This study evaluated the impact of diabetes mellitus and obesity on male infertility in Iraqi patients. It found that:
1) Serum levels of HbA1C, a marker of long-term blood sugar control, were higher in diabetic patients regardless of BMI compared to healthy controls. HbA1C was also higher in normo-BMI diabetic patients compared to obese diabetic patients.
2) Serum free testosterone levels, important for male fertility, were significantly lower in obese diabetic patients compared to overweight diabetic and healthy patients.
3) There was a significant negative correlation between serum free testosterone levels and HbA1C in obese diabetic patients, suggesting poorer blood sugar control is associated with lower testosterone.
Study of serum magnesium and fasting blood glucose in hypertensioniosrjce
A study was carried out to determine the fasting blood glucose and serum magnesium levels in
patients with hypertension. A total of 80 hypertensive patients were evaluated, of which, 58 were males and 22
were females. The mean ages of male and female hypertensive subjects were 48.06±6.53 and 50.83±7.62
respectively. Hypomagnesemia was observed in 61.25% subjects and raised fasting blood glucose was identified
in 55.1% of individuals. Therefore occurrence of low serum magnesium and raised blood sugar level in patients
with hypertension was observed
30-RELETIONSHIP OF NITRIC (DR SADIA ISHAQUE) 607-611Aziza Qadeer
This document summarizes a study that examined the relationship between nitric oxide levels and other risk factors for hypertension. The study measured serum levels of nitric oxide, lipids, and estradiol in 42 hypertensive patients and 35 normal controls. It found that hypertensive patients had higher cholesterol, LDL, and triglycerides, but lower HDL, nitric oxide, and estradiol levels compared to controls. Nitric oxide levels correlated negatively with cholesterol, LDL, and triglycerides but positively with HDL. This suggests nitric oxide levels are strongly related to blood lipid levels in hypertensive patients.
International Journal of Pharmaceutical Science Invention (IJPSI)inventionjournals
is an international journal intended for professionals and researchers in all fields of Pahrmaceutical Science. IJPSI publishes research articles and reviews within the whole field Pharmacy and Pharmaceutical Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online
The document discusses the importance of glycemic control for hospitalized patients with diabetes or hyperglycemia. It notes that hyperglycemia is common in hospitalized patients and associated with worse outcomes. The document reviews evidence that intensive insulin therapy to maintain tight glycemic control can reduce mortality, infection rates, and length of stay in intensive care units and improve outcomes for patients with acute myocardial infarction. It discusses guidelines developed for recommended glycemic targets in hospitals.
This document discusses treatment options after metformin for type 2 diabetes, comparing sulfonylureas and gliptins. It provides the following key points:
1. Sulfonylureas are more effective at reducing HbA1c levels and achieving glycemic control targets compared to gliptins. They lower HbA1c by 1-2% on average versus 0.5-1% for gliptins.
2. Studies show sulfonylureas may better preserve beta-cell function in the long-term compared to metformin or gliptins. They have been shown to enhance insulin secretion from beta and alpha cells.
3. While older studies linked sulfonylureas
This study aimed to evaluate the effects of intensive insulin therapy versus conventional insulin therapy on outcomes of patients admitted to a medical intensive care unit (ICU) who were expected to require at least 3 days of intensive care. The study found that intensive insulin therapy reduced morbidity but did not significantly reduce mortality among all 1200 patients. However, among the 386 patients who remained in the ICU for at least 3 days, intensive insulin therapy reduced morbidity and mortality by accelerating weaning from ventilation, earlier ICU and hospital discharge, and reduced mortality beyond 5 days in the ICU. Larger multicenter trials were recommended to confirm these results.
The document assessed serum essential elements, glucose, and thyroid function tests in hypothyroid patients with good or poor responses to levothyroxine (LT) therapy. Patients with a good response had normal thyroid levels similar to controls, while those with a poor response had lower T3 and T4 and higher TSH compared to controls and good responders. Zinc, copper, and iron levels were significantly lower in poor responders compared to controls and good responders. Glucose levels did not differ significantly between groups. Thyroid levels correlated with trace element levels. The study found lower trace elements in poor responders, suggesting trace elements may influence thyroid function and response to LT therapy.
This study evaluated the impact of diabetes mellitus and obesity on male infertility in Iraqi patients. It found that:
1) Serum levels of HbA1C, a marker of long-term blood sugar control, were higher in diabetic patients regardless of BMI compared to healthy controls. HbA1C was also higher in normo-BMI diabetic patients compared to obese diabetic patients.
2) Serum free testosterone levels, important for male fertility, were significantly lower in obese diabetic patients compared to overweight diabetic and healthy patients.
3) There was a significant negative correlation between serum free testosterone levels and HbA1C in obese diabetic patients, suggesting poorer blood sugar control is associated with lower testosterone.
Study of serum magnesium and fasting blood glucose in hypertensioniosrjce
A study was carried out to determine the fasting blood glucose and serum magnesium levels in
patients with hypertension. A total of 80 hypertensive patients were evaluated, of which, 58 were males and 22
were females. The mean ages of male and female hypertensive subjects were 48.06±6.53 and 50.83±7.62
respectively. Hypomagnesemia was observed in 61.25% subjects and raised fasting blood glucose was identified
in 55.1% of individuals. Therefore occurrence of low serum magnesium and raised blood sugar level in patients
with hypertension was observed
30-RELETIONSHIP OF NITRIC (DR SADIA ISHAQUE) 607-611Aziza Qadeer
This document summarizes a study that examined the relationship between nitric oxide levels and other risk factors for hypertension. The study measured serum levels of nitric oxide, lipids, and estradiol in 42 hypertensive patients and 35 normal controls. It found that hypertensive patients had higher cholesterol, LDL, and triglycerides, but lower HDL, nitric oxide, and estradiol levels compared to controls. Nitric oxide levels correlated negatively with cholesterol, LDL, and triglycerides but positively with HDL. This suggests nitric oxide levels are strongly related to blood lipid levels in hypertensive patients.
