Serum and erythrocyte magnesium levels in patients with myocardial infarction with or without heart failure

Magnesium [Mg] is a mineral that is involved in over 300 reactions in the body. Magnesium is a potent vasodilation, and plays an important role in muscle contraction. It has been early documented that Mg deficiency can precipitate ventricular arrhythmias and treatment with Mg has some anti arrythmic effect. Moreover there is an ample evidence that a significant percentage of patients with IHD suffer from Mg deficiency. The objective of the present study is to measure Mg levels in serum and RBCs of patients with some forms of IHD. The study was conducted in Baghdad hospital and Ibn - Al-Bitar Hospital. The 180 patients with IHD were divided into Two groups. Group one, 80 patients with Ischemic Heart Failure [IHF] [EF<30] aged 65.75 +/- 5.97 year [50 males and 30 females], group two, 100 patients with Muocardial Infarction [MI][EF<50] aged 50.34 +/- 6.36 year [58 males and 42 females]. Serum Mg and RBCs Mg were measured in all patient groups by Atomic Absorption Spectrophotometer. The [mean +/- SD] value of serum and RBCs Mg in patients with both groups Ischemic Heart Disease [IHD] was significantly lower when compared with that of controls [p<0.05].The serum Mg levels [0.81 +/- SD mmol/L] are significantly lower in the IHF group and in MI group [0.96 +/- 0.18 mmol/L] when compared with that of controls [1.00 +/- 0.17 mmol/L] [p<0.001]. The data obtained in present study revealed the decrease of Mg level in serum and RBCs in both patients groups, which affect the contractility of heart muscle and cardiac performance.

Electrocardiograph and echocardiograph findings of patients with long standing rheumatoid arthritis in Baghdad teaching hospital

Rheumatoid arthritis [RA] is a systemic autoimmune disease with characteristic feature of persistant inflammatory synovitis in symmetrical distribution; it has a higher incidence of fatal and non-fatal cardiovascular events which account for half of all death in RA patients. To study the cardiac involvement in long standing rheumatoid arthritis patients in comparison to healthy persons by electrocardiograph and echocardiograph. A sample of 100 Iraqi patients with long standing rheumatoid arthritis and 100 healthy individuals who served as control group matched for sex and age were selected after exclusion of risk factors [hypertension, diabetes mellitus, smoking and previous cardiac problems], both groups were studied by electrocardiograph and echocardiograph under supervision of a cardiologist. There were a significant number of patients with rheumatoid arthritis having abnormal electrocardiographic findings 21[21%] in comparison to healthy persons 7[7%] [P-value 0.004], also there were significant number of rheumatoid arthritis patients with abnormal echocardiographic findings 36[36%] in comparison to healthy individuals 11[11%] [P-value 0.000].while there were no significant association between disease duration and type of medications with cardiac abnormalities reported in this study. There is an increase of asymptomatic cardiac structural abnormalities in chronic rheumatoid arthritis patients in comparison to normal healthy individuals as detected by electrocardiograph and echocardiograph

Extent of coronary arteries disease between angiographic findings and some atherogenic lipid in Dices

Modification of lipid subtypes improves the prognosis of ischemic heart disease. Correlating the coronary angiographic finding with the measurement of different plasma lipid parameters. [180] hundred eighty patients admitted in the study, [120] patients were male, [60] patient were female, their age range [29-72 years] were randomly assigned into four groups. Group [1]: Patient with myocardial infarction [STEMI]. Group [2]: Patient with non-STEMI myocardial infarction. Group [3]: Patient with unstable angina. Group [4]: Patient with ischemic cardiomyopathy. The angiographic findings, were classified according to the guidelines of [ACC/AHA] all patients had lipid parameters correlated to their angiographic finding [A, B, C, respectively]. This study showed that there was significantly correlated between the levels of HDL, LDL, triglyceride and the coronary angiographic findings in groups [A, B, C] [0.05, 0.001, 0.001] respective. However the use of Atherogesic index [TG/HDL-c] was highly significant and nave clinical evaluation the severity of extent of coronary artery disease [i.e. the Raton [5.9] in group A, [5.2] in group B, [4.8] croup C]. Using more than one lipid parameter can assess the severity of coronary artery disease

chlamydia pneumonia an independent risk factor in ischemic heart disease?

