Dose response effect of nitroglycerin on cardiac hemodynamic functions and myocardial infarction in a rat model of ischemia reperfusion

Background: Millions of people suffer from acute coronary syndrome, angina, acute myocardial infarction [MI], or related illnesses. These patients are prescribed nitroglycerin [NG] for the management of these diseases. Accordingly, any risk associated with the use of nitroglycerin can potentially affect those people despite of the undeniable benefit in relieving acute angina

Aim of the present work: was to study the potential of treatment with 3 different doses of NG [25, 50, 100 mg/kg] to develop nitrate tolerance

Materials and Methods: 50 Male Albino rats were randomly divided into 2 main groups: sham group and ischemia/reperfusion [I/R] groups, which was further subdivided into 4 groups, Untreated group; NG 25, 50 and 100 mg groups; rats received nitroglycerin three times daily for 3 days before induction of ischemia reperfusion. The effect of NG on cardiac functions and infarction size and severity score were assessed

Results: Rats exposed to I/R exhibited a significant decrease in their cardiac hemodynamic functions [[upwards arrow] left ventricular end diastolic pressure; LVEDP and [downwards arrow]dp/dt[max]] and development of a measurable cardiac infarction area. Regarding pretreatment with NG; NG 25 mg/kg improved cardiac functions and myocardial infarction size and severity score. NG 50 mg/kg significantly decreased myocardial contractility and increased myocardial infarction size. Meanwhile NG 100 mg/kg produced significant decrease in cardiac functions and significant increase in myocardial infarction size and severity score

Conclusion: NG pretreatment dose dependently decreased cardiac hemodynamic functions and increased myocardial infarction size and severity score in a rat model of ischemia reperfusion

Epidemiology of prehypertension and hypertension among Egyptian adults

We aimed to describe the prevalence and predictors of prehypertension and hypertension in the Egyptian adult population aged 25 and above. We also described the rates and predictors of awareness, treatment and control of hypertension. Data on 6671 individuals from the 2008 Egypt Demographic and Health Survey [EDHS 2008] were used. Prevalence of prehypertension and hypertension by selected variables was calculated. Logistic regression analysis was used to elicit modifiable risk factors for prehypertension and hypertension, and the population attributable fractions [PAF] for these risk factors were calculated. The prevalence and predictors of awareness, treatment and control for hypertensives were calculated. The overall prevalence rate of prehypertension and hypertension in Egypt were 57.2% and 17.6% respectively. Only 25.2% of the population had normal blood pressure levels of <120/80 mmHg. The highest prevalences of hypertension were found in Ismailia, Alexandria, Menya, Menoufia and Luxor governorates. The prevalence of hypertension among males and females was similar; however, females had a lower prevalence of prehypertension, and a higher prevalence of normal blood pressure, than males. Overweight and obesity were the most important modifiable risk factors of prehypertension and hypertension, accounting for 25% and 56% of the PAF, respectively. The rates of awareness, treatment and control were 54.2%, 43.4% and 21.3% respectively. The most important predictors of awareness were female sex, increasing age, high wealth, and private insurance coverage. No other predictors of treatment and control were found. Mass health education programs should be urgently implemented to encourage the Egyptian population to adopt healthy lifestyles to prevent hypertension and prehypertension, and to control hypertension. Screening and clinical guidelines should be implemented to improve awareness, treatment and control rates among hypertensives

Intrafamilial transmission of hepatitis B and C among families of multi-transfused Egyptian children

