Showing 51 results for Af
Alami Harandi B, Navab I, Noroozi M,
Volume 58, Issue 3 (6-2000)
Abstract
Haghdoost H, Pasbakhsh P, Behzadi J,
Volume 59, Issue 5 (9-2001)
Abstract
The medical septal area (MSA) provides the major cholinergic projection to the hippocampus which is critical for function of the memory. Different brain areas through the MSA modulates septohippocampal functions. This study was designed to determin origins of inputs to this area. For this purpose, stereotaxic injections of one microliter HRP (25 percent, Sigma) by Hamilton syringe to the medical septal area were performed in 8 rats. Following brain tissue fixation, sectioning and enzyme histochemical reaction, the labeled neurons were detected microscopically. Retrogradely labeled perikarya observed ipsilaterally in diagonal band of Broca, lateral septum, hippocampus, subfornical area and ventral pallidum in the telencephalon, lateral preoptic area, lateral hipothalamicarea/tuber cinereum, posterior hypothalamus, submammillothalamic, supramammillary and lateral mammillary nuclei in the diencephalons, ventral tegmental area, interpeduncular nucleus, central grey area and locus coerruleus and also bilaterally in raphe nuclei of the brain stem regions. Based on this results, in addition to learning processes, MSA through its connections with subfornical and lateral hypothalamic area can also support the physiological mechanisms for dipsogenic, electrolytic, and pressor responses in living animals.
Af Zand Parsa,
Volume 59, Issue 6 (11-2001)
Abstract
In the past, coronary artery bypass grafting was the treatment of choice for patients with symptomatic multi vessel coronary artery disease, but in recent years per cutaneous transluminal coronary angioplasty (PTCA) accepted as an alternative approach to revascularization. To assess the initial success and in hospital results of coronary angioplasty of more than one lesion per procedure in patients with multi vessel coronary artery disease, a retrospective analysis of patients who underwent selective coronary angioplasty at Imam Khomeini medical center from 1994-1997 were peformed. From 1994 to 1997 per cutaneous transluminal coronary angioplasty (PTCA) were done in 257 patients, that 201 (78.2 percent) were male and their age range 23-73 years. The numbers of patients with multi vessel coronary artery disease were 98 (38.13 percent), that complete revascularization (PTCA of more than one lesion per procedure) underwent in 34 (13.58 percent) of them (27 men, 7 women, age: mean±SD 48±9.8 range 30-70). A total of 71 lesions were tried, that 22 (31 percent) were type A, 45 (63.4 percent) were type B, and 4 (5.6 percent) were type C. Among patients 21 (61.8 percent) had unstable angina and 13 (38.2 percent) had stable angina. Procedures were successful in 68 (95.8 percent) of lesions and 31 (91.2 percent) patients were discharged fro procedural complications included 3 (8.8 percent) non-Q wave myocardial infarction and no mortality. Without any complication, (success defined as residual stenosis <50 percent). As a conclusion, in selected patients with multi vessel coronary artery disease PTCA of more than one lesion per-procedure is effective and safe.
Mirkhani S. H, Delavarkhan S. M, Radmehr H,
Volume 60, Issue 1 (4-2002)
Abstract
In recent years off-pump coronary artery bypass surgery (OPCAB) has emerged as preferred method for revascularization of coronary arteries in relatively selected group of patients. Considering patients receiving incomplete revascularization need significantly higher postoperative catheterization and re-intervention (PTCA or CABG), we performed this study to identify safety and feasibility of this technique for total revascularization in nearly all patients requiring coronary artery graft surgery.
Materials and Methods: In this study, 150 consecutive patients underwent OPCAB by one surgeon. Octopus device used for regional wall stabilization. Vascular control achieved by ethibond loops, occluder, and shunts. Situations such as cardiomegaly, poor ventricular function, advanced age, hemodynamic instability, and small coronary arteries were not considered contraindications to OPCAB.
Results: Of 150 OPCAB cases, 146 (97.3 percent) were completely off-pump. The mean number of grafts per patient was 4.1 (range, 2 to 6). Total 595 distal grafts anastomosed to LAD (140) diagonals (140), right coronary artery (145), left circumflex (164). Thirty-day mortality and myocardial infarction were 0.6 percent and 3.3 percent respectively OPCAB patient experienced lesser postoperative bleeding had shorter stay at surgical intensive care unit and extubated earlier. Conduits used were left internal mammary artery, radial artery and greater saphenous vein.
