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Abstract Introduction: Hyperglycemia has a negative impact on morbidity and mortality among patients with acute myocardial infarction (AMI). Objective: The objective of the study was to evaluate the impact of chronic hyperglycemia on in-hospital and short-term outcome in patients with acute anterior MI treated with streptokinase as thrombolytic therapy. Materials and methods: A total of 100 patients with acute anterior myocardial infarction received streptokinase as thrombolytic therapy were enrolled. They were classified according to the admission glycated hemoglobin (HbA1c) level into two groups: Chronic hyperglycemic group (HbA1c ≥ 6.5%) (36 patients) and non-chronic hyperglycemic group (HbA1c <6.5%) (64 patients). Laboratory investigation, conventional echocardiography, and speckle tracking were performed. Results: Global longitudinal strain (GLS) was significantly lower in patients with chronic hyperglycemia group compared to non-chronic hyperglycemia group (−13.52 ± 4.83 vs. −15.27 ± 1.87%, p = 0.009). In-hospital outcome: Heart failure and reinfarction were significantly increased in patients with chronic hyperglycemia (45.5 vs. 16.7% and 18.2 vs. 3.3%, respectively, p < 0.05). Six months outcome: Heart failure, left ventricular (LV) remodeling, arrhythmias, and bleeding rates were significantly increased in patients with chronic hyperglycemia (41.9 vs. 12.1%, 51.6 vs. 13.8%, 6.5 vs. 1.7%, and 6.5 vs. 1.7%, respectively, p < 0.05). GLS cutoff value ≥ −13.5 has the best diagnostic accuracy in predicting LV remodeling (sensitivity: 100%, specificity: 93%, positive predictive value: 94%, negative predictive value: 100%, accuracy: 97%, and area under curve: 0.99). Conclusion: Chronic hyperglycemia had higher incidence of heart failure and LV remodeling following acute MI. GLS can be used as a predictor of LV remodeling.
Resumen Introducción: La hiperglucemia tiene un impacto negativo sobre la morbimortalidad en pacientes con infarto agudo de miocardio. Objetivo: Evaluar el impacto de la hiperglucemia crónica sobre el desenlace hospitalario y a corto plazo en pacientes con infarto agudo de miocardio (IAM) anterior, tratados con estreptoquinasa como terapia trombolítica. Materiales y métodos: Se incluyeron un total de 100 pacientes con IAM anterior, quienes recibieron estreptoquinasa como terapia trombolítica. Se clasificaron en dos grupos de acuerdo con el nivel de hemoglobina glicosilada (HbA1c) al ingreso: el grupo con hiperglucemia crónica (HbA1c ≥ 6.5%) (36 pacientes) y el grupo sin hiperglucemia crónica (HbA1c <6.5%) (64 pacientes). Se practicaron estudios de laboratorio, y ecocardiografía convencional y con rastreo de marcas. Resultados: El strain longitudinal global (SLG) fue significativamente menor en pacientes del grupo con hiperglucemia crónica comparados con los del grupo sin hiperglucemia crónica (−13.52 ± 4.83 vs. −15.27 ± 1.87%, p = 0.009). Desenlace hospitalario: La falla cardíaca y el reinfarto aumentaron significativamente en los pacientes con hiperglucemia crónica (45.5 vs. 16.7% y 18.2 vs. 3.3%, respectivamente, p < 0.05). Desenlace a los seis meses: Las tasas de falla cardíaca, remodelación del ventrículo izquierdo (VI), arritmia, y sangrado aumentaron significativamente en pacientes con hiperglucemia crónica (41.9 vs. 12.1%, 51.6 vs. 13.8%, 6.5 vs. 1.7% y 6.5 vs. 1.7%, respectivamente, p < 0.05). El punto de corte de SLG ≥ −13.5 tiene la mejor precisión diagnóstica para predecir la remodelación del VI (sensibilidad: 100%, especificidad: 93%, VPP: 94%, VPN: 100%, precisión: 97% y área bajo la curva -AUC-: 0.99). Conclusión: La hiperglucemia crónica tuvo una mayor frecuencia de falla cardíaca y remodelación del VI luego de un infarto agudo de miocardio. El SLG se puede utilizar como predictor de la remodelación del VI.
