Effects of Acetyl-L-Carnitine on Cardiac Arrhythmias and Infarct Size in Ischemic-Reperfused Isolated Rat Heart

This study aimed to examine whether acetyl-L-carnitine (ALC) was able to reduce cardiac arrhythmias and infarct size in the ischemic-reperfused isolated rat heart.Materials and MethodsThe isolated hearts were mounted on a Langendorff apparatus then perfused by a modified Krebs-Henseleit solution during 30 min regional ischemia and 120 min reperfusion (control) or by enriched Krebs solution with 0.375, 0.75, 1.5 and 3 mM of ALC (treatment groups). The ECGs were recorded and analyzed to determine cardiac arrhythmias. The infarct size was determined by using a computerized planimetry package.ResultsDuring ischemia, all used concentrations of ALC decreased number and duration of ventricular tachycardia (VT), total number of ventricular ectopic beats (VEBs) (P<0.01), incidence of total ventricular fibrillation (VF) and the time spent for reversible VF (P<0.05). At the reperfusion phase, duration of VT, incidence of total VF and reversible VF were significantly lowered by ALC (P<0.05). In addition, infarct size significantly was decreased in all treated groups. In the control group, the infarct size was 23±3.1%, however, ALC (0.375, 0.75 and 3 mM) reduced it to 8.7±2.3, 5.3±1.4, and 8±2.9%, respectively (P<0.01). ConclusionConsidering the results, it may be concluded that ALC has protective effects against cardiac ischemia-reperfusion (I/R) injuries by reduction of infarct size and arrhythmias in isolated rat heart. Among the potential cardioprotective mechanisms for ALC, increase in glucose oxidation and resulting reduced lactate production, reduction of toxic fatty acid metabolites and removing free radicals from the myocytes are more relevant

Effects of Chronic Oral Administration of Natural Honey on Ischemia/Reperfusion-induced Arrhythmias in Isolated Rat Heart

Objective(s)In this study, effects of chronic administration of oral natural honey against ischemia/reperfusion (I/R)-induced cardiac arrhythmias were investigated in isolated rat heart. Materials and MethodsMale Wistar rats were divided into four groups (n= 10-14 rats in each group) and fed with natural honey (1%, 2% and 4% dissolved in the drinking water) for 45 days except for the control group. After anesthesia, the rats’ hearts were isolated quickly, mounted on a Langendorff apparatus and perfused with a modified Krebs-Henseleit solution during stabilization, 30 min regional ischemia followed by 30 min reperfusion. The ECGs were recorded throughout the experiments to analyze cardiac arrhythmias based on the Lambeth conventions. ResultsIn the ischemic phase, honey (1%) significantly reduced (P<0.05) the number and duration of ventricular tachycardia (VT). Honey (1% and 2%) also significantly decreased number of ventricular ectopic beats (VEBs). In addition, incidence and duration of reversible ventricular fibrillation (Rev VF) were lowered by honey 2% (P<0.05). During reperfusion time, VT incidence was 73% in the control group, however natural honey (1%) decreased it to 22% (P<0.05). Honey also produced significant reduction in the incidences of total VF, Rev VF, duration and number of VT. ConclusionFor the first time, the results of present study demonstrated protective effects of chronic oral honey administration against I/R-induced arrhythmias in isolated rat heart. Antioxidant activity, the existence of energy sources such as glucose and fructose and improvement of some hemodynamic functions might be responsible for these effects

Long and Short-term Metformin Consumption as a Potential Therapy to Prevent Complications of COVID-19

Purpose: The aim of the study is to evaluate the effect of metformin in complication improvement of hospitalized patients with COVID-19. Methods: This was a randomized clinical trial that involved 189 patients with confirmed COVID-19 infection. Patients in the intervention group received metformin-500 mg twice daily. Patients who received metformin before admission were excluded from the control group. Patients who were discharged before taking at least 2000 mg of metformin were excluded from the study. Primary outcomes were vital signs, need for ICU admission, need for intubation, and mortality. Results: Data showed that patients with diabetes with previous metformin in their regimen had lower percentages of ICU admission and death in comparison with patients without diabetes (11.3% vs. 26.1% (P=0.014) and 4.9% vs. 23.9% (P≤0.001), respectively). Admission time characteristics were the same for both groups except for diabetes and hyperlipidemia, which were significantly different between the two groups. Observations of naproxen consumption on endpoints, duration of hospitalization, and the levels of spO2 did not show any significant differences between the intervention and the control group. The adjusted OR for intubation in the intervention group versus the control group was 0.21 [95% CI, 0.04-0.99 (P=0.047)]. Conclusion: In this trial, metformin consumption had no effect on mortality and ICU admission rates in non-diabetic patients. However, metformin improved COVID-19 complications in diabetic patients who had been receiving metformin prior to COVID-19 infection, and it significantly lowered the intubation rates

Self-administration medication errors at home and its predictors among illiterate and low-literate community-dwelling older adults with polypharmacy: A negative binomial hierarchical regression.

