| Abstract: |
SUMMARY AND CONCLUSIONHyperphagia (overeating) is often associated with energy over storage and obesity, which may lead to a myriad of serious health problems, including heart disease, hypertension, and type II diabetes mellitus. Thus understanding the complex pathological mechanisms underling hyperphagia and obesity has important clinical significance.Fasting therapy was at first mainly used for the treatment of obesity. The precise mechanism(s) underlying the physiological changes during fasting remains unclear; however, there is indirect evidence that such an effect may be mediated by alterations in the hypothalamic-pituitary-adrenal (HPA) axis, insulin and/or metabolic and energy homeostasis.Clarifying the underlying mechanisms will be essential to understanding the pathogenesis and treatment of energy balance disorders, such as obesity which is a major health problem and cachexia such as cancer cachexia and cachexia associated with inflammatory bowel diseasesThe hypothalamus regulates many aspects of energy homeostasis, adjusting the drive to eat and the expenditure of energy in response to a wide range of nutritional and other signals.Orexins, also named hypocretins, are neuropeptides present in the hypothalamus. Prepro-orexin is enzymatically matured into two peptides, orexin-A and orexin-B which are 33-and 28-amino-acid peptides, respectively.The orexin signaling pathway thought to participate in a complex cycle of energy homeostasis, including control of food intake, wakefulness, motor activity, metabolic rate, cardiovascular and endocrine effects. However, the role of orexins in energy expenditure is more prominent than in food intake.Many studies have extended the multifaceted role of orexins to the regulation of peripheral functions either through a central control or direct interaction with peripheral target tissues such as hypophysis, adrenals, GIT or endocrine pancreas.In a trial to clarify the possible effects of orexin-A on insulin secretion, the hypothalamo-pituitary-adrenal axis function, and the adrenergic system, as regulators of energy homeostasis, this study had been carried out on a total number of 60 adult male albino rats.The animals were divided into 3 equal groups and each group is subdivided into two equal subgroups: one for measurement of (serum insulin, blood glucose, serum corticosterone, and ACTH) and the other for measurement of the adrenergic system parameters (arterial blood pressure, H.R, and urinary VMA excretion/24 hour).Group I Control group: saline vehicle treated group.Group II Each rat was given daily S.C injection of orexin–A (20 nmol/ Kg body weight) dissolved in 0.2 ml 0.9% Na Cl for 7 days .Group III Each rat was given daily S.C injection of orexin–A (20 nmol/ Kg body weight) dissolved in 0.2 ml 0.9% Na Cl for 14 days.The results of this study show that, orexin-A was effective in stimulating insulin release in vivo and participated in long term regulation of insulin secretion. Nevertheless, from this study, it is not known whether orexin-A increases insulin release by acting directly on the pancreatic ?-cells or via an indirect pathway.Insulin is known as a long-term regulator of food intake and energy balance. Moreover, some studies demonstrated that, orexin-A plays an important role in the adipo-insular axis by stimulating insulin and leptin secretions. Taken together, the findings of this work may be indicative of a therapeutic role of orexin–A in the treatment of obesity and associated diabetes on both of the short and long term.This work also shows that, orexin-A was effective in stimulating corticosterone release in vivo and participated in both short term and long term regulation of corticosterone by acting directly on the adrenal glands, as there was an insignificant change in the levels of ACTH in the plasma after the administration of the drug for 7 days. Furthermore, a significant decrease in its plasma levels was detected after 14 days of orexin-A administration, which resulted from the negative feed back inhibition exerted by the long term elevated corticosterone levels.Therefore, orexin-A might be involved in the patho-physiology of adrenal function. Moreover, as both the orexinergic system and the HPA axis are activated in stress conditions, so they may interact to regulate energy homeostasis during stress conditions and orexin-A may mediate these stress responses improving response to stress in daily life.The results of this work also demonstrated that, orexin-A was effective in stimulating the adrenergic system which evidenced by the significant increase in the cardiovascular activities (blood pressure, heart rate) and the levels of urinary VMA/24 hours after the administration of the drug for 7 days. However, these measured parameters returned to the control levels after 14 days of orexin-A administration, and so, these results indicate that, orexin-A may participate in short term but not in long term regulation of the adrenergic system. Nevertheless, from this study, it is not known whether orexin-A acting centrally at the higher levels or directly on the adrenal medulla to exert this effect.Finally, narcolepsy which is tightly associated with orexin-A deficiency, was reported to be associated with changes in energy homeostasis, as narcoleptic patients are frequently obese, more often have insulin resistant diabetes, exhibit reduced food intake, and have lower blood pressure and temperature and this deficiency is directly involved in altered energy homeostasis in those patients.Thus, this pleuripotent orexin-A peptide hold great potential not only for the treatment of narcolepsy but also to provide insight into the coordinated regulation of multiple systems affected in this disorder .Furthermore, pharmacological intervention directed at the orexin receptors may prove to be an attractive avenue toward the discovery of novel therapeutics for diseases involving dysregulation of energy homeostasis such as obesity and diabetes mellitus.Fasting therapy was at first mainly used for thetreatment of obesity (1) and since the 1970s thistherapy has also been found to be one of the effectivetreatments for psychosomatic disorders (2). The precisemechanism(s) underlying the psychological and physiologicalchanges during fasting remains unclear; however,there is indirect evidence that such an effect maybe mediated by alterations in the hypothalamic±pituitary±adrenal (HPA) axis and/or metabolic andenergy homeostasis (3±5), as indicated in acute mentaland environmental stresses (6, 7).Recently, peptides such as orexin, neuropeptide Y(NPY) and leptin have been found to play an importantrole in the regulation of energy metabolism (8±10).The mechanisms by which they interact with eachother (11±13) and with other nutritional and metabolicfactors including insulin and cortisol (8, 