ABSTRACT
Patients on implanted permanent pacemakers frequently develop atrial fibrillation (AF). We aimed to determine the Echocardiographic and clinical parameters predicting AF in patients with a dual-chamber (DDD) pacemaker. This retrospective study included 208 patients with permanent pacemaker, classified according to development of AF during follow up into 2 groups: AF (77, 37%) and non AF (131, 63%), baseline: clinical, ECG(P-wave dispersion) and echo {diastolic wall strain (DWS),left arial volume index (LAVI), left ventricular stiffness index(LVSI)} data were assessed. AF group were older with more P wave dispersion, lesser DWS, greater LVSI& LAVI, LVSI at a cut off > 0.13 and DWS at a cut off < 0.34 were predictors of AF in patients with DDD pacemakers. LVSI and DWS could be used as simple good predictors for AF in patients with DDD pacemakers, for timely initiation of anticoagulants according to CHA2DS2VASc score to decrease ischemic stroke burden.
Subject(s)
Atrial Fibrillation , Pacemaker, Artificial , Humans , Retrospective Studies , Predictive Value of Tests , EchocardiographyABSTRACT
BACKGROUND: Our aim was to assess safety and efficacy outcomes at 1 year after MitraClip for percutaneous mitral valve repair in patients with severe mitral regurgitation. Twenty consecutive patients with significant MR (GIII or GIV) were selected according to the AHA/ACC guidelines from June 2016 to June 2019 and underwent percutaneous edge-to-edge mitral valve repair using MitraClip with a whole 1 year follow-up following the procedure. The primary acute safety endpoint was a 30-day freedom from any of the major adverse events (MAEs) or rehospitalization for heart failure. The primary efficacy endpoint was acute procedural success defined as clip implant with an improvement of MR to ≤ grade II, based on current guidelines, NYHA class, ejection fraction, and the left atrium size during follow-up. RESULTS: Mean age of the studied population was 66.8 ± 10 years and about 85% were males. All patients presented with NYHA > 2. EuroSCORE ranged between 7 and 15. Patients varied regarding their HAS-BLED score. None of them experienced MAEs at 30 days. Patients showed significant improvement of NHYA functional class, and all echocardiographic measurements such as left ventricular end systolic diameter, left ventricular end diastolic diameter, left ventricular ejection fraction, left atrium volume index and MR grade. They also showed significant improvement of right-side heart failure manifestations (lower limb edema, S3 gallop, neck veins congestion), and laboratory value (the mean Hb levels significantly increased from 11.96 ± 1.57 to 12.97 ± 1.36, while the median CRP significantly decreased from 7 (3-9) to 2 (1-3). As well, the median Pro-BNP significantly decreased from 89.5 (73-380) to 66.5 (53.5-151) following MV clipping. During the whole follow-up period, there was dramatic improvement in the NHYA functional class, echocardiographic assessment including left ventricular ejection fraction, and mitral regurge grade. During follow-up, four patients (20%) developed complications. There was no statistical difference between patients who developed complications and those who did not regarding their age (75.25 ± 12.42 versus 64.63 ± 9.21, respectively), BSA (1.69 ± 0.11 versus 1.79 ± 0.22, respectively), gender (75% versus 87.5% males respectively), MR etiology (75% versus 50% ischemic, 25% versus 50% non-ischemic), or NYHA pre- or post-mitral clipping. However, the median EuroSCORE was significantly higher in the complicated group (13, IQR= 11.5-14.5) than the non-complicated group (9.5, IQR=8.5-11.5). CONCLUSION: Percutaneous usage of MitraClip for mitral valve repair showed favorable reliability and better clinical outcomes. TRIAL REGISTRATION: ZU-IRB#2481-17-2-2016 Registered 17 February 2016, email: IRB_123@medicine.zu.edu.eg.
ABSTRACT
AIM: To compare the antibacterial efficacy of Manuka honey against E.faecalis and E.coli. MATERIALS AND METHODS: Escherichia coli (ATCC-25922) and Enterococcus faecalis (ATCC-29212) were separately inoculated in the nutrient broth and incubated at 37(o)C for 24-48 hrs. Bacterial samples were kept in contact with each disinfectant solution for varying intervals of time. Once the test time had elapsed 10µL of the bacterial dilutions were plated on Mueller-Hinton agar and incubated for 24-48 hrs at 37°C to estimate the density. Study of the disinfection process with respect to time and Modeling was done. RESULTS: The mean value of the antimicrobial activity of Manuka honey against E.coli and E.faecalis are 1.55 and 0.36 respectively and are relatively higher. It shows that there is a significant difference among the various root canal disinfectant groups against E. coli and E. feacalis. (p<0.001) CONCLUSION: Manuka honey is shown to be a potential root canal disinfectant against gram positive and gram negative bacterial pathogens.
ABSTRACT
AIM: The aim of this study was to evaluate the microhardness of human dentin by using four irrigating solutions. Materials and Methodos: A total of 40 extracted mandibular premolars were selected and sectioned horizontally in the middle third of the root. Forty specimens of 4 mm thickness were embedded in acrylic resin and polished. Four test groups, each group containing ten specimens were immersed in respective irrigating solution and subjected to vicker's microhardness test at T0, T2 and T5min. STATISTICAL ANALYSIS: The data obtained were analyzed using the one way ANOVA followed by Tukey HSD method with ap=0.05 as the level for statistical significance. RESULTS: Suggested that there was no statistically significant difference in mean values between four experimental irrigating solutions. CONCLUSION: Mixture of Tetracycline isomer i.e. Doxycycline, Citric acid and a Detergent (Tween 80) MTAD not altered the microhardness of root canal dentin significantly and seems to be an appropriate irrigating solution, because of its harmless effect on the microhardness of the root canal dentin.
