Outcomes of chronic total occlusion percutaneous coronary intervention from the RAIAN (RAjaie - Iran) registry

Objective: While most of the evidence in CTO interventions emerge from Western and Japanese studies, few data have been published up today from the Middle East. Objective of this study was to evaluate technical success rates and clinical outcomes of an Iranian population undergoing CTO PCI in a tertiary referral hospital. Moreover, we sought to evaluate the efficacy of our CTO teaching program. Methods: This is a retrospective single-center cohort study including 790 patients who underwent CTO PCI performed by operators with different volumes of CTOs PCI performed per year. According to PCI result, all patients have been divided into successful (n = 555, 70.3 %) and unsuccessful (n = 235, 29.7 %) groups. Study endpoints were Major Adverse Cardiovascular Events and Health Status Improvement evaluated using the Seattle Angina Questionnaire at one year. Results: A global success rate of 70 % for antegrade and 80 % for retrograde approach was shown despite the lack of some CTO-dedicated devices. During the enrollment period, the success rate increased significantly among operators with a lower number of CTO procedures per year. One-year MACE rate was similar in both successful and unsuccessful groups (13.5 % in successful and 10.6 % in unsuccessful group, p = 0.173). One year patients' health status improved significantly only in successful group. Conclusions: No significant differences of in-hospital and one-year MACE were found between the successful and unsuccessful groups. Angina symptoms and quality of life significantly improved after successful CTO PCI. The RAIAN registry confirmed the importance of operator expertise for CTO PCI success

Intravenous Methylprednisolone, a Possible Cause of the Atrial Fibrillation: Atrial fibrillation by methylprednisolon

We are presenting a case illustrating atrial fibrillation (AF) following the use of methylprednisolone in a patient with pelvic and femur fracture. A48- year- old man with no significant past medical history, was admitted to the emergency department after injury in a car accident. He suffered a multiple bone fracture with chief complaints of pain and shortness of breath. He was transferred to the ICU. To preventfat embolism syndrome, he was treated with methylprednisolone 500 mg every 6 h. About 4 h after the second dose, his normal sinus rhythm changed to a sinus tachycardia and then to AF. The methylprednisolone therapy was discontinued. After about 8 h of methylprednisolone discontinuation, the patient's normal sinus rhythm returned. Corticosteroids have been utilized for prevention and treatment of fat embolism syndrome, although there is uncertainty about their effectiveness. Cardiac dysrhythmias have been reported following the use of methylprednisolone. One possible mechanism of methylprednisolone induced AF is the direct effect on cell membrane, resulting in potassium efflux, which in turn, may initiate cardiac dysrhythmias. Previous methylprednisolone-associated AF case reports suggest a higher chance of AF occurrence with higher dose of methylprednisolone. Corticosteroids should be used with caution, especially when high doses are indicated and in patients with high risk for arrhythmias

Evaluation of clinical and laboratory predisposing factors of acute coronary syndrome in military staff

Background: Cardiovascular diseases are the leading cause of death in the third millennium. Acute coronary syndrome (ACS) is the most fatal cardiovascular disease, and various factors are involved in the development of this disease. These factors include clinical and laboratory factors as well as stress. Occupational stress is a risk factor for heart disease, and it also increases the risk of coronary heart disease. Military work is universally considered to be stressful. The aim of this study was to evaluate the clinical and laboratory predisposing factors of ACS in military staff. Methods: In this prospective study, 260 patients admitted to Baqiyatallah Hospital were enrolled and divided into 2 groups: 130 patients with ACS and 130 patients with stable coronary artery disease. The study population was studied for various variables, including occupational stress, sedentary lifestyle, and some laboratory markers, including the neutrophil-to-lymphocyte ratio (NLR), the ratio of monocytes to high-density lipoprotein (HDL), and red cell distribution width (RDW). Results: There were significant differences between the 2 groups in terms of physically demanding tasks (case: 61 vs control: 43; P = 0.036), an average daily sitting time of more than 3 hours (case: 58.5 vs control: 43.8; P = 0.048), and an average daily television watching time of more than 2 hours (case: 56.9 vs control: 42.3; P = 0.048). There was a significant difference concerning NLR between the case and control groups (case: 4.8 ±1.4 vs control: 2.2 ± 0.5; P = 0.011) regarding the ratio of monocytes to HDL (case: 16.6 ± 5.6 vs control: 10.6 ± 3.1; P = 0.034) and RDW (case: 14.5 ± 1.9 vs control: 12.8 ± 1.4; P = 0.041). Conclusions: According to our findings, an increase in NLR and the ratio of monocytes to HDL are predisposing factors of ACS; in addition, RDW is a predicting factor of ACS in military personnel. A sedentary lifestyle and work stress are also contributing factors to the development of ACS in this population. © 2021, Iranian Heart Association. All rights reserved

Correlation between CMR T2* and advanced echocardiographic right ventricular function criteria in patients with major thalassemia

