Effect of Opium Addiction on Aspirin Resistance in Stable Angina Pectoris

Abstract Background: The rate of cardiovascular diseases in developing countries is approximately 60% and it is still has an increasing trend. The clinical effectiveness of aspirin in preventing cardiovascular events has been well proven. Although aspirin is an effective and inexpensive drug, its consumption is not equally beneficial for all patients. Many factors can be affective on the efficacy of antiplatelet drugs such as aspirin. Methods: This study was carried out on 260 patients who had stable angina pectoris and coronary artery disease was approved by coronary angiography. Based on opium addiction, the patients were divided into two groups. Opium addiction was diagnosed base on Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) criteria. The mid-stream morning urinary sample were collected for measuring the urinary 11-dehydroxy thromboxane B2 level (UTXB2). Urinary level of UTXB2 was considered as an aspirin resistance index. Findings: The mean age of patients was 57.3 ± 8.9; and 44.6% of them were females. The aspirin resistance rate was 41.5%. Significant difference in aspirin resistance was observed between the opium addicts and non-addicts. (51.5% vs. 31.5%) (P = 0.001). The effects of confounding variables such as diabetes, hypertension, and hyperlipidemia were eliminated by regression logistic multivariable analysis. Conclusion: The prevalence of aspirin resistance in patients with stable angina pectoris was 41.5%. The prevalence of aspirin resistance in patients with stable angina pectoris who had opium addiction was significantly higher them non-addicts. Keywords: Opium addiction, Aspirin resistance, Stable angina pectoris, Coronary angiograph

Serum magnesium in association with parathyroid hormone levels in routine hemodialysis patients

Abstract Introduction: The homeostasis of magnesium (Mg) is perturbed in chronic kidney disease. It has been supposed that plasma Mg has a principal role to regulate the secretion of parathyroid hormone (PTH). Plasma Mg is capable of modulating secretion of PTH. Recent investigations showed that low serum Mg levels in patients with kidney disease have been linked to increased mortality. Objectives: The aim of this study was to determine the relationship between serum Mg and PTH levels in hemodialysis patients. Patients and Methods: This cross-sectional study was conducted on 56 hemodialysis patients in hemodialysis center of Hajar hospital of Shahrekord in 2015. Regular hemodialysis patients who had at least three months history of dialysis were enrolled to the study. The serum levels of Mg, calcium, phosphorus, intact PTH (iPTH), alkaline phosphatase, albumin and bicarbonate were measured. Results: In this study, 61.5% of the 52 patients were male. Mean ± standard deviation (SD) of patients’ age was 60.5 ± 17.7 years with median of 63 years old. The average duration of dialysis was 44±39.5 months (median 36 months). Additionally the dialysis dose was 517 ± 479 weeks (median; 414 weeks). Mean ± SD of serum iPTH and Mg were 360.1 ± 238.2 pg/mL and 2.2 ± 0.2 mg/mL respectively. In this study we found a significantly positive correlation of iPTH with serum Mg levels (r=0.28, P=0.04). Conclusion: This study shows impact of Mg on parathormone secretion. Our findings require further investigations with larger and multicentric studies. Please cite this paper as: Fooladgar M, Malekpour A, Asgari-Savadjani S, Mardani S. Serum magnesium in association with parathyroid hormone levels in routine hemodialysis patients. J Parathyr Dis. 2018;6(1):13-15. DOI: 10.15171/jpd.2018.05. Copyright © 2018 The Author(s); Published by Nickan Research Institute. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work i

The effect of chronic obstructive pulmonary disease’s severity on complications after coronary artery bypass graft surgery

Background and aims: Smoking is an important etiologic factor for cardiac and pulmonary diseases. Chronic Obstructive Pulmonary Disease (COPD) is common in candidates for Coronary Artery Bypass Graft (CABG) surgery. Severity of COPD is determined with spirometry. The aim of this study was comparison of complications after CABG in COPD patients with different severity and without COPD. Methods: This study is a cross sectional research. We divided 125 CABG patients more than 40 years old based on preoperative spirometry to four groups: without COPD (60), mild (29), moderate (24) and severe (12). Spirometry was done using spirometer MIR, made in Italia. Mortality and postoperative complications including cardiovascular and respiratory were recorded until 30 days after the surgery. Data were analyzed by SPSS, fisher exact test and 2χ, and P˂0.05) was considered significant. Results: Complications with significant difference between groups were atrial fibrillation (AF) and delirium. Frequency of AF was: Without COPD 6 (10%), mild COPD 6 (20.70 %), moderate COPD 7 (29.20%), and severe COPD 5 (41.70%) (P=0.02), and delirium was: Without COPD 3 (5%), mild COPD 1 (3.40%), moderate COPD 3 (12.5%), and severe COPD 5 (41.70%) (P=0.003). Conclusion: Based on our results, COPD even moderate and severe is not contraindication of CABG. These patients should be carefully evaluated before surgery and must be treated preoperative completely by the specialist. Under this condition, patients can tolerate and benefit from surgery with acceptable risk

