Long-term pulmonary functional status following coronary artery bypass grafting surgery

BACKGROUND: The present study aimed to describe the long-term alterations of pulmonary function and also to describe its association with post-operative pain after coronary artery bypass grafting (CABG) surgery. METHODS: In this prospective study, thirty non-smoker male patients undergoing isolated on-pump CABG were consecutively included in this study. Pulmonary function measurements were performed, in a sitting position, preoperatively, a week postoperatively, and 6 months after the surgery using a Medical Graphics PF/Dx pulmonary function system. Pain was determined by using visual analog scale (VAS) pain scores with a standardized questionnaire's. RESULTS: Regarding functional class, all patients had New York Heart Association (NYHA) Class II to III. A week after operation, a severe restrictive pulmonary impairment was revealed with a mean decrease in VC to 60.9 +/- 9.2% and in forced expiratory volume in one second (FEV1) to 64.6 +/- 12.2% of pre-operative values (P < 0.001). Regarding sternotomy related pain, the mean pain VAS score was preoperatively 3.3 +/- 1.5 that reached to 6.2 +/- 2.5 and 4.8 +/- 2.2 1 week and 6 months after the operation (P < 0.001). The trend of the changes in pain score within 6 months of operation was significantly similar to the trend of the changes in some pulmonary function indices such as FEV% and residual volume (RV). CONCLUSION: A significant reduction is expected in most pulmonary functional parameters following CABG despite normal pulmonary function state preoperatively. Severe pain originated from sternotomy may be an important factor related to pulmonary dysfunction following CABG

Effect of platelet glycoprotein IIb/IIIa PLA2 polymorphism on severity of pulmonary thromboembolism

Background: Pulmonary thromboembolism (PTE) is among the leading causes of death following surgery and/or hospital admission. Role of thrombophilic risk factors in the etiology of PTE is well known; But not much data is available on their role in severity of PTE. The aim of this study was to investigate the role of thrombotic risk factors especially PLA2 polymorphism of platelet glycoprotein IIb/IIIa in the severity of PTE. Materials and Methods: Genotyping from Factor-V (FVL) and prothrombin 20210A (PT20210A) mutations were shown to be significant risk factors for PTE and recurrent PTE. The plasma concentrations of platelet glycoprotein IIb/IIIa PLA2 polymorphism, presence of FVL and PT20210A mutations were studied in 37 patients with PTE. Results: Eleven of these patients had recurrent PTE. Lung perfusion scans were scored according to the percentage of vascular obstruction. Patients who had a pulmonary vascular obstruction (PVO) score >50were compared to those with PVO score50 and those with PVO score50 had a significantly higher frequency of platelet glycoprotein IIb/IIIaPLA2 polymorphism than those with PVO score <50. Conclusion: Our data suggest that presence of PLA2 is associated with an increased risk of PTE in the Iranian population. The association between recurrent events and coinheritance of more than one thrombophilic genetic risk factor shows that such carriers are at a higher risk of PTE. © 2014 NRITLD, National Research Institute of Tuberculosis and Lung Disease

Anti-hyperelipidemic effects of sumac (Rhus coriaria L.): Can sumac strengthen anti-hyperlipidemic effect of statins?

People believe that sumac is used as reducing fat. In the present study, the hypolipidemic effect of sumac fruits was compared with lovastatin in patients suffered hypercholesterolemia. In a randomized double-blinded-controlled trial, 172 patients diagnosed as hypercholesterolemia (high LDL level) and indicated for lipid-lowering schedules were randomly allocated to receive lovastatin (20 mg/day) or a combination of lovastatin (20 mg/day) and sumac (1 gram equivalent to a teaspoon/day, soluble in water). Immediately before initial assessment and also after a 3- month period of drugs prescription, the level of serum lipid profile was measured in both intervention groups by enzymatic assay and serum LDL level was determined using the Friedewald's equation. At baseline, the mean level of LDL was 149.26±22.36 mg/dL in the group received combination therapy, and 146.25±19.89 mg/dL in the group received lovastatin alone with no significant different (p=0.352). However, following administration of the two treatment schedules, the level of LDL was significantly more reduced in combination treatment group compared with another group that the serum level of LDL after 3-month study period was 105.75±21.21 mg/dL in combination therapy group and 117.04±15.78 mg/dL in single therapy group (p≤0.001). The positive response rate in the two groups was 93.0% and 75.6%, respectively (p=0.002). Using Multivariable logistic regression model, the use of sumac combined with statin led to higher response rate indicated by lowering serum LDL level (p=0.019). Sumac has a potential role in lowering LDL level especially when combined with anti-hyperlipidemic drugs as statins

Herbs with anti-lipid effects and their interactions with statins as a chemical anti- hyperlipidemia group drugs: A systematic review.