14) havebeen investigated in animals. In humans, on the otherhand, the changes in circulating levels of leptin andNPY in response to various nutritional states such asfasting (15±17) and to psychological and/or physicalstresses (18±20) were studied; however, changes inorexin concentrations have not yet been investigated.Interestingly, orexin-containing neurones were recentlyfound in the gut that expressed a functional changein response to energy status (21). Although changes incirculating levels of these peptides in the periphery inresponse to fasting cannot be assumed to have anyrelationship to those in the central nervous system, itseems important to investigate if these peptides are ofphysiological importance and how they are regulatedin the periphery during fasting in humans.Hypocretinergic neurons may regulate sympathetic and cardiovascular activity. Furthermore, their antagonists may apply for the treatment of hypertension and cardiovascular diseases in the future.3- QT dispersion is increased after myocardial infarction and levels are higher in patients with ventricular arrhythmias.4- QT dispersion is influenced by hypertension, diabetes mellitus, age and site of infarction ,as it is increased in patients with hypertension, diabetes mellitus, age less than 50 years and with anterior than inferior infarction.The study recommended the following:1- Whenever not contraindicated, thrombolytic therapy should be administered as early as possible in cases with AMI.2- QT dispersion can predict the potential for ventricular arrhythmias in patients with AMI.3- Future studies are needed to confirm the value of QT dispersion in risk stratification after AMI.SUMMARYThere is growing interest in QT dispersion as a marker for arrhythmia potential being a marker of inhomogenicity of ventricular repolarization. The QT dispersion is increased in myocardial ischemia and infarction, and levels are higher in patients with ventricular arrhythmias. This study was performed to assess QT dispersion in patients with acute myocardial infarction treated with thrombolytic therapy with successful reperfusion versus those who treated with thrombolytic therapy with failed reperfusion and those who treated with conventional therapy and to correlate between QT dispersion and the complicating serious ventricular arrhythmias following acute myocardial infarction. And it is also performed to assess the influence of age, sex, obesity, smoking, diabetes mellitus, hypertension and site of infarction on QT dispersion. The study included 100 patients with recent acute myocardial infarction and they are classified to 3 groups:Group 1: 30 patients who received streptokinase with successful reperfusion.Group 2: 30 patients who received streptokinase with failed reperfusion.Group 3: 40 patients who did not receive streptokinase (control group).Every patient was subjected to full history taking and thorough clinical examination. Analysis of serum electrolytes (Na, K and ca) was done and cases showing abnormal results were excluded. Serum CPK was checked on admission, after 6 hours, after 12 hours and after 24 hours after onset of thrombolytic therapy. ECG was done for every patient on admission, two hours post thrombolytic therapy and predischarge in groups I and 2. In group 3, ECG was done on admission and predischarge.The study concluded that:1- There is a statistically significant reduction in QT dispersion in patients who received thrombolytic therapy with successful reperfusion versus those who received thrombolytic therapy with failed reperfusion and those who did not receive thrombolytic therapy.2- There is a reduction in the incidence of ventricular arrhythmias in patients with successful reperfusion therapy associated with the reduction in the QT dispersion. So, reduction of QT dispersion may be a mechanism of benefit of thrombolytic therapy.3- QT dispersion is increased after myocardial infarction and levels are higher in patients with ventricular arrhythmias.4- QT dispersion is influenced by hypertension, diabetes mellitus, age and site of infarction ,as it is increased in patients with hypertension, diabetes mellitus, age less than 50 years and with anterior than inferior infarction.The study recommended the following:1- Whenever not contraindicated, thrombolytic therapy should be administered as early as possible in cases with AMI.2- QT dispersion can predict the potential for ventricular arrhythmias in patients with AMI.3- Future studies are needed to confirm the value of QT dispersion in risk stratification after AMI.SUMMARYThere is growing interest in QT dispersion as a marker for arrhythmia potential being a marker of inhomogenicity of ventricular repolarization. The QT dispersion is increased in myocardial ischemia and infarction, and levels are higher in patients with ventricular arrhythmias. This study was performed to assess QT dispersion in patients with acute myocardial infarction treated with thrombolytic therapy with successful reperfusion versus those who treated with thrombolytic therapy with failed reperfusion and those who treated with conventional therapy and to correlate between QT dispersion and the complicating serious ventricular arrhythmias following acute myocardial infarction. And it is also performed to assess the influence of age, sex, obesity, smoking, diabetes mellitus, hypertension and site of infarction on QT dispersion. The study included 100 patients with recent acute myocardial infarction and they are classified to 3 groups:Group 1: 30 patients who received streptokinase with successful reperfusion.Group 2: 30 patients who received streptokinase with failed reperfusion.Group 3: 40 patients who did not receive streptokinase (control group).Every patient was subjected to full history taking and thorough clinical examination. Analysis of serum electrolytes (Na, K and ca) was done and cases showing abnormal results were excluded. Serum CPK was checked on admission, after 6 hours, after 12 hours and after 24 hours after onset of thrombolytic therapy. ECG was done for every patient on admission, two hours post thrombolytic therapy and predischarge in groups I and 2. In group 3, ECG was done on admission and predischarge.The study concluded that:1- There is a statistically significant reduction in QT dispersion in patients who received thrombolytic therapy with successful reperfusion versus those who received thrombolytic therapy with failed reperfusion and those who did not receive thrombolytic therapy.2- There is a reduction in the incidence of ventricular arrhythmias in patients with successful reperfusion therapy associated with the reduction in the QT dispersion. So, reduction of QT dispersion may be a mechanism of benefit of thrombolytic therapy.3- QT dispersion is increased after myocardial infarction and levels are higher in patients