mohammad sadeghian

Cardiovascular disease is currently one of the world's most common and serious life-threatening diseases. Although the death rate caused by heart surgery is decreasing worldwide, there are still avoidable deaths among low-risk patients. This study investigates the factors affecting mortality in these patients after heart surgery.
This study examined all cases of open-heart surgery between 2018 and 2021 at Heshmatieh Hospital in Sabzevar. The main variables of the research include the number of deaths and the causes of death among patients within 30 days following open-heart surgery.
Overall, 406 male and 204 female patients participated in this research. The average age of the patients was 61.77 years, with an average height of 166.32 ± 10.02 cm and an average weight of 78 ± 14.5 kg. Additionally, 165 patients had high blood pressure, and 586 patients had coronary heart disease.
Although underlying factors such as age and previous diseases affect mortality after surgery, preventing infection, managing fever, and improving discharge protocols can reduce the mortality rate.

Due to the importance of atherosclerotic changes in the patients with coronary anomalies, it was aimed to evaluate the prevalence of atherosclerotic changes in patients with coronary anomalies who underwent coronary angiography at Tehran Heart Center within two years.

In this cross-sectional study, all the patients who underwent coronary angiography and were diagnosed with coronary artery anomalies were included in this study (2018-2020). The frequency and frequency percentage of the detected anomalies, cardiovascular risk factors and also the presence of coronary stenosis among the patients were then determined and reported.

Among 79 patients with coronary artery anomaly evaluated in this study, 43 (54.4%) and 36 (45.6) were male and female, respectively. Of these, 39.2% were smokers and 10.1% had an addiction to opioids. The most frequent baseline disease in these patients was dyslipidemia, hypertension, and diabetes mellitus with 63%, 49%, and 46%, respectively. Moreover, hypertension was more frequent in women (p=0.005). A total of 81.6% of the patients (all of them had abnormal coronary arteries) had atherosclerotic stenosis in their coronary arteries. The highest frequency of coronary abnormality was left circumflex from right coronary sinus with 29.1%; the others included absent left main, coronary fistula, and right coronary artery from left coronary sinus, which were 12.7%.

In the patients with coronary artery anomalies, atherosclerotic changes were frequent prevalence, which can be an important cause of sudden cardiac death in these patients.

“Sagittal balance” is defined by the anatomic relationship between the pelvis and the spine in the sagittal plane to keep the center of gravity over the feet. It is important to calculate the anatomical parameters of cervical, thoracic, lumbar, and spinopelvic regions and how any static and dynamic changes could affect the sagittal balance to understand the conditions necessary for such a balance. One of the effective changes in sagittal balance is aging, which leads to changes in spine parameters and further activation of compensatory mechanisms. Understanding the relationships between these parameters, especially in pathological cases, helps correct spine sagittal imbalance.

Entrapment of the ulnar nerve in the cubital tunnel occurs as the second most common compression neuropathy of the upper limb. Although the usual etiology is idiopathic or following cubitus valgus, a compressing mass can be a rare ca use and should be considered in atypical presentation.

Case Report: 

A 45-year-old male patient presented with subacute onset of cubital tunnel syndrome that progressed rapidly and was associated with significant pain. An intra-canal ganglion cyst was found during surgical decompression of the ulnar nerve.

Diagnosis of intra-cubital canal mass should be considered when sudden onset and rapid progression of the cubital tunnel syndrome and dramatic pain coincide. Imaging modalities like ultrasound or magnetic resonance imaging (MRI) may be helpful to reach the correct diagnosis before the surgery.

Fractional flow reserve (FFR) is a gold standard to assess the impact of stenosis on the blood flow. The FFR method enhances diagnostic accuracy, lessens the need for stenting, and reduces costs. However, FFR is used in less than 10% of percutaneous coronary intervention (PCI) procedures because it needs pressure wires to measure the distal and proximal pressures and adenosine to create hyperemic conditions. Pressure-wire-based FFR measurement is, therefore, expensive and invasive. This study aims to introduce a new approach on the basis of 3D coronary angiography and the Thrombolysis in Myocardial Infarction (TIMI) frame count for fast computation of FFR in patients with coronary artery disease. In this simulation study, we herein introduce Non-Invasive Flow Ratio drawing upon CFD to measure FFR based on coronary angiography images with less run time. In this study, 3D geometry was created based on coronary angiography images. The mean volumetric flow rate was calculated using the TIMI frame count. FFR calculated based on CFD was compared with pressure-wire-based FFR and NiFR was calculated in 85 patients. The NiFR (r = 0.738, P< 0.001) exhibited a strong correlation with pressure-wire-based FFR. The result indicated that FFR was higher than 0.8 in the arteries with non-signif icant stenosis and lower than 0.8 in the arter ies with significant stenosis. The computational simulation of FFR and hemodynamic parameters such as pressure drop is a safe, efficient, and cost-effective method to evaluate the severity of coronary stenosis.

Behçet’s disease (BD) is a multisystem inflammatory disorder. Physicians should be alerted to the possibility of BD in a patient with a carotid artery pseudoaneurysm and no clear predisposing factor such as neck trauma or surgery. Endovascular repair of carotid pseudoaneurysms is technically feasible with excellent midterm follow-up results. Administration of immunosuppressive therapy before endovascular intervention is mandatory to reduce the chance of vascular complications accompanied by BD.A 40-year-old man presented with a painful and pulsatile neck mass with 2 episodes of transient ischemic attacks. The patient also complained of recurrent urogenital ulcers and aphthous lesions together with painful rashes. Ultrasonography and computed tomography angiography revealed 2 aneurysmal dilations in the left common carotid artery at the bifurcation level. He was referred to a rheumatologist, who made the diagnosis of BD. High-dose corticosteroids and cyclophosphamide were commenced. One week later, 2 overlapping self-expanding stent grafts were deployed. The final angiogram showed no residual endoleak, and the flow of the carotid and cerebral arteries was satisfactory. The patient was discharged with no neurological complications. Follow-up ultrasonography and computed tomography angiography 6 months later showed no endoleak, as well as significant shrinkage of the aneurysm sac.