Conclusion: OPCAB is a safe method for complete revascularization in nearly all patients. The OPCAB patients experience less complications, have shorter hospital stay, absolute contraindication for OPCAB other than severe, diffuse coronary artery disease with poor run-off which is better treated by cardiopulmonary bypass.
Moein H, Zohrabi Ma, Zohrabi Mo,
Volume 60, Issue 5 (8-2002)
Abstract
This study was conducted to show the comparison of efficacy and survival of amniotic membrane grafts and homologous dura grafts.
Methods and Materials: In this study, ten dogs (age 6-9 months & weight 15 lo 20 kg) have been chosen. The study was a single blind clinical trial. The dogs have been assigned into two groups by random allocation method. The amniotic membrane (A.M) was taken from a placenta belonging to a 38 weeks fetus delivered in a cesarean section surgery. In one group the graft was a peace of dura mater and in the other one the graft was a homologous dura graft. Maintenance of all cases was the same. Forty-five days later, another surgeon who was not aware of the assignment, conducted the second exploratory surgery for evaluation of the results.
Results: None of cases in two groups had any infection, abscess formation, fistula, CSF leakage or any toxic status. The healing process was normal in both groups.
Conclusion: There seems to be no difference between the (A.M) grafts and homologous dura in the repairmen of dura mater. This is expected to occur only if the pregnant woman is carefully tested for the presence of certain clinical conditions and the preparation of A.M is contemplated in an ideal environment.
M. Hozoori, S.a. Keshavarz, M. Hosseini, Sh. Farajzade, A.a. Sabour, H. Sadrzadeh,
Volume 64, Issue 4 (7-2006)
Abstract
Background: The aim of this study was to determine the effect of two different regimes, containing different carbohydrate to protein ratios on performance, serum glucose and insulin after exercise in soccer players in Tehran Iran.
Methods: Nineteen male soccer players under training [age = 17/5 +/- 1.5 (SE) yr] were selected and completed two sequential trials separated by 1 week, in a paired cross-over study design. In each trial, subjects after running to fatigue received one of three regimes, using a random- order design as follows: HPRO ( CHO 56%, PRO 19% & fat 25% of total energy) HCHO ( CHO 64%, PRO 11% & fat 25% of total energy) or control ( CHO 60%, PRO 15% & fat 25% of total energy). The calorie of 3 regimes were equal. After consumption of meal up to120 min, blood was obtained before and at intervals. After 3 hours athlete performance was measured.
Results: The study indicates no significant difference in the serum insulin and glucose response among three regimes (P > 0.05). There was no difference in performance between three regimes after 3 h (p > 0.05).
Conclusion: The results suggest that post exercise regimes have no influence on performance, serum glucose and serum insulin. Thus total energy content and carbohydrate content may be important in recovery after exercise.
Forouzan-Nia S.k, Abdollahi M.h , Motafakker M , Dehghan Hr , Rajabiun H ,
Volume 64, Issue 7 (8-2006)
Abstract
Background: Atrial fibrillation is the most common arrhythmia following CABG. This complication can cause palpitation, significant hemodynamic instability and thromboembolic events. This prospective randomized study evaluate prophylactic effects of propranolol low dose amiodarone and high dose amiodarone in patients candidate for CABG.
Methods: Three hundred consecutive patients undergoing elective CABG were randomly categorized into three groups (each group contains 100 patients). Patients in group1 (control group) received 10mg/TDS propranolol per oral (P.o), preoperatively. Patients in group 2 received 10mg propranolol TDS, P.o plus 350mg/24h amiodarone. Patients in group 3 received 10mg propranolol TDS P.o plus 1000mg/24h amiodarone 24 hours before operation.
Results: Atrial fibrillation occurred in 12 patients (12%) in group 1, four patients (4%) in group 2 and 10 patients (10%) (P=0.035) in group 3. AF occurred in 10.36% of men and 3.84% of women. There was no AF in off- pump groups and 9.73% in on-pump groups
Conclusion: This study suggested the combination of propranolol plus low dose amiodarone for post CABG atrial fibrillation prophylaxy.