with ventricular arrhythmias.4- QT dispersion is influenced by hypertension, diabetes mellitus, age and site of infarction ,as it is increased in patients with hypertension, diabetes mellitus, age less than 50 years and with anterior than inferior infarction.The study recommended the following:1- Whenever not contraindicated, thrombolytic therapy should be administered as early as possible in cases with AMI.2- QT dispersion can predict the potential for ventricular arrhythmias in patients with AMI.3- Future studies are needed to confirm the value of QT dispersion in risk stratification after AMI.SUMMARYThere is growing interest in QT dispersion as a marker for arrhythmia potential being a marker of inhomogenicity of ventricular repolarization. The QT dispersion is increased in myocardial ischemia and infarction, and levels are higher in patients with ventricular arrhythmias. This study was performed to assess QT dispersion in patients with acute myocardial infarction treated with thrombolytic therapy with successful reperfusion versus those who treated with thrombolytic therapy with failed reperfusion and those who treated with conventional therapy and to correlate between QT dispersion and the complicating serious ventricular arrhythmias following acute myocardial infarction. And it is also performed to assess the influence of age, sex, obesity, smoking, diabetes mellitus, hypertension and site of infarction on QT dispersion. The study included 100 patients with recent acute myocardial infarction and they are classified to 3 groups:Group 1: 30 patients who received streptokinase with successful reperfusion.Group 2: 30 patients who received streptokinase with failed reperfusion.Group 3: 40 patients who did not receive streptokinase (control group).Every patient was subjected to full history taking and thorough clinical examination. Analysis of serum electrolytes (Na, K and ca) was done and cases showing abnormal results were excluded. Serum CPK was checked on admission, after 6 hours, after 12 hours and after 24 hours after onset of thrombolytic therapy. ECG was done for every patient on admission, two hours post thrombolytic therapy and predischarge in groups I and 2. In group 3, ECG was done on admission and predischarge.The study concluded that:1- There is a statistically significant reduction in QT dispersion in patients who received thrombolytic therapy with successful reperfusion versus those who received thrombolytic therapy with failed reperfusion and those who did not receive thrombolytic therapy.2- There is a reduction in the incidence of ventricular arrhythmias in patients with successful reperfusion therapy associated with the reduction in the QT dispersion. So, reduction of QT dispersion may be a mechanism of benefit of thrombolytic therapy.3- QT dispersion is increased after myocardial infarction and levels are higher in patients with ventricular arrhythmias.4- QT dispersion is influenced by hypertension, diabetes mellitus, age and site of infarction ,as it is increased in patients with hypertension, diabetes mellitus, age less than 50 years and with anterior than inferior infarction.The study recommended the following:1- Whenever not contraindicated, thrombolytic therapy should be administered as early as possible in cases with AMI.2- QT dispersion can predict the potential for ventricular arrhythmias in patients with AMI.3- Future studies are needed to confirm the value of QT dispersion in risk stratification after AMI.SUMMARYThere is growing interest in QT dispersion as a marker for arrhythmia potential being a marker of inhomogenicity of ventricular repolarization. The QT dispersion is increased in myocardial ischemia and infarction, and levels are higher in patients with ventricular arrhythmias. This study was performed to assess QT dispersion in patients with acute myocardial infarction treated with thrombolytic therapy with successful reperfusion versus those who treated with thrombolytic therapy with failed reperfusion and those who treated with conventional therapy and to correlate between QT dispersion and the complicating serious ventricular arrhythmias following acute myocardial infarction. And it is also performed to assess the influence of age, sex, obesity, smoking, diabetes mellitus, hypertension and site of infarction on QT dispersion. The study included 100 patients with recent acute myocardial infarction and they are classified to 3 groups:Group 1: 30 patients who received streptokinase with successful reperfusion.Group 2: 30 patients who received streptokinase with failed reperfusion.Group 3: 40 patients who did not receive streptokinase (control group).Every patient was subjected to full history taking and thorough clinical examination. Analysis of serum electrolytes (Na, K and ca) was done and cases showing abnormal results were excluded. Serum CPK was checked on admission, after 6 hours, after 12 hours and after 24 hours after onset of thrombolytic therapy. ECG was done for every patient on admission, two hours post thrombolytic therapy and predischarge in groups I and 2. In group 3, ECG was done on admission and predischarge.The study concluded that:1- There is a statistically significant reduction in QT dispersion in patients who received thrombolytic therapy with successful reperfusion versus those who received thrombolytic therapy with failed reperfusion and those who did not receive thrombolytic therapy.2- There is a reduction in the incidence of ventricular arrhythmias in patients with successful reperfusion therapy associated with the reduction in the QT dispersion. So, reduction of QT dispersion may be a mechanism of benefit of thrombolytic therapy.3- QT dispersion is increased after myocardial infarction and levels are higher in patients with ventricular arrhythmias.4- QT dispersion is influenced by hypertension, diabetes mellitus, age and site of infarction ,as it is increased in patients with hypertension, diabetes mellitus, age less than 50 years and with anterior than inferior infarction.The study recommended the following:1- Whenever not contraindicated, thrombolytic therapy should be administered as early as possible in cases with AMI.2- QT dispersion can predict the potential for ventricular arrhythmias in patients with AMI.3- Future studies are needed to confirm the value of QT dispersion in risk stratification after AMI.SUMMARYThere is growing interest in QT dispersion as a marker for arrhythmia potential being a marker of inhomogenicity of ventricular repolarization. The QT dispersion is increased in myocardial ischemia and infarction, and levels are higher in patients with ventricular arrhythmias. This study was performed to assess QT dispersion in patients with acute myocardial infarction treated with thrombolytic therapy with successful reperfusion versus those who treated with