European Journal of Medical and Health Research
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Exploring the Comorbidity, Pathophysiology, and Integrated Treatment Strategies of Hypertension and Depression
Get PDFHypertension and depression are widely prevalent conditions with substantial comorbidity. Hypertension, characterized by persistently elevated arterial pressure, is associated with significant cardiovascular morbidity and mortality. Depression, a multifactorial mood disorder, adversely affects mental and physical health through mechanisms involving neuroinflammation, neurotransmitter imbalances, and hormonal dysregulation. The association between these disorders has been recognized since the mid-20th century.Historical medical literature from ancient Chinese and Indian systems identified symptoms indicative of hypertension, later classified as a distinct disease entity by Fredrick Akbar Mahomed in the 19th century. Notable epidemiological studies have elucidated the significant relationship between hypertension and depression, particularly among medical students and other high-risk populations.Research indicates that common pathophysiological mechanisms, including sympathetic nervous system overactivity, chronic inflammation, and endothelial dysfunction, underlie the comorbidity of hypertension and depression. Elevated levels of norepinephrine, proinflammatory cytokines, and oxidative stress contribute to the expression or worsening of both conditions. Shared genetic and environmental factors further compound this relationship, highlighting the need for integrated treatment strategies.Pharmacological interventions, including angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, have shown potential to improve mental health outcomes in patients with comorbid hypertension and depression. However, inconsistent findings regarding the impact of antihypertensive medications on depression necessitate further investigation. The comorbidity of these conditions complicates treatment adherence, leading to poorer health outcomes and increased healthcare costs.The clinical implications of this unidirectional or bidirectional comorbidity are considerable, affecting quality of life, treatment adherence, and overall health outcomes. Integrated care approaches, incorporating lifestyle modifications and combined pharmacological treatments, have shown promise in improving compliance and outcomes.Despite extensive research, limitations persist, including difficulties in establishing causality, inconsistent diagnostic criteria, and the influence of confounding variables. Future research should focus on clarifying the bidirectional relationship between these conditions, the impact of social determinants, and the efficacy of various treatment modalities. Identifying high-risk populations and refining intervention strategies are crucial for improving clinical outcomes in patients with comorbid hypertension and depression.This paper aims to review the current literature regarding the association and comorbidity of hypertension and depression.Abbreviations: ACE: Angiotensin-Converting Enzyme; ARBs: Angiotensin Receptor Blockers; DBP: Diastolic Blood Pressure; mm Hg: Millimeters of Mercury; QoL: Quality of Life; SBP: Systolic Blood Pressur
Intrarectal Migration of an Intrauterine Device: A Case Study and Review of Literature
