Surgical outcome of coronary artery fistulas repair in children

Coronary artery fistula (CAF) is a rare congenital anomaly that can be complicated by endocarditis, myocardial infarction, or coronary aneurysms. This article reviews the clinical characteristics and surgical outcome of 10 patients with CAF in Rajae Heart Center. From 1990 to 2000, 10 patients (age, 6 months to 15 years; mean age, 8.5 years) were diagnosed with CAF by echocardiography and cardiac catheterization. Six were female and 4 were male. All patients with isolated CAF (9) were asymptomatic. One patient with associated anomaly (mitral valve prolapse with severe mitral regurgitation) had dyspnea on exertion and palpitation. Five fistulas originated from the right coronary artery-three from the left and two from the left circumflex. Drainage was to the right ventricle (7), right atrium (2), and pulmonary artery (1). The ratio of pulmonary to systemic flow ranged between 1 and 1.6. All patients had surgical ligation. In the symptomatic patient, in addition to ligation, mitral valve replacement was performed. There was no operative or late death. Follow-up evaluation (range, 1-6 years; mean, 4.2 years) showed no evidence of recurrent or residual CAF. Surgical management of CAF is a safe and effective treatment resulting in 100 survival and clousure rate. © Springer Science+Business Media, Inc. 2005

Abdominal volume index: A predictive measure in relationship between depression/anxiety and obesity

Background: Obesity is a risk factor for mood disorder (such as depression and anxiety). We aimed to assess application of A Body Shape Index (ABSI) and abdominal volume index (AVI), as new indices of obesity to evaluate the relationship between obesity and depression/anxiety. Methods: This cross sectional study was conducted on 307 overweight and obese women (249 females, 58 males) 20-60 years in Iran in 2017-2018. The anthropometric measures including weight, waist circumference, hip circumference, body fat and derived values of body mass index, waist�hip ratio, AVI and ABSI were evaluated. HADS questionnaire for depression and anxiety completed. Results: Prevalence of depression was 36.1 in women; men 24.1; overweight 28.1; obese 36.5 and central obesity 33.7. Anxiety was apparent in 27.1 of overweight 30.3 obese and 29.6 central obesity. People with depression and anxiety had higher WC, BF and AVI. ABSI had no significant correlation with depression/anxiety. The odds of depression (1.06; 95 CI, 1.02-1.12) and anxiety (1.06; 95 CI, 1.01-1.11) were elevated with increase AVI. Conclusion: Our results suggested that AVI as an indirect measure of abdominal obesity along with WC and BF could be useful in predicting the relationship between obesity and depression/anxiety. © 2020 Hadi S et al. Licensee African Health Sciences

Evaluation of the effects of pycnogenol (French maritime pine bark extract) supplementation on inflammatory biomarkers and nutritional and clinical status in traumatic brain injury patients in an intensive care unit: A randomized clinical trial protocol

Background: Traumatic brain injury (TBI) is one of the major health and socioeconomic problems in the world. Immune-enhancing enteral formula has been proven to significantly reduce infection rate in TBI patients. One of the ingredients that can be used in immunonutrition formulas to reduce inflammation and oxidative stress is pycnogenol. Objective: The objective of this work is to survey the effect of pycnogenol on the clinical, nutritional, and inflammatory status of TBI patients. Methods: This is a double-blind, randomized controlled trial. Block randomization will be used. An intervention group will receive pycnogenol supplementation of 150 mg for 10 days and a control group will receive a placebo for the same duration. Inflammatory status (IL-6, IL- 1β, C-reactive protein) and oxidative stress status (malondialdehyde, total antioxidant capacity), at the baseline, at the 5th day, and at the end of the study (10th day) will be measured. Clinical and nutritional status will be assessed three times during the intervention. The Sequential Organ Failure Assessment (SOFA) questionnaire for assessment of organ failure will be filled out every other day. The mortality rate will be calculated within 28 days of the start of the intervention. Weight, body mass index, and body composition will be measured. All analyses will be conducted by an initially assigned study arm in an intention-to-treat analysis. Discussion: We expect that supplementation of 150 mg pycnogenol for 10 days will improve clinical and nutritional status and reduce the inflammation and oxidative stress of the TBI patients. Trial registration: This trial is registered at clinicaltrials.gov (ref: NCT03777683) at 12/13/2018. © 2020 The Author(s)

Doppler findings in a rare Coronary Artery Fistula

One of the primary forms of congenital anomalies of the coronary arteries is coronary artery fistula (CAF). It is defined as a direct communication between the coronary artery and any surrounding cardiac chamber or vascular structure, which bypasses the myocardial capillary bed. We present a newborn baby with a large coronary artery fistula connecting the left anterior descending (LAD) artery to the left ventricular (LV) apex. Associated cardiac abnormalities were found: a ventricular septal defect (diameter 4 mm), a patent foramen ovale as well as trivial tricuspid and mitral regurgitation. Here we demonstrate the echocardiograms of an extremely rare form of CAF diagnosed within the first days of postnatal life

