*Kurdistan Board for
Depression is a common disorder amongst the general population and frequently encountered by most physicians. Selective Serotonin Re-Uptake Inhibitors (SSRI's) have become the most commonly prescribed antidepressants due to their superiority compared with other antidepressants in the treatment of acute major depression. Although exceedingly rare, hepatotoxicity resulting from sertraline use has been previously reported. In these case reports, the liver injury pattern was predominately hepatocellular. Unlike previous cases, we report the case of a patient presenting with markedly elevated cholestatic enzymes and painless jaundice while taking sertraline for treatment of depression.
Introduction An appreciation of normal diastolic function permits a better understanding of clinical features of diastolic heart failure. Cardiac function is critically dependent upon diastolic physiologic mechanisms to provide adequate left ventricular filling (cardiac input) in parallel with left ventricular ejection (cardiac output). These processes must function under a variety of physiological conditions, both at rest and during exercise. 1 Events during diastole begin with the relaxation of the contracted myocardium. This is a dynamic, energydependant, process that includes two phases: 1-Isovolumic relaxation which is a period between aortic valve closure and mitral valve opening during which left ventricular pressure declines with no change in volume. 2-Autonomic relaxation which is a period between mitral valve opening and mitral valve closure during which the left ventricle fills at variable pressure. 2 Diastolic dysfunction (DD) is characterized by elevated diastolic pressure in left ventricle despite normal or sub-normal diastolic volume. 3 Hypertrophy of cardiac cells, increased interstitial collagen deposition or infiltration of the myocardium with amyloid proteins causes decreased distensability of the cardiac tissue. The ventricle then behaves as a balloon made Background and objective: Hypertension is a very common medical disorder, affecting nearly 40% of our population. Diastolic dysfunction is one of complications that happens and is regarded as a predictive of subsequent heart failure. The aim of this study was to determine the frequency of left ventricular diastolic dysfunction by echocardiography among hypertensive patients. Methods: This study involved 150 hypertensive cases (82 female and 68 male) age from 25-81 years old. Transthoracic echocardiography approach, using SIEMENS SONOLINE Omnia 2005 machine with the probe of p4-2 was used by the researcher. A comparative 150 normal non-hypertensive healthy adults with hypertensive patients are examined again by echocardiography. The parameter for the diastolic dysfunction measurement is E/A ratio. Results: It was found that 88 (58.7%) of hypertensive patients have diastolic dysfunction, while 4.9% of non-hypertensive group have diastolic dysfunction with significant statistical differences between both groups (P <0.001), who were age >60years have 79%, while age 25-35years old have 21% (P <0.001). Among left ventricular hypertrophy patients, 87.5%, versus 12.5% have diastolic dysfunction (P <0.001). Females are more liable for diastolic dysfunction, who have 70.7% than males who have 44.1% (P <0.001). Conclusion: Diastolic dysfunction is common among hypertensive patients, particularly among females, aged, and who have echocardiographic criteria of left ventricular hypertrophy, represent risk factors for diastolic dysfunction.
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