ECG finding in Sudanese athletes: a pilot study

Sudden deaths of young competitive athletes are tragic events that continue to have a considerable impact on the medical communities which raised the need for a pre-participation cardiovascular screening as a systematic practice of medically evaluating large, general populations of athletes for the purpose of identifying abnormalities that could provoke disease progression or sudden death. The aim of the study was to detect ECG changes among Sudanese athlete. The study was a descriptive crossectional study including 30 Sudanese male athletes and 20 male control subjects matched with age. The exercisers were grouped according to the type of exercise performed to static, dynamic, and mix type of exercise. Each group included 10 subjects. Their age ranged between 18-30 years. All subjects included in the study were clinically evaluated and an ECG record was obtained. significant sinus bradycardia in athletics groups was observed. The mean [+SD] PR interval in control subjects and athletes was 0.18 [p < .011] ms and 0.20 [p < .010] ms respectively [p < .005]. Comparisons among groups revealed significant prolongation in PR interval in the dynamic exercisers [mean 0.22 ms] when compared to control subjects, the static and mix exercisers. The QT interval was prolonged among dynamic exercisers when compared with the other athletes and the control subject [p < .008]. There was sinus bradycardia in all groups of athletes. A statistically significant prolongation of the PR, QT and RR intervals among dynamic type of exercise in comparison to different types of exercise was obtained. A pre participations ECG screening is recommended to be performed for all Sudanese athletes before participation in any competitive exercise

Depiction and clarity of TMJ in corrected tomography: influence of variabilities of the pre-estimated condylar angle measurements

The primary objective of TMJ tomography is the accurate depiction of anatomic detail from which diagnostic information concerning osseous morphology, surface irregularities and condylar-fossa relationships can be determined. The current use of the term corrected lateral tomography implies that the parasagittal condyle position and image layer have been individually selected on the basis of condyle position in relation to reference plane as determined by submento-vertex radiographs. This study was designed to evaluate the effect of variation of horizontal condylar angulation on the diagnostic quality of the produced tomographic images. The horizontal condylar angle was measured on dry skull using cephalometric submento-vertex radiograph using a standardized technique. Corrected lateral tomograms were produced using the pre-determined horizontal condylar angle and by varying this angle +2, +4, +6 and +8 or -2, -4, -6, and -8 degrees. Qualitative analysis, include depiction and clarity, of condylar head and outline form and cortication of the joint temporal components and quantitative analysis, include geometric linear and angular measurements of the produced tomograms were carried out by the investigators. The results of this study showed that condylar slopes were well demarcated in all cut depths while the temporal components were presented well in the most medial cuts only. By increasing or decreasing the condylar angle, the most medial cuts showed the highest concordance with the predetermined angle followed by the central cuts, while the most lateral cut revealed the heighst variation and was markedly affected. With regards to joint space, Joint space measurements were not greatly affected by decreasing the angle except at the extreme (-8°) but it is affected prematurely on increasing the angle by [+4°].

Value of adenosine deaminase determination in the diagnosis of tuberculous ascites

Tuberculous peritonitis [MP] is a common problem in the developing world. A number of diagnostic tests have been described, but none proved to be of sufficient sensitivity and specificity. The gold standard remains laparoscopy with direct biopsy, yet it is invasive and not always available. Ascitic fluid adenosine deaminase [ADA] activity has been proposed as a useful diagnostic test. The present study was performed to determine the diagnostic utility of ascitic fluid ADA in the diagnosis of TBP. The study included twenty five patients with ascites, they were divided into 2 groups: Group 1 included 13 patients with TBP, Seven had TB peritonitis and cirrhosis, and six had TB peritonitis in the absence of cirrhosis [isolated TB peritonitis]. Group 2 [control group] included 12 patients with ascites of different etiologies, 7 had liver cirrhosis, 2 had nephrotic syndrome, and 3 had malignant ascites. Adenosine deaminase activity in ascitic fluid was examined in patients with confirmed TB peritonitis and compared with that of patients in the control group. The results showed that abdominal swelling was the most frequent symptom, while ascites was the most frequent sign of TB peritonitis, all TB peritonitis patients had exudative ascites with lymphocytes predominance in 76%. The mean adenosine deaminase activity was significantly higher in the ascetic fluid of the tuberculous peritonitis group [52.62 +/- 16.08 IU/L] than in the non-tuberculous group [16.17 +/- 7.99 IU/L], P < 00001. ADA showed a sensitivity and specificity of 92.3% and 100%, respectively. In conclusion: adenosine deaminase activity determination in ascitic fluid is a useful less invasive screening test in the diagnosis of peritoneal tuberculosis, particularly when more invasive diagnostic methods via peritoneoscopy and laparoscopy are not available

Pyrin / marenostrin mutations [M694V and V726A] in Egyptian patients with familial Mediterranean fever

Diagnosis of familial Mediterranean fever [FMF] has until recently been based on clinical signs alone. Undiagnosed patients with Familial Mediterranean Fever [FMF] are at risk for developing amyloidosis or for being subjected to unnecessary operations. The gene causing IMF, designated MEFV [Pyrin/ marenostrin] was recently identified and found to be expressed in mature neutrophils, suggesting that it functions as an inflammatory regulator. The aim of the present study was to search for pyrin mutations [M694V and V726A] associated with familial Mediterranean fever in Egyptian patients

Patients and Methods: the study included 15 patients with FMF, and ten healthy controls. Mutations in the 25 samples were assessed by amplifying genomic DNA with use of three primers that selectively amplify the normal or altered DNA sequence of the 2 MEFV mutations [M694V and V726A] by polymerase chain reaction

Results: showed that in patients with FMF family history was relevant in 6 [40%] patients. Fever and Abdominal pain were present in all [100%] the cases, chest pain in 5 [33.3%], artharalgia in 2 [13.3 %], and six [40%] patients had past history of appendicectomy. M694V mutant was detected in 11 [73%] patients and V726A in 8 [53%], all healthy controls [100%] were negative for both M694V and V726A mutants of MEFV gene and positive for normal MEFV gene with a sensitivity and specificity of 63% and 100% respectively

Conclusion: MEFV gene mutations [M 694 V and V 726 A] seem common in Egyptian patients with FMF. The ARMS assay is a rapid and accurate method for detecting mutations in familial Mediterranean fever. It may be a useful test in detecting patients with atypical clinical presentations, who do not satisfy diagnostic clinical criteria

Serum and CSF electrolytes, zinc and glucose concentration in febrile convulsions; are they useful biochemical markers in such cases?

This study was designed to assess serum and CSF concentrations of sodium, potassium, zinc and blood glucose in infants and children presented with febrile convulsions in comparison with age matched healthy controls. On the other hand, it aimed to investigate the correlation between serum and CSF concentrations of those variables in enrolled cases in a trial to delineate their usefulness as biochemical markers in such cases. Twenty-one cases with febrile convulsions [FC] were included in the current study as group I [cases] and ten age matched clinically healthy children were also enrolled as group II [controls]. Full history taking, thorough clinical examination, CBC and ESR estimation, assessment of serum Na, K, Zn and blood glucose concentrations were done for all subjects included in the current study. Lumbar puncture with complete CSF examination was carried out for all cases, excluding bacterial or viral meningitis or encephalitis and determining the CSF concentrations of the previously mentioned biochemical variables. In conclusion, it was recommended to assess Na and Zn levels in cases with febrile convulsions to detect any possible deficiency and to conduct future studies to investigate the effect of their supplementation, whenever deficient, on the course and recurrence of convulsions