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Faisal Lutfi M, Abdel-Moneim AMH, Alsharidah AS, Mobark MA, Abdellatif AAH, Saleem IY, Al Rugaie O, Mohany KM, Alsharidah M. Thymoquinone Lowers Blood Glucose and Reduces Oxidative Stress in a Rat Model of Diabetes. Molecules 2021; 26:2348. [PMID: 33920728 PMCID: PMC8073923 DOI: 10.3390/molecules26082348] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 04/05/2021] [Accepted: 04/13/2021] [Indexed: 11/24/2022] Open
Abstract
The aim of the present study was to assess the short-term effects of Thymoquinone (TQ) on oxidative stress, glycaemic control, and renal functions in diabetic rats. DM was induced in groups II and III with a single dose of streptozotocin (STZ), while group I received no medication (control). The rats in groups I and II were then given distilled water, while the rats in group III were given TQ at a dose of 50 mg/kg body weight/day for 4 weeks. Lipid peroxidase, nitric oxide (NO), total antioxidant capacity (TAC), glycated haemoglobin (HbA1c), lipid profiles, and renal function were assessed. Moreover, the renal tissues were used for histopathological examination. STZ increased the levels of HbA1c, lipid peroxidase, NO, and creatinine in STZ-induced diabetic rats in comparison to control rats. TAC was lower in STZ-induced diabetic rats than in the control group. Furthermore, rats treated with TQ exhibited significantly lower levels of HbA1c, lipid peroxidase, and NO than did untreated diabetic rats. TAC was higher in diabetic rats treated with TQ than in untreated diabetic rats. The histopathological results showed that treatment with TQ greatly attenuated the effect of STZ-induced diabetic nephropathy. TQ effectively adjusts glycaemic control and reduces oxidative stress in STZ-induced diabetic rats without significant damaging effects on the renal function.
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Affiliation(s)
- Mohamed Faisal Lutfi
- Department of Physiology, College of Medicine, Qassim University, Buraydah 51452, Saudi Arabia; (M.F.L.); (A.-M.H.A.-M.); (A.S.A.)
- Department of Physiology, Faculty of Medicine, Nile College, Sheikh Zayed 7121, Sudan
| | - Abdel-Moneim Hafez Abdel-Moneim
- Department of Physiology, College of Medicine, Qassim University, Buraydah 51452, Saudi Arabia; (M.F.L.); (A.-M.H.A.-M.); (A.S.A.)
- Department of Physiology, Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt
| | - Ashwag Saleh Alsharidah
- Department of Physiology, College of Medicine, Qassim University, Buraydah 51452, Saudi Arabia; (M.F.L.); (A.-M.H.A.-M.); (A.S.A.)
| | - Mugahid A. Mobark
- Department of Pharmacy Practice, College of Pharmacy, Qassim University, Mansoura 51452, Saudi Arabia;
- Department of Pathology, Faculty of Medicine, University of Kordofan, El-Obeid 13314, Sudan
| | - Ahmed A. H. Abdellatif
- Department of Pharmaceutics, College of Pharmacy, Qassim University, Buraydah 51452, Saudi Arabia;
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Al-Azhar University, Assiut 71524, Egypt
| | - Imran Y. Saleem
- School of Pharmacy & Biomolecular Sciences, Liverpool John Moores University James Parsons Building, Liverpool L3 5UG, UK;
| | - Osamah Al Rugaie
- Department of Basic Medical Sciences, College of Medicine and Medical Sciences, Qassim University, Unaizah, P.O. Box 991, Qassim 51911, Saudi Arabia;
| | - Khalid M. Mohany
- Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Assiut University, Assiut 71515, Egypt;
| | - Mansour Alsharidah
- Department of Physiology, College of Medicine, Qassim University, Buraydah 51452, Saudi Arabia; (M.F.L.); (A.-M.H.A.-M.); (A.S.A.)
