Percutaneous transvenous mitral commissurotomy in a patient with situs inversus and dextrocardia: a case report

<p class="abstract"><strong>INTRODUCTION:</strong> Dextrocardia situs inversus refers to the heart being a mirror image situated on the right side of the body. Distorted cardiac anatomy provides technical difficulties during fluoroscopy‐guided transcatheter procedures. This is even more difficult in the case with percutaneous transvenous mitral commissurotomy (PTMC). Mitral valvuloplasty is a minimally invasive therapeutic procedure to correct an uncomplicated mitral stenosis by dilating the valve using a balloon. Here, we describe a case of a 25 years-old male with situs inversus and dextrocardia.</p> <p class="abstract"><strong>CASE REPORT</strong>: A 25 years-old man, having situs inversus and suffering from mitral stenosis was referred to hospital for PTMC. His initial examination findings were unremarkable and an electrocardiographic (ECG), trans-esophageal and transthoracic echocardiographic evaluation were performed. Mitral valve (MV) was dome shape and severely stenotic with mild mitral regurgitation (MR). Left ventricular&nbsp;ejection Fraction (LVEF) was about 40%, Femoral arterial and venous punctures were made on the left side; the left femoral artery and vein were cannulated with a 5F arterial and 6F venous sheaths, respectively. Then special maneuvers were done to solve the mitral valve stenosis. At the end of the procedure, no MR was documented by checking LV angiogram and there were no signs of mitral stenosis (MS).</p> <p class="abstract"><strong>DISCUSSION:</strong> Mirror‐image dextrocardia, as in our case, has been estimated to occur with a prevalence of 1:10,000. However, there are only a few case reports in the literature on PTMC in similar settings. This might be due to the fact that many of these patients undergo surgical commissurotomy due to the technical difficulties involved in a percutaneous procedure in general. Trans-septal catheterization is considered a technical challenge in anatomically malpositioned hearts, as it is fraught with a higher risk of cardiac perforation. Despite the challenging anatomy, PTMC has been demonstrated to be a safe and feasible option for MS in patients with unusual cardiac anatomy.</p> <p class="abstract">&nbsp;</p> <p class="abstract">&nbsp;</p><table cellspacing="0" cellpadding="0" align="left"><tbody><tr><td width="35" height="12">&nbsp;</td></tr><tr><td>&nbsp;</td><td>&nbsp;</td></tr></tbody></table><p class="abstract"><strong>Keywords:</strong> PTMC, Dextrocardia, Surgical Commissurotomy</p

Coronary Artery Disease Risk Factors in Patients Undergoing Coronary Artery Bypass Graft Surgery

Introduction: Nowadays, with the advancement of technology and industrial life, the prevalence of heart diseases including coronary artery diseases has considerably increased. Coronary artery diseases are one of the most common and serious diseases that threaten human life. Methods: The present study is a comparative-descriptive research. The statistical population were 188 patients admitted in surgery ward of Rasht medical centers to receive coronary artery bypass graft surgery in 2012. Data gathered by questionnaire individual information and risk factors of coronary artery disease, and analyzed by SPSS software. Results: In this study in both youth and adults groups, 38.30% had smoking history and 42% had the positive family history of heart disease. According to Chi-square test, there was no significant difference among risk factors of smoking, hypertension, hyperglycemia, higher level of LDL, elevated triglycerides, and age of the participants (P> 0/05); while there was a significant difference between positive family history of heart disease and age (p<0.005), and also between heart disease history and age (p<0.005). The findings of the present study indicated that in young patients the highest percentage increase in laboratory risk factors and behavioral risk factors belonged to triglycerides (52. 4 %) and smoking (43%), respectively. Conclusion: It is ultimately concluded that social misconceptions about the refusal of coronary artery heart disease risk factors at the youth age should be changed, and through taking necessary educational measures guide the society towards health promotion, lifestyle changes and modification of coronary artery disease including smoking and triglyceride level

Effectiveness of Mouth Washes on Streptococci in Plaque around Orthodontic Appliances

Background and Purpose. Fixed orthodontics may be associated with accumulation of Mutans Streptococci (MS), enamel demineralization, and an increased number of carious lesions, predominantly in sites adjacent to brackets. This study was undertaken to assess the effectiveness of Listerine, Oral-B, and Ortho-kin on the accumulation of MS in plaque around orthodontic brackets. Materials and Methods A double-blind randomized cross-over clinical trial on 25 orthodontic patients, classified into 6 groups was done to assess MS in plaque and saliva with the side specific modified Strip-Mutans technique and the plaque (PI) was measured before and after rinsing using 3 types of commercial mouth-rinses. A washout period (3 weeks) was awaited between using each mouth-rinse and the data was analyzed via Wilcoxon and Kruskal Wallis statistical tests. Results. This study of 25 patients, 5 men and 20 women, with an average age of 19 ± 6/3 assessed the effectiveness of mouth-rinses on MS. Our results showed that Ortho-kin had a better effect than Oral-B and Listerine (P < 0/09). Ortho-kin also had better effects than Oral-B and Listerine on plaque accumulation (P < 0/001). Conclusion. Ortho-kin showed better effects on decreasing MS and PI because it contained chlorhexidine

