Ahmed K. Mortagy

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.

Thiamine Level in Hospitalized Elderly Egyptian Patients with Congestive Heart Failure and Left Ventricular Systolic Dysfunction

ACKNOWLEDGMENTS Conflict of Interest: The editor in chief has reviewed the conflict of interest checklist provided by the authors and has determined that the authors have no financial or any other kind of personal conflicts with this letter. Author Contributions: Barbara Bardenheier, Pascale Wortley, and Abigail Shefer: development of study concept, interpretation of data, and writing of manuscript. Sponsor’s Role: None.

Vitamin D status in hospitalized male patients in Ain Shams University Hospitals and relation to body composition

Background Vitamin D deficiency is highly prevalent worldwide; its effect on bone is well known and understood, but the effect of this deficiency is still not clear. Objective This study examines vitamin D status in Egyptian hospitalized elderly male patients and its relation to body composition, muscle strength, and performance. Design This was a cross-sectional study. Participants and methods Data collected from a previous cross-sectional study, in which a systematic random sampling technique was used where every third patient (skip interval) was included in the study and vitamin D was measured only to a selected number of patient who meets inclusion criteria, were selected for inclusion in the study on the basis of the exclusion criteria, which may have affected the parameters measured. Complete assessment of history and physical examination were performed. Measurements Body composition was measured using bioelectrical impedance analysis (Geratherm), hand grip was measured using a Jamar handheld dynamometer, performance was measured using the timed get up and go test, and 25-hydroxyvitamin D was measured by enzyme-linked immunosorbent assay. Results Our study included 88 elderly men 60 years of age or older; the mean age of the participants studied was 64.74 ± 4.6 years, and 86.3% were married, 22.7% were physically active, and 15.9% were nonsmokers. The mean BMI was 26.4 ± 7.2 kg/m2 and the mean vitamin D level was 12.15 ng/ml. The prevalence of vitamin D insufficiency was 19.3% and that of vitamin D deficiency was 79.5%. Vitamin D deficiency was not associated with age, occupation, marital status, smoking (type, duration, and quantity), hand grip, timed get up and go test, and parameters of body composition. Conclusion Vitamin D deficiency and insufficiency is highly prevalent among elderly Egyptian men, and its impact on body composition, muscle function, and strength is not significantly noticeable.

Assessment of Executive Functions in Chronic Hepatitis C Virus Infected Patients

Background: Chronic infection with HCV is one of the most important causes of chronic liver disease, which can progress to cirrhosis and hepatocellular carcinoma (HCC). It is well established that advanced forms of the disease are accompanied by overt and global cognitive deficits (hepatic encephalopathy) but now there is a growing evidence that the alterations in cerebral function in patients with chronic HCV infection may appear long before the development of severe liver cirrhosis, it has been hypothesized that it is related to a direct effect of HCV on the brain; or the neurotoxic effect of HCV-related systemic inflammation. Aim: The purpose of the study was to assess the possible existence of executive dysfunction in chronic HCV infected patients without cirrhosis. Study design: case control study. Participants: 100 elderly patients aged 60 years and above, 50 patients are HCV positive (cases) and 50 patients are HCV negative (controls) both groups have no liver cirrhosis. Methods: All participants were subjected to the following: Diagnosis of HCV by detection of HCV ab using ELISA technique, non invasive assessment of liver cirrhosis using abdominal ultrasound, and evaluation of executive functions using 5 neuropsychological tests (block design, digit span backwards, animal verbal fluency, clock drawing, and EXIT 25). Results: The study showed that there is a significant difference between cases and controls regarding Exit 25 and Digit span backwards tests scores indicating affection of the phonological loop component of working memory among HCV positive patients. Conclusion: Executive functions are affected in patients with chronic HCV infection without liver cirrhosis.

Depression as a Predictor of Length of Hospital Stay in Elderly Patients Admitted to Ain Shams University Hospitals

Background: Depression among the physically ill is common and frequently under-diagnosed. Elderly patients with depressive symptoms are at higher risk of hospital admission for non psychiatric conditions and are more likely to have longer hospital stays and worse hospital outcomes, compared with non depressed patients. Objectives: The aim of this study was to find out if depression can be considered a predictor of prolonged hospital stay in elderly patients. Design: A prospective cohort study. Participants: 205 consecutive patients 60 years and over both males and females. Settings: Ain shams university hospitals. Measurements: All participants were assessed using comprehensive geriatric assessment including Geriatric depression scale (GDS) and the length of stay was registered. Results: Depressed patients had longer length of hospital stay compared to non depressed patients and the least length of hospital stay was for cases with no risk on GDS scale compared to other groups and the difference is highly significant statistically (p=<0.001). Conclusion: length of hospital stay is significantly longer among depressed elderly. Key wards: Depression –Length of hospital stay– Elderly

Prevalence of hypovitaminosis D and its relation to cardiovascular risk among elderly diabetic female patients

Vitamin D deficiency is highly prevalent worldwide and certain groups as elderly persons women and institutionalized persons are particularly prone to severe deficiency. Objective: To identify the prevalence of hypovitaminosis D and its relation to cardiovascular risk among elderly diabetic female patients. Method: A cross sectional study conducted from the first of October 2014 to the end of March, 2016, where 163 elderly diabetic females who attended Ain shams university hospital at that time were included. They underwent careful history taking, body mass index calculation, blood pressure measurement and Serum 25(OH) D measurement, assessment of insulin secretion including fasting serum C-peptide and CPI measurement in addition to assessment of glycemic control by fasting blood sugar estimation. The level of 25 hydroxy vitamin D (25OHD) was measured. Results: The prevalence of vitamin D deficiency (25OHD level <20 ng/mL ) and insufficiency (25OHD concentration of 20–29 ng/mL) among elderly Egyptian diabetic female patients are 71.2% and 28.2% resp. There is statistically significant association between vitamin D deficiency and low fasting C peptide level and c peptide index. The 3 independent predictor of the presence of vitamin D deficiency were types of diabetic medications, low C-peptide and CPI values and upon logistic regression analysis for these 3 variables, lower CP level was an independent predictor of the presence of vitamin D deficiency. Results showed a weak negative correlation between serum 25(OH)D, systolic BP, BMI and HOMA IR in studied subjects. Conclusion: Prevalence of vitamin D deficiency among elderly Egyptian diabetic female patients is 71.2%. There is statistically significant association between vitamin D deficiency and low fasting C peptide level and c peptide index.

Self-acceptance and life satisfaction in Egyptian older people: Can one exist without the other?

Self-acceptance involves positive self-regard that includes awareness of both personal strengths and limitations. Thus, holding positive attitudes towards oneself emerges as a central characteristic of positive psychological functioning [1]. Self-acceptance (self-esteem) and happiness are substantially interrelated. Past research has shown that life satisfaction which is a measure of subjective well-being [2] and self-acceptance (self-esteem) which is the most recurrent criterion of well-being [1] were clearly discriminable constructs and high self-esteem emerged as the strongest of several predictors of life satisfaction overall [3]. The answer to the question ‘Does one have to be happy to have high selfacceptance and does one have to have high self-acceptance to be happy?’ may be of importance to guide the growing efforts to maintain life satisfaction for older people. A survey research design was used with a convenience sample of 450 community-dwelling older people (60 years old and above) in Cairo. Personal interviews were conducted using orally administered questionnaires after obtaining informed consent. The questionnaires included: 1 Self Acceptance Scale of Ryff’s Psychological Well Being Scales [1]. 2 Satisfaction with Life Scale [4]. 3 Self-rating of health status on a scale from very poor to very good.