ABSTRACT
Given the high prevalence and high mortality of cardiovascular disease, special attention should be paid to its treatment. Currently, the main treatment for ST-elevation myocardial infarction is restoring blood flow by dissolving the clot. In addition to this basic treatment, several pharmacologic agents have been studied during the past years. In this paper, clinical trials about glucose-insulin-potassium are discussed in addition to adjuvant treatment which has been suggested in recent years. All studies published in journals or presented at scientific conferences were searched in Elsevier, PubMed, Cochrane, and SID databases using relevant keywords. After quality control, eligible articles were included in the study. The results of this review article showed that studies on the effects of glucose-insulin-potassium treatment on mortality, cardiac enzyme levels, left ventricular ejection fraction, ST resolution, and inflammatory and oxidative biomarkers have been conflicting. But, generally, evidence from newer studies conducted on larger numbers of patients has shown ineffectiveness of glucose-insulin-potassium therapy. Currently, glucose-insulin-potassium therapy should not be recommended as an adjunct to thrombolytic therapy
ABSTRACT
Due to the high mortality of ischemic heart disease, many of these patients can be life-saving treatments. There are conflicting information on the effects of insulin in patients with myocardial infarction. We aim to evaluate the effects of insulin on infarct size in myocardial infarction thorough evaluating troponin I enzyme and echocardiography. This randomized clinical trial enrolled 74 patients with ST segment elevation myocardial infarction referred to Vaseie hospital of Sabzevar in 2009. Patients were categorized into two groups by block randomization and were treated with high dose of GIK [25% glucose, 50IU of soluble insulin per liter, and 80mmol of potassium per liter at 1ml/kg/hour] [GIK group] or normal saline [control group] as adjunct to thrombolytic therapy. We analyzed Plasma concentrations of troponin I, at baseline, 16 and 24 hours after admission. Echocardiography was done at 72 hours after admission. Data were analyzed Variables were compared using independent T tests and repeated measure ANOVA. cTnI peaked to 20.13 +/- 12.46U/L in GIK group and to 20.11 +/- 10.62 U/L in controls [p=0.44]. Left ventricular ejection fraction was 39% vs.41% in GIK vs. control, p=0.34. There was no significant difference between groups in cardiac enzymes and ejection fraction. In patients with myocardial infarction treated with streptokinase, insulin offers no effect on infarct size
ABSTRACT
Background and Purpose: Some researchers believe that the treatment with glucose-insulin-potassium [GIK] in ST segment elevation myocardial infarction [STEMI] can reduce the mortality rate. Others, however, contradict this view. Therefore, the present study was designed to evaluate the clinical and paraclinical effects of GIK in STEMI patients
Methods: This triple blind clinical trial was conducted from September 2008 to July 2009 on 72 STEMI patients in the CCU of Vasei Hospital in Sabzevar, Iran. They were assigned through block randomization into standard care or additional GIK infusion [25% glucose, 50 IU of soluble insulin per liter, and 80 mmol of potassium chloride per liter at 1.5 ml/kg/hour]. They were assessed for the number of MACEs [death, reinfarction and serious arrhythmias], plasma concentrations of cardiac enzymes [CK, CK-MB], and left ventricular ejection fraction. The statistical analysis was conducted in SPSS 11.5 using Fisher's exact test, ttest and repeated measurement. P< 0.05 was considered as the basis of significance
Results: MACE rate was 30.3% for GIK and 25.6% for control patients [p=0.66]. There was no significant difference in plasma concentrations of cardiac enzymes between GIK and control patients. Left ventricular ejection fraction was 39% for GIK and 41% for control patients [p=0.34]
Conclusion: In patients with STEMI treated with streptokinase, GIK therapy offers no clinical and paraclinical effects
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Background and Purpose: Using levonorgestrel tablet is one of EC methods that could be effective until 72 hours after sexual intercourse. Therefore, the present study was intended to investigate the women's awareness about correct use and sideeffects of this tablet
Methods and Materials: In this descriptive analytical study, women referring to heath centers of Sabzevar were selected through cluster sampling. Data were collected through a questionnaire including specific demographic characteristics and the participants' awareness about correct using and side effects of levonorgestrel tablet. The reliability of the questionnaire was checked with cronbach alpha [= alpha 0.716], and its validity was controlled by expert. The sample size was 396 persons. The obtained data were analyzed in SPSS using descriptive and analytical statistics [independent t-test and Pearson correlation coefficient]
