Detection of thrombogenicity induced by radiofrequency catheter ablation

The aim of this study is to determine the independent and incremental procoagidant effect of RF ablation by assessing biochemical marker of thrombogenicity. The biochemical markers used in this study is direct measures of fibrinolysis [d-dimer, DD]. This study is a comparative clinical trial that was conducted in EP laboratory of National Heart Institute. This study included forty patients are divided into twenty patients referred for radio-frequency transcatheter ablation in right side of the heart [patients with AVNRT] and twenty patients with accessory pathway in the left side of heart with supraventricular tachycardia. Patients with history of recent electrophysiological study [EPS], malignant disease, history of embolic events, recent surgery or trauma, history of atrial fibrillation, active thrombotic process, renal failure, cerebrovascular stroke or previously identified coagulopathy or thrombocytopenia were excluded from the study. No medications affecting the function of the platelets and coagulation system was administered in any of the study subjects. Any antiarrhythmic drugs were withdrawn prior to study. All patients included in the study were subjected to full history taking, thorough clinical examination, resting 12-lead electrocardiogram, transthoracic echocardiography, CBC, FT, PTT, routine laboratory investigations. D-dimer measurement was measured immediately after insertion of the venous sheaths, before introduction of the electrode catheters, on completion of EPS and mapping, before production of the first RF ablation [post-EPS measurements], after completion of the RF procedure [post-RF measurements], before sheath removal and at 36 to 40 hours later and before discharge from the hospital. The D-dimer level in all the studied patients increased significantly after EPS and in spite of that it decrease before discharge it is still significantly higher than that of the baseline level [P < 0.001]. In patients with AVNRT [right sided] and in patients with AP [left sided] the D-dimer level increased significantly after EPS and it decrease before discharge but it was still significantly higher than that of the baseline level [P < 0.001]. Comparison between left and right sided ablation showed no significant difference in the D-dimer level [P > 0.05]. Both right and left sided EPS ablation was associated with an increase in the D-dimer level and this increase continued until discharge

Multivessel coronary stenting versus bypass surgery in patients with multivessel coronary artery disease and normal left ventricular function immediate and six months follow up

The usual goal for CABG is complete revascularization, which may be associated with greater freedom from recurrent angina and better long-term survival. In selected patients with multivessel coronary artery disease and normal left ventricular function, intracoronary stenting may offer an effective alternative to coronary bypass surgery. was to compare the immediate and six months follow up of the results of percutaneous coronary intervention [PCI] and the conventional coronary bypass surgery [CABG] in symptomatic patients with multivessel coronary artery disease and normal left ventricular function. The study included 61 patients who were randomly selected and divided into two groups: group [1]: 33 patients who underwent CABG and group [2]: 28 patients who underwent percutaneous coronary intervention. Both groups were followed up immediately post procedures and for a period of six months after. Stress ECG was done for returning patients during the 6 months follow up. During the immediate post operative follow up, only one patient in group 1 [3%] and 19 patients in group 2 [67.6%] were free of complications [P<0.001] Postoperative angina, acute renal failure, need for inotropic support, blood transfusion and lung atelectasis were significantly higher in group [1] than group [2]. Coronary dissection was found only in the PCI group. Other complications found in both groups were of no statistical significance. Regarding the cost and hospitals stay, it was significantly higher and more in group [1] than group [2]. During the 6 months follow up of the symptoms and the level of activity, there was no statistically significant difference regarding the angina and positive stress test between both groups. There was no statistical difference between the two groups in the composite end points [exercise tolevance, incidence of angina and mortality] during the 6 months follow up after the operation. PCI is relatively safer procedure, less costly and with lower hospital stay than CAVG, but it should be done in the presence of surgical back up because it is not completely free of risk and disadvantages. CABG still will have its role in managing patients with complex lesions not amenable to catheter interventions

Therapeutic effects of Egyptian honey

The chemical analysis of 100 g fresh honey was: 0.3 g protein, 78.5 g carbohydrate, 0.34 g fat, 18.7 g water 0.17 g ash, 6.6 mg calcium, 0.82 mg iron, 0.03 mg vitamin B1, 0.06 mg vitamin B2 and 7.3 mg vitamin C. Honey stimulated the intestinal motility of rats' and rabbits. It was also found to stimulate the amplitude of the motility of non-oestrous, oestrous and pregnant rats' uterus. As for rabbits uterus, small doses of honey did not affect its motility but large doses caused a strong stimulation of the uterine movement. Honey slightly inhibited the Toad's heart and slightly increased the arterial blood pressure. Honey had antimicrobial action as it inhibited the growth of some organisms [Escherichia coli, Staphylococcus aureus] and other examined [Klebsiella pneumonie, Pseudomonas pyocyaneus, Bacillus subtilis and Salmonella typhi]