Background: Tissue iron deposition is an important adverse effect in patients with major thalassemia, leading to right-sided heart failure. This study was performed to determine the association between cardiovascular magnetic resonance using T2-weighted sequences (CMR T2*) and advanced echocardiographic right ventricular (RV) function criteria in patients with major thalassemia at Rajaie Cardiovascular, Medical, and Research Center in 2014 and 2015. Method: This comparative study assessed the association between CMR T2* and advanced echocardiographic RV function criteria in 38 patients with major thalassemia at Rajaie Cardiovascular, Medical, and Research Center in 2014 and 2015. Results: CMR T2* was correlated with the RV E/E� (echo) (P = 0.0001, r = -0.681), TAPSE (echo) (P = 0.001, r = 0.504), RVEDV (CMR) (P = 0.008, r = 0.425), and RVEDV/BSA (CMR) (P = 0.005, r = 0.443) according to the Spearman test. Additionally, CMR T2* was associated with the basal RV Sm (echo) (P = 0.0001, r = 0.626), RV strain (echo) (P = 0.034, r = 0.382), RVEDV/H (CMR) (P = 0.002, r = 0.483), LVEDV (CMR) (P = 0.022, r = 0.372), and LVEDV/H (CMR) (P = 0.017, r = 0.385) according to the Pearson test. Conclusions: Totally, according to the obtained results, it may be concluded that the RV E/E�, TAPSE, basal RV Sm, and RV strain from echocardiography and the RVEDV, RVEDV/BSA, RVEDV/H, LVEDV, and LVEDV/H from CMR may be indicators of myocardial iron overload in patients with major thalassemia. © 2018, Iranian Heart Association. All rights reserved

Correlation between CMR T2* and advanced echocardiographic right ventricular function criteria in patients with major thalassemia

Background: Tissue iron deposition is an important adverse effect in patients with major thalassemia, leading to right-sided heart failure. This study was performed to determine the association between cardiovascular magnetic resonance using T2-weighted sequences (CMR T2*) and advanced echocardiographic right ventricular (RV) function criteria in patients with major thalassemia at Rajaie Cardiovascular, Medical, and Research Center in 2014 and 2015. Method: This comparative study assessed the association between CMR T2* and advanced echocardiographic RV function criteria in 38 patients with major thalassemia at Rajaie Cardiovascular, Medical, and Research Center in 2014 and 2015. Results: CMR T2* was correlated with the RV E/E� (echo) (P = 0.0001, r = -0.681), TAPSE (echo) (P = 0.001, r = 0.504), RVEDV (CMR) (P = 0.008, r = 0.425), and RVEDV/BSA (CMR) (P = 0.005, r = 0.443) according to the Spearman test. Additionally, CMR T2* was associated with the basal RV Sm (echo) (P = 0.0001, r = 0.626), RV strain (echo) (P = 0.034, r = 0.382), RVEDV/H (CMR) (P = 0.002, r = 0.483), LVEDV (CMR) (P = 0.022, r = 0.372), and LVEDV/H (CMR) (P = 0.017, r = 0.385) according to the Pearson test. Conclusions: Totally, according to the obtained results, it may be concluded that the RV E/E�, TAPSE, basal RV Sm, and RV strain from echocardiography and the RVEDV, RVEDV/BSA, RVEDV/H, LVEDV, and LVEDV/H from CMR may be indicators of myocardial iron overload in patients with major thalassemia. © 2018, Iranian Heart Association. All rights reserved

Student Research Projects Inhibiting Factors from the Students Perspective

Background & Objective: Identifying the research barriers and assess the ability of students to use the university services and facilities is crucial to promote research activities. Present study was carried out to determine the inhibiting factors influencing the student's research projects from the view point of Yasuj University of Medical Sciences students in 2008. Materials & Methods: In this cross sectional study 96 students of Yasuj Medical University were selected by stratified random sampling. The data were collected by validate & reliable questionnaire, containing demographic information, inhibiting factors related to students (personal) and organization. The data were analyzed by SPSS software. Results: The mean scores against the personal barriers and the organizational barriers questions were 43.23±12.96 and 62.58±12.08 respectively. There was a significant difference between personal and organizational barriers (P<0.001) and personal barriers were more important. According to the results, the student's inadequate skills & knowledge of research methodology and lack of awareness of research topics were the most prevalent personal barriers. The most prevalent organizational barriers were unavailability of research consulters, inadequate research skills of consulter, insufficient facilities & equipment and lack of motivating staff & faculties. Other variables such as gender, subject of study and research experience are mentioned in the full text. Conclusion: This study showed that the personal barriers were more important than organizational barriers which interfere with the student's research projects. This can be corrected and controlled by teachers, faculty members, university officials and students, themselves

One-step approach to Quaternary (B, N, P, S)-Doped hierarchical porous carbon derived from Quercus Brantii for highly selective and efficient CO2 Capture: A combined experimental and extensive DFT study

Recently, the enhancement of atmospheric carbon dioxide (CO2) concentration has a negative impact on the environment and human health. Adsorption is well recognized as a promising technology to control CO2 emission in which the design of an optimum adsorbent is one of the most critical challenges. In this article, multiheteroatoms doped porous carbons have been successfully derived from Quercus Brantii by one-step doping-activation to investigate the textural characteristics and heteroatoms doping effects on CO2 capture application. Based on the physicochemical properties of the adsorbents, which were characterized using varied techniques (FE-SEM, EDS, HR-TEM, XRD, FT-IR, XPS, BET, and BJH), the introduction of heteroatoms provides more active sites in carbon networks and develops the porous architecture of each activated carbon, resulting in diverse CO2 capture performances. The low content of phosphorus (P) incorporated in P-doped activated carbon (PAC) perfected the performance of CO2 capture to reach a high uptake (7.13 mmol g-1 at 1 bar and 20 degrees C) on a heterogeneous surface. Apart from the high equilibrium and dynamic CO2 uptake, these Quercus Brantii-based carbonaceous adsorbents present superior CO2 selectivity over N2, CH4, and H2, prominent cyclic regeneration capacity, high turnover frequency (TOF) and turnover number (TON) for commercial scale as well as fast kinetic adsorption. The density functional theory (DFT) method was performed to reveal the adsorption mechanisms as well as electronic properties of the systems