thrombolytic therapy with failed reperfusion and those who treated with conventional therapy and to correlate between QT dispersion and the complicating serious ventricular arrhythmias following acute myocardial infarction. And it is also performed to assess the influence of age, sex, obesity, smoking, diabetes mellitus, hypertension and site of infarction on QT dispersion. The study included 100 patients with recent acute myocardial infarction and they are classified to 3 groups:Group 1: 30 patients who received streptokinase with successful reperfusion.Group 2: 30 patients who received streptokinase with failed reperfusion.Group 3: 40 patients who did not receive streptokinase (control group).Every patient was subjected to full history taking and thorough clinical examination. Analysis of serum electrolytes (Na, K and ca) was done and cases showing abnormal results were excluded. Serum CPK was checked on admission, after 6 hours, after 12 hours and after 24 hours after onset of thrombolytic therapy. ECG was done for every patient on admission, two hours post thrombolytic therapy and predischarge in groups I and 2. In group 3, ECG was done on admission and predischarge.The study concluded that:1- There is a statistically significant reduction in QT dispersion in patients who received thrombolytic therapy with successful reperfusion versus those who received thrombolytic therapy with failed reperfusion and those who did not receive thrombolytic therapy.2- There is a reduction in the incidence of ventricular arrhythmias in patients with successful reperfusion therapy associated with the reduction in the QT dispersion. So, reduction of QT dispersion may be a mechanism of benefit of thrombolytic therapy.3- QT dispersion is increased after myocardial infarction and levels are higher in patients with ventricular arrhythmias.4- QT dispersion is influenced by hypertension, diabetes mellitus, age and site of infarction ,as it is increased in patients with hypertension, diabetes mellitus, age less than 50 years and with anterior than inferior infarction.The study recommended the following:1- Whenever not contraindicated, thrombolytic therapy should be administered as early as possible in cases with AMI.2- QT dispersion can predict the potential for ventricular arrhythmias in patients with AMI.3- Future studies are needed to confirm the value of QT dispersion in risk stratification after AMI.SUMMARYThere is growing interest in QT dispersion as a marker for arrhythmia potential being a marker of inhomogenicity of ventricular repolarization. The QT dispersion is increased in myocardial ischemia and infarction, and levels are higher in patients with ventricular arrhythmias. This study was performed to assess QT dispersion in patients with acute myocardial infarction treated with thrombolytic therapy with successful reperfusion versus those who treated with thrombolytic therapy with failed reperfusion and those who treated with conventional therapy and to correlate between QT dispersion and the complicating serious ventricular arrhythmias following acute myocardial infarction. And it is also performed to assess the influence of age, sex, obesity, smoking, diabetes mellitus, hypertension and site of infarction on QT dispersion. The study included 100 patients with recent acute myocardial infarction and they are classified to 3 groups:Group 1: 30 patients who received streptokinase with successful reperfusion.Group 2: 30 patients who received streptokinase with failed reperfusion.Group 3: 40 patients who did not receive streptokinase (control group).Every patient was subjected to full history taking and thorough clinical examination. Analysis of serum electrolytes (Na, K and ca) was done and cases showing abnormal results were excluded. Serum CPK was checked on admission, after 6 hours, after 12 hours and after 24 hours after onset of thrombolytic therapy. ECG was done for every patient on admission, two hours post thrombolytic therapy and predischarge in groups I and 2. In group 3, ECG was done on admission and predischarge.The study concluded that:1- There is a statistically significant reduction in QT dispersion in patients who received thrombolytic therapy with successful reperfusion versus those who received thrombolytic therapy with failed reperfusion and those who did not receive thrombolytic therapy.2- There is a reduction in the incidence of ventricular arrhythmias in patients with successful reperfusion therapy associated with the reduction in the QT dispersion. So, reduction of QT dispersion may be a mechanism of benefit of thrombolytic therapy.3- QT dispersion is increased after myocardial infarction and levels are higher in patients with ventricular arrhythmias.4- QT dispersion is influenced by hypertension, diabetes mellitus, age and site of infarction ,as it is increased in patients with hypertension, diabetes mellitus, age less than 50 years and with anterior than inferior infarction.The study recommended the following:1- Whenever not contraindicated, thrombolytic therapy should be administered as early as possible in cases with AMI.2- QT dispersion can predict the potential for ventricular arrhythmias in patients with AMI.3- Future studies are needed to confirm the value of QT dispersion in risk stratification after AMI.SUMMARYThere is growing interest in QT dispersion as a marker for arrhythmia potential being a marker of inhomogenicity of ventricular repolarization. The QT dispersion is increased in myocardial ischemia and infarction, and levels are higher in patients with ventricular arrhythmias. This study was performed to assess QT dispersion in patients with acute myocardial infarction treated with thrombolytic therapy with successful reperfusion versus those who treated with thrombolytic therapy with failed reperfusion and those who treated with conventional therapy and to correlate between QT dispersion and the complicating serious ventricular arrhythmias following acute myocardial infarction. And it is also performed to assess the influence of age, sex, obesity, smoking, diabetes mellitus, hypertension and site of infarction on QT dispersion. The study included 100 patients with recent acute myocardial infarction and they are classified to 3 groups:Group 1: 30 patients who received streptokinase with successful reperfusion.Group 2: 30 patients who received streptokinase with failed reperfusion.Group 3: 40 patients who did not receive streptokinase (control group).Every patient was subjected to full history taking and thorough clinical examination. Analysis of serum electrolytes (Na, K and ca) was done and cases showing abnormal results were excluded. Serum CPK was checked on admission, after 6 hours, after 12 hours and after 24 hours after onset of thrombolytic therapy. ECG was done for every patient on admission, two hours