Effects of obstructive sleep apnea treatment on left atrial volume and left atrial volume index

Obstructive sleep apnea (OSA) and increased left atrial volume (LAV) both independently increase cardiovascular mortality. We hypothesized that treatment of OSA with continuous positive airway pressure (CPAP) may decrease LAV. We retrospectively identified 47 OSA patients receiving CPAP who had echocardiograms done before and after polysomnography. Compliance was defined as CPAP use at-least five nights weekly and 5 h per night. The compliant group (n = 23) had a significant decrease in diastolic blood pressure (DBP; 4.4 ± 8.9 mmHg, p < 0.05) and mean arterial pressure (MAP; 4.7 ± 10.3 mmHg, p < 0.05), while no significant changes were observed in the noncompliant group (n = 24). LAV data were available in 13 compliant and 20 noncompliant patients. LAV decreased nonsignificantly (3.54 ± 16.6 mL, n = 13, p = 0.65) in CPAP-compliant patients, while it increased (15.47 ± 22.3 mL, n = 20, p < 0.006) in noncompliant patients. Similar changes were seen in the LAV index. Untreated OSA was associated with an increase in LAV and LAV index without significant changes in blood pressure. Treatment of OSA was associated with a decrease in DBP and MAP with a nonsignificant decrease in LAV. Treatment of OSA may prevent adverse left atrial remodeling. There are no conflicts of interest or financial disclosures for any of the authors.     

Correlates of death anxiety in Pakistan

To ascertain the effect of gender, age, and religiosity on death anxiety, 132 participants were interviewed using Templer Death Anxiety Scale and Collett-Lester Fear of Death Scale (CLS). Women, older participants, and less religious participants were found to be more scared of their impending death. Gender effect was more pronounced, however, on the CLS. Women and less religious people reported to experience greater anxiety than their respective counterparts about different dimensions of death, for example, the shortness of life, total isolation of death, fear of not being, and disintegration of body after dying. The findings of the current work indicate that the general predictors of death anxiety, gender, age, and religiosity reported in Western, predominantly Christian samples also hold in an Eastern, Muslim sample.     

Antidiabetic effects of sage (Salvia officinalis L.) leaves in normal and streptozotocin-induced diabetic rats

BackgroundSage (Salvia officinalis L.) has a wide range of biological activities, such as anti-oxidative properties, anti-bacterial, hypoglycemic, anti-inflammatory, fungistatic, virustatic, astringent, eupeptic and anti-hydrotic effects. This study was designed to examine the antidiabetic effect of sage ethanolic extract in normal and streptozotocin-induced diabetic rats.MethodsOral administration of sage extract (0.1, 0.2, and 0.4 g/kg body weight) and glibenclamide (600 μg/kg) for 14 days on the level of serum glucose, triglycerides, total cholesterol, urea, uric acid, creatinine, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in normal and streptozotocin-induced diabetic rats were evaluated.ResultsOral administration of 0.2 and 0.4 g/kg body wt. of the sage extract for 14 days exhibited a significant reduction in serum glucose, triglycerides, total cholesterol, urea, uric acid, creatinine, AST, ALT and increased plasma insulin in streptozotocin-induced diabetic rats but not in normal rats. Glibenclamide was used as reference and showed similar antidiabetic effect.ConclusionsIt is concluded that the traditional use of S. officinalis as an antidiabetic agent is justified and that extracts from this plant show a dose-dependent activity which is comparable to the standard antidiabetic drug glibenclamide.     

Smoking in Saudi Arabia and its relation to coronary artery disease

Objectives

The health hazards related to smoking are well known. Smoking is a recognized risk factor for coronary artery disease (CAD). Despite rejection of smoking by the Saudi community, we are still seeing smokers in our population. This study is designed to determine the prevalence of smoking in the Kingdom of Saudi Arabia (KSA), and to find out its relation to CAD. This study is part of the Coronary Artery Disease In Saudis (CADIS) study.

Methods

This health survey was conducted by collecting data regarding smoking status among adult Saudis aged between 30 and 70 years of both sexes in KSA over a five year period from 1995 up to 2000. The study sample was of normal distribution and representative of all regions of KSA. The data were analyzed to provide the prevalence of smoking and its relation with CAD.

Results

The total number of subjects was 17,350, and current smokers were 2217; accordingly the overall prevalence of smoking among Saudis was 12.8%. Males (1555) were significantly smoking more than females (662) with a prevalence of 18.7% and 7.3%, respectively (P < 0.0001). Smoking is more prevalent among Saudis living in urban, northern, western, and eastern regions compared to other regions of KSA. Smokers are more likely to develop CAD compared to non-smokers (P < 0.0001).

Conclusions

Smoking is a prevalent health problem among Saudis that requires intervention for eradication. We found clear association between cigarettes smoking and CAD particularly among males. Persistent education of the health hazards related to smoking is recommended particularly at early age in-order to prevent initiation of smoking.     