BACKGROUND The present systematic review aimed to express the clinical anti-lipid effects of different types of herbs, as well as described studied interactions between herbal remedies and prescribed drugs for hyperlipidemic patients which were based on in vitro experiments, animal studies, and empirical clinical experiences. METHODS For this systematic review, we explored 2183 published papers about herbal drugs interactions from November 1967 to August 2014, fulfilling eligibility criteria by searching in some databases such as Web of Science, Medline, Scopus, Embase, Cinahl, and the Cochrane database. The main keywords used for searching included: herbal medicine, herbs, statin, lipid, and herb-drug interaction. RESULTS Among published articles about herb-drug interactions, 185 papers met the initial search criteria and among them, 92 papers were potentially retrievable including a description of 17 herbs and medicinal plants. In first step and by reviewing all published manuscripts on beneficial effects of herbs on serum lipids level, 17 herbs were described to be effective on lipid profile as lowering serum triglyceride, total cholesterol, low-density lipoprotein cholesterol as well as increasing serum high-density lipoprotein level. Some herbs such as celery could even affect the hepatic triglyceride concentrations. The herbal reaction toward different types of statins is varied so that grapefruit or pomegranate was interacted with only some types of statins, but not with all statin types. In this context, administration of herbal materials can lead to decreased absorption of statins or decreased the plasma concentration of these drugs. CONCLUSION Various types of herbs can potentially reduce serum lipid profile with the different pathways; however, the herb-drug interactions may decrease pharmacological therapeutic effects of anti-hyperlipidemic drugs that should be considered when approved herbs are prescribed

DIFFUSING CAPACITY FOR LUNG CARBON MONOXIDE (DLCO) IN CHEMICAL LUNG INJURIES DUE TO THE USE OF MUSTARD GAS IN THE POISONED SOLDIERS OF IRAN-IRAQ WAR 2006

Objectives: To assess the Mustard gas exposure effects on pulmonary system, particularly on diffusing capacity for lung carbon monoxide (DLCO) and simple spirometry. Methodology: Sixty-five sulfur mustard-poisoned soldiers from Mostazafan and Janbazan organization were referred to our center in 2005. Complete history, physical examination, chest X ray, Echocardiography, Arterial blood gas, high - resolution computerized tomography, diffusion capacity for lung carbon monoxide and spirometry of these were performed and compared this result with normal value. Results: The mean value of indices in studied injured subjects was: Spirometry: forced expiratory volume in one second (FEV1) = 70.4, Forced vital capacity (FVC) = 66.5, EFE 25-75=81.1, FEV1/FVC=101.9, Flow 25% = 28.7, Flow 50%=72.9, Flow 75%=100.1, Sample volume: Functional residual capacity of lungs (FRC) = 131.5, residual volume (RV) = 157.3, RV/TLC=169.1, Total lung capacity (TLC) = 91.3, KCO=131.6, TLCO=116.3. No significant correlation was observed between TLCO values with HRCT, echocardiography, ABG and spirometry values (P>0.05). Conclusion: We recommend TLCO & RV/TLV tests to assess severity of Injuries as there is no a suitable criterion to measure the real consequences of mustard gas on affected combatants. and Biological markers are also needed to determine cause-effect relations

Therapeutic effects of Crocus sativus: An overview of systematic reviews

Background and aims: Crocus sativus is of medicinal plants possessing many beneficial effects in treatment of various disorders. This study aimed to overview the therapeutic effects of Crocus sativus on the basis of reviews and systematic reviews. Methods: Computerized search of review articles was performed using PubMed, Google Scholar, Scopus and Web of Science, Medline database from 1996 to 2015. Results: Searches identified 8 reviews and systematic reviews of therapeutic effects of Crocus sativus. Despite remarkable difference in interventions, and type of studies carried out on this plant (in vivo and in vitro), it seemed to have many therapeutic effects on the treatment of various types of diseases. In all the reviews, the objectives were similar, e.g. inhibition of growth of cancer cell lines, analgesic activity, improvement of health condition and treatment of some disease but the type of study (in vivo and in vitro) (animal studies: rat, mouse, guinipig, rabbit) and content was quite different. The most common effects of Crocus sativus were anti-carcinogenesis, tumoricidal, anti-depressant, antihypertensive, anticonvulsant, antitussive, anti-genototoxic and cytotoxic effects, anti-Alzheimer’s, antitussive, anxiolytic, aphrodisiac, antioxidant, anti-nociceptive, anti-inflammatory, relaxant activity, and effects on the gastrointestinal tract, on ocular blood flow and on retinal function, effect on coronary artery diseases, and hypnotic, and anesthetic effects. Conclusion: The results of various studies on Crocus sativus showed that it has a lot of therapeutic effects on the treatment of various types of diseases. However, to be able to use these results in our daily life, additional clinical trials with larger sample size and longer duration may be required to evaluate its toxicity and safety in each and every case of its therapeutic effects

