The effect of reflexotherapy and massage therapy on vital signs and stress before coronary angiography: An open-label clinical trial

Abstract BACKGROUND: Complementary medicine interventions are now successfully used to reduce stress as well as to stabilize hemodynamic indices within different procedures. The present study aimed to examine the effect of massage therapy and reflexotherapy on reducing stress in patients before coronary angiography. METHODS: In this open-label clinical trial, 75 consecutive patients who were candidate for coronary angiography were randomly assigned to receive reflexotherapy (n = 25), or massage therapy (n = 25), or routine care (n = 25) before angiography. The Spielberger State-Trait Anxiety Inventory was used to determine the stress level of patients before and after interventions and vital signs were also measured. RESULTS: Improvement in diastolic blood pressure, heart rate, and respiratory rate was shown in the reflexotherapy group, and similar effects were observed following other interventions including massage therapy and routine resting program. In subjects who received reflexotherapy the level of stress decreased slightly compared with the other two groups. However, following interventions the level of stress in reflexotherapy group was shown to be lower than other study groups. CONCLUSION: Reflexotherapy before coronary angiography can help to stabilize vital sign as well as reduce the level of stress. The effect of massage therapy was limited to reducing stress

Fatality rate of myocardial infarction in patients with and without diabetes in Iran’s hospitals in 1392

Introduction: Data shows that no study at a national level on fatality rates of myocardial infarction (MI) and its determinants in diabetic and non-diabetic hospitalized Iranian patients, has yet been published. The aim of this study was to determine the case fatality rate (CFR) of MI in patients with and without history of diabetes and the factors associated with MI mortality in Iran. Materials and Methods: In this cross-sectional, national study, data of 20,750 new patients with MI were used. For data analysis, Chi-square test, t-test and logistic regression model in Stata software were used. Modeling was done per gender. Results: Of 20,750 new patients with MI, 4,612 (22.3%) patients had diabetes. Case Fatality rates of MI were 13.22% (confidence interval [CI] 95%=12.27-14.23) in diabetic patients and 11.7% (11.28-12.26) in non-diabetic patients, and were significant (p=0.036). Odds ratio (OR) of mortality from ST segment elevation myocardial infarction STEMI was 4.77 (CI 95%=4.20-5.43) in men, approximately twice that in women (OR=2.13, CI 95%=1.78-2.54). Conclusion: Although CFR was higher in diabetic patients than in non diabetic ones, the statistically significant difference was not clinically noteworthy, due to the small difference in CFR between the two groups and large sample size of the study. Therefore, prompt management and provision of required healthcare in emergency and CCUs within the appropriate time and access to specialized treatments for diabetic and non diabetic patients are recommended

The association of changes in electrocardiography, echocardiography and cardiac enzymes with One-month mortality in AMI patients referring to Hajar Hospital of Shahrekord

Background and aim: Various laboratory tests with their own particular strengths and weaknesses exist for diagnosis of acute myocardial infarction (AMI). This study was conducted to determine the association of changes in electrocardiography, echocardiography and cardiac enzymes with One-month mortality in AMI patients referring to Hajar Hospital of Shahrekord in 2011. Materials and method: For this descriptive analytical study, 107 AMI patients were randomly enrolled. For gathering data a questionnaire was used. Demographic data and test results of cardiac enzymes, EKG, and echocardiography according to the medical profile were registered in the questionnaire. The follow-up continued for 40 days through phone calls and medical profile and the mortality and/or any recurrent myocardial complication was entered into the medical profile. Data analysis was performed by SPSS 11 using chi-square, Spearman correlation coefficient, and t test. Results: The mean age of patients was 60.62± 12.58years. Mortality showed a direct association with age and personal history of ischemic heart disease (p<0.05). In addition, one-month mortality was directly associated with troponin, ejection fraction, and the number of segments involved in echocardiography (p<0.05); troponin level in outliving people was less, the mortality among patients with less ejection fraction was higher, and the number of involved segments was higher in the dead compared to the outliving. Conclusion: The findings of this study emphasize the value of echocardiography in determining the prognosis of AMI. Moreover, troponin could have a high prognostic value in addition to its high value in diagnosis

Comparison of the papers published in journal of shahrekord university of medical sciences with those published in other medical journals of Iran in view of methodology

