Successful nonsurgical treatment of a radial artery pseudoaneurysm following transradial coronary angiography

Transradial coronary angiography has been known as an alternative to the transfemoral approach with fewer serious complications. Radial artery pseudoaneurysms present as a rare complication of transradial catheterization. Although some methods have been applied for the obliteration of pseudoaneurysms, the use of radial bands such as the TR Band® [Terumo Medical Corporation, Somerset, NJ] is a novel efficient technique only suggested by a few reports. We describe a 34-year-old man, who underwent transradial primary coronary angiography due to ST-elevation myocardial infarction. Two months later, he noticed a pulsatile mass on his hand where the catheterization was done. Ultrasonography proved the diagnosis of a pseudoaneurysm. Consequently, a TR Band® was applied to compress the mass. Interestingly, 24 hours later, ultrasonography confirmed a thrombosed pseudoaneurysm and the pulsatile mass had completely disappeared gradually without recurrence at 2 months' follow-up. Hence, this case report aims to propose the TR Band® as an effective noninvasive method for the treatment of pseudoaneurysms following catheterization

Efficacy of thrice-daily versus twice-daily insulin regimens on glycohemoglobin [HB A1c] in type 1 diabetes mellitus: a randomized controlled trial

To improve glycemic control and prevent late complications, the patient and diabetes team need to adjust insulin therapy. The aim of this study is to evaluate the efficacy of thrice-daily versus twice-daily insulin regimens on HbAlc for type 1 diabetes mellitus by a randomized controlled trial in Hamedan, west of Iran, The study included 125 patients under 19 years of age with type 1 diabetes mellitus over a 3- month period. All patients with glycohemoglobin [HbAlc] >/= 8% were followed prospectively and randomized into two trial and control groups The control group received conventional two insulin injections per day: a mixture of short-acting [regular] + intermediated acting [NPH] insulins pre-breakfast [twice daily], and the trial group was treated by an extra dose of regular insulin before lunch [three times daily]. Main outcome measure was HbAlc at baseline and at the end of 3 months. The mean blood glucose level and number of hypoglycemia were recorded. All patients underwent monthly intervals follow up for assessing their home blood glucose records and insulin adjustment. Overall, 100 patients completed the study protocol 52% were females, mean +/- SD of age of 12.91 +/- 3.9 years. There were no significant differences in baseline characteristics including age, gender, pubertal stage, adherence to diet, duration of disease and total daily insulin dose [p>0. 05]. There was a significant decrease individually in both groups in HbAlc level [p<0.05], but there was no significant difference in HbAlc reduction in patients on twice-daily insulin injections and those on thrice-daily insulin injection groups [1.12 +/- 2.12 and 0.98 +/- 2.1% respectively, [p>0.05]. Compared with twice daily insulin, a therapeutic regimen involving the addition of one dose regular insulin before lunch caused no significant change in the overall glycemic control of patients with type 1 diabetes mellitus. Our results emphasize that further efforts for near normoglycemia should be focused upon education of patients in terms of frequent outpatient visits, more blood glucose monitoring and attention to insulin adjustments

Serum zinc levels in patients with alopecia areata: a case-control study

The etiology of alopecia areata is not clear, but a possible autoimmune cause has been suggested. Serum zinc levels in alopecia areata has been studied, but the reported results were discordant. The aim of this study was to measure the serum zinc levels of the patients with alopecia areata and to compare it with those of the control group. In this case-control study, 46 alopecia areata patients admitted to the skin clinic of Imam Khomeini Hospital, Jundishapour University of Medical Sciences in Ahwaz and 33 sex and age matched individuals were studied. The serum zinc levels of both groups were measured using atomic absorption spectrometry and the results were compared. The mean +/- SD serum zinc level was 873 +/- 154.9 micg/l and in alopecia areata patients 831.8 +/- 155.8 micg/l in control group[P>0.05]. No difference was observed between the serum zinc levels of patients with alopecia areata and controls. More studies for evaluation of a possible relationship between serum zinc levels and alopecia areata is recommended