Glucocorticoid-Induced Leucine Zipper Promotes Neutrophil and T-Cell Polarization with Protective Effects in Acute Kidney Injury

n/

The effect of weight reduction on antioxidant enzymes and their association with dietary intake of vitamins A, C and E

ABSTRACT Objective: Our goal was to assess the effects of weight loss on antioxidant enzymes of red blood cells and it&apos;s relation with vitamins A, E and C intake in 30 obese women. Subjects and methods: General information, anthropometric measurements, 3-day food recall, and fasting blood samples were collected from 30 obese women at the beginning of the study and after 3 months intervention. Weight loss was set at about 10% of their weight before the intervention. Results: Glutathione reductase and catalase activities showed a significant increase (P &lt; 0.01) after weight reduction, but no significant changes were seen in the superoxide dismutase and glutathione peroxidase activities. There was a positive linear correlation between daily vitamin C intake with superoxide dismutase enzyme after intervention (P = 0.004, r = 0.507). There was a negative linear correlation between vitamin E intake and glutathione peroxidase activity before intervention (P = 0.005, r = -0.5). A negative correlation was found between daily vitamin A intake and glutathione reductase enzyme before and after intervention (r = -0.385, r = -0.397, P &lt; 0.05) respectively. No significant correlation was observed between vitamins A, C, E amounts and catalase activity. Conclusions: Ten percent weight reduction can have a significant role in increasing antioxidant enzymes activities, especially glutathione reductase, and catalase enzymes in obese women. However, it is important to take into consideration a balanced amount of certain nutrients while administering a diet with limited energy. Arq Bras Endocrinol Metab. 2014;58(7):744-9 Keywords Obesity; enzymic antioxidants; weight reduction RESUMO Objetivo: Nosso objetivo foi avaliar os efeitos da perda de peso sobre as enzimas antioxidantes de eritrócitos, e a relação destas com a ingestão das vitaminas A, E e C. Sujeitos e métodos: Foram coletadas informações gerais e medidas antropométricas, registro alimentar de três dias e amostras de sangue em jejum de 30 mulheres obesas no início do estudo e depois de três meses da intervenção. A perda de peso determinada antes da intervenção foi de 10% do peso. Resultados: As atividades da glutationa redutase e da catalase mostraram aumento significativo (P &lt; 0,01) depois da perda de peso, mas não houve mudanças significativas nas atividades da superóxido dismutase e da glutationa peroxidase. Foi observada uma correlação linear positiva entre a ingestão diária de vitamina C e a enzima superóxido dismutase após a intervenção (P = 0,004, r = 0,507). Houve uma correlação linear negativa entre a ingestão de vitamina E e a atividade da glutationa peroxidase antes da intervenção (P = 0,005, r = -0,5). Foi observada uma correlação negativa entre a ingestão diária de vitamina A e a enzima glutationa redutase antes e depois da intervenção (r = -0,385, r = -0,397, P &lt; 0,05), respectivamente. Não foram observadas correlações significativas entre as vitaminas A, C, E e os níveis e a atividade da catalase. Conclusões: Uma redução de 10% no peso pode ter um papel significativo no aumento da atividade das enzimas antioxidantes, especialmente na glutationa redutase e catalase em mulheres obesas. Entretanto, é importante levar em consideração uma ingestão equilibrada de certos nutrientes ao se recomendar uma dieta com níveis de energia restritos. Arq Bras Endocrinol Metab. 2014;58(7):744-9 Descritores Obesidade; enzimas antioxidantes; redução de pes

Analysis and Modeling of Energy Demand System in Iran’s Buildings and the Industry

In this study, the demand of the Iran’s energy carriers is analyzed and modeled for the country’s largest consumer, buildings and related industries, in the status quo and future perspective. To this objective, the building sector is divided into two sections: household section (residential buildings) and services (business-office and service buildings) according to the ISIC classification that each of these sections is divided into sub-sections. In addition, building-related industries include some non-metallic minerals and basic metals industries. Regarding to scenario-based energy planning helps to increase the understanding of different probabilities in the future. The future outlook for the system is modeled with the horizon of 2035 with the LEAP modeling tool in the “reference” scenario, indicating the sustainability of the existing energy system in the future. The results of modeling indicate an increasing demand for energy as expected that energy demand carriers in buildings and related industries from 559.8 million barrels in 2014 reach up to 1040.6 million barrels of crude oil equivalents in 2035. Therefore, in order to reduce energy consumption, solutions are modeled and analyzed according to the scenarios for “Improvement of energy consumption in buildings and related industries”, then the greenhouse gas emissions and their environmental effects are investigated