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Elhakeem RF, Lutfi MF, Ali ABM, Sukkar MY. Can short-term heart rate variability predict coronary artery disease in patients undergoing elective coronary angiography due to typical chest pain? J Clin Transl Res 2020; 6:66-70. [PMID: 33426355 PMCID: PMC7787221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 07/05/2020] [Accepted: 07/27/2020] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Presence of typical chest pain and normal coronary angiography suggests the possibility of microvascular ischemia of the myocardium as well as other non-cardiac causes that are also likely to decrease heart rate variability (HRV). This raises a question of whether poor HRV can predict abnormal elective coronary angiography (ECA). AIM The aim of this study was to compare HRV in patients with typical chest pain when they are classified according to ECA outcomes. METHODS The study enrolled 150 patients planned for ECA in the cardiac center of AlShaab Teaching Hospital, Khartoum, Sudan, due to typical chest pain. Following assessment of medical history and clinical examination, the Bluetooth electrocardiography (ECG) transmitter and receiver were used for ECG recording and evaluation of time and frequency domains HRV. ECA confirmed the diagnosis of coronary artery disease (CAD) in 108 patients, who were considered as the test group. The other 42 subjects were considered as a control group after the exclusion of CAD. RESULTS The Mean±SD of Ln(pNN10), Ln(pNN20), LnLF, and LnHF was significantly higher in subjects with normal angiography compared with CAD patients. However, these statistically significant differences disappeared when the comparison was adjusted for age, gender, BMI, and HR of the studied groups. CONCLUSION HRV is comparable in patients with typical chest pain regardless of ECA outcomes. RELEVANCE FOR PATIENTS The HRV differences between patients with normal and abnormal ECA are likely to be biased by CAD risk factors such as old age, male gender, and tachycardia that are known to disturb HRV. The possibility of microvascular ischemia in patients with normal ECA may have attenuated HRV in this group and make it comparable to those suffering from macrovascular ischemia due to CAD.
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Affiliation(s)
| | - Mohamed Faisal Lutfi
- 1College of Medicine, Qassim University, KSA,2Nile College of Medicine, Khartoum, Sudan,
Corresponding author: Mohamed Faisal Lutfi College of Medicine, Qassim University, KSA and Nile College of Medicine, Khartoum, Sudan Tel.: +249912257731 Fax: +2499183797836 Mailbox: 12702 - Code: 11121
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Sourg HAA, Ahmed ABM, Elhakeem RF, Lutfi MF. Indicators of metabolic syndrome in normotensive normoglycemic asthmatic patients. J Clin Transl Res 2020; 6:27-35. [PMID: 33330745 PMCID: PMC7735662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 06/22/2020] [Accepted: 07/07/2020] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Pathophysiology of hypertension and bronchial asthma (BA) shares many similarities, especially those related to the metabolic syndrome (MS). AIM In this study, the indicators of the MS were evaluated in normoglycemic normotensive asthmatic patients to clarify if the components of the MS can still interact to increase the risk of BA, provided that blood pressure and glucose level are kept within the normal physiological ranges. METHODS Body mass index (BMI), waist circumference (WC), mean arterial blood pressure (MABP), fasting blood glucose (FBG) and fasting blood insulin (FBI) levels, the quantitative insulin sensitivity check index (QUICKI), serum lipid profile, and spirometric measurements were all compared between 120 asthmatic patients and 59 non-asthmatic subjects. Cigarette smoking, pregnancy, age below 20 years or above 40 years, diabetes mellitus and hypertension, and other chronic diseases were excluded from all studied groups. RESULTS Asthmatic patients demonstrated higher WC (median [25th-75th interquartile]=88.50 [78.00-101.75], FBI [19.98 (11.12-40.14)], and triglyceride (TG) level [109.5 (76.50-134.0)]) compared with non-asthmatic subjects (81.00 [72.00-92.00], 13.78 [8.84-30.24], and 89.00 [64.25-104], P<0.05). QUICKI and MABP were lower in asthmatic patients (0.310 [0.283-0.338] and 86.66 [83.33-93.33]) compared with non-asthmatic subjects (0.320 [0.297-0.353] and 93.33 [83.33-93.33]), (P<0.05). BMI, FBG, low-density lipoprotein, high-density lipoprotein, and total cholesterol levels were comparable in the studied groups. CONCLUSIONS The present finding gives further evidence for higher WC, FBI, TG level, and insulin resistance in normotensive, normoglycemic asthmatic patients compared to healthy controls. RELEVANCE FOR PATIENTS The findings of this study suggested that abdominal obesity, hypertriglyceridemia, hyperinsulinemia, and insulin resistance may still be interacting and hence increase the risk of BA in normotensive, normoglycemic subjects.
