Role of novel cardiac biomarkers in prediction, diagnosis, and severity assessment of atherosclerotic coronary artery disease

Atherosclerotic cardiovascular disease is a major health problem around the world. Insulin resistance assessed by homeostatic model assessment of insulin resistance [HOMA-IR], triglyceride/ HDL, serum high sensitive C-reactive protein [hs-CRP], and HbA1c are probably associated with atherosclerosis. The aim of this study was to find if there was an association between HOMA-IR, triglyceride/ HDL ratio and their product as well as hs-CRP and HbA1c with the presence and the severity of coronary artery disease and to find the best cut off value for clinical practice. The study involved 170 consecutive patients with suspected or known CAD referred for coronary angiography divided into two groups; CAD group [Group I] and non CAD group [Group II] based on coronary angiography. The blood samples including HbA1c, hs-c-reactive protein, fasting blood glucose creatinine, urea, insulin and lipid spectrum were obtained after overnight fasting. Patients with CAD had higher HOMA-IR than those no CAD [4.47 +/- 4.26 vs. 2.49 +/- 1.99, p=0.002]. Stepwise multiple logistic regression analysis demonstrated that HOMA-IR > 2.66 was independently associated with CAD [odds ratio: 3.057 ; 95% confidence interval: 1.211-7.717; p=0.018] after adjustment for age, male sex, diabetes and waist circumference. HOMA-IR correlates positively with BMI [p=0.008 and r=0.227], waist circumference [p=0.002 and r=0.267] and HbA1c [p=0.015 and r=0.213]. Also HOMA-IRxTG/HDL was higher in patients with CAD compared to those no CAD [18.35 +/- 22.72 vs, 9.50 +/- 10.50, p=0.018]. However there were insignificant differences in levels of triglyceride/HDL, HbA1c, and hs-CRP among both groups [p= 0.124, 0.523, 0.250 and 0.764 respectively]. HOMI-IR was significantly higher in patients with DVD [Double-vessel Disease] and MVD [Milti-vessel Disease] compared to patients with no CAD [p=0.002 and 0.000 respectively]. Moreover HOMA-IR was significantly higher in patients with DVD and MVD compared to patients with SVD [Single-vessel Disease] [P=0.035, 0.001 respectively]. HOMA-IR x TG/HDL was significantly increased in DVD and MVD patients [P=0.012 and 0.001 respectively] compared to patients with no CAD and also when compared to patients with SVD [P=0.005 and 0.000 respectively]. HOMA-IR is considered as a marker for prediction of CAD and severity assessment

Evaluation of the effect of sildenafil and/or doxazosin on Benign prostatic hyperplasia-related lower urinary tract symptoms and erectile dysfunction

To verify the association between lower urinary tract symptoms [LUTS] and erectile dysfunction [ED] and evaluate the influence of sildenafil and doxazosin either as single agents or combined on both symptoms. A prospective randomized study including 150 patients presented with LUTS caused by BPH in association with clinically diagnosed ED, with age equal or more than 45 years from April 2010 to April 20011. They were categorized into three comparative groups each one containing 50 patients. These groups were comparable regarding pretreatment international prostate symptoms score [IPSS] and international index of erectile function [IIEF]. The patients of the first group were given sildenafil 50 mg as monotherapy, those of the second group were given doxazosin 2 mg and those of the third group were given combination of both drugs for 4 months for each group. The main post-treatment parameters for assessment and comparison include assessment of patient's symptoms by repeated IPSS and IIEF, uroflowmetry and assessment of PVR. The statistics was done by use of the chi-square test Pre-treatment parameters were assessed and compared between the three groups. After 4 months of treatment, the comparative parameters were applied to all groups and the differences were measured post-treatment regarding IPSS, erectile function score, uroflowmetry, and post-void residual [PVR] urine. Sildenafil alone caused mild improvement in IPSS, more improvement in IIEF score, and little effect on flow rate and PVR urine. Doxazosin alone caused more improvement in IPSS, flow rate and PVR urine and less improvement in IIEF score. A combination of both sildenafil and doxazosin caused more improvement in all of the comparative parameters than when each drug was given alone. There is a strong relationship between LUTS and ED. Doxazosin or sidenafil as a single drug could be used in treating mild or mild to moderate symptoms but more severe symptoms may usually need a combination of both drugs