International Journal of Pharmaceutical Science Invention (IJPSI)inventionjournals
is an international journal intended for professionals and researchers in all fields of Pahrmaceutical Science. IJPSI publishes research articles and reviews within the whole field Pharmacy and Pharmaceutical Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online
The document discusses the importance of glycemic control for hospitalized patients with diabetes or hyperglycemia. It notes that hyperglycemia is common in hospitalized patients and associated with worse outcomes. The document reviews evidence that intensive insulin therapy to maintain tight glycemic control can reduce mortality, infection rates, and length of stay in intensive care units and improve outcomes for patients with acute myocardial infarction. It discusses guidelines developed for recommended glycemic targets in hospitals.
This document discusses treatment options after metformin for type 2 diabetes, comparing sulfonylureas and gliptins. It provides the following key points:
1. Sulfonylureas are more effective at reducing HbA1c levels and achieving glycemic control targets compared to gliptins. They lower HbA1c by 1-2% on average versus 0.5-1% for gliptins.
2. Studies show sulfonylureas may better preserve beta-cell function in the long-term compared to metformin or gliptins. They have been shown to enhance insulin secretion from beta and alpha cells.
3. While older studies linked sulfonylureas
This study aimed to evaluate the effects of intensive insulin therapy versus conventional insulin therapy on outcomes of patients admitted to a medical intensive care unit (ICU) who were expected to require at least 3 days of intensive care. The study found that intensive insulin therapy reduced morbidity but did not significantly reduce mortality among all 1200 patients. However, among the 386 patients who remained in the ICU for at least 3 days, intensive insulin therapy reduced morbidity and mortality by accelerating weaning from ventilation, earlier ICU and hospital discharge, and reduced mortality beyond 5 days in the ICU. Larger multicenter trials were recommended to confirm these results.
The document assessed serum essential elements, glucose, and thyroid function tests in hypothyroid patients with good or poor responses to levothyroxine (LT) therapy. Patients with a good response had normal thyroid levels similar to controls, while those with a poor response had lower T3 and T4 and higher TSH compared to controls and good responders. Zinc, copper, and iron levels were significantly lower in poor responders compared to controls and good responders. Glucose levels did not differ significantly between groups. Thyroid levels correlated with trace element levels. The study found lower trace elements in poor responders, suggesting trace elements may influence thyroid function and response to LT therapy.
ABSTRACT- In today’s modern lifestyle high blood cholesterol is one of the most dreaded causes of heart diseases among the global population. Fast lifestyle, lack of exercise, obesity and improper food intake all sum up to deranged lipid profile as well as diabetes. Diabetes and high blood cholesterol goes hand in hand which leads to an increased incidence of coronary artery and cardiovascular disorders which still remains as one of the leading causes of mortality overall. In the present study there has been an effort put to draw a correlation between glycosylated hemoglobin which is a marker for level of blood glucose in diabetic patients as well as deranged lipid profile. Blood samples collected in sterile vials were first centrifuged and then put into analyzer for the computation of the lipid profile and the glycosylated hemoglobin. Results computed were made a note of and then prepared for statistical analysis. Results thus obtained showed that females showed significantly higher levels of total serum cholesterol and Non-HDL compared to males other than that their lipid parameters were a little higher than males in general. Diabetic female patients showed a significantly higher level of glycosylated hemoglobin. There was a significant difference in the HDL values of patients in pre diabetic state and worst control of glycemic hemoglobin. There were also significant differences observed in the TGL, TGL/HDL and VLDL values between Diabetic and control patients. In general there were increased correlation of HbA1c with TSC and LDL and the respective ratios as HbA1c increases while LDL/HDL showed a significant increase with HbA1c.
Key-words- Cholesterol, Diabetes mellitus, Lipid profile, HDL, LDL, Lipid ratios
Potential role of uric acid in correlation with epidemics of hypertension and...Apollo Hospitals
This document summarizes a study examining the potential role of uric acid in correlation with hypertension and albumin creatinine ratio in patients with diabetic nephropathy. The study included 180 subjects divided into three groups: healthy controls, those with type 2 diabetes but without nephropathy, and those with both type 2 diabetes and nephropathy. Results showed higher levels of factors like blood sugar, HbA1c, creatinine and albumin creatinine ratio in the nephropathy group compared to the other groups. While uric acid correlated positively with blood pressure and albumin creatinine ratio in the diabetes groups, no significant difference was found. Larger future studies are needed to better evaluate
Osteoarthritis is the most common disease of women after menopause. There are many factors to develop the disease. Hormones play important role to in this context. The objective of the present study is to determine whether the levels of thyroid and sex hormones are associated with osteoarthritis (OA) in postmenopausal women. Forty three patients suffering from OA and twenty control subjects were included in this study. Thyroid and sex hormones were measured in the serum by enzyme linked immunosorbent assay technique. In OA patients serum estrogen levels were low as compared to control subjects(p<0.001), but these patients did not show any significant change in thyroid hormones and progesterone hormone levels when compared with control subjects. The findings suggest that estrogen deficiency after menopause may contribute to develop OA in postmenopausal women.
Incidence Of Micro-Albuminura In Diabetes Mellitus Type 2; A Prospective Stud...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Treatment Of HCV in CKD Patients - Prof. Hussein El-FishawyMNDU net
- Hepatitis C virus (HCV) infection affects an estimated 170-200 million people worldwide and is a major cause of liver disease.
- HCV infection is highly prevalent among patients with end-stage renal disease undergoing hemodialysis, ranging from 1-100% depending on geographic region.
- Chronic HCV infection increases mortality in hemodialysis patients, both from hepatic causes like liver cancer as well as extrahepatic causes such as cardiovascular disease. It is associated with higher mortality compared to HCV-negative patients.
Diabetes and heart two sides of the same coinSunil Wadhwa
This ppt presented in a CME of doctors in March 2017 discusses-if all Diabetics should be treated aggressively for prevention of coronary artery disease & SHOULD IT BE PRESUMED AS IF THEY ARE ALREADY PATIENTS OF CAD?