Results: Among women studied, 29.8% had used the tablet, and the average score of awareness in correct using of tablet on the basis of 100 was 46.1 +/- 34.5, while the average score of knowing the tablet's side effects on the basis of 100 was only 22.39 +/- 28.92. A negative correlation was found between the correct using score and age [p=0.029, r=-0.11]
Conclusion: The findings revealed that the average awareness score of correct using and side-effects of the tablet are low
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Background and Purpose: Crimean Congo fever was first characterized in 1944 in the Crimean peninsula and then in 1956 in Congo. Their sameness was recognized after long investigation in the two continents, and was labeled as Crimean Congo Hemorrhagic Fever or CCHF. It is one of the hemorrhagic fevers, which manifests as a sudden onset of high fever, chills; severe headache, dizziness, back and abdominal pain after a short incubation period, CCHF is characterized by a sudden onset of high fever, chills and myalgia, and turns into hemorrhagic phase after five days
The Patient: The patient was a 15-year-old boy treated for brucellosis from 15 days ago and was admitted because of fever, headache and vomiting diagnosed as brucella meningitis. Because of thrombocytopenia, sporadic petecia and epistaxi, diagnosis of CCHF was suspected and reported as positive according to RT-PCR
Conclusion: Likelihood of CCHF in animal husbandry occupations is possible, and since its symptoms are similar to brucellosis, its diagnosis must be considered together with brucellosis
ABSTRACT
The aim of this study is to investigate water consumption, domestic wastewater generation and organic matter concentration, based on both, economical income and meteorological temperature. The method of this study is descriptive and analytical. A checklist was used to collect data on economical income. Water consumption was obtained based on water bills. Wastewater generation and organic matter such as biochemical oxygen demand [BOD] per capita/ day were measured every four hours, during a day in three regions of Kermanshah city: Kasra, Ellaheiah and Taavon. Comparing water consumption in winter and summer showed significant difference in three regions, mentioned above. The water consumption was [398 +/- 75, 291 +/- 48 and 188 +/- 50] for warm climate and [200 +/- 25, 188 +/- 35 and 140 +/- 41] for three regions respectively in cold weather. In spite of an apparent difference in BOD in three regions, it was not significant statistically. Water consumption has strongly considerable relationship with economical income [r=0.988, P-value<0.001], while the generated wastewater in these regions were not different, statistically for warm climate [220 +/- 60, 204 +/- 15 and 170 +/- 34], and in cold weather [170 +/- 21, 158 +/- 31 and 112 +/- 29], also the generated wastewater did not have considerable difference in cold climate. This study confirms that, the effects of these two parameters, i.e.monthly economical income and environmental temperature on water consumption, generated wastewater and biodegradable organic loading per capita/day is considerable. It was concluded that water consumption and wastewater generations were much more in warm climate than in cold weather. Finally through this study the estimation of water consumption, wastewater generation and BOD concentration becomes possible, which is beneficial for establishment of water consumption
Subject(s)
Drinking , Income , Meteorological Concepts , Temperature , Waste Disposal, FluidABSTRACT
Background and Purpose: Most congenital anomalies are preventable and their identification and prevention are much more cost-effective than their treatment and rehabilitation. The present study was conducted to determine the incidence of apparent congenital anomalies in neonates born in Mobini Maternity Hospital in Sabzevar, Iran
Methods and Materials: This cross-sectional descriptive research was conducted on all neonates born with apparent anomalies from February 2005 to February 2006. The data collection instrument was a questionnaire including the information on parents, neonate, and the anomaly which was confirmed by a pediatrician. The collected data were analyzed in SPSS 11.5 using chi-square
Results: Out of 7786 live neonates, 191 cases [2.4%] had distinct congenital anomalies. Incidence of anomalies was 56.5% in males [108 cases], which was significantly higher than females [p<0.001]. The most common anomalies were musculoskeletal [43.97%] and genitourinary [17.8%]
Conclusion: The findings indicate that the incidence of anomalies in neonates born in Sabzevar is similar to other studies