Management of symptomatic ureteral calculi during pregnancy: experience of 23 cases

To present our experience in the management of symptomatic ureteral calculi during pregnancy. Twenty-three pregnant women, aged between 19 and 28 years presented to the obstetric and urology departments with renal colic [17 cases, 73.9%] and fever and renal pain [6 cases, 26.1%]; suggesting ureteric stones. The diagnosis was established by ultrasonography [abdominal and transvaginal]. Outpatient follow-up consisted of clinical assessment and abdominal ultrasonography. Follow-up by X-ray of the kidneys, ureter, and bladder [KUB], or intravenous urography [IVU] was done in the postpartum period. Double J [DJ] stent was inserted in six women [26%] with persistent fever followed by extracorporeal shock wave lithotripsy [ESWL] one month post-partum. Ureteroscopic procedure and pneumatic lithotripsy were performed for 17 women [distal ureteric stone in 10, middle ureter in 5, and upper ureteric stone in 2]. Stone-free rate was 100%. No urologic, anesthetic, or obstetric complications were encountered. Ureteroscopy, pneumatic lithotripsy, and DJ insertion could be a definitive and safe option for the treatment of obstructive ureteric stones during pregnancy

Penile fracture: evaluation, therapeutic approches and outcome result. single surgeon experience

The experience of a single surgeon with a series of23 penile fractures, including 21 corrected surgically and 2 managed conservatively, in 3 year period is presented .Standard diagnostic and therapeutic modalities are described. Between December 2004 and October 2007, 23 patients 19 to 58 years old [mean age 38] were evaluated in Assiut university hospital after blunt trauma to the erect penis. The interval from injury to presentation was between 2 and 72 hours. Of these patients, 18 had been injured during sexual intercourse, 3 had been injured during manual detumescence, and 2 due to rolling over in bed. Sonography and MRJ were used for diagnosis in all patients. Surgery in 21, involved a subcoronal incision and degloving in 15 patients and inguinal scrotal incision in 6 patients. 2 patients were treated conservatively after diagnosed by MRJ as deep dorsal vein rupture. Injury involved unilateral and bilateral corporeal rupture in 18 and 3 cases, respectively, and urethral injury in 4. At follow up, all patients [23] reported normal erection and voiding. Mild glanular parathesia on erection and numbness were experienced in 2 patients explored by subcoronal incision and degloving. This study confirmed the overall superiority of immediate surgical repair. MRI is a good and reliable tool for diagnosis of fracture penis and affects the mode of freatment whether conservative or surgical. Scrotal inguinal incision as a method of exploration in fracture penis is effective and reliable as well as subcoronal incision and degloving

Preliminary pharmacological study of the pterocarpans macckian and trifolirhizin isolated from the roots of ononis vaginalis

Preliminary pharmacological study was conducted for the pterocarpans macckian [Mac] and trifolirhizin [Trif]. The two compounds isolated from Ononis vaginalis were tested for their hepatoprotective effects against CCU[4] induced hepatotoxicity in rats. Activity was accessed by measuring liver enzymes and NP-SH groups. Estrogenic activity was expressed as increase in uterine weight of young female rats. Rat paw edema as a model of acute inflammation induced in Wistar rats using carragenan was used to evaluate the anti-inflammatory activity. Percentage inhibition of the aggregation induced by adenosine diphosphate [ADP] to platelets-rich plasma [PRP] obtained from rats was used as measure for antiplatelet aggregation effect. The aglycone Mac was only more active than the glycoside Trif in the anti-inflammatory assay. It resulted in 65.7% reduction in carregeenan induced rat paw edema compares with 79.8% reduction by indomethacin at the same molar concentration. The activity of Trif was about half of that of silymarin in reducing the elevated levels of liver enzymes at the same molar concentration. About 10 fold molar concentration of Trif produced about half fold increase in uterine weight produced by 17 beta estradiol