This presentation is updated till March 2017
Diabetic Dyslipidemia
By Dr. Usama Ragab Youssif
ISMA CME Activity 2021
In Tolip EL Galala Hotel
-----------
Introduction
Physiology of lipid metabolism
Pathophysiology of diabetic dyslipidemia
Statin therapy (+/- ezetimibe) evidence and translation of evidence
Residual CV risk: excess TG
EPA therapy evidence and translation of evidence
1) The study aimed to determine if incomplete inhibition of platelet thromboxane production by aspirin (ASA), as measured by urinary 11-dehydro thromboxane B2 levels, was associated with increased cardiovascular risk in patients in the CHARISMA trial.
2) Urinary 11-dehydro thromboxane B2 levels were measured in 3261 patients to identify determinants of thromboxane production and whether clopidogrel added to ASA could reduce thromboxane biosynthesis.
3) Baseline characteristics and outcomes were compared between patients who did and did not experience a primary endpoint of stroke, MI or cardiovascular death during follow-up. Determinants of urinary 11-dehydro throm
This study examined the relationship between serum uric acid levels and stroke in patients with diabetes mellitus. The study compared 100 patients with both stroke and diabetes, 50 patients with stroke but no diabetes, and 50 patients with diabetes but no stroke. It found that serum uric acid levels were highest in patients with both stroke and diabetes, lower in patients with stroke only, and lowest in patients with diabetes only. Serum uric acid levels were also correlated with fasting blood glucose, post-meal blood glucose, glycated hemoglobin, and diabetes duration. The study concludes that high serum uric acid may be a marker for increased risk of stroke in patients with diabetes.
Cardiovascular disease is a major risk for those with diabetes.
1) Studies like the Framingham Heart Study and UKPDS found diabetes to be a significant risk factor for cardiovascular mortality and events like heart attacks.
2) Having diabetes poses similar risks as having a heart attack, with endothelial dysfunction, dyslipidemia, and other factors increasing cardiovascular risks.
3) Lifestyle changes like diet, exercise, weight loss and optimal control of blood pressure, cholesterol and blood sugars can help prevent premature cardiovascular events for those with diabetes.
Background and Aim: Many studies have found association between Red Cell Distribution Width (RDW) values and hypertension, dipping pattern, and end-organ damage. RDW values are affected by blood vitamin B12, iron, and folic acid levels, parameters that were not assessed in the previous studies. The aim of our study was to evaluate the relation between RDW and hypertension, dipper pattern, and end-organ damage independently from vitamin B12, folic acid, and ferritin levels in newly diagnosed hypertensive patients.
CholesLo shows clinical significance in
helping reduce plasma cholesterol and
homocysteine levels and therefore affects
favourably the risk of subsequent development
of cardiovascular disease. Furthermore, our
findings suggest that the dose required to cause
such improvements in plasma lipid profile is
safe enough to be considered for use in general
population.
Cholesterol May be a Negative Whereas Triglycerides Positive Acute Phase Reac...asclepiuspdfs
Background: We tried to understand some undetermined missions of cholesterol and triglycerides (TG) in the plasma in patients with the sickle cell diseases (SCD). Methods: All patients with the SCD and age and gender-matched control cases were included into the study. Results: We studied 363 patients with the SCD (194 males) and 255 control cases (136 males), totally. Mean ages of the SCD patients were similar in males and females (31.1 vs. 31.0 years, respectively, P > 0.05). Although the body weight and body mass index (BMI) were significantly suppressed in the SCD patients (59.9 vs. 71.5 kg and 21.9 vs. 25.6 kg/m2, respectively, P = 0.000 for both), the body heights were similar in both groups (164.9 vs. 167.0 cm, P > 0.05). Parallel to the suppressed mean body weight and BMI, fasting plasma glucose (92.8 vs. 97.6 mg/dL, P = 0.005), total cholesterol (121.4 vs. 165.0 mg/dL, P = 0.000), low-density lipoproteins (70.4 vs. 102.4 mg/dL, P = 0.000), and high-density lipoproteins (26.0 vs. 39.6 mg/dL, P = 0.000) values were all suppressed in the SCD patients, significantly. Similarly, both systolic (115.2 vs. 122.6 mmHg, P = 0.000) and diastolic blood pressure (73.0 vs. 86.6 mmHg, P = 0.000) were also suppressed in them, significantly. Interestingly, only the plasma TG were increased in the SCD patients (129.4 vs. 117.3 mg/dL, P = 0.000), significantly. Similarly, mean alanine aminotransferase value was not suppressed in them, too (27.4 vs. 27.3 U/L, P > 0.05). Conclusion: Cholesterol may be a negative whereas TG positive acute phase reactants in the plasma.
Relative Hyperoxia in cyanotic congenital heart disease on veno-arterial ECMO...Texas Children's Hospital
Extracorporeal membrane oxygenation (ECMO) is an
established intervention for respiratory or cardiorespiratory
support in children with congenital heart disease (CHD)
when all other interventions have failed. Hyperoxia
following successful resuscitation has been associated with
increased mortality in pediatric and adult studies,
including, specifically, hyperoxia during ECMO
management. We hypothesized that this effect may be
pronounced in patients with lower arterial oxygen
saturation at baseline, such as those with cyanotic CHD. We
aimed to determine if relative hyperoxia in children with
cyanotic single ventricle circulation on Veno-Arterial (VA)-
ECMO is a risk factor for mortality in a large multicenter
registry analysis.
The document discusses exercise in the primary and secondary prevention of cardiovascular disease. It covers several key points:
1) Many studies have shown that higher levels of physical fitness are associated with lower risks of premature cardiovascular death. Regular exercise can help prevent cardiovascular disease.
2) Even relatively small amounts of daily exercise, such as 15 minutes, have been shown to significantly reduce mortality risks. More exercise provides greater benefits.
3) Exercise can help manage diabetes and obesity, two major risk factors for cardiovascular disease. It improves glucose control and cardiovascular risk profiles.
4) Cardiac rehabilitation programs that include regular exercise have been shown to significantly reduce mortality and hospitalization rates for cardiovascular patients.