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Affiliation(s)
- Hanadi Abdelgadir Ahmed Sourg
- Faculty of Medicine, University of Khartoum, Khartoum, Sudan
- Faculty of Medicine, Al Neelain University, Khartoum, Sudan
| | | | | | - Mohamed Faisal Lutfi
- College of Medicine, Qassim University, Qassim, KSA
- Nile College of Medicine Khartoum, Sudan
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Lutfi MF. The physiological basis and clinical significance of lung volume measurements. Multidiscip Respir Med 2019. [DOI: 10.4081/mrm.2017.220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
From a physiological standpoint, the lung volumes are either dynamic or static. Both subclasses are measured at different degrees of inspiration or expiration; however, dynamic lung volumes are characteristically dependent on the rate of air flow. The static lung volumes/capacities are further subdivided into four standard volumes (tidal, inspiratory reserve, expiratory reserve, and residual volumes) and four standard capacities (inspiratory, functional residual, vital and total lung capacities). The dynamic lung volumes are mostly derived from vital capacity. While dynamic lung volumes are essential for diagnosis and follow up of obstructive lung diseases, static lung volumes are equally important for evaluation of obstructive as well as restrictive ventilatory defects. This review intends to update the reader with the physiological basis, clinical significance and interpretative approaches of the standard static lung volumes and capacities.
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Elhakeem RF, Lutfi MF, Ali ABM, Sukkar MY. Chest Pain Characteristics in Cardiac Syndrome X Compared to Coronary Artery Disease. Open Access Maced J Med Sci 2019; 7:2282-2286. [PMID: 31592275 PMCID: PMC6765080 DOI: 10.3889/oamjms.2019.609] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 06/23/2019] [Accepted: 06/24/2019] [Indexed: 12/03/2022] Open
Abstract
AIM This study aimed to assess if clinical remarks gained by analysis of the present and past medical history of patients undergoing elective coronary angiography (ECA) due to typical chest pain can help to predict the outcome of ECA. MATERIAL AND METHODS One hundred and fifty-four ECA candidates with a history of typical chest were seen on the same day intended for ECA in the cardiac centre of AlShaab Teaching Hospital, Khartoum, Sudan. The details of the present complaints, characteristics of chest pain, past medical and socioeconomic history were recorded from each subject guided by a questionnaire. ECA confirmed CAD in 112 of the studied patients and were considered as the test group. The remaining patients (N = 42) were diagnosed as CSX after exclusion of significant narrowing of the coronary vessels and were considered as the control group. RESULTS Univariate analysis of pain characteristics among patients undergoing coronary angiography revealed that pain is less likely to radiate to the neck (OR = 0.44, 95% CI = 0.21 - 0.91, P = 0.027) and the back (OR = 0.48, 95% CI = 0.23 - 1.00, P = 0.049) in patients with CAD. Presence of shortness of breathing and/or dizziness significantly decrease the odds of having abnormal coronary angiography (OR = 0.30 and 0.48, 95% CI = 0.12 - 0.77 and 0.22 - 0.92, P = 0.013 and 0.030 respectively). Past history of diabetes mellitus significantly increases the odds of having abnormal coronary angiography (OR = 3.96, 95% CI = 1.68 - 9.30, P = 0.002). In contrast, past medical history of migraine decreases the odds of having positive finding in ECA (OR = 0.31, 95% CI = 0.13 - 0.72, P = 0.006). CONCLUSION Characteristics of chest pain are comparable in CAD and CSX. However, pain is less likely to radiate to the neck and/or the back in the first group. Presence of dyspnea and dizziness during angina attacks as well as the history of migraine significantly decreases the odds of having abnormal coronary angiography.
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Affiliation(s)
| | - Mohamed Faisal Lutfi
- College of Medicine, Qassim University, KSA, Buraydah, Qassim, Saudi Arabia
- Nile College of Medicine, Khartoum, Sudan
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Alsharidah M, Algeffari M, Abdel-Moneim AMH, Lutfi MF, Alshelowi H. Effect of combined gliclazide/metformin treatment on oxidative stress, lipid profile, and hepatorenal functions in type 2 diabetic patients. Saudi Pharm J 2017; 26:1-6. [PMID: 29379326 PMCID: PMC5783821 DOI: 10.1016/j.jsps.2017.11.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Accepted: 11/14/2017] [Indexed: 12/11/2022] Open
Abstract
Background Type 2 diabetes is a chronic condition that requires pharmacotherapy interventions. Metformin and gliclazide are widely used drugs in monotherapy. However, their complementary action made utilization of the combination of these drugs an appealing approach. Aims The study compared major therapeutic potentials of combined metformin/gliclazide treatment over metformin monotherapy based on the following parameters: oxidative stress, lipid profile, and hepatorenal functions. Subjects and methods This is a comparative study was conducted from March 2015 to March 2016. The study screened 80 type 2 diabetic patients, of which 40 patients underwent combined metformin + gliclazide therapy (500 mg BD + 80 mg OD, respectively). The other 40 were matched for age and duration of diabetes mellitus with the previous group and received metformin monotherapy (500 mg BD). The levels of fasting blood glucose (FBG), total glycated hemoglobin (HbA1c), lipid peroxidation, total antioxidant capacity, serum creatinine, aspartate and alanine transaminases, total cholesterol, triglycerides, high-density lipoproteins, and low-density lipoproteins were measured according to the standard methods. Results Oxidative stress, lipid profile, and hepatorenal functions were comparable in patients of both groups. However, patients on metformin treatment showed significantly lower levels of FBG [7.61 (6.70–8.89) mmol/L vs. 9.00 (7.30–10.68) mmol/L; P = .022] and HBA1c [7.00 (6.40–7.65)% vs. 8.20 (7.20–9.75)%; P < .001] compared to those on combined therapy. Conclusion Oxidative stress, lipids profile, and hepatorenal functions were not different in patients who were on combined metformin/gliclazide therapy and compared to those metformin alone. In contrast, glycemic control was poor in the diabetic patients undergoing combined therapy.