Flavonoids from morus nigra L. grown in Saudi Arabia

The ethyl acetate extract of Morus nigra L. leaves grown in Saudi Arabia afforded three known flavonoids; kacnipferol, Kaempferol-3-O-beta-D-glucopyranoside [astragalin] and quercetin-3-O-beta-D-glucopyranoside [isoquercitrin]. The Structures were determined utilizing different physical, chemical and spectroscopic data

Characterization of two isolates of prunus necrotic ringspot virus [PNRSV] from peach and apricot in Egypt

Two isolates of PNRSV were isolated from peach and apricot trees at the Experimental Station of the Faculty of Agriculture, Cairo University, Giza, Egypt. The peach isolate of PNRSV [PNRSV-PF] was differentiated from the apricot isolate [PNRSV-AP] by ten differential host species. Both isolates were purified successfully with the electro-elution technique. Both isolates had A[max] and A[min] at 260 and 240 nm respectively. The A260/280 ratios were 1.55 and 1.60 for the AP and the PF isolates, respectively. Electron microscopy examination showed spherical virions with ca 27-29 nm in diameter. Both isolates had molecular weight of coat protein subunits of 29 kDa, determined by polyacrylamide gel electrophoresis [SDS-PAGE]. Antisera raised against the two isolates detected their counter antigens in peach and apricot trees. Both antisera cross reacted with their homologous and heterologous antigens in dot blot immunoassay [DBIA] and agar-double diffusion [ADD] tests. The two virus isolates appeared to belong to the same sero-group and represent two different pathotypes. PNRSV-AP varied in sero-grouping of that of beet necrotic ringspot ilarvirus, a tentative isolate of PNRSV, when examined in ADD test. Indirect ELISA showed that 64.2% of 210 tested apricot trees were infected, while 150-inspected peach trees showed 29.5% infection. Four sets of primers were used to amplify both movement protein [MP] and coat protein [CP] genes of the two Egyptian isolates of PNRSV isolated from apricot and peach trees. Amplicons of the correct size [ 894 bp] for the MP gene and [ 704 bp] for the CP gene were obtained from the two examined isolates of PNRSV. Nested PCR using specific primers for both the MP and the CP genes confirmed the authenticity of the PCR amplified products. RT-PCR detected successfully the presence of PNRSV in the pollen grains of infected apricot and peach trees. Nucleotide sequences of the MP genes of the two isolates were revised by the GenBank and given the accession # EU100388 for the peach isolate and EU106649 for apricot isolate. Phylogenetic analysis of RNA 3-MP showed ca 65% similarity between PNRSV-AP and PNRSV-PF; indicating that the two isolates of PNRSV are distantly related. The relatedness between the two isolates and other PNRSV isolates is discussed

Biological, serological and molecular studies on prunus necrotic ring spot virus infecting Rosa hybrida L. in Egypt

Prunus necrotic ring spot virus [PNRSV] was isolated for the first time in Egypt from naturally infected rose plants collected from the experimental farm of the Faculty of Agriculture, Cairo University. Observed symptoms circumvented necrotic ring spots on leaves, bud failure, and color breaking of petals. The virus was transmitted mechanically. The purified virus had Amax and A min at 260 and 240 nm respectively. The 260/280 ratio was 1.56. Yield of purified virus from infected Gompherina globosa was 0.182 mg/g tissue. Electron micrograph of the purified virus showed spherical [23-nm] as well as bacilliform virus particles [42x23 nm]. The induced antiserum from the purified virus was successfully used to detect PNRSV in rose plants in several locations in Egypt. The full length of the replicase gene of PNRSV was successfully amplified by reverse transcription-polymerase chain reaction [RT-PCR] using different sets of specific primers. A sensitive and specific IC-RT-PCR protocol was used for the detection of PNRSV from rose tissues. Sequence analysis of PNRSV/rep gene of the rose isolate indicated 60% similarity to that of PNRSV-AF278534 and NC-004362

Phytochemical and biological study of the aerial parts of lotus lalambensis growing in Saudi Arabia

