How to predict the presence of silent ischemia in asymptomatic type 2 diabetic patients? Role of myocardial performance index

Clinical Research. Presentation type: Oral Presentation. Introduction: Coronary artery disease (CAD) is an important cause of morbidity and mortality in diabetic patients. Silent myocardial ischemia (SMI) is common in diabetic patients and is associated with poorer prognosis. Myocardial performance index ”Tei index” that reflects both left ventricular (LV) systolic and diastolic function. The aim of our study was to test the value of Tei index in prediction of SMI in asymptomatic type 2 diabetic patients. Methodology: Asymptomatic patients with type 2 diabetes were included in our study. We excluded patients with known CAD, previous revascularization, low ejection fraction or abnormal ECG from the study. All patients had undergone history taking and clinical examination, ECG, echocardiography with measuring of Tei index and Holter monitoring for detecting silent ischemia. Results: 200 patients were recruited. We divided our patients into two groups: Group I: 64 patients with SMI, Group II: 136 patients without SMI. There was no significant difference between the two groups regarding clinical and conventional echocardiographic data. Tei index was significantly higher in patients with silent ischemia (p < 0.00001). Sensitivity, specificity, positive, and negative predictive values of Tei index ⩾0.6 in prediction of Holter detected silent ischemia were 85.9 %, 90 %, 78.6 %, and 88.6 % respectively. We found a significant positive correlation between Tei index and number of ischemic episodes (r = 0.366, p = 0.0029). Conclusion: Measuring Tei index is helpful in predicting the presence of silent ischemia in asymptomatic type 2 diabetic patients

Do prolactin and its receptor play a role in alopecia areata?

Context: Studying the link between prolactin and autoimmunity has gained much ground over the past years. Its role played in alopecia areata (AA) is not clear yet, as previous reports yielded controversial results. Aims: This study aimed to measure the serum level of prolactin and to detect the expression of its receptor in AA, in an attempt to highlight its possible role in the pathogenesis of this disease. Subjects and Methods: A case-control study of 30 AA patients and 20 controls from outpatient clinic were undertaken. Every patient was subjected to history taking and clinical examination to determine the severity of alopecia tool (SALT) score. Blood samples were taken from patients and controls to determine the serum prolactin level. Scalp biopsies were obtained from the lesional skin of patients and normal skin of controls for assessment of the prolactin receptor. Statistical Analysis: Depending upon the type of data, t-test, analysis of variance test, Chi-square, receiver operator characteristic curve were undertaken. Results: On comparing the serum prolactin level between patients and controls, no significant difference was found, while the mean tissue level of prolactin receptor was significantly higher in patients than in controls. In patients, a significant positive correlation was found between the prolactin receptor and the SALT score. Conclusions: Prolactin plays a role in AA, and this role is probably through the prolactin receptors rather than the serum prolactin level