pulse pressure as a predictor of increased cardiac risk in middle-aged hypertensive patients

This work aimed to study the pulse pressure [PP] as a predictor of increased risk of cardiovascular diseases [CVD] in middle-aged hypertensive patients. This study included 100 middle-aged patients with newly diagnosed essential hypertension and had not received any anti-hypertensive medications previously. PP was calculated for all patients who were classified into 2 groups; hypertensives with PP 50 mmHg. All the included patients have been studied by electrocardiography and echocardiography. The number and percentage of patients with left ventricular hypertrophy [LVH] were significantly higher in the group of hypertensive patients with PP>50 mmHg than those with PP 50 mmHg than those with pp 50 mmHg in middle-aged hypertensive patients is a predictor of LVH and increased risk of CVD independent of SBP so, the width of PP must be considered in the risk assessment of hypertensive patients and antihypertensive medications reducing the PP should be evaluated in the future

Osteopenia in patients with type 1 diabetes: prevalence and some aspects of pathophysiology

To evaluate the prevalence of osteopenia in patients with type 1 diabetes and its relationship to the metabolic control of diabetes. Also, to study if there is any changes in the biochemical markers of bone formation in type 1 diabetics. This study included 50 male patients with uncomplicated type 1 diabetes, their ages ranged from 18 to 33 years with mean +/- SD [25.3 +/- 5.4 years] and also, sex and aged matched 20 healthy subjects were included as control group. The bone mineral density was measured at the calcaneal bone for all participants using quantitative ultrasonometry. Laboratory evaluation also was done, including glycosylated hemoglobin, serum levels of calcium, phosphate, alkaline phosphatase and osteocalcin. The prevalence of osteopenia in patients with type 1 diabetes was 62% and 8% of type 1 diabetics met the criteria of osteoporosis. Type 1 diabetic patients had significantly lower levels of mean serum osteocalcin than the control group. Also, type 1 diabetic patients with calcaneal osteopenia had significantly higher levels of mean serum glycosylated hemoglobin and sign significantly lower levels of mean serum osteocalcin than those diabetics without calcaneal osteopenia. Osteopenia is frequent in patients with type 1 diabetes with prevalence of 62% and 8% of type 1 diabetics met criteria of osteoporosis. This diabetic osteopenia results mainly from decreased bone formation and the poor metabolic control. We recommend screening of type 1 diabetics for osteopenia and optimization of metabolic control to prevent osteoporosis

Predictors of presence of oesophageal varices in cirrhotic patients without a previous history of variceal bleeding

Current medical management dictates that all cirrhotic patients without a history of variceal bleeding undergo endoscopic screening for the presence of oesophageal varices [OV]. However, referral for endoscopic screening of only patients at high risk for varices may be cost-effective. To identify clinical, laboratory, and ultra-sonographic parameters that predict the presence of OV in patients with liver cirrhosis. The study included 100 patients with liver cirrhosis without a history of variceal bleeding. A complete blood count, complete liver function tests, abdominal ultrasonography, and upper gastrointestinal endoscopy were done for all patients. Also platelet count/spleen diameter ratio [P/S ratio] was calculated for all patients. Cases defined as the presence of any oesophageal varices [OV] and controls defined as no oesophageal varices [NOV]. Logistic regression analysis was performed to evaluate association between the presence of O/ and patient characteristics. The prevalence rate of OV was 76% of cirrhotic patients. We found that platelet count, spleen diameter, P/S ratio, portal vein diameter, ascitis, serum albumin, serum bilirubin, prothrombin time and concentration, and Child-Pugh's classes were significantly different among patients with and without OV. In a multivariate analysis, the P/S ratio was the only parameter which was independently associated with the presence of OV. The prevalence adjusted positive and negative predictive values of P/S ratio cut-off value