Evaluation of efficacy of beta blockers administered early in acute myocardial infraction

In order to evaluate the efficacy and safety of early intravenous blockers in acute myocardial infarction [AMI], 51 patients with AMI were included and divided into 3 groups. Group 1 [21 patients] who received I.V. Popranolol [P] 0.1 mg/kg, then orally 20 mg in divided doses to keep the heart rate at 60/min. thereafter. Group 2 [10 patients] who received I.V. Metoprolol [M] 15 mg in 3 doses then 100 mg/12 hours orally till discharge, and group 3 [20 patients] who served as control group. No difference was noted between the 3 groups as regards base line to medications,. etc. Chest pain relief was easier in groups 1 and 2 than group 3. Chest pain recurrence was 25% in group 1, 20% in group 2 and 50% in group 3 [P >0.05 + trend]. Infarct extension occurred in 2 patients of control group but no in patients in groups 1 and 2. Ventricular arrhythmia was noted in 21 patients [10%] of group 1, one [10%] of group 2 and 5 [25%] of group 3 [P >0.05 + trend]. Left ventricular failure was noted in 4 patients [20%] of group 1, 2 [20%] of group 2 and 7 [35%] of group 3 [P >0.05 + trend]. Significant reduction of heart rate and blood pressure was noted in groups 1 and 2 versus group 3. Serum CPK level was lower in groups 1 and 2 than in group 3. However, echocardiography failed to identify improved left ventricular function in groups 1 and 2 versus group 3. Despite that the beneficial effects of beta-blockers were not showed to be significant at statistical level in the study [only trends], this may be attributed to the small number of patients in each group. It could be concluded that early use of 4 beta-blockers [P] or [M] is safe and beneficial in AMI resulting in smaller infarct size, less incidence of recurrent angina, infarct extension and lower risk of ventricular arrhythmias

Study of accuracy of mean pulmonary arterial wedge pressure as an index of mean left atrial pressure before and after percutaneous balloon mitral valvotomy

In order to study the relation of mean pulmonary arterial wedge pressure [PAWP] and mean left arterial pressure [LAP], 60 patients who had tight mitral stenosis and were candidates of percutaneous balloon mitral valvotomy [PBMV] were included. Complete right and left heart study was done before and immediately after PBMV, with trial to obtain adequate wave from PAWP and to confirm it by a wedge blood sample with oxygen saturation >95%. 89 comparative readings of mean LAP and mean PAWP were available from 60 patients. There were 2 groups: Group A, contained 42 readings, where oximetry confirmed adequate PAWP wave form and group B contained 47 readings with oximetry was not available to confirm PAWP wave form. It was concluded that, mean PAWP can accurately reflect the mean LAP if adequate PAWP wave form is obtained and if wedge blood sample had oxygen saturation of >95%, regardless of the magnitude of mean LAP or mean PAP

Biochemical studies on human adenosine deaminase related to neurological function and the effect of blood transfusion and some inhibitors on its activity

Human erythrocyte adenosine deaminase [adenosine aminohydrolase ADA, EC 3.5.4.4] in normal and some patients suffering from mental retardation was investigated before and after transfusion therapy. We standardized a new and simple spectrophotometric assay of adenosine deaminase based on the continuous monitoring of the reaction products, inosine and ammonia by a NADH-coupled enzyme system. The inhibitory effect of some adenosine analogues on the activity of erythrocyte adenosine deaminase was investigated