Salimi J, Rostamnejad M, Meisami A.p,
Volume 65, Issue 5 (8-2007)
Abstract
Background: Dialysis access procedures and complications are important causes of morbidity and hospitalization for chronic hemodialysis patients. Ideally, any patient undergoing hemodialysis should receive an autogenous fistula that can be accessed throughout the patient's life. In patients with primarily unsuitable or secondarily surgically-exhausted veins, a prosthetic graft can be performed. Several recently published studies report the outcome of prosthetic grafts. The conclusions of these studies differ dramatically. The aim of this prospective study was to determine the patency, infection and thrombosis rates using Poly-tetrafluoroethylene (PTFE) in grafts for vascular access in hemodialysis patients.
Methods: During this three-year prospective study, 84 patients underwent placement of vascular access graft at the Vascular Surgery Department of Sina Trauma and Surgery Research Center in Tehran. Demographics, complications, and subsequent treatment were recorded. Primary patency rates were estimated using the Kaplan-Meier method. Logrank tests were used to evaluate the statistical differences in survival distribution.
Results: The mean patient age was 55 years (±12 years). Hypertension, diabetes and smoking were considered to be risk factors for atherosclerosis in 45, 26 and 19 cases, respectively. The patients were followed up for at least 24 months. The primary patency rates were 78%, 63.3% and 54.9% at 6, 12 and 18 months, respectively. There were 39 (46.4%) access failures, which were related to infection in five cases (6%), thrombosis in 30 cases (35.7%) and bleeding in two cases (2.4%). The patency rate in patients without hypertension and with hypertension were 62.2% and 29.7%, respectively (P<0.03). Patency rates for upper extremity and lower extremity grafts were 60% and 26%, respectively (P<0.05).
Conclusion: A PTFE vascular graft seems to be an appropriate vascular access and is a promising alternative when upper extremity arteriovenous fistulas cannot be constructed. Additionally, good care and educating patients can further decrease the rate of complication and morbidity, thereby resulting in a better patency rate.
Ahmadi F, Alimadadi A, Lesan Pezeshki M,
Volume 65, Issue 10 (1-2008)
Abstract
Background: While excellent organ quality and ideal transplant conditions eliminate many of the known factors that compromise initial graft function (IGF), slow graft function (SGF), still occurs after living donor kidney transplantation (LDKT). The aim of our current study is determination SGF frequency and its risk factors in LDKT
Methods: In this prospective study, between April 2004 and March 2006, data were collected on 340 LDKT, in Baghiyattallah Hospital, Tehran. Recipients were analyzed in two groups based on initial graft function (IGF): Creatinine <3 mg/dl 5 day after transplantation, SGF: Creatinine ≥ 3 mg/dl 5 day after transplantation with out dialysis in the first week. Donors' and recipients' characteristics and recipient lab. data were compared in two groups by chi-square, Mann-whitney & independent samples T-test.
Results: The incidence of SGF was 22 (6.2%) and IGF 318 (89.8%), Recipients' BMI in IGF were 22.1±3.9 and in SGF were 25.3±3.8 (P=0.001 95% Cl 1.097-1.401 OR= 1.24). SGF relative frequency in female donors is more than male donors. A multivariate analysis model confirms this significant difference. (P=0.044 95% Cl 1.028-7.971 OR= 2.862). SGF relative frequency in PRA (Panel Reactive Antibody) positive recipients are more than negative ones. A multivariate analysis model confirms this significant difference. (P=0.007 95%Cl 1.755-35.280 OR= 7.849). Recipients' age and donors' BMI are significant in univariate analysis (P=0.002 & P=0.029 respectively) but multivariate analysis model dose not confirm those significance. Serum ca & P & PTH levels don't have significant difference between IGF & SGF. Using calcium channels blockers have not a protective effect.
Conclusions: We conclude that negative PRA and lower recipient BMI have protective effects on SGF. Recipients with female donors have higher chance to develop SGF. We recommend recipients reduce their BMI before transplantation. The male donors are preferred to female ones.
Gholampour Azizi I, Khoushnevis S H, Hashemi S J,
Volume 65, Issue 13 (3-2008)
Abstract
Background: Aflatoxins are severe toxic secondary metabolites found in most plant
products. When animals consume contaminated feed stuff to Aflatoxin B1 (AFB1), the
toxin is metabolized by liver and is excreted as Aflatoxin M1 (AFM1) via milk. Aflatoxins
are acute toxic compounds, immunosuppressive, mutagen, tratogen and carcinogen.