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Affiliation(s)
- Mansour Alsharidah
- Physiology Department, College of Medicine, Qassim University, Saudi Arabia.,College of Pharmacy, Qassim University, Saudi Arabia
| | - Metab Algeffari
- Department of Family Medicine, College of Medicine, Qassim University, Saudi Arabia
| | - Abdel-Moneim Hafez Abdel-Moneim
- Physiology Department, College of Medicine, Qassim University, Saudi Arabia.,Physiology Department, Faculty of Medicine, Mansoura University, Egypt
| | | | - Haila Alshelowi
- Department of Pediatric Endocrinology, Albassam Diabetes and Endocrine Center, Saudi Arabia
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Abstract
From a physiological standpoint, the lung volumes are either dynamic or static. Both subclasses are measured at different degrees of inspiration or expiration; however, dynamic lung volumes are characteristically dependent on the rate of air flow. The static lung volumes/capacities are further subdivided into four standard volumes (tidal, inspiratory reserve, expiratory reserve, and residual volumes) and four standard capacities (inspiratory, functional residual, vital and total lung capacities). The dynamic lung volumes are mostly derived from vital capacity. While dynamic lung volumes are essential for diagnosis and follow up of obstructive lung diseases, static lung volumes are equally important for evaluation of obstructive as well as restrictive ventilatory defects. This review intends to update the reader with the physiological basis, clinical significance and interpretative approaches of the standard static lung volumes and capacities.
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Affiliation(s)
- Mohamed Faisal Lutfi
- Department of Physiology, Faculty of Medicine and Health Sciences, Al-Neelain University, Khartoum, Sudan
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Abstract
BACKGROUND Although ventricular late potential (VLP) was extensively studied in risk stratification of myocardial infarction (MI) patients, comparable researches evaluating presence of VLP in MI-free coronary artery disease (CAD) and cardiac syndrome X (CSX) subjects are scarce. This study aimed to compare presence of VLP between CSX and CAD patients. METHODS Signal average ECG (SAECG) was performed to 49 patients with a history of typical cardiac pain before undergoing diagnostic coronary angiography (DCA) in Al-Shaab cardiac center, Khartoum, Sudan. QRS duration, duration of the terminal part of the QRS complex with amplitude less than 40 microvolts (LAS40) and the root mean square voltage of the terminal 40 milliseconds (RMS40) of the filtered QRS complex were identified for each patient. Presence of two or more of QRS duration > 120 ms, RMS40 > 38 ms and LAS40 < 20 μV was considered indicative of VLP. Associations between VLP and patients grouped according to DCA results were assessed using appropriate statistical tests. RESULTS VLP was present in 11.11% (3.63%-24.66%) and 15.38% (2.66%-42.23%) of patients with CAD and CSX respectively. Presence of VLP was comparable in patients with CAD and CSX (OR = 0.69, 95% CI = 0.11-6.05, P = 0.692), even after controlling for the possible variations in gender, age, body mass index (BMI), hypertension and diabetes mellitus in the studied groups. CONCLUSION Presence of VLP is comparable among CSX and CAD patients.
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Affiliation(s)
- Mohamed Faisal Lutfi
- Department of Physiology, Faculty of Medicine and Health Sciences, Al-Neelain University, Khartoum, Sudan.
