[Ankle / brachial index in thrombotic cerebrovascular disease patients]

Previous studies showed that Ankle Brachial Index [ABI] score less than 0.9 increases probability of ischemic heart disease up to 2 times, risk of TIA/ stroke to quadruple, and asymptomatic carotid and popliteal artery stenosis to one and half fold. ABI <0.9 is related with diffuse atherosclerosis. The aim of this study was to review ABI findings in patients with cerebral artery disease. This cross-sectional descriptive study was done on 98 patients with thrombotic cerebrovascular accident in Yazd Shahid Sadughi Hospital, between February 2001 and February 2002. A questionnaire including demographic, clinical, and paraclinical data was completed and results were analyzed using descriptive statistics and frequency distribution tables. Forty four percent of the patients were men. Mean age was 73/1 +/- 1/5. ABI<0.9 was seen in 15% of the cases. In patients older than 65 years old ABI<0.9 frequency rate was 12.5% and in patients younger that 65 year old it was 3.1%. There was no significant difference between ABI<0.9 and history of diabetes mellitus, hypertension, smoking, and ischemic heart disease. ABI<0.9 was prominently seen in patients with hyperlipidemia [P<0.05]. ABI<0.9 was seen in older ages, hypertensive, smoker, and CAD patients more than the others [P>0.07]. Because of lack of samples in the present study, authors suggest a study with a larger sample group

Effect of glucose - insulin - potassium [GIK] solution on short term prognosis of unstable angina

Unstable angina as a clinical condition includes a major group of patients manifested with acute coronary syndrome. Misdiagnosis of this clinical syndrome causes myocardial infarction [MI] and death. Conventional and advanced forms of treatment are used with the aim of rapid stabilization of unstable angina. Although infusion of glucose - insulin - potassium [GIK] solution has had good results in acute MI, no major trial has studied its effect in unstable angina. The main goal of this study was evaluation of the effectiveness of GIK solution on prognosis of hospitalized unstable angina patients. This randomized clinical trial included patients with class II and III unstable angina [two groups of 94 patients, each] with a mean age of 62.47 +/- 13.20 years and Female /Male ratio of 1.35 admitted in the CCU's of Yazd from September 2003 to May 2004. There was no significant difference between the study and control groups regarding mean age, sex ratio and unstable angina class [P = 0.15, P = 0.77 and P = 0.76]. The study group had significant reduction in recurrent chest pain and duration of hospitalization [P = 0.001 and P = 0.02]. The most common adverse effect ofGIK solution was pain at infusion site. Use of GIK solution causes early stabilization of unstable angina patients without any significant or life threatening adverse effect

[Clinical and paraclinical characteristics of hospitalized pa talents with congestive heart failure in Yazd [a survey of 258 patients]]

The Clinical and Paraclinical Characteristics of patients with congestive heart failure [CUF] have been described by a number of previous studies, but very little information is available on this issue in Iran. This study aimed to delineate the clinical and paraclinical characteristics of Iranian patients hospitalized with CHF. During an observational, analytical, descriptive, cross-sectional study, 258 consecutive patients were interviewed and examined at S hospitals in Yazd, Iran from January to December 1999.Questionnaire comprised of information regarding etiology, signs, symptoms, paraclinical data, etc. Results were analyzed by SPSS9.01 and EP16 programs using ANOVA, Chi-Square and f-TEST and reported as Mean +/- SD. The study population had a high mean age [67.59 +/- 0.73], 0.8% were less than 35 years old and 70.80% were older than 65 years. Mortality rate due to heart failure was 7.5%. Major causes of CHF were ischemia [65.1%]. valvular lesions [5.8%], cardiomyopathy [5%] and hypertensive heart diseases [4.6%]. Mean number of hospitalizations per year was 2.2 +/- 0.1, while mean hospitalization time was 7.25 +/- 3.8 days and mean cost was 1122439 +/- 89874.8 rials. Even though many background and aggravating factors of heart failure are preventable, this disease incurs a lot of expenditure on our country's health system. Therefore, there is a requirement for programming and research in the fields of education, treatment and prevention of this disease for all members of the community

[Relation between admission blood glucose levels and in-hospital and one year mortality in non-diabetic acute myocardial infarction patients]

Several studies have evaluated the association of admission blood glucose levels and short and long term mortality after myocardial infarction and have had different results. The aim of this study was evaluation of association between admission blood glucose levels and in-hospital and one year mortality in non-diabetic patients with AMI. In this study, demographic, clinical and Para clinical data of 120 non-diabetic patients with AMI on admission was collected and analyzed. The patients were followed for one year. Blood glucose level >/= 140 mg/dl was defined as hyperglycemia. 78% of patients were men. The mean age and admission blood glucose level was 63 +/- 13 years and 146 +/- 76mg/dl, respectively. Death due to cardio vascular causes was seen in 20% of patients in hospital and 9.8% during the one year follow up. The mean admission blood glucose level in patients who died in hospital was significantly more than live patients and also had an influence on the in-hospital outcome. Every 100mg/dl increase in blood glucose level was associated with 11% increase in in-hospital mortality risk in non-diabetic patients. Our results demonstrate that admission blood glucose level is a good marker for diagnosing patients with worse prognosis after AMI. We suggest that later studies should focus on optimal control of hyperglycemia with insulin in patients with AMI