BACKGROUND: Atrial fibrilation (AF) is the most common complication following heart surgeries; it often occurs in patients after coronary artery bypass graft (CABG). The purpose of this review is to categorize prophylaxes or treatment by administration of Amiodaron in patients with CABG. DATA RESOURCES: We searched google scholar, pubmed, and Cochrane Library databases (the period 1970–2010) for articles on Amiodaron in CABG and cardiac surgery. A total of 1561 articles were identified, and 30 articles met the criteria and were enrolled in this review. RESULTS: Most studies supported Amiodarone for prophylaxi purpose in patients who were performed with CABG; few papers supported Amiodaron as a drug for treating CABG. The prophylaxis can decrease the incidence rate of AF in CABG, but if it uses as a treatment, the side effect of Amiodaron wil decrease because al of the patients wil not get Amiodarone. In the other hand use of Amiodarone as a treatment does not influence the length of hospital stay significantly but these kinds of study are so few. CONCLUSION: No appropriate therapeutic method has been defined for AF. At present, the common way of treating AF following cardiac surgery is mainly based on prophylaxis in medical books and references.

AIM: To evaluate the clinical success of living related conjunctival limbal and amniotic membrane transplantation for treatment of chemical injury induced limbal stem cell deficiency.METHODS: From July 2005 to December 2007, 10 eyes of 9 male patients with chemical injury induced limbal stem cell deficiency were included in the study. All subjects underwent living related conjunctival limbal and amniotic membrane transplantation. Blepharorrhaphy was performed in two cases. Systemic immunosuppression with cyclosporine and prednisolone was initiated.RESULTS: Complete corneal epithelialization was observed in 3 eyes (30%). In one of the patients immunologic rejection and corneal melting led to perforation 1.5 months after surgery. The increasing dose of systemic immunosuppression was used to control it. Three eyes were described as primary failure because graft could not re-epithelialize the corneal surface. The remained four eyes showed partial re-epithelialization, but failed to cover the entire corneal surface with epithelium. Best corrected visual acuity ranged from hand movement to counting finger at 1 meter before the surgery and after the surgery was light perception to 20/80. Five eyes had visual improvement without any additional procedure. Dry eye and persistent inflammation were known as main causes of failure.CONCLUSION: Living related conjunctival limbal allograft and amniotic membrane transplantation can be a good option in the management of limbal stem cell deficiency in selected cases in which tear production and control of ocular inflammation are adequate.

OBJECTIVES: The aim of this study was to evaluate the effect of pre-hypertension and its sub-classification on the development of diabetes. METHODS: In this cohort study, 2,941 people 40 to 64 years old without hypertension or diabetes were followed from 2009 through 2014. According to the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC)-7 criteria, we classified participants into normal and pre-hypertension groups. The effect of pre-hypertension on the 5-year incidence rate of diabetes was studied using inverse probability of treatment weighting. We modeled the exposure and censored cases given confounding factors such as age, sex, body mass index, smoking, economic status, and education. RESULTS: The 5-year incidence rate of diabetes among people with pre-hypertension and those with normal blood pressure (BP) was 12.7 and 9.7%, respectively. The risk ratio (RR) for people with pre-hypertension was estimated to be 1.13 (95% confidence interval [CI], 0.90 to 1.41). The RRs among people with normal BP and high-normal BP, according to the JNC-6 criteria, compared to those with optimal BP were 0.96 (95% CI, 0.73 to 1.25) and 1.31 (95% CI, 1.01 to 1.72), respectively. CONCLUSIONS: Our results showed that participants who had higher levels of BP (high-normal compared to optimal BP) had a higher risk of diabetes development. With regard to the quantitative nature of BP, using the specifically distinguishing of stage 1 hypertension or high-normal BP may be a more meaningful categorization for diabetes risk assessment than the JNC-7 classification.
Blood Pressure ; Body Mass Index ; Classification ; Cohort Studies* ; Diabetes Mellitus* ; Education ; Hypertension ; Incidence* ; Iran ; Joints ; Models, Structural* ; Odds Ratio ; Prehypertension* ; Prospective Studies* ; Risk Assessment ; Smoke ; Smoking

