Short Term Outcome of Percutaneous Coronary Intervention in Anaemic Patients Presenting with Coronary Artery Diseases

Background: Percutaneous coronary intervention (PCI) has been an effective and widely used treatment for patients with coronary artery disease (CAD). The presence of anaemia in critically ill patients undergoing surgical procedures has been associated with worse clinical outcomes. Hence, the current study was conducted to assess short term outcome of percutaneous coronary interventions in anaemic patients presenting with coronary artery diseases. Methods: This prospective observational study enrolled 200 patients who underwent PCI. Patients were classified into 2 groups: anaemic patients and non-anaemic patients. The anaemic patients were furtherly be classified according to severity of anaemia into 3 grades mild anaemia, moderate anaemia, and severe anaemia. All cases were subjected to complete history taking, clinical examination and baseline laboratory tests: including CBC, serum urea and creatinine, cardiac enzymes include serum troponin, CK-MB and standard 12-lead ECG. Results: The mean Heart Rate was statistically significantly higher in the anaemic group as compared with the non-anaemic group. The mean Ejection Fraction was statistically significantly lower in the anaemic group as compared with the non-anaemic group. The percentage of LM affection in the anaemic group was statistically significantly higher as compared with the non-anaemic group. The incidence of arrythmia in the anaemic group was statistically significantly higher as compared with the non-anaemic group. Severe anaemic and low EF% patients were associated with higher incidence of stroke and MI. Conclusions: Patients with baseline anaemia before PCI have a higher incidence of PCI associated complications. Therefore, anaemia could be a predictor of PCI related complications.

Epidemiology of Pacemaker Implantation among Patients in Tanta University Hospitals

Background: This study describes cardiac pacing activity during 2021: demographic data of patients underwent permanent pacemaker implantation (PPM), risk factors, clinical presentations, indications, mode of pacing, and complications post PPM implantation. Cardiac pacemakers have become the common treatment of symptomatic bradycardia or high-grade atrioventricular block. Methods: The study was carried out at the department of cardiology Tanta University Hospitals. 102 patients were included in this study. This study was done over a period of six months from October 2020 until April 2021 and follow up for 6 months. All the data about the patients underwent permanent pacemaker implantation were collected by the coordinator in the participating cardiac center. Results: The most frequent risk factors of PPM implantation was hypertension (69%), followed by diabetes mellitus (29%), coronary artery disease (21%), chronic kidney disease (18%), hypothyroidism (6%), cardiomyopathy (3%), valvular heart disease (2%) and congenital heart disease (1%). The most common indication is complete heart block (69%), followed by second degree heart block "mobeitz type 2" (13%), slow atrial fibrillation (7%), symptomatic heart failure patients with LVEF ? 35% , QRS ? 150 ms (6%), trifascicular block (3%), sick sinus syndrome (2%). The most frequent mode of pacing used in our study was DDD mode (63%), followed by VVI mode (32%) with (78%) sinus rhythm and (22%) atrial fibrillation rhythm, then CRT-D (4%). Overall complication rate (9%) within 6 months. In our study the most common complication is infection (5%), followed by haematoma (1%), lead fracture (1%), pneumothorax (1%), and lead displacement (1%). Conclusion: Approximately three-quarters of the patients related to atrioventricular block underwent permanent pacemaker implantaion. Approximately more than half of pacemakers related to patients underwent permanent pacemaker implantation were dual chamber pacemakers. Infection is the most common complication in our study and this is important for strict infection control measures.

Brain Derived Neurotrophic Growth Factor and Cognitive Function in Children with Iron Deficiency Anemia.

