Résumé
Background: Association between increased serum uric acid and cardiovascular risk is present in general population including patients with hypertention The effect of gender on the role of serum uric acid in progression of left ventricular hypertrophy in hypertensive individuals has not been well characterized
Aim of the Study: The aim of the present study was to determine whether sex differences contribute to the risk of association of serum uric acid and left ventricular hypertrophy in hypertensive individuals
Patients and Methods: Seventy participants with essential hypertension [34 men. 36 women; with mean age 54.4+/-1.6 years] were enrolled to undergo echocardiography to calculate the left ventricular mass index [LVMI]. Twenty-four hour ambulatory blood pressure monitoring was done to assess blood pressure level precisely .Serum uric acid was determined
Results: The LVMI was significantly positively correlated with serum uric acid [r=0.295, P<0.01] in all participants. After controlling for factors such as age, sex, mean 24-h systolic blood pressure, creatinine clearance, and duration of hypertension, serum uric acid was still found to be significantly and independently associated with LVMI. Because serum uric acid was significantly higher in men than in women [6.8+/-0.3 and 5.1+/-0.2 mg/dl, respectively], subsequent analysis was performed by gender. Multiple regression analysis revealed that the LVMI was significantly and independently associated with serum uric acid in women, but not in men
Conclusions: The potential effect of serum uric acid on LV hypertrophy is more pronounced in hypertensive females than in males
Résumé
Background: thrombus formation has predilection to form within the left atrial appendage [LAA] in patients with rheumatic mitral stenosis both in atrial fibrillation and in sinus rhythm. Transesophageal echocardiographay [TEE] was used for LAA evaluation however it has its own limitations
Aim of the Work: evaluation and comparison of LAA wall dynamics using TEE pulsed wave Doppler tissue imaging [Pw-DTI] in patients with pure mitral stenosis both in sinus rhythm and in atrial fibrillation
Patients and Methods: 90 patients with severe pure rheumatic mitral stenosis and left ventricular ejection fraction > 50%, 50 of them were in sinus rhythm and 40 were with atrial fibrillation and 20 persones were selected as control. After 2D and M-mode transthoracic echo-Doppler evaluation, TEE has been done. From mid-esophageal short axis view at the level of aortic valve the LAA was visualized with Pw-DTI, the med lateral and medial walls velocity curves were recorded, peak inward D1, 02, and outward D3 waves velocities were measured
Results: A triphasic [d1, d2 and d3], LAA flow velocity curve was recorded in all controls and only in 4 patients of the sinus group however it was biphasic [absent d1] in 46 patients of the sinus group and in all patients of the AF group. Mechanical Pw-DTI derived velocity curve was triphasic [D1, D2 and D3] in all included sinus patients and controls however it was biphasic [absent D1] in all AF patients Timing in sinus patients and in control subjects showed that the inward D1 corresponded in time to the LAA out flow, and mitral E wave ie. it was early diastolic wave, the second inward 02 wave followed the ECG atrial P wave and just preceded mitral inflow A and LAA out flow d2 waves, it was due to atrial appendage contraction, finally 03 followed 02 and was followed by LAA inflow d3 wave, It was due to LAA relaxation. Mean peak velocity of D1, 02 and 03 were significantly decreased [P<0.01], in sinus patients compared to controls. Mean peak velocity of D2 and D3 were significantly decreased [P<0.01] compared to both sinus patients and control subjects indicating impaired both contractile and relaxation function of LAA that is more severely affected in fibrillating patients when compared to sinus patients Heterogenity of contractile and relaxation velocities with significantly lower D1, D2, D3 [P< 0.01] of lateral wall then medial wall peak velocities in both patient groups and controls were recorded. Those with spontinous echo-contrast had significantly lower [P< 0.01]. peak D1, D2, D3 than those without echo-contrast
Conclusion: transesophageal Pw-DTI enable us to directly assess the mechanical function of the LAA which is more phyiological. This mechanical function was impaired in rheumatic mitral stenosis patients and was more severely affected in fibrillating patients
Résumé
The chemical industry has grown much more rapidly in the last 3-4 decades than industry as a whole, and now it accounts for 10-12% of the output of manufacturing industries in the principal industrialized countries. Chemical industry is a promising and increasing economic activity in Egypt. This industry comprised a large number of activities covering manufacturing, formulating and processing of hundreds of end-products; plastics, pharmaceuticals, construction materials, agrochemicals, rubber, artificial fibres, oils, coke, glass, detergents, dyes, porcelain, cables, and many other products. This study is aiming at investigating work-related accidents in some Egyptian chemical industries. Factories employing more than 100 workers, and present in Greater Cairo are included in the study. The data analyzed, are based on the statistics received in the Ministry of Man-power and Training, during 1989, from 39 establishments. The total labour force in the 39 plants was 53, 135; 45, 080 males, 7, 884 females, and 171 juvenilles. Job-related accidents in the studied plants were 5, 146 representing 9.685% of all job-connected labour force. Two thirds of the injured workers aged 20-39 years age less experience. Falls of subjects, falls of objects, and struck-by-objects were the major causes of accidental injuries 23.3%, 13.7%, and 13% respectively. Mechanical moving vehicles, liftening and transport objects, and the working environment, were the main agents of accidents for 42.8%, 20.8%, and 17.4% of injuries respectively. Upper and lower extremities were the main parts of body injured *60%], followed by multiple injuries [13.2%] and Head injuries [4.7%]. The total days lost due to the related injuries amounted 103, 887 with an incidence rate of 9.885%, frequency rate of 46.73 hours per one million hours worked and severity rate of 9.43 days per 1000 days worked