Relationship between right ventricular pacing and non-sustained ventricular arrhythmias in patients with dual-chamber pacemaker and normal range left ventricular ejection fraction

Background@#Right ventricular pacing (RVP) increases heart failure, AF, and death rates in pacemaker patients and ventricular arrhythmias (VAs) in defibrillator patients. However, the impact of RVP on VAs burden and its clinical significance in pacemaker patients with normal range LVEF of > 50–55% remains unknown. We sought to evaluate the relationship of RVP and VAs and its clinical impact in a pacemaker patient population. @*Methods@#Records of 105 patients who underwent de novo dual-chamber pacemaker implant or a generator change (Medtronic™ or Boston Scientific™) for AV block and sinus node disease at a tertiary care center between September 1, 2015, and September 1, 2016, were retrospectively reviewed. @*Results@#Data from 105 patients (51% females, mean age 76 ± 1 years, mean LVEF 61 ± 0.7%) without history of VAs (98.2%) were reviewed over 1044 ± 23 days. Dependent patients (100% RVP) exhibited the lowest VAs burden when compared to  1/h of PVC runs and increasing PVC runs/h were significantly associated with hospitalization (p = 0.04) and all-cause mortality (p = 0.03), respectively. @*Conclusions@#In pacemaker patients with normal range LVEF (> 50–55%), 100% RVP is associated with the lowest burden of NSVT. Furthermore, patients with < 1% RVP also exhibit low VA burden; however, intermittent RVP seems to significantly correlate with non-sustained VAs.

Fraser syndrome: Phenotypic variability and unusual findings in four Egyptian families

Background and aim: Fraser syndrome [FS] is a rare autosomal recessive disorder characterized by cryptophthalmos, cutaneous syndactyly, laryngeal malformations and urogenital defects. It may be also associated with ear, nose and skeletal abnormalities. There is a marked interfamilial clinical variability. However, there is strong phenotypic similarity and concordance of the degree of severity of the disease within a family. Our aim was to report new cases of FS from the Egyptian population

Patients and methods: The study was carried out on 6 new cases of FS from four Egyptian families. All patients satisfied the diagnostic criteria for FS

Results: Cryptophthalmos and ambiguous genitalia were each present in 5/6 of the studied cases, while syndactyly and urinary tract abnormalities were found in 4/6 of them. Nasal anomalies, sclerocornea and abnormal hair growth pattern were constant features observed in 100% of the cases. The frequency of additional anomalies in our series was also higher than those previously reported as umbilical abnormalities and contractures of large joints

Conclusion: In conclusion, our findings add further evidence for the clinical variability associated with FS. The studied cases showed inconsistent compatibility with life and variable expressions in prenatal sonographic findings and postnatal clinical manifestations

relation of opium addiction and reproductive toxicity in male rats: a histological and hormonal study

Consuming of opium is a new phenomenon that could be significantly observed in some regions of Iraqi Kurdistan region, especially in districts near to Iran borders. Long term consumption of opioids affects body homeostasis. This study is designed to determine the effects of opium on reproductive histological and hormonal parameters in addition to the study of qualitative sperm abnormalities in experimental rats. The rats of the experiment were divided into three groups: Control group and the two experimental groups which were treated with two different concentrations of opium [25 and 50 mg/kg/day] for 7 days. After the decided period, the rats were dissected. Serum testosterone and sperm quality was determined and histological sections were prepared from the testis. Testosterone significantly reduced in opium treated rats in both low and high doses. The histological sections of testis showed testicular degeneration in the seminiferous tubules, while higher dose showed loss of normal architecture of seminiferous tubules, in addition to present of giant cell in lumen of tubules. Several types of sperm abnormalities were observed, but the head-neck connection abnormality was the dominant. This finding suggests that opium addiction can cause significant decrease in the male sexual hormone secretion and it also leads to the alteration in the sperms and testis structure. This may lead to sexual suppression and infertility which needs further investigations

Synthesis of some new pyranoquinoline derivatives of potential antineoplastic activity

Few reports concerning the antineoplastic activity of certain pyranoquinolines have been reviewed. In the present work, synthesis of some pyranoquinoline derivatives as antitumour agents is described. The key intermediate 10-amino-3-oxo- pyrano[3,2-t] quinoline-9-carbonitrile III was prepared. Acylation of the amino compound III afforded the corresponding amides IV, while its reaction. with certain aromatic aldehydes gave the 10-arylidineamino derivatives V. Also, the reaction of III with triethylorthofonnate yielded the ethoxymethyleneamino derivative VI, which when subjected to a substitution reaction with hydrazine hydrate or methylamine, afforded compounds VII and VIII, respectively. Reaction of the aminonitrile derivative with carbon disulfide yielded the tetracyclic structure pyranopyrimidoquinoline IX. Additionally, heating 6-aminocoumarin I with arylidine derivatives afforded pyranoquinoline-9-carbonitriles X and 9-carboxylates XI. The nitrilo derivative XII was prepared from the reaction of I with ethyl ethoxymethylene cyanoacetate, which upon alkylation with 2-chloroethanol yielded the key compound XIII. Acylation and alkylation of this compound, in addition to its chlorination and subsequent reaction of the chloro intermediate with various amines ended up with the desired compounds XIV, XV, XVI and XVII

new modality for early diagnosis and severity prediction in necrotizing enterocolitis

