Exercise as a non pharmacological intervention and alternative to oral estrogen therapy in post menopausal women with endothelial dysfunction

Both exercise and postmenopausal estrogen therapy augment endothelial function through increasing bioavailability of nitricoxide [NO]. The aim of this study was to: 1- determine the effects of acute bouts of exercise on brachial artery endothelium dependent flow mediated vasodilatation FMD in postmenopausal women. 2- Whether these responses were augmented by the concurrent use of oral estrogen. 3- Whether these two interventions independently or together achieve FMD values observed in pre menopausal women. This study was conducted on 30 apparently healthy post menopausal women their mean of age was [54 +/- 4 years old]. FMD was quantified during supine rest and again 60 minutes after treadmill exercise for 45 minute at 60% v[02] max - subjects were studied twice, before and after 4 weeks of oral estradiol. The normal reference values was obtained from concurrent determinant of FMD in 30 pre menopausal women their mean of age was [28 +/- 2] years old under identical basal conditions. flow mediated vasodilatation in post menopausal women markedly impaired when compared with pre menopausal women. The mean of absolute diameter change in brachial artery for flow mediated dilatation in post menopausal women was significantly less than premenopausal women [2.01 +/- 0.2mm [6.1%] Vs 4.1 +/- 0.4mm [12%] P<0.05]. After exercise the absolute change in the brachial artery diameter for FMD in postmenopausal women significantly approximate normal values [3.8 +/- 0.3mm [11.4%] P<0.05]. In contrast after estrogen therapy the mean of absolute brachial artery diameter change for FMD was augmented at rest [P < 0.01] but was not further enhanced after exercise. [3.7 +/- 1.32 mm [11.5%] VS 3.5 +/- 1.4mm [10.5%] P > 0.05]. Both interventions increased FMD to values in pre menopausal women. in post menopausal women both acute exercise and oral estrogen normalize FMD. However there effects weren't additive so these results reinforce that exercise is an alternative non pharmacological intervention to estrogen in post menopausal women with endothelial dysfunction

Methicillin-resistant staphylococcus aureus [MRSA] surveillance in diabetic foot clinic [DFC]

Aim: To investigate the prevalence of methicillin-resistant S. aureus [MRSA] among infected /colonized foot ulcer, nasal carriage and hospital environment in diabetic foot clinic

Methods: During 3 months duration among 64 selected diabetic patients, S. aureus were identified, then Methicillin resistance detection was done by oxacillin disk diffusion tests, and confirmed by detection of PBP2a production by screen latex agglutination test. All MRSA isolates were tested for their antibiotic susceptibilities by the NCCLS agar disk diffusion method

Results: Infection/colonization rate among 64 selected diabetic patients was 41% vs. 17%. Nasal carriage of MRSA was detected among 21 patients [34%] and one isolates from 6 studied HCW[16%]. Only 4 MRSA isolates [13%] were isolated from the desk of the DFC at the end of the clinical session. Multiple resistance to non-beta-lactam antimicrobials [erythromycin, clindamycin, gentamicin and tetracycline], was also highly prevalent among the infected and nasal colonization of MRSA isolates by 30% and 5% respectively

Conclusion: This study underscores the need for hospital clinicians to be aware of the common bacterial isolates in their unit and their usual antibiotic susceptibility. This is imperative in order to make rational decisions for the prudent use of antibiotics, particularly for empirical therapy

Prognostic factors for ovulatory response to letrozole in polycystic ovary syndrome

To evaluate prospectively the prognostic factors for ovulatory response to letrozole therapy in polycystic ovary syndrome [PCOS]. The IVF and Assisted Reproduction Center in Sana'a, Yemen. Thirty-three infertile patients with anovulatory PCOS were recruited. Ovulation was induced using 2.5 mg/day letrozole administered from day 3 to 7 of the cycle. When the dominant follicle reached a diameter > 18 mm, HCG 10.000 IU was given IM and timed intercourse was advised. Clinical and endocrinal parameters between responder and non-responder groups were analyzed. There was no significant difference between letrozole responders and non-responders as regards to the period and type of infertility, BMI, LH, FS H or LH/FSH ratio and E[2] levels. However, statistically significant differences were found with respect to patient age, menstrual pattern, hirsutism and fasting insulin levels between responders and non-responders to ovulation induction with letrozole in PCO patients. Response of the PCOS patients to ovulation induction by letrozole may be related to patient age, menstrual pattern, presence of hirsutism, and serum insulin levels