BackgroundMany studies in high-income countries have investigated gender differences in the care and outcomes of patients hospitalized with acute myocardial infarction (AMI). However, little evidence exists on gender differences among patients with AMI in lower-middle-income countries, where the proportion deaths stemming from cardiovascular disease is projected to increase dramatically. This study examines gender differences in patients in the lower-middle-income country of Egypt to determine if female patients with AMI have a different presentation, management, or outcome compared with men.Methods and FindingsUsing registry data collected over 18 months from 5 Egyptian hospitals, we considered 1204 patients (253 females, 951 males) with a confirmed diagnosis of AMI. We examined gender differences in initial presentation, clinical management, and in-hospital outcomes using t-tests and χ2 tests. Additionally, we explored gender differences in in-hospital death using multivariate logistic regression to adjust for age and other differences in initial presentation.We found that women were older than men, had higher BMI, and were more likely to have hypertension, diabetes mellitus, dyslipidemia, heart failure, and atrial fibrillation. Women were less likely to receive aspirin upon admission (p<0.01) or aspirin or statins at discharge (p = 0.001 and p<0.05, respectively), although the magnitude of these differences was small. While unadjusted in-hospital mortality was significantly higher for women (OR: 2.10; 95% CI: 1.54 to 2.87), this difference did not persist in the fully adjusted model (OR: 1.18; 95% CI: 0.55 to 2.55).ConclusionsWe found that female patients had a different profile than men at the time of presentation. Clinical management of men and women with AMI was similar, though there are small but significant differences in some areas. These gender differences did not translate into differences in in-hospital outcome, but highlight differences in quality of care and represent important opportunities for improvement.

Background Flexor tendon injuries are a commonly occurring injury presenting to hand surgeons. Using PRP to augment tendon healing has been advocated only recently. Few studies discussed the effect of injection of PRP in tendon healing after tendon repair in large joints as regard functional outcome and range of motion (e.g. Achilles tendon and rotator cuff) Objective To study the effect of combination of PRP injection with physiotherapy on gliding and range of motion improvement after zone II flexor tendon repair. Patients and Methods prospective interventional controlled clinical study preformed on 40 patients with zone II flexor tendon injury. Patients were divided into two groups, group I (interventional group) PRP was injected around the tendon at the site of repair after one and six weeks of repair and patients received physiotherapy according to our unit protocol. In group II (control group) patients received physiotherapy only. Both groups were evaluated at six and twelve weeks regarding the range of motion according to Buck-Gramko II criteria. Results Based on the Buck-Gramcko II criteria, the overall results ranged between fair and good in both groups after six weeks of repair, the score ranged between 7-16 (mean= 11.5) in group I and 6-14 (mean= 10) in group II, There was no statistical difference between the two groups (P = 0.46).After 12 weeks of repair, the overall results ranged between good and excellent in both groups, the score ranged between 11-17 (mean= 14) in group I and 9-16 (mean=12.5) in group II. There was no statistical difference between the two groups (p = 0.207). Conclusion PRP injection had no statistical significant effect of on the gliding after flexor tendon repair at zone II.