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Abstract Cardiorenal syndrome is a life-threatening condition. The aim of the current study was to determine the cardioprotective effects of amlexanox in 5/6 nephrectomized rats. Rats were randomly assigned to three groups: sham, 5/6 nephrectomized rats, and amlexanox-treated 5/6 nephrectomized group. Amlexanox (25 mg/kg/day, i.p.) administration was started just after surgery and continued for 10 weeks. After treatment, kidney function (serum creatinine and urea) and blood pressure (systolic and diastolic) were measured. Heart weight (normalized to tibial length) and fibrosis area percentage were measured. Serum brain natriuretic peptide (BNP, heart failure marker) and cardiac levels of ß1-adrenergic receptor (ß1AR), ß-arrestin-2, phosphatidylinositol-4,5-bisphosphate (PIP2), diacylglycerol (DAG), pS473 Akt (a survival marker), and caspase-3 activity (an apoptosis marker) were also measured. The 5/6 nephrectomy caused renal impairment, cardiac fibrosis, apoptosis, and heart failure indicated by down- regulation of cardiac ß1AR down-stream signals compared with those in the sham group. Interestingly, amlexanox significantly reduced all cardiopathological changes induced after 10 weeks of 5/6 nephrectomy. Amlexanox showed potent cardiac antifibrotic and antiapoptotic effects in 5/6 nephrectomized rats, which were associated with reduced heart failure. To our knowledge, this is the first study that addresses the potent in vivo cardioprotective effects of amlexanox
Subject(s)
Animals , Male , Rats , Cardio-Renal Syndrome/pathology , beta-Arrestin 1/adverse effects , Aftercare/classification , Creatinine/adverse effects , Heart Failure/complicationsABSTRACT
Background: Repair operation for recurrent inguinal hernia is a more exigent than the primary inguinal hernia. Open hernia repair associated with lower recurrence and fewer complications while the Laparoscopic repair associated with less pain postoperatively, early recovery time with subsequent earlier return to activity and better results regarding the wound.Methods: From November 2015 to March 2019, a total of 86 patients were randomized. 42 patients were recruited to total extra-peritoneal repair (TEP) group and 44 patients for Lichtenstein group. Overall, 86 were operated in general surgery department, Menoufia University hospitals.Results: The mean age of patients was 41.3±14.4, range from (25-55 years). One conversion occurred in the TEP group to Lichtenstein. Operative time was significantly low in TEP group (82.7 min) compared to Lichtenstein group (108 min). Hospital stay was significantly less in TEP group (1 day) compared to Lichtenstein group (1.8 days). Patients undergoing Lichtenstein repair have significant earlier oral intake than TEP group (3.7 vs. 6.6 hours). 12 cases developed seroma in Lichtenstein group with significant p value (0.001). This study showed less immediate and early VAS score in TEP group (2.3) versus high VAS score in Lichtenstein group (5.9) with highly significant p value (0.0001).Conclusions: TEP offer excellent results than LR for treatment of unilateral or bilateral recurrent inguinal hernia with lower morbidity and less incidence of post-operative pain with subsequent earlier return to normal activities.
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Objective@#Irregular patterns of marital cohabitation are a common problem in upper Egypt due to employment conditions. The objective of this study was to investigate the effect of irregular marital cohabitation on the quality of life and sexual function of infertile men. @*Methods@#In total, 208 infertile men were included and divided into two groups. The first group included 134 infertile men with an irregular pattern of marital cohabitation and the second group included 74 infertile men with a regular pattern of marital cohabitation. All subjects were assessed through a clinical evaluation, conventional semen analysis, the fertility quality of life (FertiQoL) questionnaire, the International Index of Erectile Function (IIEF-5) score, and the premature ejaculation diagnostic tool (PMEDT). @*Results@#The two groups were compared in terms of conventional semen parameters, FertiQoL, IIEF-5 score, and PMEDT. Infertile men with an irregular pattern of marital cohabitation had significantly lower subscale and total FertiQoL and IIEF-5 scores. Additionally, they had significantly higher PMEDT scores. Erectile dysfunction and premature ejaculation were more common in them than in infertile men with a regular pattern of marital cohabitation. @*Conclusion@#Irregular patterns of marital cohabitation had an adverse effect on quality of life and sexual function in infertile men.
