introduction and aim of the work:-mitral stenosis still shows it self older population in developed countries.Percutaneous balloon mitral Valvuloplasty (PBMV) is the treatment of choice for severe and /or hemodynamically significant mitral stenosis. It has been developed as an alternative modality to surgical closed commissurotomy for mitral steno-sis5. Elderly patients with mitral stenosis are a special entity who suffered a severe form of the disease and in the same time at higher risk of surgical mitral valve replacement, the aim of the current study is to assess and analyze clinical and echocardiographic consequences after percutaneous balloon mitral Valvuloplasty in those patients. Study design Uncontrolled prospective longitudinal single center study performed in patients referred for percutaneous balloon mitral valvuloplasty. Patients :-The current study included 40 elderly consecutive patients who underwent PBMV in Sohag university hospital cathlab unit. results and conclusion:-There was no in hospital mortality , only one patient developed severe MR , technical failure was encountered in 2 patients, because of failure of the balloon ability to traverse tight valves.This study agreed that PBMV can be applied to those with less favorable valve morphology, PBMV is a safe and effective procedure and optimal results can be achieved in patients with higher wilkin's score if they are carefully selected and operated at experienced centers.

Background:-lupus nephritis occurs in up to 60-70 % of patients with SLE and also constitutes one of the major organ manifestations that considerably alters the course and prognosis of SLE. LN is considered a major cause that leads to renal failure, which has a major impact on the short and long-term outcomes of patients with SLE. Regimens containing immunosuppressive drugs are the main treatment for active LN and early treatment response can predict long-term prognosis, So we aim to find reliable predictors of early treatment response in patients with SLE. Finding more comprehensive parameters to develop a better treatment regimen may help decrease longer-term morbidity and mortality. Aim of the study: to examine the predictive factors of renal remission in lupus nephritis patients with lupus nephritis. Results: In our study, after diagnosis by six months, about 61% of patients achieved remission. We found that the Chronicity index and Presence of interstitial fibrosis, are reliable factors for predicting the treatment response either the responder or not at the end of the sixth month of treatment. On multivariate analysis, the Chronicity index was considered an independent predictor of disease remission after 6 months Conclusion: Chronicity index ≤ 3 was considered of significant value for detecting treatment response at the sixth.

Objectives: Disturbance in the Low-density lipoprotein cholesterol (LDL-C), Highdensity lipoprotein cholesterol (HDL-C), total cholesterol (TC), triglyceride (TG) and serum total homocysteine are predisposing factors in myocardial infarction. Design and methods: The study group consisted of 56 patients 35 male (aged 47.8±4.8 years), and 21 females (aged 46±4.3 years). The entry criterion for the patient group has a history of typical or atypical chest pain, unequivocal changes in the electrocardiogram. The control group consisted of 30 normal volunteers, 16 male (aged 48.4±5.2 years) and 14 females (aged 45.1±4.9 years). Measurement of serum total homocysteine was performed by enzyme linked immune sorbant assay (ELISA). Measurement of TC, TG, and HDL-C were performed using spectrophotometer. LDL-C was calculated. Results: Patients with myocardial infarction were found to have higher serum total homocysteine levels (23.93±2.99 mol/L in male and 25.82±3.82 mol/L in female) than controls (10.45±2.73 mol/L and 12.92±0.9 mol/L in both male and female respectively) (for each comparison; p < 0.001). Serum total homocysteine levels were significantly correlated with high Triglycerides and low HDL-C. Conclusions: The above mentioned findings suggest the potential usefulness of Triglycerides, HDL-C and serum total homocysteine as risk factors in myocardial infarction patients. These findings should be used in the future studies on the etiology and pathogenesis of myocardial infarction and to ascertain which patients are at risk for subsequent cardiovascular events and who will benefit from revascularization. Abbreviation: LDL-C (Low density lipoprotein-cholesterol), HDL-C (High density lipoprotein-cholesterol), MI (Myocardial infarction), TG (Triglycerides) and Hcy (homocysteine)

Background: One of the most significant modifiable risk factors for coronary artery disease (CAD) is dyslipidemia. Acute coronary syndromes (ACS) were shown to be a key contributing factor to patients being admitted to the Coronary Care Unit (CCU) at Sohag University Hospital. Objectives: To analyze lipid profile in patients with ACS who presents at Sohag university hospital, and its clinical and complications pattern. Patiets and methods: This study involved 100 patients above 18 years old diagnosed with ACS. Patients were classified into 3 groups; ST-elevation MI (STEMI), non-ST-elevation MI (NSTEMI) and unstable angina (UA) group. All participants were subjected to history taking, clinical assessment and measuring complete lipid profile values. Results: STEMI group has higher significant total cholesterol (TC), low-density lipoprotein cholesterol LDL-C (P < 0.001), Triglycerides (TG) (P =0.022), TC/HDL (P =0.027 ) and TG/HDL levels (P = 0.001) and lower significant high-density lipoprotein cholesterol (HDL-C) (p=0.006) than other groups. There was a significant correlation between age groups and TC (P<0.001), LDL-c (P=0.009), very low-density lipoprotein cholesterol (VLDL-c) (P=0.016), HDL (P=0.001), Triglycerides (P=0.008), TC/HDL (P<0.001) and TG/HDL (P=0.040). Furthermore, there was no significant correlation between gender and TC, LDL-c, VLDL, HDL, TG, TC/HDL and TG/HDL (P>0.05). Conclusion:Patients with ACS have a significant prevalence of dyslipidemia as a risk factor. These individuals are more likely to have low HDL than high LDL values; nevertheless, they are more likely to have high TG values than low HDL values.