Studying the effect of chronic glucocorticoide injection on the depressive behavior in mice

Chronic cortisol is considered to be a hallmark of neuroendocrine and psychiatric disorders, such as Cushing's disease and depression. It remains unclear whether cortisol directly contributes to the altered mood and behaviour seen in these diseases. To answer this question, a model of chronic cortisol was utilized, in which, male albinos mice were injected intraperitoneally with corticosterone [13 mg/kg] for 23 days. Locomoter Activity was measured during this period. The results show that Acute treatment with Corticosterone increased Total Activity, Mobile Time, Active time, Rearing Counts, however, Chronic but not acute treatment with Corticosterone decreased these activities. This study suggests that chronic corticosterone may contribute to at least part of the symptoms [i.e. locomoter activities] displayed by patients with depression

Predictors of asymptomatic cardiac events and prognostic value of cardiac biomarkers in chronic kidney disease patients

Patients with chronic kidney disease [CKD] are at increased risk of cardiovascular events; cardiovascular disease is a leading cause of death in patients with chronic kidney disease; Circulating biomarkers play a major role in the early detection of cardiovascular disease in those patients. To clarify the prevalence of asymptomatic different cardiac events in CKD and to explore the degree of elevation of N- terminal-pro-B-type Natriuretic Peptide [NT-pro-BNP] in asymptomatic cardiac patients with varying degree of CKD and the relationship between the elevation of this biomarker and the occurrence of these cardiac complications. This case-control study included 40 CKD patients and 40 controls; patients were recruited from nephrology unit of internal medicine department; Assiut university hospital; known to have chronic kidney disease in different grades [grade I- grade V]. Resting transthoracic echocardiography [TTE] and plasma NT-pro-BNP concentrations were measured in patients who were asymptomatic for clinical evidence of any cardiac events, [n=40; mean age 47.63 +/- 17.93 years; 52.5%were males] as well as healthy volunteers n=40; mean age 42.00 +/- 13.25; 62% were males]. In addition, the correlation between plasma NT-pro-BNP concentration and parameters of echocardiography was examined. Increased prevalence of left ventricular hypertrophy [LVH] [70%]; left ventricular diastolic dysfunction [77.5%], left ventricular systolic dysfunction [17.5%] and coronary artery disease [27.5%] in CKD patients as well as serum NT-pro-BNP levels in the patients were significantly higher [6703.75 +/- 2947.68 pg/ml] than those in healthy volunteers [124.83 +/- 140.40 pg/ml] [p=0.000]. NT-pro-BNP level was higher also in patients who had hypertension [p=0.002]; anemia [p-0.004]; hypoalbuminamia [p=0.000];left ventricular hypertrophy [LVH] [7873. 57 +/- 2719. 31 pg/ml] [p = 0.000], diastolic dysfunction [7524. 52 +/- 2824.74 pg/ml] [p= 0.000]; systolic dysfunction [10371.43 +/- 2771.71] [p=0.000] and patients who had segmental wall motion abnormality [SWMA] [8709.0.9 +/- 3512.3.9] [p=0.000] and correlate Positively with C reactive protein [CRP] level [r-0.751 p=0.000]; left ventricular mass [LVM] [r=0.772 p=0.000] and left ventricular mass index [LVMI] [r=0.715 p=0.000] and negatively with ejection fraction [EF] by echocardiography [r=-0.483 p=0.000]. NT-pro-BNP level elevation in asymptomatic patients with CKD reflects underlying cardiac dysfunction, ischemic heart disease and hypertrophy independent of renal function

Determinants of the risk for diabetic foot ulceration in Sohag University Hospital

