Association of Anticardiolipin Antibodies and Extent of Coronary Artery Disease in Military Personnel and Non Military Population With Acute Coronary Syndrome

Introduction: Cardiac involvement is one of the chief complications considerably contributing to the morbidity and mortality of patients with systemic autoimmune diseases. Anticardiolipin antibody is a marker of elevated myocardial infarction risk and it also predicts post cardiac intervention risk. In the current study, we aimed to evaluate the association between anticardiolipin IgM and IgG levels and atherosclerotic involvement of coronary arteries.Methods: Patients with acute coronary syndrome admitted to a military hospital were included in the study. Patients were categorized to military personnel and non-military personnel. Laboratory data including lipid profile, blood sugar, anticardiolipin IgM and anticardiolipin IgG were verified. Existence and the extent of Coronary Artery Disease (CAD) were defined according to angiographic findings. The relationship between anticardiolipin antibody levels and the number of vessels were evaluated.Results: According to our sample population calculation, we performed the study on a total of 92 patients. Measurement of both anticardiolipin antibodies (IgM and IgG) in military personnel and non personnel patients showed no significant difference. In both military personnel and non personnel groups, there was a significant association between anticardiolipin IgM and IgG levels and number of coronary arteries with significant stenosis. The C Reactive Protein (CRP) level was significantly higher in military personnel.Conclusions: According to the study results, anticardiolipin antibody levels were the same in both military personnel and non personnel. Also systolic and diastolic blood pressures were not significantly different in both groups. Increased CRP level in military personnel may be a warning signal about the possibility of premature CAD in this population, hence aggressive risk factor modification is recommended. Paradoxically lipid profile and FBS levels were more favorable in military personnel, which indirectly reflects their higher state of physical activity

Comparison of Tension-free Vaginal Tape Versus Transobturator Tape in Women with Stress Urinary Incontinence

Objective: This study compared the Tension-free vaginal tape (TVT) and Transobturator tape (TOT) procedures for surgical treatment of stress urinary incontinence in women. Materials and methods: This prospective non randomized clinical trial was conducted in Vali-e-asr hospital from March 2001 to March 2005. A total of 71 patients with clinical and urodynamic diagnosis of Stress urinary incontinence (SUI) were enrolled in the study. Patients were divided into two groups and underwent TVT or TOT procedures. Mean operation time, cure rate, post  operative urinary retention, bleeding and infection were compared between two groups. SPSS software was used for statistical analysis. Chi square and fisher exact test calculated the effects of the nominal variables. Mean difference of quantitative variables were compared by student's T- test. P ≤0.05 was considered statistically significant. Results: There was no significant difference in mean time of operation and peri-operative complications among groups. Urinary retention was 13.8% (n=5) in the TVT group versus 2.8% (n=1) in TOT group (NS). The rates of cure (91.6% vs 91.4%), improvement (5.6% vs 8.6%) and failure (2.8% vs 0) were similar for the TVT and TOT groups. The rate of hemorrhagic complications was 5.5% in TVT and 2.8% in TOT group (NS). Conclusion: TOT appears to be equally efficient to TVT for  surgical treatment of stress urinary incontinence after 30 months follow-up

Posterior Intravaginal Slingplasty for Vaginal Prolapse

Objective: Urogynecologists are constantly looking for simple, safe and effective ways to cure vaginal apex prolapse. The aim of this study was to evaluate the results of posterior intravaginal slingplasty (PIVS). Materials and methods: A total of 38 patients with advanced vaginal apical prolapse underwent posterior intravaginal slingplasty in Vali-e-Asr hospital in Tehran. In this clinical trial (before-after study), demographic, pre-operative, operative details and post-operative follow-up data were collected for all patients. The data were analyzed using SPSS software and Mac Nemar test.  P<0.05 was considered for statistical significance. Results: The mean for patients' age was 67 (50-81) years, for operation time was 35 (25-45) minutes and for blood loss was 125 (70-300) ml. No intraoperative rectal perforation was observed and there was a significant difference in patients' symptoms such as pelvic pain, nocturia, urgency and urinary tract infection before and after the surgery (p < 0.001). Conclusion: PIVS had similar efficacy with other studies in the treatment of vaginal vault prolapse. The procedure reduces the complication rate and shortens the rehabilitation period with a satisfying result

Relationship between metabolic syndrome and angiographic severity of coronary artery disease

BACKGROUND: There are a few literature data on the correlation between metabolic syndrome (MetS) and coronary disease among Iranian population. This study aimed to find relationship between MetS and severity of coronary artery disease (CAD) in presence of diabetes. METHODS: Total of 192 patients were consecutively enrolled in the study who were admitted to coronary care unit because of acute coronary syndrome (ACS) and then underwent coronary angiography. MetS was defined by Iranian criteria. A coronary atherosclerosis score was used to quantify the extent of atherosclerotic involvement. The relationship between MetS and angiographic CAD severity or clinical presentation was compared between them after adjusting for diabetes. RESULTS: Individuals with MetS (n = 125) had a higher prevalence of ST-elevation myocardial infarction (71% vs 30%, P &lt; 0.001), multi-vessel disease (50% vs. 34%, P = 0.003), decreased ejection fraction (P = 0.001) and more severe angiographic stenosis based on both modified Gensini (P = 0.081) and syntax (P = 0.008) scores, compared to those without MetS. Syntax score showed statistically significant difference between two groups before (P = 0.021) and after adjustment for diabetes (P = 0.005). CONCLUSION: MetS was related to the severity of CAD both clinically and by angiographic scores but diabetes was a challenging factor and may independently increase the severity of CAD. &nbsp;&nbsp;</div