Prevalence of Cardiovascular Risk Factors and 10-Years Risk for Coronary Heart Disease in the United Arab Emirates.

BACKGROUND: In the United Arab Emirates (UAE), cardiovascular diseases (CVDs) are the leading cause of mortality, and the incidence of premature coronary heart diseases (CHDs) is about 10-15 years earlier than that in people of western countries. AIM: The current cross-sectional study aims to describe the prevalence of CVD risk factors and estimate the 10-years risk for CHDs in the population of Abu Dhabi, UAE. OBJECTIVE: The main objective was to report the 10-years risk for CHD in a sample of the UAE population. METHODS: We have analyzed the dataset from the Abu Dhabi Screening Program for Cardiovascular Risk Markers (AD-SALAMA), a population-based cross-sectional survey conducted between 2009 and 2015 (a sample of 1002, 20 to 79 years old without CVDs or diabetes). RESULTS: 18.0% of our sample have had hypertension (HTN), 26.3% were current smokers, 33% have had total cholesterol ≥200 mg/dL, 55.0% have had non-high-density lipoprotein (non-HDL) levels ≥130 mg/dL, 33.1% have had low-density lipoprotein cholesterol (LDL-C) levels ≥130 mg/dL, calculated by ß-quantification as 112.3 ± 47.1 mg/dL. 66.8% were overweight or obese, and 46.2% had a sedentary lifestyle. Nearly 85% of our sample has had one or more major cardiovascular risk factors. The estimated 10-year risk of cardiovascular disease according to different risk assessment tools was as follows: 7.1% according to the national cholesterol education program Framingham risk score (FRAM-ATP), 2.9% according to Pooled Cohort Risk Assessment Equation (PCRAE) , 1.4% according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III), and 1.1% according to Reynolds Risk Score. Despite the fact that our sample population have had exhibited major risk factors, the above-mentioned international scoring systems underestimate the 10-year risk of cardiovascular diseases, given the high prevalence at younger ages. CONCLUSION: The proportion of modifiable risk factors has been found to be high in the UAE population, and the majority of them have had one or more risk factors with a higher 10-years risk for CHDs.

Bariatric Bypass Surgery to Resolve Complicated Childhood Morbid Obesity: Case Report Study.

Children obesity has become one of the most important public health problems in many countries worldwide. Although the awareness of childhood obesity as a modifiable health risk is high, but many societies do not prioritize this issue as a health care problem, which may lead to comorbidities and even premature death. Despite the rising interest in bariatric surgery for children, only laparoscopic sleeve gastrectomy (LSG) is being considered in resolving childhood obesity who failed other dietary or drug therapies; however many of LSG procedures failed to reduce the weight in children or resulted in complications postsurgery.Here, we present a novel bariatric procedure to clue out a female child 13 years old presented with Legg-Calvé-Perthes disease-associated morbid obesity. The surgical bariatric technique applied both fundal resection and surgical bypass in pediatric obesity using the Elbanna novel bariatric technique.Bariatric surgical bypass may be considered in complicated-childhood cases who failed all other options.

Colon in the chest: an incidental dextrocardia: a case report study.

Diaphragmatic injury is an uncommon traumatic injury (<1%). Although most diaphragmatic injuries can be obvious (eg, herniation of abdominal contents on chest radiograph), some injuries may be subtle and imaging studies can be nondiagnostic in many situations. Patients with diaphragmatic hernia either traumatic or nontraumatic may initially have no symptoms or signs to suggest an injury to the diaphragm.Here, we report a case of a 75-year-old woman diagnosed with irritable bowel syndrome -associated dominant constipation, presented with shortness of breath, cough, expectoration, tachycardia, and chest pain. Dextrocardia was an incidental finding, diagnosed by electrocardiography, chest radiograph, and CT chest. Parts of the colon, small intestine, and stomach were within the thorax in the left side due to left diaphragmatic hernia of a nontraumatic cause. Acquired incidental dextrocardia was the main problem due to displacement of the heart to contralateral side by the GI (gastrointestinal) viscera (left diaphragmatic hernia).The patient was prepared for the laparoscopic surgical repair, using a polyethylene mesh 20 cm to close the defect, and the patient recovered with accepted general condition. However, 5 days postoperative, the patient passed away suddenly due to unexplained cardiac arrest.Intrathoracic herniation of abdominal viscera should be considered in patients presented with sudden chest pain concomitant with a history of increased intra-abdominal pressure.

Heart rate variability as an indicator of left ventricular systolic dysfunction.

OBJECTIVES: The aim was to compare measures of heart rate variability (HRV) in patients who presented with non-cardiac vascular episodes with age- and gender-matched control patients. METHODS: One hundred and fifty patients, randomly selected from a cohort of 522 subjects, were enrolled in a screening study. Of these, 256 were identified to have had a stroke or transient ischaemic attack (TIA), or to have peripheral vascular disease (PVD) at the first presentation to Ninewells Hospital, Dundee, Scotland. Only 114 patients remained in the study (100 cases and 14 controls). Multiple regression analysis was used to assess the association between HRV parameters and measures of mean heart rate and ejection fraction. RESULTS: Heart rate and HRV indices were significantly inversely correlated with both normal left ventricular (LV) function [r = 0.2-0.5; p = 0.037-0.0001] and left ventricular systolic dysfunction (LVSD) [r = 0.3-0.5; p = 0.07-0.01] in the patients. HRV did not predict LVSD in this cohort of patients. Multiple regression analysis showed only ischaemic heart disease (IHD) and cigarette smoking had an independent relation to HRV parameters. Cigarette smoking (p = 0.008), IHD (p = 0.02) and diabetes (p = 0.03) were significant predictors of reduced HRV (standard deviation of the normal-to-normal interval: SDNN), independent of LVSD. DISCUSSION: There were no significant differences in HRV indices between non-cardiac vascular patients (TIA, stroke, PVD) and their age- and gender-matched controls. HRV had no diagnostic value as a pre-screening test to identify suspected LVSD in these patients. CONCLUSION: HRV cannot be used as a screening test to identify hidden LVSD. Further studies will be needed to assess the possibilities that HRV is a convenient marker of endothelial dysfunction.