OBJECTIVES: The aim of this study was to evaluate the effect of pre-hypertension and its sub-classification on the development of diabetes.METHODS: In this cohort study, 2,941 people 40 to 64 years old without hypertension or diabetes were followed from 2009 through 2014. According to the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC)-7 criteria, we classified participants into normal and pre-hypertension groups. The effect of pre-hypertension on the 5-year incidence rate of diabetes was studied using inverse probability of treatment weighting. We modeled the exposure and censored cases given confounding factors such as age, sex, body mass index, smoking, economic status, and education.RESULTS: The 5-year incidence rate of diabetes among people with pre-hypertension and those with normal blood pressure (BP) was 12.7 and 9.7%, respectively. The risk ratio (RR) for people with pre-hypertension was estimated to be 1.13 (95% confidence interval [CI], 0.90 to 1.41). The RRs among people with normal BP and high-normal BP, according to the JNC-6 criteria, compared to those with optimal BP were 0.96 (95% CI, 0.73 to 1.25) and 1.31 (95% CI, 1.01 to 1.72), respectively.CONCLUSIONS: Our results showed that participants who had higher levels of BP (high-normal compared to optimal BP) had a higher risk of diabetes development. With regard to the quantitative nature of BP, using the specifically distinguishing of stage 1 hypertension or high-normal BP may be a more meaningful categorization for diabetes risk assessment than the JNC-7 classification.
Blood Pressure ; Body Mass Index ; Classification ; Cohort Studies ; Diabetes Mellitus ; Education ; Hypertension ; Incidence ; Iran ; Joints ; Models, Structural ; Odds Ratio ; Prehypertension ; Prospective Studies ; Risk Assessment ; Smoke ; Smoking

OBJECTIVES: The aim of this study was to evaluate the effect of pre-hypertension and its sub-classification on the development of diabetes. METHODS: In this cohort study, 2,941 people 40 to 64 years old without hypertension or diabetes were followed from 2009 through 2014. According to the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC)-7 criteria, we classified participants into normal and pre-hypertension groups. The effect of pre-hypertension on the 5-year incidence rate of diabetes was studied using inverse probability of treatment weighting. We modeled the exposure and censored cases given confounding factors such as age, sex, body mass index, smoking, economic status, and education. RESULTS: The 5-year incidence rate of diabetes among people with pre-hypertension and those with normal blood pressure (BP) was 12.7 and 9.7%, respectively. The risk ratio (RR) for people with pre-hypertension was estimated to be 1.13 (95% confidence interval [CI], 0.90 to 1.41). The RRs among people with normal BP and high-normal BP, according to the JNC-6 criteria, compared to those with optimal BP were 0.96 (95% CI, 0.73 to 1.25) and 1.31 (95% CI, 1.01 to 1.72), respectively. CONCLUSIONS Our results showed that participants who had higher levels of BP (high-normal compared to optimal BP) had a higher risk of diabetes development. With regard to the quantitative nature of BP, using the specifically distinguishing of stage 1 hypertension or high-normal BP may be a more meaningful categorization for diabetes risk assessment than the JNC-7 classification.