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Rayis DA, Ahmed MA, Abdel-Moneim H, Adam I, Lutfi MF. Trimester Pattern of Change and Reference Ranges of Hematological Profile Among Sudanese Women with Normal Pregnancy. Clin Pract 2017; 7:888. [PMID: 28243426 PMCID: PMC5264546 DOI: 10.4081/cp.2017.888] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 12/12/2016] [Accepted: 12/28/2016] [Indexed: 11/23/2022] Open
Abstract
Trimester specific reference ranges of hematological indices were described in several populations; however, comparable reports among Sudanese women with normal pregnancy are lacking. To evaluate trimester pattern of change and reference ranges of hematological profile among Sudanese women with normal pregnancy, we followed 143 women with singleton gestation since early pregnancy until the third trimester in Saad Abu-Alela Hospital, Khartoum, Sudan, during the period of January-December 2015. Obstetrics and medical history was gathered using questionnaire and hematological profile was investigated using hemo-analyser. The first, second and third trimester mean (SD) [5th-95th centile] of hematological profile were as follow: RBC counts 4.30 (0.36) [3.69-4.93], 4.35 (0.36) [3.69-4.93], 4.08 (0.44) [3.44-4.78] ×106/mm3; hemoglobin concentration 10.81 (1.22) [8.92-12.74], 10.62 (0.93) [9.00-12.10], 10.83 (1.13) [8.82-12.60] g/dL; hematocrit 35.38 (3.52) [30.12-40.30], 34.43 (2.51) [30.58-38.23], 35.17 (3.18) 29.66-40.04] %; WBC counts 7.69 (1.96) [4.36-11.20], 8.45 (1.97) [5.48-12.13], 8.36 (2.11) [5.00-11.96] ×103/mm3; platelet counts 278.02 (66.93) [182.6-418.0], 251.96 (64.17) [163.8-381.8], 238.36 (57.10) [150.4-346.2] ×103/mm3. The present study is the first to establish trimester specific, reference range for hematological profile among Sudanese women with normal pregnancy. The trimester reference range of RBC, WBC and platelets and other hematological indices are mostly parallel to international records.
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Affiliation(s)
- Duria A Rayis
- Department of Obstetrics and Gynecology, University of Khartoum , Sudan
| | - Mohamed A Ahmed
- Department of Obstetrics and Gynecology, University of Khartoum , Sudan
| | | | - Ishag Adam
- Department of Obstetrics and Gynecology, University of Khartoum , Sudan
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Lutfi MF. Anxiety Level and Cardiac Autonomic Modulations in Coronary Artery Disease and Cardiac Syndrome X Patients. PLoS One 2017; 12:e0170086. [PMID: 28068419 PMCID: PMC5222583 DOI: 10.1371/journal.pone.0170086] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2016] [Accepted: 12/28/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Anxiety and cardiac autonomic modulations (CAM) were thoroughly investigated in coronary artery disease (CAD) and cardiac syndrome X (CSX) patients worldwide, but not among Sudanese with similar pathology. AIMS To compare levels of anxiety and CAM between Sudanese patients with CSX and CAD. MATERIALS AND METHODS Anxiety was evaluated in 51 CAD and 26 CSX patients using Taylor Manifest anxiety score (TMAS) questionnaire while heart rate variability derived indices were used to assess CAM, namely natural logarithm of low frequency (LnLF), high frequency (LnHF) and LF/HF ratio (LnLF/HF). RESULTS Low anxiety levels were achieved by 6 (23.1%) and 9 (17.6%) patients with CSX and CAD respectively. High anxiety level was achieved by only one (3.8%) patient, who was suffering from CSX. TMAS was significantly higher in CSX (31.27 (21.97)) compared to CAD (21.86 (12.97), P = 0.021). However, abnormally increased anxiety was not associated with higher risk of CSX. LnLF, LnHF and LnLF/HF were comparable in CAD and CSX patients. CONCLUSION CSX and CAD patients showed comparable CAM. Although anxiety levels were higher in CSX compared to CAD, TMAS ≥ 35 failed to show significant association with CSX.