Immune system may interplay between Chlamydia pneumoniae infection and ischemic heart disease [IHD].Major histocompatibility genes regulate innate and adaptive immunity. This study was established to shed light on the possible association between ischemic heart disease [IHD] with Chlamydia pneumoniae infection and HLA antigens. Microlymphocytotoxicity assay has been applied for HLA-typing of 150 blood samples of 100 IHD patients and 50 healthy normal controls, In addition enzyme linked immunosorbant assay [ELISA] used to detedct C pnuminiae IgA and IgG. An increased frequency of HLA-A2, B35 alleland HLA-A2-B*35 haplotype was observed for patients group versus control group with P-value [0.0001, 0.05, and 0.001] respectively. This finding demonstrated that the HLA-B35 positive haplotypes confer the C.pneumoniae-related risk for IHD. HLA-DR3,DR4 and DR7 might play a role in AIH susceptibility

Inflammatory markers [interleukin-6 and C- reactive proteins] in patients with type 2 diabetes mellitus and positive family history of ischemic heart disease

Patients with family history of type-2 diabetes and ischemic heart disease [IHD] have an increased risk of developing these diseases in the future. It's currently believed that inflammatory mediators such as Interleukin-6 [IL-6] and C-reactive protein [CRP] play an important role in the pathogenesis of metabolic disorders. This study was conducted to assess the parameters of chronic inflammation in patients with newly diagnosed diabetes and positive family history of ischemic heart disease. The present study included 48 Iraqi patients with a diagnosis of diabetes established since 2003 using the 1999 WHO criteria, 20"of these patients had a family history of ischemic heart disease. The mean age of study participants was 49.4 +/- 10.2 years [ranging from 20 - 68]. Enzyme linked immunosorbant assay [ELISA] used to detect IL-6 and CRP,. while blood sugar and lipid profile were detected using commercially available kits which provided by [BioRad]. It was found that patients with a positive family history of IHD the concentration of IL 6 and CRP were found to be higher while HDL were found to be lower when compared with type 2 diabetic subjects with a negative family history for IHD. This finding demo nstrated that patients with newly diagnosed diabetes and a family history of IHD have increased risk of macroangiopathic complications related to the elevated concentrations of inflammatory markers

Across-sectional study of brucellosis in patients admitted to baquba to general hospital

Brucellosisls a very common disease in Iraq the manifestations of the disease are different from one persom to the other in which the clinical diagnosis needs a thorugh study and documented precise investigations. To describe selected possible for acquiring brucellosis in Diala governorate and compare the relative frequency of selected clinical features between pediatric and adult age groups. A cross sectional study was done on a sample of 108 patients with an established diagnosis of Brucellosis admitted to Baquba General Hospital during the period extending from May 2001 to June 2003. Males constituted about two thirds of the study sample [65.7%] About a fifty [20.4%] of the study sample were in the pediatric age group [<16 years of age]. Raw milk or unpasteurized cheese and raw liver was among the risky for acquiring the infection reported by 67% and 58% of the study sample respectively. Animal contact [Agricultural activities] was reported by 59.3%. Among pediatric age group, the most frequent clinical features were: Spinal tenderness, abdominal pain, arthralgia, sweating aches lack of energy and arthritis. While among adults: Arthralgia, headache, aches, sweating, lack of energy, spinal tenderness, chills, fever, loss of appetite and arthritis were among the most frequently reported symptoms. Hepatosplenomegally is rarely reported and epididymoorchitis is a frequent complication of brucellosis in children. This result showed a male preponderanc in comparison to female Patients and this probably due to occupational exposure

Insight on the side effects of lipid lowering agents [Statin] in Iraqi patients with ischemic heart diseases

3-hydroxy-3 methyl glutaryl co enzyme inhibitor [MMG-COA] [statin] is a very common drug used in many medical conditions regardless of the presence or absence of dyslipidemia. One of these conditions is the cardiac disorders. Throwing a light on the prevalence of their side effects in Iraqi patients. Two hundred seventy patients with ischemic heart disease from the period of November 2006-November 2007 referred to Baghdad teaching hospital [the medical city]. Those cases were using statin and grouped into two groups. Group A: patients admitted with acute coronary syndrome [myocardial infarction and unstable angina] [230 patients 77%]. Group B: patients with associated risk factors [Hypertension, diabetes mellitus, smoking and secondary lipidemia] 40 cases 23%, have history of ischemic heart disease on treatment they use the drug in range of [10-40] daily with review monthly for the side effects. All 270 cases were free from other organic disorders [i.e. renal, thyroid, malignancy, or any longstanding disease]. All patients went through a questionnaire which includes: age, gender, risk factors [Hypertension, diabetes mellitus, smoking, and lipidemia], routine blood tests, lipid profile, liver function tests, C-reactive proteins, thyroid function tests, chest X-ray, electrocardiography and echocardiography done for all patients, all patients used to take drugs in the range of 10-40mg daily for at least one year. The side effects noticed in this study were gastric, musculoskeletal, elevated liver enzymes [40%, 28.9%, and 1% respectively from the total number of patients]. Other side effects in other systems like skin, respiratory, and cardiac were not encountered. This study showed that the side effects of statin were not involving all the body systems