Purpose: Investigations of the hemodynamic changes of the venous system in patients with multiple sclerosis (MS) have shown contradictory results. Herein, the biomechanical parameters of the internal jugular vein (IJV) and common carotid artery (CCA) of MS patients were extracted and compared to healthy individuals. Methods: B-mode and Doppler sequential ultrasound images of 64 IJVs and CCAs of women including 22 healthy individuals, 22 relapsing-remitting multiple sclerosis (RRMS) patients, and 20 primary-progressive multiple sclerosis (PPMS) patients were recorded and processed. The biomechanical parameters of the IJV and the CCA walls during three cardiac cycles were calculated. Results: The IJV maximum and minimum pressures were higher in the MS patients than in the healthy subjects, by 31% and 19% in RRMS patients and 39% and 24% in PPMS patients. The venous wall thicknesses in RRMS and PPMS patients were 51% and 60% higher than in healthy subjects, respectively. IJV distensibility in RRMS and PPMS patients was 70% and 75% lower, and compliance was 40% and 59% lower than in healthy subjects. The maximum intima-media thicknesses of the CCAs were 38% and 24%, and the minimum intima-media thicknesses were 27% and 23% higher in RRMS and PPMS patients than in healthy individuals, respectively. The shear modulus of CCA walls in RRMS and PPMS patients was 17% and 31%, and the radial elastic moduli were 47% and 9% higher than in healthy individuals. Conclusion Some physical and biomechanical parameters of the CCA and IJV showed significant differences between MS patients and healthy individuals.

PURPOSE: Early diagnosis and treatment of acute pyelonephritis in children is of special importance in order to prevent serious complications. This study was conducted to determine the diagnostic value of serum interleukin (IL)-6 and IL-8 in children with acute pyelonephritis. METHODS: Eighty-seven patients between 1 month to 12 years old with urinary tract infection (UTI) were divided into 2 groups based on the result of 99m-technetium dimercapto-succinic acid renal scan: acute pyelonephritis (n=37) and lower UTI (n=50) groups. White blood cell (WBC) count, neutrophil (Neutl) count, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) concentration, platelet count, and serum IL-6 and IL-8 concentrations of both groups were measured and compared. RESULTS: There was a significant difference between two groups regarding WBC count, Neutl count, ESR, and CRP concentration (P<0.05). In addition, the difference between the two groups regarding serum IL-6 and IL-8 concentrations was not significant (IL-6, 60 and 35.4 pg/mL and IL-8, 404 and 617 pg/mL, respectively). The sensitivity and specificity of serum IL-6 and IL-8 for diagnosis of acute pyelonephritis were 73%, 42% and 78%, 32%, respectively. Sensitivity, specificity, negative and positive predictive values of serum IL-6 and IL-8 were less than those of acute phase serum reactants such as CRP. CONCLUSION: This study showed that there was no significant difference between acute pyelonephritis and lower UTI groups regarding serum IL-6 and IL-8 levels. Therefore, despite confirming results of previous studies, it seems that IL-6 and IL-8 are not suitable markers for differentiating between acute pyelonephritis and lower UTI.
C-Reactive Protein ; Child ; Early Diagnosis ; Erythrocyte Count ; Humans ; Interleukin-6 ; Interleukin-8 ; Interleukins ; Leukocytes ; Neutrophils ; Platelet Count ; Pyelonephritis ; Sensitivity and Specificity ; Urinary Tract Infections

There are many of methods of treating cancer. However, the concept of curing the cancer is beyond our current knowledge. Some patients who have the cancer may seek an alternative manner of curing their disease. Alternative medicines, such as spiritual and complementary therapy, are able to cure the cancer and, at the least, are safe. Research on the importance of spirituality in cancer care has mainly been performed in geographically heterogeneous populations. The results are limited to these specific religious-cultural contexts and enlightened by contributions from ethnicity and religion. This article focused on the religiousness and spiritual support of cancer patients from diverse and heterogeneous groups around the globe. An electronic search of peer-reviewed articles was systematically performed to obtain the relevant literature with the CINAHL, PsycINFO, and PubMed databases. The keywords included religion, cancer, illness, psychotherapy, and spiritual and alternative treatment/therapies. The inclusion criteria for the reviews were that the documents were original quantitative research and published in English. Articles that were not directly relevant to the present objective were excluded. The present outcome of these review resources suggest that it may be helpful for clinicians to address spirituality, particularly with regard to prevention, healing, and survival of cancer patients. This article indicates that it may be useful for clinical oncologists to be informed of the prevalence of the use of spiritual medicine in their specialized field. In addition, patients should routinely be asked about the use of spiritual medicine as part of every cancer patient' evaluation.
Delivery of Health Care ; Humans ; Prevalence ; Psychotherapy ; Spirituality

