The Effect of Soluble Fiber Supplementation on Metabolic Syndrome Profile among Newly Diagnosed Type 2 Diabetes Patients

Diets with high fiber content improve most metabolic syndrome (MetS) profile in non-diabetic individuals, but there is scarce information about the role of fiber intake in patients with the MetS and diabetes. The objective of this study is to determine whether soluble fiber supplementation improve MetS profile for 8 weeks of intervention in newly diagnosed type 2 diabetes (T2D) adult patients. After one week of dietary stabilization phase, 36 newly diagnosed T2D patients were stratified to different strata according to sex, age, fasting blood sugar (FBS), and waist circumference (WC). Then they were randomly allocated into 2 groups. The psyllium group (n = 18) received 10.5 g of psyllium daily for 8 weeks. The control group (n = 18) maintained their regular diet for 8 weeks. Soluble fiber supplementation showed significant reduction in the majority of MetS profile; FBS (43.55 mg/dL, p < 0.001), triglyceride (37.89 mg/dL, p < 0.001), total cholesterol (20.32 mg/dL, p < 0.001), systolic blood pressure (7.50 mmHg, p < 0.001), diastolic blood pressure (2.78 mmHg, p = 0.013), and WC (2.54 cm, p < 0.001) in the intervention group compared with the control group after 8 weeks of intervention. The high-density lipoprotein cholesterol was reduced in both groups, but this reduction was insignificant. The improvement in the MetS profile was enhanced by combining psyllium to the normal diet. Consumption of foods containing moderate amounts of these fibers may improve MetS profile in newly diagnosed T2D patients. This study was registered in Current Controlled Trials (PHRC/HC/28/15).

Comparative study on renoprotective effect of aliskiren-pentoxifylline combination, valsartan and enalapril among patients with hypertension, type 2 diabetes mellitus and diabetic nephropathy

This study was conducted to evaluate the renoprotective effect of aliskiren-pentoxifylline combination and compare it with enalapril and valsartan in patients with hypertension, type 2 diabetes mellitus and diabetic nephropathy [DN]. Sixty patients with hypertension, type 2 diabetes mellitus and microalbuminurea [20-200microg/min or 30-300mg/24h] were selected from UNRWA and private clinics in Ga/a Strip and divided into three groups. The first group [n=20] was treated with enalapril [10-20mg/day], the second group [n=20] was treated with valsartan [I60mg/day], whereas the third group [n=20] was treated with aliskiren-pentoxifylline combination [150,400mg/day]. All patients were follovved-up for nine months by measuring serum creatinine level and urinary albumin excretion [UAE] rate before and at 3, 6 and 9 months of treatment. Paired T-test and independent T-test were used to analyze our results and the significance was tested at p< 0.05. The results showed a significant reduction in both UAE rate and serum creatinine level among patients who used aliskiren-pentoxifylline combination after 6 and 9 months of treatment, where the reduction was highly significant after 9 months of treatment [p=0.001 for UAE, p=0.000 for serum creatinine level]. In the valsartan treated group, the reduction in UAE rate was significant [p=0.045] after 9 months of treatment, while no significant reduction was noticed in serum creatinine level [p=0.807]. Moreover, no significant reduction was seen in UAE rate [p=0.125] and serum creatinine level [p=0.445] among patients who were given enalapril. In conclusion, aliskiren-pentoxifylline combination showed renoprotective effect more distinct than enalapril and valsartan among patients with DN

effect of apple cider vinegar and grape vinegar on lipid profile in albino white rats

This study was designed to determine and compare the effect of apple and grape vinegars on lipid profile in male Albino White rats. Fifty male albino white rats [Wt.200-300 gram] divided into five groups with 10 rats in each group. The control group [G1] was fed standard animal food. Group 2 [G2] and group 3 [G3] were fed apple cider vinegar in their food for 4 weeks [3%, 6%, respectively], while group 4 [G4] and group 5 [G5] were fed grape vinegar in their food for 4 weeks [3%, 6%, respectively]. Blood samples were collected at the start and at the end of the experiment to assess total cholesterol [TC], triglyceride [TG], high density lipoprotein cholesterol [HDL-c] and low density lipoprotein cholesterol [LDL-c]. Results showed significant reduction in TC, TG, and LDL-c, associated with significant elevation in HDL-c after 4 weeks of vinegar feeding. The significant changes seen upon vinegar feeding on lipid profile were directly correlated with the concentration used. In conclusion, vinegars would have beneficial effect in cardiovascular disease reduction