This document reviews traditional and non-traditional risk factors for cardiovascular disease. It discusses how hypertension, diabetes, high total cholesterol, high LDL cholesterol, high triglycerides, and low HDL cholesterol are traditional risk factors. It also examines non-traditional markers like homocysteine, plasminogen activator inhibitor-1, fibrinogen, and various inflammatory markers that may help predict cardiovascular risk. While many non-traditional markers show promise, most are not routinely used in clinical practice and their predictive value requires further confirmation.
Physical activity and risk of cardiovascular disease—aArhamSheikh1
High levels of both leisure time physical activity and moderate levels of occupational physical activity are associated with a 20-30% lower risk of cardiovascular disease among men and women. The meta-analysis included 21 prospective cohort studies with over 650,000 participants followed for an average of 10 years. Both high leisure time physical activity and moderate occupational physical activity were associated with roughly a 20-30% lower risk of coronary heart disease and stroke for men and women. No evidence of publication bias was found across the studies.
The document discusses the paradoxical relationship between obesity and mortality in patients with kidney disease undergoing dialysis. Several studies are reviewed that found higher BMI in dialysis patients was associated with lower risks of death and hospitalization, unlike the general population where obesity increases health risks. The studies accounted for various factors and found even extreme obesity was protective. Weight gain over time was also associated with reduced mortality risk. The reasons for this reverse epidemiology are unclear but proposed mechanisms include increased stores of nutrients and anti-inflammatory proteins in adipose tissue.
Lipoproteins and Lipid Peroxidation in Thyroid disordersIOSR Journals
1) The study evaluated lipids and oxidative stress in 80 patients with thyroid dysfunction, including 53 hypothyroid and 27 hyperthyroid patients, compared to 40 healthy controls.
2) In hypothyroid patients, T3, T4 levels were significantly decreased while TSH was elevated. Total cholesterol, triglycerides, LDL, and VLDL were significantly increased compared to controls.
3) MDA levels were higher in both hypothyroid and hyperthyroid patients compared to controls, indicating oxidative damage in thyroid disorders.
A comparative analysis of biochemical and hematological parameters in diabeti...amsjournal
This study evaluated the biochemical and the hematological parameters in diabetic and non- diabetic patients. The measured biochemical parameters were fasting blood sugar, serum alanine aminotransferase (SGPT/ALT), total cholesterol, urea, creatinine and hematological parameters were hemoglobin, total white blood cell, neutrophil, lymphocyte,monocyte, eosinophil and ESR. There were 403 diabetic and 320 non-diabetic subjects included in this study and the study was carried out in BIRDEM (Bangladesh Institute of Research & Rehabilitation in Diabetes, Endocrine and Metabolic Disorders) General Hospital). It was observed that the mean values of SGPT/ALT (p<0.001),><0.001)><0.001)><0.001),><0.004),><0.001) of hematological parameters were significantly higher in diabetic patients than in the non-diabetic patients. In univariate analysis, all biochemical parameters and only four hematological parameters were found significantly associated with fasting blood sugar after adjusted with age and sex. The fasting blood sugar correlates highly with the other biochemical parameters but less or none with the hematological parameters. Our findings demonstrated that control of increased biochemical parameters and abnormal hematological levels in the early stage of diabetes mellitus may help the patients to raise quality of life.
Abstract—Subclinical Hypothyroidism is a much more common disorder with a world-wide occurrence as compared to overt Hypothyroidism. Overt Hypothyroidism is associated with abnormalities of lipid metabolism, but the significance of dyslipidemia in subclinical hypothyroidism (SCH) remains controversial.
Aims: To compare the lipid profile between subclinical hypothyroid patients & healthy controls (age & sex matched) so as to determine any association between lipid profile & subclinical hypothyroidism.
Materials and Methods: In a case-control study, Thyroid stimulating hormone (TSH), free T3, free T4, anti thyroperoxidase (TPO) antibodies, total cholesterol, high density lipoprotein(HDL) cholesterol, low density lipoprotein (LDL) cholesterol, Very low density lipoprotein (VLDL) cholesterol, serum triglycerides were measured in 50 patients with subclinical hypothyroidism and 50 age- and sex-matched Euthyroid controls after an overnight fasting.
Results: Mean serum triglycerides (TG) and very low-density cholesterol (VLDL) were significantly higher in patients with SCH than controls (P < 0.05). No association was found between serum total cholesterol, high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) cholesterol and SCH.
Conclusions: Dyslipidemia is more common in SCH compared to controls. High serum triglycerides and VLDL were observed in patients with SCH.
ABSTRACT- In today’s modern lifestyle high blood cholesterol is one of the most dreaded causes of heart diseases among the global population. Fast lifestyle, lack of exercise, obesity and improper food intake all sum up to deranged lipid profile as well as diabetes. Diabetes and high blood cholesterol goes hand in hand which leads to an increased incidence of coronary artery and cardiovascular disorders which still remains as one of the leading causes of mortality overall. In the present study there has been an effort put to draw a correlation between glycosylated hemoglobin which is a marker for level of blood glucose in diabetic patients as well as deranged lipid profile. Blood samples collected in sterile vials were first centrifuged and then put into analyzer for the computation of the lipid profile and the glycosylated hemoglobin. Results computed were made a note of and then prepared for statistical analysis. Results thus obtained showed that females showed significantly higher levels of total serum cholesterol and Non-HDL compared to males other than that their lipid parameters were a little higher than males in general. Diabetic female patients showed a significantly higher level of glycosylated hemoglobin. There was a significant difference in the HDL values of patients in pre diabetic state and worst control of glycemic hemoglobin. There were also significant differences observed in the TGL, TGL/HDL and VLDL values between Diabetic and control patients. In general there were increased correlation of HbA1c with TSC and LDL and the respective ratios as HbA1c increases while LDL/HDL showed a significant increase with HbA1c.
