SummaryCardiovascular complications are the main cause of morbidity and mortality in peritoneal dialysis (PD) patients. Left ventricular hypertrophy (LVH) is a major predictor of the development of cardiovascular events. This study aimed to identify risk factors that contribute to the development of LVH and to determine their cutoffs in patients on maintenance peritoneal dialysis.In this cross sectional study we evaluated the association of 23 variables including age, PD vintage, ultrafiltration, urine volume, residual renal function, mean daily SBP, mean daily DBP, fasting glucose, HbA1c, peritoneal glucose load index (PGLI), fluid overload (FO), plasma brain natriuretic peptide (BNP), plasma hsCRP and IL-6, serum albumin, white blood cell (WBC) count, hemoglobin, hematocrit, triglycerides, LDL-C (low density lipoprotein cholesterol), HDL-C (high density lipoprotein cholesterol), and PTH with LVH in 38 stable patients on maintenance PD ≥ 24 months.LVH was detected in 57.9% of patients. Logistic regression and receiver operating characteristics (ROC) analysis revealed that HbA1c, PGLI, FO, plasma BNP, hsCRP and IL-6 seem to be possible predictors of LVH. The cutoffs associated with the presence of LVH were: 7.5%, 3.2 g/kg/day, 1.7 L, 330 pg/mL, 7.5 mg/dL and 3.3 pg/mL for HbA1c, PGLI, FO, plasma BNP, hsCRP and IL-6, respectively (sensitivity 72.8 to 81.8% and specificity 75.0 to 93.8%).The results suggest that efforts should be made to reduce the peritoneal glucose load (PGL), to improve the hydration status, and to attenuate the inflammatory process in order to reduce the risk of the development of LVH among PD patients. (Int Heart J 2015; 56: 186-191)

Abstract:Family is societal institution that is conceptualized as "Vital" and "Valid" its importance is emphasized by social conservatives across cultures. Consanguinity is usually socially motivated and can be genetically harmful; it is a state of being descended from a common ancestor. It has been practiced by many societies around the globe from time immemorial, and a part of most civilizations as far back as the Old Testament of the Bible, and in the Arab world before the emerging of the Islam, and therefore, it is not monopoly where Islamic faith prevails.We scrutinize the effect of consanguinity on family health, its benefits and its detriments, and how should be tackled on medical and policy levels. We also pursue the Islamic attitude and discourses on the marriage custom, law, ethics and principles. Attention is then drawn to the cultural influences and challenges in the Arab word.

BackgroundChronic pain is a common condition that affects one-third of the population, accounting for a large number of medical consultations and a significant proportion of health care costs.Evidence suggests that anxiety and depression are associated with increased pain sensitivity and pain-related disability, co-morbid states that are more disabling than either condition alone.Likewise, sleep disorders have also been linked with chronic pain, and people who experience pain-related sleep disturbances are significantly more disabled than those who do not.ObjectivesThe objective of this study was to determine the prevalence of anxiety, depression, and sleep disorders, painful musculoskeletal conditions in a sample of adults with disabilities.MethodsThis cross-sectional study analyzed data of 1692 adults aged 18 or older who have disabilities over 10 years (2005 to 2014). We examined the following chronic conditions, in which pain is a key symptom and forms part of the diagnosis, and organized them into 3 groups. Group 1 consisted of (rheumatic diseases), arthritis, osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis; group 2 consisted of muscular dystrophy; and group 3 consisted of neck or back pain;The prevalence (95% confidence interval) of painful musculoskeletal conditions was determined according to the diagnosis. Factors associated with these painful conditions were analyzed separately for men and women by using a logistic regression model.ResultsThe prevalence of painful musculoskeletal conditions was 66.9% (95% CI, 66%–67.5%). Factors associated with these conditions in both men and women included older age, a sleep disorder, and concomitant chronic anxiety and/or depression was 23.5% (95% CI, 22.5%–24%), all of which were higher in women than in men. Of the 1692 adults with disability included in the study, 65% were women. The average age was 50.5 (standard deviation, 12.5 y), and 65% of participants were 50.5 or older. In addition, 48% of participants were married. Of the participants, 16% had been diagnosed with chronic anxiety and 22% with chronic depression; and 32% with sleep disorder (sleeping 6 hours or less per day. Prevalence of Painful Conditions in Adults with Disabilities, by Group of Conditions and by Sex, Differences between men and women were significant at P <.001 (for all groups of conditions, except muscular dystrophy.ConclusionsThe prevalence of painful musculoskeletal conditions associated with depression, anxiety, and/or a sleep disorder, is high in people with disability, especially in women. To design plan for rehabilitation and improving the quality of life of adults with disability and painful conditions; treatments for depression, anxiety and/or sleep disorders should be considered in addition to conventional treatments.Disclosure of InterestNone declared