Procedural sedation during transradial coronary angiography to prevent spasm.

AIM: Radial artery spasm is common during transradial procedures and is the most common cause of procedural failure. The objectives of this study were to assess whether the routine administration of sedation at the beginning of transradial coronary angiography with the use of hydrophilic-coated and smaller sheaths/catheters would reduce the incidence of radial artery spasm. PATIENTS AND METHODS: Patients undergoing transradial coronary angiography were prospectively randomized to receive midazolam during the procedure or no sedative treatment. The primary endpoint was angiographically confirmed radial artery spasm. Stenosis of the radial artery was measured with a computer-assisted quantification method. RESULTS: In all, 150 patients were randomized into a treatment group and a control group. Spasm occurred in 15 patients of the treatment group (20 %) versus 16 in the control group (21.3 %). There were no differences between the two groups regarding the incidence of spasm and the distribution of spasm severity (p > 0.05). No significant differences were observed between the two groups in terms of 30-day mortality or repeat hospitalization for any cause (p > 0.05). CONCLUSION: Routine use of midazolam could not reduce the occurrence of radial artery spasm during transradial coronary angiography.

Epicardial adipose tissue thickness in patients with chronic obstructive pulmonary disease having right ventricular systolic dysfunction.

OBJECTIVE: The aim of the present study was to evaluate epicardial fat thickness (EFT) in patients with chronic obstructive pulmonary disease (COPD) having right ventricular systolic dysfunction (RVSD). PATIENTS AND METHODS: This study was comprised of 98 patients with COPD and 40 healthy controls. All the study participants underwent 2-dimensional, pulsed and tissue-doppler transthoracic echocardiographic examination for the measurements of EFT and parameters of right and left ventricular functions. Patients with COPD were divided into mild and severe RVSD groups according to right ventricular fractional area changes (RVFACs). RESULTS: Age, gender, prevalence of diabetes mellitus, hypertension, body-mass-index (BMI) and dyslipidemia were similar between COPD patients and controls, as were between mild, and severe RVSD groups. Prevalence of smoking were higher in COPD patients than in controls. Right ventricular end-diastolic diameter, myocardial performance index and peak pulmonary systolic pressure were found to be higher in COPD patients, while tricuspid annular plane systolic, excursion, isovolumic accelerating time, EFT and EFT/BMI were found to be lower in COPD patients. COPD patients with severe RVSD had thinner EFT and lower EFT/BMI values than those with mild RVSD (4.10 ± 0.77 vs 5.48 ± 1.28 mm, p < 0.001, respectively). CONCLUSIONS: The present study shows that the EFT decreases in patients with COPD and it is also associated with the degree of RVSD. Therefore, evaluating EFT in patient with COPD may provide information about the severity of the disease.

An ancient plant Lawsonia inermis (henna): determination of in vitro antifungal activity against dermatophytes species.

World is endowed with a rich wealth of medicinal plants. There is a widespread belief that green medicines are healthier and more harmless or safer than synthetic ones. Medicinal plants have been used to cure a number of diseases. The ancient plant Lawsonia inermis or henna is used as medicinal plant because of its attributed strong fungicidal, anti-inflammatory, analgesic, antibacterial, virucidal, antiparasitic, antiamoebiasis, astringent, antihemorrhagic, hypotensive, sedative, anticancer effect and possible anti-sweating properties. In this study, we investigated antifungal activity of L. inermis against clinical dermatophytes species. This study was carried out using 70 clinical isolates of dermatophytes representing six different species; 44 Trichophyton rubrum, 8 Trichophyton mentagrophytes, 6 Microsporum canis, 6 Trichophyton tonsurans, 4 Epidermophyton floccosum, and 2 Trichophyton violaceum. The antifungal activity of L. inermis (henna) was determined by agar diffusion method and henna was used as paste form. Henna paste showed the high antifungal activity against all dermatophytes species (20 to 50mm inhibition zone).

NT-proBNP is associated with SYNTAX score and aortic distensibility in patients with stable CAD.

OBJECTIVE: A high N-terminal pro-brain natriuretic peptide (NT-proBNP) level provides significant prognostic information on patients with coronary artery disease (CAD). It is unclear whether aortic distensibility (AD), which reflects the aortic stiffness, and the extent and complexity of CAD, assessed with the SYNTAX score (SS), affect the secretion of NT-proBNP in stable CAD. We aimed to investigate the relationship between NT-proBNP levels and AD as well as with the extent and complexity of CAD in stable CAD patients. METHODS: The study included 411 patients with stable CAD (mean age = 61.7 ± 9.9 years, male/female = 247/164). The patients were divided into two groups according to the median NT-proBNP value (NT-proBNPlow group < 114 pg/ml and NT-proBNPhigh group ≥ 114 pg/ml). AD was calculated from the echocardiographically derived ascending aorta diameters and hemodynamic pressure measurements. Coronary angiography was performed and SS was determined in all patients. NT-proBNP and other biochemical markers were measured in all subjects. RESULTS: The AD and ejection fraction values of the NT-proBNPhigh group were lower and their SS levels were higher compared with those from the NT-proBNPlow group (p < 0.05, for all). The NT-proBNP level was independently associated with AD (ß = -0.378, p < 0.001), SS (ß = 0.262, p < 0.001), and ejection fraction (ß = - 0.295, p < 0.001) on multiple linear regression analysis. CONCLUSION: NT-proBNP was independently associated with an impaired elastic property of the aorta and with the extent and complexity of CAD as well as with left ventricular systolic dysfunction.