Impact of anemia on diastolic function among a sample of Egyptian patients with type 2 diabetes

Anaemia which is common in patients with diabetes has an established role in heart failure. Whether or not anaemia contribute to an increased risk of cardiac dysfunction in patients with type 2 diabetes, needs to be evaluated. Aim of the work: to investigate the effect of anaemia as a risk factor on the abnormal diastolic function in type 2 diabetes. Seventy diabetic patients from Diabetes Clinic, Ain Shams University Hospitals, Cairo, Egypt were investigated for control of blood glucose, haemoglobin level, creatinine clearance and albuminuria. Transthoracic echocardiography and tissue Doppler were performed to study parameters diagnosing diastolic dysfunction. 71.4% of the patients were anaemic. Diastolic dysfunction was more prominent in the anaemic patients as they showed significantly higher LAA, E/A, E/E' [0.35 +/- 0.06 cm2, 1.29 +/- 0.63, 8.7 +/- 0.4, respectively] compared to the non anaemic patients [0.32 +/- 0.06 cm2, p,0.05, 0.99 +/- 0.51, p<0.05, 6.86 +/- 0.18, p<0.001, respectively]. By multivariate analysis haemoglobin showed independent association with E/A even after adjustment for age, BMI, BP, albuminuria and creatinine clearance. Decreased haemoglobin level is a potent independent risk factor of diastolic dysfunction among type 2 diabetic patients. Thus maintenance of haemoglobin level in these patients within normal range improves the degree of cardiac

Epidemiology and prognosis of acute renal failure in children

One hundred and thirty three children with nonsurgical forms of acute renal failure [ARF] were admitted during a six-month period [January to June, 1991] to the Department of Paediatrics, Mayo Hospital, Lahore; they comprised 1.8% of the hospitalised children. Newborns and infants constituted 69% of the patients. Acute diarrhoea [53%], sepsis [21%], and haemolytic uraemic syndrome [8%] were the leading causes of ARF. The case fatality rate was 23.3%, with septicaemia as the major cause [48%] of death. Four patients [3%] developed chronic renal failure. Good prognosis indicators were prerenal oliguria versus renal oliguria, based on history, and low fractional excretion of sodium [< 1%] and renal failure index [< 1]; oliguria of less than seven days; unclouded sensorium; and early dialysis at the onset of complications