post thrombolytic therapy and predischarge in groups I and 2. In group 3, ECG was done on admission and predischarge.The study concluded that:1- There is a statistically significant reduction in QT dispersion in patients who received thrombolytic therapy with successful reperfusion versus those who received thrombolytic therapy with failed reperfusion and those who did not receive thrombolytic therapy.2- There is a reduction in the incidence of ventricular arrhythmias in patients with successful reperfusion therapy associated with the reduction in the QT dispersion. So, reduction of QT dispersion may be a mechanism of benefit of thrombolytic therapy.3- QT dispersion is increased after myocardial infarction and levels are higher in patients with ventricular arrhythmias.4- QT dispersion is influenced by hypertension, diabetes mellitus, age and site of infarction ,as it is increased in patients with hypertension, diabetes mellitus, age less than 50 years and with anterior than inferior infarction.The study recommended the following:1- Whenever not contraindicated, thrombolytic therapy should be administered as early as possible in cases with AMI.2- QT dispersion can predict the potential for ventricular arrhythmias in patients with AMI.3- Future studies are needed to confirm the value of QT dispersion in risk stratification after AMI.SUMMARYThere is growing interest in QT dispersion as a marker for arrhythmia potential being a marker of inhomogenicity of ventricular repolarization. The QT dispersion is increased in myocardial ischemia and infarction, and levels are higher in patients with ventricular arrhythmias. This study was performed to assess QT dispersion in patients with acute myocardial infarction treated with thrombolytic therapy with successful reperfusion versus those who treated with thrombolytic therapy with failed reperfusion and those who treated with conventional therapy and to correlate between QT dispersion and the complicating serious ventricular arrhythmias following acute myocardial infarction. And it is also performed to assess the influence of age, sex, obesity, smoking, diabetes mellitus, hypertension and site of infarction on QT dispersion. The study included 100 patients with recent acute myocardial infarction and they are classified to 3 groups:Group 1: 30 patients who received streptokinase with successful reperfusion.Group 2: 30 patients who received streptokinase with failed reperfusion.Group 3: 40 patients who did not receive streptokinase (control group).Every patient was subjected to full history taking and thorough clinical examination. Analysis of serum electrolytes (Na, K and ca) was done and cases showing abnormal results were excluded. Serum CPK was checked on admission, after 6 hours, after 12 hours and after 24 hours after onset of thrombolytic therapy. ECG was done for every patient on admission, two hours post thrombolytic therapy and predischarge in groups I and 2. In group 3, ECG was done on admission and predischarge.The study concluded that:1- There is a statistically significant reduction in QT dispersion in patients who received thrombolytic therapy with successful reperfusion versus those who received thrombolytic therapy with failed reperfusion and those who did not receive thrombolytic therapy.2- There is a reduction in the incidence of ventricular arrhythmias in patients with successful reperfusion therapy associated with the reduction in the QT dispersion. So, reduction of QT dispersion may be a mechanism of benefit of thrombolytic therapy.3- QT dispersion is increased after myocardial infarction and levels are higher in patients with ventricular arrhythmias.4- QT dispersion is influenced by hypertension, diabetes mellitus, age and site of infarction ,as it is increased in patients with hypertension, diabetes mellitus, age less than 50 years and with anterior than inferior infarction.The study recommended the following:1- Whenever not contraindicated, thrombolytic therapy should be administered as early as possible in cases with AMI.2- QT dispersion can predict the potential for ventricular arrhythmias in patients with AMI.3- Future studies are needed to confirm the value of QT dispersion in risk stratification after AMI.SUMMARYThere is growing interest in QT dispersion as a marker for arrhythmia potential being a marker of inhomogenicity of ventricular repolarization. The QT dispersion is increased in myocardial ischemia and infarction, and levels are higher in patients with ventricular arrhythmias. This study was performed to assess QT dispersion in patients with acute myocardial infarction treated with thrombolytic therapy with successful reperfusion versus those who treated with thrombolytic therapy with failed reperfusion and those who treated with conventional therapy and to correlate between QT dispersion and the complicating serious ventricular arrhythmias following acute myocardial infarction. And it is also performed to assess the influence of age, sex, obesity, smoking, diabetes mellitus, hypertension and site of infarction on QT dispersion. The study included 100 patients with recent acute myocardial infarction and they are classified to 3 groups:Group 1: 30 patients who received streptokinase with successful reperfusion.Group 2: 30 patients who received streptokinase with failed reperfusion.Group 3: 40 patients who did not receive streptokinase (control group).Every patient was subjected to full history taking and thorough clinical examination. Analysis of serum electrolytes (Na, K and ca) was done and cases showing abnormal results were excluded. Serum CPK was checked on admission, after 6 hours, after 12 hours and after 24 hours after onset of thrombolytic therapy. ECG was done for every patient on admission, two hours post thrombolytic therapy and predischarge in groups I and 2. In group 3, ECG was done on admission and predischarge.The study concluded that:1- There is a statistically significant reduction in QT dispersion in patients who received thrombolytic therapy with successful reperfusion versus those who received thrombolytic therapy with failed reperfusion and those who did not receive thrombolytic therapy.2- There is a reduction in the incidence of ventricular arrhythmias in patients with successful reperfusion therapy associated with the reduction in the QT dispersion. So, reduction of QT dispersion may be a mechanism of benefit of thrombolytic therapy.3- QT dispersion is increased after myocardial infarction and levels are higher in patients with ventricular arrhythmias.4- QT dispersion is influenced by hypertension, diabetes mellitus, age and site of infarction ,as it is increased in patients with hypertension, diabetes mellitus, age less than 50 years and with anterior than inferior infarction.The study recommended the following:1- Whenever not contraindicated, thrombolytic