Methods: During the winter of 2006, pasteurized and sterilized (ultra high temperature)
(UHT) milk packages were collected from supermarkets in Babol city. 78 pasteurized and
33 sterilized milk, totally 111 samples were tested for AFM1 by competitive Enzyme
Linked Immunosorbent Assay (ELISA). Solid phase in plastic micro wells coated whit
anti-Aflatoxin M1 antibodies. We added 100 microliter skimmed milk and Aflatoxin M1
standard solutions in each well. In each plate, we appointed seven wells for standards.
Plates were incubated at 20-25° centigrade for 45 min. Each well was washed four times
by washing buffer 20X concentration. Then 100 micro liter conjugated solution (100X)
was added to each well, and the plate was incubated at 20-25 centigrade for 15 min. After
that, the wells were washed. After adding the substrates to wells, we incubated the plate
at 20-25° centigrade in a dark place for 15 min. The reaction was stopped by stop solution.
After one hour, light absorption was read at 450 nm by ELISA reader.
Results: AFM1 were detected in 100% of all samples. 100% of samples were above of
European community regulations (50ng/l). AFM1 contamination mean levels pasteurized
and sterilized milk were 230.5 and 221.66 respectively. Therefore more than four fold
levels European community. There is not a significant relationship between AFM1
contamina-tion level and different months of winter applying statistical test.
Conclusion: The results showed the need for introducing safety limits for AFM1 levels in
child milk under Food Legislative liable of Iran. Aflatoxin M1 contamination is a serious
problem for public health, and it is potentially hazardous for human health.
, , , ,
Volume 66, Issue 4 (7-2008)
Abstract
Background: The Ross procedure has been known as a good method for aortic valve replacement. Pulmonary allograft postoperative stenosis subsequent to the Ross procedure has been noted as an important disadvantage of this technique, although risk factors related to this complication are not clearly recognized. In this study we evaluate the risk factors of pulmonary allograft stenosis after Ross procedure.
Methods: This retrospective cohort study was carried out on 42 patients who underwent the Ross procedure. Left ventricular outflow tract obstruction was repaired using pulmonary allografts 22.7±2.5 mm in diameter. Echocardiographic and clinical examinations were performed for all patients at six and 12 months after surgery. Echocardiographic data as well as data related to the allografts were recorded.
Results: The mean age of the patients was 28.5±10 years. Postoperative pulmonary valve stenosis was detected in 13 patients (31%). Nine patients (21.4%) had mild stenosis and four patients (9.5%) had moderate stenosis. No relationship was detected between the degree of stenosis and the size of allograft (p=0.08). There was a significant correlation between postoperative pulmonary stenosis and donor age (p=0.04). Predictive variables of pulmonary allograft stenosis after the Ross procedure were low donor and recipient age (p=0.03 and 0.05, respectively).
Conclusions: This study shows that the Ross procedure has a rather low incidence of postoperative stenosis and is a suitable substitute for aortic valve replacement. Low donor age is associated with pulmonary allograft stenosis formation, perhaps due to greater viability of tissue cells from younger donors.
Razmpa E, Azimi C, Soltan Sanjarei M, Nazari H, Ghasempoure A, Yousefi M,
Volume 66, Issue 7 (10-2008)
Abstract
Normal
0
false
false
false
EN-US
X-NONE
AR-SA
MicrosoftInternetExplorer4 !mso]>
ject classid="clsid:38481807-CA0E-42D2-BF39-B33AF135CC4D" id=ieooui>
Background: A high percentage of the patients at ENT or plastic
surgery clinics have ENT abnormalities, either congenital or those developing
later in life. Some are life threatening, while others cause disability and
esthetic problems, with profound consequences for the affected child and the
family. In addition, ENT abnormalities usually place stress on interpersonal
relationships, causing social isolation, unhappiness and depression. The
majority of these abnormalities is genetic and follows autosomal recessive pattern
of inheritance. Geneticists believe that there is a higher frequency of autosomal
recessive disorders among the offspring of consanguineous parents. The aim of
this study was to find the frequency of ENT abnormalities among children born of consanguineous parents.
Methods: We studied 3503 files (pedigrees) of patients referred for genetic
counseling at the Department of Genetics at Imam
Khomeini Hospital,
Tehran, Iran, from 1999 to 2000. We studied these
cases according to degree of parental consanguinity, patterns of inheritance
and gender using SPSS v.15.