Get PDFIntrauterine devices (IUDs) are a widely used and generally safe method of long-term contraception. However, complications such as uterine perforation and migration can occur, although they are rare. This article presents a case of a 30-year-old woman with a history of two pregnancies and deliveries, who had a copper IUD inserted two years prior during the lactation period. She was admitted with severe pelvic pain and constipation lasting for three days, without externalized gastrointestinal bleeding or vomiting. Clinical examination revealed generalized abdominal tenderness with hypogastric guarding, while laboratory tests indicated elevated inflammatory markers. Imaging studies, including abdominal ultrasound and CT scan, revealed the migration of the IUD and its partial perforation into the rectal ampulla. Emergency surgery was performed, including the repair of a rectal perforation, lateral protective colostomy, and appendectomy. The postoperative course was uneventful, and colonic continuity was restored six weeks later. This case underscores the importance of considering IUD migration in a patients presenting with abdominal pain and highlights the need for timely diagnosis and intervention to prevent serious complications. Regular follow-up and patient education on the potential risks and signs of IUD complications are essential for early detection and management
Assessment of Lipid Profile and Clinical Manifestation of Obese Patients with Type 2 Diabetes
Get PDFThis case-control study involved 356 diabetic patients and 384 apparently healthy individuals, matched for age and sex, who attended the outpatient department at Al-Zahrawi Private Hospital in Mosul from January to December 2004. The study aimed to evaluate changes in serum lipid profile among type 2 diabetics in relation to body mass index (BMI) and determine the extent and pattern of dyslipidemia in obese diabetics. Fasting plasma glucose and serum lipid profile were compared between type 2 diabetics and control subjects based on BMI. Data analysis utilized chi-square, Z, ANOVA, and Duncan tests. Fasting plasma glucose levels were highest in obese diabetics, and the frequency of poorly controlled diabetics increased with higher BMI. There was a significant positive association between BMI and serum triglyceride (TG) (p < 0.01), total cholesterol (TC) (p < 0.001), LDL-C (p < 0.001), and VLDL-C (p < 0.01). Serum HDL-C levels significantly decreased (p < 0.01) with increasing BMI. The prevalence of dyslipidemia increased with higher BMI levels in both genders. In conclusion, several lipid abnormalities in type 2 diabetics underscore the importance of diabetic control, regular lipid profile monitoring, and obesity management
Effects of Helicobacter pylori Infection on Insulin Resistance in Type 2 Mellitus Diabetics and Non-Diabetics Subjects at Brazzaville University Hospital
Get PDFIntroduction: H.pylori infection is the most common bacterial infection worldwide and is associated with gastrointestinal diseases and extra-gastrointestinal pathologies such as diabetes mellitus and insulin resistance. Objective: To evaluate insulin resistance in diabetics and non-diabetics infected with H. pylori. Methods: We conducted a descriptive cross-sectional study. 90 patients were selected and divided into two groups, 44 patients with T2DM and 46 non-diabetic patients. All information concerning the age and sex of subjects was collected from medical records. Insulin levels were determined by ELISA, blood glucose and HbA1C levels by Cobas c 311, and the HOMA-IR index was calculated. Results: The mean age of T2DM patients was 51 ± 11 years, and that of NDT patients 40±15 years. Women (68) predominated over men (22), with a sex ratio of 0.32. The mean values for T2DM patients were: glycemia 12.6±2.3 mmol/l, HbA1C 10.37±2.9%, HOMA-IR 2.69±1.35 (p<0.001), Insulinemia 8.71±3.14 μU/ml (p= 0.801). Univariate logistic regression analysis showed: Glycemia OR 2.29 [95% IC 1.80-4.5], HbA1C OR 3.08 [95% IC 0.87-1.02], Insulin OR 1.02 [95% IC 1.0-0.16] and HOMA-IR OR 4.4 [95% IC 0.55-0.95]. Means for NDT infections were: blood glucose 9.7±1.0 mmol/l, insulin 9.7±1.64 μU/ml, HOMA-IR 1.45±0.42, HbA1C 8.6±0.9%. Univariate logistic regression analysis showed: Blood glucose OR1.1 [95% IC1.01-2.14], HbA1C OR 1.35 [95% IC 0.08-1.34], Insulin OR 0.51 [95% IC 0.12-1.08], HOMA-IR OR 2.4 [95% IC 0.32-1.45]. Conclusion: Our study showed a statistical significant difference between H.pylori infection and Insulin resistance, also confirms the link of both.Abbreviations: T2DM: Type two diabetes of mellitus, NDT: No-Diabetics, OR: Odd ratio