Key-words- Cholesterol, Diabetes mellitus, Lipid profile, HDL, LDL, Lipid ratios
Potential role of uric acid in correlation with epidemics of hypertension and...Apollo Hospitals
This document summarizes a study examining the potential role of uric acid in correlation with hypertension and albumin creatinine ratio in patients with diabetic nephropathy. The study included 180 subjects divided into three groups: healthy controls, those with type 2 diabetes but without nephropathy, and those with both type 2 diabetes and nephropathy. Results showed higher levels of factors like blood sugar, HbA1c, creatinine and albumin creatinine ratio in the nephropathy group compared to the other groups. While uric acid correlated positively with blood pressure and albumin creatinine ratio in the diabetes groups, no significant difference was found. Larger future studies are needed to better evaluate
Osteoarthritis is the most common disease of women after menopause. There are many factors to develop the disease. Hormones play important role to in this context. The objective of the present study is to determine whether the levels of thyroid and sex hormones are associated with osteoarthritis (OA) in postmenopausal women. Forty three patients suffering from OA and twenty control subjects were included in this study. Thyroid and sex hormones were measured in the serum by enzyme linked immunosorbent assay technique. In OA patients serum estrogen levels were low as compared to control subjects(p<0.001), but these patients did not show any significant change in thyroid hormones and progesterone hormone levels when compared with control subjects. The findings suggest that estrogen deficiency after menopause may contribute to develop OA in postmenopausal women.
Incidence Of Micro-Albuminura In Diabetes Mellitus Type 2; A Prospective Stud...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Treatment Of HCV in CKD Patients - Prof. Hussein El-FishawyMNDU net
- Hepatitis C virus (HCV) infection affects an estimated 170-200 million people worldwide and is a major cause of liver disease.
- HCV infection is highly prevalent among patients with end-stage renal disease undergoing hemodialysis, ranging from 1-100% depending on geographic region.
- Chronic HCV infection increases mortality in hemodialysis patients, both from hepatic causes like liver cancer as well as extrahepatic causes such as cardiovascular disease. It is associated with higher mortality compared to HCV-negative patients.
Diabetes and heart two sides of the same coinSunil Wadhwa
This ppt presented in a CME of doctors in March 2017 discusses-if all Diabetics should be treated aggressively for prevention of coronary artery disease & SHOULD IT BE PRESUMED AS IF THEY ARE ALREADY PATIENTS OF CAD?
This presentation is updated till March 2017
Diabetic Dyslipidemia
By Dr. Usama Ragab Youssif
ISMA CME Activity 2021
In Tolip EL Galala Hotel
-----------
Introduction
Physiology of lipid metabolism
Pathophysiology of diabetic dyslipidemia
Statin therapy (+/- ezetimibe) evidence and translation of evidence
Residual CV risk: excess TG
EPA therapy evidence and translation of evidence
1) The study aimed to determine if incomplete inhibition of platelet thromboxane production by aspirin (ASA), as measured by urinary 11-dehydro thromboxane B2 levels, was associated with increased cardiovascular risk in patients in the CHARISMA trial.
2) Urinary 11-dehydro thromboxane B2 levels were measured in 3261 patients to identify determinants of thromboxane production and whether clopidogrel added to ASA could reduce thromboxane biosynthesis.
3) Baseline characteristics and outcomes were compared between patients who did and did not experience a primary endpoint of stroke, MI or cardiovascular death during follow-up. Determinants of urinary 11-dehydro throm
This study examined the relationship between serum uric acid levels and stroke in patients with diabetes mellitus. The study compared 100 patients with both stroke and diabetes, 50 patients with stroke but no diabetes, and 50 patients with diabetes but no stroke. It found that serum uric acid levels were highest in patients with both stroke and diabetes, lower in patients with stroke only, and lowest in patients with diabetes only. Serum uric acid levels were also correlated with fasting blood glucose, post-meal blood glucose, glycated hemoglobin, and diabetes duration. The study concludes that high serum uric acid may be a marker for increased risk of stroke in patients with diabetes.
Cardiovascular disease is a major risk for those with diabetes.
1) Studies like the Framingham Heart Study and UKPDS found diabetes to be a significant risk factor for cardiovascular mortality and events like heart attacks.
2) Having diabetes poses similar risks as having a heart attack, with endothelial dysfunction, dyslipidemia, and other factors increasing cardiovascular risks.
3) Lifestyle changes like diet, exercise, weight loss and optimal control of blood pressure, cholesterol and blood sugars can help prevent premature cardiovascular events for those with diabetes.
Background and Aim: Many studies have found association between Red Cell Distribution Width (RDW) values and hypertension, dipping pattern, and end-organ damage. RDW values are affected by blood vitamin B12, iron, and folic acid levels, parameters that were not assessed in the previous studies. The aim of our study was to evaluate the relation between RDW and hypertension, dipper pattern, and end-organ damage independently from vitamin B12, folic acid, and ferritin levels in newly diagnosed hypertensive patients.
CholesLo shows clinical significance in
helping reduce plasma cholesterol and
homocysteine levels and therefore affects
favourably the risk of subsequent development
of cardiovascular disease. Furthermore, our
findings suggest that the dose required to cause
such improvements in plasma lipid profile is
safe enough to be considered for use in general
population.
Cholesterol May be a Negative Whereas Triglycerides Positive Acute Phase Reac...asclepiuspdfs
Background: We tried to understand some undetermined missions of cholesterol and triglycerides (TG) in the plasma in patients with the sickle cell diseases (SCD). Methods: All patients with the SCD and age and gender-matched control cases were included into the study. Results: We studied 363 patients with the SCD (194 males) and 255 control cases (136 males), totally. Mean ages of the SCD patients were similar in males and females (31.1 vs. 31.0 years, respectively, P > 0.05). Although the body weight and body mass index (BMI) were significantly suppressed in the SCD patients (59.9 vs. 71.5 kg and 21.9 vs. 25.6 kg/m2, respectively, P = 0.000 for both), the body heights were similar in both groups (164.9 vs. 167.0 cm, P > 0.05). Parallel to the suppressed mean body weight and BMI, fasting plasma glucose (92.8 vs. 97.6 mg/dL, P = 0.005), total cholesterol (121.4 vs. 165.0 mg/dL, P = 0.000), low-density lipoproteins (70.4 vs. 102.4 mg/dL, P = 0.000), and high-density lipoproteins (26.0 vs. 39.6 mg/dL, P = 0.000) values were all suppressed in the SCD patients, significantly. Similarly, both systolic (115.2 vs. 122.6 mmHg, P = 0.000) and diastolic blood pressure (73.0 vs. 86.6 mmHg, P = 0.000) were also suppressed in them, significantly. Interestingly, only the plasma TG were increased in the SCD patients (129.4 vs. 117.3 mg/dL, P = 0.000), significantly. Similarly, mean alanine aminotransferase value was not suppressed in them, too (27.4 vs. 27.3 U/L, P > 0.05). Conclusion: Cholesterol may be a negative whereas TG positive acute phase reactants in the plasma.