[Adequacy of glycemic control and serum lipid profile in hemodialysis of Palestinian patients with diabetes mellitus]

Inadequate glycemic control and lipid abnormalities which are prevalent among diabetic patients on hemodialysis may act synergistically to place these patients at an augmented risk for morbidity and mortality of diabetic complications. The purpose of this case-controlled study was to assess the glycemic control and prevalence of dyslipidemia among diabetics who were on hemodialysis, by following them up for ten months and carrying out the following measurements, glycated hemoglobin [A[1c], LDL, HDL, total cholesterol, and triglycerides, over the time of study, from Nov 2007 to Aug 2008. Fifteen patients died during the study period, ten of them had history of hypertension before reaching the chronic renal failure. The results showed a significant elevation in A[1C]% among the patients in comparison to healthy controls. More than 40% of patients were with inadequate glycemic control [A[1c] >6.5%]. More than half [55.6%] of patients who underwent insulin therapy were with inadequate glycemic control. Dyslipidemia was characteristic in patients where the levels of HDL-C were found to be significantly lower in all patients compared to controls 32.5 +/- 8.8 vs. 42.7 +/- 9.1 mg/dl; respectively. The mean LDL/HDL ratio in patients was higher than in controls, 3.6 +/- 1.3 vs. 2.7 +/- 0.8; respectively. Inadequate glycemic control in diabetics on hemodialysis was prevalent, insulin resistance is suggested, dyslipidemia is predominate, and further follow up of these patients is recommended

Adequacy of glycemic control and serum lipid profile in hemodialysis of Palestinian patients with diabetes mellitus

Inadequate glycemic control and lipid abnormalities which are prevalent among diabetic patients on hemodialysis may act synergistically to place these patients at an augmented risk for morbidity and mortality of diabetic complications. The purpose of this case-controlled study was to assess the glycemic control and prevalence of dyslipidemia among diabetics who were on hemodialysis, by following them up for ten months and carrying out the following measurements, glycated hemoglobin A[1c], LDL, HDL, total cholesterol, and triglycerides, over the time of study, from Nov 2007 to Aug 2008. Fifteen patients died during the study period, ten of them had history of hypertension before reaching the chronic renal failure. The results showed a significant elevation in A[IC]% among the patients in comparison to healthy controls. More than 40% of patients were with inadequate glycemic control [A[IC] >6.5%]. More than half [55.6%] of patients who underwent insulin therapy were with inadequate glycemic control. Dyslipidemia was characteristic in patients, where the levels of HDL-C were found to be significantly lower in all patients compared to controls 32.5 +/- 8.8 vs. 42.7 +/- 9.1 mg/dl; respectively. The mean HDL/LDLratio in patients was higher than in controls, 3.6 +/- 1.3 vs. 2.7 +/- 0.8; respectively. Inadequate glycemic control in diabetics on hemodialysis was prevalent, insulin resistance is suggested, dyslipidemia is predominate, and further follow up of these patients is recommended

[ comparative study of the use of ampicillin and cefuroxime in the treatment of pneumonia children in Gaza strip]

An empirical antimicrobial therapy for suspected bacterial pneumonia is generally chosen according to the age of the child, the clinical presentation and the local resistance. The purpose of this prospective study was to investigate the effectiveness of intravenous Ampicillin and Cefuroxime in the treatment of suspected bacterial pneumonia in children aged between 4-36 months. To achieve this, eight patients diagnosed clinically, laboratory and radiologically as having pneumonia, 40 patients were treated with intravenous Ampicillin [20 Males, 20 Females] and 40 patients were treated with intravenous Cefuroxime [20 Males, 20Females]. Ampicilling was prescribed at a dose of 200 mg/kg/day, while Cefuroxime was given at a dose of 150 mg/kg/day for the period of treatment. All signs, symptoms were followed up during the course of treatment for each antibiotic. Complete blood cell count measured on admission and on discharge for all children. The results showed that both antibiotics are very effective in the treatment of pneumonia in children with no significant differences in clinical efficacy of Ampicillin as compared with Cefuroxime. Therefore Ampicillin could be used more often due to its availability, effect and lower cost, especially physicians had avoided the use of Ampicillin for the past few years

