Short term effects of antiepileptic drugs on the heart using electrocardiograph as an assessment tool of investigation: a pilot case finding study

Background: Antiepileptic drugs can induce changes in the electrocardiograph [ECG] records including prolongation of QT interval but there is no evidence to link this effect with the sudden death that reported in epilepsy. The new generations of antiepileptic drugs showed variable effect on the heart. Lamotrigine did not prolonged the QT interval in healthy subjects while levetiracetam prolonged the QT interval in patients cardiac channelopathy presented with congenital long QT syndrome

Objective: This study aimed to investigate effects of antiepileptic drugs that prescribed in a therapeutic regimen to new cases of epilepsy as a part of management on the ECG records at the end of the 1[st] three months of treatment

Patients and Methods: A total number of 25 patients, presented for the first time with epilepsy, were recruited from Al-Yarmouk Teaching hospital. Each patient was assessed clinically by consultant neurology prior to enrollment in the study. An electrocardiogram [ECG] was obtained at the time of entry into the study prior to the admission of the study and after three months of treatment with antiepileptic drugs. In addition to the measurements of heart rate and different EGG intervals, a QT-nomogram and cardiac restitution were used in analysis

Results: At the time of entry, three patients had a significant short corrected QT interval [QTcB]; four patients had a borderline QTcB interval; and one patient had prolonged QTcB interval. QT-nomogram revealed that many patients have abnormal interval and antiepileptic drugs significantly reduced the relaxation phase of cardiac cycle and prolonged the ventricular repolarization

Conclusion: Antiepileptic drugs carried a harmful effect on the heart and their assessment should be not restricted in the measurement of QT interval before and after treatment or to study their effects on the healthy subject as epilepsy is commonly associated with mutation of sodium and/or potassium channels. Case finding of significant prolonged QT interval in respect to gender and age, assessment of QT nomogram and cardiac restitution are useful tools to identify the patients who are at risk of arrhythmias

clot-lysis effect of selective alpha[1]-adrenoceptor antagonist in vitro model associated with high peroxynitrite level

Alpha[1]-adrenoceptor blocking agents showed several effects beyond their action on the vascular smooth muscles. They improve the lipid profile and inhibit the aggregation of blood platelets. To investigate the clot-lysis effect of selective alpha[1]-adrenoceptor antagonists and its relation to peroxynitrite level in vitro experimental model. Venous blood samples obtained from ten healthy subjects. To each pre-weighed clot, 100 micro L of either distilled water as a negative control, prazosin [10 micro g], terazosin [20 micro g] and alfuzosin [25 micro g] were added. Peroxynitrite level was measured in sera and sangious fluid that formed after clot-lysis. Prazosin, terazosin and alfuzosinjn order, significantly reduced the clot weight up to 3.7%. Peroxynitrite level in sangious fluids was higher in treated groups than that of negative control or sera levels. Alpha[1]-adrenoceptor antagonists induced clot-lysis effect. This effect is associated with generation peroxynitrite

Effect of chlorpromazine on intact and irradiated aliquot ctdsDNA samples

Chlorpromazine is widely used in human medicine in the therapy of schizophrenia, organic psychosis and the manic phase of manic depressive illness. It expressed a selective cytotoxicity and the results of genotoxicity were positive. This study is designed to explore the effect of chlorpromazine on irradiated and non irradiated calf thymus double strands DNA [ctdsDNA] molecule. Aliquots of irradiated [subjected to UVB light] and non-radiated ctdsDNA samples were incubated with different concentrations of chlorpromazine. Further series of experiments studied the simultaneous effects of chlorpromazine and UVB light on aliquots of ctdsDNA. The changes in optic densities of ctdsDNA aliquots were monitered and recorded by UV-spectrophotometer at 260 nm. Chlorpromazine exerts dual effects on non-radiated ctdsDNA aliquots represented by hyperchromasia and hypochromasia in regard to its concentration. It potentiates the effect of UVB radiation on ctdsDNA molecules. Its effect is differed in respect to the radiation status. Chlorpromazine exerts several effects on aliquot ctdsDNA samples which are related to the nature of DNA molecule as well as to the concentration of chlorpromazine. Also chlorpromazine potentiates the hyperchromatic effect of UVB radiation on aliquot ctdsDNA samples but it produces complete damage of DNA molecule when the aliquot ctdsDNA samples irradiated in presence of chlorpromazine

Ciprofloxacin but not amoxicillin significantly elevated serum peroxynitrite level in patients with enteric [typhoid fever]: in vitro study

Peroxynitrite is one intermediate of reactive nitrogen species with bactericidal and cylotoxic effects. Fluoroquinolones. drugs used for salmonella infections, are interacted with nitrogen species and their baeterieida effect is influenced by these species. This study aims to assess serum peroxynitrite level in patients with enteric [typhoid] fever and. to investigate the effect of ciprofloxacin or amoxicillin on serum peroxynitrite level as well as in aqueous buffer solution in vitro. Thirty patients with enteric fever diagnosed clinically and serologically and twenty healthy individuals served as controls were admitted in this study. None of our sample was received anli-salmonellosis agents. Our results show that serum peroxynitrite level tended to be significantly less in patients with typhoid fever in comparison with controls. In in vitro experimental model, ciprofloxacin but not amoxicillin at 6.25 ug elevate significantly serum peroxynitrite level. In aqueous solution, the ability of ciprofloxacin to produce peroxynitrite is higher than that of amoxicillin. We conclude that Ciprofloxacin. as bactericidal agent against salmonellosis, may act via producing or elevating peroxynitrite level