Results: Of all 3503 files, 206 had ENT abnormalities, of which 157 had consangui-neous
marriages. Among these 157 pedigrees, 496 cases had consanguineous parents. Out of the 496 cases, the
four most frequent ENT abnormalities were: 115 cases (23.2%) of deafness,
53
cases (10.7%) of hearing loss, 12 cases (2.4%) of cleft lip and palate, and 5 cases (1%) of cleft
palate.
Conclusion: This high frequency of ENT abnormalities
indicates that consanguineous marriage should be discouraged by Iranian policy
makers in order to reduce the burden of these disorders on society. Further
research into the cultural problems that encourage consanguineous marriage and
ways of resolving these problems is recommended.
Karimiyazdi A, Sazgar Aa, Aghayan Hr, Sadrhoseini Sm, Arjmand B, Tavasoli A, Imamirazavi Sh,
Volume 66, Issue 9 (12-2008)
Abstract
Background: Several therapeutic modalities have been cited for patients with microtia. Recently there are several reports about using cadaveric homograft cartilage for some other purposes. The aim of this study was to assess the results of auricular reconstruct-tion in 10 patients (12 ears) with congenital atresia using homograft rib cartilage from the Iranian Tissue Bank.
Methods: We enrolled 10 patients with microtia who were referred to the Imam Khomeini Hospital from September 2006 to July 2007 for auricular reconstruction. The reconstruction was performed using a pre-shaped homograft(s) of each patient's ear(s) made by the Iranian Tissue Bank from the 6th, 7th and 8th costal cartilage according to the method of Marquette. In six patients, the second stage of reconstructive surgery was performed three months after the first stage. The patients were followed regarding the ear appearance, the dimensions of cartilage and tissue reaction.
Results: The mean age of the patients was 11.08 (SD=5.57) years and the average duration of follow-up was 6.29 (SD=3.12) months. Eight cases had unilateral involvement (six right and two left), in addition to two cases of bilateral involvement. During the follow-up period, the appearance of the helix was satisfactory in 11 ears and the lobule in 10 ears. The height and width of the reconstructed auricles was an average of 1-2 millimeters different from the opposite ear. Erythema was the most common early complication. Late complications, including cartilage exposure and infection, were observed in one patient.
Conclusion: Auricular reconstruction using homograft costal cartilage in patients with microtia has promising results. The short term resorption can be ignored and significant early or late complications are infrequent.
Radmehr H, Tatari H, Salehi M, Bakhshande A,
Volume 66, Issue 12 (3-2009)
Abstract
Background: The usage of pericardium of patient himself, for support of anastomosis lines may carry benefits in patients undergoing aortic valve replacement with pulmonary autograft (Ross). The aim of the present study was to compare the short term results of aortic valve replacement with pulmonary autograft with routine and offered methods.
Methods: In a non-randomized clinical trial, 64 patients who referred to cardiac surgery ward of Imam Khomeini hospital Tehran Iran from December 2002 to December 2006 for aortic valve replacement with pulmonary autograft with two different methods. In the first two years of this study all of the patients were operated with routine procedure (group A, n=28) and during the next two years, all of them were operated with authors' offered method in which the patient`s pericardium was used for support of anastomosis lines (group B, n=36). Some of clinical parameters and outcome were compared between two groups.
Results: There were no significant differences between mean of age, sex, pathology, preoperative and postoperative EF in two groups. In group B, the mean pump time was significantly lower than group A (144.09±26 vs. 179.64±25 min). The mean Cross-clamp time was significantly lower in group B (118.5±22 vs. 136.93±19 min) Need for blood transfusion in ICU was significantly lower in group B (35.71% vs. 68.57%). Mean ICU Stay and Postoperative Hospital Stay were significantly lower in group B (1.3±0.3 vs. 1.9±0.7 and 5.2±0.9 vs. 5.9±1.5 days respectively). Overall mortality was four death (6.25%) which was not significant between two groups.
Conclusions: The usage of patient's pericardium for support of anastomosis lines in patients undergoing aortic root replacement with pulmonary autograft carry advantages to routine procedure and its utilization is advocated in other centers.
Farahvash Mr, Yegane Ra, Farahvash B, Sheidaeian M, Masoomi M,
Volume 67, Issue 3 (6-2009)
Abstract
Normal
0
false
false
false
EN-GB
X-NONE
AR-SA
MicrosoftInternetExplorer4 !mso]>
ject classid="clsid:38481807-CA0E-42D2-BF39-B33AF135CC4D" id=ieooui>
Background: Trauma is the 2nd cause of mortality in Iran, after cardiovascular
diseases. In traumatic patients, head and neck and face skeletal fracture is
common. The most common facial fracture is mandible fracture and the least
common is frontal fracture. Complications due to orbital fracture are more
devasting than the other fractures in face.
