Influence of diabetes on the outcome of acute coronary syndrome in Kuwait

To describe the baseline characteristics and management of patients with and without diabetes mellitus [DM] hospitalized with acute myocardial infarction [AMI] and to assess the influence of DM on hospital outcomes and hospital mortality. We analyzed data from a 6-month observational study [Kuwait Acute Coronary Syndrome Registry] of unselected patients admitted with a diagnosis of AMI over a period of 6 months, from December 2003 through May 2004. Of 1,295 patients enrolled, 609 [47%] were diabetics and 686 [53%] were non-diabetics. Diabetics were more likely to have a past history of coronary artery disease, hypertension and left ventricular systolic dysfunction than non-diabetics. There was less use of beta-blockers and aspirin in diabetics as compared to non-diabetics [62 vs. 71% and 95.5 vs. 97.9%, p<0.03, for beta-blockers and aspirin, respectively]. Left ventricular failure and cardiogenic shock occurred more often in diabetics compared to non-diabetics [16 vs. 7% and 5 vs. 3%, p<0.001, for left ventricular failure and shock, respectively]. The mortality rate was 6% for diabetics and 2% for non-diabetics [p<0.001]. DM is a major health problem among the adult population in Kuwait and almost half the AMI population suffer from diabetes. Diabetic patients had higher rates of complications, especially left ventricular failure and cardiogenic

Neurosarcoidosis as a first presentation of systemic sarcoidosis: case report

Neurosarcoidosis [NS] is a well-recognized complication of systemic sarcoidosis, but it is an uncommon first presentation of the disease. Moreover, seizure disorder is a much less common presentation of this subset. We report a case of a 30-year-old male admitted with status epilepticus due to NS. Magnetic resonance imaging [MRI] of the brain demonstrated multiple nodular lesions. Chest radiograph showed bilateral hilar lymphadenopathy that proved by histopathological examination to contain non-caseating granulomas [NCG]. Other causes of granulomatous lesions were excluded by relevant investigations. Corticosteroids [CS] markedly improved the clinical and radiological findings. Seizures were well controlled by antiepileptic drugs