Combined Open-Heart Coronary Artery Bypass Surgery and Subtotal Thyroidectomy in a 54-year-old patient: A Case Report

BACKGROUND: Combined open-heart surgery and thyroidectomy is a rare procedure. However, some difficulties will occur for cardiac surgery when thyromegaly extends into the retrosternal space.CASE DETAILS: A 54-year-old woman suffering from dyspnea, chest pain and decreased left ventricular function (EF=40%) was diagnosed with coronary artery disease (3 vessel disease) and became candidate for coronary artery bypass grafting (CABG). Also, she had multinodular goiter with normal thyroid function test. After midsternotomy, a huge goiter was seen in the upper mediastinum. Because the mass had covered the ascending aorta and involved the posterior aspect of the innominate vein making access to aorta impossible, thyroidectomy was performed at first followed by CABG. Post-operation course was satisfactory. Fourteen months later, the patient was euthyroid and in NYHA class 1.CONCLUSION: The evidence of the case showed that combined CABG and thyroidectomy can be performed safely.KEYWORDS: Coronary Artery Bypass Grafting, Subtotal Thyroidectomy, Surger

Serum free testosterone level in coronary artery disease in candidates for coronary artery bypass graft surgery: A cross-sectional study

Background: Due to the controversy over the effect of serum testosterone levels on coronary artery diseases, this survey explores the serum levels of free testosterone, luteinizing hormone, and follicle-stimulating hormone in candidates for coronary artery bypass graft compared with an age-matched control group and evaluates the associated factors in these participants. Objective: To determine the testosterone level in elective coronary artery bypass grafting participants. Materials and Methods: In this cross-sectional study, all male patients aged > 40 yr as candidates for elective coronary artery bypass grafting, who were referred to the Afshar Hospital, Yazd, Iran, from March 2018 to March 2019, were included. In total, 100 men were enrolled (50 cases and 50 controls). Their serum levels of free and total testosterone, luteinizing hormone, and follicle-stimulating hormone were measured and the results were compared. Results: The findings indicated a significant difference between the two groups in total and free testosterone (both p < 0.001); they were lower in the case group. There was also a significant difference in the total testosterone of the participants with diabetes mellitus compared with no-diabetic individuals (p = 0.007). Free testosterone of diabetic subjects taking insulin was lower compared with those taking no insulin (p = 0.04). There was also an association between the body mass index and free testosterone, left ventricular ejection fraction and total testosterone, and a significant and negative relation between the duration of hospital admissions and free testosterone (p < 0.05). Conclusion: This study illustrates that participants with coronary artery disease bear a significantly low testosterone level in comparison with the healthy control group. Key words: Coronary artery disease, Testosterone, Coronary artery bypass graft surgery

Serum Free Testosterone Level in Coronary Artery Disease in Candidates for Coronary Artery Bypass Graft Surgery: A Cross-sectional Study

Background: Due to the controversy over the effect of serum testosterone levels on coronary artery diseases, this survey explores the serum levels of free testosterone, luteinizing hormone, and follicle-stimulating hormone in candidates for coronary artery bypass graft compared with an age-matched control group and evaluates the associated factors in these participants. Objective: To determine the testosterone level in elective coronary artery bypass grafting participants. Materials and Methods: In this cross-sectional study, all male patients aged > 40 yr as candidates for elective coronary artery bypass grafting, who were referred to the Afshar Hospital, Yazd, Iran, from March 2018 to March 2019, were included. In total, 100 men were enrolled (50 cases and 50 controls). Their serum levels of free and total testosterone, luteinizing hormone, and follicle-stimulating hormone were measured and the results were compared. Results: The findings indicated a significant difference between the two groups in total and free testosterone (both p < 0.001); they were lower in the case group. There was also a significant difference in the total testosterone of the participants with diabetes mellitus compared with no-diabetic individuals (p = 0.007). Free testosterone of diabetic subjects taking insulin was lower compared with those taking no insulin (p = 0.04). There was also an association between the body mass index and free testosterone, left ventricular ejection fraction and total testosterone, and a significant and negative relation between the duration of hospital admissions and free testosterone (p < 0.05). Conclusion: This study illustrates that participants with coronary artery disease bear a significantly low testosterone level in comparison with the healthy control group. Key words: Coronary artery disease, Testosterone, Coronary artery bypass graft surgery

Modified Blalock-Taussig Shunt and Giant Perigraft Reaction

This is a case of a modified Blalock-Taussig shunt, which was complicated by perigraft transudative, fibrinous fluid accumulation and recurrence after surgical intervention. Follow-up and expectant management of the patient was successful. Our experience regarding this complication is presented

Dietary habits and the 10-year risk of overweight and obesity in urban adult population. A cohort study predicated on Yazd Healthy Heart Project

Sarebanhassanabadi M, Kalantari MS, Boffetta P, et al. Dietary habits and the 10-year risk of overweight and obesity in urban adult population. A cohort study predicated on Yazd Healthy Heart Project. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2020;14(5):1391-1397.Background and objective: Overweight and obesity are thought to be associated with increased risk of chronic disease in the Middle East. The present study aimed to determine the association between dietary habits and the incidence of overweight and obesity in urban adult population in the central part of Iran after a 10-year follow-up. Methods: This cohort study was initiated with 2000 participation aged 20-74 years from Yazd city in Iran based on Yazd Healthy Heart Project (YHHP). The participants without overweight and obesity at the baseline of the study were followed up to 10 years. Demographic data, anthropometric measurements, behavioral and metabolic risk factors of cardiovascular diseases and dietary habits were assessed at baseline and phase II. Results: After a 10-year follow up, 516 non-overweight and 1068 non-obese participants were included for the final analysis. Once adjustments were made for all potential confounders including age, sex, smoking, economic status, physical activity and education, it was identified that lack of weight control increased the risk of obesity (hazard ratio; 95% CI) in total population (1.9; 1.06, 3.4), as well as the risk of overweight (2.39; 1.07, 5.27) and obesity (2.65; 1.13, 6.25) in men. Moreover, consumption of mayonnaise increased the 10-year risk of overweight in women (6.09; 1.2, 30.99). Conclusions: As revealed by the present study, unhealthy dietary habits can increase the incidence of overweight and obesity in central part of Iran. Therefore, changing the lifestyle appears to be urgent in reducing the risk of overweight and obesity. (c) 2020 Diabetes India. Published by Elsevier Ltd. All rights reserved