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Affiliation(s)
- Mohamed Faisal Lutfi
- Department of Physiology - Faculty of Medicine and Health Sciences - Al-Neelain University, Khartoum, Sudan
- * E-mail:
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Abstract
Background Previous studies reported increased risk of cardiac events in subjects with fasting blood glucose (FBG) levels lower than the diagnostic threshold of diabetes mellitus. However, whether increased cardiac events in those with upper normal FBG is secondary to the shift of their cardiac sympathovagal balance towards sympathetic predominance is unknown. Aims To assess the association between FBG levels and cardiac autonomic modulation (CAM) in euglycaemic healthy subjects based on heart rate variability (HRV) derived indices. Subjects and Methods The study enrolled 42 healthy young adults. Following sociodemographic and clinical assessment, blood samples were collected to measure FBG levels. Five minutes ECG recordings were performed to all participants to obtain frequency domain HRV measurements, namely the natural logarithm (Ln) of total power (LnTP), very low frequency (LnVLF), low frequency (LnLF) and high frequency (LnHF), low frequency/ high frequency ratio (LnLF/HF), normalized low frequency (LF Norm) and high frequency (HF Norm). Results FBG levels correlated positively with LnHF (r = 0.33, P = 0.031) and HF Norm (r = 0.35, P = 0.025) and negatively with LF Norm (r = -0.35, P = 0.025) and LnLF/HF (r = -0.33, P = 0.035). LnHF and HF Norm were significantly decreased in subjects with the lower (4.00 (1.34) ms2/Hz and 33.12 (11.94) n.u) compared to those with the upper FBG quartile (5.64 (1.63) ms2/Hz and 49.43 (17.73) n.u, P = 0.013 and 0.032 respectively). LF Norm and LnLF/HF were significantly increased in subjects with the lower (66.88 (11.94) n.u and 0.73 (0.53)) compared to those with the higher FBG quartile (50.58 (17.83) n.u and 0.03 (0.79), P = 0.032 and 0.038 respectively). Conclusion The present study is the first to demonstrate that rise of blood glucose concentration, within physiological range, is associated with higher parasympathetic, but lower sympathetic CAM. Further researches are needed to set out the glycemic threshold beyond which further increase in glucose level readjusts sympathovagal balance towards sympathetic predominance again.
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Affiliation(s)
- Mohamed Faisal Lutfi
- Department of Physiology, Faculty of Medicine and Health Sciences, Al-Neelain University, Khartoum, Sudan
- * E-mail:
| | - Ramaze Farouke Elhakeem
- Department of Physiology, Faculty of Medicine and Health Sciences, Al-Neelain University, Khartoum, Sudan
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Lutfi MF. Diagnostic accuracy of resting left ventricular akinesia/hypokinesia in predicting abnormal coronary angiography. BMC Cardiovasc Disord 2016; 16:137. [PMID: 27295983 PMCID: PMC4906607 DOI: 10.1186/s12872-016-0312-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2016] [Accepted: 06/03/2016] [Indexed: 12/03/2022] Open
Abstract
Background Although several reports demonstrate the efficacy of stress echocardiography in diagnosing coronary artery disease, comparable studies on the competence of the same imaging technique at rest are limited. This study aimed to evaluate whether ventricular akinesia/hypokinesia and left ventricular ejection fraction (LVEF) < 55 % at rest are useful in predicting abnormal coronary angiography. Methods This study prospectively enrolled 100 diagnostic coronary catheterization candidates. Any routine echocardiography that the candidates had undergone before diagnostic coronary catheterization was reviewed. Patients were subclassified according to the presence and location of ventricular akinesia/hypokinesia, LVEF, and the results of diagnostic coronary catheterization. LVEF < 55 % was considered below the normal physiological limit. Abnormal coronary angiography was defined as narrowing of half or more of the caliber of at least one major coronary artery. Results Abnormal coronary angiography was significantly associated with akinesia/hypokinesia (OR = 4.85, P = 0.002) and LVEF < 55 % (OR = 5.75, P = 0.001). Screening of akinesia/hypokinesia and LVEF < 55 % as diagnostic tools for abnormal coronary angiography achieved comparable sensitivities (87.2 % vs. 88.9 %), specificities (41.5 vs. 41.8), and diagnostic accuracies (41.5 vs. 41.8). Left ventricular anterior wall akinesia/hypokinesia achieved a higher diagnostic odds ratio (9.7), sensitivity (95 %), and negative predictive value (96.4 %) compared with other types of akinesia/hypokinesia. Conclusion The overall diagnostic accuracy of akinesia/hypokinesia and LVEF < 55 % to predict abnormal coronary angiography was poor, probably owing to significant influences of macro- as well as micro-vascular ischemia on left ventricular function.
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Affiliation(s)
- Mohamed Faisal Lutfi
- Department of Physiology, Faculty of Medicine and Health Sciences, Al-Neelain University, Mailbox: 12702, Khartoum, 11121, Sudan.