One of the most common complications of diabetes in the lower extremity is the diabetic foot ulceration [DFU]. To identify the determinants of the risk for diabetic foot ulceration [DFU] in terms of peripheral neuropathy [PN] or peripheral vascular disease [PVD] among a sample of diabetic foot patients. A cross sectional study included 100 diabetic foot patients attending Sohag University Hospital for follow up during the period from January 2009 to January 2010. They were subjected to complete medical history taking and thorough clinical examination. Diabetic Neuropathy Symptoms [DNS] along with the Diabetic Neuropathy Examination [DNE] scores were used together to define and assess PN. PVD diagnosis was based on identification of claudication pain symptoms; absent or weak foot pulses on palpation of the dorsalis pedis and/or the tibialis posterior arteries; coldness of skin; and finally confirmed by arterial doppler of lower limbs. The mean age of the patients was 57.92 +/- 9.2 years; 65% were males and 79% lived in rural areas. The majority [79%] had type 2 DM with mean disease-duration of 13.4 +/- 6.9 years. Fifty percent of the study patients were smokers and ex-smokers, 33% were hypertensive and 24% had previous history of foot ulceration or amputation. Male gender, old age, low socioeconomic status, smoking, hypertension, type 2 DM, long duration of DM, uncontrolled DM, and previous history of foot ulceration, amputation or other diabetic complications were all significant determinants of PN and PVD; two major risk factors of DFU

Epidemiology and management of type 1 diabetes mellitus at the Ain Shams University pediatric hospital

Type 1 diabetes mellitus is the most common metabolic disease in childhood. An interplay between genetic susceptibility and environmental factors [triggering or suppressive] may account for the pathogenesis of type 1 diabetes The diabetes control and complications trial [DCCT] showed the importance of strict metabolic control in delaying and preventing complications. The aim of this work was to describe the epidemiological features of type 1 diabetes mellitus [the pattern of seasonality at birth and at diagnosis, the initial symptoms of presentation, and the precipitating factors] and to compare the frequency of occurrence of long term complications [as microalbuminuria, and diabetic neuropathy and retinopathy] in relation to different insulin regimens among children attending pediatric hospital at Ain Shams University. This descriptive study was conducted on 416 patients of type 1 diabetes mellitus at pediatrics hospital, Ain Shams University. For each patient a questionnaire form was filled in through an interview with the patients and/or their parents and clinical examination was performed. Also, data were collected retrospectively from the patients' medical records. There was evidence of seasonality at diagnosis with overall predominance at summer. Also, seasonality at birth was clearly evident where 48.3% of cases were delivered during summer season. Polyuria and polydepsia were the most common presenting symptoms, 90.14% and 80.04% respectively. About 60.57% of cases were presented by Diabetic Ketoacidosis [DKA]. As regards the precipitating factors, infection preceded the diagnosis of 21.9% of cases, while psychological trauma was evident in 8.7% of cases. Frequencies of occurrence of long term complications were 9.6% for microalbuminuria, 2.4% for hypertension, 1.4% for orthostatic hypotension, 4.1% for diabetic retinopathy, and 3.1% for diabetic neuropathy. These complications were more frequent with conventional insulin regimen in comparison to the intensive regimen and the difference was statistically significant. Seasonal pattern was evident at diagnosis and at birth which is more common during summer. Diabetic children on intensive insulin therapy were experienced less long term complications than those on conventional regimen. Longitudinal studies are required to confirm the presence of seasonality at birth and at diagnosis including control from normal population .Intensive diabetes therapy should be encouraged among children with type 1 diabetes mellitus to delay onset of long term complications

