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   2014| April-June  | Volume 15 | Issue 2  
    Online since July 24, 2014

 
 
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ORIGINAL ARTICLES
The efficacy of hydration with normal saline versus hydration with sodium bicarbonate in the prevention of contrast-induced nephropathy
Khalil Mahmoodi, Bahram Sohrabi, Farzad Ilkhchooyi, Majid Malaki, Mortaza E Khaniani, Mehdi Hemmati
April-June 2014, 15(2):33-36
DOI:10.4103/1995-705X.137489  PMID:25104980
Background: Contrast-induced acute kidney injury [contrast-induced nephropathy (CIN)] is one of the major causes of hospital-acquired acute renal failure. Volume supplementation is the most effective strategy to prevent acute renal failure caused by contrast; but the effects of sodium bicarbonate regimens are unknown in CIN prevention. The aim of this survey is to compare the efficacy of hydration with normal saline versus hydration with sodium bicarbonate in the prevention of the CIN in patients undergoing coronary angiography. Materials and Methods: In a clinical trial, 350 patients undergoing coronary interventions were randomized into two groups: One group received normal saline and another group received sodium bicarbonate before and after infusion of the contrast. Patients in both the groups had received N-acetylcysteine. CIN was defined as relative increase in serum creatinine equal to or more than 25% of baseline or increase to 0.5 mg/dl in 48 h after the injection of the contrast. Results: CIN was seen in 46 patients (13.1%) after coronary interventions. Incidence of CIN in patients receiving normal saline (19.4%) was more than in patients receiving sodium bicarbonate (6.9%) (P = 0.001). Hemodialysis was needed only in one patient who received saline normal. Relative risk to induce CIN in both groups was as 2.8 and was in the range of 1.50-5.25 with confidence interval of 95% and P = 0.001. Thus, the probability of CIN was significantly more in the usage of normal saline. Conclusion: This survey showed that hydration with sodium bicarbonate is superior to hydration with normal saline and has better protection effects.
  2,478 267 8
Oxytocin ameliorates the immediate myocardial injury in heart transplant through down regulation of the neutrophil dependent myocardial apoptosis
F Fadhil Al-Amran, Murteza Shahkolahi
April-June 2014, 15(2):37-45
DOI:10.4103/1995-705X.137493  PMID:25104981
Cardiac oxytocin (OT) is structurally identical to that found in the hypothalamus, which thereby indicates that cardiac OT is derived from the same gene and is an active form of OT. The abundance of OT and OT receptors in atrial myocytes shows that, directly and/or via the release of the cardiac hormone atrial natriuretic peptide, OT can regulate the force of cardiac contractions. Previous studies have demonstrated the role of OT in the myocardial inflammatory response. The mechanism by which OT elicits protective myocardial effects in the immediate post-transplantation period is not yet clear, and the role of the early phase inflammatory elements in this mechanism has not yet been studied. As a result, in this study, we have investigated the anti-inflammatory effects of OT on myocardial protection in the immediate post-transplantation period. Methods: Adult male Albino rats were grouped into: Sham, Control, and OT-treated groups. The control and treated groups sustained cervical heterotopic heart transplant. Myocardial injury was assessed by measuring: Plasma cardiac troponin I, myocardial proinflammatory cytokines, and histopathological assessment for score of injury, and degree of apoptosis. Myocardial myeloperoxidase, neutrophil infiltration, and neutrophil chemotactant agents, reactive oxygen species, and reactive nitrogen species formation all were measured in the myocardium after 3 hour of reperfusion to assess the neutrophil-dependant myocardial injury and the mechanism involved. Results: Oxytocin down-regulates the neutrophil chemotactant agents the KC/CXCL1 and MIP-2/CXCL2 which recruit less neutrophil into myocardium, this decrement in myocardial PMN infiltration is associated with less reactive oxygen species and reactive nitrogen species formation in the myocardium after 3 hours of global ischemia reperfusion. These oxytocin-induced down-regulation inflammatory and oxidative processes will end in less myocardial injury through impedance in the post-myocardial ischemia/reperfusion apoptotic process. Conclusion: Oxytocin ameliorates myocardial injury in heart transplant through down-regulation the myocardial inflammatory response, reactive oxygen species, and neutrophil-dependant myocardial apoptosis.
