ABSTRACT
Background: Percutaneous coronary intervention [PCI] may been associated with high-er risk of cardiac events during this procedure. The goal of this study was to compare high dose atorvastatin therapy with low dose atorvastatin therapy 24 hours before PCI to a reduction in Peri- percutaneous coronary intervention myocardial infarction
Methods: One hundred ninety patients with stable angina were enrolled in a randomiz-ed controlled clinical trial study. All patients received low dose atorvastatin. The patients scheduled for elective PCI were randomized to atorvastatin [80 mg/d, n=95] or placebo [n=95] within 24 hours before the procedure. Creatine kinase-MB, troponin I, and high sensitive C- reactive protein levels were measured at baseline and at 6 and 12 hours after the procedure. PCI related myocardial infarction was defined as increasing of Creatine kinase-MB or troponin I three times compared with values before procedure
Results: Myocardial infarction was detected after coronary intervention in 4.2% of patients in the atorvastatin group and in 13.7% of those in the placebo group [P=0.022]. Mean of changed levels of Creatine kinase-MB [0.7+/-0.5 versus 3.3+/-1.9 ng/mL, P<0.001], troponin I [0.1+/-0.2 versus 0.4+/-0.7 ng/mL, P=0.052] and hs-CRP [0.1+/-0.5 versus 1+/-0.9 ng/mL, P<0.001] were significantly lower in the statin than in the placebo group
Conclusion: Pretreatment with high dose atorvastatin within 24 hours before elective percutaneous coronary intervention significantly reduces procedural myocardial infarct-tion in elective coronary intervention
ABSTRACT
Hemorrhoid is among the most common anorectal diseases and patients with high-grade disease conditions need surgical treatment. Many surgical procedures are available to treat the disease. The aim of this study was to compare the operative time and outcomes, [post-operative pain and complications] of Ligasure hemorrhoidectomy with those of the open conventional method. This randomized single-blind clinical trial included 57 patients [28 in Ligasure and 29 in the open group]. The primary variable was the operative time for the excision of a single hemorrhoidal packet. The other variables were post-operative pain measured by morphine doses administered to control pain, scores of visual analogue scale [VAS] used to measure pain severity, pain during home stay measured by doses of oral ibuprofen and the mean daily VAS scores, early complications including bleeding and urinary retention, longer-term complications and time to return to work. The demographic data were comparatively the same between the two groups. The average time to excise a single packet of hemorrhoid was significantly shorter in the Ligasure group [8.91 min vs. 17.35 min, P<0.001]. Post-operative pain measurements [morphine doses and VAS scores] were lower in the Ligasure group, but the differences were not statistically significant [P=0.055 and 0.077, respectively]. Complications of the two procedures were also comparable. Neither of the groups returned to work in a shorter time. Ligasure hemorrhoidectomy seems to be a safe method and it can reduce the operative time significantly. It may also have a modest effect on post-operative pain