Phytochemical investigation of the aerial parts of Lotus lalambensis Schweinf resulted in the isolation and identification of 20 known compounds. Liquid-Liquid fractionation of the crude extract followed by chromatographic purification resulted in the isolation of lupeol, beta-sitosterol, oleanolic acid, beta-sitosterol glucoside and stigmasterol glucoside from the petroleum ether fraction. The chloroform fraction afforded heptadecanol, kaempferol [1], kaempferol-3-O-alpha-L-rhamnoside [2], lotaustralin [3], epilotaustralin [4], linamarin [5], kaempferol-3,7-di-O-alpha-L-rhamnopyranoside [kaempferitin] [6] and ethyl-O-beta-D-glucopyranoside [7]. From the ethyl acetate fraction three simple rhamnosyl derivatives; butyl-O-alpha-L-rhamnopyranoside [8] methyl-O-alpha-L-rhamnopyranoside [9] and methyl-O-beta-L-rhamnopyranoside [10] were obtained. Kaempferol-3-0-beta-D-glucopy-ranoside-7-O-alpha-L-rhamnopyranoside [11], kaempferol-3-O-alpha- [beta-D-glucopyranosyl-[1""->2'"]- L-rhamnopyranoside]-7-O-alpha-L-rhamnopyranoside [12], kaempferol-3-O-beta-D-glucopyranoside-7-O-alpha-[beta-D-glucopyranosyl-[1""->2'"]-L-rhamnopyranoside] [13] and the myo-inositol [+] D-pinitol [14] were isolated from the butanol extract. The total extract and different fractions were evaluated for their possible estrogenic, anti-inflammatory and anti-platelets aggregation activities. The chloroform extract showed the highest estrogenic activity, while the petroleum ether was the best in protection against inflammation induced by carrageenan. The strongest inhibition of platelet aggregations was observed with the aqueous fraction

GC/MS analyses, anti-inflammatory and anti-microbial activities of the volatile constituents of three clematis species growing in Saudi Arabia

A comparative study of the volatile constituents of three Clematis species growing in Saudi Arabia namely Clematis hirsute Guillemin and Perr, C simensis Fresen and C wightiana Wallich was carried out using GC/MS technique. Protoanemonin, eugenol and butylated hydroxyltoluene were the most abundant common constituents in the three species. Volatiles of Clematis hirsute and C simensis showed closely similar MIC when tested against Gram-positive, Gram-negative bacteria and fungi. While those of C. wightiana were less active. Similarly, the anti-inflammatory activity of C. wightiana was less than that of the other two species

GC/MS analysis of the fatty acids of three Clematis species growing in Saudi Arabia and their anti-inflammatory activity

A comparative study of the fatty acid contents of three Clematis species growing in Saudi Arabia namely Clematis hirsuta, C. simensis and C. wightiana was carried out This comparison was preformed by GC/MS technique. Plamitic acid represented the major fatty acid in the three species. The anti-inflammatory activity of the three species was also conducted. The petroleum ether fraction of the ethanol extracts exhibited the highest activity

Disturbance of some coagulation and fibrinolytic factors in essential hypertension

Hypertension is an established risk factor for acute coronary events. Growing evidence is now apparent that hypertension is accompanied by hypercoagulable and/or hypofibrinoltic state, both of which can be the cause of several cardiovascular risk factors noticed with hypertension. To show the relationship between hypertension and some components of fibrinolytic and coaguIation systems . In this study, the plasma levels of fibrinogen, FVII, D-dimer, t-PA and PAI-I were studied in three groups of male persons. A hypertensive group of patients [16], complicated hypertensive group [16] and a group of normotensive persons [16] were included in this work Patients were selected from outpatient clinic of Cardiology Department, Assiut University Hospital, during the period from December 2001 until December 2002. The mean plasma levels of fibrinogen, FFVII, t-PA, PAZ-I and D dimer before treatment of the hypertensive and complicated hypertensive groups were significantly higher than that of the normotensive group .The mean plasma levels of these factors [except FVII] in the complicated hypertensive group were significantly higher than that of the hypertensive group. After treatment of these groups, the mean plasma levels of all factors decreased significant and there was no significant difference between the two groups. It is clear from this study that there are disturbances in the levels of coagulation and fibrinolytic factors in hypertensive patients particularly in the complicated hypertensive patients. This indicates severity of disturbance of these factors in hypertensive patients making them risk factors for the development of coronary heart disease, myocardial infarction, unstable angina, etc