Background: The negative effects of iron deficiency anemia (IDA) on cognition are well documented in previous studies; however, distinct mechanisms of these effects are still a matter of debate. Brain derived neurotrophic factor (BDNF) has an important role in brain functions specially memory and learning and was reported to be low in IDA in animal studies. Objective: This study was thus designed to estimate BDNF serum level in patients suffering from IDA and correlate its level to their cognitive function. Study Design: Cross sectional case-control study. Place and Duration of the Study: The Outpatient Clinic in the Children`s Hospital, Ain Shams University, between May, 2009 and March, 2010. Methods: The study was conducted on 27 child suffering from IDA (hemoglobin <11gm/dl and serum ferritin<12ng/ml) with a mean age of 7.96±3.06 years. Full history taking and thorough clinical examination were done. Complete blood count, serum ferritin and BDNF were measured. Cognitive assessment using Wechsler intelligence test was performed for enrolled children. Fifty healthy age and sex matched children were enrolled as controls. Results: Wechsler intelligence test showed significantly lower verbal, performance and total IQ values among IDA patients compared to controls. Total IQ score showed significant positive correlation with hemoglobin level and significant negative correlation with red cell width (RDW). Although BDNF level was not significantly lower in IDA patients, it showed a significant positive correlation with object assembly. Multiple regression analysis using total IQ as a dependent variable showed that RDW was the most determinant factor that affected IQ scores. Conclusion: Wechsler IQ test results were adversely affected in IDA patients. BDNF level was not significantly lower in IDA children but it showed a significant positive correlation with one of Wechsler IQ test items in such patients. Larger scale studies are recommended to further investigate BDNF as a possible mediator that disturb cognitive functions in IDA and explore other mediators.

Nutritional Knowledge, Attitude and Practice of Predominantly Female Preschool Teachers: Effect of Educational Intervention.

Aims: The study was designed to assess the changes in knowledge, attitude and practice (KAP) of preschool teachers before and after 3 months of attending a nutrition education intervention program. Study Design: Place and duration of the study: Nine governmental and 13 private schools from 2 urban districts in Cairo, Egypt between September 2011 and March 2012. Methodology: We included 150 preschool teachers (149 female and 1 male) from 9 governmental and 13 private schools. The teachers filled a questionnaire regarding their KAP towards children nutrition. Re-evaluation was done using the same questionnaire 3 months after attending a nutrition education program. Results: Initially private school teachers had significantly higher nutrition knowledge and attitude than governmental teachers (P=.012 and <.001 respectively). This difference was eliminated post intervention regarding knowledge (P=.06) but private school teachers still had significantly higher attitude by then (P=.001). Although no significant difference was initially detected in practice (P=.53), that of private school teachers was significantly better post intervention (P=.007). Finally all enrolled teachers showed significant increase in KAP scores after attending the nutrition education sessions (P<.001 for all the KAPs). Conclusion: Nutrition KAPs are essential for preschool teachers and should thus be assessed and cyclically reinforced by educational programs.

Sugar Sweetened Beverages Consumption in Preadolescent Children: 25-Hydroxy Vitamin D and Bone Mineral Density Affection.

Objective: To study the effect of heavy consumption of sugar sweetened beverages on serum 25-hydroxy vitamin D (25OHD) level and bone mineral density (BMD) in preadolescents. Study Design: Case-control. Place and Duration of Study: Outpatient clinic in Children`s hospital, Ain Shams University, between September, 2009 and July, 2010. Methods: A questionnaire to define the frequency of beverage consumption was filled by one thousand children within the age range of 8-12 years. Fifty children were selected from the heavy sugar sweetened beverages consumers and were compared to 50 clinically healthy age and sex matched children who gave no history of more than average sugar sweetened beverages intake. Each enrolled case filled a questionnaire that assesses duration of beverage intake, frequency and type as well as milk consumption. Questions concerning symptoms of pain, limitation of movement and fractures were also included. Anthropometric measurements were taken. Serum calcium and phosphorus were measured as well as the circulating 25OHD and dual-emission xray absorptiometry scan assessed their BMD Z-score. Results: Children who heavily consumed the sugar sweetened beverages had significantly lower 25 (OH) vitamin D, and BMD Z-score as compared to the controls (t= 4.05, P<0.001 and t= 3.73, P<0.001, respectively). There was significant negative correlations between duration of beverage intake and both BMD Z-score and 25OHD among heavy sugar sweetened beverage consumers(r=0.38, P=0.01 and r=0.4, P<0.001, respectively). A significant negative correlation was detected between duration of beverage intake and serum calcium among heavy sugar sweetened beverage consumers (r = -0.46 and P<0.001) and significant positive correlation between BMD Zscore and 25OHD among them (r = 0.69 and P<0.001). Conclusion: Sugar sweetened beverages intake is associated with a decrease in 25OHD which contributes to low bone mineralization in preadolescents and the duration of intake is the most determinant factor for this association. Consumption of carbonated beverages had more hazardous effect on 25OHD and BMD than packed fruit juice while milk intake showed an opposite effect. We recommend more awareness programs for preadolescents and their parents whether at school or as a part of national campaigns to boost healthy trends in beverage consumption.