Several studies have reported clustering of hepatitis B virus [HBV] and hepatitis C virus [HCV] infection in households. We aimed to measure the prevalence of HBV and HCV infections among family members of known HBV and/or HCV positive children, and to identify possible routes of intrafamilial transmission. 68 children with known HBV and/or HCV infections [index cases] were recruited. Blood samples were obtained from 303 of their family members for analysis for hepatitis B surface antigen [HBsAg] and HCV antibodies according to the index case status. A detailed questionnaire was applied to all study participants to investigate possible routes of medical, community and household infection. 2 relatives of the HBV infected index cases were positive for HBsAg [prevalence of 1.3% [21154]]. Both infected subjects were adults, were unvaccinated with HBV vaccine, had previous medical interventions, and had accompanied the index case during hospitalisation. No HBsAg infections were detected among siblings of HBV index cases, all of whom were vaccinated with the HBV vaccine. Prevalence of HCV infection among family members of HCV positive index cases was 9.3% [24/258], higher than the 4.4% [2/45] found among family members of HCV negative index cases. On logistic regression analysis, risk factors for HCV infection were older age, medical interventions, higher crowding index, and exposure to the blood of index cases. Sharing towels, beds, and eating utensils were not found to be associated with HBV or HCV infection. Absence of HBV infection among younger people in this study may be due to their high HBV vaccination coverage. There was a relatively higher prevalence of HCV infection among family members of HCV-infected index cases. Direct exposure to blood of the index case appeared to be the most important route of intrafamilial infection

epidemiology of diabetes mellitus in Egypt: results of a national survey

It is estimated that by the year 2030, Egypt will have at least 8.6 million adults with diabetes. Little data is available on the epidemiology of diabetes in Egypt. We aimed to describe the epidemiology of known diabetes in the adult Egyptian population above the age of 20 years. Data from the 2008 Egypt Demographic and Health Survey [EDHS 2008] were used for this study. Prevalence of diabetes for selected socio-demographic variables was calculated by gender. Prevalence of comorbid conditions, and risk factors for complications of diabetes, were estimated by gender. Health care utilization among diabetics was estimated. The crude prevalence rate of known diabetes in Egypt in 2008 was 4.07% [0.25]. It increased with age, to reach 19.8% among females aged SO-S9. Only 18% of males, and 7.8% of females, had a normal body mass index. 37.S% of male diabetics smoked. The prevalence of hypertension among diabetics was 7S% for males, and 66.9% for females; of these, only 2% of males, and 14.3% of females, were controlled to < 130/80 mmHg. 13.3% of males had a history of myocardial infarction or stroke. 44.9% of males, and 80.4% of females, had no insurance coverage. More than half of diabetics visited a private physician at their last visit. 9.3% of males, and 3.8% of females, had been hospitalized in the past year. Diabetes is highly prevalent among older persons in Egypt. Public health policy should educate the public on the risk factors for diabetes, and should implement guidelines for adequate control of this disease

Sphincter saving resection after preoperative chemoradiation for T3 carcinoma of the lower rectum

Surgical treatment has evolved over the past ten years particularly for cancer involving the mid and lower third of the rectum. carcinomas of the lower third of the rectum are usually treated by abdominoperineal resection especially for T3 lesions. Few data are available evaluating Concomitant chemotherapy with preoperative radiotherapy for increasing sphincter saving resection [SSR] in low rectal cancer The purpose of this study was to evaluate the possibility of SSR for T3 cancers of the lower third of the rectum and subsequently the complication oncologic and functional results of preoperative chemoradiation followed sphincter saving procedure is assessed and determined. Twelve patients with T3 rectal carcinoma were treated by preoperative radiation with concomitant chemotherapy were included in the study. All patients had invasive adenocarcinoma of the rectum and underwent staging before treatment by endorectal ultrasonography All patients underwent conservative surgey after chemoradiation for low rectal cancer tumors located at a mean of 5 cm from the anal verge. Transanal intersphincteric resection was done in 7 patients. A colonic J-pouch was done in 2 patients. All patients had a defunctioning loop ileastomy. There were no deaths related to preoperative chemoradiation or surgery. Morbidity occurred in 33.3% of patients was complicated by a pelvic abscess that responded to conservative treatment. The other complications local recurrence at the anastomosis site at 13 months and was treated by salvage APR After preoperative chemoradiation all the tumors appeared as an ulcerative scar without any vegetative component. The mean tumor size in fresh specimens was 3.6 cm range [l-9]. The mean distal margin, assessed in fresh specimens without traction, was 23 +/- 8 mm [range 10-40]. The mean radial margin assessed microscopically was 8 +/- 4 mm [range 1-20]. Both distal and radial margins were negative [> 2 mm] in 11 [91.6%] patients; they were positive [