a faculty of medicine, department of clinical Pathology, alexandria university, alexandria, egypt; b chru de montpellier and université de montpellier, irmB, laboratoire de Biochimie Protéomique clinique, montpellier, france; c faculty of medicine, department of neuropsychiatry, alexandria university, alexandria, egypt; d faculty of medicine, department of anesthesia and surgical care, alexandria university, alexandria, egypt ABSTRACT Background: Multiple sclerosis (MS) is a highly heterogeneous disease affecting the central nervous system (CNS). Cerebrospinal fluid (CSF) has been preferred over other body fluids when studying this disease since it is the closest sample related to MS pathological changes. The aim of this study was to investigate differences of CSF protein expression in MS patients by twodimensional polyacrylamide gel electrophoresis (2-DE) in order to identify candidate biomarkers with potential clinical utility. Methods: We analysed the CSF protein expression of seven remitting-relapsing MS patients and seven control subjects using 2-DE. As a complementary step, the CSF of patients was pooled and compared to control-pooled CSF using 2-DE in order to minimise the inter-individual variations. Statistically significant spots were identified by mass spectrometry. Results: In the analysis of the individual samples, a consistent up-regulation of four statistically significant spots was noticed in the CSF of the patients. In the analysis of the pooled samples, 4 spots were up-regulated in the control pool, while 12 spots were up-regulated in the patient pool. Using matrix-assisted laser desorption ionisation with two time of lights (MALDI-TOF/TOF), we did not yield any results for the identification of proteins but with liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS), we were able to reach the identity of four proteins which were alpha-1-antichymotrypsin, prostaglandin-H2 D-isomerase, desmoplakin and hornerin. Conclusion:The results of this study support the presence of changes in the CSF proteome of MS patients. There is a need to investigate the role of these candidate CSF spots in a larger number of MS patients.

The role of angiotensin converting enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARB) in the pandemic context of coronavirus disease 2019 continues to be debated. Patients with hypertension, diabetes mellitus, chronic renal failure, cerebro-cardiovascular disease, or chronic obstructive pulmonary disease (COPD), who often use ACEi/ARB, may affect risk of severe COVID-19. However, there are no data available on the association of ACEi/ARB use with COVID-19 severity in this population. Design and method:This study is an observational study of patients with a positive SARS-CoV-2 test and inpatient treatment at a healthcare facility, using the registry information of COVIREGI-JP. Our primary outcomes were consisting of in-hospital death, ventilator support, extracorporeal membrane oxygenation support, and ICU admission. Out of the 6,055 patients, 1,921 patients with preexisting hypertension, diabetes mellitus, chronic renal failure, cerebro-cardiovascular disease, or COPD were enrolled. We also evaluated 1,097 patients with hypertension.Results: Factors associated with an increased risk of the primary outcomes were aging, male sex, COPD, severe renal impairment, and diabetes mellitus. No correlations were observed with ACEi/ARB, cerebro-cardiovascular diseases, or hypertension. Associated factors in male patients were aging, renal impairment, hypertension, and diabetes. In female patients, factors associated with an increased risk were aging, ACEi/ARB, renal impairment, and diabetes, whereas hypertension was associated with a lower risk of the primary outcomes. In patients with hypertension, factors associated with an increased risk of the primary outcomes were aging, male sex, severe renal impairment, and diabetes mellitus, but not ACEi/ ARB, cerebro-cardiovascular diseases, or COPD.Conclusions: Independent factors for the primary outcomes were aging, male sex, COPD, severe renal impairment, and diabetes, but not ACEi/ARB, in the COVID-19 patients with preexisting hypertension, diabetes mellitus, chronic renal failure, cerebro-cardiovascular disease or COPD. Based on this registry data analysis, more detailed data collection and analysis is needed with the cooperation of multiple healthcare facilities.