BackgroundOlder adults with polypharmacy are more prone to medication errors. People with low educational attainment have more difficulties in taking their medications.ObjectivesThis study aimed to identify the extent of medication self-administration errors (MSEs) and the contributing factors among illiterate and low-literate community-dwelling older adults with polypharmacy.MethodThe present cross-sectional study was conducted among people aged 60 and above. The data were collected using the sociodemographic, clinical, and Belief about Medicines Questionnaires (BMQ). To determine the extent of MSE, a medication error checklist was used. The negative binomial hierarchical regression model in the five blocks was performed.ResultsThe final sample size was 276 people. The frequency of MSEs in the last 6 months was 69.2%. Sixteen percent of participants had made four or more mistakes. The most common MSEs were forgetting, improper taking of medications with food, improper timing, incorrect dosage (lower dose), and forgetting the doctor's instructions. Near 18% of participants reported adverse events following their mistakes. The significant predictors of MSEs were being completely illiterate (p = 0.021), the higher number of doctor visits per year (p = 0.014), irregularly seeing doctors (p ConclusionDespite the high prevalence of MSEs among older patients, practical strategies to deal with them at their homes have not been established among health systems. MSE as a multifactorial event can be caused by a collection of internal and external factors. Further studies to identify the role of patients, clinicians, procedures, and systems in developing MSEs as interconnected components are needed

Effects of Chronic Oral Administration of Natural Honey on Ischemia/Reperfusion-induced Arrhythmias in Isolated Rat Heart

Abstract Objective(s) In this study, effects of chronic administration of oral natural honey against ischemia/reperfusion (I/R)-induced cardiac arrhythmias were investigated in isolated rat heart. Materials and Methods Male Wistar rats were divided into four groups (n= 10-14 rats in each group) and fed with natural honey (1%, 2% and 4% dissolved in the drinking water) for 45 days except for the control group. After anesthesia, the rats&apos; hearts were isolated quickly, mounted on a Langendorff apparatus and perfused with a modified Krebs-Henseleit solution during stabilization, 30 min regional ischemia followed by 30 min reperfusion. The ECGs were recorded throughout the experiments to analyze cardiac arrhythmias based on the Lambeth conventions. Results In the ischemic phase, honey (1%) significantly reduced (P&lt;0.05) the number and duration of ventricular tachycardia (VT). Honey (1% and 2%) also significantly decreased number of ventricular ectopic beats (VEBs). In addition, incidence and duration of reversible ventricular fibrillation (Rev VF) were lowered by honey 2% (P&lt;0.05). During reperfusion time, VT incidence was 73% in the control group, however natural honey (1%) decreased it to 22% (P&lt;0.05). Honey also produced significant reduction in the incidences of total VF, Rev VF, duration and number of VT. Conclusion For the first time, the results of present study demonstrated protective effects of chronic oral honey administration against I/R-induced arrhythmias in isolated rat heart. Antioxidant activity, the existence of energy sources such as glucose and fructose and improvement of some hemodynamic functions might be responsible for these effects

Flow chart for study subject selection.

BackgroundOlder adults with polypharmacy are more prone to medication errors. People with low educational attainment have more difficulties in taking their medications.ObjectivesThis study aimed to identify the extent of medication self-administration errors (MSEs) and the contributing factors among illiterate and low-literate community-dwelling older adults with polypharmacy.MethodThe present cross-sectional study was conducted among people aged 60 and above. The data were collected using the sociodemographic, clinical, and Belief about Medicines Questionnaires (BMQ). To determine the extent of MSE, a medication error checklist was used. The negative binomial hierarchical regression model in the five blocks was performed.ResultsThe final sample size was 276 people. The frequency of MSEs in the last 6 months was 69.2%. Sixteen percent of participants had made four or more mistakes. The most common MSEs were forgetting, improper taking of medications with food, improper timing, incorrect dosage (lower dose), and forgetting the doctor’s instructions. Near 18% of participants reported adverse events following their mistakes. The significant predictors of MSEs were being completely illiterate (p = 0.021), the higher number of doctor visits per year (p = 0.014), irregularly seeing doctors (p ConclusionDespite the high prevalence of MSEs among older patients, practical strategies to deal with them at their homes have not been established among health systems. MSE as a multifactorial event can be caused by a collection of internal and external factors. Further studies to identify the role of patients, clinicians, procedures, and systems in developing MSEs as interconnected components are needed.</div

Participant characteristics (n = 276).

BackgroundOlder adults with polypharmacy are more prone to medication errors. People with low educational attainment have more difficulties in taking their medications.ObjectivesThis study aimed to identify the extent of medication self-administration errors (MSEs) and the contributing factors among illiterate and low-literate community-dwelling older adults with polypharmacy.MethodThe present cross-sectional study was conducted among people aged 60 and above. The data were collected using the sociodemographic, clinical, and Belief about Medicines Questionnaires (BMQ). To determine the extent of MSE, a medication error checklist was used. The negative binomial hierarchical regression model in the five blocks was performed.ResultsThe final sample size was 276 people. The frequency of MSEs in the last 6 months was 69.2%. Sixteen percent of participants had made four or more mistakes. The most common MSEs were forgetting, improper taking of medications with food, improper timing, incorrect dosage (lower dose), and forgetting the doctor’s instructions. Near 18% of participants reported adverse events following their mistakes. The significant predictors of MSEs were being completely illiterate (p = 0.021), the higher number of doctor visits per year (p = 0.014), irregularly seeing doctors (p ConclusionDespite the high prevalence of MSEs among older patients, practical strategies to deal with them at their homes have not been established among health systems. MSE as a multifactorial event can be caused by a collection of internal and external factors. Further studies to identify the role of patients, clinicians, procedures, and systems in developing MSEs as interconnected components are needed.</div

The frequency of self-administration medication errors by different types of error among illiterate and low-literate older adults with polypharmacy in the last 6 months (n = 276).

The frequency of self-administration medication errors by different types of error among illiterate and low-literate older adults with polypharmacy in the last 6 months (n = 276).</p

The consequences of medication errors among participants who had committed an error (n = 191).

The consequences of medication errors among participants who had committed an error (n = 191).</p

The frequency of self-administration errors among illiterate and low-literate older adults with polypharmacy in the last 6 months (n = 276).

The frequency of self-administration errors among illiterate and low-literate older adults with polypharmacy in the last 6 months (n = 276).</p