Association Between Serum Ferritin Level and Liver Function Tests in Children with Beta-Thalassemia (Thalassemia Center of Kut Hospital, Iraq)
Get PDFBackground: Thalassemia represents a heterogeneous autosomal recessive hereditary anemia.Ferritin is a 450 KDa soluble protein. It can be found in all of the body's cells, but it's particularly abundant in marrow macrophages, spleen, and liver.Objective: In patients with β thalassemia major and β thalassemia Intermedia, serum ferritin levels are measured, and their correlation with bilirubin levels, liver enzymes AST (aspartate transaminase) and ALT (alanine transaminase), in beta-thalassemia major and β thalassemia Intermedia.Patients and Methods: A cross-section study that involved 90 patientsincluded 50 Thalassemia Major (TM) and 40 Thalassemia intermediate(TI). Patients who were randomly chosen for this study would be gathered from the Kut Hospital Thalassemia Center. Every patient's are kid, aged 5 to 17, regardless of gender. Abbott C4000 Architect Additionally, the TSB, ALT, AST, and serum ferritin were determined using the Cobas c 111 analyzer.Results: The studies include both genders 52.9% of the females had B-thalassemia major and 47.1% had β-thalassemia intermediate, whereas 57.1% of the men had βTM and 42.9% had βTI. There were 37.8% of females and 62.2% of males in the sample.Patients with severe thalassemia exhibited a statistically significant increase in the mean± SD of serum ferritin (4016.54 ± 2500.81 ng/ml) compared to the mean ± SD of β-thalassemia intermedia (1629.48 ± 1235.33 ng/ml), with a p-value of 0.000. Patients with major β-thalassemia had a mean TSB level that was statistically significantly lower (1.32 ± 0.69 mg/dl) than the mean level of β-thalassemia intermedia (2.10 ± 0.86 mg/dl), with a p-value of 0.000. In the B-thalassemia major group, serum hepcidin did not exhibit a statistically significant association with serum ferritin (r=-0.04), while in the B-thalassemia intermedia group, serum ferritin exhibited a statistically significant moderate negative correlation with TSB (r=-0.38), p-value. 0.01.Conclusions: Ferritin levels may be useful in thalassemia syndrome diagnosis and prognosis determination
Investigating the Influence of Culture Conditions on Antimicrobial Activity of NC01 Strain
Get PDFMyxococcus sp. is an important large genus in the family of myxobacteria because it is considered a prospecting source of secondary metabolites. This study aims to: (i) Identify potential NC01 strain by morphological, biochemical and 16S rDNA gene sequences; (ii) Evaluate antimicrobial activity by agar well-diffusion and microdilution methods; (iii) Survey medium and fermentation conditions that exhibit the best antimicrobial activity and (iv) Determine active fractionation by thin-layer chromatography (TLC) bioautography. The results show that the NC01 strain was designated Myxococcus fulvus. This strain demonstrated inhibition in 9/10 of the strains tested with the most impressive activity being recorded on MSSA, A. niger and Penicillium sp. with a minimum inhibitory concentration of 1 μg/mL however this strain did not show inhibition of E. coli. The survey of fermentation conditions revealed the crude extract exhibited the best antimicrobial activity on medium P at pH 7.2, temperature 37 oC. The two segments No. 2 and No. 3 (Rf = 0.23 and Rf = 0.28) contain compounds that were active on A. niger
Clinical Outcomes of Intestinal Obstruction in Al- Hussein Teaching Hospital Patients: A Hospital-Based Study
No full textBackground: Intestinal obstruction is one of the most common surgical emergencies in the world and carries a very high risk for morbidity and mortality. Little information exists about clinical outcomes in patients with intestinal obstruction in the Iraqi population.
