Prevalence of vitamin D insufficiency among community dwelling elderly in Dakahlia as a representative of rural areas in Egypt.

BACKGROUND: Vitamin D has a basic role in bone growth and metabolism and has been noticed for its important role in many diseases. OBJECTIVES: To detect the prevalence of vitamin D insufficiency among the elderly in Dakahlia. METHODOLOGY: A cross-sectional study was conducted on 176 elderly patients (60 years and older) recruited from Meet Abbad-Nabaroh-Dakahlia, Egypt. The level of 25 hydroxy vitamin D (25OHD) was measured. A normal level of vitamin D is defined as a 25OHD concentration ≥30 ng/mL. Vitamin D insufficiency is defined as a 25OHD concentration of 20-29 ng/mL. Vitamin D deficiency is defined as a 25OHD level <20 ng/mL. RESULTS: There were no cases of vitamin D deficiency among the studied population. The prevalence of vitamin D insufficiency (25OHD level of 20-29 ng/mL) among the elderly in Dakahlia was 26 %. Prevalence of vitamin D insufficiency was (37.9 %) in males and (15.3 %) in females. CONCLUSION: There was a low prevalence of vitamin D insufficiency in an elderly rural population and a higher prevalence of vitamin D insufficiency among males than females.

Changes in glutamate decarboxylase enzyme activity and tau-protein phosphorylation in the hippocampus of old rats exposed to chronic mild stress: reversal with the neuronal nitric oxide synthase inhibitor 7-nitroindazole.

Effects of chronic stress are not completely understood. They may underlie depression and dementia. This study assessed the association between chronic stress, glutamate levels, tau-protein phosphorylation, and nitric-oxide in old rats exposed to chronic mild stress (CMS). Old (>15 months) male Wistar rats were exposed to CMS. Comparison groups included old and young control rats, young CMS-exposed, and old CMS-exposed rats treated with the neuronal nitric-oxide synthase (nNOS) enzyme inhibitor, 7-nitroindazole (20 mg/kg/day i.p.). Hippocampal glutamate levels and glutamate decarboxylase (GAD) activity were determined and tau protein phosphorylation was assessed. Age was a significant (p=0.025) source of variation in glutamate level [811.71+/-218.1, 665.9+/-124.9 micromol/g tissue protein (M+/-SD) in young and old control rats, respectively]. Old rats exposed to CMS were characterized by an increased risk to develop anhedonia. There was significant (p=0.035) decrease in GAD enzyme activity (-60.06%) and increased tau protein hyperphosphorylation in old rats exposed to CMS compared to control. Administration of 7-nitroindazole to CMS-exposed old rats significantly (p=0.002) increased GAD activity, decreased glutamate levels (7.19+/-3.19 vs. 763.9+/-91 micromol/g tissue protein; p=0.0005), and decreased phosphorylation of tau proteins compared to CMS exposed rats.

Morbidity and Mortality following Surgery for Hip Fractures in Elderly Patients.

AIM: To determine morbidity and mortality in elderly patients following hip fracture surgery in Egypt and its correlates and to determine the utility of the POSSUM scale to predict morbidity and mortality among our population. METHODOLOGY: We assessed postoperative morbidity and mortality following hip fracture surgery in a 6-month prospective observational study of 100 elderly patients who were undergoing surgical repair at the beginning of the study. The exclusion criteria included surgically unfit patients and patients refusing to participate in the study. The study was conducted in Ain Shams University Hospital, Ain Shams Specialized Hospital, and El-helal Hospital. RESULTS: The subjects were categorized as survivors and nonsurvivors according to the 6-month mortality, and the groups were compared statistically according to this classification. The observed 6-month mortality was 19.56%. POSSUM had high specificity for predicting 6-month survival (97.3%). A multivariate regression analysis revealed that postoperative admission to the intensive care unit and lack of ambulation were major risk factors associated with the 6-month mortality. CONCLUSIONS: The POSSUM system had high specificity for predicting survivors (97.3%) but failed to predict mortality (sensitivity = 5.6%). The major risks for 6-month mortality are intensive care unit admission and lack of ambulation.