Effect of hyoertension om aortic root size and prevelance of aortic regurgitation

Although early reports suggested that hypertension predisposed to aortic root enlargement and consequent aortic regurgitation, more recent pathological and M-mode echocardiographic studies have not found an association between hypertension and aortic root enlargement when age is considered. Objective: The aim of this study is to asses the effect of hypertension on aortic root size and to estimate the prevalence of aortic regurgitation. Methods: Measurement of two-dimensional echocardiographic diameters of the aortic root at four locations and compared findings with resting blood pressures and measures of body BMI in 110 normotensive and 110 hypertensive men and women matched for age and sex. Colour and continuous wave Doppler study are used to diagnose and assess severity of aortic regurgitation. Results:Aortic diameters at the annulus [2.40 plus or minus 0.29] versus 2.33 plus or minus 0.24 cm, P=06] and sinuses [3.45 plus or minus 0.43 versus 3.35 plus or minus 0.35, p=08] were marginally higher, whereas diameters at the supra-aortic ridge [2.93 plus or minus 0.39 versus 2.73 plus or minus 0.33 cm, P less than 01] were significally increased in hypertensive subjects. Aortic diameters increased with increasing quartiles of diastolic and systolic pressures, particularly at the supra-aortic ridge and ascending aorta. In multivariate analyses, blood pressure remained an independent determinant of distal aortic diameters after body size and age were considered. Aortic regurgitation was seen in 6 normotensive and 8 hypertensive subjects and did not differ in severity. Conclusion: Hypertension is associated with a slight increase in aortic root size, most notably of the supra-aortic ridge and proximal ascending aorta. Although dilation at the commissural attachment might be expected to predispose to an increase in aortic regurgitation, we did not detect such a difference in this population of, asymptomatic hypertensive individuals

Growth assessment in asthmatic patients

Asthma is a chronic disease and the chronic disease states regardless etiology can cause growth failure in infant and toddler. To assess growth of asthmatic patients. One hundred asthmatic children between [5-15 years] of age. Both asthmatic and control group studied in term of height, weight and skin fold thickness, all anthropometric measurements of height, weight and skin fold thickness measured for both groups. Height, weight and skin fold thickness were significantly retarded in asthmatic, the more severe the disease and longer duration the more retardation in the height and weight. The height was affected more than the weight by the disease duration and severity. The diminution in skin fold thickness was retarded both with increase disease duration and severity but the female was less retarded than male as the disease duration prolonged. All growth parameter [height, weight, SFT] affected by asthma [duration and severity], so the growth parameters can be used in asthmatic children to evaluate the effect of treatment.

Echocardiographic parameters of left ventricle systolic and diastolic function in patients with beta-thalassemia major

Advances in the current treatment of beta-thalassemia major have contributed to improve prognosis, and nowadays, an increasing number of patients do survive up to the third or fourth, decade. Cardiac complications are still the most common cause of death in patients with major thalassemia. Assessment of Left ventricular systolic and diastolic parameters in beta-Thalassemia Major patients and its relation to ferritin level and to spleen status. A Cross -sectional descriptive study done at Ibn Al- Albalady Hospital for Children and Maternity Baghdad city from beginning of January 2011-to the end of July 2011,[427] patients with beta-thalassemia major were considered for analysis, all patients on regular blood transfusion and chelation therapy. M-mode, 2D and Doppler echocardiographic parameters were averaged over 3 cardiac cycles and all echocardiographic measurements were performed according to the guidelines for performance of a pediatric echocardiogram by American Society of Echocardiography. LA, Aortic diameter ,LA/AO ratio, LV posterior wall thickness, interventricular wall thickness, Left Ventricular end systolic and diastolic diameter were larger in beta-thalassemic patients. Peak E, peak A, isovolumic relaxation time were higher in thalassemic patient. There were no difference in E/A flow ratio and E deceleration time. Strok volume, LV mass index and MPI were higher in thalassemic patients. No change in Ejection Fraction and Fraction Shortening. No effect found in all mitral valve Doppler parameters in relation to ferritine level. LV mass index higher in splenctomized patients. No effect found in all mitral valve Doppler parameters in relation to spleen status. The findings of this study shows that in beta-Thalassemic patients there is good systolic function but decrease in diastolic function and there was no correlation between ferritin level and LV systolic and diastolic function

Growth delay in steroid sensitive nephrotic patients

Growth in patients with idiopathic nephrotic syndrome [INS] is influenced by several factors, they suffer the influence of the disease itself as long as there is proteinuria, caused by the increase of the glomerular permeability and leading to hypoproteinemia. The effects of the glucocorticoid treatment, which alters growth by a direct action on the growth cartilage, or via disturbances of growth factors. In this study we assess the effect of nephrotic syndrome, it's relapse rate and it's treatment [i.e. steroid], in the statural growth of steroid sensitive nephrotic patients. A Prospective study of 110 steroid responsive nephrotic patients collected from AL- Kadhemia Teaching Hospital, Central Child Teaching Hospital, Child Wellfaire Teaching Hospital and AL-Karama Teaching Hospital. The study started from first of June 2005 to first of June 2006. Data collected as following: age, sex, date of first diagnosis, duration of disease, number of relapses per year, measurement of the height, weight and body mass index and sign of steroid toxicity. Total number of our patients were 110, 74[67.3%] were males and 36[32.7%] were females, with male to female ratio of 2: 1. The age of our patients range from 2-18 years with a mean of 7.9+3.8 years. Thirtyone [28.2%] of them were with height below 3[rd] percentile for their age, 24[77.4%] were males and 7[22.6%] were females. Twenty- five [22.7%] patients were at pubertal age. Eighteen [72%] were males and 7[28%] were females, and 17[68%] of them have height below 3rd percentile. Seventy - six [69%] patients have their onset of the disease at age between 2 and 6 years. Forty-six [41.8%] of patients have disease duration of less than 3 years, 3 [6.5%] of them were have height below 3[rd] percentile, 46[41.8%] with duration of 3-6years, 14[30.4%] them were have height below 3rd percentile and 18[16.4%] with duration of more than 6 years, 14[77.8%] of them have height below 3rd percentile. Fifty-five [50%] patients had frequent relapses, twenty-seven [49.1%] of them have height below 3[rd] percentile, compared to 4[7.3%] of those with infrequent relapse had height below 3rd percentile. Forty-seven [42.7%] patients show sign of steroid toxicity[cushigoid facial appearance with or with out hypertention, obesity, hirsutism..etc] 25[53.2%] of them have height below 3[rd] percentile, compared to 6[9.5%] of those who have no sign of toxicity. Nephrotic syndrome is a potentially chronic disease with patients suffering a relapsing course and being at risk of frequent courses of prednisolone therapy with increase the risk of growth delay especially in patients reaching pubertal age and still taking steroid therapy