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Lutfi MF. Patterns of changes and diagnostic values of FEF50%, FEF25%-75% and FEF50%/FEF25%-75% ratio in patients with varying control of bronchial asthma. Int J Health Sci (Qassim) 2016; 10:3-11. [PMID: 27004052 DOI: 10.12816/0031221] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND The pattern of change in FEF50%, FEF25%-75% and FEF50%/FEF25%-75% ratio depends on mechanics of forceful expiration, provided that non-homogenous lung emptying is faithfully recorded in the expiratory flow-volume loops. OBJECTIVE To assess the potential clinical value of FEF50%, FEF25%-75% and FEF50%/FEF25%-75% ratio as an indicator of bronchial asthma (BA) control. METHODOLOGY The study involved 75 patients with BA matched for age and gender with 45 non-asthmatic subjects. Based on asthma control test (ACT) and spirometry, asthmatic patients were subdivided into controlled and poorly controlled/uncontrolled. The relationship between FEF50% and FEF25%-75% as well as FEF50%/FEF25%-75% ratio and ACT score were assessed using linear regression. ROC curves were used to assess reliability of FEF25%-75% and FEF50% to diagnose BA in patients with different degree of asthma control. RESULTS FEF50% correlated strongly with FEF25%-75% (r = 0.989, P < 0.001) and the relationship between the two indices is governed by the formula FEF50% = 1.132* FEF25%-75% - 0.003. There was no significant correlation (r = - 0.159, P = 0.083) between FEF50%/FEF25-75% ratio and ACT score. The diagnostic capability of FEF25%-75% for spirometric diagnosis of BA is only marginally better compared to FEF50% (area under ROC curves were 0.88 and 0.89 respectively, P < 0.001); however, diagnostic power of both spirometric indices deceased with poor BA control. CONCLUSION FEF50%/FEF25%-75% has no clinical value as an indicator for BA control. Role of FEF25%-75% in evaluation of BA is marginally better than FEF50%; however, efficiency of both indices declined substantially as BA control worsened.
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Affiliation(s)
- Mohamed Faisal Lutfi
- Department of Physiology, College of Medicine, Qassim University, KSA, Faculty of Medicine and Health Sciences, Al-Neelain University, Khartoum, Sudan
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Lutfi MF. Patterns of heart rate variability and cardiac autonomic modulations in controlled and uncontrolled asthmatic patients. BMC Pulm Med 2015; 15:119. [PMID: 26459382 PMCID: PMC4603942 DOI: 10.1186/s12890-015-0118-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2015] [Accepted: 10/05/2015] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Previous heart rate variability (HRV) studies in asthmatic subjects (AS) demonstrate predominance of parasympathetic drive concomitant with low HRV, which is against the general belief that enhanced parasympathetic modulation improves HRV. The aim of this study was to compare patterns of HRV and cardiac autonomic modulations of AS to healthy control subjects (HS). METHODS Eighty AS and forty HS were enrolled in the study. Asthma control test and spirometry were used to discriminate uncontrolled (UA) from controlled (CA) asthmatic patients. Natural logarithmic (Ln) scale of total power (TP), very low frequency (VLF), low frequency (LF) and high frequency (HF) were used to evaluate HRV. Normalized low frequency (LF Norm) and high frequency (HF Norm) were used to determine sympathetic and parasympathetic autonomic modulations respectively. RESULTS CA patients achieved significantly higher LnTP, LnLF, LnHF and HF Norm but lower LF Norm and LnLF/HF compared with UA patients (p < 0.05). Although CA patients showed increased HRV and augmented vagal modulation compared with HS, these findings were no longer significant following adjustment for mean heart rates and anti-asthma treatment. All measured HRV parameters were not significantly different in UA patients compared with the HS (p > 0.05). CONCLUSIONS CA is associated with enhanced parasympathetic modulations and higher HRV compared with UA. However, neither CA nor UA patients had different autonomic modulations and/or HRV compared with HS.
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Affiliation(s)
- Mohamed Faisal Lutfi
- Department of Physiology, Faculty of Medicine and Health Sciences, Al-Neelain University, Khartoum, Sudan.
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Abodola MA, Lutfi MF, Bakhiet AO, Mohamed AH. The anti-inflammatory and analgesic properties of prosopis chilenses in rats. Int J Health Sci (Qassim) 2015; 9:265-271. [PMID: 26609291 PMCID: PMC4633190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
BACKGROUND Prosopis chilensis is used locally in Sudan for inflammatory conditions of joints; however, literature lacks scientific evidence for anti-inflammatory effect of this plant. AIMS To evaluate anti-inflammatory and analgesic effects of prosopis chilenses. MATERIAL AND METHODS Edema inhibition percent (EI %) and hot plate method were used to evaluate anti-inflammatory and analgesic effects of Prosopis chilenses in Wistar albino rats. Anti-inflammatory and analgesic effects of Prosopis chilenses were compared to indomethacin and acetylsalicylic acid respectively. RESULTS Ethanolic extract of prosopis chilensis at a dose of 200 and 100mg/kg body weight achieved peak EI% (EI% = 96.1%) and (EI% = 94.4%) three and four hours after oral dosing respectively. The maximum EI% for indomethacin was 97.0% and was recorded after 4 hours following oral administration of the drug at a dose of 5 mg/kg body weight. Prosopis chilensis extracts at doses of 100 and 200 mg/kg body weight significantly increased the rats' response time to hot plate compared to acetylsalicylic acid at a dose rate of 100mg/kg body weight (P<0.05). CONCLUSION The current results suggest potential anti-inflammatory and analgesic effects of prosopis chilenses. Relevance of these effects to prosopis chilenses phy-to-constituents was discussed.