Methods: These descriptive cross sectional studies are designed on 92 patients with
orbital fractures in a referral educational trauma center, Imam Khomeini
hospital, Tehran, Iran. Sample size was the patients
who referred to this hospital with orbital fracture during the ten years period
(1986-2000).
Results: In this study 74 patients were male and 18 patients were female. Mean age
of patients was 30 years. The most common cause of orbital fracture was motor
vehicle accident which was seen in 38 patients.46 patients had fracture in left
orbit and 44 patients in right. Isolated orbital fracture was seen in 38
patients and 54 patients had concomitant trauma and fracture in the other
organs. Management of orbital fracture was reduction of displaced bone fragment
and fixation for osteosynthesis. The most common methods for osteosynthesis was
fixation with miniplate which used in 53 patients and then reconstruction of
orbital floor and roof with autologus bone graft. The most common complications
due to orbital fracture was related to eyes that were seen in 20 patients.
Conclusion: Face
fractures are a piece of all problems in multiple trauma patients as the tip of
iceberg. Concomitant injuries are the concealed part of this iceberg. Early
detection of orbital fracture and immediate treatment that prevent the future
complications and deformities due to orbital fractures.
Ashrafi M, Hamidi Beheshti Mt, Shahidi Sh, Ashrafi F,
Volume 67, Issue 5 (8-2009)
Abstract
Background: Kidney transplantation had been evaluated in some
researches in Iran mainly with clinical approach. In this research we
evaluated graft survival in kidney recipients and factors impacting on
survival rate. Artificial neural networks have a good ability in
modeling complex relationships, so we used this ability to demonstrate
a model for prediction of 5yr graft survival after kidney
transplantation.
Methods: This retrospective study was done on 316 kidney
transplants from 1984 through 2006 in Isfahan. Graft survival was
calculated by Kaplan-meire method. Cox regression and artificial neural
networks were used for constructing a model for prediction of graft
survival.
Results: Body mass index (BMI) and type of transplantation
(living/cadaver) had significant effects on graft survival in cox
regression model. Effective variables in neural network model were
recipient age, recipient BMI, type of transplantation and donor age.
One year, 3 year and 5 year graft survival was 96%, 93% and 90%
respectively. Suggested artificial neural network model had good
accuracy (72%) with the area under the Receiver-Operating
Characteristic (ROC) curve 0.736 and appropriate results in goodness of
fit test (κ2=33.924). Sensitivity of model in identification of true
positive situations was more than false negative situations (72% Vs
61%).
Conclusion: Graft survival in living donors was
more than cadaver donors. Graft survival decreased when the BMI
increased at transplantation time. In traditional statistical approach
Cox regression analysis is used in survival analysis, this research
shows that artificial neural networks also can be used in constructing
models to predict graft survival in kidney transplantation.
Tanaray B, Eslami M, Salehi M, Jahanzad I, Emami M,
Volume 68, Issue 7 (10-2010)
Abstract
Background: Studies of the association between post operative AF and Plasma level of NT- Pro BNP have reported conflicting findings. The aim of the present study was evaluation of the association between post coronary bypass graft- Atrial Fibrillation (AF) and Plasma level of NT- ProBNP as an independent risk factor of AF development in patients undergoing coronary artery bypass graft.
Methods: In a cohort study, 79 patients with sinus rhythm who admitted in Imam Khomeini Hospital in Tehran, Iran, during February 2009 and February 2010 for CABG are included the study and followed for developing post operative AF rhythm.
Results: Post operative AF was found in 17.7% of patients. The peak time from the operation to the first AF episode was in second post op day in ten patients (71.4%). The serum level of ProBNP in patients with AF was significantly higher (1624± 647 versus 221± 238 pg/ml, p< 0/0001). Increased age, Increased LA size and high plasma level of ProBNP were associated with increased risk for post op AF. After adjustment of risk factors, plasma level of ProBNP was the most important risk factor with odds ratio of 15.34 with CI 95% 1.77-132.95 and then LA diameter with odds ratio of 6.11 with CI 95% 0.99-37.42 was independently correlated with post op AF. Correlation between plasma level of ProBNP with age and LA size was seen too (LA size r = 0.0281, p= 0.012). Between age and ProBNP (r= 0.337, p= 0.002). The best cut off point for plasma ProBNP as a predictor of post op AF was 854 pg/ml.