Potentiation of gentamicin induced nephrotoxicity by molsidomine in rats

Reactive oxygen metabolites have been implicated in gentamicin induced nephrotoxicity. This study tests whether or not nephrotoxicity of gentamicin is associated with cellular activation or lipid peroxidation and the use of vasodilator, molsidomine, plays a role in the renal lesion. Rats were treated with a toxic dose of gentamicin alone or in combination with molsidomine for seven days. The results showed that gentamicin induced nephrotoxicity was associated with a significant activation of cellular lipid peroxidation manifested by high serum and cortical tissue malondialdehyde, and the use of molsidomine aggravates this process. These data indicate that vasodilators and in particular those with nitric oxide [NO] donating property may be extremely harmful when used gentamicin

Lipid peroxidation and gentamicin therapy in patients

The effect of gentamicin therapy on the lipid peroxidation process was studied. Thirty patients were enroled in this study, and twenty healthy individuals were served as control. The results showed that gentamicin significantly suppressed the activity of lipid peroxidation as manifested by low level of the byproduct malondialdehyde. This effect was observed when gentamicin was prescribed either therapeutically for seriously ill patients table [1] or prophylactically for the prevention of post surgical infected complications table [2]. It is concluded that gentamicin behaves as an inhibitor of lipid peroxidation beside its antimicrobial effects

Effect of molsidomine on trace metals in gentamicin induced nephrotoxicity in rats

This study was designed to determine the changes in trace metals after gentamicin renal injury. Rats receiving gentamicin [100 mg/kg/ day IM for 7 days] showed deterioration in renal function. Renal proximal tubular necrosis and an elevation in serum and renal cortical tissue of copper levels while the corresponding levels of zinc were depressed. The use of molsidomine can attenuate those changes in trace metals but failed to correct the deterioration in renal function or the histopathological changes. These results suggest that the alterations in trace metals seem not to be a good indicator of gentamicin nephrotoxicity

Considerable risk factors for malignancies of gastrointestinal tract; A descriptive and inferential case-control study

The problem of malignancies of digestive system was studied in a sample of 208 patients who attended the institute of Radiation and Nuclear Medicine from January 1984 to January 1986. Carcinoma of the stomach is the leading cancer in this community and the predominant histopathological findings were adenocarcinoma and squamous cell carcinoma. Among the socioeconomic factors, people who lived in urban areas are more risky for developing malignancies. Smoking but not alcohol influence the distribution of malignancies, the way of food preparation and the behaviour of intake were considered to be important factors associated with the development of the malignancies of digestive system. People who had a history of alteration of bowel habits are significantly prone to malignancies of G.I.T. regardless of their sites. Results suggest that beside the socio-economic factors, the nature of the diet consumed is consider a high risk factor in the development of gastrointestinal tract malignancy in Iraq

Epidemiological trend of breast cancer in Iraq

To establish the risk factors in patients with breast cancer in Iraq, we conducted this case-control study at the institute of Radiation and Nuvlear Medicine. One results showed that breast cancer is a disease of middle age attacks women who were not lactated, menstruated at younger age, having a low birth rate, use contractive pills and it causes a severe psychological reactions. Breast cancer is related to the disease of familial inheritance and is clustered in certain socio-educational status and ethnic groups in Iraq. According to the results reported in this study, the distribution pattern of breast cancer and its risk and protective factors in Iraq are similar to that reported elsewhere and an intensive teaching programme is recommended since more than half of the reported cases were presented with metastases

Trace elements concentration in cord blood in healthy newborn births and their relations to anthropometric measurements

Serum Copper and Zinc levels of cord blood were studied at delivery in 156 healthy newborns. The relation of gestational age, birth weight, length, head circumference, mid-arm circumference and Apgar scores with these levels were assessed. Cord blood values for Copper and Zinc were 59.6 +/- 29.76 micro g/dl and 105.1 +/- 36.39 micro g/dl respectively for males and 60.22 +/- 25.99 micro g/dl and 97.61 +/- 40.66 micro g/dl respectively for females. A significant high level of Zinc in male newborns of mothers with a good obstetrical history in comparison with those of bad obstetrical history [109.0 +/- 30.03 vs 96.2 +/- 50.02, P < 0.05] was affected. Zinc cord blood positively correlated with birth weight [r =0.233, P < 0.05] in female but not male newborns. This study shows that fetal trace metals are altered with the fetal developmental variables and the implementation of these findings are discussed

Effect of alpha tocopherol on the glycerol induced acute renal failure in rats: Biochemical, morphological and hiscopathological assessment

The importance of alpha tocopherol acetate administration in determining its beneficial action in glycerol- induced acute failure was investigated by examining the effects of a single dose of alpha tocopherol given immediately [0 h] and at one hour [1 h] before glycerol injection. Alpha tocopherol, when given at 1 h, significantly raised blood urea and serum creatinine concentrations when compared to untreated animals or those that received glycerol or alpha tocopherol. The administration of alpha- tocopherol neither attenuated the increase in kidney weight associated with acute renal failure nor reduced the kidney damage as assessed by histological examination. The results show that single administration of alpha tocopherol afforded no protective effect on renal function

Experimental dilating cardiomyopathy and myocardial ionic changes in mice.