Low-level laser for treatment of tinnitus: a self-controlled clinical trial

BACKGROUND: Despite the high prevalence and morbidity, tinnitus still remains an obscure symptom. We assessed the efficacy of low-level laser for treatment of tinnitus. METHODS: It was a self controlled clinical trial study on 61 outpatients with subjective tinnitus. The patients were irradiated with a 650-nm, 5-mW soft laser for twenty days and twenty minutes per day. The sensation of tinnitus was measured on a Visual Analog Scale (VAS) before and two weeks after treatment and they were compared by means of Wilcoxon signed rank-test. RESULTS: Thirty-eight (62.3%) patients were men and twenty-three (37.7%) were women. Fourteen patients (31.8%) worked in noisy environment. The VAS mean difference before and after the treatment was statistically significant (p < 0.0001). The best treatment effect was in the youngest group and there were significant differences between this group and the middle age and older groups (p = 0.018 and 0.001, respectively). The mean VAS score reduction was not statistically significant between male and female patients (p = 0.23). Also, the treatment outcome according to the noise level in patient’s workplaces was not significantly different in women (p = 0.693), but it was significant in men (p = 0.029). CONCLUSIONS: Transmeatal low-level laser irradiation is effective for the treatment of tinnitus and some variables like age and job can affect the treatment outcom

The research and development on the antioxidants in prevention of diabetic complications

Diabetes mellitus can damage the eyes, kidneys, nerves and heart. Microvascular and macrovascular disorders are the leading causes of morbidity and mortality in diabetic patients. Hyperglycemia can increase the indicators of lipid peroxidation and oxidative stress in which free radicals have the main role in the pathogenesis of these complications. Therefore, antioxidants which combat oxidative stress should be able to prevent and repair free radicals induced damages. Although free radicals contribute to kidney damage, atherosclerosis, diabetes, heart disease, nephrotoxicity and hepatotoxicity; however, clinical trials do not uniquely confirm a substantial impact on diabetic damage. It seems that antioxidants in vegetables, fruits and grains help preventing diabetes complications; however, there is little evidence that taking single antioxidants such as vitamin E or vitamin C protect these complications. The findings about combination antioxidants are also complicated and not entirely clear. In this review paper we tried to present the role of oxidative stress on micro-vascular complications of type 2 diabetes mellitus. Other objective of this paper is to review the new findings about the role of various antioxidants on prevention and treatment of diabetes mellitus as well as its complications including retinopathy, nephropathy and neuropathy

The viewpoints of members of medical teams about patients’ privacy

زمینه و هدف: حریم خصوصی در محیط های درمانی ارتباط بسیار نزدیکی با ارزش های هنجاری دارد و موضوعی است که افراد به طور معمول میل دارند آن را محفوظ داشته، از آن حفاظت کرده و بر آن کنترل داشته باشند. این مطالعه با هدف بررسی دیدگاه اعضای تیم درمان نسبت به حریم خصوصی بیماران طراحی و اجرا شده است تا بدینوسیله راهکارهایی در راستای حل مشکلات موجود و افزایش رضایتمندی بیماران اندیشیده شود. روش بررسی: این مطالعه یک بررسی توصیفی مقطعی با روش نمونه گیری آسان است که در آن دیدگاه ها و نظرات 150 نفر از اعضای تیم درمان در مراکز آموزشی درمانی دانشگاه علوم پزشکی شهرکرد اعم از پزشکان، پرستاران، ماماها، کارکنان آزمایشگاه و کارکنان بخش رادیولوژی در نیمۀ اول سال1391، در خصوص رعایت حریم خصوصی بیماران در مراکز درمانی با استفاده از پرسشنامه پژوهشگر ساخته مورد نظرسنجی قرار گرفت. یافته ها: از نظر اکثر شرکت کنندگان در مطالعه (92) حفظ حریم افراد مفهومی مهم و نیازی اساسی در انسان است. همچنین 3/93 اعتقاد داشتند برای جلوگیری از تجاوز به حریم خصوصی بیماران ارائه راهکارهای جدید ضروری است و طبق نظر 7/66 افراد در رابطه با حفظ حریم بیماران در بعد آموزش توجه زیادی صورت نمی گیرد. 7/72 افراد لزوم تغییر در برنامه آموزش دانشجویان علوم پزشکی در خصوص حریم خصوصی بیمار را ضروری دانستند. نتیجه گیری: با توجه به نتایج این مطالعه تغییر در برنامه آموزشی دانشجویان گروه علوم پزشکی در خصوص حریم بیماران به نحوی که باعث افت کیفیت آموزشی نشود، یک راهکار مناسب جهت اصلاح دیدگاه و عملکرد دانشجویان و فارغ التحصیلان در این زمینه و بر بالین بیماران است