Conclusion: Increased level of preoperative ProBNP levels could be an independent predictor of post operative Atrial Fibrillation.
Mansoureh Toghae , Abdoreza Naser-Moghadasi , Baharak Mehdipour-Aghabagher,
Volume 68, Issue 8 (11-2010)
Abstract
Background: Bickerstaff's brainstem encephalitis (BBE) is a very uncommon central nervous system disease with unknown etiology. As it is usually responsive to treatment, the diagnosis this disease is important. It seems There is no reported Bickerstaff's brainstem encephalitis case in Iran.
Case presentation: An 83 year old woman presented with vertigo, ataxia and dysarthria from a week prior to admission. Her T2 weighted MRI revealed high intensity lesions in the pons area. She received treatment with impression of ischemic stroke. After few days, lower extremities became weak symmetrically and deep tendon reflexes depressed. Deep sensory loss was noted too. The EMG-NCV studies showed acute polyneuropathy and in CSF examination increased protein content was noted. The patient improved after IVIG and corticosteroid therapy with impression of Bickerstaff's brainstem encephalitis.
Conclusion: In spite of severe initial presentation, Bickerstaff's brainstem encephalitis has a good prognosis if it diagnosed and treated properly. Although clinical features is too important, but paraclinical work up are necessary to diagnose this syndrome.
Bolourian Aa, Beheshti Monfared M, Gachkar L, Ghomeisi M, Shahzamani M, Foroughi M, Kazem Arabnia Mk, Ghods K, Dabbagh A,
Volume 69, Issue 1 (4-2011)
Abstract
Background: Atrial fibrillation is the most common but benign arrhythmia following cardiac surgery. Although this arrhythmia is often self-limited and vanishes in about 24 hours upon surgery a number of arrhythmias might ensue among which some might be really life-threatening. A multitude of therapeutic modalities have been proposed for the prevention of this arrhythmia and one of them is posterior pericardiotomy. This method has not been fully accepted by the peers yet and more studies are needed to prove its efficacy and benefits to the patients.
Methods: In this single-blind randomized clinical trial, done over a 2-year period from February 2009 to January 2011, the effects of posterior pericardiotomy were evaluated in 174 patients (87 the case and 87 the control groups) undergoing elective coronary artery bypass grafting (CABG). The case group underwent CABG with posterior pericardiotomy while the control group underwent CABG-only operation. The postoperative incidence of arrhythmia, especially atrial fibrillation, was assessed for a week using statistical methods.
Results: The prevalence of postoperative atrial fibrillations were fewer in the group undergoing CABG with posterior pericardiotomy compared with the CABG-only group (P<0.004).
Conclusion: Posterior pericardiotomy seems to reduce the incidence of atrial fibrillation following elective CABG therefore, its application is suggested for elective
CABGs
Tahmasebi Mn, Ayati Firoozabadi M, Panjavi B, Kaseb Mh,
Volume 69, Issue 2 (5-2011)
Abstract
Background: One of the most common orthopedic complaints is direct or indirect trauma to the knee with torn anterior cruciate ligament (ACL). Reconstruction of the torn ACL is emphatically offered in active individuals as by this operation, we prevent osteoarthritis, knee instability and injury to the meniscus. There are numerous methods for graft fixation in the femoral tunnel in ACL reconstruction. If the graft proves to be stable after the operation, patients would not complain of giving way knee joints. In this clinical trial, we compared transfemoral pinning with endobutton fixation of hamstring graft in arthroscopic ACL reconstruction by examining knee stability and use of other relevant functional tests.
Methods: Fourteen Patients who had undergone arthroscopic ACL reconstruction in Shariati Hospital during the years 2008-2009 and were being followed up were evaluated at least 15 months post-operatively by physical examination and the use of an
arthrometer made by the Faculty of Mechanics of Sharif Technical University.
Results: The results showed that two out of seven patients in which their ACL had been reconstructed by hamstring graft fixation by endobutton technique, and in one out of seven patients who had undergone ACL reconstruction by hamstring graft fixation through transfemoral pinning, Lachmann test (in 25 position) was greater than 5 mm but there were not any complaints of giving way knee joints.
Conclusion: The clinical results of ACL reconstruction by transfemoral pinning technique seems to be superior to the reconstruction by endobutton technique.