This study was designed to examine the myocardial ionic changes in experimental animal models of dilating cardiomyopathy induced by treating male balb-c mice either with cobalt chloride [2 mg/ kg, i.p] or tyramine HC1 [5 mg/kg i.p] once daily for 5 and 10 days. Age and weight matched mice were treated with distilled water served as controls. Our results showed that cobalt chloride and tyramine HC1 produced an increase in cardiac mass and non specific histopathological changes of congestive cardiomyopathy. The induction of cardiomyopathy was associated with significant alterations in myocardial ions which is related to the inducing agent. We conclude that the similarity and discrepency in myocardial ions levels in experimental dilating [congestive] cardiomyopathy is a part related to the causative agent

Experimental dilating cardiomyopathy and verapamil therapy in the mice

The effects of verapamil, a calcium channel blocker were examined on the norepinephrine and tyramine induced changes in mice myocardium. Tyramine but not norepinephrine [5 mg/kg/day, s.c. for 5 days] caused significant increase in cardiac mass reflected by increase ratios of heart wet and dry weights to body weight. The histopathological changes seen by light microscopy include cell necrosis and fibrosis with hypertrophied nuclei. Simultaneous treatment of the animals with verapamil [1 mg/kg/day, s.c. for 5 days] attenuated the above mentioned changes that were induced by catecholamines. Based on the data obtained in this study, it is proposed that catecholamines induced changes in the myocardium may involve facilitation of calcium entry which induce cell necrosis and lead to the development of dilated cardiomyopathy and verapamil is capable to attenuate these changes

study of certain risk factors associated with a high blood pressure among outpatient attendants in Al-Yarmok hospital

A simple methodological screening of blood pressure to detect undiagnosed hypertensives and to assess the associated risk factors of hypertention was applied in a random sample of 351 patients attending the outpatient clinic at Al- yarmok hospital in Baghdad. The results showed that the percentages of undiagnosed systolic hypertension were 20.3% and 24.8% and of diastolic hypertension were 15.3% and 19.8% for women and men respectively. The development of hypertension was associated with the risk factor obesity, but there was no statistically significant difference with contraceptive pills. The results of this study indicated a high prevalence of undiagnosed [or undetected] hypertension and call for a large population based survey to confirm this finding prior to initiating anearly detection and treatment program on the national level; and also to prevent the development of cardiovascular diseases

Therapeutic trial in idiopathic oligospermia: principal results

This work was undertaken to investigate the pharmacological intervention in Management of idiopathic oligospermia. Thirty patients, were either on Cyclofenil, Mesterolone, Gonadotrophin or vitamin E therapy enrolled in this study. Our results showed these agents induced a variable effects in sperm count and motility, and a successful pregnancy was reported in one out of seven cases treated with cyclofenil. We conclude this pharmacological effect of these drugs in idiopathic oligospermia is not effective and of temporary nature. More research is needed to find a better and effective approach to the management of idiopathic oligospermia

Experimental models of dilating cardiopyopathy in the rat: biochemical and histopathological investigations

We deviced a plan of experimental models to study the problem of dilating [congestive] cardiomyopathy. In one set, rats were treated either with distilled water [control] or cobalt acetate [20 mg/kg. ip] six times weekly [cobalt treated] or adriamycin [50 mg/kg. ip] four times weekly [adriamycin treated] and the treatment maintained for two weeks. In another set rats were subjected to stressful situations either by immobilizing them individually in animal cages or by immersing them in water three hours daily six times a week over a period of two weeks. Our results showed that all these treated groups had cardiomegaly and we distinguished different non specific histopathological changes suggestive of cardiomyopathy associated with an increase in serum cholesterol levels. According to these findings it may be appropriate to consider that the different histopathological changes of cardiomyopathies depend on the insulting stimuli, and serum cholesterol could be a useful biochemical marker of this problem entity

Cinnarizine therapy: a new concept in prevention of experimental dilating cardiomyopathy

This work was undertaken to investigate the role of cinnarizine, a potent vasodilator with a property of calcium entry blocker in ameliorating the cardiomyopathic lesion induced by cobalt and adriamycin toxicity. Cobalt 20mg. Kg[-1]or adriamycin 50mg. Kg[-1] have been injected intra-peritonealy twice weekly in rats treated with cinnarizine 2mg.Kg[-1] intra-peritonealy. The results showed that cobalt or adriamycin induced cardiomegaly. The associated alteration in haemoglobin level and red blood corpuscles count as well as the histopathology of heart were modified when cinnarizine injected simultaneously with cobalt or adriamycin