Relative Hyperoxia in cyanotic congenital heart disease on veno-arterial ECMO...Texas Children's Hospital
Extracorporeal membrane oxygenation (ECMO) is an
established intervention for respiratory or cardiorespiratory
support in children with congenital heart disease (CHD)
when all other interventions have failed. Hyperoxia
following successful resuscitation has been associated with
increased mortality in pediatric and adult studies,
including, specifically, hyperoxia during ECMO
management. We hypothesized that this effect may be
pronounced in patients with lower arterial oxygen
saturation at baseline, such as those with cyanotic CHD. We
aimed to determine if relative hyperoxia in children with
cyanotic single ventricle circulation on Veno-Arterial (VA)-
ECMO is a risk factor for mortality in a large multicenter
registry analysis.
The document discusses exercise in the primary and secondary prevention of cardiovascular disease. It covers several key points:
1) Many studies have shown that higher levels of physical fitness are associated with lower risks of premature cardiovascular death. Regular exercise can help prevent cardiovascular disease.
2) Even relatively small amounts of daily exercise, such as 15 minutes, have been shown to significantly reduce mortality risks. More exercise provides greater benefits.
3) Exercise can help manage diabetes and obesity, two major risk factors for cardiovascular disease. It improves glucose control and cardiovascular risk profiles.
4) Cardiac rehabilitation programs that include regular exercise have been shown to significantly reduce mortality and hospitalization rates for cardiovascular patients.
This document reviews traditional and non-traditional risk factors for cardiovascular disease. It discusses how hypertension, diabetes, high total cholesterol, high LDL cholesterol, high triglycerides, and low HDL cholesterol are traditional risk factors. It also examines non-traditional markers like homocysteine, plasminogen activator inhibitor-1, fibrinogen, and various inflammatory markers that may help predict cardiovascular risk. While many non-traditional markers show promise, most are not routinely used in clinical practice and their predictive value requires further confirmation.
Physical activity and risk of cardiovascular disease—aArhamSheikh1
High levels of both leisure time physical activity and moderate levels of occupational physical activity are associated with a 20-30% lower risk of cardiovascular disease among men and women. The meta-analysis included 21 prospective cohort studies with over 650,000 participants followed for an average of 10 years. Both high leisure time physical activity and moderate occupational physical activity were associated with roughly a 20-30% lower risk of coronary heart disease and stroke for men and women. No evidence of publication bias was found across the studies.
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This document summarizes a study that assessed liver function in 200 Sudanese patients with long-standing type 2 diabetes compared to 100 healthy controls. The levels of various liver enzymes and proteins were measured and compared between the two groups. The study found significantly higher levels of ALT, AST, ALP, and bilirubin and lower levels of total protein and albumin in the diabetic patients compared to controls. It also found positive correlations between the levels of ALT, AST, ALP and bilirubin and the duration of diabetes, and negative correlations between the levels of total protein and albumin and diabetes duration. The study concludes that type 2 diabetes is associated with abnormal liver function tests and that liver dysfunction increases with longer diabetes duration
This thesis submitted by Ayman Noureldeen Mostafa aims to compare glycated albumin and glycated hemoglobin as indicators of glycemic control in hemodialysis patients with diabetes. A cross-sectional study of 50 chronic kidney disease patients with diabetes undergoing hemodialysis for over 3 months will be conducted. Patients will have their blood glucose, glycated albumin, and glycated hemoglobin measured over a 3 month period. The results will be statistically analyzed to determine which marker provides a more accurate reflection of blood glucose levels in this patient population. The thesis is submitted in partial fulfillment of a doctorate degree in internal medicine under the supervision of Dr. Mohamad Abbas Sobh and Dr. Ashraf
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Androgens & Cardiovascular Diseases in Women: From Basic Research to Clinical...InsideScientific
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- Review the key role of androgens in cardiovascular pathophysiology
- Discuss potential mechanisms by which androgens mediate a deleterious cardiometabolic profile in females
- Interpret gaps and opportunities in basic and clinical practice in conditions of androgen excess
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Postprandial hypertriglyceridemia and androgen dysfunction
1. Journal of Biology, Agriculture and Healthcare www.iiste.org
ISSN 2224-3208 (Paper) ISSN 2225-093X (Online)
Vol.4, No.16, 2014
142
Postprandial hypertriglyceridemia and androgen dysfunction
relationship in men with end stage renal disease
Zainab A. A. Al-Shamma phD.1
, *
Dr. kais Hasan abd 2
F.I.B.M.S.( Neph )
, Shaymaa Zahraw 3
PhD
1
Dept. of Clinical Pharmacy and Therapeutics, Baghdad College of Pharmacy/ Baghdad-Iraq
E-mail z.alshamma@gmail.com
2
Head of Kidney disease and transplantation unit of Baghdad medical teaching hospital /Baghdad-Iraq
E-mail qais altaee@yahoo.com
3
Departments of Chemistry and Biochemistry - collage of medicine Al- Nahrain University/ Baghdad-Iraq
E-mail: sh_zahraw@yahoo.com
Abstract:
Background: Gonadal function is affected with end stage renal disease. In men the disturbances of the
hypothalamic–pituitary–testicular axis can be detected with only moderate reductions in the glomerular filtration
rate. There are many evidences that confirm the effect of testosterone on lipid metabolism in postprandial state.
Objective: to study the relationship between low level of total testosterone and postprandial lipids in male
patients with end stage renal disease.