Barberry in the treatment of obesity and metabolic syndrome: possible mechanisms of action

Safieh Firouzi,1,2,* Mahsa Malekahmadi,1,2,* Majid Ghayour-Mobarhan,1,3 Gordon Ferns,4 Hamid Reza Rahimi3,5 1Metabolic Syndrome Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; 2Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran; 3Department of Modern Sciences and Technology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran; 4Department of Medical Education, Brighton and Sussex Medical School, University of Brighton Falmer Campus, Brighton, UK; 5Neurogenic Inflammation Research Center, Mashhad University of Medical Sciences, Mashhad, Iran *These authors contributed equally to this work Abstract: Obesity is a consequence of an imbalance between energy intake and energy expenditure. It affects people of both genders and all age groups, ethnicity and socioeconomic groups, and in developed and developing countries. Obesity is often accompanied by the metabolic syndrome (MetS). MetS is characterized by a clustering of cardiovascular risk factors, including high blood pressure, adiposity, dyslipidemia and glucose intolerance, which together increase the risk of atherosclerotic cardiovascular disease, type 2 diabetes mellitus and other causes of mortality. Nowadays, there is a growing interest in the use of plant-based agents instead of synthetic drugs to manage chronic diseases such as MetS; one such example is Berberis vulgaris. B. vulgaris contains isoquinonline alkaloids such as berberine, berberrubine and berbamine. Recent studies have proved that berberine exhibits pharmacological activities and positive effects on the risk factors of obesity and MetS. We have reviewed original articles related to the possible molecular mechanisms of action of berberine on obesity and MetS. Berberine suppresses adipocyte differentiation and decreases obesity. It also regulates glucose metabolism via decreasing insulin resistance and increasing insulin secretion. Other effects of berberine include antihyperlipidemic and antihypertensive activities and endothelial protection. Keywords: berberine, syndrome metabolic, obesity&nbsp

The effect of Vitamin C and Zn supplementation on the immune system and clinical outcomes in COVID-19 patients

SARS-CoV-2 (Severe Acute Respiratory Syndrome-Coronavirus-2) is the most dangerous form of the coronavirus, which causes COVID-19. In patients with severe COVID-19, the immune system becomes markedly overactive. There is evidence that supplementation with select micronutrients may play a role in maintaining immune system function in this patient population. Throughout the COVID-19 pandemic, significant emphasis has been placed on the importance of supplementing critical micronutrients such as Vitamin C and Zinc (Zn) due to their immunomodulatory effects. Viral infections, like COVID-19, increase physiological demand for these micronutrients. Therefore, the purpose of this review was to provide comprehensive information regarding the potential effectiveness of Vitamin C and Zn supplementation during viral infection and specifically COVID-19. This review demonstrated a relation between Vitamin C and Zn deficiency and a reduction in the innate immune response, which can ultimately make patients with COVID-19 more vulnerable to viral infection. As such, adequate intake of Vitamin C and Zn, as an adjunctive therapeutic approach with any necessary pharmacological treatment(s), may be necessary to mitigate the adverse physiological effects of COVID-19. To truly clarify the role of Vitamin C and Zn supplementation in the management of COVID-19, we must wait for the results of ongoing randomized controlled trials. The toxicity of Vitamin C and Zn should also be considered to prevent over-supplementation. Over-supplementation of Vitamin C can lead to oxalate toxicity, while increased Zn intake can reduce immune system function. In summary, Vitamin C and Zn supplementation may be useful in mitigating COVID-19 symptomology. © 2022 The Author

Effect of Egg Consumption on Blood Pressure: a Systematic Review and Meta-analysis of Randomized Clinical Trials

Purpose of Review: We identified and quantified the results of randomized controlled trials (RCTs) that have assessed the impact of egg consumption on blood pressure in adults. Recent Findings: We conducted a comprehensive search of medical bibliographic databases up to February 2019 for RCTs investigating the effect of egg consumption on blood pressure in adults. Fifteen RCTs were included with a total of 748 participants. Overall, egg consumption had no significant effect on systolic blood pressure (weighted mean difference (WMD) = 0.046 mmHg; 95 CI � 0.792, 0.884) and diastolic blood pressure (WMD = � 0.603 mmHg; 95 CI � 1.521, 0.315). Subgroup analyses had no effect on pooled results and no heterogeneity was found among included studies. Summary: Egg consumption has no significant effects on systolic and diastolic blood pressure in adults. Due to several limitations among existing studies, general conclusions cannot be drawn regarding the beneficial or neutral impact of egg consumption on blood pressure in adults. © 2020, Springer Science+Business Media, LLC, part of Springer Nature