Están preparadas las ciencias veterinarias y zootécnicas para el futuro: una visión desde Colombia / Are the colombian zootechnics and veterinary sciences prepare for the future?: A vision from Colombia

Se hace revisión de literatura de los ámbitos de aplicación de la medicina veterinaria y la zootecnia con el objetivo de entender su significado y acción en la sociedad actual y futura, con énfasis en la realidad colombiana. Se muestra cómo estas ciencias tienen competencias y responsabilidades importantes en diversos sectores como el ambiental, social, una salud y no únicamente en el agropecuario. La crisis ambiental y el gran dinamismo que caracteriza el mundo contemporáneo, han creado nuevas necesidades que representan una gran oportunidad para las ciencias veterinarias y zootécnicas, si éstas logran responder a los nuevos retos y aprovechar su rol natural en los sectores que ahora les competen. Su institucionalidad y hegemonía dependerá de su capacidad de adaptación, flexibilidad y liderazgo. Por lo tanto, es pertinente que las ciencias veterinarias y zootécnicas colombianas realicen una prospección colectiva disciplinaria para entender los nuevos retos y les permita prepararse para el futuro.

Dilataciones quisticas congenitas de la via biliar extrahepatica / Congenital dilatation of extrahepatic bile ducts

Se presentan tres casos de dilataciones congénitas de la Via Biliar extrahepática y se realiza revisión bibliográfica de esta patologia de presentación frecuente. Se concluye que el diagnóstico suele ser dificultoso en el preoperatorio y los métodos colangiográficos son los mejores. El tratamiento de elección en la actualidad es la Quistectomia y Hepaticoyeunostomia en "Y de Roux".

Effect of cardiopulmonary bypass on hemostatic mechanism in open heart surgery

The clinical significance of alteration in coagulation and fibrinolysis following CPB was studied in [20] cardiac patients undergoing elective open heart surgery for value replacement or repair. To all patients, the following tests were done: Platelet count, platelet aggregation, bleeding time, prothrombin time, euglobulin clot lysis time, fibrin degradation products, plasma beta thromboglobulin and plasma platelet factor 4 in 4 predetermined time. The results of the study showed significant decrease of platelet count, platelet aggregation and euglobulin clot lysis time while bleeding time and prothrombin time were significantly increased 30 minutes after CPB and one hour postoperative [P< 0.05]. All the previous parameters slightly approached the pre-operative value 24 hours post-operative but did not reach it. 5 patients [25%] showed abnormal level of FDPs [>10 ug/ml]. Beta thromboglobulin and platelet factor 4 significantly increased 30 minutes after CPB [P< 0.05]. One hour postoperative, platelet factor 4 reached the pre-operative value while beta thromboglobulin reached the preoperative value 24 hours postoperative. A significant negative correlation was found between 24 hours blood loss and both platelet count [r= 0.7] and ECLT [r= 0.7] and P.T. [r= 0.8]. So it is concluded that platelet dysfunction is the most important cause of inadequate restoration of coagulation function after CPS

Hongos comestibles, venenosos y alucinatorios de Costa Rica. / Edible, poisonous and hallucinatory fungi of Costa Rica

Este es el primer informe en torno a hongos comestibles, venenosos y alucinatorios en Costa Rica. Se incluye un total de 67 especies de las cuales 4 son alucinatorias, 55 comestibles y 8 venenosas. Comprende tambien los resultados de un estudio de las intoxicaciones a nivel nacional, basado en datos de varios Centros de Salud, entre los anos de 1972 y 1977. Se desglosan los resultados de las intoxicaciones por ano, por centro de salud asi como por edad y sexo