Percutaneous Coronary Intervention (PCI) is a non-surgical procedure for the treatment of Coronary Artery Diseases (CADs). One of the most common disorders associated with these procedures is the occurrence of Cognitive Impairments (CIs). This study aimed to assess the Reaction Time (RT) and anticipatory skill of PCI patients and healthy subjects, using computer-based software as a safe and easy method.

Ten male PCI patients and ten healthy male individuals participated in this cross-sectional study. Auditory choice and complex choice RT, visual choice and complex choice RT, and anticipatory skill of the low and high speed of the ball of both groups were analyzed by Speed Anticipation Reaction Test (SART) software.

No significant difference was seen between two groups in terms of simple auditory RT (P=0.15), auditory complex choice of RT (P=0.19), and anticipatory skills of the low speed of the ball (P=0.16). However, the performance of PCI patients was significantly worse on the simple visual RT (P=0.01), visual complex choice RT (P=0.05), and anticipatory skill of the high speed of the ball (P=0.04) compared to those of the healthy controls.

The assessment of RT and anticipatory skill as neurocognitive tests is considered to be one of the useful methods for evaluating the cognition function of patients, who have cardiovascular diseases. Furthermore, the pilot study suggests that PCI patients had a similar or even poorer performance in cognitive function compared with healthy people.

 Acute lymphoblastic leukemia (ALL) is the most common malignancy in children. Epigenetic factors especially DNA methylation of promoter associated cytosine connected to guanine by phosphodiester bond (CpG islands) are considered as one of the most effective mechanisms in pathogenesis of ALL and have been demonstrated as a biomarker for lineage and subtype classification, prognostication, and disease progression.

 In the present study, we examined the relationship between the promoter hypermethylation of the mir-200b and mir-34a regulator genes on the Notch signaling pathway in patients with ALL and controls in order to investigate association between promoter hypermethylation and development, progression and clinical factors.

 Genomic DNA was extracted from 60 samples (30 blood samples from leukemia patients and 30 normal samples) and modified by sodium bisulfite. Methylation-specific PCR was used to analyze the promoter methylation status of mir-34a and mir200b genes in the studied population. The results were analyzed with SPSS software version 20.

 Our results showed significant association of mir-200b (P < 0.0001) and mir-34a (P < 0.004) genes hypermethylation with ALL. Also there was significant relationship between hypermethylation of mir-200b gene with family history (P = 0.003) and platelets (P = 0.01), and methylation of mir-34a gene with cancer state (P = 0.003) and Hb (P = 0.001) in ALL.

 In this study, we emphasized the important role of epigenetics on acute lymphoblastic leukemia development and progression. Our results showed that analysis of the methylation status of mir200b and mir-34a genes can provide novel prognostic markers for ALL.
 

The peace between Imam Hassan and Muawiya in the year 41 AH, led to the transfer of Imam Hassan to Muawiya during an agreement between the two sides of the caliphate. This has led to several attacks on Imam's personality throughout history. Among the reasons behind these attacks were the caliphate clauses and the financial privileges of the peacemaker. But what is remarkable is the substantive difference between the two provisions of peace treaty with the other articles. The other side of the peace treaty is the character of a leader who is thinking about preserving it'sreligious and cultural achievements, and these two paragraphs represent a character who intends to make maximum advantage of the opportunity, possibly seeking greater financial gains. The discovery of the right or wrong of these two faces requires further careful examination of the historical sources that this has been disturbuted by such concerns.

The optimal target for revascularization in patients with history of coronary artery bypass graft surgery (CABG) is unclear. This study was designed to compare the outcome of percutaneous coronary intervention (PCI) on saphenous vein grafts (SVG) and that on native vessels in patients with previous CABG in terms of major adverse cardiac events (MACE). The study drew upon data on consecutive patients hospitalized for PCI and MACE rate during a nine-month follow- up period. The patients were divided according to the target vessel for PCI into two groups: SVG and native vessel. Between 2003 and 2007, 226 patients underwent PCI 6.57 ± 4.55 years after CABG. Their mean age was 59.52±9.38 years, and 176 (77.9%) were male. PCI was performed on the SVG in 63 (27.9%) patients and on the native coronary artery in the rest. During a nine-month follow-up period, 9 (4%) patients suffered MACE; the prevalence of MACE was not significantly different between the SVG group (4.8%) and the native vessel group (4.9%), (p value = 0.999). PCI on grafted and native vessels did not affect MACE in patients undergoing PCI after CABG.

Rotavirus is the most important pathogen responsible for acute diarrhea in infants and young children. The incidence of rotavirus infection was studied in 156 children less than six years of age who were suffering from acute gastroenteritis, between February 22, 2006 and February 21, 2007 in Mashhad. Rotavirus antigen was detected by latex agglutination test (Rotascreen) in 28.8% of the stool samples examined. The frequency of rotavirus infection was significantly higher among patients under 24 months of age (69%) than among children two years old or more (31%). The peak of incidence was in the winter. This study revealed that rotavirus is an important etiological agent of acute gastroenteritis among children in Mashhad.