  1,940 82 2
CASE REPORTS
Electrocution induced symptomatic bradycardia necessitating pacemaker implantation
Kuan Leong Yew
April-June 2014, 15(2):49-50
DOI:10.4103/1995-705X.137497  PMID:25104983
Electrical or electrocution injury is a common accidental occurrence and mostly workplace related. Fatal arrhythmias, skin injury and sudden death may ensue. However, it is rare for electrocution to result in permanent low rate sinus bradycardia, incompatible with an active lifestyle. The probable mechanisms for this pathological sinus bradycardia are sinus node dysfunction and autonomic dysfunction with vagal predominance. We describe a young patient who suffered a non fatal electrocution with resultant low rate sinus bradycardia and its successful treatment with a dual chamber rate responsive pacemaker.
  1,957 63 2
A case of anomalous origin of circumflex artery from right sinus of valsalva recognized by three-dimensional transesophageal echocardiography and coronary computed tomography angiography
Hale Yilmaz, Baris Gungor, Sinan Sahin, Osman Bolca
April-June 2014, 15(2):57-59
DOI:10.4103/1995-705X.137510  PMID:25104986
Anomalous origin of the circumflex coronary artery from the right sinus of Valsalva is the most common coronary anomaly. It is thought to be of no clinical relevance unless cardiac surgery is performed. We report a 53-year-old patient with aberrant circumflex coronary artery origin from the right aortic sinus of Valsalva which was first suspected from transthoracic 2D and transesophageal 3D echocardiographic views and confirmed by coronary CT angiography. The patient did not receive further diagnostic or therapeutic options. Therefore, we recommended medical therapy with optimal treatment of his cardiovascular risk factors together with regular clinical follow up.
  1,545 88 1
Negative pressure pulmonary edema following septoplasty surgery triggering acute subendocardial myocardial in farction
Zeynettin Kaya, Abdullah Tuncez, Umut Gok, Enes Elvin Gul, Gokhan Altunbas
April-June 2014, 15(2):46-48
DOI:10.4103/1995-705X.137495  PMID:25104982
Negative pressure pulmonary edema (NPPE) is defined as fluid transudation into the pulmonary interstitium which occurs as a result of elevated negative intrathoracic pressure caused by the upper respiratory tract obstruction and strong inspiratory effort. NPPE is usually seen during emergence from general anesthesia in the early post-operative period especially after upper respiratory tract surgery. We present a case of a 37-year-old male patient who underwent septoplasty operation and developed NPPE which could not diagnosed and progressed to acute subendocardial myocardial infarction.
  1,261 84 1
A giant left main trunk and left circumflex artery-to-right ventricle fistula
Zhao-hui Peng, Min Li, Gao Xin, Gang Sun
April-June 2014, 15(2):51-53
DOI:10.4103/1995-705X.137501  PMID:25104984
Coronary artery fistula including the left trunk and left circumflex is uncommon. We present a 24-year-old male patient with a giant left main trunk and left circumflex artery to right ventricle fistula, which is diagnosed by transthoracic echocardiography and coronary computed tomography angiography. In this paper, the case report is to provide a better understanding of clinical characteristics for this disease.
  1,226 61 -
A PICTURE IS WORTH A THOUSAND WORDS (IMAGE)
Post-myocardial infarction left ventricular free-wall rupture
Nagaraja Moorthy
April-June 2014, 15(2):60-60
DOI:10.4103/1995-705X.137515  PMID:25104987
  829 101 -
CASE REPORTS
Carcinoma of unknown primary presenting as large right atrial and ventricular mass secondary to disseminated tumor thrombosis
Prashanth Panduranga, Zahid Kazmi, Najib Al-Rawahi, Zulfikar Habibulla, Nabil Al-Lawati, Faiza Al-Kindi
April-June 2014, 15(2):54-56
DOI:10.4103/1995-705X.137506  PMID:25104985
We report a 65-year-old male patient who presented with right heart failure and a large mobile right atrial and ventricular mass on echocardiography. His computed tomography demonstrated bilateral supraclavicular/mediastinal lymphadenopathy, right atrial and ventricular mass with right pulmonary artery segmental embolism, and multiple liver hypodense lesions. His tumor markers were negative. However, fine-needle aspiration cytology of supraclavicular lymph node revealed metastatic carcinoma suggestive of squamous cell carcinoma. He was suspected to have carcinoma of unknown primary origin. This case illustrates a rare presentation of carcinoma of unknown primary origin with disseminated tumor thrombosis primarily manifesting in heart and other sites.
  778 54 -
ART AND MEDICINE
Art and Medicine
Rachel Hajar
April-June 2014, 15(2):61-61
PMID:25104988
  440 59 -
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