There is a lack of awareness among physicians of the considerable disability caused by non-motor symptoms (NMS) in PD. The aim of this work is to estimate the prevalence of NMS in a series of patients with Parkinson's disease (PD). MATERIALS AND METHODS: We studied 112 patients with Parkinson's disease. Motor symptoms were scored on the Unified Parkinson's Disease Rating Scale (UPDRS) part III and the Hoehn and Yahr (HY) Scale. Other symptoms were quantified with the Non-Motor Symptom Questionnaire and Scale (NMSQuest and NMSS) as well as Minimental State Examination (MNSE). RESULTS: Analysis of the data from the NMSS showed that mood/cognition was the most commonly affected domain (prevalence rate=87.5%), followed by sleep disturbance/fatigue second (78.6%). However, all other non-motor symptoms scored highly: gastrointestinal and urinary (76.8% for both), sexual dysfunction (73%), cardiovascular (70.5%) with significantly higher percentage in predominantly akinetic/rigid patients. Perceptual problems/hallucinations (9.9%) were infrequent in this population. Dementia was recorded in 22.3% of patients, most of them having a mild degree of dementia. UPDRS scores were correlated with total scores in both NMSQuest and NMSS. CONCLUSIONS: Mood/cognition, sleep disorders, GIT, and sexual disorders were common non motor manifestations in this population of PD patients.

There is a lack of awareness among physicians of the considerable disability caused by non-motor symptoms (NMS) in PD. The aim of this work is to estimate the prevalence of NMS in a series of patients with Parkinson's disease (PD). MATERIALS AND METHODS: We studied 112 patients with Parkinson's disease. Motor symptoms were scored on the Unified Parkinson's Disease Rating Scale (UPDRS) part III and the Hoehn and Yahr (HY) Scale. Other symptoms were quantified with the Non-Motor Symptom Questionnaire and Scale (NMSQuest and NMSS) as well as Minimental State Examination (MNSE). RESULTS: Analysis of the data from the NMSS showed that mood/cognition was the most commonly affected domain (prevalence rate=87.5%), followed by sleep disturbance/fatigue second (78.6%). However, all other non-motor symptoms scored highly: gastrointestinal and urinary (76.8% for both), sexual dysfunction (73%), cardiovascular (70.5%) with significantly higher percentage in predominantly akinetic/rigid patients. Perceptual problems/hallucinations (9.9%) were infrequent in this population. Dementia was recorded in 22.3% of patients, most of them having a mild degree of dementia. UPDRS scores were correlated with total scores in both NMSQuest and NMSS. CONCLUSIONS: Mood/cognition, sleep disorders, GIT, and sexual disorders were common non motor manifestations in this population of PD patients.

There is a lack of awareness among physicians of the considerable disability caused by non-motor symptoms (NMS) in PD. The aim of this work is to estimate the prevalence of NMS in a series of patients with Parkinson's disease (PD). MATERIALS AND METHODS: We studied 112 patients with Parkinson's disease. Motor symptoms were scored on the Unified Parkinson's Disease Rating Scale (UPDRS) part III and the Hoehn and Yahr (HY) Scale. Other symptoms were quantified with the Non-Motor Symptom Questionnaire and Scale (NMSQuest and NMSS) as well as Minimental State Examination (MNSE). RESULTS: Analysis of the data from the NMSS showed that mood/cognition was the most commonly affected domain (prevalence rate=87.5%), followed by sleep disturbance/fatigue second (78.6%). However, all other non-motor symptoms scored highly: gastrointestinal and urinary (76.8% for both), sexual dysfunction (73%), cardiovascular (70.5%) with significantly higher percentage in predominantly akinetic/rigid patients. Perceptual problems/hallucinations (9.9%) were infrequent in this population. Dementia was recorded in 22.3% of patients, most of them having a mild degree of dementia. UPDRS scores were correlated with total scores in both NMSQuest and NMSS. CONCLUSIONS: Mood/cognition, sleep disorders, GIT, and sexual disorders were common non motor manifestations in this population of PD patients.

