study is to further delineate the mode of feeding and its impact on visual and neural maturation of term infants at 6 months of age, and to assess the influence of various socioeconomic and demographic factors upon this process. This work was conducted on 40 infants [26 males and 14 females], their ages ranged from 22 to 26 weeks with a mean of 23.88 +/- 1.5 weeks. They were recruited from the general, neonatal, and breastfeeding clinics at Center for Social and Preventive Medicine [CSPM], Cairo University. Proper history taking, thorough clinical examination, and neurophysiologic studies including flash visual evoked potential [FVEP], and brain stem auditory evoked potential [BAEP] were done for all infants. According to their mode of feeding, infants were divided into 2 groups: Group A, consisted of 20 infants with exclusive breastfeeding, and Group B, consisted of 20 infants with complementary feeding. Results revealed that the visual and neural functions were relatively more mature in the exclusively breastfed infants when compared to the complementary-fed infants, although the differences didn't reach statistically significant levels in the majority of test results. In addition, better results in favor of the first and second birth orders were obtained in most test results, but again they didn't reach statistically significant differences in most tests. There were no or weak relevant associations between the results of the neurophysiologic studies and baseline characteristics of our infants. In conclusion, FVEP and BAEP were more mature in exclusively breastfed infants relative to complementary-fed infants at B months of age, and thus exploring the advantage of breast milk In earlier development and maturation of visual and neural functions than complementary feds during early life. Our results support the World Health Assembly resolution, 2002 of exclusive breastfeeding for the first six months of life

Isolation of aeromonas species from diarrheal patients in Ismailia Governorate

In order to know the prevalence of Aeromonas species as a causative agent of diarrhea in Ismailia, three hundred and fifty stool samples and rectal swabs were collected from infants and children under the age of 5 years visiting El Kilo 11 Clinic suffering from acute diarrhea in the period from May 2004 to September 2004. Stool samples were collected from control group of fifty healthy infants and children of matched age and sex. It was found that 29 diarrheal samples were positive for Aeromonas species with prevalence of 8.28%. None of control samples were positive for Aeromonas. In most cases it was found that the infection is water or food borne. Aeromonas strains show high degree of antibiotic susceptibility

Uterine rupture: an audit to analyze management options, maternal and fetal outcome

Study Design: An analysis of 14 cases of ruptured uterus was done during January 2003 to December 2003 in Obstetrics and Gynae Department of Lahore General Hospital, Lahore. The purpose of this Audit was to analyse the different management options, maternal and fetal outcome in uterine rupture. Material and Total no of births in 2003 was 4840. Total number of ruptured uterus found to be 14 [2.9%/1000] deliveries. Among these incomplete rupture were 3 [21.4%] and complete rupture were 11 [78.4%]. Regarding the common sites of uterine rupture lower uterine segment interior surface = 11 [78.4%]. Lower uterine segment posterior surface = 2 [14.2%] and upper uterine segment rupture was = 1 [7.14%]. The most common cause of uterine rupture was found to be multiparity and injudicious use of oxytocin by TBA in 5 cases. [35.7%] and previous uterine surgery in 5 cases [35.7%]. 2 cases [14.21] were due to cephalopelvic disproportion due to hydrocephalus and 2 [14.2%] cases were of malpresentation [transverse lie] mostly handled at home by TBAs. Hysterectomy, total or sub total was done in 7 cases [50%]. Repair of uterus was done in 5 cases [35.7%], in 2-cases [14.2%]. Bladder repair alongwith uterine repair was done. In two cases [14.2%] of scar dehiscence, repeat cesarean section was done. The maternal mortality was found to be zero, while intrauterine death were 10[71.4%] and alive babies were 4 [28.5%] high perinatal mortality of 71% were found. Ruptured uterus is avoidable catastrophe by proper education, training of patients and TBA's and by providing effective family planning services, transportation, diagnostic facilities and by reducing the unnecessary caesarean section

Microscopical changes in the renal tissue due to schistosoma haematobium infestation in adult golden hamsters and the curative effect of myrrh [mirazid] on these changes

Mirazid is a trade name of the purified oleo-gum resin extract from myrrh of commiphora molmol tree. It is used for treatment of schistosomniasis either haematobium or mansoni. This experimental model was done to demonstrate the histological, histochemical and ultrastructural changes of mirazid on the kidney of both adult golden hamsters and those infested with schistosoma haematobium. Forty two groups. adult male golden hamsters were used in this study. Half of them were divided into The control animals were given normal saline and the, treated animals were given mirazid. The rest of animals were infested with schistosoma haematobium parenterally.Eight weeks post infestation they were divided into two equals groups, the infested non-treated animals were given normal saline and the fourth group infested treated animals were treated with mirazid. All animals were given the treatment by intraperitoneal injection once daily for 3 days. After 24 hours from the last dose, kidney specimens were prepared to demonstrate the histological, histochemical and ultrastructural changes. Light microscopic examination of kidney slices of the infested non treated animals showed variable degrees of glomerular degeneration. There was hyaline material deposition in renal tubules. There was an increase in collagenous fibers depsition in the glomerular capillary tufts and in Bowmanis capsule. PAS reaction was decreased in the basement membranes of renal tubules and in brush borders of proximal convoluted tubules. The infested treated animals showed an obvious improvement in the glomeruli with marked reduction in hyaline immaterial deposition. There was a decrease in collagenous fibers deposition and PAS reaction in the renal glomeruli and tubules. Electron microscopic examination of the infested non treated kidney showed enlarged and, broad podocytes around a thick basement membrane of the capillary endothelium. The filteration slits were markedly decreased in number or completely disappeared. After treatment, the majority of podocytes regained their numerous minor processes and filteration slits inbetween. In conclusion, mirazid could be considered a safe and effective schistosomicidal drug

Serum cardiac troponin-T and total homocysteine abnormalities in hemodialysed chronic renal failure patients

Objective: Accelerated atherosclerosis is associated with chronic hemodialysis and more than one half of deaths in dialysis patients are of cardiovascular etiology. The study was designed to assess the concentration of serum total homocysteine [t-Hcy] and cardiac troponin-T [cTn-T] for the early detection of cardiovascular disease in chronic renal failure [CRF] and also to clarify their possible role as risk factors for the development of atherosclerosis in these patients to prevent and/or delay complications and to find out if there is a relation between these atherogenic markers with lipid profile and renal functions

Subjects and Methods: Sixty patients divided into three groups, GI: 20 chronic kidney disease [CKD] patients under conservative treatment. GII: 20 CKD patients on regular hemodialysis, GIII: 20 CKD patients with cardiac complications, all together with twenty healthy age and sex matched control subjects. Cardiac troponin-T, total homocysteine as well as lipid profile [total cholesterol, triacylglycerols, high density lipoprotein cholesterol and low density lipoprotein cholesterol] and renal profile [serum creatinine, BUN and uric acid] were determined

Results: Serum cTn-T was highly significantly increased in the three studied groups by 242, 614 and 7757%, respectively as compared to controls. Meanwhile, t-Hcy was significantly increased [p<0.05] in GI and highly significantly increased [p<0.001] in GII and GIII when compared to control group. There was a significant negative correlation between cTn-T and t-Hcy in GI [r=-0.38], uric acid in GII [r=-0.37] and creatinine in GIII [r=-0.39]. Such abnormalities might contribute to accelerated atherosclerosis in CKD patients

Conclusions: Laboratory determination of serum cTn-T together with t-Hcy is strongly recommended for early detection of cardiovascular disease in CKD