Assessment of statistical relationship of ejection time and acceleration time with the severity of valvular aortic stenosis

Valvular aortic stenosis is a relatively common disease among valvular heart diseases and can be rheumatic, degenerative or congenital. Evaluation of the severity of the disease is sometimes challenging and problematic. Besides, the use of more parameters of non-invasive methods for the assessment of valvular disease and its severity seems attractive and helpful. Transthoracic echocardiography [TTE] is an appropriate modality for the evaluation of the aortic valve. In this study, TTE was performed for 80 patients with valvular aortic stenosis. The goals were to assess the statistical relationships between ejection time [ET] and acceleration time [AT] and their ratio [AT/ET] with the four traditional parameters of the echocardiographic severity of aortic valvular stenosis [aortic jet velocity, aortic valve area, mean pressure gradient and LVOT VTI/aortic VTI ratio]. There was a meaningful relationship between adjusted ET with the four above-mentioned parameters, d. ET [ET-adjusted ET according to heart rate and stroke volume] was inversely related with the aortic valve area [calculated with continuity equation]. AT/ET was significantly correlated with the four mentioned parameters. The regression equations were calculated. The cut-off value of AT/ET for the echocardiographic diagnosis of severe valvular stenosis was 0.36 [with 95% level of confidence]

[ systematic review of herbal medicinal products for the treatment of menopausal symptoms]

Many women are interested to use complementary and alternative medicines for relief from their menopausal symptoms. The prevalence of herbal medicinal product use among menopausal women highlights the need for investigation into these interventions. The goal of this study was to evaluate the benefit of herbal medicinal products for the treatment of menopausal symptoms by performing a systematic review of clinical trials. Literature searches of four computerized databases were done to identify randomized clinical trials of herbal medicinal products for the treatment of menopausal symptoms. Manufacturers of herbal products were contacted, and our own files were also searched. There were no restrictions on the language of publication. Trials were considered if the outcome measures related to the physical or psychological impact of menopause, whether by compendium scores, questionnaires, or women's symptom diaries, excluding studies describing artificially induced menopause. This review was not concerned with biochemical or pathological data. Eighteen randomized clinical trials that fit our criteria were identified. These studies investigated black cohosh [n = 4], red clover [n = 4], kava [n = 3], dong quai [n = 1], evening primrose oil [n = 1], ginseng [n = 1], and combination products [n = 4]. Trial quality was generally good, with 16 of 18 studies scoring 3 or more [maximum 5] on the Jadad Scale. There is no enough evidence for any herbal medical product in the treatment of menopausal symptoms. However, the evidence for black cohosh is promising.The studies involving red clover show it may be of benefit for more severe menopausal symptoms. There is some document for the use of kava, but safety concerns mean this herbal product is not a therapeutic option at present