Objective: To provide an overview of the clinical presentation, management and outcomes of patients with intestinal obstruction at Al-Hussein Teaching Hospital in Samawah, Iraq.Methods: A prospective observational study from January 2022 to December 2023 included a total of 287 patients who were admitted with intestinal obstruction. Demographic data, etiology of the obstruction, clinical features, diagnostic testing, treatment options, and outcome data were all collected during this study. Statistical analysis was done using SPSS version 26. Results: The mean age of the patients was 48.6±16.2 years (62.7% male). The leading causes of intestinal obstruction were adhesions (38.3%) and hernias (24.7%), with small bowel obstructions comprising 68.3% of all cases. Conservative treatment was successful in 31.4% of the patients; however, a higher percentage (68.6%) required surgical treatment. Overall mortality rate following surgery was 6.6% and 23.8% of patients developed complications, including the most common postoperative complication of wound infection (9.1%). Mean length of stay in the hospital was 8.4±4.6 days. Conclusion: Intestinal obstruction in our study was most prevalent in middle- aged males, with the leading cause of intestinal obstruction in our patients being adhesions. Surgical treatment frequently required, with satisfactory postoperative results. Early detection and timely treatment greatly improve the chance of decreasing morbidity and mortality
Coffea plant (Caffeine): Examining its Impact on Physical and Mental Health
Get PDFThis research delves into the extensive use of caffeine across various consumables like foods, drinks, medications, and supplements. Caffeine's influence on the central nervous system renders it a popular substance globally. The study aims to elucidate how caffeine impacts health and overall well-being. It examines both the physical and mental repercussions of caffeine consumption, highlighting its advantages, risks, and individual differences in sensitivity. Moreover, the research investigates how caffeine affects diverse aspects such as sleep, mood, cognition, and physical performance, both positively and negatively. Notably, it also scrutinizes the association between caffeine intake and health conditions like heart disease, bone health, and mental well-being. The research promotes responsible caffeine consumption by advocating for moderation and understanding one's tolerance levels. It underscores the significance of comprehending caffeine's effects to enable informed decisions among consumers, healthcare providers, and policymakers. Emphasizing the prevalence of caffeine consumption, the study underscores the necessity of recognizing its impact on various bodily systems, including the cardiovascular, respiratory, endocrine, and neurological systems. While coffee, a common source of caffeine, offers health benefits, it's crucial to acknowledge caffeine as a chemical compound capable of influencing our nervous and other bodily systems. Excessive consumption of caffeine can pose detrimental effects on health. In essence, this research aims to raise awareness regarding the advantages and disadvantages associated with caffeine consumption. As the most widely consumed psychoactive substance globally, understanding caffeine's effects is imperative for maintaining overall well-being. Many individuals kickstart their day with coffee, unaware of both the positive and negative effects of caffeine
Cardiovascular Involvement in Behçet Disease
Get PDFBehçet's disease is a disease with mixed vascular tropism: venous and arterial. Vasculo-Behçet or angio-Behçet presents a particular patient profile. Vascular involvement, especially pulmonary artery aneurysm, thoracic aortic aneurysm and Budd Chiari syndrome are entities affiliated with the disease and strike the prognosis. Our series is predominantly male, with an average age of 36 years. Venous disease concerns the majority of patients: 40 patients. It is most often a deep vein thrombosis of the lower limbs. In the arterial system, the pulmonary artery aneurysm was found in 7 patients, the most common location of aneurysms. The association of venous and arterial involvement is more important. Corticosteroid therapy is prescribed in three out of four patients. Immunosuppressive treatment such as azathioprine or cyclophosphamide are prescribed in almost half of patients with venous involvement
Blood Donation Pattern and Characteristics of Blood Donors in Saudi Arabia
Get PDFBackground: Blood donation rates in Saudi Arabia are relatively low compared to other countries. Understanding the patterns and characteristics of blood donors is crucial for improving donation rates and ensuring a sustainable blood supply. This Study utilizes data from the Wateen App to examine blood donation patterns in Saudi Arabia.Methods: A cross-sectional study was conducted using data from individuals who registered on the Wateen App. The Study analyzed demographic information, donation frequency, blood group distribution, regional variations, temporal trends, and user satisfaction with the App. Statistical analyses were performed to identify significant findings.Results: The Study found that the majority of registered donors were male, with a higher proportion in the 25-35 age group. Most donors had donated once, while a small percentage had multiple donations. O+ blood group donors constituted the most significant proportion, followed by A+ and B+. The Eastern province had the highest incidence of registered donors. Over the years, there has been a gradual increase in the number of donors. There was no significant correlation between donation numbers and different months, seasons, or Ramadan.Conclusion: This Study provides insights into blood donation patterns in Saudi Arabia. Efforts should be made to address gender disparities, engage a wider age range of donors, promote donations among individuals with less common blood types, and improve donation infrastructure in regions with lower donation rates. The Wateen App has shown positive outcomes in enhancing donor engagement. Further research and collaborative efforts are necessary to improve the blood donation system in Saudi Arabia