Value of Neutrophil to Lymphocyte Ratio as a Predictor of Mortality in Patients Undergoing Aortic Valve Replacement

Background: Neutrophil to lymphocyte ratio (NLR) has been studied as a measure of inflammation and as a prognosticating factor in various medical conditions including neoplastic, inflammatory and cardiovascular. The prognostic role of NLR in predicting mortality in patients with aortic stenosis undergoing surgical aortic valve replacement (AVR) has not been studied. The aim of our study is to explore the utility of NLR as a predictor of both, short and long-term mortality, in patients undergoing surgical AVR. Methods: Consecutive patients with aortic stenosis admitted for AVR to our institution were evaluated for study inclusion. Of the 335 patients admitted from January 2007 to September 2011, 234 met study inclusion criteria. Patients were divided into two groups depending on their initial preoperative NLR level with a cutoff value of 3. Three-year vital status was accessed with electronic medical records and Social Security Death Index. Survival analysis, stratified by NLR, was used to evaluate the predictive value of preoperative NLR levels. Results: Patients with NLR \u3e/=3, when compared to those with NLR /=3 had 4.77 fold increase in 3-year mortality (1.48-15.32, P=0.0090). Conclusions: NLR is an independent predictor of short-term and long-term mortality in patients with aortic stenosis undergoing AVR surgery, especially those with NLR \u3e/=3. We strongly suggest the use of NLR as a tool to risk stratify patients with aortic stenosis undergoing AVR surgery

Geophysical site assessment of an active urban development site, South Eastern Suburb of Cairo, Egypt

There has been significant structural damage of newly-built residential buildings in Quarter-27 District in the South of Cairo, Egypt. The proximity of an active limestone quarry may also be affecting ground stability. This paper shows how a near-surface geophysics survey could characterize the site, unusually after the initial housing construction had already been undertaken. Geophysical surveys included seismic refraction (acquired between phases of quarry blasting), electrical resistivity and ground penetrating radar 1D and 2D datasets. Geophysical results produced maps of a 3D ground model that also included water table depth, known major faults and a saturated layer that may have caused the building damage. ERT and GPR data was deemed optimal of the geophysical techniques trialled. This study shows that it is possible to undertake geophysical surveys to characterize a restricted urban site development

A Giant Left Atrial Myxoma

Atrial myxomas are the most common primary cardiac tumors. Patients with left atrial myxomas generally present with mechanical obstruction of blood flow, systemic embolization, and constitutional symptoms. We present a case of an unusually large left atrial myxoma discovered incidentally in a patient with longstanding dyspnea being managed as bronchial asthma

In-stent thrombosis after 68 months of implantation inspite of continuous dual antiplatelet therapy: a case report

Lately, there has been an increased incidence of late stent thrombosis; especially following Drug eluting stent (DES) implantation. Several factors are associated with an increased risk of stent thrombosis, including the procedure itself, patient and lesion characteristics, stent design, and premature cessation of anti-platelet drugs. We present a case of late stent thrombosis (LST) following DES implantation after a period of 68 months, making it the longest reported case of LST reported in the literature, despite the use of dual anti-platelet therapy

Silymarin-loaded chitosan nanoparticles alleviate dyslipidemia, oxidative stress, metabolic disturbance and histopathological injury associated with high fat diet-induced non-alcoholic fatty liver disease in rats

With an increasing incidence of obesity and metabolic syndrome epidemic, nonalcoholic fatty liver disease (NAFLD) continues to be one of the most prevalent liver illnesses worldwide. One of recommended treatment in NAFLD is silymarin. Howerver, the problem is that silymarin has weak water solubility and limited bioavilability. Therefore, prepration of silymarin in nano-formulation would enhance silymarin's therapeutic effects and bioavailability. This study was designed to evaluate the biochemical and molecular effects of silymarin-loaded chitosan nanoparticles (SILCSNPs) in NAFLD treatment in rats. Fifty rats were divided into five groups include: Group 1: Control group, group 2: HFD-induced NAFLD, group 3: HFD-induced NAFLD that orally received nano-chitosan, group 4: HFD-induced NAFLD that orally received nano-silymarin and group 5: HFD-induced NAFLD that orally received silymarin-loaded chitosan nanoparticles (SILCSNPs). The dose of each treatment was 40 mg/kg/day for 60 days. Lipid parameters (triglycerides, total cholesterol), ALT, AST, hepatic (catalase, SOD and MDA) and mRNA expression of lipogenesis-related genes including ACC (acetyl-CoA carboxylase) and FASN (fatty acid synthase) as well as fatty acids catabolism-related genes including CPT-1 (carnitine palmitoyl-transferase I), PPAR-α (peroxisome proliferator-activated receptor alpha) were measured. Histopathological examination of liver was also conducted. A significant elevation in HDL, catalase, SOD, CPT-1, PPAR-α levels as well as substantial reduction in triglycerides, cholesterol, ALT, AST, MDA, ACC and FASN levels were detected in treated groups in compared to the HFD-induced NAFLD group. Histopathological examination of the liver showed histological amelioration in hepatic tissue in treated groups in compared to the HFD-induced NAFLD group. SILCSNPs revealed a significant potential effect against NAFLD metabolic disturbance and considered an advanced trend in NAFLD treatment

Silymarin-loaded chitosan nanoparticles alleviate dyslipidemia, oxidative stress, metabolic disturbance and histopathological injury associated with high fat diet-induced non-alcoholic fatty liver disease in rats

With an increasing incidence of obesity and metabolic syndrome epidemic, nonalcoholic fatty liver disease (NAFLD) continues to be one of the most prevalent liver illnesses worldwide. One of recommended treatment in NAFLD is silymarin. Howerver, the problem is that silymarin has weak water solubility and limited bioavilability. Therefore, prepration of silymarin in nano-formulation would enhance silymarin's therapeutic effects and bioavailability. This study was designed to evaluate the biochemical and molecular effects of silymarin-loaded chitosan nanoparticles (SILCSNPs) in NAFLD treatment in rats. Fifty rats were divided into five groups include: Group 1: Control group, group 2: HFD-induced NAFLD, group 3: HFD-induced NAFLD that orally received nano-chitosan, group 4: HFD-induced NAFLD that orally received nano-silymarin and group 5: HFD-induced NAFLD that orally received silymarin-loaded chitosan nanoparticles (SILCSNPs). The dose of each treatment was 40 mg/kg/day for 60 days. Lipid parameters (triglycerides, total cholesterol), ALT, AST, hepatic (catalase, SOD and MDA) and mRNA expression of lipogenesis-related genes including ACC (acetyl-CoA carboxylase) and FASN (fatty acid synthase) as well as fatty acids catabolism-related genes including CPT-1 (carnitine palmitoyl-transferase I), PPAR-α (peroxisome proliferator-activated receptor alpha) were measured. Histopathological examination of liver was also conducted. A significant elevation in HDL, catalase, SOD, CPT-1, PPAR-α levels as well as substantial reduction in triglycerides, cholesterol, ALT, AST, MDA, ACC and FASN levels were detected in treated groups in compared to the HFD-induced NAFLD group. Histopathological examination of the liver showed histological amelioration in hepatic tissue in treated groups in compared to the HFD-induced NAFLD group. SILCSNPs revealed a significant potential effect against NAFLD metabolic disturbance and considered an advanced trend in NAFLD treatment