Comparison of preoperative and one-month postoperative serum cholesterol after cholecystectomy.

Objective: Cholecystectomy is a gold-standard procedure for symptomatic gallbladder stones. However, dyslipidemia is reported in about 50% of these patients. The aim of this study is to evaluate the change in the levels of total cholesterol following cholecystectomy. Methods: In this cross-sectional study, patients who underwent cholecystectomy for gallstone in (XXX) Nursing Home were included. Preoperative cholesterol levels and those following a month of the surgery were measured in the patients. A form, comprising of the demographic details, along with clinical outcomes was prepared for each patient and the data were analyzed using SPSS v25.0 software. Results: 33 patients were included in this study, of which 29 were females and 4 were males. 48.5% of our patient's population were aged above 50 years. The mean of preoperative cholesterol levels was 203.78 mg/dL. One month after the surgery, the mean cholesterol level was found to be 197.03 mg/dL. Overall, there was no statistical difference between the preoperative and one-month postoperative cholesterol level. Conclusion: Our patients did not present hypercholesterolemia with gallstone disease. Furthermore, one month after the surgical intervention (Cholecystectomy), we did not find any significant changes in the cholesterol levels. Detailed investigation of complete lipid profile with long-term follow up in a larger population is thereby required.

Frequency of recurrence of peripheral artery disease among angioplasty and stenting patients.

BACKGROUND: Peripheral artery disease (PAD) is a cardiovascular disease that is characterized by obstruction of peripheral artery. It is associated with comorbidities, reduced quality of life and mortality. The aim of this study was to determine the frequency of recurrence of PAD among patients who underwent angioplasty or stenting and associated risk factors. METHODS: In this retrospective study, all patients referred to the cardiovascular center of (XXX) with the diagnosis of lower extremity PAD were included. Patients' demographic information, age, gender, smoking status, history of diabetes, history of hypertension, dyslipidemia, number of vessels, type of stent, recurrence of the disease, and size of the lesion were obtained from the hospital database. Endovascular revascularization therapy was either performed by angioplasty or stenting method. The data were analyzed by SPSS v21. RESULTS: Of 88 patients included in this study, 12.5% were reported with restenosis. Gender, age, size of the lesion, the status of smoking, history of hypertension, and dyslipidemia were not significantly associated with the recurrence of stenosis, p > 0.05. There was a significant relationship between the vessels involved and the type of revascularization method and the recurrence of the PAD. CONCLUSION: Endovascular revascularization technique and type of vessel involved in PAD are significant factors contributing to restenosis in our population of study. However, further studies with a greater sample size are required in this area.

Frequency of Pathological Types of Hyperthyroidism in Thyroid Scan Patients.

BACKGROUND: Hyperthyroidism is a common systemic disorder where Graves' disease is known as the leading cause of the disease. Thyroid stimulating hormone, T4 and T3 antibody assay is usually performed for the diagnosis of the pathology. However, with uncertainty in the results and in order to estimate the magnitude and the exact cause of the disease, radioactive iodine uptake (RAIU) test is recommended. The aim of this study is to evaluate underlying pathology in the patients presenting hyperthyroidism using RAIU test results. METHODS: This is a cross-sectional retrospective study conducted on the patients with hyperthyroidism referred to Shahid Madani Hospital in Khorramabad. Data regarding the biochemical analysis and RAIU test was collected from the records and a questionnaire based on demographic and clinical information was completed for each patient. RESULTS: Of 137 patients presenting hyperthyroidism, 62.04% presented with Graves' disease, 24.08% with toxic multinodular goiter and 13.86% with toxic adenoma. 24-hour RAIU test showed that the percent of radioiodine uptake was most in toxic adenoma with 67.7%, Graves' disease 53.5% and multinodular goiter 39%, respectively. From the age-based analysis, we found that Graves' was most common in 20-30 years old individuals accounting for 34%, multinodular goiter in 50+ aged individuals with 36.3% and toxic adenoma was most prevalent in 30-40 and 50+ aged patients, with 26.3%. In our population of interest, 81.8% toxic multinodular goiter patients were females. CONCLUSION: Our study presents the outcome of RAIU tests in hyperthyroidism based on the underlying pathologies. We also conclude, in light of other findings, that Graves' disease is the most common cause of hyperthyroidism in our population.

Atrial Fibrillation and Ventricular Tachyarrhythmias: Advancements for Better Outcomes.

Cardiac arrhythmias are associated with several cardiac diseases and are prevalent in people with or without structural and valvular abnormalities. Ventricular arrhythmias (VA) can be life threating and their onset require immediate medical attention. Similarly, atrial fibrillation and flutter lead to stroke, heart failure and even death. Optimal treatment of VA is variable and depends on the medical condition associated with the rhythm disorder (which includes reversible causes such as myocardial ischemia or pro-arrhythmic drugs). While an implanted cardioverter defibrillator is often indicated in secondary prevention of VA. This review highlights the newest advancements in these techniques and management of ventricular and atrial tachyarrhythmias, along with pharmacological therapy.

A Descriptive Study on the Usage of Exploratory Laparotomy for Trauma Patients.

