Immediate and one-year outcome of patients presenting with Acute Coronary Syndrome complicated by stroke: Findings from the 2nd Gulf Registry of Acute Coronary Events (Gulf RACE-2)

ABSTRACT: BACKGROUND: Stroke is a potential complication of acute coronary syndrome (ACS). The aim of this study was to identify the prevalence, risk factors predisposing to stroke, in-hospital and 1-year mortality among patients presenting with ACS in the Middle East. METHODS: For a period of 9 months in 2008 to 2009, 7,930 consecutive ACS patients were enrolled from 65 hospitals in 6 Middle East countries. RESULTS: The prevalence of in-hospital stroke following ACS was 0.70%. Most cases were ST segment elevation MI-related (STEMI) and ischemic stroke in nature. Patients with in-hospital stroke were 5 years older than patients without stroke and were more likely to have hypertension (66% vs. 47.6%, P = 0.001). There were no differences between the two groups in regards to gender, other cardiovascular risk factors, or prior cardiovascular disease. Patients with stroke were more likely to present with atypical symptoms, advanced Killip class and less likely to be treated with evidence-based therapies. Independent predictors of stroke were hypertension, advanced killip class, ACS type --STEMI and cardiogenic shock. Stroke was associated with increased risk of in-hospital (39.3% vs. 4.3%) and one-year mortality (52% vs. 12.3%). CONCLUSION: There is low incidence of in-hospital stroke in Middle-Eastern patients presenting with ACS but with very high in-hospital and one-year mortality rates. Stroke patients were less likely to be appropriately treated with evidence-based therapy. Future work should be focused on reducing the risk and improving the outcome of this devastating complication.     

Organic Selenium,Probiotics, and Prebiotics Effects on Growth,Blood Biochemistry,and Carcass Traits of Growing Rabbits During Summer and Winter Seasons

Lead (Pb) is a ubiquitous and toxic heavy metal and it can damage the immune system in humans and animals. Many researchers have reported that Selenium (Se) could possess various pharmacological effects in mammals. However, few studies have been carried out to investigate the protective role of Se in birds, especially in chickens. In this study, we investigated the protective effects of Se against Pb-induced inflammatory responses and the expression of heat shock proteins (HSPs) in peripheral blood neutrophils. One hundred eighty Hy-Line brown chickens were randomly divided into the control group (Con group), Se supplementation group (+Se group), Pb supplementation group (+Pb group), and the Se and Pb compound group (Se+Pb group). On the 90th day of the experiment, the peripheral blood was collected to extract neutrophils, and then, the levels of HSPs and cytokines were examined. The results showed that, after Pb treatment, the levels of IL-(1β, 1R, 4, 8, 10, and 12β), TGF-β4, and HSP (27, 40, 60, 70, and 90) mRNA were significantly increased and levels of IL-2 and IFN-γ mRNA were decreased compared with those in the control group. Compared with the control group, the protein levels of HSP60 and HSP70 were also increased in the Pb treatment group. Co-administration of Se (1 mg/kg/day) and Pb resulted in a reversal of the Pb-induced cytokine changes in neutrophils accompanied by a significant decrease in HSPs. Our study demonstrated that Pb could decrease the immune function via changing the expression of cytokines and HSPs in chicken neutrophils, but Se could relieve the toxic effect induced by Pb.     

Natural plant species inventory of hotspot areas in Arabian Peninsula: Southwest Al-Baha region,Saudi Arabia

Plant hotspot areas are the areas that are very rich in plant species diversity. These areas have a priority for conservation. To highlight the plant diversity for nature conservation purposes a case study in Al Baha region, Saudi Arabia is presented, in which the importance of the natural vegetation and flora of one of the hotspot areas of Saudi Arabia is evaluated through the explanation of its natural plant species. A survey study has been conducted in an area of 167.6 km2, a 97 sample each with 20X20 m were laid out covering the whole ecological zones of the study site. Data of flora, vegetation cover and topography were gathered from each sample site. The study revealed about 319 plant species belonging to 228 genera and 75 families. Two species were found endemic to Saudi Arabia, 14 were endemics to Arabian Peninsula, and five were regional endemics that are only found in East Africa and Arabian Peninsula, while 39 species are rare and endangered.     

On the Estimation of the Distribution Function Using Extreme and Median Ranked Set Sampling

We study relationships between extreme ranked set samples (ERSSs) and median ranked set sample (MRSS) with simple random sample (SRS). For a random variable X, we show that the distribution function estimator when using ERSSs and MRSS are more efficient than when using SRS and ranked set sampling for some values of a given x. It is shown that using ERSSs can reduce the necessary sample size by a factor of 1.33 to 4 when estimating the median of the distribution. Asymptotic results for the estimation of the distribution function is given for the center of the distribution function. Data on the bilirubin level of babies in neonatal intensive care is used to illustrate the method.