Subjects &Method: the study involved 38 male patients with end stage renal disease ( age range of 30- 60 years
) attending the unit of kidney disease and transplantation at Baghdad Teaching Hospital , and 35 healthy subjects
(control group ) of matching age and weight during the period from January to march 2013. Postprandial venous
blood was obtained for glucose, lipid profile, urea and creatinine measurement immediately after separation of
the serum by routine colorimetric methods .
The determination of androgen sex hormones (luteinizing hormone , follicle stimulating hormone , testosterone ,
and sex hormone binding globulin ,) was done using Enzyme-Linked Immuno Sorbent Assay. (Sandwich
assay).
Results: There was a significant negative correlation between free testosterone, and postprandial triglyceride in
both ESRD patients and control groups with a significant difference in testosterone between these two groups.
The sex hormone binding globulin was also correlated negatively with postprandial triglyceride in the control
group.
Conclusion: Decline in free testosterone level associated increased postprandial hypertriglyceridemia, which
could, both, be considered predictors for cardiovascular disease risk factors in male patients with ESRD.
Key words : Postprandial hypertriglyceridemia , free testosterone, androgen dysfunction ,ESRD.
Introduction:
Chronic kidney disease is a progressive loss in renal function over a period of months or years. There are no
specific symptoms of deterioration of kidney function. A reduced appetite and feeling unwell might be the
main symptoms of kidney dysfunction. Diabetes and /or high blood pressure are the main risk factors for
development of kidney problems . Chronic kidney disease was classified in five stages begin with stage 1, with
mildest and causing few symptoms which progressed to severe illness with poor life expectancy in stage 5 if
untreated. This is according to the professional guidelines classification. Creatinine levels may be normal in the
early stages of CKD, and the condition is discovered if urinalysis shows that the kidney is allowing the loss of
protein or red blood cells into the urine (Levin et al 2008). Eventually, kidney failure (stage 5 CKD) ensues and
kidney replacement therapy is required (NKF-KDOQI 2002 &Johnson 2011).
In CKD, the secretion of hormones and the response of target tissues were affected causing endocrine
dysfunctions. As many as 50 to 70% of men with ESRD have been reported to be hypogonadal on the basis of
low concentrations of total and free testosterone due to moderate reductions in the GFR which leads to an
alterations of sex steroid production and metabolism
( Karagiannis and Harsoulis 2005 & Albaaj et al 2006)
Dyslipidemia is one of the important clinical features in ESRD manifested by hyper-triglyceridemia, elevated
level of very low density lipoprotein (VLDL), high plasma concentration of lipoprotein remnants, accumulation
of oxidized lipids and lipoproteins, low plasma HDL, cholesterol concentration and impaired HDL maturation
2. Journal of Biology, Agriculture and Healthcare www.iiste.org
ISSN 2224-3208 (Paper) ISSN 2225-093X (Online)
Vol.4, No.16, 2014
143
and function , while serum cholesterol and LDL cholesterol values are frequently within or below the normal
limits (Vaziri 2006).Many studies reported that low total testosterone level is associated with an adverse lipid
profile, which were included high TG level and low HDL-C (Agledahl et al 2008 & Page et al 2008 & Makinen
et al 2008).
The major finding of the recent study has shown that the administration of total testosterone has beneficial effects
on dyslipidemia especially on TG level. Another important finding of this study was the young and middle-aged
men with the lowest total testosterone concentrations, had the highest risk of incident dyslipidemia (Cornoldi et al
2010).
Subjects & Methods:
This study included 38 male patients with ESRD of age range between 30-60 years and disease duration from 2-
19 months, who were attending kidney disease and transplantation at Baghdad Teaching Hospital during the
period from January to march 2013. Patients with diabetes mellitus and thyroid disease were excluded from this
study .this study also included 35 normal male volunteers of matching age and BMI who were nonsmoker; non
alcoholics and none ,had dyslipidemia as revealed from pervious laboratory tests .
Ten milliliters (10ml) of venous blood were withdrawn in 3-4 hr. after meal from both patient and
control group. Blood samples were collected in a plain tube and centrifuged for 15 minutes at 3000rpm after
being allowed to clot at room temperature for 30 minutes. The separated serum was divided into aliquots and
were stored frozen at (-20 c˚) to be used later for estimation of androgen sex hormone , luteinizing hormone
(LH) ,follicle stimulating hormone (FSH) , testosterone , free testosterone, sex hormone binding globulin
(SHBG) by Enzyme -Linked Immune Sorbent (ELISA, Sandwich Assay) .
While glucose, lipid profile, urea and creatinine analysis all were done immediately after separation of
the serum by the routine colorimetric methods. Body mass index was calculated as body weight (in Kg/Sq height
(meter).The oral consent had been taken from all patients and controls for blood collection.
Statistical study:
All results were expressed as mean± standard deviation (mean±SD). All statistical analysis was performed
using Statistical Package for the Social Sciences (SPSS version 15.0). Independent student t-test as performed
to assess differences between two means. Person correlation coefficient was used to determine the correlation
between quantitative data .P value < 0.05 was considered significant (Elliott and Woodward 2007).
Results & Discussion;
As shown in table 1, there is significant differences in total testosterone, , free testosterone , FSH, LH
between two groups ( p< 0 .0001) ,while no significant differences in SHBG (p > 0.05) can be noted. All other
parameters measured were significantly higher (including serum lipids, urea, and creatinine).In the present study,
the results were represent clearly low serum total testosterone and free testosterone in the ESRD patients relative
to the normal controls, and this was associated with higher rise in the serum postprandial triglycerides, while
there was no significant differences in SHBG level between both ESRD patients and their control group. These
results were confirmed by the result of Albaaj et al 2006, while another study, noted that concentration of SHBG
was elevated ( Albaaj et al 2006 & Al-Khallaf etal 2012 ).Male hypoandrogenism i.e. low testosterone is the
most common gonadal dysfunction in men, mainly due to reduced prolactin clearance. A prolactin-induced
inhibition of gonadotropin, is considered as one of the most important causes of testosterone deficiency, and has
been reported to associate cardiovascular risk factors and mortality in CKD and uremic inhibition of LH
signaling at the level of the Leydig cells (Gungor et al 2010). Yilmaz et al 2011 found that every nmol/L
decrease in total testosterone concentration in male lead to increase in the percentage (Approximately 22%) of
cardiovascular risk in the ESRD patients (Yilmaz et al 2011).