Is herbal therapy safe in obesity? A case of apium graveolens (Celery) induced hyperthyroidism

BACKGROUND: Apium graveolens is one of the well-known herbs used for the treatment of different; however, allergic reactions have been reported after its use. This report aimed to demonstrate the A. graveolens induced hyperthyroidism after its oral consumption for weight loss. CASE REPORT: Mr. A, 48-year-old, with no history of any thyroid diseases, was diagnosed with hyperthyroidism due to daily consumption of 4 g of dried celery leaves for 45 days. After cessation of consumption and treatment with methimazole, the symptoms remitted. Then, the medication was discontinued when the lab tests and ultrasound were normal and indicated the patient’s definite recovery. In 2 months follow up of, he was normal and thyroid-stimulating hormone (TSH), T4, T3, anti-TSH receptor, anti thyroperoxidase and antithyroglobulin were in normal ranges. CONCLUSION: Hyperthyroidism may be induced by consumption celery. Although many studies have reported side effects such as allergic reactions for this herb, this is the first report of hyperthyroidism induced by celery in which the patient recovered after discontinuing the medication. Therefore, it can be assumed that celery induces hyperthyroidism as a side effect of this herb if it is used for a long term. © 2016,.Isfahan University of Medical Sciences(IUMS). All rights reserved

The protective effects of ginger on the development of coronary atherosclerosis: An experimental animal study

The use of ginger extracts has been recently suggested to be effective for prevention of establishing and development of coronary atherosclerosis due to its antioxidant and anti-inflammatory components. In the present study, the effect of standardized ginger extract on the development of experimentally induced atherosclerosis in animal models was investigated. The study protocol was consist of three groups of male rabbits (n = 5 each group) that were randomly divided to three groups to fed a common stock diet (containing bran and fresh vegetables) plus high cholesterol pack, or stock diet plus ginger (0.1 g/kg body weight/day) (group II) together with cholesterol, or only stock diet as the atheroma control for 75 days. Atheroma was graded macroscopically by mean graticule count percent. The degree of experimental cholesterol atherosclerosis was graded on an arbitrary scale of 0 to 4, and serum level of total cholesterol was also measured. The atherosclerotic lesion area was macroscopically smaller in rabbits that consumed ginger in comparison with the lesion area in those animals no received ginger extract (43.26 ± 8.7 mm2 versus 82.3 ± 7.9 mm2, p<0.001). Microscopically, the mean grading in coronary artery of rabbits received high cholesterol diet without ginger was 3.1±0.56, while in the group received high cholesterol diet plus ginger was 1.6±0.85 with a significant difference. Regarding effects of ginger on total cholesterol level and considering nonsignificant cholesterol level at baseline, the level of cholesterol after 75 days reached 66.72±0.12 mg/dL in the control group, 776±40.55 mg/dL in group fed high cholesterol without ginger, and 446±23.97 mg/dL in the group fed ginger with a significant level in high cholesterol plus ginger group than in high cholesterol alone group (p<0.001). Ginger can effectively protect the development of atherosclerosis manifested by lowering serum cholesterol level, as well as reducing infarct size and grade

A case of carbamazepine induced systemic lupus erythematous (SLE)

ABSTRACT Carbamazepine is an anticonvulsant drug that used to treat seizures and nerve pain and such as most drugs have side effect. Systemic lupus erythematous is one of connective tissue disorders that often caused by an auto immune mechanism of unknown, although some drugs cause SLE. This report aimed to demonstrate the carbamazepine induced SLE after its oral consumption for Convulsion. This is the report carbamazepine- induced systemic lupus in a 16-year-old patient who had been treated with

Synthesis ofadsorbentfrom Tamarixhispida and modified bylanthanummetalfor fluoride ions removalfromwastewater:Adsorbent characteristicsandrealwastewater treatmentdata

This dataarticledescribesafacilemethodforproductionofan adsorbent from Tamarixhispida wastedwoodandmodified by lanthanum metalfor fluoride ionsremovalfromwastewater.The main characteristicsoftheadsorbentconsistofBETsurfacearea, functional groups,andelementalanalysisispresented.Thedata for attenuatingthepollutantsfromarealwastewatertreatment which wasprovidedfromaglassfactoryisalsorepresented.More than 90%of fluoride contentoftherealwastewaterwastreatedby the adsorbent.Generally,thesedatawouldbeinformativefor extendresearchaimtoindustrialwastewatertreatmentandthose who workinthewastewatertreatmentplants