Tehran University Medical Journal

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Background: Persistence of left ventricular hypertrophy (LVH) in renal transplant recipients is associated with unfavorable outcomes. Calcineurin-inhibitor (CNI) nephrotoxicity is a major cause of morbidity and mortality after kidney transplantation. In this study we compared sirolimus (SRL) with calcineurin-inhibitor as primary immunosuppressants for the attenuation of left ventricular hypertrophy in renal transplantation recipients.

Methods: In this prospective cohort study done in Shariati Hospital in 2010, we evaluated the effects of sirolimus and CNI on LVH of 55 renal transplant recipients. The cases (19) received sirolimus while the controls (36) received CNI while being matched for age and duration of transplantation. Data regarding blood pressure (BP), hemoglobin, serum creatinine, uric acid and lipid concentrations were assessed and changes in left ventricular (LV) mass were evaluated by echocardiography over a one-year follow-up.

Results: Left ventricular mass significantly decreased (P=0.0001) in the SRL group but blood pressure did not differ between the two groups. LV mass and LV mass index both decreased significantly (P≤0.05) but the difference was not associated with changes in BP. The difference in interventricular septal thickness at end diastole (IVSD) and posterior wall diameter (PWD) were significant (P≤0.05) in the SRL group but the difference in end diastolic diameter (EDD) was not significant.

Conclusion: Conversion from CNI to SRL-based immunosuppressive therapy in RTRs is safe and SRL may decrease LVH. SRL seems to be safe and improve renal function without cardiac compromise in kidney transplant recipients.

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Background: Improvement of growth, nutrition and calories intake in neonates is derived by massage. Methods: This study is a randomized clinical trials settled in Vali-e-Asr Hospital Neonatal Intensive Care Unit (NICU) ward in 2012. The control group consisted of 19 infants who were not massaged on them. 15 infants in the intervention group received massage therapy for 10 days, three times a day by trained massage theurapist. Massage last 15 minutes and was done one hour after feeding. Massages were done in 2-7 days neonates. Weight gain, intake calories and oral feeding were compared between studied groups. Data was registered in SPSS v.18 and was analyzed via compatible statistics tests. Results: There were no significant different anthropometric measures at birth (weight-head circumferences and height) and gestational ages of delivery between two groups. Massages had no side effects on cases. Caloric intake at the end of 10 days (end of intervention) showed significant differences between the two groups (P=0.04). But no differences was shown for weight gain. Cases who received massage reached sooner to oral feeding but this difference was significant at 90% significance level (P=0.08). Conclusion: After 10 days, massage therapy increases oral nutritional intake but to find more accurate details requires further studies to be planned.

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Background: Recently, the role of inflammation and oxidative stress in the pathophysiology of atrial fibrillation (AF) after cardiac surgery has been emphasized. Vitamin C as an antioxidant important role in reducing the incidence of postoperative atrial fibrillation. This study aimed to investigate, administration of vitamin C, as a way to reduce the incidence of atrial fibrillation after coronary bypass surgery.

Methods: In this double-blind clinical study, 290 patients in Rajaee Heart Center, from March 2013 to December 2014 who underwent coronary artery bypass surgery were randomly divided into intervention and control groups to receive vitamin C and placebo. The intervention group before the surgery in the operating room received 2 grams of vitamin C intravenously then one gram per day for four days prior to surgery. After the operation, the two groups were compared in terms of the following: Atrial and ventricular arrhythmias after surgery, ICU stay and hospital stay and duration of intubation.

Results: 113 cases and 177 controls (191 men and 99 women) with a mean age of 55.40±14.40 years in both groups (vitamin C and placebo) were enrolled. The incidence of postoperative atrial fibrillation was 55% in the placebo group to 35% in the vitamin C group decreased (P= 0.001). Duration of intubation in the intervention group 11.8 and the control group was 14.14 hours (P= 0.004). The amount of drainage was lower in vitamin C group (P= 0.003). Vitamin C had no effect on the rates of hospital and ICU stay (P= 0.075). There was no significant reduction in threatening arrhythmia (VT) and VF in this period (P= 0.159).

Conclusion: Vitamin C supplements may reduce atrial fibrillation after coronary artery bypass surgery also can improve conditions such as reducing the duration of intubation. With regard to the safety, these supplements can be recommended for the prevention of atrial fibrillation before coronary artery bypass surgery.