OBJECTIVE: Laparotomy is commonly indicated in patients presenting blunt or penetrating trauma. This cross-sectional study is designed to evaluate the frequency and the causes of laparotomy following abdominal trauma. MATERIALS AND METHODS: The data of 71 patients who underwent laparotomy as a result of abdominal trauma in Shohada Ashayer Hospital, Khorramabad were evaluated and a questionnaire was completed for each patient. All the data were analyzed statistically using SPSS. RESULTS: Of 71 patients, 61 underwent positive laparotomy whereas, negative laparotomy was performed in 10 patients. The results from this study showed that the most common organ of the injury was spleen (19.7%), followed by other solid organs. The small intestine (16.4%) was found more prone to injuries in penetrating trauma. Incidence of blunt trauma injury due to road accidents was the greatest 50.82% and 20% of penetrating traumas were the result of a firearm. CONCLUSION: Abdominal trauma injury is common in our study population where spleen, small intestine and other solid organs are chiefly involved. Indications of laparotomy should be fully examined in order to avoid negative laparotomies and associated complications.

Application of tissue-engineered interventions for coronary artery bypass grafts.

Coronary artery bypass graft is one of the extensively conducted procedures to release occlusion in the coronary vessel. Various biological grafts are used for this purpose, superiorly, saphenous vein graft, if unavailable, other vessels in the body, with likewise characteristics are exploited for the purpose. The choice of graft is yet under discovery that could impeccably meet all the requirements. Variation in perioperative and postoperative results have given uneven clinical inferences of these conduits. Alternatively, tissue-engineering is also being applied in this area for clinical improvements. This review underlines some of the commonly used grafts for coronary artery bypass graft and advancements in tissue engineering for this purpose.

Evaluating Mortality Rate and Associated Parameters in Patients with Acute Coronary Syndrome.

BACKGROUND: Acute coronary syndrome (ACS) is one of the leading causes of mortality worldwide and is characterized by unstable angina or acute myocardial infarction. The aim of this study is to evaluate the clinical characteristics of patients who died of ACS. METHODS: In this cross-sectional study, 1000 patients presenting ACS were included. Data and records of these patients were evaluated for parameters such as; deceased status, age, gender, diagnosis, ECG, common complaints, associated risk factors, Killip class, pulse, blood pressure, geographic setup (urban or rural), complications and season in which the disease was presented. Statistical analysis was performed on the data obtained using SPSS-win software. RESULTS: The mortality rate among ACS patients in our study was 7.1%. Of these patients, AMI was the most prevalent diagnosis and chest pain was the most common complaint. Furthermore, low blood pressure, advanced age, increased pulse rate and fall/winter season were associated with the increased risk of mortality. ST deviation was the most seen ECG finding and most of the mortalities were within the 24 hours of admission. CONCLUSION: Our study reports risk factors associated with mortality in ACS patients. Advanced and timely therapeutic measurements are likely to reduce the incidence of mortality in these patients.

Postoperative complications associated with coronary artery bypass graft surgery and their therapeutic interventions.

Coronary artery disease is one of the commonest surgery demanding cardiovascular diseases. Coronary artery bypass graft surgery is practiced all over the world for the treatment of coronary artery disease. Systemic trauma during the surgery is associated with a wide range of complications, some of which are fatal. Preoperative risk factors such as age, previous illness and obesity are common predictors of these adverse events. Advances in therapeutic medicine have allowed timely treatment of these adverse events and co-morbidities. This review summarizes some of the most occurring complications associated with coronary artery bypass graft and corresponding treatment options.

Animal- and human-based evidence for the protective effects of stem cell therapy against cardiovascular disorders.

The increasing rate of mortality and morbidity because of cardiac diseases has called for efficient therapeutic needs. With the advancement in cell-based therapies, stem cells are abundantly studied in this area. Nearly, all sources of stem cells are experimented to treat cardiac injuries. Tissue engineering has also backed this technique by providing an advantageous platform to improve stem cell therapy. After in vitro studies, primary treatment-based research studies comprise small and large animal studies. Furthermore, these studies are implemented in human models in the form of clinical trials. Purpose of this review is to highlight the animal- and human-based studies, exploiting various stem cell sources, to treat cardiovascular disorders.

Age and the Head-Up Tilt Test Outcome in Syncope Patients.

BACKGROUND: The head-up tilt test (HUTT) is a useful diagnostic tool for syncope. OBJECTIVES: We sought to investigate the outcome of the HUTT in syncope patients and identify the relationship between age and different hemodynamic outcomes. PATIENTS AND METHODS: In this cross-sectional study, we prospectively enrolled consecutive patients who presented with syncope and underwent the HUTT with a clinical suspicion of neurocardiogenic syncope after the exclusion of orthostatic hypotension cases. The HUTT consisted of consecutive passive and active phases. In the passive phase, the patients were tilted at 70 degrees for 20 minutes; and if negative, the test was repeated with 400 micrograms of sublingual nitroglycerin for another 20 minutes. Positive responses were classified according to the classification of the vasovagal syncope international study (VASIS) and compared for age and gender. RESULTS: A total of 498 patients were enrolled (age = 44.93 ± 18.77 years; male = 271 [54.4%]). Overall, 291 (58.4%) patients had a positive HUTT, while 256 (88.5%) patients had a positive result during the active phase. The test results were as follows: 107 (36.7%) mixed type (VASIS I), 103 (35.3%) cardioinhibitory (VASIS IIA = 44 [15.1%]; VASIS IIB = 59 [20.2%]), and 80 (27.4%) vasodepressive (VASIS III). There was no relationship between gender and syncope type. The trend of the HUTT result significantly changed with age, and the rate of cardioinhibitory syncope decreased after middle ages (P value for trend = 0.02). CONCLUSIONS: Hemodynamic response to the HUTT was associated with age. Cardioinhibitory response became less frequent with age due to exaggerated vagal activity in the younger patients as compared with the older subjects.