Serum Level of Plasminogen Activator Inhibitor Type-1 in Addicted Patients ‎with Coronary Artery Disease

Background: Plasminogen activator inhibitor-1 (PAI-1) is a glycoprotein with inhibitory effects on the formation of plasmin from plasminogen by plasminogen activator. Thus, it prevents clot lysis in vessel walls. Several evidences prove the relationship between coronary artery disease and response to fibrinolytic therapy in patients with myocardial infarction with PAI-1 level. Opium addiction is one of the most important factors in causing myocardial infarction and cardiovascular events. This is due to it causing imbalance between coagulation and anticoagulation factors in the blood. This study was designed and implemented to determine the levels of PAI-I in opium-addicted patients with coronary artery disease in comparison with non addicts. Methods: In this case-control study, 160 patients with coronary heart disease, which was confirmed by angiography results, were enrolled. All of the patients had a medical history, their creatine levels and lipid profile were evaluated, morphine urine test was performed, and after that a blood sample was taken to determine the levels of PAI-1. Thus, the 80 patients who had a positive morphine urine test result formed the case group, and the control group was constituted of the 80 patients with negative morphine test results. The two groups were matched. Findings: Average level of PAI-1 in the control group was 2.4±2.6 and in the case group was 8.8 ± 9.1 and it was statistically significant (P < 0.001). The frequency of two vessel disease was higher in opium addicted patients than non-addicted patients and this was statistically significant (P = 0.030). However, the frequency of single vessel and three vessel disease was the same in the two groups. The two groups had no differences in age, lipid profile, and creatinine level. Moreover, females are at a higher risk of high PAI-1 levels. Conclusion: PAI-1 levels in opium addicted patients with coronary heart disease are higher than other patients. In these patients, the risk of atherosclerosis and myocardial infarction is higher than normal

Association of serum magnesium level with resistant hyperlipidemia in diabetic and hypertensive patients

Introduction: Both diabetes mellitus and hypertension are aspects of metabolic syndrome. Objectives: The aim of this study was to determine the relationship between serum magnesium level with resistant hyperlipidemia in a group of diabetic and hypertensive patients. Patients and Methods: The present cross-sectional study was carried out on 90 hypertensive and diabetic patients who referred to outpatient university clinic in Shahrekord (45 hypertensive and 45 diabetic patients). Included patients had high triglyceride levels despite 8 weeks of treatment with lipid-lowering agents. Results: There was an inverse significant relationship between serum magnesium and triglyceride levels in diabetic patients (P = 0.002, r =-0.458), however, this correlation was not significant in hypertensive patients (P = 0.754, r = 0.048). Conclusion: This study showed, serum magnesium may affect triglycerides levels in diabetic patients, however, our finding requires further investigation with larger population

Effect of Opium Addiction on Aspirin Resistance in Stable Angina Pectoris

Background: The rate of cardiovascular diseases in developing countries is approximately 60% and it is still has an increasing trend. The clinical effectiveness of aspirin in preventing cardiovascular events has been well proven. Although aspirin is an effective and inexpensive drug, its consumption is not equally beneficial for all patients. Many factors can be affective on the efficacy of antiplatelet drugs such as aspirin. Methods: This study was carried out on 260 patients who had stable angina pectoris and coronary artery disease was approved by coronary angiography. Based on opium addiction, the patients were divided into two groups. Opium addiction was diagnosed base on Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM IV) criteria. The mid stream morning urinary sample were collected for measuring the urinary 11-dehydroxy thromboxane B2 level (UTXB2). Urinary level of UTXB2 was considered as an aspirin resistance index. Findings: The mean age of patients was 57.3 ± 8.9; and 44.6% of them were females. The aspirin resistance rate was 41.5%. Significant difference in aspirin resistance was observed between the opium addicts and non-addicts. (51.5% vs. 31.5%) (P = 0.001). The effects of confounding variables such as diabetes, hypertension, and hyperlipidemia were eliminated by regression logistic multivariable analysis. Conclusion: The prevalence of aspirin resistance in patients with stable angina pectoris was 41.5%. The prevalence of aspirin resistance in patients with stable angina pectoris who had opium addiction was significantly higher them non-addicts