RESUMO
Background: the incidence of cardiovascular disease is remarkably increased in dialysis patients and accounts for the major cause of death in this group of subjects. The relative risk of mortality from ischemic heart disease has been estimated as 22-fold higher in dialysis patients than in the background population. This high cardiovascular morbidity and mortality in chronic haemodialysed patients has led to the hypothesis of 'accelerated atherosclerosis. Endothelial dysfunction and chronic inflammatory activity, two important phenomena in atherogenesis, can be found in ESRD
Aim of work: the aim of the study to assess serum level of ICAM-1 and Nitric oxide as markers of endothelial dysfunction in hypertensive hemodialysis patients
Patients and Methods: the current study included 75 individuals divided into 3 groups, Group I served as control group, it included 25 apparently healthy normotensive subjects, their age ranged from 20 to 45 years old [mean +/- SD 40 +/- 4.8 years] all of them were males. Group II included 25 patients with hypertension, the duration of hypertension from 1 to 5 years, their age ranged from 35 to 60 years old [mean +/- SD 4 7. 7 +/- 5 .4 years] all of them were males. Group III included 25 patients on regular hemodialysis 3 times/ week. They had been undergoing dialysis for a mean of 6.3 +/- 2.9 years. Their age ranged from 20 to 55 years old [mean +/- SD 41.8 +/- 8.4 years], all of them were males. All groups were subjected to: Complete history taking and through clinical examination including assessment of blood pressure. Laboratory examination including renal function tests including, blood urea nitrogen, serum creatinine, fasting and 2 hours postprandial blood glucose. Complete blood count on the automated coulter counter. Total. LDL, Triglycerides and HDL cholesterol were measured by enzymatic analytical chemistry. Soluble intercellular adhesion molecule-1 [sICAM-1] and Nitric Oxide as markers of endothelial function. sICAM-1 was assayed by ELISA methods and Nitric Oxide assessed by Gresis reaction
Results: in this study when we compared HD patients to healthy nonnotensive subjects and non complicated hypertensive patients, we found significant increase of soluble ICAM-1 level in the circulation of HD group of patients. Also this study had shown that serum levels of sICAM-1 is significantly increased in uncomplicated hypertensive patients than nonnotensive subjects. As regard Nitric oxide there was a significant reduction in No- level in hypertensive patients and HD patients with hypertension when compared with normal individuals and more lower in haemodialysed hypertensive group than non haemodialysed hypertensive group
Conclusion: hypertensive chronic hemodialysis patients are at risk to develop endothelial dysfunction which may explain accelerated atherosclerosis that occurred in chronic hemodialysis patients
RESUMO
The standard WHO oral rehydration solution [ORS] provides simple and effective approach to rehydration but it does not has anti-diarrhea effect, it does not reduce the stool volume or the duration or the severity of diarrhea. The present study is a comparative one aiming to evaluate the efficacy of using a soluble mixture of carob bean juice, sorghum, and rice flour in treatment of acute diarrhea among infants and young children in comparison with the standard WHO ORS. The study included 1000 children, with an age range from 6 to 36 months, who presented by acute watery diarrhea and some dehydration according to WHO classification. They were randomly divided into two groups: group A [the study group] included 80 patients and group B [the control group] included 20 patients. The patients of the study group were treated with a soluble mixture of carob bean juice, sorghum, and rice flour plus ORS while the patients of the control group were treated with ORS only. The study revealed that the study group, compared with the control group, had a significant reduction of diarrhea frequency [p<0, 001], a significant reduction in daily fluid intake [p<0, 001], and a significant reduction in the hours after which well formed stool appeared [p<0, 003]. There were no significant differences between the daily weight gain and the total duration of diarrhea! episode in both groups [p <0, 1 and <0, 1]
Conclusion: Soluble mixture of carob bean, sorghum and rice flour can be safely and effectively used in treatment of watery diarrhea among infants and young children