Background: The metabolic syndrome (MetS) is a clustering of vascular risk factors that tend to increase the risk of occurrence of diabetes mellitus type 2 (DMT2), cardiovascular and cerebro-vascular ischemic events. ...Background: The metabolic syndrome (MetS) is a clustering of vascular risk factors that tend to increase the risk of occurrence of diabetes mellitus type 2 (DMT2), cardiovascular and cerebro-vascular ischemic events. The aim of the present study is to investigate the association of extra-cranial and intracranial arterial atherosclerosis as well as silent brain infarction (SBI) with MetS, thereby determining the potential cerebrovascular atherosclerotic risk of MetS in the Egyptian population. Methods: A case control study was conducted on 50 Egyptian subjects with MetS and 30 without with age range from 40 - 60 years old. All participants were free from cerebrovascular ischemic events [stroke or transient ischemic attack (TIA)]. All participants underwent complete neurological examination, assessment of the diagnostic criteria for MetS, carotid and transcranial duplex ultrasonography (U/S) and brain MRI. Results: Preclinical carotid atherosclerosis (athero-sclerotic plaques with <50% stenosis) was associated with MetS (P value = 0.02) that persisted after adjustment for age and other confounders. There was no significant association between increased intima media thickness (IMT) and MetS. There was non-significant association between MetS and intracranial atherosclerotic disease (ICAD) or the degree of intracranial stenosis (ICS). Conversely, there was a highly significant association between MetS and SBI even after adjustment for age and other confounders (P value = 0.001). Conclusion: Metabolic syndrome is an important factor associated with mild to moderate atherosclerosis (<50% stenosis) and silent brain infarcts among asymptomatic individuals. Interventions to reduce MetS are important for prevention of subclinical and clinical cerebral atherosclerotic disease.展开更多
Acute upper gastrointestinal bleeding (UGIB) remains an important emergency situation. In the last two decades, major developments took place influencing incidence, etiology and outcome of patients with acute UGIB. Pe...Acute upper gastrointestinal bleeding (UGIB) remains an important emergency situation. In the last two decades, major developments took place influencing incidence, etiology and outcome of patients with acute UGIB. Peptic ulcer bleeding is the most significant complication of ulcer disease being responsible for 50% of all cases mortality. Aim of the study: To compare between endoscopic clip application versus argon plasma coagulation in management of bleeding peptic ulcer (BPU). Patients and Methods: Sixty patients suffering from acute UGIB were randomly divided into two groups: group I included 30 patients treated with endoscopic clip application and Group II included 30 patients subjected to endoscopic APC. All patients were classified according to Forrest classification and the clinical Rockall score. Results: There were significant differences between the two groups as regard Forrest classification (P 0.05). Re bleeding was significant with higher Rockall score in group I (P 0.05). Conclusion: Endoscopic application of hemoclips have a less re bleeding rate than Argon plasma coagulation for treatment of bleeding peptic ulcer, although this was statistically insignificant, meanwhile APC is still less cost and easy. Clinical and endoscopic assessment (through Rokcall score and Forrest classification) could help in making best choice for endoscopic management.展开更多
文摘Background: The metabolic syndrome (MetS) is a clustering of vascular risk factors that tend to increase the risk of occurrence of diabetes mellitus type 2 (DMT2), cardiovascular and cerebro-vascular ischemic events. The aim of the present study is to investigate the association of extra-cranial and intracranial arterial atherosclerosis as well as silent brain infarction (SBI) with MetS, thereby determining the potential cerebrovascular atherosclerotic risk of MetS in the Egyptian population. Methods: A case control study was conducted on 50 Egyptian subjects with MetS and 30 without with age range from 40 - 60 years old. All participants were free from cerebrovascular ischemic events [stroke or transient ischemic attack (TIA)]. All participants underwent complete neurological examination, assessment of the diagnostic criteria for MetS, carotid and transcranial duplex ultrasonography (U/S) and brain MRI. Results: Preclinical carotid atherosclerosis (athero-sclerotic plaques with <50% stenosis) was associated with MetS (P value = 0.02) that persisted after adjustment for age and other confounders. There was no significant association between increased intima media thickness (IMT) and MetS. There was non-significant association between MetS and intracranial atherosclerotic disease (ICAD) or the degree of intracranial stenosis (ICS). Conversely, there was a highly significant association between MetS and SBI even after adjustment for age and other confounders (P value = 0.001). Conclusion: Metabolic syndrome is an important factor associated with mild to moderate atherosclerosis (<50% stenosis) and silent brain infarcts among asymptomatic individuals. Interventions to reduce MetS are important for prevention of subclinical and clinical cerebral atherosclerotic disease.
文摘Acute upper gastrointestinal bleeding (UGIB) remains an important emergency situation. In the last two decades, major developments took place influencing incidence, etiology and outcome of patients with acute UGIB. Peptic ulcer bleeding is the most significant complication of ulcer disease being responsible for 50% of all cases mortality. Aim of the study: To compare between endoscopic clip application versus argon plasma coagulation in management of bleeding peptic ulcer (BPU). Patients and Methods: Sixty patients suffering from acute UGIB were randomly divided into two groups: group I included 30 patients treated with endoscopic clip application and Group II included 30 patients subjected to endoscopic APC. All patients were classified according to Forrest classification and the clinical Rockall score. Results: There were significant differences between the two groups as regard Forrest classification (P 0.05). Re bleeding was significant with higher Rockall score in group I (P 0.05). Conclusion: Endoscopic application of hemoclips have a less re bleeding rate than Argon plasma coagulation for treatment of bleeding peptic ulcer, although this was statistically insignificant, meanwhile APC is still less cost and easy. Clinical and endoscopic assessment (through Rokcall score and Forrest classification) could help in making best choice for endoscopic management.
