Effects of dexamethasone in primary intracerebral hemorrhage in the south west of Iran

Previous study revealed the value of dexamethasone in the treatment of vasogenic edema associated with brain tumor and abscess. However there are poor documented studies about its usefulness in primary intracerebral hemorrhage. In this study we evaluated dexamethasone effects in primary intracerebral hemorrhage. In a double blind randomized placebo-controlled clinical trial we evaluated 200 intracerebral hemorrhage cases between 40 to 80 years old whom were admitted at Golestan Hospital [Ahwaz, IR] between March 2002 And March 2003. They were divided in two groups; dexamethasone [N=100] and placebo [N=100]. Then mortality, GI bleeding, fever, electrolytes disturbances, hypertension and hyperglycemic status were analyzed in two groups. Ethical considerations were employed and subjects were followed by appropriate statistical methods for 21 days to assess the major outcomes. Mortality was much higher in the dexamethasone group; Dexamethasone group [49.3%] and placebo [23.4%] and also fever was higher seen in the dexamethasone group; dexamethasone group [40.2%] and placebo group [24.7%] but there was not any significant statistical difference between two groups as regards other complications. Dexamethasone is widely used for cerebral edema associated conditions but in this study we saw that it's complications in intracerebral hemorrhage such as increasing fever and mortality are significantly higher. Hence it use for treatment of primary intracerebral hemorrhage should be reconsidered

Comparison of Specifications, Short Term Outcome and Prognosis of Acute Myocardial Infarction in Opium Dependent Patients and Nondependents

The effects of opium dependence on prognosis and short term outcome of patients with acute myocardial infarction [AMI] are not clear yet. From March 2004 to August 2004 all male patients admitted with diagnosis of AMI were enrolled. Patients who fulfilled DSM- IV-TR criteria were chosen as opium dependent patients [ODP]. Demographic data, risk factors, peak enzyme levels, location of MI, mortality and ejection fraction were collected and analyzed. We studied the mortality, readmission, functional class, performed revascularizations and coronary angiogram results in a short term follow-up [184 +/- 37 days]. A total number of 160 patients were enrolled, of which 45 [28.1%] were opium dependent. In 137 patients 6 months follow up was completed. Duration of admission was higher in O.D.P [11.3 days versus 8.7, P= 0.03] There was no significant difference in age, EF, location of MI, peak enzymes levels, angiographic findings, risk factors [except for cigarette smoking and triglyceride level], in-hospital mortality, need for readmission, 6 months mortality, functional class, and the need for revascularization. In an unselected cohort of patients admitted with AMI, there was no significant difference in specifications, short term outcome and prognosis of AMI between ODP and nondependents except for duration of hospitalization