Tropical latanoprost in cases of uncontrolled glaucoma

Forty-two eyes of 42 patients were enrolled in this study to evaluate the ocular hypotensive effect of latanoprost. Latanoprost 0.005% was administered once daily as a single drop early in the morning, the other ocular medications were continued. A reduction in intraocular of 20% or more from the baseline intraocular pressure was considered a good response. In the 42 eyes, the mean baseline intraocular pressure was 23.2 +/- 7.2 mmHg. Intraocular pressure was significantly reduced compared with baseline measurements. The mean intraocular pressure reduction was 4.1 +/- 5.2 mmHg after one month, 4.0 +/- 5.8 mmHg after three months and 3.6 +/- 4.2 mmHg after six months. A reduction of intraocular pressure by 20% from the baseline intraocular pressure was achieved in 28 eyes after six months follow up. A reduction of 40% or more was observed in 16 eyes after six months follow up

study on the relation between proton pump inhibitor and gastric giardiasis

Thirty patients treated with proton pump inhibitor and still having symptoms related to gastritis or peptic ulcers were subjected to upper gastrointestinal endoscopy and gastric biopsy for detection of giardiasis in these cases. Results showed presence of 3 [10%] cases of gastric giardiasis, intestinal metaplasia and presence of H. pylori in these cases. It was concluded that there may be a relation between the presence of gastric giardiasis and the intake of proton pump inhibitor

Causes of minimal hepatic periportal fibrosis present in Egypt

This study aimed to elucidate the common causes of minimal periportal fibrosis in Egypt. Out of 50 patients having minimal periportal fibrosis, 22 had schistosomiasis as a sole etiology and 33 had combined schistosomiasis with both HBV and HCV. Rare causes included tuberculosis in 4% of the patients and HIV in 2%. No cause could be elicited in 14% of the patients. It was concluded that although schistosomiasis is the commonest cause of minimal hepatic fibrosis in Egypt, yet it is not the sole etiological factor

Coumarins with antiviral and cytotoxic activity from Egyptian panunculus asiaticus L

Three coumarins were isolated from the CHCl3 extract of the aerial parts of Ranunculus asiaticus L. [Ranunculaceae]. They were identified as aesculetin dimethyl ether [6,7-dimethoxy-coumarin] [I], isoscopoietin [II] and scopoietin [III], based on their spectral and physical data. The cytotoxic and antiviral activities of I and III were evaluated

Constituents of convolvulus lanatus vahl with antiviral and cytotoxic activity

Three coumarins; namely, scopoietin [I], umbelliferone [II] and esculetin [III] as well as caffeic acid [IV] and a flavone glycoside, isoquercitrin [V] were isolated from EtOAc extract of the aerial parts of Convolvulus lanatus Vahl. [Convolvulaceae]. The identification was based on spectral and physical data of the isolated compounds. The cytotoxic and antiviral activities of compounds I, IV and V were evaluated

Insulin resistance syndrome in pre-eclampsia

This study is designed to determine if hyperinsulinaemia, hypertension, hypertriglyceridaemia, and low level of high density lipoprotein 2[HDL[2]] cholestrol are present in women with non-proteinuric hypertension or pre-eclampsia. In 40 cases pregnancy - induced hypertension [20 non-proteinuric hypertension and 20 pre-eclampsia] and 20 healthy pregnant women [control group]. Serum concentration of insulin, triglyceride and HDL2 cholesterol were measured It has been found that insulin and triglyceride were significantly increased while HDL2 cholesterol was significantly decreased in both non-proteinuric hypertension and Pre-eclampsia as copmared with the control group. There was no significant difference in serum concentrations of insulin, triglyceride or HDL2 cholesterol between both groups of pregnancy induced hypertension. It has been concluded that the metabolic characteristics of insulin resistance syndrome are present in non-proteinuric hypertension, but they are not aggravated in Pre-eclampsia. Although these metabolic perturbations may be related to the pathogenesis of Pre-eclampsia, it is propable that Pre-eclampsia has characteristic serum factor[s] responsible for the pathopysiological changes in this symlrome