value of right ventricular outflow-tract fractional shortening for assessment of right ventricular function

Assessment of right ventricular function is important. However, this is not easy to achieve due to the complex anatomy and geometry of the right ventricle, making the evaluation of its function limited. Therefore, a simple reliable and easy method is needed. This work was to evaluate the use of right ventricular outflow tract fractional shortening obtained by M-mode echocardiography as a measure of right ventricular systolic function in patients having inferior wall myocardial infarction with or without evidence of right ventricular infarction [as a model of right ventricular disease]. Fifty patients with first acute inferior wall myocardial infarction, their ages ranged from 30 to 80 years with [mean +/- SD = 54.56 +/- 11.5], were investigated. Ten healthy controls also were studied. M-mode echocardiography was used to measure right ventricular outflow tract fractional shortening and right ventricular long axis excursion. Two-dimension echocardiography was used to measure right ventricular ejection fraction. Ventricular outflow tract fractional shortening [p<0.0001], right ventricular long axis excursion [p<0.0001] and right ventricular ejection fraction [p<0.0001] were reduced in patients compared to controls. Also were reduced in patients in group [B] compared to patients in group [A]. Right ventricular outflow tract fractional shortening correlated with long axis excursion [r=0.86, p<0.0001], right ventricular ejection fraction [r=-0.84, p<0.0001]. Right ventricular outflow tract fractional shortening provides a simple and non-invasive measure of right ventricular systolic function and could be helpful in diagnosis of right ventricular infarction in patients have inferior wall MI. In combination with long axis excursion and Doppler velocities, they should provide comprehensive assessment of right ventricular function

Twenty four-hour ambulatory blood pressure monitoring in detection and management of hypertension compared to clinic readings

Blood pressure measurements taken in a physicianis clinic or by patients themselves don't represent readings throughout the day. Ambulatory blood pressure monitoring [ABPM] overcomes this problem by providing multiple readings over time with minimal intrusion into the patient's daily activities. The purpose of our study was to evaluate the value of 24-hour ABPM in detection and management of hypertension over traditional over traditional office measurements. A total of 100 never-treated or already known essential hypertensive patients divided into 2 groups, first group included 50 patients managed according to 24 hour ambulatory blood pressure monitoring results and the second group 50 patients according to office blood pressure measurements. All patients underwent the following procedures: [i] repeated clinic blood pressure measurements, [ii] blood sampling for routine chemistry examinations; [iii] 24-hour urine collection for microalbuminuria; [iv]echocardiography; and ABPM for the first group. Main indications for ABPM were borderline hypertension [44%], de novo hypertension 20%] and resistant hypertension [36%]. Mean age of the first group was 44.1 +/- 9.8 versus 54.4 +/- 11.6 years [p=0.002] and 24-hour ambulatory blood pressure was 129/80 mmHg with mean +/- SD 11.4/10.1. ambulatory blood pressure monitoring has changed our treatment strategy in 80% of patients. Its parameters were significantly correlated with left ventricular hypertrophy [p=0.04], diastolic dysfunction [p=0.012], hypertension duration and body mass index than traditional clinic measurements did. Twenty four hours ambulatory blood pressure monitoring is an important yet underused tool for the management of hypertension patients especially those with borderline, recent onset and even resistant hypertension. Our collective results revealed superiority over office blood pressure measurement

Qualitative and Quantitative coronary angiogra-ply in patients with st segment elevation myocardial infarction versus patients with non- st segment elevation M.I.

This study was carried out at Nasser Institute Hospital during the period from October 1997 to August 1999. The aim of this work was to identify if there is a significant difference between ST segment elevation myocardial infarction [STEMI] and non-ST segment elevation myocardial infarction [NSTEMI] as regards risk factor distribution, cardiac enzymes elevation, echocardiographic examination and quantitative coronary angiographic parameters. Forty patients with acute myocardial infarction were studied, 20 were diagnosed as STEMI [group 1] and the other 20 patients were diagnosed as NSTEMI [group 2] on the basis of electrocardiographic analysis. Every patient was submitted to full medical history, thorough clinical examination and measurement of cardiac enzymes including CPK, LDH, CK-Mb fraction. Resting electrocardiography, echocardiography and coronary angiograms were performed. The results of this work showed that patients with NSTEMI had a statistically significant more prevalent history of myocardial ischemia or infarction [40% versus 5% in patients with STEMI]. Also, a statistically significant lower level of cardiac enzymes and a statistically significant less occurrence of regional wall motion abnormalities were detected. On the other hand, risk factors [age, sex, smoking, hypertension, diabetes mellitus and hyperlipidaemia], left ventricular function, fractional shortening and all QCA parameters showed no statistically significant difference between both groups

Dermatoglyphics in glucose6- phosphate dehydrogenase deficiency

The palmar and plantar dermatoglyphics were studied in 30 male children affected with G6PD deficiency, their mothers who were taken as obligate carriers and their 17 unaffected male sibs. The results were compared with those of 420 normal persons as control group. Certain significant dermatogiyphic features were detected both in the patients and their mothers but not in their unaffected male sibs. These features may be due to the association or linkage between the mutant X-linked gene of G6PD and one or more of the genes controlling the development of dermal ridge patterns However, the similarity of the findings of the patients and carriers led us to suggest taking these features to identify the carriers in a family having a patient with G6PD deficiency

Dermatoglyhic patterns in children with congenital deafmutism

Dermatoglyphic patterns were read by direct vision and recorded for 115 children having isolated cogential deafmutism [C.D.M.] and compared with the normal Egyptians reported by Hafez et al[5]. The findings were analysed as described by Cummins and Midlo[3] type of C line was interpreted by plate method[9], D line by Cummins and Midlo method[3], and the classification of interdigital areas as described by Plato and Werteleki[10]. Palmar creases were analysed as described by Alter[1]. The results showed important significant differences in the dermatoglyphic features of children with C.D.M. which could be summarized as follows: [a] increased frequency of arches in both digits and toes, [b] low ridge count in the digits, [c] high ridge count in the toes, [d] increased frequency of open/arch in hypothenar, thener/I, area III and area IV, and [e] increased frequency of partial simian crease. The changes may be due to the linke of the specific and responsible genes of dermal development with the gene of C.D.M