Background: Chronic heart failure (CHF) is a leading cause of both morbidity and mortality worldwide. The pathophysiologic understanding of chronic heart failure (CHF) has shifted from a mere hemodynamic disorder to a much more complex approach including changes and imbalances in neurohormonal, immune, and metabolic functions. Hyperuricemia is a constant finding in CHF. Aim: To estimate the level of uric acid (UA) in patients with CHF, and to explore the possible relationship with established prognostic markers in these patients. Patients and Methods: Ninety-five patients with CHF were studied. Detailed clinical assessment, ECG, laboratory investigations and echocardiography were performed for all patients. Serum UA level >7.0 mg/dl was considered high. Results: The age range of patients was 28-85 years (median age 67). Of this group, 54 were males. The duration of the disease ranged from 113 years. In addition, 56% of patients were diabetic, 64% were hypertensive, and 74% had ischemic heart disease. 41 patients were class III New York Heart Association (NYHA) functional calcification, whereas 34 patients and 12 patients were in class II & IV respectively. The following diagnostic information was obtained: 1) blood pressure readings were 60-123mmHg (mean=87.9±14.4). 2) atrial fibrillation (AF) was noted in 36 patients (38%) 3) left ventricular ejection fraction (EF %) was 13-68% (mean=37.9±20.1) 4) blood urea ranged from 13-197 mg/dl (mean=64.7±42.6) 5) serum creatinine was 0.4-5.5mg/dl (mean=1.4±0.9) 6) serum sodium was 119-148 (mean=134.2±5.9) 7) Elevated serum uric acid levels were found in 73% of our patients. We found a significant inverse correlation between serum uric acid level and mean arterial blood pressure (r =-0.42, p = 0.019) and with left ventricular ejection fraction (EF%) (r =-0.31, p = 0.003). We also demonstrated a direct correlation between serum UA and blood urea (r= +0.21, p= .042), serum Cr (r= +0.21, p= 0.051) and age (r=+0.37, p= 0.034). No significant differences were noted in serum UA level

Background: Stroke is the second leading cause of chronic disability and death in the world. Educating the public and physicians about stroke-related symptoms are critical success factors in early stroke treatment. Aim: This study was carried out in order to assess acute stroke management strategies in a teaching hospital. Patients and Methods:The study included all consecutive patients admitted to the general medical ward during the period of March to November 2008 who had a diagnosis of acute stroke. The total number was 217 patients, presumed to have stroke during their initial evaluation in the emergency room. However, ward evaluation confirmed only 193 patients to have a diagnosis of acute stroke (sudden onset of any neurological deficit). Brain imaging was performed in 167 out of the 193 patients. Results were obtained for 140 patients. Results: The age of those with clinical and radiological evidence of acute stroke (n=140) was 65±12 years. Sixty-five were females. The median time elapsed between the onset of symptoms and the arrival to the hospital was 12 hours (range: 1-336 h). Females presented earlier than males (19 hours versus 35 hours; p<0.05). Forty-eight patients (34%) presented within the first four hours and 71 (51%) arrived after eight hours, whilst 8 patients (6%) were not able to determine the time of onset of symptoms. The mean time for brain image from hospitalization was 3.5±2.3 days with no gender difference. Ischemic infarction was reported in 104/140 (74%) patients, intracerebral hemorrhage was reported in 16 (11%) patients and brain ischemia with hemorrhagic transformation was reported in 14 (10%). Normal brain images were found in 6 (5%) patients. 108 patients (78%) received in-hospital aspirin treatment with a mean time to start aspirin 1.2±1.4 days. The mean length of stay in hospital was 7.5±3.7 days. Ninety-nine (80%) of the patients were discharged on aspirin. The in-hospital outcome was assessed by the Rankin Disability Status scale as static course (in 107 patients; 85%), improvement of neurological function