Functional capacity in patients with coronary artery bypass grafting surgery after cardiac rehabilitation program

To evaluate the effect of cardiac rehabilitation program on cardiac function and functional capacity in patients with coronary artery bypass grafting surgery. Forty patients with CABG were included. Thirty patients served as group I and ten patients as group II [control group]. Group I patients were enrolled in cardiac rehabilitation program for 12 weeks. All patients were subjected to: functional classification scaling, exercise stress test at the start and at 12 weeks [to detect the metabolic energy times and functional capacity of patients] and echocardiography at the start and at 12 weeks to evaluate the cardiac function. There was no significant difference between patients and controls at the start as regard exercise stress test, left ventricular ejection fraction and functional class. At 12 weeks: the exercise stress test results showed a significant increase in exercise duration, METs and VO2 max in group I in comparison to group II, and in group I at 12 weeks in comparison to its initial results. The echocardiography results showed a highly significant difference of LVEF between group I and group II at 12 weeks and in group I at 12 weeks in comparison to the start. Early return to work, at 12 weeks, was noticed in 14 out of 16 male patients [87%] in group I, and two out of five male patients [40%] in group II. Cardiac rehabilitation is an important component of the current interdisciplinary approach to the management of the patients with various presentations of coronary heart disease

Macrovascular affection in systemic sclerosis

Objective: the aim of this study was to elucidate early macrovascular affection in systemic sclerosis [SSc] patients and to find out its relation to ant centromere antibody [ACA] in order to attenuate such complication if present

Methodology: this study was carried out on thirty SSc female patients fulfilling the 1980 American Rheumatology Association [ARA] Criteria for systemic sclerosis. They were classified into twenty limited cutaneous SSc [LcSSc] and ten diffuse cutaneous SSc [DcSSc] patients according to clinical examinations. Fifteen, age and sex matched healthy controls were also included. Serum ACA was assessed by ELISA technique. Ankle brachia! Pressure index [ABPJ] and Carotid Duplex Scan [CDS] were used to detect the presence of large vessel affection. Patients with high risk factors for peripheral arterial occlusive disease [PAOD] were excluded from the study. Patients receiving steroids and oral contraceptive pills were also excluded from the study

Results: the results of our study showed no statistically significant difference in the levels of basic risk factors for PAOD [serum cholesterol, triglycerides and glucose, high and low density lipoproteins] between LcSSc, DcSSc and the control group [p>0.05]. There was a high statistically significant reduction in ABPI in LcSSc patients compared to controls, while no statistically significant difference was found between DcSSc patients and controls, whereas a statistically significant reduction in ABPI was found in LcSSc compared to DcSSc patients as p<0.001, p>0.05 and p<0.05 respectively. There was a statistically significant increase in carotid artery intimal thickening [CAIT] in DcSSc patients compared to controls as well as between DcSSc patients compared to LcSSc patients while no significant difference was found between LcSSc patients and controls as p<0.05, p<0.05 and p>0.05 respectively. There was a statistically significant reduction in ABPI in SSc patients with positive ACA compared to those with negative ACA asp< 0.05

Conclusion: macrovascular affection is considered a complication in SSc patients who have higher incidence of lower limb large vessel abnormalities in LcSSc patients as evidenced by ABPI and central large vessel affection in DcSSc patients as evidenced by CDS. Also, we can conclude that there is an association between ACA and peripheral macrovascular affection in LcSSc patients

Is acquired total protein s deficiency associated with antiphospholipid antibodies in systemic lupus erythematosus?

Hypothesis: protein S [PS] is a vitamin K dependent plasma protein, and it's free from is required for protein C to be functional. Antiphospholipid antibodies [apl] may cause functional PS deficiency by binding free PS. In patients with SLE have increased incidence of apl, which have been associated with thrombotic events

Objective: to determine the level of total protein S and its relation to [apl]

Methodology: 22 SLE patients diagnosed according to ACR revised criteria [Tan et al., 1982] and ten healthy subjects were included in this study. Assays for protein S, IgG, up1 were performed in patients and control groups

Results: the protein S was lower in the patients than the control and the difference was highly significant. There was a highly significant differences between the level of PS in patients with apl+ve compared with apl-ve patients [p<0.01]

Conclusion: this study confirms an association between apl and PS deficiency