Prevalence of malnutrition and intestinal parasites among preschool children in the Gaza strip

Helminthiasis is one of the public health problems worldwide. This is especially true in Gaza Strip. This study demonstrated the parasites prevalent among mal-nutritional preschool-children according to the anthropometric cutoff points [WHO, 2007] and their family socio-demographic variability

relation between dual energy x-ray absorptiometry measurement of body fat composition and plasma ghrelin in patients with end-stage renal disease

To clarify the role of ghrelin in malnutrition in uremia and its relationship to fat composition using dual x-ray absorptiometry DXA. This is a cohort study including Group I: 60 patients with end stage renal disease 30 on hemodialysis [group IA] and 30 pre-dialysis [group IB] and Group II: 20 controls. This study was carried out in Cairo University Hospital, Kasr Al-Aini, Cairo, Egypt in 2007. Body fat composition total, differential, and lean body mass was assessed using DXA, and plasma ghrelin was measured. Ghrelin was significantly higher in hemodialysis and pre-dialysis groups compared to the control group, and higher in hemodialysis group compared to the pre-dialysis group. In hemodialysis, ghrelin was negatively correlated with weight, body mass index BMI, and truncal fat mass, and positively correlated with serum creatinine. In pre-dialysis, ghrelin inversely correlated with weight, BMI, and truncal fat mass, and positively correlated with serum creatinine, lean body mass. In control, plasma ghrelin showed negative correlation with weight, BMI, truncal fat mass, and body fat mass, and positive correlation with lean body mass. Ghrelin was markedly elevated in renal failure due to its decrease in excretion. Negative correlation between ghrelin and fat composition was detected in dialysis patients. Serial evaluation of body fat composition using DXA is recommended for assessment of nutritional status of those patients

Bone Mineral density in Egyptian cirrhotic patients

Osteopenic bone disease is a well-recognized complication of liver cirrhosis. The aim of this work was to determine the bone mineral density [BMD] in Egyptian cirrhotic patients and to correlate the results with various clinical, laboratory and ultrasonographic characteristics. Thirty-eight cirrhotic patients, 18 males and 20 females were included in this study. They were subjected to complete history taking, clinical examination, abdominal Ultasonography Dual X-ray absorptiometry [DXA] for BMD measurement. BMD was measured in the lumbar spine, proximal femur and forearm. 32 [84.2%] patients had abnormal DXA finding. Osteoporosis was present in 42.1%, 15.8 and 10.5% in lumbar spine, forearm and femurs respectively. Osteopenia was present in 42.1%, 31.6% in lumbar spine, forearm and femurs respectively. The detection of abnormal DXA in lumbar spine was significantly higher compared with that in femurs and forearm. Aspartate transaminase [AST] and alanine transaminase [ALT] were significantly lower in patients with abnormal DXA finding. Body mass index [BMI] and AST were significantly lower in patients with fracture risk. Also, collaterals detected by ultrasonography were significant prevalent in patients with fracture risk. BMI, Mid-upper arm circumference [MAC], hemoglobin, and BMD of lumbar spine forearm were significantly lower in patients with collaterals. 27 [71.1%] patients complained of poor health indicating physical inactivity had significantly lower MAC, hemoglobin, BMD of lumbar spine and forearm. Significant negative correlations were found between age of patients and BMD of their lumbar spine and forearm. MAC, Serum total protein, AST, ALT and hemoglobin had significant positive correlation with BMD. T score of forearm was significantly lower in patients with history of hepatic encephalopathy. No significant correlation were found between DXA findings and duration of lever disease, BMI, Child-pug's score, serum albumin, serum bilirubin, prothrombin time and ascites grade. Significantly lower BMD of left femur and forearm was found in females compared with males. In postmenopausal females, a significant negative correlation was found between duration of menopause and BMD of forearm. A significant positive correlation was found between number of pregnancies and T score left femur. Osteopenic bone disease was highly prevalent in Egyptian cirrhotic patients and was most evident in lumbar spine. BMD was not correlated with criteria of severity of liver disease. It was significantly lower in females but not influenced by menopausal status

Right lower quadrant pain: Evaluation of the sensitivity, specificity and predictive values of ultrasongraphy and colour doppler in the diagnosis

