[Short- and long-term outcomes of angioplasty and stenting for high-risk extracranial carotid stenosis in carotid endarterectomy]

Carotid endarterectomy [CEA] is a standard method for patient with significant carotid stenosis but direct surgical repair via carotid endarterectomy may not be a good option in some patients because of the overall health status that may make the surgery too risky. Carotid angioplasty and stenting [CAS], is a relatively new procedure for the treatment of carotid artery disease in patients who may not be fit enough to undergo surgery. In this investigation, we determined short- and long-term outcomes of stent angioplasty in high-risk patients for whom the risk of perioperative morbidity and mortality is high. We have followed 82 consecutive symptomatic patients with a >/= 50% and asymptomatic patients with a >/= 70%- 80% carotid stenosis within 15.9 months of angioplasty and stenting in Baqiyatallah and Jamaran hospitals from 2008-2010. All the patients were considered poor surgical candidates by experienced surgeons and anesthesiologists upon pre-surgical consultation. This descriptive cross-sectional study was performed on 28 women and 54 men with a mean age of 69.7_9.2 years. The procedure was technically successful in 79 [96.3%] cases. There were 6 [7.3%] deaths, 5 [6.1%] strokes, 4 [4.9%] MIs and 4 [4.9%] TIAs during the follow-up period. The clinical results during the short available follow-up period suggested stent angioplasty to be useful, effective, reliable and safe in the treatment of significant cervical carotid stenosis in high-risk patients. Further analytical investigations with longer follow-up periods for predicting risk factors are recommended

Efficacy of different concentrations of garlic extract in reduction of oral salivary microorganisms

Garlic is a plant with antimicrobial effects and different concentrations of garlic extract can decrease oral microorganisms. This study evaluates the effectiveness of different concentrations of garlic extract in an oral salivary microbial population. A total of 40 patients were selected based on information obtained through a questionnaire. Saliva samples were collected from all 40 subjects in dry plastic vials by spitting. Each sample was divided into 3 groups [2 cases and 1 control]. One milliliter of sample was added to 9 mL of sterile physiologic serum and mixed. Then, this mixture was serially diluted to prepare a 10[-3] suspension. One mL of garlic hydro-alcoholic extract was added to 1 mL each of the case specimens and transferred to a Trypticase Soy Agar [TSA] culture medium. Case specimens were exposed to 40% and 70% concentrations of garlic extract after 30 and 60 seconds. Control specimens were prepared by the same method, but without exposure to garlic extract. All samples were incubated at 37°C for 48 hours. Assessments were made based on colony counts to determine inhibitory activity of garlic extracts on oral salivary microorganisms. There was a significant reduction in colony forming unit [CFU] at 30 and 60 seconds for 40% concentrations of garlic extracts in comparison to the control group. In other words, 78% and 83.5% reduction in CFU, respectively. On the other hand, for the 70% concentrations, an 86.5% and 90.8% reduction occurred in CFU at 30 and 60 seconds, correspondingly. The mean colony counts of salivary microbial population at the 70% concentration were 771.72 +/- 703.86 at 30 seconds and 524.8 +/- 497.4 at 60 seconds. According to our findings, garlic extract is effective in the reduction of an oral microbial population. It may be useful as an alternative product and new treatment modality with fewer side effects