ABSTRACT
Background: Obstructive sleep apnea [OSA] is a condition of sleep related pharyngeal collapse, in which recurrent episodes of upper airway occlusion occur during sleep causing diminution [hypopnea] or cessation of airflow [apnea] in the pharynx provoking arousals and sleep fragmentation, resulting in daytime sleepiness. Oximetry alone is very valuable tool in the diagnosis and management of OSA, it can identify most cases allowing referral for continuous positive airway pressure [CPAP] treatment
Objective: To evaluate the overnight oximetry monitoring as a swift and accessible
Patients and Method: Cross sectional study of 20 patients, 12 males and 8 females with high probability of OSA, attended to respiratory clinic in Baghdad teaching hospital suffering from excessive daytime sleepiness, they were clinically evaluated plus using overnight oximetry as an objective testing method
Results: The study sample was 20 patients, 12 males [60%], 8 females [40%], mean age 48 years, mean BMI 45.6 Kg/m[2], female mean BMI 53.1 Kg/m[2], male mean BMI 37 Kg/m[2], and mean basal Po2 saturation 89.6 %. Desaturation index [DI] show significant correlation with AHI, BMI, and gender, while no significant correlation with age. AHI show significant correlation with baseline SPO 2 and gender, and no correlation with BMI and age
Conclusion: Desaturation index assessed by nocturnal pulse oximetry maintain its utility as a screening method in the recognition of obstructive sleep apnea in obese patients with high clinical pretest suspicion. DI when combined with appropriate clinical evaluation could be used as an initial diagnostic test for OSA
ABSTRACT
Prescription of appropriate antihyperglycemic agent depending on the standard guidelines has an important role in controlling diabetes and improving patient health. The aim of the present prospective study is to follow-up the adherence of prescribers to the standard guidelines for the prescription of anti-diabetic drugs in patients with type 2 diabetes mellitus. A prospective clinical trial was carried out on 64 individuals (43 patients and 21 healthy volunteers) of both sexes with the age range from 40-70 years. Parameters followed-up were fasting blood glucose (FBG), lipid profile, liver and renal function tests. The values of these parameters (at admission and after 3 months of follow-up) were calculated and compared with that of the control group and with the recommended treatment goals stated by American Diabetes Association (ADA) and the American Association of Clinical Endocrinologists (AACE/ ACE). Despite of continued treatment, no improvements were seen regarding followed-up parameters. It has been suggested that the adherence of prescribers to the standard guidelines for prescription of anti-diabetic agents is poor in our center, all patients evaluated have highly uncontrolled hyperglycemia where different anti-hyperglycemic drugs fail to attain glycemic control, and therapeutic strategy followed should be reconsidered.
ABSTRACT
Cadmium (C d) and zinc (Zn) are an industrial and environmental pollutant of aquatic system has attracted the attention of research's all over the world. In the present study the toxic effects of zinc (Zn) and Cadmium (C d) on the liver of male mice. Male Balb /c mice weighing 32-34 gm, 70 days old, were treated orally with (1-10 mg/kg body wt. CdCl2 and 1-8 mg/kg body wt. ZnCl2). The body weight, liver weight, histological examination of liver, along with DNA ladder for apoptosis was studied. Cadmium and zinc induced both a time, and dose dependent increase in apoptotic, severity of necrosis. Liver weight, body weight decreased with increase of dose. It has been concluded that cadmium and zinc caused necrotic effect in liver and apoptotic as well as decrease body weight and liver weight.
ABSTRACT
Background: The distinction between Burkitt lymphoma (BL) and diffuse large B-cell lymphoma (DLBCL) is not always easy, so much so that the WHO 2008 Blue Book has incorporated a provisional category of B-cell lymphoma, unclassifiable with features intermediate between DLBCL and BL." One of the immunohistochemical (IHC)markers used at time to differentiate between the two is IHC expression of BCL2, which was initially believed to be consistently negative in BL. Later it was recognized that weak BCL2 expression is still compatible with the diagnosis of BL. To verify or otherwise this current view this study was undertaken. Materials and methods: We retrieved 39 confirmed cases of BL, in both children and adults. All these cases had typical morphology IHC profile, and Mib-1 index that are typical of BL. All these cases were then stained with a monoclonal antibody against BCL2 oncoprotein, using 2-step Envision system. Results: Out of 39 cases,31 cases (79.4%) were completely negative for BCL2, whereas 5 (12.8%) were weak focal positive. However, another 4 (10.2%) cases did show strong diffuse Cytoplasmic staining for BCL2. fluorescent in-Situ hybridization (FISH) for t(14:18) was optimally done on 6 out of 9 cases. All these 4 cases were from adults with 3 out of 4 arising in the parotid region. Two out of 4 cases also showed t(8:14) on FISH. Conclusions: It was concluded that contrary to the common belief, stong BCL2 IHC expression is possible in typical BL in adults and cannot be absolutely relied upon to distinguish between BL and DLBCL.
