No abstract

Congestive cardiac failure is one of the deadliest diseases in the world, with more than 26 million patients. Echocardiogram and angiography consider as the gold standards for heart failure diagnosis. Nevertheless, they are not commonly used for long-term follow up as they need highly skilled and experienced operator. In this paper, a simple and low-cost system for automatic assessment of systolic cardiac performance using systolic cardiac intervals is presented. The proposed system utilized electrocardiogram (ECG) and phonocardiogram (PCG) to calculate pre-ejection period (PEP) and left ventricle ejection time (LVET). The ratio between PEP and LVET was computed to assess the performance of the systolic cardiac function. ECG and PCG were acquired using a commercial stethoscope which was modified to convert PCG auscultation to electrical signals. ECG and PCG signals were digitized and transferred to a personal computer. A custom MATLAB application was designed to display the acquired ECG and PCG, and to compute PEP, LVET, and PEP/LVET ratio. The system was tested on 17 healthy subjects and results showed high agreement between the systolic heart function status assessed by the proposed system and the corresponding echocardiography results. These results imply that the proposed system could be used for long-term follow up for patients with congestive heart failure.

Aims: This work evaluates the vitamin D status in patients with statins- associated muscle symptoms. Study Design:  A case control prospective study. Place and Duration of Study:  Neurology Department, Mansoura University, Mansoura, Egypt, between June 2020 and May 2021. Methodology: Total of 85 participants included in this study, 60 participants of them have chronic Stroke and ischemic heart disease, treated by different kinds of statins and 25 participants were healthy controlled individuals. The 60 patients were 35 males (55%) and 25 females (45%), with age ranging from 40 to 70 years. The 60 participants were divided into two groups: The first group included (30 patients) treated with statins and they did not have Statin-Associated Muscle Symptoms (SAMS).The second group included (30 patients) also treated with Statin and they complained of SAMS. The third group is the control group, which contains the 25 participants who were healthy people. The control group included15 males (55%) and 10 females (45%) with age ranged from 35 to 65 years. Laboratory investigations were conducted on all participants in this study. The participants were subjected to total of 5 laboratory tests, which include: (1) Vitamin D (Enzyme immunoassay method), (2) Total CK (Enzymatic method), (3) Total Cholesterol and Triglycerides (Enzymatic method), (4)High density lipoproteins Cholesterol (Precipitation method), (4)Low density lipoproteins Cholesterol (Freid Wald equation), and (5) C – reactive protein (CRP: Latex Agglutination Method) was done beside elecetrophysiology study ( Needle electromyography (NEMG) was include). Results: Out of 60 patients the statistical readings of Vitamin D levels for the studied groups, demonstrating a significant statistical difference in Vitamin D levels between patients complaining of statin-associated muscle symptoms group (P≤0.001), and the other groups with lowest mean of (26.30 ±3.75), while patient without statin-associated muscle symptom group had the mean rating of (29.33 ±3.69), and the control group had the highest mean of (30.14 ±3.57). Conclusion: There is a positive relationship between vitamin D deficiency and statin-associated muscle symptoms. Vitamin D status may play an important role in diagnosis and management of SAMS. Further studies are needed to evaluate the relationship between vitamin D and SAMS.

Background: Compression neuropathies have previously been associated with one another. Migraine has not been considered a type of compression neuropathy but, some recent studies found that some types of migraines may be treated by targeted peripheral nerve decompression. So, the association between migraines and carpal tunnel syndrome (CTS), {the most common compression neuropathy} may exists. Objective: The aims of this study are to found whether there is a relationship between carpal tunnel syndrome and migraine, and if so to determine the factors causing this relationship. Methods: The present study is a cross-sectional case control study of 120 patients with CTS in addition to age and sex matched 120 healthy controls. It was conducted at Mansoura University Hospitals, Egypt in the period from July, 2017 through June, 2018. All subjects underwent neurological examination, nerve conduction study of median nerve bilaterally, and evaluation according to headache by the International Headache Society, 2016 criteria. Also, the clinical severity of CTS was assessed and calculation of body mass index (BMI) was done. Evaluation of patients by Boston questionnaire form (BQF) {composed of two parts, Symptom Severity Scale (SSS) and the Functional Status Scale (FSS)}. Lastly, assessment of patients by Beck Depression Inventory (BDI). Results: Patients had significantly higher rates of migraine headache (28.3 %) either alone (17.5 %) or combined with tension headache (10.8 %) when compared to controls. No statistically significant differences were found between the studied groups regarding the frequency of isolated tension headache. However, the total rate of cases with tension headache (n=43) including those in association with migraine is significantly higher in patients when compared to controls. Patients had significantly higher rates of various grades of symptoms severity. All patients but 17 are functionally affected while none of the controls group is affected. Patients had significantly higher rates of borderline and moderate depression when compared to controls. Univariate logistic regression analysis for predictors of migraine headache in the studied patients shows that, older age (P value = 0.0001), female sex (P value = 0.003), being manual worker (P value = 0.005), obesity class 11 (P value = 0.023), very severe functional severity scale (P value = 0.001), borderline and moderate depression (P value = 0.008 and 0.002 respectively) were significant predictors of migraine. Conclusion: There is a significant association between CTS and migraine headache. This association suggests the possibility of a common risk factors for development of migraine headache include older age, female gender, obesity, low functional and high symptoms scores and depressive symptoms.