therapy should be administered as early as possible in cases with AMI.2- QT dispersion can predict the potential for ventricular arrhythmias in patients with AMI.3- Future studies are needed to confirm the value of QT dispersion in risk stratification after AMI.SUMMARYThere is growing interest in QT dispersion as a marker for arrhythmia potential being a marker of inhomogenicity of ventricular repolarization. The QT dispersion is increased in myocardial ischemia and infarction, and levels are higher in patients with ventricular arrhythmias. This study was performed to assess QT dispersion in patients with acute myocardial infarction treated with thrombolytic therapy with successful reperfusion versus those who treated with thrombolytic therapy with failed reperfusion and those who treated with conventional therapy and to correlate between QT dispersion and the complicating serious ventricular arrhythmias following acute myocardial infarction. And it is also performed to assess the influence of age, sex, obesity, smoking, diabetes mellitus, hypertension and site of infarction on QT dispersion. The study included 100 patients with recent acute myocardial infarction and they are classified to 3 groups:Group 1: 30 patients who received streptokinase with successful reperfusion.Group 2: 30 patients who received streptokinase with failed reperfusion.Group 3: 40 patients who did not receive streptokinase (control group).Every patient was subjected to full history taking and thorough clinical examination. Analysis of serum electrolytes (Na, K and ca) was done and cases showing abnormal results were excluded. Serum CPK was checked on admission, after 6 hours, after 12 hours and after 24 hours after onset of thrombolytic therapy. ECG was done for every patient on admission, two hours post thrombolytic therapy and predischarge in groups I and 2. In group 3, ECG was done on admission and predischarge.The study concluded that:1- There is a statistically significant reduction in QT dispersion in patients who received thrombolytic therapy with successful reperfusion versus those who received thrombolytic therapy with failed reperfusion and those who did not receive thrombolytic therapy.2- There is a reduction in the incidence of ventricular arrhythmias in patients with successful reperfusion therapy associated with the reduction in the QT dispersion. So, reduction of QT dispersion may be a mechanism of benefit of thrombolytic therapy.3- QT dispersion is increased after myocardial infarction and levels are higher in patients with ventricular arrhythmias.4- QT dispersion is influenced by hypertension, diabetes mellitus, age and site of infarction ,as it is increased in patients with hypertension, diabetes mellitus, age less than 50 years and with anterior than inferior infarction.The study recommended the following:1- Whenever not contraindicated, thrombolytic therapy should be administered as early as possible in cases with AMI.2- QT dispersion can predict the potential for ventricular arrhythmias in patients with AMI.3- Future studies are needed to confirm the value of QT dispersion in risk stratification after AMI.SUMMARYThere is growing interest in QT dispersion as a marker for arrhythmia potential being a marker of inhomogenicity of ventricular repolarization. The QT dispersion is increased in myocardial ischemia and infarction, and levels are higher in patients with ventricular arrhythmias. This study was performed to assess QT dispersion in patients with acute myocardial infarction treated with thrombolytic therapy with successful reperfusion versus those who treated with thrombolytic therapy with failed reperfusion and those who treated with conventional therapy and to correlate between QT dispersion and the complicating serious ventricular arrhythmias following acute myocardial infarction. And it is also performed to assess the influence of age, sex, obesity, smoking, diabetes mellitus, hypertension and site of infarction on QT dispersion. The study included 100 patients with recent acute myocardial infarction and they are classified to 3 groups:Group 1: 30 patients who received streptokinase with successful reperfusion.Group 2: 30 patients who received streptokinase with failed reperfusion.Group 3: 40 patients who did not receive streptokinase (control group).Every patient was subjected to full history taking and thorough clinical examination. Analysis of serum electrolytes (Na, K and ca) was done and cases showing abnormal results were excluded. Serum CPK was checked on admission, after 6 hours, after 12 hours and after 24 hours after onset of thrombolytic therapy. ECG was done for every patient on admission, two hours post thrombolytic therapy and predischarge in groups I and 2. In group 3, ECG was done on admission and predischarge.The study concluded that:1- There is a statistically significant reduction in QT dispersion in patients who received thrombolytic therapy with successful reperfusion versus those who received thrombolytic therapy with failed reperfusion and those who did not receive thrombolytic therapy.2- There is a reduction in the incidence of ventricular arrhythmias in patients with successful reperfusion therapy associated with the reduction in the QT dispersion. So, reduction of QT dispersion may be a mechanism of benefit of thrombolytic therapy.3- QT dispersion is increased after myocardial infarction and levels are higher in patients with ventricular arrhythmias.4- QT dispersion is influenced by hypertension, diabetes mellitus, age and site of infarction ,as it is increased in patients with hypertension, diabetes mellitus, age less than 50 years and with anterior than inferior infarction.The study recommended the following:1- Whenever not contraindicated, thrombolytic therapy should be administered as early as possible in cases with AMI.2- QT dispersion can predict the potential for ventricular arrhythmias in patients with AMI.3- Future studies are needed to confirm the value of QT dispersion in risk stratification after AMI.SUMMARYThere is growing interest in QT dispersion as a marker for arrhythmia potential being a marker of inhomogenicity of ventricular repolarization. The QT dispersion is increased in myocardial ischemia and infarction, and levels are higher in patients with ventricular arrhythmias. This study was performed to assess QT dispersion in patients with acute myocardial infarction treated with thrombolytic therapy with successful reperfusion versus those who treated with thrombolytic therapy with failed reperfusion and those who treated with conventional therapy and to correlate between QT dispersion and the complicating serious ventricular arrhythmias following acute myocardial infarction. And it is also performed to assess the influence of age, sex, obesity, smoking, diabetes mellitus, hypertension