Psychiatric disorders in cardiac patients

Psychiatric disorders and coronary heart disease are not uncommonly seen together in the same patient especially in association with myocardial infarction these disorders vary from simple anxiety, depression, posttraumatic stress disorder, adjustment disorder. Studying the depressive disorders in the Iraqi cardiac patients and its prevalence after April 2003 and trying to ascertain any mispractice in management of such patients by ignoring the psychiatric cause. 260 patients admitted to Baghdad teaching hospital medical departments over the period December 2005- October 2007. Those patients were having either stable angina unstable angina and myocardial infraction. A uniform questionnaire was used for all patients to find out the prevalence any psychiatric disorders. This study showed the presence of depression during the pre and post cardiac events in 70 cases [27%] anxiety was also a very common problem in about 60 cases [23%], however the percentage of patients whom were had psychiatric disorders after an acute events due to unsettled security in the country since 2003 were as follow depression [21% cases 8%] from the total number of cases respectively. Psychiatric disorders are becoming a common problem in many Iraqi cardiac patients because of the difficulties of their daily life since 2003 and it represents about 50% of the cases of psychiatrics disorders. This may make it an important issue to use antidepressant drugs in many of those patients

value of using echocardiography in patients of advanced liver disease with cardio pulmonary complications

Patients with chronic liver disease are liable to get cardio - pulmonary complications, one of these complications is development of pulmonary hypertension ranging from mild to it's sever form - this complication could give some abnormal findings in chest x-ray, electrocardiography but more prominently by echocardiography. To clarify the benefit of using the echocardiogram is detecting pulmonary hypertension prior to the use of invasive methods [catheterization] in patients with advanced liver disease. A total of 50 patients with chronic liver diseases [cirrhosis, chronic active hepatitis] their age range is [25-70 years] [mean are 37.07 years], the fifty patients were free from any cardiac or respiratory diseases. The study extending from December 2007-August 2008. All patients went through full history and routine blood test: including complete blood picture, fasting blood sugar, blood urea and screatinne, lipid profile, liver function tests, clinical examination, and investigations included routine blood test, chest x-ray, and electrocardiography, echocardiography [Transthoracie and transoesphageal]. The child-Pugh score used for assessing the severity and prognosis of chronic liver disease and it classified into three groups [A, B, C] used in this study. Fifteen patients from the 50 cases [30%] only proved to have cardio-pulmonary changes [i.e. pulmonary hypertension right ventricular hypertrophy and dilatation with the mean value of >/= 25mm Hg at rest or >/= 30mm Hg during exertion] those patients were having fatigue in [70%] of them while dysponea, chest pain, cyanosis, syncope were detected in 30%, 10%, 1%, 2% respectively in those cases of pulmonary hypertension with chronic liver disease. The use of non invasive methods especially echocardiography were helpful in detecting the presence of pulmonary hypertension in patients with chronic liver disease

Interpretation of clinical, radiological, electrocardiographic and echocanliographic findings in pulmonary hypertension

10 make correlation between clinical radiological electrocardiographic and echocardiographic finding in cases of Pulmonary Hypertension. 140 patients referred to the medical departments, Haghdad Teaching Hospital [90 of them admitted in this study were as follow]; [52 [47%] cases having Ischemic heart disease, 28 [25%] cases having C.O.P.D., 10 [9%] cases having connective tissue diseases, 9 [8%] eases of Rheumatoid Arthritis, 1 case S.L.E.]. The remaining 50 cases were excluded from the study because they have another chronic disorder like Diabetus mellitus, Renal failure, Malignancy, Skeletal deformity. Forty normal volunteers were admitted in this study both groups were assessed clinically, radiologically, electrocardiographically, echoeardiographically plus the routine blood tests including F.B.S, B. urea, lipid profile. 90 cases of patients admitted in this study showed variable findings the prominent finding was loud pulmonary sound "p2" in 100% of cases, 19.6% of cases showed cardiomegaly, 33% prominent pulmonary marking, 11.4% percardial effusion, 28% Right Ventricular Hypertrophy. It is not necessary to find all the clinical, radiological, electrocardiographic and the echocardiographic changes in any patient with pulmonary hypertention>30 mm Hg

echocardiographic abnormalities in 52 Iraqi patients with rheumatoid arithritis

To study the prevalence of echocardiographic findings in unselected population of patients with rheumatoid arthritis [RA] Fifty two RA patients and fifty two normal healthy people assessed clinically, Echo Cardiografically, ECG, pulmonary function tests and laboratory investigations. Two-dimensional echocardiography demonstrated significant cardiac disease in [59%] of patients in form of right ventricular dilatation [25%], left ventricular dilatation [11.5%], left atrial dilatation [3.8%], mitral valve abnormalities [11.5%] [M.V. regurgitation, M.V. thickening, M.V. prolapsed, M.V. stenosis], septal hypertrophy [5.8%], diastolic pressure dysfunction[5.8%], thick aortic calcified cusps [3.8%], aortic regurgitation[5.8%], mild pericardial effusion[13.5%], tricuspid Regurgitation [11.5%] and raised pulmonary artery pressure above 30 mmHg [3.8%].The normal healthy people had only two people one had M.V. regurgitation and the other had mild M.V. prolapse and there were no other abnormalities in [ECG] of [PFT]. Wide and frequent varieties of echocardiographic cardiac abnormalities were found in an unselected population of patients with RA, using Doppler echocardiography giving different grades of severity of cardiac manifestation