Background and aim: Scientific and research journals are considered as one of the most important tools for scientific and research information and science advancement in any discipline. Publishing articles in these journals is known to be an important indicator for knowledge generation. Comparing and assessing medical journals which present research outcomes, quantitatively and qualitatively, is particularly important to improve and promote them. The present study was conducted to compare the papers published in scientific and research Journal of Shahrekord University of Medical Sciences (JSKUMS) with those published in other medical journals of Iran in view of methodology. Methods: This cross-sectional study examined and compared the observance of scientific writing of "Materials and Method" and "Results" of 113 articles published in JSKUMS with that of 269 articles published in other medical journals of Iran within 2010-2012 through random sampling using a validated questionnaire. The data were analyzed by SPSS software using Chi square, ANOVA, and t test. Results: The percentage of original, cross-sectional, clinical trial, and experimental studies published in JSKUMS in 2011-2012 was respectively 93, 48, 20, and 17. The mean number of authors of the articles was 4.9 ± 3 and the most common errors in JSKUMS and other medical journals of Iran were failure to mention method of sampling (29 and 42 respectively), sample size (7 and 9 respectively), the software used (39 and 10 respectively), methods of randomization and blinding (72 and 27 respectively), letter of consent and ethics committee's approval (11 and 4 respectively), failure to provide confidence intervals for descriptive indicators (9 and 14 respectively) and required analytical indicators (7 and 16 respectively), and failure to observe the instructions of drawing tables (30 and 17 respectively) and graphs (35 and 25 respectively). The number of case-control studies and cohorts was significantly higher in other medical journals of Iran compared to JSKUMS. Conclusion: Identifying the common errors in the examined journals provided the context for improving and promoting them quantitatively and qualitatively. Therefore, it seems helpful to inform the authors and consider the most common errors, to empower the reviewers and address the quality and quantity of workshops on research methodology and scientific writing, and to provide opportunities for publishing guidelines for research and writing research papers

Comparison of cardiac arrhythmia prevalence in smoking and non smoking myocardial infarction patients admitted in Hajar University hospital, Shahrekord, 2006

Background and aim: Smoking is one of the main reversible risk factors for coronary artery disease. Incidence of arrhythmia induced by myocardial infarction is the most important reason for death in these patients. Mortality rate in smoking myocardial infarction patients is grater than non smoking patients, but the aim of this study was to compare the incidence of arrhythmias between smoking and non smoking myocardial infarction patients. Methods: In this case and control descriptive analytic study, 200 myocardial infarction patients (100 smoking & 100 non-smoking patients) who were referred to cardiac care unite in Hajar university hospital were selected. Data were collected using questionnaires, filing the form of physiological variables, laboratory findings and finally types of arrhythmias and myocardial infarctions. Data were analyzed by the independent-t test and the Fishers exact test. Results: The average age in smoking patients was 54.23±8.12 and it was 55.23±8.11 in non-smoking patients. Type of myocardial infarctions in 70.5% of the cases was anterior myocardial infarction and the rest was inferior myocardial infarction. Our study showed that the type of arrhythmia in smoking group was different than non-smoking group. Sinus tachycardia, Atrial Flutter, preventricular heart beat, ventricular tachycardia and ventricular fibrillation were higher in smoking group compared to the non-smoking group (P<0.05) Conclusion: According to this study, the incidence of arrhythmia in smoking patients with myocardial infarction is greater than non-smoking patients. Therefore, more attention should be focused on smoking patients with myocardial infarction for arrhythmia

Right coronary artery-to-pulmonary artery fistula, the role of echocardiography

Coronary artery fistula is an uncommon but hemodynamically significant anomaly of the coronary arteries, occurring as an incidental finding in 0.1% to 0.2% of coronary angiograms. Although half of the patients with a coronary artery fistula remain asymptomatic, the other half develops CHF, infective endocarditis, myocardial ischemia, or rupture of an aneurysm. This report is illustrative of the right coronary artery fistula to the right pulmonary artery in a 57-year-old male. The definitive diagnosis was made during transesophageal echocardiography and confirmed at operation

Comparison of N-acetylcysteine, ascorbic acid, and normal saline effect in prevention of contrast-induced nephropathy

BACKGROUND: Considering the crucial role of appropriate preventative strategies in reducing the rate of contrast-induced nephropathy (CIN) occurrence and its related morbidity and mortality, the effect of N-acetylcysteine (NAC), ascorbic acid (AA), and normal saline (NS) was investigated in the patient's undergone coronary angiography. METHODS: In this clinical trial, 120 patients scheduled for elective coronary angiography with serum creatinine (Cr) level > 1.5 mg/dl or glomerular filtration rate (GFR) >= 60 selected by convenience method. Selected patients were allocated in three treatment groups randomly to receive oral NAC (600 mg/twice daily) plus NS (100 ml/hour) (Group A), oral AA (250 mg/twice daily) plus NS (100 ml/hour) (Group B) and NS (100 ml/hour) (Group C), respectively. The occurrence of CIN was evaluated based on serum Cr and GFR in three studied groups, before and after angiography procedure. The analysis of variance and paired t-test were used for data analysis by SPSS. RESULTS: The serum Cr increased and GFR decreased significantly during the intervention in three groups (P 0.050). CONCLUSION: The study showed that nor the addition of NAC neither the addition of AA to sodium chloride infusion has more beneficial effect than hydration with sodium chloride, in the prevention of CIN