and site of infarction on QT dispersion. The study included 100 patients with recent acute myocardial infarction and they are classified to 3 groups:Group 1: 30 patients who received streptokinase with successful reperfusion.Group 2: 30 patients who received streptokinase with failed reperfusion.Group 3: 40 patients who did not receive streptokinase (control group).Every patient was subjected to full history taking and thorough clinical examination. Analysis of serum electrolytes (Na, K and ca) was done and cases showing abnormal results were excluded. Serum CPK was checked on admission, after 6 hours, after 12 hours and after 24 hours after onset of thrombolytic therapy. ECG was done for every patient on admission, two hours post thrombolytic therapy and predischarge in groups I and 2. In group 3, ECG was done on admission and predischarge.The study concluded that:1- There is a statistically significant reduction in QT dispersion in patients who received thrombolytic therapy with successful reperfusion versus those who received thrombolytic therapy with failed reperfusion and those who did not receive thrombolytic therapy.2- There is a reduction in the incidence of ventricular arrhythmias in patients with successful reperfusion therapy associated with the reduction in the QT dispersion. So, reduction of QT dispersion may be a mechanism of benefit of thrombolytic therapy.3- QT dispersion is increased after myocardial infarction and levels are higher in patients with ventricular arrhythmias.4- QT dispersion is influenced by hypertension, diabetes mellitus, age and site of infarction ,as it is increased in patients with hypertension, diabetes mellitus, age less than 50 years and with anterior than inferior infarction.The study recommended the following:1- Whenever not contraindicated, thrombolytic therapy should be administered as early as possible in cases with AMI.2- QT dispersion can predict the potential for ventricular arrhythmias in patients with AMI.3- Future studies are needed to confirm the value of QT dispersion in risk stratification after AMI.SUMMARYThere is growing interest in QT dispersion as a marker for arrhythmia potential being a marker of inhomogenicity of ventricular repolarization. The QT dispersion is increased in myocardial ischemia and infarction, and levels are higher in patients with ventricular arrhythmias. This study was performed to assess QT dispersion in patients with acute myocardial infarction treated with thrombolytic therapy with successful reperfusion versus those who treated with thrombolytic therapy with failed reperfusion and those who treated with conventional therapy and to correlate between QT dispersion and the complicating serious ventricular arrhythmias following acute myocardial infarction. And it is also performed to assess the influence of age, sex, obesity, smoking, diabetes mellitus, hypertension and site of infarction on QT dispersion. The study included 100 patients with recent acute myocardial infarction and they are classified to 3 groups:Group 1: 30 patients who received streptokinase with successful reperfusion.Group 2: 30 patients who received streptokinase with failed reperfusion.Group 3: 40 patients who did not receive streptokinase (control group).Every patient was subjected to full history taking and thorough clinical examination. Analysis of serum electrolytes (Na, K and ca) was done and cases showing abnormal results were excluded. Serum CPK was checked on admission, after 6 hours, after 12 hours and after 24 hours after onset of thrombolytic therapy. ECG was done for every patient on admission, two hours post thrombolytic therapy and predischarge in groups I and 2. In group 3, ECG was done on admission and predischarge.The study concluded that:1- There is a statistically significant reduction in QT dispersion in patients who received thrombolytic therapy with successful reperfusion versus those who received thrombolytic therapy with failed reperfusion and those who did not receive thrombolytic therapy.2- There is a reduction in the incidence of ventricular arrhythmias in patients with successful reperfusion therapy associated with the reduction in the QT dispersion. So, reduction of QT dispersion may be a mechanism of benefit of thrombolytic therapy.3- QT dispersion is increased after myocardial infarction and levels are higher in patients with ventricular arrhythmias.4- QT dispersion is influenced by hypertension, diabetes mellitus, age and site of infarction ,as it is increased in patients with hypertension, diabetes mellitus, age less than 50 years and with anterior than inferior infarction.The study recommended the following:1- Whenever not contraindicated, thrombolytic therapy should be administered as early as possible in cases with AMI.2- QT dispersion can predict the potential for ventricular arrhythmias in patients with AMI.3- Future studies are needed to confirm the value of QT dispersion in risk stratification after AMI.SUMMARYThere is growing interest in QT dispersion as a marker for arrhythmia potential being a marker of inhomogenicity of ventricular repolarization. The QT dispersion is increased in myocardial ischemia and infarction, and levels are higher in patients with ventricular arrhythmias. This study was performed to assess QT dispersion in patients with acute myocardial infarction treated with thrombolytic therapy with successful reperfusion versus those who treated with thrombolytic therapy with failed reperfusion and those who treated with conventional therapy and to correlate between QT dispersion and the complicating serious ventricular arrhythmias following acute myocardial infarction. And it is also performed to assess the influence of age, sex, obesity, smoking, diabetes mellitus, hypertension and site of infarction on QT dispersion. The study included 100 patients with recent acute myocardial infarction and they are classified to 3 groups:Group 1: 30 patients who received streptokinase with successful reperfusion.Group 2: 30 patients who received streptokinase with failed reperfusion.Group 3: 40 patients who did not receive streptokinase (control group).Every patient was subjected to full history taking and thorough clinical examination. Analysis of serum electrolytes (Na, K and ca) was done and cases showing abnormal results were excluded. Serum CPK was checked on admission, after 6 hours, after 12 hours and after 24 hours after onset of thrombolytic therapy. ECG was done for every patient on admission, two hours post thrombolytic therapy and predischarge in groups I and 2. In group 3, ECG was done on admission and predischarge.The study concluded that:1- There is a statistically significant reduction in QT dispersion in patients who received thrombolytic therapy with successful reperfusion versus those who received thrombolytic therapy