ABSTRACT
Recent data indicated a high prevalence of abnormal glucose metabolism in patients with no history of diabetes mellitus [DM] at the time of acute myocardial infarction [AMI]. The aim of this retrospective study was to assess the predictive value for clinical outcome for admission hyperglycemia in patients presenting with acute ST-elevation myocardial infarction [STEMI]. Other risk factors such as history of DM, hypertension, Body Mass Index [BMI], smoking, serum level of glycosylated haemoglobin [HbA1c] and low density lipoprotein [LDL] were evaluated. The data of two hundred and eighty five [285] patients with STEMI was extracted and evaluated retrospectively. Patients were classified according to admission serum glucose [AG] into three groups: Group 1 with AG level of <=7 mmol/L and group 2 with AG level between >7 and <15 mmol/Land group 3 of AG >/= 15 mmol/L. In the study group the mean age was 59.7 +/- 14 years, range [24-88] and 180 [63%] were male. 173 [60%] patients with STEMI had hyperglycemic with glucose of more than 7 mmol/L with or without history of DM, eighty four [29%] patients had hyperglycemia and history of DM,89 [31%] patients had hyperglycemia [stress] without DM. Thirty two percent had history of hypertension and 26% had history of smoking. The frequency of more than two Major Acute Cardiac Events [MACE] such as pulmonary odema, significant arrhythmias, or cardiogenic shock were at frequency of 70% in group 3.19% in group 2, and 11% in group 1. Thirty patients died during the study [10.5%]: twelve patients [4.2%] were in group 3, eleven patients [3.9%] in group 2 and seven [2.4%] in group 1. The odds ratio of stress hyperglycemia in group 3 compared with group 1 after adjustment for age and sex as predictor of mortality was 3.3 [Cl 0.99-10.98, P=0.032, like wise, the odds ratio in group 2 compared with group 1 after adjustment was 2.4 [Cl: 0.75- 8.07, P=0.065].The history of DM, high serum level of LDL and the level of HBA1 c and Anterior AMI were significant predictors of adverse outcome while other risk factors such as BMI, history of hypertension and smoking were of no significance. These data indicate that hyperglycemia of more than 15 mmol/L on admission without history of DM is powerful predictor of adverse clinical outcome in the setting of acute myocardial infarction. Other useful predictors are history of DM, and high serum level of glycosylated hemoglobin, LDL and the site of anterior MI on ECG. The BMI, history of hypertension and smoking are not useful predictors of adverse mortality
Subject(s)
Humans , Male , Female , Glycated Hemoglobin , Blood Glucose , Predictive Value of Tests , Retrospective Studies , Diabetes Mellitus , Hypertension , Body Mass Index , Smoking , Cholesterol, LDLABSTRACT
To compare local infiltration anesthesia plus sedation with spinal anesthesia for pilonidal sinus surgery, with respect to recovery time, postoperative complications and patient satisfaction. This study was conducted at Prince Hashem Military Hospital, Zarqa. A total of 64 patients were randomized into two groups; local infiltration anesthesia group [n=32] received local anesthesia of 20 ml 0.5% bupivacaine infiltrated around the pilonidal sinus plus 1.5-3 mg intravenous midazolam and spinal anesthesia group [n=32] received 1.5 ml of 0.5% bupivacaine into the subarachnoid space as spinal anesthesia. Perioperative side effects, visual analogue pain scale score for three days, patient satisfaction and hospital stay were recorded and assessed. Patients in the spinal anesthesia group spent more time in the operating theater and recovery room. Two thirds of the patients in the local infiltration anesthesia group [65.6%] left the hospital on the day of surgery, compared to only [34.4%] in the spinal anesthesia group. About 91% were satisfied in-group local infiltration anesthesia in comparison to 75% in the spinal anesthesia group Postoperative complications occurred in five patients of spinal anesthesia group [3 urinary retention and 2 spinal headache]. Sacrococcygeal local infiltration anesthesia for pilonidal sinus resulted in lower complications, shorter hospital stay and more postoperative patient's satisfaction