Epidemiological characteristics and determinants of mortality in acute coronary syndrome in Iran

Abstract Background and purpose: Acute coronary syndrome (ACS) includes ST elevation myocardial infarction (STEMI), non–ST-segment elevation myocardial infarction (NSTEMI), and unstable angina. This study was conducted to determine the characteristics of patients with ACS and determinants of their mortality in Iran. Materials and methods: This study was a hospital-based prospective cohort study in which we used the data of 20,750 patients registered in National Registry of myocardial infarction in hospitals with cardiology ward in 31 provinces in Iran. To determine the factors associated with patients’ mortality, Cox regression (relative hazards model) was used. Results: Mortality rate in followed up patients with STEMI and NSTEMI was 3698.4 and 4573.3 per 1000 person-year, respectively. The mean age of patients with STEMI was 60.5± 13.1 years and in those with NSTEMI was 62.9± 13.4 years. The prevalence of STEMI and NSTEMI was 75.8% and 24.2%, respectively. The most important determinants of mortality in patients were age over 84 years of old, female sex, illiteracy, lack of receiving thrombolytic therapy, right bundle branch block, STEMI, heart failure, and receiving angioplasty. Conclusion: The characteristics of patients with ACS, could help the health system personnel in strategy adoption and decision making as well as assessment, monitoring, and treatment of patients. Training people to refer early for emergency care in case of manifesting ACS symptoms, and providing them with treatment at golden time could be of great benefit in reducing the rate of mortality

Determination of instantaneous interventricular septum wall thickness by processing sequential 2D echocardiographic images

Non-invasive quantitative analysis of the heart walls thickness is a fundamental step in diagnosis and discrimination of heart disease. Thickness measurements in 2D echocardiographic images have many applications in research and clinic for assessing of wall stress, wall thickening and viability parameters. Regarding to interventricular septum wall thickness measurement by conventional manual method is more dependent on sonographer experiment; this encouraged these researchers to develop a semi-automatic computer algorithm in accessing to interventricular septum segments thickness. We proposed and carried out a computerized algorithm for wall thickness measurements in 2D echocardiographic image frames. In this program, wall thickness measurement is based of intensity profile function and adaptive bilateral thresholding operation. For validation, thicknesses of septum base and mid segments were estimated in constituent image frames with use of proposed method and then were compared with conventional manual results at same images of the cardiac cycle by statistical methods. In our sample image frames (240 corresponding segments; with different rang of image quality), a bias of 0.10 and 0.12 mm with SD differences of ±0.81 and ±0.72 mm and correlation coefficients of 0.87 and 0.89 were found in base and mid segments, respectively. Interobserver variability using the Computer-Assisted Method (CAM) and Conventional Manual Method (CMM) were 4.0 and 4.7 for the basal and 2.8 and 3.9 for the middle segments. The method introduced in the present study permits precise thickness assessment of base and mid segments of the interventricular septum wall and has high concordance with CMM. © 2007 Asian Network for Scientific Information

The Potential Association between the Risk of Post-Surgical Adhesion and the Activated Local Angiotensin II Type 1 Receptors: Need for Novel Treatment Strategies

Background: Post-surgical adhesion bands (PSABs) are a common complication after abdominal or pelvic surgeries for different reasons like cancer treatment. Despite improvements in surgical techniques and the administration of drugs or the use of physical barriers, there has only been limited improvement in the frequency of postoperative adhesions. Complications of PSAB are pain, infertility, intestinal obstruction, and increased mortality. The most important molecular mechanisms for the development of PSAB are inflammatory response, oxidative stress, and overexpression of pro-fibrotic molecules such as transforming growth factor beta. However, questions remain about the pathogenesis of this problem, for example, the causes for individual differences or why certain tissue sites are more prone to post-surgical adhesions. Summary: Addressing the pathological causes of PSAB, the potential role of local angiotensin II/angiotensin II type 1 receptors (AngII/AT1R), may help to prevent this problem. Key Message: The objective of this article was to explore the role of the AngII/AT1R axis potential to induce PSAB and the therapeutic potential of angiotensin receptor blockers in the prevention and treatment of PSAB