The results of many studies considered the low level of serum testosterone or free testosterone a consequence of
the changes in gonadal steroid genesis and decreased in synthesis and secretion of testosterone follow the
progression of CKD as a result of the hypothalamic–pituitary–testicular axis dysfunction (Gungor et al 2010 &
Yilmaz et al 2011 & Carrero et al 2010).
In healthy adult male, testosterone plays important role in lipid metabolism. With the age progressing
the testosterone level will start decrease which predicts the development of central obesity and accumulation of
intra-abdominal fat (Allan and McLachlan 2010 &Brand et al 2011).According to the results of many
studies which have considered that the metabolic influence of TG and triglyceride rich lipoprotein (TRL)
remnants which comprise a heterogeneous group of apo B-containing lipoproteins, including chylomicrons,
VLDLs and IDLs have direct relation to atherogenic state (López-Miranda et al 2004) .The mechanisms of aging
and death in humans were discussed in many studies and one of their possible explanations that there was
negative influence of androgens on the lipid profile which is more pronounced in aging men (Kolovou et al
3. Journal of Biology, Agriculture and Healthcare www.iiste.org
ISSN 2224-3208 (Paper) ISSN 2225-093X (Online)
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2011).One of these studies has attributed the increase in the HDL consumption to the stimulation of reverse
cholesterol transport (Hersberger et al 2005).
This hypothesis was supported by Jones et al. 2011 in their recent study by a longer-term testosterone
replacement therapy (TRT) demonstrating that after an initial fall in their serum concentrations, HDL-C levels
returned to baseline levels after 12 month (Jones et al. 2011).
In end stage renal disease patients there is an increase in ppTG levels and abnormal prolongation of
this increase (Montague and Murphy 2009 & Piecha et al 2009 & Attman and Samuelsson 2009 ).The
disturbance of the clearance of Chylomicrons remnants may underlie this change. However, since Chylomicrons
compete with TRL of hepatic origin for lipolysis by LPL, the postprandial increase in triglycerides in the
circulation is worsened by TRL of hepatic origin ( Kaysen 2009). 2
Thus, the postprandial increase in TG
involves not only the metabolism of Chylomicrons of intestinal origin but also the metabolism of TRL of hepatic
origin (Saland and Ginsberg 2007).
The general mechanisms underlying the dyslipidemia of renal disease may be alteration in the
metabolism of postprandial lipoproteins, alteration in the metabolism of other TRL, changes in the route of
reverse cholesterol transport, structural changes of lipoproteins that mean HDL-C undergoes structural changes
through the incorporation of serum amyloid A, resulting in the so-called acute phase or inflammatory HDL,
which act not as protective particles, but as pro-atherogenic particles(Saland and Ginsberg 2007& Kwan et al
2007& Perrea et al 2008).In chronic kidney disease there is an increase in pp TG levels and abnormal
prolongation of this increase (Perrea et al2008 & Badiou et al 2009 & Mesquita et al 2010).
The clearance of Chylomicrons remnants disturbed. However, since Chylomicrons compete with TRL
of hepatic origin for lipolysis by LPL, Thus, the postprandial increase in TG involves not only the metabolism of
Chylomicrons of intestinal origin but also the metabolism of TRL of hepatic origin (Mesquita et al 2010)
.Supportive observational studies have identified pp TG levels to be a superior predictor of CVD risk compared
with fasting levels (Mesquita et al 2010 & Nordestgaard et al 2010)..
An inverse correlation between testosterone
and each of ESRD, BMI , total cholesterol and TG was reported (Gungor et al 2010).
References:
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5. Journal of Biology, Agriculture and Healthcare www.iiste.org
ISSN 2224-3208 (Paper) ISSN 2225-093X (Online)
Vol.4, No.16, 2014
146
Tables:
Table (1):- comparison between ESRD patients and their controls:
P*
= 0.05 ,p**
= 0.0005 , p***
= 0.0001
Parameters
ESRD (mean ±SD) (n=38) Control(mean ±SD) (n=35)
Age (yr)
46.66±10.36
44.6±8.17
BMI (kg/m
2
) 26.34±3.91 27.77±2.91
RBG (mmol/l) 5.74±1.14 5.36±1.12
pp TG (mmol/l) 2.72±0.65 1.76±0.53
***
S. Cholesterol (mmol/l) 5.78±0.68 4.27±0.70
***
S. HDL (mmol/l) 0.85±0.13 1.18±0.22
***
S. LDL (mmol/l) 3.4 ±0.7 2.96±0.57
***
S. VLDL (mmol/l) 1.24±0.3 0.81±0.24
***
Ath. index 4.17±1.26 2.6±0.76
***
B. Urea (mmol/l) 28.58±10.94 5.85±0.74
***
S. Creatinine (µmol/l) 551.0±326.15 74.4±7.79
***
S. FSH (IU/l) 10.14±4.24 6.32±1.47
***
S. LH (IU/l) 11.78±5.23 5.28±2.1
***
S. Total Testosterone (nmol/l) 8.81±3.43 15.17±5.59
***
S. SHBG (nmol/L ) 35.5±21.89 32.94±13.52
S. Free Testosterone (pmol/l) 20.63±13.89 32.16±13.19
6. Journal of Biology, Agriculture and Healthcare www.iiste.org
ISSN 2224-3208 (Paper) ISSN 2225-093X (Online)
Vol.4, No.16, 2014
147
Figures:
Figure (1): Correlation between total testosterone and postprandial triglyceride.
Figure 2: Correlation between free testosterone, and postprandial triglyceride.
0
1
2
3
4
5
0 10 20 30 40 50 60
TGmmol/l
free testosterone pmol/l
ESRD r = -0.332, p = 0.041
0
1
2
3
4
0 5 10 15 20 25 30
TGmmol/l
T.testosterone nmol/l
control r=-0.294, P =0.025
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