Objective: to test the value of treatment of gasteroesophageal reflux disease (GERD) in improving the obstructive sleep apnea syndrome (OSAS). Patients and methods: The study included 63 patients diagnosed with OSAS after complete history taking, Epworth sleepiness scale (ESS), physical examination, and full night polysomnography. Of them 29 patients were diagnosed with concomitant GERD by standardized Reflux Disease Questionnaire (RDQ), upper endoscopy, and 24-hour pH monitoring and received Pantoprazole 40 mg once daily for 2 months. The patients were reevaluated by polysomnography, ESS, quality of life SF36 v2 questionnaire. Results: The twenty- nine patients with OSAS and GERD had significantly higher body mass index (BMI), waist circumference, and reported non significant increase in sleep and daytime symptoms of OSAS. After 2 months treatment with Pantoprazole, there was significant decrease in apnea hypopnea index (AHI), snoring events, arousal index, and ESS. Meanwhile, there was a significant improvement in sleep efficiency, minimum O2 saturation, desaturation index and quality of life parameters (SF 36 v2). Conclusions: GERD and OSAS are common co morbid conditions. Adequate treatment of GERD with Pantoprazole, 40 mg/day for 2 months was effective in improving many subjective and objective findings of OSAS. In patients with OSAS and history suggestive of GERD, upper endoscopy, pH monitoring and treatment with proton pump inhibitors (PPIs) may be an important adjunct in controlling OSAS symptoms.

To date, no single agent has gained a sufficient prognostic significance for NSCLC patients. So, there is an urgent need for new innovative biomarkers in NSCLC. The present study was designed to: 1) Evaluate the role of Nitric Oxide (NO), Sialic Acid (SA) and Glutathione S-Transferase (GST) as prognostic indicators in NSCLC.2) Correlate the above parameters levels with the clinicopathological status of the patients. The study included 30 patients with newly diagnosed histopathologically confirmed NSCLC, as well as 10 healthy volunteers with matched age and sex as controls. Blood samples and lung tissue biopsies were taken from all subjects on admission. Results: Serum and tissue levels of NO, SA and GST activities were significantly higher in NSCLC patients compared to controls. These levels decreased significantly after chemotherapy. The serum and tissue levels of the studied parameters decreased significantly in the responders compared to resistant cases. In conclusion, NO, SA, besides GST correlated significantly with the clinicopathological status of NSCLC patients and are considered sensitive prognostic biochemical indices.

Objective: to test the value of treatment of gasteroesophageal reflux disease (GERD) in improving the obstructive sleep apnea syndrome (OSAS). Patients and methods: The study included 63 patients diagnosed with OSAS after complete history taking, Epworth sleepiness scale (ESS), physical examination, and full night polysomnography. Of them 29 patients were diagnosed with concomitant GERD by standardized Reflux Disease Questionnaire (RDQ), upper endoscopy, and 24-hour pH monitoring and received Pantoprazole 40 mg once daily for 2 months. The patients were reevaluated by polysomnography, ESS, quality of life SF36 v2 questionnaire. Results: The twenty- nine patients with OSAS and GERD had significantly higher body mass index (BMI), waist circumference, and reported non significant increase in sleep and daytime symptoms of OSAS. After 2 months treatment with Pantoprazole, there was significant decrease in apnea hypopnea index (AHI), snoring events, arousal index, and ESS. Meanwhile, there was a significant improvement in sleep efficiency, minimum O2 saturation, desaturation index and quality of life parameters (SF 36 v2). Conclusions: GERD and OSAS are common co morbid conditions. Adequate treatment of GERD with Pantoprazole, 40 mg/day for 2 months was effective in improving many subjective and objective findings of OSAS. In patients with OSAS and history suggestive of GERD, upper endoscopy, pH monitoring and treatment with proton pump inhibitors (PPIs) may be an important adjunct in controlling OSAS symptoms.

