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Table of Contents - Current issue
September-December 2017
Volume 3 | Issue 3
Page Nos. 83-105
Online since Thursday, March 1, 2018
Accessed 1,255 times.
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ORIGINAL ARTICLES
Effect of chronic hepatitis C on serum zinc and its relation as a cofactor to cognitive impairment and nutritional status in hemodialysis patients
p. 83
Elsaid H Ibrahim, Mohamed N Mowafy, Dalia A Maharem, Ahmad M Awad, Sherif M Mamdouh Mohammed
DOI
:10.4103/ejode.ejode_23_17
Background and aim
The prevalence of hepatitis C virus (HCV) infection among dialysis patients is higher than in the general population. The prevalence of cognitive impairment (CI) is common among hemodialysis (HD) patients. Also patients with end-stage liver disease are vulnerable to cognitive dysfunction. Malnutrition and inflammation are common occurrences in maintenance HD patients. About 40–78% of individuals on HD suffer from hypozincemia. Zinc deficiency has been observed with high prevalence in liver cirrhosis. This study was carried out to assess the effect of chronic HCV on serum zinc level and its relation as a cofactor to CI and nutritional status in HD patients.
Patients and methods
The study involved 80 HD participants who were enrolled into two groups: group I: 40 HCV-positive HD patients (20 without liver cirrhosis and 20 with liver cirrhosis) and group II: 40 HCV-negative HD patients without liver cirrhosis. All participants were evaluated as regards detailed history and clinical examination, standardized mini-mental state examination (MMSE), malnutrition inflammation score (MIS), Child–Pugh classification, complete blood picture (CBP), prothrombin time, international normalized ratio, alanine aminotransferase, aspartate aminotransferase, serum albumin, bilirubin, blood urea, serum creatinine, Na, K, Ca, P, transferrin, ammonia, serum zinc level (predialysis and postdialysis session), virology including anti-HCV Ab, quantitative HCV PCR and hepatitis B surface antigen,
Kt
/
V
, fibrosis-4 score (FIB-4 score), and abdominal ultrasonography.
Results
We found that MMSE and zinc level were significantly lower and MIS was significantly higher in HCV HD patients with liver cirrhosis when compared with HCV HD patients without liver cirrhosis and HCV-negative HD patients. A positive significant correlation was found between zinc level and MMSE while there was a negative significant correlation between zinc level and MIS.
Conclusion
There may be an association between hypozincemia, CI, and malnutrition in HD patients especially those with chronic hepatitis C associated with liver cirrhosis.
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A putative role for oxidative stress in pathophysiology of diabetic cardiomyopathy
p. 95
Mohamed Fathelbab, Eman M Fahmy, Amr A Elshormilisy, Ahmed E Gaafar, Nermien E Waly
DOI
:10.4103/ejode.ejode_22_17
Objectives
Cardiovascular disease associated with diabetes remains the leading cause of morbidity and mortality worldwide. There is a growing scientific and public interest in connecting oxidative stress as a cause of endothelial dysfunction associated with pathological conditions such as diabetes mellitus (DM). Free radicals’ scavengers play a pivotal role in maintaining homeostasis. We investigated potential risk factors and the role of oxidative stress in the pathophysiology of diabetic cardiomyopathy.
Patients and methods
Eighty type 2 DM patients along with 65 normal healthy volunteers were recruited for this study. We calculated BMI, and measured arterial blood pressure. We measured glycosylated hemoglobin (HbA
1C
), lipid profile levels, catalase, nitric oxide, the enzymes superoxide dismutase, and malondialdehyde in plasma.
Results
We found that the mean BMI (32.63±3.42), HbA
1C
(8.07±1.39), malondialdehyde (1007.21±299.341), and nitric oxide (6.79±1.95) were significantly higher in the patient group compared with the control group. On the other hand, superoxide dismutase (2.97±0.69) and catalase (35.44±10.56) in diabetic patients were significantly lower compared with controls.
Conclusion
Our results confirm the role of oxidative stress in pathophysiology of DM. This suggests that antioxidants may have a putative therapeutic and a prognostic role in diabetic cardiomyopathy.
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Effect of Qat on the level of blood glucose and lipids among Yemeni patients with type 2 diabetes
p. 100
Zayed A Atef, Mohamed A Bamashmos, Gameel Alghazali
DOI
:10.4103/ejode.ejode_17_17
Background
The habit of chewing Qat is one of Yemen’s social and cultural characteristics. Most Yemeni adults chew Qat regularly. The general belief among the Yemeni diabetics is that Qat chewing helps to lower their blood glucose.
Objective
In this study, we investigated the effect of Qat chewing on the level of blood glucose on patients with type 2 diabetes.
Patients and methods
The study included 260 patients with type 2 diabetes who were divided into two groups: Group 1 included 130 patients who were non-Qat chewers. Group 2 included 130 patients who were Qat chewers All patients underwent clinical examination; fasting, postprandial, and random blood glucose examination before and after Qat chewing; and glycated hemoglobin and lipid profile.
Results
The results of the study demonstrated that there was a significant increase in heart rate and arterial blood pressure after Qat chewing, whereas there were no significant changes in the level of blood glucose before and after Qat chewing. Moreover, we found that there were no effects in the levels of total cholesterol and triglyceride, whereas there was a nonsignificant decrease and a nonsignificant increase in the levels of low-density lipoprotein-cholesterol and high-density lipoprotein-cholesterol, respectively, among the Qat chewers.
Conclusion
We found that there was a significant effect of Qat on heart rate and hypertension. There was no significant effect of Qat on the blood glucose or lipids levels. The only effect, which leads to wrong belief, is that Qat chewing produces feeling of euphoria, stimulation, heightened awareness, increased confidence, alertness, and energy, resulting in temporary alleviation of fatigue which the diabetic patients experience. All these effects are because of the cathinone and moderate sympathetic effects.
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