Effects of sildenafil on lipid profile and glycemic control in patients with type 2 diabetes mellitus and metabolic syndrome.

Background: Insulin resistance impairs nitric oxide (NO) bioavailability; obesity promotes a state of metabolic syndrome and damages the vascular endothelium by altering lipid profile. Phosphodiesterase-5 (PDE-5) inhibitors restore NO signaling may improve metabolic parameters through a number of mechanisms. We hypothesized that daily administration of the PDE-5 inhibitor; sildenafil will improve fasting plasma glucose (FPG), triglyceride (TG) levels and body weight, in obese diabetic patients. Methods: Totally, 25 obese diabetic male patients with metabolic syndrome treated with sildenafil 25 mg daily for 3 months. Body weight, FPG levels, and lipid profile were determined monthly. Results: Treatment with sildenafil caused a reduction in fasting glucose levels, fasting TGs, cholesterol, low-density lipoprotein (LDL), very-LDL and increased high-density lipoprotein; body weight was significantly reduced. Conclusion: We have provided the first evidence that sildenafil therapy improve glycemic control, lipid profile and body mass index in diabetic patients with metabolic syndrome.

Epicardial fat thickness obese patients an observational echocardiographic study

Obesity currently affects nearly one-third of the population in the industrialized world. Traditionally, anthropometric measures such as body mass index [BMI] or waist circumference have been used to quantify overall adiposity; however, regional fat depots may be of greater importance than overall adiposity. Several studies have highlighted pericardial fat and abdominal visceral adipose tissue [VAT] as unique, pathogenic fat depot. Recognize the relation of obesity to increase epicardial fat pad thickness in Iraqi patients. Epicardial fat thickness was measured in 62 consecutive subjects [28 women 45%, 34 men 55%] mean age of 47.77 years [SD 8.03], using routine transthoracic echocardiogram. Epicardial fat was identified as the echo-free space between the outer wall of the myocardium and the visceral layer of the pericardium, and its thickness was measured perpendicularly on the free wall of the right ventricle at end-systole. The results show progressive increase of epicardial fat with increasing BMI which was very significant statistically. High mean epicardial fat is significantly associate with increasing waist circumference. No difference in those below and above 45 years of age in mean epicardial fat and there is gender difference in epicardial fat, where males had more epicardial fat than females. There is increase in the epicardial fat pad thickness in overweight and obese [BMI >/= 25] patients if compared to normal persons epicardial fat increase with increasing waist circumference more likely in male obese and independent on age.

Effect of very early atorvastatin initiation for acute myocardial infarction on creatine kinase release

It have been suggested that pre-treatment with a statin agent prior to myocardial infarction limits myocardial creatine kinase release, and thus may act to limit myocardial infarct size in humans. To examine the effect of very early statin initiation for AMI, to the extent of myonecrosis as manifested by peak serum creatine kinase levels. Patients with AMI admitted to Al-Kindy teaching hospital cardiac care unit from February 2007 through February 2008, who fulfilled the inclusion criteria cited in the present study, were randomly assigned into two study groups. The statin group patients have received a single oral dose of 40 mg atorvastatin at time of admission and repeated for the next days until discharge, patients not receiving statin serves as controls. Blood samples were obtained upon admission and every 8 h for another three consecutive samples to identify peak creatine kinase levels. Patients who had statin therapy initiated immediately after hospital admission have similar peak creatine kinase concentrations as compared to those not receiving statin therapy [1020 +/- 621 IU/L vs. 911 +/- 591 IU/L,P= 0.332]. Statin initiation in AMI patients fails to show any observable effect on creatine kinase release, which can be attributed to the need of an extended period for the statin agent to achieve the predictable outcome and suggesting the necessity of statin pretreatment in patients at high risk for AMI

QTc and QTd intervals in patients with type 2 diabetes complicated by peripheral sensory neuropathy

QT interval reflects depolarization and repolarization of the left ventricle, both QT interval and QT dispersion in surface 12 leads ECG of diabetic patients increase with progression of cardiac autonomic neuropathy [CAN] and this may lead to increase risk of dangerous dysrhythmias, it was found that there was association of this phenomenon with other complications of diabetes as ischemic heart disease and microalbuminuria. To asses the relation of QTc and QTd to age, duration of disease, gender, body mass index [BMI], and to presence of peripheral distal symmetrical sensory neuropathy. A longtudinal study of 38 diabetic patients type 2 complaining of distal sensory neuropathy, 12 leads ECG done for all and QTc and QTd are measured with classical method, data collected from patients about age, gender, duration of diabetes and their weight and high for body mass index [BMI]. The result of this study declare that the sample mean age is 46.18 years, mean duration of diabetes is 8.5 years, 57.9% are female, 42.1% male and 60% of them had BMI above 25 kg/m2. 31.6% of the patients had prolong QTc and 42.1% had prolong QTd. 50% of those over 50 years had prolond QTc and 85% of those over 40 years had prolong QTd inspite of that relation of prolongation to age is not significant statistically [P more than 0.05], while the relation of QT intervals to duration of disease is significant statistically, female gender show clear association to prolongation of both QTc and QTd which is significant statistically [P less than 0.05] and inspite of the relation of prolongation of QT intervals to increase in BMI but was not significant statistically. QTc and QTd prolongation is more common in diabetics who is complaining of symmetrical peripheral sensory neuropathy specially if duration of diabetes is more than 5 years and more in females than males

Oral carriage rate of candida species in diabetic patients

It is well known that oral carriage of Candida species increase in many situations, like obesity, debility, leukemia, viral infection, use of certain drugs in addition to diabetes mellitus. Find the relation between diabetes and its control on oral carriage of Candida. Thirty four hundred oral swabs from diabetic patients 67% are females and 33% are males, 41.7% are type 1 diabetes and 58.3% are type 2.different culture media are used. We found that 37.9% of diabetics had oral carriage, older age group had more but the difference is not significant statistically P>0.05, in addition females carry more Candida than males P<0.05, while type of diabetes had no effect on oral carriage we found that control of diabetes had significant effect P<0.01. There is high carriage rate of Candida species in oral cavity of diabetic patients 37.9%, the rate of carriage increase in females and those with poor control. Candida albicans is the most common type with all the associated factors

Oral carriage rate of Candida species in diabetic patients

It is well known that diabetes is one of the predisposing factors, which affect the oral carriage rate of Candida species, in this paper we try to study the size of this problem. A total of 340 oral swabs from diabetic patients [type l and 2], 67% females and 33% males taken, results show that 37.9% of those had isolates of Candida species older patients had higher carriage rate but is not significant statistically [P>0.05]. Females had higher carriage raw [P<0.0l] possibly due to hormonal difference no difference found between type 1 and 2 of diabetes [P>0.05]. Those with poor control had higher carriage rate than those with good control [P<0.01]. In this study we see that being diabetic, female, with poor control had high chance to had oral carriage of Candida especially of albicans type