INTRODUCTIONDiabetes mellitus is the most common metabolic disorder in humans, and its incidence is increasing rapidly worldwide. Although polyunsaturated fatty acids have beneficial effects on diabetes mellitus, previous data regarding the possible positive effects of n-3 fatty acids on glycaemic indices were inconclusive. We conducted a double-blind randomised clinical trial to determine the effects of eicosapentaenoic acid (EPA), an n-3 polyunsaturated fatty acid, on overweight patients with type 2 diabetes mellitus (T2DM).

METHODSThis double-blind, placebo-controlled randomised clinical trial was conducted on a total of 67 overweight patients with T2DM for a duration of three months. Of these 67 patients, 32 received 2 g purified EPA daily, while 35 received a placebo of 2 g corn oil daily. The patients' fasting plasma glucose (FPG), serum insulin, glycated haemoglobin (HbA1c) and insulin sensitivity indices were assessed.

RESULTSAfter three months of EPA supplementation, the group that received EPA showed significant decreases in FPG (p < 0.001), HbA1c (p = 0.01) and homeostasis model assessment of insulin resistance (HOMA-IR) (p = 0.032), when compared to the placebo group. EPA supplementation resulted in decreased serum insulin levels, with the levels between the EPA and placebo groups showing a significant difference (p = 0.004).

CONCLUSIONThe results of our study indicate that EPA supplementation could improve insulin sensitivity. It was able to decrease serum insulin, FPG, HbA1c and HOMA-IR. EPA could have beneficial effects on glycaemic indices in patients with T2DM.

Blood Glucose ; drug effects ; Cross-Over Studies ; Diabetes Mellitus, Type 2 ; blood ; drug therapy ; Double-Blind Method ; Eicosapentaenoic Acid ; therapeutic use ; Female ; Humans ; Insulin Resistance ; Male ; Middle Aged ; Overweight ; blood ; complications ; Placebos ; Treatment Outcome

OBJECTIVES: Considering the increase in the non-communicable diseases associated with tobacco use in recent decades in Iran, it is necessary to have a general view of the current condition. This study aimed to identify factors associated with tobacco use and to estimate the probability of a 5-year transition in the stages of tobacco use in an adult population. METHODS: In this study, 5190 people in the 40-64-year-old population of Shahroud (North East of Iran) were interviewed in 2009 and 2014 on tobacco smoking. The association of independent variables with tobacco smoking was evaluated using the population-averaged logit model. We calculated smoking transition probabilities from non-smoking to current smoking and past-smoking stages during a 5-year span. RESULTS: The prevalence of current tobacco smoking in 40-69-years age group was 11.1% (95% CI 10.3-12.0), 1% among women (95% CI 0.8-1.3) and 25.6% among men (95% CI 23.7-27.6). During this 5-year period, the probability of transition of a non-smoker to an overall current tobacco smoker was 2.3%. Meanwhile, 18.5% of the overall current tobacco smokers had changed into past smokers. Unemployed (OR = 2), male gender (OR = 53.9), widow/widowers (OR = 5.4), divorces (OR = 3.3), and high economic status (OR = 1.2) are associated to tobacco smoking. CONCLUSIONS Compared with the other studies, the prevalence of tobacco use in this population is low but transition rate of non-smokers into current smokers or past smokers is high. Conducting interventions on determinants of starting and quitting smoking and education and awareness raising on the risk and harms of smoking seems necessary.
Adult ; Age Factors ; Aged ; Female ; Humans ; Iran ; epidemiology ; Longitudinal Studies ; Male ; Middle Aged ; Prevalence ; Risk Factors ; Sex Factors ; Socioeconomic Factors ; Time Factors ; Tobacco Use ; epidemiology