Background: Chronic obstructive pulmonary disease (COPD) is a progressive disease characterized by increasing airflow limitation and respiratory symptoms, often associated with chronic co morbidities, leading to a significant burden for the patient. Aim of the work: to assess plasma NT-proBNP level in patients with acute exacerbation of COPD (AECOPD) and to evaluate the prognostic value of elevated NT-proBNP levels to predict in-hospital outcome of those patients. Material and Methods: From 1 November 2010 to 30 April 2011, 45 adult patients ≥ 40 years of age with acute exacerbation of COPD (AECOPD) admitted to department of pulmonary medicine &or Respiratory ICU ;Assiut University Hospital; Egypt were enrolled in this study. Plasma NT-proBNP levels were measured and systolic pulmonary arterial pressure (SPAP) was estimated by echocardiography. Arterial blood gas analysis, forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) were also measured. Results: NT-proBNP levels were significantly elevated during the acute exacerbation compared to recovery (254 pg/mL [interquartile range IQR, 103 to 972 pg/mL] vs 89 pg/mL [IQR, 45 to 269 pg/mL]; p = 0.000). Also in those patients requiring ICU admission [416 pg/mL (IQR, 214 to 972)] vs [200.5 pg/mL (IQR,103 to 516)]p=0.000.To predict ICU admission in patients with AECOPD, a receiver operating Characteristic (ROC) analysis was performed with NT-proBNP level > 300 has the best sensitivity and specificity (Sensitivity = 89.5%, Specificity = 92.3%) with area under the ROC curve (AUC) = 0.933. NT-proBNP levels at exacerbation were significantly elevated in patients with cor pulmonale compared to those without cor pulmonale [329 pg/mL (IQR, 167 to 972)] vs [197pg/mL (IQR,103 to 324)]p=0.000. With cut-off level of NT-proBNP > 214 pg/ml, which gives the best sensitivity and specificity (Sensitivity = 95.7%, Specificity = 72.7%) with area under the ROC curve (AUC) = 0.895. There was significant correlation between NT-proBNP levels at exacerbation and partial pressure of carbon dioxide (PaCO2),(PH),systolic pulmonary artery pressure(SPAP),duration in ICU and length of hospital stay (r =-0.422, p =0.004) , (r =-0.426, p =0.004) , (r = 0.811, p =0.000) , (r = 0.765, p =0.000) and (r = 0.805, p =0.000) respectively. Conclusions: This study revealed that, plasma NT-proBNP levels are elevated in AECOPD patients and can predict the need for ICU admission. Also can predict the occurrence of cor pulmonale in those patients.