To develop a new method for diagnosing necrotizing enterocolitis and prediction of severity with the use of computed tomography [CT]. Urine specimens from 63 premature neonates were obtained at 4-hours interval for 24 hours duration after administration of iodinated water-soluble contrast material [Iohexol] entrally for 45 neonates from them. Twelve neonates had definite necrotizing enterocolitis [NEC] [group I] and 10 neonates had suspected NEC [group II]. Urine from another two groups without any clinical evidence of NEC [at the time these studies were performed] was collected, 23 neonates [group III] received Iohexol [who underwent upper gastrointestinal study], and 18 neonates [group IV] did not receive Iohexol. The attenuation coefficient of each urine specimen was determined with CT [equivalent to the concentration of the Iohexol in urine]. The mean CT attenuation coefficient of urine from neonates who did not receive Iohexol [group IV] was 5.2 +/- 3.5 HU [Hounsfield unit], and that from neonates without NEC [group III] [who underwent upper gastrointestinal study] was 6.8 +/- 3.0 HU. The mean CT attenuation coefficient of urine from patients with suspected necrotizing enterocolitis [group II] was 28.0 +/- 3.8 HU, and that from patients with definite necrotizing enterocolitis [group I] was 73.0 +/- 19.8 HU. The mean CT attenuation coefficient in neonates with NEC were significantly higher than that from suspected group and than that from patients without NEC whether received the Iohexol or not [P<0.01]. Follow up samples revealed significant reduction in the CT attenuation coefficient after treatment. Urine from neonates with necrotizing enterocolitis show significantly higher CT attenuation coefficients than those from patients without necrotizing enterocolitis. CT examination of urine may allow early diagnosis of necrotizing enterocolitis, effect of treatment as well as severity prediction

B2 microglobulin: a useful marker of disease activity in patients with idiopathic dilated cardiomyopathy [IDC]

30 patients with idiopathic dilated cardiomyopathy [IDC], 25 males and 5 females aged 55 +/- 3 years were investigated consequently between January 1993 and October 1994. The positive control group consisted of 15 patients with invasively diagnosed 2 or 3 vessel coronary artery disease who had a comparable degree of concomitant heart failure [i.e. ischemic cardiomyopathy]. 15, age and sex matched healthy donors and 14 patients with coronary artery disease and normal left ventricular function composed the negative control group. T-cell markers [IL2 and CD4] and renal function tests were measured with B2-microglobulin. It was concluded that, B2 microglobulin level in IDC resulted from its enhanced synthesis by T-lymphocytes as well as from its diminished clearance through kidneys. Thus, B2 microglobulin may serve as useful marker of disease activity, reflecting different aspects in the multi factorial pathogenesis of IDC

Factors affecting birth weight in Kuwait: part II-pregnancy characteristics and health factors

The aim of this study was to determine the mean birth weight of Kuwaiti infants, the incidence of low birth weight and the impact of maternal age, smoking, health status, parents' consanguinity and pregnancy characteristics on infants' birth weight. The study was conducted in the major maternity hospital in Kuwait where the body weight of 1995 newborn infants was recorded shortly after birth. Data describing maternal age, duration of pregnancy, sex of the infant and maternal illness during pregnancy were recorded. Mothers were interviewed to collect data on duration between present and last pregnancy, birth order of the infant, parents' consanguinity and frequency of smoking. The results show that the mean birth weight was 3.5 Kg and the incidence of low birth weight was 3.4%. The results illustrate that young mothers were more liable to have small infants while old mothers were more liable to deliver a very heavy or low birth weight infant. The weight of the newborn infant was positively correlated with duration of pregnancy, duration between present and last pregnancy and birth order. The mean birth weight of male infants [3.51 Kg] was higher than females [3.47 Kg]. Parents' consanguinity and maternal smoking had a slight effect on infants' birth weight. The results show that diabetic mothers delivered large babies. On the contrary, the incidence of low birth weight was highest [7.0%] among infants of hypertensive mothers