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Affiliation(s)
- MA Abodola
- Department of Pharmacology, Faculty of Medicine and Health Sciences Alneelain University, Sudan
| | - MF Lutfi
- Department of Physiology, Faculty of Medicine and Health Sciences Alneelain University, Sudan and College of Medicine, Qassim University, KSA
| | - AO Bakhiet
- Deanship of Scientific Research, University of Science and Technology, Sudan
| | - AH Mohamed
- Head Department of Pharmacology, Medicinal and Aromatic Plant Research Institute, National Center of Research, Sudan
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Abstract
Background: In patients with advanced obstructive ventilatory disorders, expiration may last for a relatively long time until the end-of-test standards for forced vital capacity (FVC) are satisfied. This may be difficult for both the patient and the technician. The Forced expiratory volume in 3 seconds (FEV3) and Forced expiratory volume in 6 seconds (FEV6) maneuvers are simple, undemanding and easier to perform when compared with FVC; however, their reliability to be used as alternatives for FVC is controversial. Aim: To judge whether FEV3 and FEV6 can be used instead of FVC in detecting airway obstruction in asthmatic patients. Settings and Design: This study was a cross-sectional case–control laboratory-based study. Materials and Methods: The study involved 40 known asthmatic patients and 40 apparently healthy, gender- and age-matched controls. Spirometery was used for assessing pulmonary function according to the American Thoracic Society and European Respiratory Society criteria. Statistical Analysis: A significant difference in the means between the groups was performed using Student's t-test. The receiver operating characteristic (ROC) curves were used to compare efficiency of the studied spirometric measurements on asthma diagnosis. Results: The mean of FEV3 was not significantly different when compared with the mean of FVC (P = 0.352 for asthmatic patients and P = 0.957 for control group). This was also true when the mean of FEV6 was compared with the mean of FVC (P = 0.805 for asthmatic patients and P = 0.957 for control group). The area under the ROC curves of FEV1/FVC%, FEV1/FEV3% and FEV1/FEV6% were also comparable. Conclusion: FEV3 and FEV6 are accurate and reliable alternatives for FVC in assessing airway obstruction of asthmatic patients.
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Affiliation(s)
- Mohamed Faisal Lutfi
- Department of Physiology, Faculty of Medicine, Alneelain University, Khartoum, Sudan
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Lutfi MF. Effects of â2-agonist therapy on blood pressure, glycaemic control and electrolytes levels of asthmatic patients. Sud Jnl Med Sci 2011. [DOI: 10.4314/sjms.v6i2.72452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Lutfi MF, Sukkar MY. The effect of gender on heart rate variability in asthmatic and normal healthy adults. Int J Health Sci (Qassim) 2011; 5:146-54. [PMID: 23267292 PMCID: PMC3521833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
OBJECTIVE Low heart rate variability (HRV) has been identified as a strong predictor of a large number of diseases, reflecting the vital role of autonomic nervous system in maintaining health. It has been hypothesized that the gender differences in autonomic modulation may explain the gender differences in morbidity and/or mortality rate. This study aims to compare the autonomic balance of males with that of females based on short-term HRV analysis. MATERIALS AND METHODS This cross sectional case-control study involved eighty males matched with seventy-six females. The age M±SD is 28.5±5.4 years in males and 27.3±5.6 years in females. Biocom 3000 ECG recorder was used for studying HRV. Data was analyzed using SPSS Software (v.17), screening studied variables for significant differences in the means between the groups was performed using unpaired t test. Mean heart rate (MHR) was introduced as a covariate in the statistical analysis of HRV using general linear model. RESULTS All short-term HRV (5-min) time domain indices, total power (TP), very low frequency (VLF), low frequency (LF) and high frequency (HF) components of frequency domains were significantly higher in males except MHR, which was significantly higher in females (P<0.05 for all). CONCLUSION Global autonomic activity was higher in males. In contrast, females have higher heart rate compared with males.
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Affiliation(s)
- Mohamed Faisal Lutfi
- Dr. Mohamed Faisal Lutfi, MSc, PhD, Assistant Professor of Physiology, Head Department of Physiology, Alneelain University - Faculty of Medicine and Health Sciences - Department of Physiology, Khartoum - Sudan, Tel: +2499122577 - +249121090160 - +249999033383,
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