Background: A high incidence of thromboembolic events is observed in thalassemia patients. This study investigated the relationship between carotid intima-media thickness (CIMT) and lipid profile, iron metabolic indices (IMI), and inflammatory markers in β-thalassemia intermedia (β- TI) patients.
Patients and methods: Forty-five β-TI patients at Assiut University Hospital and 34 healthy individuals
were enrolled in the study. We measured Lipid profile, IMI, highly sensitive CRP (Hs-CRP), and interleukin-
6 (IL-6) and compared the results between both groups. We used CIMT measurement as a marker for
subclinical atherosclerosis. We used both univariate and multivariate analyses to test relations and
independent predictors of CIMT.
Results: β-TI patients had higher CIMT (P = 0.000). CIMT was positively correlated with absolute neutrophil count (ANC) (r = 0.320, p = 0.032), ferritin (r = 0.544, p = 0.000), Hs-CRP (r = 0.603, p= 0.000), and IL-6 (r = 0.520, p = 0.000). Hs-CRP was an independent predictor of CIMT (p = 0.000). Hs-CRP cut off value of 60.4 ug/dl has sensitivity of 63.3% and specificity of 93.3% in predicting premature atherosclerosis.
Conclusion: β-TI patients had higher CIMT despite the protective lipid profile. Hs-CRP was an independent
predictor of CIMT.

Accurate assessment of volume status (VS) in hemodialysis (HD) patients is challenging. The use of chest ultrasound (CUS) for detection of extravascular lung water has recently gained wide acceptance. The aim of this study was to evaluate the use of CUS in VS assessment in HD patients in comparison to clinical and inferior vena cava (IVC) indices and to assess their relationship with volume displacement after ultrafiltration. This prospective cohort study was carried out on 38 patients on regular HD. VS was assessed using a 13-point clinical score, and IVC indices and CUS score were measured pre- and post-ultrafiltration. Correlation between these
parameters and with ultrafiltration volume was tested. There was a statistically significant reduction in post-ultrafiltration CUS score and the 13-point clinical score (P <0.01). Moreover, reduction in all the IVC indices (inspiratory and expiratory diameters and collapsing index) was detected but did not reach statistical significance (P = 0.185, P = 0.296, and P = 0.194, respectively). CUS score had statistically significant correlations with ultrafiltration volume and New York Heart Association classes (P <0.001 and <0.001, respectively). Neither clinical signs nor IVC indices can be used independently for the assessment of VS in HD patients. CUS is a useful guide in VS assessment, and we recommend its routine use in the management of HD patients. Concomitant use of bioimpedance analysis (BIA) may be needed in addition to CUS for more accurate assessment of VS in HD patients.

Objectives We aimed to study the prevalence of each type of pulmonary hypertension (PHT) (precapillary, post capillary and combined) in end stage renal disease patients (ESRD) under haemodialysis (HD). We also studied the correlation between the systolic pulmonary artery pressure (SPAP) and different patient clinical and laboratory variables. Methods This cross-sectional study was conducted on 106 HD patients. Demographic and clinical data, blood samples for laboratory variables of the studied patients were all collected. A standard echocardiography was done. Pulmonary function test was performed with standard spirometry. Results The total prevalence of PHT in our study population was 77.3%. The prevalence of isolated post capillary PHT, pre capillary PHT and combined pre and post capillary PHT was (32.07%, 23.58% 21.69%) respectively. The prevalence of “unexplained” PHT was 0.9%. There were significant positive correlation between SPAP and smoking index (r=0.427, P=0.035), duration of dialysis (r=0.416, P=0.046), ferrittin level (r=0.312, P=0.048), cardiac output (CO) (r=0.683, P=0.000) and AV fistula flow (r=0.529, P=0.018), while there were significant negative correlation between SPAP and hemoglobin (HB) level (r=−0.598, P=0.010) and serum iron (r=−0.572, P=0.049). Multivariate analysis showed significant association with smoking index (P=0.01), duration of dialysis (P=0.032), HB level (P=0.042) and CO (P=0.000) after adjusting other factors. Conclusions In our study there was a high prevalence of PHT in HD patients with a very low prevalence of the unexplained types of PHT. Smoking index, duration of dialysis, HB level and CO were independent risk factors of increased SPAP.