The aim of this study was to evaluate the role of the gray-scale ultrasound and color Doppler in the diagnosis of various causes of right lower quadrant pain. Eighty patients [27 males and 53 females with age range 5-70 years] were included in this study. In 25 cases, gastrointestinal pathology, including appendicitis [22 cases], Crohn's disease [one case] and intussusception [two cases], was detected. Gynecological abnormalities in 34 cases were ectopic pregnancy in 10 cases, ovarian lesions in 24; Dermoid cyst [6], simple cysts [4], endometrioma [8], complicated cysts [6] including one case of tubo-ovarian abscess. Stone lower end right ureter was met within seven cases. One case showed lipoma of the right rectus muscle. The remaining 13 cases were normal. All cases were subjected to preliminary abdominal and pelvic ultrasound using 3.5-5 mHz curvilinear probe, followed by graded compression technique using 7-12 mHz linear array transducer. Transvaginal examination was performed in 30 cases. Color Doppler study was performed in 50 cases to detect vascularity. CT was done in two cases [complicated appendicitis]. MRI was done in 10 complex ovarian masses for better lesion characterization. The findings were correlated with surgical, histopathological and clinical follow-up findings. From the results obtained, it was concluded that the use of ultrasound examination in the evaluation of different causes of RLQ pain showed sensitivity, specificity, positive and negative predictive values of 96, 100, 100 and 81%, respectively. The combination of gray scale and color Doppler study improved the diagnostic accuracy. Abdominal ultrasound using graded compression technique could help in detecting cases of acute appendicitis and differentiating them from other gastrointestinal or gynecological lesions. Transvaginal ultrasound study was a great help in verifying different gynecological lesions including ectopic pregnancy and right ovarian lesions

Cosmetic breast surgery: ultrasound evaluation

Several types of cosmetic breast surgery including breast augmentation, reduction and reconstruction are commonly practiced nowadays. Mammograms after breast conservation therapy for carcinoma of after cosmetic surgery require correlation with physical findings and surgical procedures performed. Mammographic appearances or post surgical changes after these procedures are commonly encountered. Ultrasonography is a useful complement to mammography in evaluation of post-operative changes. Aim of the Study: Was to evaluate the role of the gray- scale ultrasound in the postoperative follow-up and detection of complication after various types of cosmetic breast surgery. Subjects and Twenty six female patients were included in the study, [age range 14-52 years]. Standard mamrnographic views [cranio-caudal and mediolateral oblique were taken in 24 cases, in the other two cases [early post operative] mammography was painful. Ultrasound evaluation was undergone in all cases. MRI was done in 2 cases. In 6 cases with breast augmentation, 3 cases were normal, the other three showed extracapsular rupture in 4 implantes, internal wall derangement in two, breaks and internal echoes inside in one implant, in this case MRI axial and sagittal spin echoes was done, it confirmed the intra and extracapsular rupture. Regarding the reduction mammoplasty [11 cases]: Us replaced mammography in early postoperative cases [2 cases] with tender inflamed breasts, in three cases mass discrimination fibroadenomas, cysts and fat necrosis was accurately assessed. In Reconstructed breast [9 cases]: Us was complementary to mammography in assessment of ill defined dense area. Us guided fine needle biopsy was done in 2 cases of fat necrosis. Ultrasound examination is highly sensitive and specific in post-operative assessment of saline implants integrity in augmentation mammplasty. Ultrasonography is a useful complement to mammography in demonstrating the origin of a palpable mass after other types of surgery, US guided fine needle biopsy is minimally invasive technique in confirming the diagnosis of suspicious mass

Perinatal mortality in twin pregnancy a survey of twin deliveries in Zagazig

A survey of all twin deliveries from October 1994 through May 1997, in Zagazig area was done using prenatal data records and hospital files. Among 23, 680 deliveries, there were 188 pairs of twins representing 7.9/1000 births. Among these there were 44 deaths, this gives a prenatal mortality rate of 117/1000 twin birth representing 9% of the overall prenatal deaths, and approximately 6 times the death rate for singletons. 60.5% of all deaths occurred in women who failed to receive antenatal or intranatal care. Immaturity accounts for the majority of prenatal deaths [75%]. 93% of deaths occurred in low birth weight infants < 2500 g, of these 75.5% were <1500g. We recommend increased utilization of prenatal services for all twin pregnancies, and delivery should take place in well equipped and staffed hospitals. Improvement of hospital statisites and recording system by well trained personnel and using of computerized software programs are highly recommended