ABSTRACT
OBJECTIVE: To detect subclinical peripheral vascular disease in obese Egyptian patients and establish relations between obesity, metabolic risk factors, and PVD. METHODS: This was a prospective case-control study including 100 obese patients (BMI >30) (G1). In addition, 100 age and sex matched non-obese healthy subjects as a control group (G2). Both groups were subjected to duplex ultrasound, Radionuclide muscle scan. Angiography was done for 17 patients. RESULTS: The image pattern of 99mTc-MIBI muscles uptake was studied and perfusion reserve (PR%) was calculated in (G1) and (G2). Comparison between the two groups showed statistically significant difference (P < 0.001) as regarding laboratory findings. Patients were categorized according to PR% into +ve for ischemia (mean PR% was 28.4 ± 20.3) and -ve for ischemia (mean PR% was 65.0 ± 11.4). Among (G1) 64 patients positive for ischemia by both PR% and Doppler, 36 patients were negative by Doppler and 22 of them were positive for ischemia by PR%. Angiography was done for 17 of them and proved ischemia in all of them. CONCLUSION: The Tc-99m sestamibi muscle scan can be used as a screening and diagnostic tool of preclinical atherosclerosis in obese patients.
ABSTRACT
BACKGROUND: Patients with transient ischemic attack (TIA) are generally clinically unstable, with fear of developing a handicapping stroke. Identification of those at highest and lowest risk of stroke in the first days and weeks after a TIA would allow appropriate use of worthy secondary prevention strategies. OBJECTIVE: Incorporation of a clinical scoring system, neurovascular imaging, and magnetic resonance-diffusion-weighted imaging (MR-DWI) to help predicting risk of developing an ischemic stroke following a TIA. SUBJECTS AND METHODS: A prospective observational study was conducted on 25 patients with TIAs, 64% were females, and 26% were males, with a mean age of 57±10.36. Patients were assessed clinically and an ABCD(2) score was applied. Patients have undergone diffusion-weighted imaging (DWI), within 24 h from the event, and intra- and extracranial duplex study. Patients were followed up at intervals of one week, three months, six months, and one year. RESULTS: Six patients (24%) developed stroke on their follow-up, most of them (83.3%) had their strokes within the first three months and had an initial ABCD(2) score of ≥4. The development of stroke was associated with the presence of significant extra and/or intracranial vessel disease (P=0.006) and the presence of acute lesions on their DWI (P=0.035). CONCLUSION: Incorporation of brain MR-DWIs and neurovascular imaging together with the ABCD(2) score improves prediction of ischemic stroke following TIA.
ABSTRACT
To estimate the frequency of isolated enlarged vestibular aqueduct (EVA) in patients with non-syndromic sensorineural hearing loss (SNHL) in an Egyptian population sample and to correlate its size with the degree of hearing loss. The study group comprised 16 patients (32 ears) suffering from non-syndromic SNHL since childhood. After a complete basic audiological evaluation, all patients were submitted to non contrast CT scan of the petrous bone in both axial & coronal planes. Vestibular aqueduct (VA) was measured at two points (midpoint & operculum) on right & left sides. The study group was divided according to VA size into three groups: group A, B and C. Group A included 6 ears (4 patients) with EVA, group B included 11 ears (7 patients) with borderline EVA and group C included 15 ears (9 patients) with normal VA size. There were no statistically significant differences between the three groups as regards laterality, degree of hearing loss and audiometric configuration. There was no correlation between VA midpoint & operculum and different variables (age and average pure tone thresholds). However, a significant correlation between VA midpoint & operculum was found. EVA was diagnosed in 6 out of 32 ears (18.75%) in the study sample. EVA size was not related to the degree of hearing loss or configuration. Despite the insignificant findings, moderate and high frequency sloping SNHL were considered the most common findings seen in patients with EVA.