Gastric cancer and Helicobacter Pylori infection in the Eastern Libya: A descriptive epidemiological study

Background and study aimsThe aim of this study was to determine the pattern of histologically-proven gastric cancer in Eastern Libya and explore its association with Helicobacter pylori infection.Patients and methodsThe registries of the Departments of Histopathology, Faculty of Medicine, Benghazi University and Oncology, Al-Jomhoria Hospital, Benghazi, were reviewed for cases with primary gastrointestinal cancer from January 2000 to December 2002 (sole Histopathology and Oncology Departments in Eastern Libya). Slides of hematoxylin and eosin stain of gastric cancer patients were re-stained to detect H. pylori. The American Joint Committee on Cancer Tumor, Node, Metastasis staging was used for clinical and pathologic staging. Gastric cancer biopsy materials were classified into intestinal or diffuse type according to Lauren criteria.ResultsOne hundred and fourteen cases of gastric cancer were diagnosed. Tumor stages were: 2 (14%), 3 (21%), 4 (57%) and unknown (8%). Most common site of involvement was the antrum (48%). Diffuse adenocarcinoma occurred in 56 patients (49.1%), intestinal adenocarcinoma in 46 (40.4%) and malignant gastric lymphoma in 12 (10.5%). The overall frequency of H. pylori infection was 63.2% (72/114), more frequent in intestinal adenocarcinoma (71.7%) and malignant lymphoma (66.6%) than diffuse adenocarcinoma (55.3%). The frequency of gastric cancer increased throughout the three years of study.ConclusionThe majority of the patients were diagnosed in locally advanced or metastatic stage. Clearly more efforts need to be given to early detection. We showed a stronger association of H. pylori infection with intestinal type gastric adenocarcinoma and malignant lymphoma than diffuse adenocarcinoma suggesting that H. pylori infection is the most probable causal factor of gastric cancer in this part of Libya.     

Low Helicobacter pylori eradication rates with 4- and 7-day regimens in an Iranian population

BACKGROUND: In Iran, there is insufficient information on the efficacy of Helicobacter pylori eradication regimens shorter than 10 days. This study aims at assessing the efficacy of 4- and 7-day H. pylori eradication regimens in a high-incidence area of gastric cancer in Iran. METHODS: Subjects with an endoscopic diagnosis of gastritis, positive urease test, and a histological diagnosis of chronic gastritis were enrolled. Patients were randomly assigned to one of three groups: AOC7 (1000 mg amoxicillin, 20 mg omeprazole, and 500 mg clarithromycin twice daily for 7 days), FOT4 (200 mg furazolidone, 20 mg omeprazole, and 500 mg tetracycline twice daily for 4 days) and FOT7 (the same treatment as the FOT4 group but for 7 days). Sensitivity to these antibiotics was determined in all isolates recovered from culture. The efficacy of eradication was assessed 8 weeks after the end-of-treatment by the 14C-urea breath test. RESULTS: One hundred and twenty-eight patients were enrolled in the study. Culture was positive for 84 patients and none of these were resistant to amoxicillin, tetracycline or furazolidone, 1.2% were resistant to clarithromycin and 32.1% to metronidazole. Forty-five, 41 and 42 patients were randomly allocated to the AOC7, FOT4, and FOT7 groups, respectively. The intention-to-treat eradication rates were 35.5, 17.1, and 23.8% for the AOC7, FOT4, and FOT7 groups, respectively. CONCLUSION: Treatment regimens of 4 or 7 days are unacceptable for H. pylori infection in Iran, even in the presence of a favorable sensitivity profile.     

Peri‐implant soft tissue inflammatory parameters and crestal bone loss among waterpipe (narghile) smokers and never‐smokers with and without type 2 diabetes mellitus

1 Background

Peri‐implant soft tissue inflammatory parameters and crestal bone loss (CBL) among waterpipe smokers (WS) with and without type 2 diabetes mellitus (T2DM) remains uninvestigated. The aim of the present study was to assess peri‐implant soft tissue inflammatory parameters and CBL among WS and never smokers (NS) with and without T2DM.

2 Methods

Demographic data and information regarding duration of implants in function, daily frequency of smoking, duration and treatment of T2DM, and daily toothbrushing was collected using a questionnaire. Peri‐implant plaque index (PI), bleeding on probing (BOP), probing depth (PD) ≥4 mm, CBL, and hemoglobin A1c (HbA1c) levels were assessed in all individuals. Level of significance was set at 5%.

3 Results

Seventy‐nine male individuals (39 patients with T2DM [20 WS and 19 NS] and 40 systemically healthy individuals [21 WS smokers and 19 NS]) were included. The mean age was comparable among individuals in all groups. The mean HbA1c levels were significantly higher among patients with T2DM compared to controls (P < 0.01). Peri‐implant PI, BOP, PD, and CBL were comparable among WS and NS with T2DM. Among patients without T2DM, PI (P < 0.05), PD ≥4 mm (P < 0.05) and mesial and distal CBL (P < 0.05) were significantly higher in WS than NS. Among individuals without T2DM, BOP was significantly higher among NS (P < 0.05) than WS. In patients with T2DM, BOP was comparable among WS and NS.

4 Conclusions

Peri‐implant soft tissue inflammatory parameters and CBL were comparable among WS and NS with T2DM. Among individuals without T2DM, these parameters were worse among WS than NS.