with failed reperfusion and those who did not receive thrombolytic therapy.2- There is a reduction in the incidence of ventricular arrhythmias in patients with successful reperfusion therapy associated with the reduction in the QT dispersion. So, reduction of QT dispersion may be a mechanism of benefit of thrombolytic therapy.3- QT dispersion is increased after myocardial infarction and levels are higher in patients with ventricular arrhythmias.4- QT dispersion is influenced by hypertension, diabetes mellitus, age and site of infarction ,as it is increased in patients with hypertension, diabetes mellitus, age less than 50 years and with anterior than inferior infarction.The study recommended the following:1- Whenever not contraindicated, thrombolytic therapy should be administered as early as possible in cases with AMI.2- QT dispersion can predict the potential for ventricular arrhythmias in patients with AMI.3- Future studies are needed to confirm the value of QT dispersion in risk stratification after AMI.SUMMARYThere is growing interest in QT dispersion as a marker for arrhythmia potential being a marker of inhomogenicity of ventricular repolarization. The QT dispersion is increased in myocardial ischemia and infarction, and levels are higher in patients with ventricular arrhythmias. This study was performed to assess QT dispersion in patients with acute myocardial infarction treated with thrombolytic therapy with successful reperfusion versus those who treated with thrombolytic therapy with failed reperfusion and those who treated with conventional therapy and to correlate between QT dispersion and the complicating serious ventricular arrhythmias following acute myocardial infarction. And it is also performed to assess the influence of age, sex, obesity, smoking, diabetes mellitus, hypertension and site of infarction on QT dispersion. The study included 100 patients with recent acute myocardial infarction and they are classified to 3 groups:Group 1: 30 patients who received streptokinase with successful reperfusion.Group 2: 30 patients who received streptokinase with failed reperfusion.Group 3: 40 patients who did not receive streptokinase (control group).Every patient was subjected to full history taking and thorough clinical examination. Analysis of serum electrolytes (Na, K and ca) was done and cases showing abnormal results were excluded. Serum CPK was checked on admission, after 6 hours, after 12 hours and after 24 hours after onset of thrombolytic therapy. ECG was done for every patient on admission, two hours post thrombolytic therapy and predischarge in groups I and 2. In group 3, ECG was done on admission and predischarge.The study concluded that:1- There is a statistically significant reduction in QT dispersion in patients who received thrombolytic therapy with successful reperfusion versus those who received thrombolytic therapy with failed reperfusion and those who did not receive thrombolytic therapy.2- There is a reduction in the incidence of ventricular arrhythmias in patients with successful reperfusion therapy associated with the reduction in the QT dispersion. So, reduction of QT dispersion may be a mechanism of benefit of thrombolytic therapy.3- QT dispersion is increased after myocardial infarction and levels are higher in patients with ventricular arrhythmias.4- QT dispersion is influenced by hypertension, diabetes mellitus, age and site of infarction ,as it is increased in patients with hypertension, diabetes mellitus, age less than 50 years and with anterior than inferior infarction.The study recommended the following:1- Whenever not contraindicated, thrombolytic therapy should be administered as early as possible in cases with AMI.2- QT dispersion can predict the potential for ventricular arrhythmias in patients with AMI.3- Future studies are needed to confirm the value of QT dispersion in risk stratification after AMI.SUMMARYThere is growing interest in QT dispersion as a marker for arrhythmia potential being a marker of inhomogenicity of ventricular repolarization. The QT dispersion is increased in myocardial ischemia and infarction, and levels are higher in patients with ventricular arrhythmias. This study was performed to assess QT dispersion in patients with acute myocardial infarction treated with thrombolytic therapy with successful reperfusion versus those who treated with thrombolytic therapy with failed reperfusion and those who treated with conventional therapy and to correlate between QT dispersion and the complicating serious ventricular arrhythmias following acute myocardial infarction. And it is also performed to assess the influence of age, sex, obesity, smoking, diabetes mellitus, hypertension and site of infarction on QT dispersion. The study included 100 patients with recent acute myocardial infarction and they are classified to 3 groups:Group 1: 30 patients who received streptokinase with successful reperfusion.Group 2: 30 patients who received streptokinase with failed reperfusion.Group 3: 40 patients who did not receive streptokinase (control group).Every patient was subjected to full history taking and thorough clinical examination. Analysis of serum electrolytes (Na, K and ca) was done and cases showing abnormal results were excluded. Serum CPK was checked on admission, after 6 hours, after 12 hours and after 24 hours after onset of thrombolytic therapy. ECG was done for every patient on admission, two hours post thrombolytic therapy and predischarge in groups I and 2. In group 3, ECG was done on admission and predischarge.The study concluded that:1- There is a statistically significant reduction in QT dispersion in patients who received thrombolytic therapy with successful reperfusion versus those who received thrombolytic therapy with failed reperfusion and those who did not receive thrombolytic therapy.2- There is a reduction in the incidence of ventricular arrhythmias in patients with successful reperfusion therapy associated with the reduction in the QT dispersion. So, reduction of QT dispersion may be a mechanism of benefit of thrombolytic therapy.3- QT dispersion is increased after myocardial infarction and levels are higher in patients with ventricular arrhythmias.4- QT dispersion is influenced by hypertension, diabetes mellitus, age and site of infarction ,as it is increased in patients with hypertension, diabetes mellitus, age less than 50 years and with anterior than inferior infarction.The study recommended the following:1- Whenever not contraindicated, thrombolytic therapy should be administered as early as possible in cases with AMI.2- QT dispersion can predict the potential for ventricular arrhythmias in patients with AMI.3- Future studies are needed to confirm the value of QT dispersion in risk stratification after AMI.
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