Autonomic system evaluation in non diabetic ESRD

Background: Cardiac autonomic nervous system dysfunction [CAND] has been associated with an increased risk of ventricular arrhythmias and sudden death in patients with End Stage Renal Disease [ESRD]. Autonomic dysregulation, which is common among patients on Hemodialysis even without diabetes, may contribute to dysrhythmias and an increased risk of sudden death in ESRD

Objective of the study: This study was done to find out cardiovascular autonomic system dysfunction in non-diabetic ESRD on maintenance hemodialysis [MHD] at a tertiary care center

Method: This was a single hospital based cross-sectional study. All non-diabetic ESRD patients of both genders doing maintenance hemodialysis in Shaikh Zayed Hospital from were included by nonprobability purposive sampling technique. Duration of study was 3 month. All 200 participants underwent five standard autonomic function tests as Heart rate [R-R interval] variation during deep breathing, immediate heart rate response to standing [30:15 ratio test], Heart rate response to Valsalva maneuver, Blood pressure response to standing and Blood pressure response to sustained hand grip

Result: The early cardiovascular autonomic nervous system dysfunction was found in 30% non-diabetic ESRD. There was significant difference in CAND in patient on longer duration of dialysis [p<0.05] but there were no significant differences of it among gender and age subgroup

Conclusion: In conclusion, cardiovascular autonomic dysfunction is not uncommon abnormalities on non-diabetic ESRD patients. Early recognition of the abnormality will prompt clinician predicting prognosis, treatment and better care of patients

Alveolar bone grafting with mandibular symphysis as donor material

The purpose of this study was to assess the outcome of alveolar bone grafting using symphysis menti as donor material and assess its adequacy and morbidity. Seventeen patients with previously repaired cleft lip and palate, belonging to different parts of the country were selected and treated at Armed Forces Institute of Dentistry, Rawalpindi - Pakistan. In this study the demographics donor sites and surgical outcome of cleft alveolus grafting have been highlighted. There were ten males [58.8%] and seven females [41.2%]. Two patients had bilateral cleft, [11.7%] while rest had unilateral cleft alveolus. The most commonly used donor site was mandibular symphysis [52.9%] followed by iliac crest. The comparatively higher mean age in our study emphasizes the need for education of these patients at national level to provide treatment at optimum age

Monitoring progesterone level and markers of oxidative stress in blood of buffalo-cows with impaired fertility

Buffaloes are mainly reared in small holder farms and suffer from a lot of stressful conditions such as mal-nutrition, high milking, bad hygiene, parasitic infestation and pollution. In order to investigate the possible relationship between oxidative stress and fertility in buffaloes, studies were carried out on buffalo-cows at Lower Egypt Governorates. Case history was corded and the general health status were investigated. Gynecological examinations were carried out and blood samples were taken from normal cyclic and animals have impaired fertility due to inactive ovaries, delayed puberty, endometritis, repeat breeding, retention of placenta and cystic ovaries. Serum samples were used for assaying progesterone level [ELISA], total antioxidant activity and lipid peroxide [Malondialdehyde]. Samples of heparinized whole blood were used for colorimetrically determination of glutathione reduced and selenium[Graphite atomic spectrophotometry], hemoglobin derivatives [UV spectrophotometry] electrical conductivity [conductivity meter] and intrinsic viscosity [viscosity meter]. Values of these markers were compared to those of normal cyclic animals. The obtained results indicated that the serum progesterone level varied due to the type of affection. Total antioxidant activity [serum] glutathione reduced and selenium [blood] values are decreased, while, malondialdehyde [serum] value is increased in buffalo-cows showing impaired fertility. Also, hemoglobin derivatives tend to decrease in the affected animals, especially the oxy- and carboxy derivatives. Electrical conductivity in the examined buffalo-cows shows little changes due to impaired fertility. While no appreciable change was observed in the intrinsic viscosity in cases of impaired fertility as compared to control. It was concluded that there is a tight relationship between oxidative stress and impaired fertility in buffalo-cows under the Egyptian conditions

Elevation of 2'-deoxucytidine plasma level in Egyptian breast cancer patients subjected to chemotherapy

Objective: to explore whether or not the determination of 2'-deoxycytidine plasma level can be used as a marker for tumor response to chemotherapy

Subjects: hundred Egyptian women, Fifteen normal volunteers controls and eighty five patients suffering from breast cancer treated repeatedly with Cytoxan , methotrexate and 5-fluorouracil regimen [CMF]

Setting : national Cancer Institute, Cairo University, Egypt

Intervention: 2'-deoxycytidine [Dcyd] had been quantitated by HPLC in plasma of normal volunteers and breast cancer patients. The separation of Dcyd from other related compounds was carried out by HPLC system equipped with a Jasco-Tri-rotar V pump and UV spectrophotometer constructed with a Hitachi gel No.3012 and column [4.6mm x 15cm], Hitachi. Tokyo, Japan

Results: a positive correlation was observed between Dcyd level and the number of courses received. In patients receiving over 15 courses, Dcyd plasma levels were 6 fold higher than that found in the normal volunteers. Postmenopausal patients exhibited 50% higher Dcyd level than in premenopausal cases. Dcyd level in patients with lymph node positive was also 5 fold higher than the level observed in patients with free lymph nodes treated with high number of chemotherapeutic courses. With respect to the clinical response, non-responders showed 6 fold higher plasma Dcyd level than responders

Conclusion: it seems that determination of plasma level of Dcyd may be a good prognostic tumor marker and may be help in assessment early response to chemotherapeutic regimen

Efficacy of albendazole in giardiasis

Albendazole and metronidazole were compared in 68 patients diagnosed positive for giardiasis. Albendazole 1200 mg, one dose was given to 24 patients, albendazole 400 mg twice a day for 3 days was given to 23 patients, and metronidazole 400 mg 3 times a day for 5 days to 21 patients. Response to therapy was monitored by clinical examination and analysis of fresh faecal samples on days 0, 3, 7 and 10. Response to the single dose of albendazole was 55%, to the divided dose of albendazole 70%, and to metronidazole 84%. The results show that albendazole, originally recommended for helminthic infection, can also be used in patients with mixed protozoal infection or for infections resistant to metronidazole

Does the rapid healing of duodenal ulcers mean longer remissions?

A study was conducted to test the response to therapy and the relapse rates of endoscopically-confirmed duodenal ulcers. Endoscopy to check for healing was performed at 4 and 8 weeks in cases receiving H2-blockers and misoprostol and at 14 and 28 days in cases receiving a proton pump inhibitor. Endoscopy was repeated at 1, 3, 6 and 12 months to check for relapses. Healing rates were 61%-77% and 75%-85% at 4 and 8 weeks in the group receiving H2-blockers and misoprostol. Healing rates were 68% and 100% at days 14 and 28 with the proton pump inhibitor. The relapse rates within 3 months were 72%-86% and 100% respectively. This study indicates that the faster the ulcer healed, the earlier the relapse occurred

First 4-years orthognathic surgery audit of a Saudi teaching hospital

The study represents a retrospective audit of the first four years of orthognthic surgery carried out at a Saudi teaching hospital. The results showed that orthognathic surgery was the most common oral and maxillofacial surgery performed in that particular hospital, which is one of two teaching hospitals covered by the division of oral and maxillofacial surgery, faculty of dentistry, King Saud University in Riyadh, Kingdom of Saudi Arabia. The variation in the patients characteristics, treatment provided, and final outcome is presented