To study and compare the features of the course of ACS in patients who underwent COVID19 infection. Material and Methods:The study included ACS patients with ST segment elevation admitted from January 2021 to February 2022. Patients were compared with a group of patients who did not suffer from COVID 19 infection and were hospitalized for ACS in a similar period of time. The study included 114 patients. In all patients, the presence of IgG antibodies to the agent of the coronavirus infection COVID-19 was determined, which indicates that the person has already had a coronavirus infection or not. Patients were divided into 2 groups: 1 -patients who had COVID19 infection; 2 -not recovered from coronavirus infection. All patients were assessed the following indicators: the presence of coronary artery disease before hospitalization, the incidence of cardiogenic shock, the presence of STEMI, as well as the number of deaths during hospitalization. Results:In the first group, only 39.5% (45) of patients were examined, of which men -80.0% (36). Prior to hospitalization, coronary artery disease was present in 64.4% (29) of patients. STEMI was present in 75.5% (34) of patients. The incidence of cardiogenic shock in 4.4% (2) of patients. The number of deaths during hospitalization is 4.4% (2). In the second group, only 60.5% (69) of patients were examined, of which 78.3% (54) were men. Prior to hospitalization, CAD was present in 55.07% (38) of patients. STEMI was recorded in 59.4% (41) of patients. The incidence of cardiogenic shock is 1.45% of patients. The number of deaths during hospitalization was 1.45%. Conclusion:Before hospitalization, CAD was present in the majority of patients 39.5% (45) who had COVID 19, who did not have COVID19 patients 60.5% (69). STEMI was present in 75.5% (34) of patients who had COVID19 and 59.4% (41) of those who did not have COVID 19 infection (p < 0.05). During the pandemic, there is a high incidence of cardiogenic shock in 4.4% (2) of patients who have had COVID19 and 1.45% (1) of those who have not been ill. The percentage of deaths during hospitalization in COVID19 survivors is higher compared to 4.4% with 1.45% who did not recover.

Objective: Hypertension remains one of the major health problems worldwide. Elevated HR increases the risk of cardiovascular disease and contributes to the total mortality in hypertensive patients. The current survey aims to estimate the correlation of increased resting HR level to hypertension and to evaluate its use as a predicting and prognostic marker of hypertension in Sudan Design and method: This is a cross-sectional study based on a survey conducted by Sudanese society of hypertension during the MMM, 2018 campaign. A total of 23981 participants were recruited through opportunistic sampling from six Sudanese states, all being more thant 18 years of age (F/M ratio 1:1). Average of three measurements of heart rate, systolic and diastolic blood pressure was calculated. Hypertensive patients were defined as those having systolic blood pressure (SBP) more than or equal 130 mmHg or diastolic blood pressure (DBP) more than or equal 80 mmHg, or being on antihypertensive medication. Results: The crude prevalence of hypertension in our study sample was 37.4 percent. Among hypertensive patients, only 10.9 percent were aware of having high blood pressure, among whom, 65.5 percent were already on treatment for hypertension and 40.3% have their BP controlled. Normal resting HR was observed among 90.0 percent while tachycardia (HR more than100 bpm) and bradycardia (HR less than 60 bpm) were observed among 8.5 percent and 1.5 percent respectively of all hypertensive patients. Hypertensive patients unaware of having high blood pressure constituted 74.6 percent. Among unaware hypertensives, resting HR was correlated with systolic, diastolic BP, age and gender and is significantly higher among known hypertensive not receiving medication. Among known hypertensive patients, a significant correlation was observed between HR was correlated to smoking, age, gender, BMI, SBP and DBP. The age group (18–39) showed the highest percentage of elevated HR and hypertension compared to other age groups. Conclusions: The prevalence of hypertension is alarming and the situation is aggravated by the poor control and lack of awareness. Based on the above results, resting heart rate can be used as a predicting and prognostic marker of hypertension specially among young adults.

Objective:The main objectives of our screening survey is to detect the prevalence, control, awareness and risk factors of hypertension Design and method: This cross-sectional screening survey was conducted among 23168 adults, during the May Measurement Month 2018 campaign in six states. Volunteers ≧ 18 years were recruited through opportunistic sampling. Each participant had three blood pressure measurements and completed a questionnaire on demographic and medical history. Hypertensive patients were defined as those having systolic BP ≧ 130mmHg or diastolic BP ≧ 80 mmHg, or taking antihypertensive medication, control of hypertension was defined a systolic BP ≦140 mmHg and a diastolic BP ≦ 90 mmHg. Results:The overall prevalence of hypertension was 25.9% among the study participants (14.8% for males and 11.1% for females). The majority of identified hypertensive participants (74.1%) had no previous history of known hypertension. Overall 63.0% were on treatment and 35.6 % had controlled blood pressure. In the multivariable regression model, factors associated with increased awareness of having hypertension included female sex (OR 1.37 95% CI 1.12: 1.69), older age > 60 years (OR 1.81 95%, CI 1.36: 2.40), frequently measured their BP (OR 21.3 95% CI 15.3: 29.7), and presence of comorbidities (P < 0.001), Compared to individuals with a normal BMI, overweight participants were more likely to have hypertension (OR 1.63, 95% CI 1.48: 1.79) and more likely to have the disease uncontrolled (OR1.47, 95% 1.33: 1.63). Diabetic patients also had less BP control, while a history of myocardial infarction or stroke did not influence the rates of BP control among hypertensive subjects. Conclusion:Our study suggests that the prevalence of hypertension is increasing. Our data also demonstrated a striking lack of awareness of the disease and alarming levels of poor disease control particularly among young adults, overweight subjects and diabetics.