[Relationship between serum cardiac troponin T and I with Left ventricular hypertrophy and systolic dysfunction in hemodialysis patients]

Cardiovascular diseases are the most frequent cause of death among hemodialysis patients. Left ventricular hypertrophy and systolic dysfunction are potent predictors of cardiovascular morbidity and mortality in hemodialysis patients. Cardiac troponin T and I are the indices of myocardial cell damage. This study was done to determine the relationship between serum cardiac troponin T and I with left ventricular hypertrophy and systolic dysfunction in hemodialysis patients. In this case-control study, 56 hemodialysis patients were divided into two groups according to echocardiographic findings. The first group included 35 patients with left ventricular hypertrophy as case group and 21 patients without left ventricular hypertrophy as controls. Serum level of cardiac troponin T and I were measured using electro chemiluminscence immune assay. Serum level of cardiac troponin T and I was significantly higher in patients with left ventricular hypertrophy [0.99 +/- 0.12 ng/ml and 0.17 +/- 0.09 ng/ml, respectively] in comparison with controls [0.37 +/- 0.05 ng/ml and 0.13 +/- 0.09 ng/ml, respectively] [P<0.05]. There was no correlation between serum cardiac troponin T and I level with left ventricular systolic dysfunction. Cardiac troponin I and T do not have any value for the diagnosis of left ventricular systolic dysfunction in hemodialysis patients

[Origin of left coronary artery arising from the right coronary cusp]

Anomalous coronary artery origin is a rare clinical entity with varied clinical outcomes ranging from asymptomatic to sudden cardiac death. The incidence of anomalous origin of left coronary artery arising from the right coronary cusp is 0.3-1%. CT angiography is the choice method for coronary anomalies, but often coronary angiography in RAO [right anterior oblique] view shows the coronary course. We present a case that referred to our hospital with post myocardial infarction angina for coronary angiography. A resting 12-lead electrocardiogram showed ST-segment elevation in leads v2, v3, v4. A transthoracic echocardiogram indicated LVEF 25% [Left ventricular ejection fraction], septal akinesia and apical dyskinesia. Coronary Angiography showed an anomalous origin of the left coronary artery from the right coronary cusp and significant stenosis in LAD [left anterior descending] and LCX [left circumflex] arteries with poor run off

Assessment of general health, stress coping and marital satisfaction in infertile women undergoing IVF treatment

Nowadays, infertility has turned to a social distress and it is accompanied by numerous psychological and social problems. This phenomenon is known as an agonizing and disappointing stressor for couples, especially for women. Infertility stress can affect personal, social and marital relationships, may cause mental instability and lead to divorce. Likewise, studies have shown IVF may be accompanied by numerous and severe psychological disorders. Considering psychosocial and cultural importance of fertility, especially in women, and the high birth rate in Iran, a closer look at this phenomenon with an emphasis on its psycho-social aspects is of importance. Therefore this descriptive study was undertaken to determine mental well-being, marital satisfaction and stress coping in infertile women. 150 infertile women attending the forth Shahid of Mehrab Hospital in Kermanshah were randomly selected during 2003. The data were gathered by the researchers, based on CRI-Coping Responses, Index of Marital Satisfaction [IMS] and the General Health Questionnaire [GHQ-28]. For the statistical evaluation of the findings, chi-squared and t-test were calculated. P-values smaller than 0.05 were considered significant. The results showed that 44% of the subjects had psychological disorders based on GHQ. Based on the findings from this questionnaire, the cases were divided into two healthy and unhealthy groups. Anxiety rates among the unhealthy group and the functional disorders in the healthy ones revealed to be significantly high [p<0.01]. 34% of the infertile women, most of whom had been identified to have psychological disorders by GHQ, had excitement based reactions and 93% of the ones on the healthy group had problem-based confrontational responses. The findings also revealed that infertility had not had any unpleasant effects on the marital satisfaction of the healthy cases, whereas 35% of the unhealthy ones showed the opposite. Regarding the results of this study, infertility may have numerous psychological impacts on the infertile and act as a predisposing factor for psychological disorders and matrimonial problems. Therefore, a team of psychiatrists accompanying infertility treatment experts is effective in the treatment process and prevention of psychiatric problems in these patients