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Background: Women undergoing hysteroscopic myomectomy are prone to significant blood loss and hematological disturbances. Oxytocin is a uterotonic drug, used mainly in obstetric practice. Tranexamic acid is a haemostatic drug that has been used to reduce blood loss after trauma and in many surgeries. The aim of our study was to compare the safety and efficacy of oxytocin versus tranexamic acid in reducing perioperative blood loss during hysteroscopic myomectomy.Methods: This study included 60 patients scheduled for hysteroscopic myomectomy allocated into 2 groups: group A: received 10 mg/kg of tranexamic acid slowly intravenous after induction of anesthesia, while group B: received infusion of 10 IU of oxytocin at a rate of 400 mIU/min throughout the procedure. Preoperative and postoperative hemoglobin and hematocrit levels, need for blood transfusion, duration of operation, complications and medications adverse effects were recorded.Results: The 2 groups were comparable in terms of the mean difference between preoperative and postoperative hemoglobin a hematocrit levels, operative time, operative complication and medications’ adverse effects. No patients needed blood component transfusion in either group.Conclusions: It can be concluded that tranexamic acid and oxytocin are equally effective in reducing blood loss and transfusion requirements during hysteroscopic myomectomy with comparable good safety profiles. Both of them can be used according to availability and surgeon preferences.
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Dietary nitrate has been implicated in the formation of methemoglobin and carcinogenic nitrosamines in humans. The present study conducted to investigate the effects of apple peels extracts on lowering the deleterious effect of nitrate and nitrite. Various nutritional, immunological and biochemical parameters were estimated. Apple peels [ethanol or methanol] 1% extracts was added to the high dose of nitrate or nitrite in rats diet. KNO3 used as nitrate compound at 0.2% and NaNO2 used as nitrite compound at 0.05% for 8 weeks. The results indicated that the presence of either nitrate or nitrite in rat diet caused a significant decrease in food intake, body weight gain [BWG], food and protein efficiency ratio [FER, PER] when compared with control group. It could be observed that the values of immunoglobulins [lgG and 1gM], hemoglobin [Hb] and hematocrit [HCT] were significantly decreased in rats fed on basal diet with nitrate or nitrite without added apple peels extract p
Subject(s)
Animals, Laboratory , Nitrites/adverse effects , Malus/drug effects , Plant Extracts , Immunoglobulins , RatsABSTRACT
The present work seeks to investigate the effect of high doses of nutmeg [Myristica fragrans] on healthy albino rats. Twenty male albino rats Sprague Dawley were divided into 4 groups; the first group fed on basal diet [control]; the rats of second, third and fourth groups were fed on basal diet supplemented with nutmeg [5%, 10% and 15%] respectively for eight weeks. The food intake, body weight gain ratio BWG%, feed efficiency ratio FER, organs / body weight ratio, parameters of serum, Total protein, Albumin AL, liver functions [AST and ALT] and kidney functions [Urea and Creatinine] in healthy albino rats were estimated and histopathological changes in liver, kidney and heart were examined also. The obtained results revealed nonsignificant differences in serum total protein for all groups fed on basal diet supplemented with different levels [5, 10 and 15%] of nutmeg and control group. In addition the data shows significant increase in serum AST and ALT for all groups fed on basal diet supplemented with different levels of nutmeg [5, 10 and 15%] comparing with control group. In addition, it could be showed nonsignificant differences in serum albumin for all groups fed on basal diet supplemented with different levels [5, 10 and 15%] of nutmeg comparing with control group. Meanwhile significant increase in serum urea and creatinine were recorded for all groups fed on different levels [5, 10 and 15%] of nutmeg compared with control group. The results obtained in this study revealed that high doses nutmeg consumption could affect the histology of liver and kidney of albino rat. The results concluded that the functions of liver and kidney may have been adversely affected. It is recommended that caution should therefore be advocated in the intake of this product and further studies be carried out to examine these findings
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Animals, Laboratory , Drug Overdose , Liver Function Tests/blood , Kidney Function Tests/blood , RatsABSTRACT