Background: Chronic obstructive pulmonary disease (COPD) is a progressive disease characterized by increasing airflow limitation and respiratory symptoms, often associated with chronic co morbidities, leading to a significant burden for the patient. Aim of the work: to assess plasma NT-proBNP level in patients with acute exacerbation of COPD (AECOPD) and to evaluate the prognostic value of elevated NT-proBNP levels to predict in-hospital outcome of those patients. Material and Methods: From 1 November 2010 to 30 April 2011, 45 adult patients ≥ 40 years of age with acute exacerbation of COPD (AECOPD) admitted to department of pulmonary medicine &or Respiratory ICU ;Assiut University Hospital; Egypt were enrolled in this study. Plasma NT-proBNP levels were measured and systolic pulmonary arterial pressure (SPAP) was estimated by echocardiography. Arterial blood gas analysis, forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) were also measured. Results: NT-proBNP levels were significantly elevated during the acute exacerbation compared to recovery (254 pg/mL [interquartile range IQR, 103 to 972 pg/mL] vs 89 pg/mL [IQR, 45 to 269 pg/mL]; p = 0.000). Also in those patients requiring ICU admission [416 pg/mL (IQR, 214 to 972)] vs [200.5 pg/mL (IQR,103 to 516)]p=0.000.To predict ICU admission in patients with AECOPD, a receiver operating Characteristic (ROC) analysis was performed with NT-proBNP level > 300 has the best sensitivity and specificity (Sensitivity = 89.5%, Specificity = 92.3%) with area under the ROC curve (AUC) = 0.933. NT-proBNP levels at exacerbation were significantly elevated in patients with cor pulmonale compared to those without cor pulmonale [329 pg/mL (IQR, 167 to 972)] vs [197pg/mL (IQR,103 to 324)]p=0.000. With cut-off level of NT-proBNP > 214 pg/ml, which gives the best sensitivity and specificity (Sensitivity = 95.7%, Specificity = 72.7%) with area under the ROC curve (AUC) = 0.895. There was significant correlation between NT-proBNP levels at exacerbation and partial pressure of carbon dioxide (PaCO2),(PH),systolic pulmonary artery pressure(SPAP),duration in ICU and length of hospital stay (r =-0.422, p =0.004) , (r =-0.426, p =0.004) , (r = 0.811, p =0.000) , (r = 0.765, p =0.000) and (r = 0.805, p =0.000) respectively. Conclusions: This study revealed that, plasma NT-proBNP levels are elevated in AECOPD patients and can predict the need for ICU admission. Also can predict the occurrence of cor pulmonale in those patients.

Background: Chronic obstructive pulmonary disease (COPD) is a progressive disease characterized by increasing airflow limitation and respiratory symptoms, often associated with chronic co morbidities, leading to a significant burden for the patient. Aim of the work: to assess plasma NT-proBNP level in patients with acute exacerbation of COPD (AECOPD) and to evaluate the prognostic value of elevated NT-proBNP levels to predict in-hospital outcome of those patients. Material and Methods: From 1 November 2010 to 30 April 2011, 45 adult patients ≥ 40 years of age with acute exacerbation of COPD (AECOPD) admitted to department of pulmonary medicine &or Respiratory ICU ;Assiut University Hospital; Egypt were enrolled in this study. Plasma NT-proBNP levels were measured and systolic pulmonary arterial pressure (SPAP) was estimated by echocardiography. Arterial blood gas analysis, forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) were also measured. Results: NT-proBNP levels were significantly elevated during the acute exacerbation compared to recovery (254 pg/mL [interquartile range IQR, 103 to 972 pg/mL] vs 89 pg/mL [IQR, 45 to 269 pg/mL]; p = 0.000). Also in those patients requiring ICU admission [416 pg/mL (IQR, 214 to 972)] vs [200.5 pg/mL (IQR,103 to 516)]p=0.000.To predict ICU admission in patients with AECOPD, a receiver operating Characteristic (ROC) analysis was performed with NT-proBNP level > 300 has the best sensitivity and specificity (Sensitivity = 89.5%, Specificity = 92.3%) with area under the ROC curve (AUC) = 0.933. NT-proBNP levels at exacerbation were significantly elevated in patients with cor pulmonale compared to those without cor pulmonale [329 pg/mL (IQR, 167 to 972)] vs [197pg/mL (IQR,103 to 324)]p=0.000. With cut-off level of NT-proBNP > 214 pg/ml, which gives the best sensitivity and specificity (Sensitivity = 95.7%, Specificity = 72.7%) with area under the ROC curve (AUC) = 0.895. There was significant correlation between NT-proBNP levels at exacerbation and partial pressure of carbon dioxide (PaCO2),(PH),systolic pulmonary artery pressure(SPAP),duration in ICU and length of hospital stay (r =-0.422, p =0.004) , (r =-0.426, p =0.004) , (r = 0.811, p =0.000) , (r = 0.765, p =0.000) and (r = 0.805, p =0.000) respectively. Conclusions: This study revealed that, plasma NT-proBNP levels are elevated in AECOPD patients and can predict the need for ICU admission. Also can predict the occurrence of cor pulmonale in those patients.