Levosimendan versus milrinone in heart failure: a study of hemodynamic changes

Levosimendan is a drug with a considerable cardiotonic properties; it improve myocardial contractility without causing an increase in myocardial oxygen consumption. The aim of this randomized double blinded study was to compare the effect of levosimendan and milrinon on heamodynamic performance in patients with severe cardiac dysfunction due to acute heart failure. A total of 375 patients admitted to general I.C.U with acute heart failure with the need for hemodynamic monitoring and further hemodynamic support were allocated to this study. After exclusion of 215 patients, 160 patients were randomized to receive levosimendan [Group L, no.=81], or milrinon [Group M no.=79]. Group L patients [no.=81] received an initial loading dose of 12 micro g/kg i.v over 10 minutes, followed by a continuous infusion of 0.1 micro g/kg/min in a maximum of 0.4 micro g/min [according to hemodynamic tolerance]. Group M patients [no.=79] received a loading dose of 25 micro g/kg up to 75 micro g/kg followed by 0.375 micro g/kg/min that was escalated to 0.75 micro g/kg/min to reach satisfactory hemodynamic response. The favored target was to increase cardiac output to more than 30% of the baseline and decrease after load especially that of the right side [pulmonary artery pressure PAP] to more than -25% of the initial reading. Those hemodynamic results were expected to occur within 24 hours from starting the infusion. Hemodynamic parameters monitored were: Repeated baseline measurement of cardiac output [CO], pulmonary capillary wedge pressure [PCWP], mean right atrial pressure [CVP], mean pulmonary artery pressure [PAP] by means of pulmonary artery catheter. Cardiac index [CI], systemic vascular resistance [SVR], pulmonary vascular resistance [PVR] was calculated through hemodynamic measurements. Readings were taken 10 minutes after beginning of loading dose infusion, 1 hour, 4 hours, 8 hours, 12 hours, 18 hours and 24 hours, whilst systolic and diastolic blood pressure was continuously monitored by arterial cannula and heart rate and rhythm through ECG monitoring. The study target was achieved in 49 patients in the levosimendan group and 33 patients of the milrinone group. After tracing the study patients for 180 days, 7 patients of the levosimendan group had died, compared with 9 patients of the milrinone group. Levosimendane showed an improvement in hemodynamic performance than milrinone in case of acute heart failure and showed a lower mortality incidence than the latter drug as well

Hearing loss in divers in Red sea

As the popularity of Scuba diving [diving with self contained underwater breathing apparatus] continues to grow scientists are better able to determine what the long-term effects on the human body, the group at high risk for adverse effects is professional divers making repeat deep dives with shortened decompression times. The most well-known injuries of diving are dysbaric osteonecrosis, hearing loss, and permanent neurological deficits, usually the result of a decompression accident; these effects may occur without decompression incident or injury. Reports of cognitive dysfunction and damage to the liver, retina, and heart of the diver with no history of decompression sickness are now emerging, these symptoms may occur gradually and away from the dive site, physicians should be aware of the signs and symptoms related to adverse events of diving in order to minimize its morbidity and mortality to detect the effect of scuba diving on the hearing threshold of sport divers who have no history of excessive noise exposure or of diving-related inner ear damage. Thirty of sport divers were included in our study compared with thirty control group of non divers, both groups were subjected to clinical assessment, tympanometry, pure tone audiometery. Divers group shows significant difference in sensory neural hearing loss at high frequency 4KHz,6KHz,8KHz, while there were no significant difference in low frequency at 0.5KHz1KHz,2KHz. Sport diving is risky for long term diving as it affect inner ear causing high tone sensory neural hearing loss, follow up is advised for hearing sport divers especially the professionals

Study of risk factors for Ischaemic heart disease in middle aged women

This is a prospective study conducted to examine the relationships of obesity, lipids and apolipoproteins, menopausal status, prior combined oral contraceptive [COC] use, and parity with the risk for ischemic heart disease [IHD] among middle aged women. A total of 160 women, aged 35 to 59 years were recruited, 100 cases with IHD, and 60 healthy women as controls. High apolipoprotein-B [Apo-B], low density lipoprotein cholesterol [HDL-C], and high triglyceride [TG] levels, were found to have independent influence on the risk of developing IHD in the studied cases. Other risk factors that were found to have significant relation to IHD were increased body mass index [BMI], postmenopause particularly before 50 years, increased low- density lipoprotein cholesterol [LDL-C], increased total cholesterol [TC], decreased apolipoprotein-A-I [Apo-A-I]. Parity and prior combined oral contraceptive use were not found to be significant risk factors. An equation including all the studied factors was suggested to be used for prediction of IHD in middle-aged women