To evaluate the role of angiogenesis in the form of microvessel density [MVD] and proliferative activity in the form of argyrophilic nucleolar organizer region [AgNOR] as independent prognostic parameters in prostatic cancer, tumour tissue from 20 radical prostatectomy specimens was examined. Examination of CD34-immunostained sections was used to calculate MVD. Modified silver stain method was used to calculate AgNORs. The distribution of the microvessel and mean number were variable in benign and different grades of adenocarcinoma. In well differentiated carcinoma, the mean MVD was 34.33 +/- 3.83 while moderately differentiated and high grade lesions were associated with significantly increased MVD [mean 45 +/- 5and 61.67 +/- 7.64 respectively]. Silver stain for AgNOR revealed non-significant increase in the mean count between benign prostatic hyperplasia [BPH], prostatic intraepithelial neoplasia [PIN], and low grade carcinoma [mean = 1.3 +/- 0.48, 1.67 +/- 0.58 and 1.5 +/- 0.55 respectively]. There was significant increase of AgNOR count in malignant cells versus BPH and PIN [mean = 2.09 +/- 0.94, 1,3 +/- 0.48 and 1.67 +/- 0.58 respectively]. There was non-significant difference in the mean number of AgNOR between low and intermediate group [mean = 1.5 +/- 0.55 and 2.33 +/- 0.58 respectiv-ely]. However, there was significant increased number in high grade carcinoma [mean = 4.33 +/- 1.53]
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Humans , Male , Neovascularization, Pathologic , Immunohistochemistry , Antigens, CD34 , PrognosisSubject(s)
Humans , Male , Female , Behavior , Social Adjustment , Depression/etiology , Depression/psychology , Aggression/psychology , Socioeconomic Factors , Comparative Study , Surveys and Questionnaires , ChildABSTRACT
Magnetic resonance images [MRI] of the pelvis in 33 women suspected of having an adnexal mass on physical examination or ultrasound study were done to determine accuracy of MRI in characterization of adnexal masses prior to surgery with correlation to histopathology. Masses were classified according to MRI diagnosis into three groups [benign [neoplastic and non neoplastic] and malignant groups]. They were analysed for size, location, morphologic characteristics and signal behaviour. In every case an attempt was made to generate a specific diagnosis according to previously reported characteristics MR appearance. Surgical follow up was obtained within 19 days of MRI examination for 30 patients. Surgical interference was avoided in 3 non neoplastic cases which diagnosed by MRI as theca lutein cysts, where follow up by clinical, examination, MRI and serial serum titre of B-subunit of hCG showed regression of masses by medical treatment. Of the total 30 operative adnexal masses, MRI, was 85.7% sensitive and 95% specific in prosectively diagnosing ovarian malignancy. MRI is highly accurate in identifying common benign and non neoplastic pelvic masses. In conclusion, when physical examination or ultrasound examination are inconclusive, pelvic MRI can aid in the evaluation of women with suspected pelvic masses
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Humans , Female , Magnetic Resonance Imaging , Sensitivity and Specificity , Pelvic Neoplasms/surgery , Follow-Up StudiesABSTRACT
To study the effect of increasing weight of the lower denture on the physiologic rest position of the m and ible, 30 complete denture wearers complaining of instability of their lower dentures were selected. The physiologic rest position was recorded and the weight of the lower denture was increased 50% for one week and the rest position was recorded. After one week, the weight was increased 100% of its original weight and the physiologic rest position was recorded. The collected data were tabulated and statistically analyzed
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Vertical DimensionABSTRACT
Since the Daubney and Hudson report in 1933 of nymphal Rhipicephalus appendiculatus ticks transmitting Rift Valley fever [RVF] virus in Kenya, there has been much speculation regarding the role of ticks in maintaining and transmitting this virus. We fed laboratory reared larvae, nymphs, and adults of five Egyptian tick species on viremic hamsters and the subsequent developmental stages or generation of these ticks on suscepetible hamsters to determine whether these tick species can maintain and transmit the virus. All results were negative or essentially negative. The tick species were Hyalomma dromedarii, H. impeltatum, H. marginatum rufipes, Rhipicephalus sanguineus and R. simus. These species commonly infest the various domestic animals that were infected by RVF virus during the 1977 -1978 RVF epidemic in Egypt