The haematocrit value in diabetic patients with ischaemic stroke.

During a 3-yr period, 238 patients with acute ischaemic stroke were admitted to the medical department of Mubarak teaching hospital, Kuwait. One hundred patients had diabetes, (42%), including 55 females, and 45 males. Compared with non-diabetics, no significant difference was found in age, sex, prevalence of hypertension, heart disease, atrial fibrillation, transient ischaemic attacks or in plasma cholesterol and triglycerides. Plasma glucose on admission was significantly higher in diabetics (14.6 +/- 5.7) compared with non-diabetics (6.1 +/- 1.2 mmol/l) p less than 0.0001. Haematocrit (HCT) was also significantly higher in diabetics (43.17 +/- 5.75) than in non-diabetics (41.20 +/- 5.85) p less than 0.046. Diabetics had higher mortality (21%) than non-diabetics (10%) p less than 0.05. Severe disability was also more frequent in diabetics (23%) than in non-diabetics (10.8%) p less than 0.05. Diabetic men had significantly higher HCT (45.7 +/- 5.2) than non-diabetic (43.1 +/- 4.1) p less than 0.04. Diabetic women had also higher HCT (41.1 +/- 6.2) than non-diabetic (38.8 +/- 5.8), but this was not statistically significant. Compared with age (+/- 2 yr) and sex matched diabetic patients with other clinical problems, diabetic stroke patients had significantly higher plasma glucose (14.6 +/- 5.7) than non-stroke patients (11.8 +/- 3.7 mmol/l) p less than 0.01. Hct was also significantly higher in diabetic stroke patients (43.17 +/- 5.75) compared with other diabetic patients (41.04 +/- 4.3) p less than 0.04.

Pattern of obesity and insulin, glucagon, sex hormone binding globulin and lipids in obese Arab women.

A standard oral glucose tolerance test was performed in 86 healthy premenopausal obese Arab women (BMI greater than or equal to 30) Glucose, insulin and glucagon were measured at 0, 30, 60, 90 and 120 min. Sex hormone binding globulin (SHBG), plasma lipids and uric acid were also estimated. Waist-hip circumference ratio (WHR) had significant positive correlation with age, triglycerides (TG), uric acid, fasting and 120 min glucose, and 120 min insulin and significant negative correlation with SHBG. Body mass index (BMI) had significant correlation with uric acid, fasting and 120 min insulin, and significant negative correlation with high density lipoprotein cholesterol (HDL Chol). When separated in two subgroups, with WHR greater than 0.80 (41), and less than or equal to 0.80 (45 cases), plasma glucose was in the diabetic range in seven; and impaired glucose tolerance (IGT) in 11 women in the former subgroup. Only three with IGT but no diabetics, were in lower WHR subgroup. WHR in diabetics (0.93), and in IGT cases (0.90) was significantly higher than in other women (0.80). Fasting insulin was not different, but at 90 and 120 min, insulin was higher in the high WHR subgroup who had also higher fasting, 90 and 120 min glucose. Glucagon level, though slightly higher in the higher (WHR) subgroup, may indicate relative hyperglucagonaemia because of the associated significantly higher glucose. Compared with age matched non-obese controls, obese women in both subgroups had significantly higher insulin, uric acid and significantly lower HDL Chol and lower glucagon (insignificant). Obese women in the higher WHR subgroup (greater than 0.80) had also significantly higher systolic blood pressure, TG and lower SHBG.

The carpal tunnel syndrome in hypertensive patients treated with beta-blockers.

We report the development of the carpal tunnel syndrome in 3 hypertensive men (aged 46-58) treated with beta-blockers (propranolol in two patients and metoprolol in the 3rd) for 8-11 years. Known causes of carpal tunnel syndrome were excluded in each case. Withdrawal of the beta-blocker was followed by complete resolution of symptoms and signs after a period of 8-10 weeks. No evidence of recurrence could be detected during follow-up of 7-18 months. The possible mechanisms of drug-induced carpal tunnel syndrome are briefly discussed.

Transient atrial fibrillation in hypertensive patients with thiazide induced hypokalaemia.

During the previous 34 months, 3 hypertensive patients on long-term thiazide therapy were admitted to the medical department, Mubarak Hospital, Kuwait, with atrial fibrillation (AF) and hypokalaemia. They received potassium chloride by intravenous infusion, followed by oral therapy with reversion to sinus rhythm. There were no clinical, electrocardiographic, radiological, or echocardiographic signs of cardiac or pericardial disease, and the other usual cases of AF were also excluded. The contribution of thiazide-induced hypokalaemia to the occurrence of AF in our patients is discussed.

Type A behaviour in Arab patients with myocardial infarction.

Sixty male patients with myocardial infarction were compared to a similar number of patients with noncardiovascular disease on scales measuring Type A behaviour (TAB) and neuroticism. No significant differences emerged. Differences in TAB were observed in relation to nationality and there was a positive correlation between TAB and neuroticism. TAB is discussed in the light of sociocultural variations and the suggestion is made that TAB might be a culture-bound cluster of characteristics.