Cytokeratin and vimentin in parotid salivary gland pleomorphic adenoma

The expression of cytokeratin and vimentin is described in 10 pleomorphic adenomas and in normal salivary gland tissue using an immunoperoxidase method. From our observations we can conclude the following 1] In tumour tissue the basal layer of tubulo - ductal structures and the spindle cells in masses showed positive staining with monoclonal cytokeratin [KG 8.13] and vimentin antibodies. The luminal cell layer was positive to cytokeratin antibody. 2] The distribution of cytokeratin and vimentin in pleomorphic adenoma was similar to that present in normal salivary gland tissue. 3] The basal cell in tubulo-ductal structures expressing both epithelial and mesenchymal cell markers seem to represent a population of stem cells capable of differentiation along epithelial and mesenchymal lines of differentiation. These cells can have an important role in the histogenesis of pleomorphic adenoma

Evaluation of nutrition knowledge and attitude among post graduate students with medical and non medical background

A demographic and attitudinal questionnaire and a knowledge test were administered to post graduate students with medical and non medical background upon entry to their first nutrition course at the High Institute of Public Health. Knowledge was assessed regarding basic principles of nutrition and nutrition application [food sources, food functions, requirements and factors affecting requirement and other nutritional information] using t-test for paired observations. results indicated that the students had a relatively low knowledge of nutrition upon entering the course, but there was a significant improvement upon completion of the course. Moreover, stepwise multiple regression analysis applied to determine the effect of different factors on initial knowledge and achievement score indicated that educational background was the most important independent variable affecting significantly students initial knowledge where students with medical background showed a higher score than those with non medical background, while prescore was the most important independent variable affecting significantly students achievement where students with low prescore showed a higher achievement score as compared to those with high prescore. Attitudes were assessed regarding the role of dietitian in the hospital, nutrition education and general nutrition using Wilcoxon matched pairs test. Attitudes were not greatly altered during the nutrition course

Patients' satisfaction with diets presented in Kuwaiti hospitals

The study was implemented to investigate patients satisfaction with diets presented in Kuwaiti hospitals. Four hospitals were included in the study, Al-Sabah and Chest disease hospitals in which dietary services are offered directly by the nutrition and catering administration of the Ministry of Health and Al-Jahra and Farwanya hospitals in which dietary services are offered by catering companies. The survey included 171 Kuwaiti and 355 non-Kuwaiti patients. Data was collected by direct interview technique using a pre-coded questionnaire. The patients were questioned about their opinion of the hospital diet, its quanity, temprature, time of presentation and how frequently do they bring foods from outside the hospital.The result of this study show that patients reported that breakfast and dinner were offered early. In the mean time 30.2% reported that the quantity of food offered is more than required and as a result 50% of the patients did not consume all the food offered to them. The results also show that 10% of the patients felt hungry after consuming hospital meals, 21.4% received exogenous food either regularly or occasionaly. The results also show that 11.6% of the patients received diets that were not compatible with their diagnosis

Synthesis of trisubstituted psoralens as potential photosensitizing agents

Eight new trisubstituted psoralenes have been synthesized starting with 7-hydroxycoumarins. The photosensitizing activity of 8-aroyl-4,5-dimethylpsoralenes and 8-aroyl-4-methyl-4'-substituted psoralenes were compared to that of the very active xanthotoxin. Some representatives of the prepared psoralenes showed in vitro lethal photosensitizing activity on Bacillus subtilis

Chemical composition of animal bile

The crude bile salt percent, moisture content, total solid percent, nitrogen and crude protein content in bile salts and dehydrated bile obtained from the gall bladder of sheep, cattle, old and calf buffaloes were analyzed

Iron and folic acid metabolism in chicks

The effects of iron and/or folic acid deficiency on hemoglobin, hematocrit, growth rates, liver weights and folic acid metabolism were investigated in chicks. A severe anemia developed in all chicks fed the deficient diets; those fed the diet low in iron and folic acid developed the most severe anemia. Maximum growth retardation was noted in chicks fed the folic acid deficient diet rather than in the double deficient chicks. A significant decrease in plasma folic acid was noted in the folate deficient groups and a comparable reduction in plasma N[5]- methyl tetrahydrofolic acid was observed in the iron deficient chicks. Perhaps the most interesting observation made from this study is that the chick maintains more than half of its plasma folic acid as tetrahydrofolic acid rather than in the form of N[5]- methyl tetrahydrofolale which is the major circulating form in most mammals tested. It was concluded from this study that as in man or the rat prolonged iron deficiency may enhance or induce secondary folate deficiency in the chicks. Further, the chicks susceptibility to dietary folate deficiency in contrast to other species may be related to the form in which it maintains its circulating folate

Etiology of infectious diarrhea in Egyptian children in a clinic population

Two pilot studies of infant diarrhea were conducted in Egypt in October, 1979, and June, 1980. The study identified one or more enteric pathogens in 87% of patients and 54% of controls. Giardia lamblia, rotavirus, and toxigenic E. Coli were the leading causes of illness. The latter two organisms have not been reported before in Egypt. In the second study, more limited in scope, G. Lamblia and rotavirus were the most important agents