The prevalence of cardiac autonomic neuropathy in pure type II diabetic patients

Cardiac autonomic neuropathy (CAN) has a negative effect on survival and quality of life in people with diabetes mellitus (DM) and is regarded as a subtype of the diabetic autonomic neuropathy. This type of neuropathy is the most prominent focusing because of its life threatening and the availability of the cardiovascular tests that can diagnose it. This study aims to determine the prevalence of CAN in patients with type 2 diabetes mellitus. This cross sectional study included 103 (56 males and 47 females) pure diabetic patients without hypertension or pre-diagnosis of ischemia. They had attended to the diabetic center in Marjan Medical City in Hilla from March 2013 to February 2014. The patients had undergone thorough assessments that included clinical (history and full examination). The study found that  most of the diabetic patients presented with CAN (72.8%). Patients with CAN were older when compared to patients without CAN (p?0.01) and  had longer duration of DM (p?0.01). The most abnormal sympathetic response was diastolic blood pressure response to hand grip while the most abnormal parasympathetic response was heart rate response to breathing. On contrary, the lowest abnormal response was found in postural blood pressure test. In conclusion, This study concludes that CAN is a common complication of type 2 diabetes that affected a large percentage of diabetic patients. The duration of the diabetes and the age of patients are important non modifiable risk factors for the development of CAN. Additionally, heart rate variability is considered as an important test for early detection of CAN. Key words: Diabetes mellitus, Cardiac autonomic neuropathy, Cardiac autonomic reflex test

Antiatherosclerotic Potential of Clopidogrel: Antioxidant and Anti-Inflammatory Approaches

Background. Atherosclerosis is characterized by endothelial dysfunction, vascular inflammation, and the buildup of lipids, cholesterol, calcium, and cellular debris within the intima of the walls of large and medium size arteries. Objective. To evaluate the effect of clopidogrel on atherosclerosis progression. Materials and Methods. A total of 28 local domestic rabbits were assigned to four groups: normal control, atherogenic control, vehicle control, and clopidogrel treated. Serum triglycerides, total cholesterol, HDL-C, plasma high sensitive C-reactive protein (hsCRP), plasma malondialdehyde (MDA), and plasma reduced glutathione (GSH) were measured at the end of the experiment. Immunohistochemical of aortic atherosclerotic changes were also performed. Results. There was no statistically significant difference between atherogenic control group and vehicle group. Levels of lipid profile, atherogenic index, hsCRP, and MDA are increased while GSH levels were decreased in animals on atherogenic diet. Immunohistochemical analysis showed that aortic expressions of VCAM-1, MCP-1, TNF-α, and IL-17A were significantly increased in atherogenic control group. Histopathologic finding showed that animals on atherogenic diet have significant atherosclerotic lesion. Compared to atherogenic control group clopidogrel do not have significant effect on lipid profile. Clopidogrel significantly reduces hsCRP and MDA levels and increases GSH level. Furthermore, clopidogrel treatment significantly reduced aortic expressions parameters and the histopathologic examination of the aortic arch showed a significant reduction of atherosclerotic lesion. Conclusions. This study outlines how clopidogrel reduces lipid peroxidation, systemic inflammation, and aortic expression of inflammatory markers and hence reduces the progression of atherosclerosis