مجله دانشکده پزشکی اصفهان
پیاپی 571 (هفته سوم خرداد 1399)

Some studies have shown that serum levels of troponin increase in some other diseases in addition to heart diseases. The aim of this study was to determine the frequency and factors associated with increasing troponin in patients admitted to the intensive care unit.

In this cross-sectional study, 62 patients admitted to intensive care units (ICU) of Alzahra hospital, Isfahan, Iran, during the Years 2018-2019, were selected. Patients’ serum troponin levels were measured, and based on the outcomes including cardiac, pulmonary, systemic, and renal complications, frequency of mortality, duration of hospitalization in ICU, and duration of intubation were analyzed.

The mean serum level of troponin I was 47.12 ± 4.38 and 50.00 ± 2.59 ng/l in the living and dead patients, respectively (P = 0.033). The mean serum level of troponin T was 0.57 ± 0.05 and 1.07 ± 0.08 ng/l in the living and dead patients, respectively (P < 0.001). Moreover, troponin I level was significantly different based on the age groups, and serum level of troponin T was different based on the causes of admission in ICU.</div>

 Our study shows that in addition to patients with myocardial infarction (MI), other patients such as the elderly who hospitalized in the ICUs and patients with intracerebral hemorrhage, may also be at increased troponin levels.

Acute myocardial infarction is one of the most common causes of mortality, which is associated with various clinical manifestations, and in some cases leads to lack of timely identification. Therefore, the aim of this study was to determine the relationship between the clinical features of acute myocardial infarction and gender in patients admitted to educational hospitals in Isfahan City, Iran.

This study was performed on 500 patients with acute myocardial infarction (142 women and 358 men). After obtaining patients' satisfaction and recording demographic data, clinical symptoms and complaints were recorded. Chi-square and t tests were used to compare the data.

The age of heart attacks was lower in women than in men (P < 0.001). Smoking (P < 0.001) and addiction (P < 0.001) in men were more than women, while underlying diseases as risk factor for myocardial infarction were significantly higher in women (P < 0.001). At the time of myocardial infarction, there was no difference in incidence of chest pain as the key diagnostic manifestation of myocardial infarction between two sexes, but the nonspecific symptoms were higher in women than in men (P < 0.001).

 It seems that nonspecific symptoms, especially among women, should be taken seriously, and timely diagnostic and therapeutic measures should be performed for them.

Leishmaniasis is endemic in Iran, and Mashhad is one of the most involved cities. Glucantime, prescribed as intralesional or systemic injection, is the most common treatment for cutaneous leishmaniasis. We investigated the additive effect of topical ciprofloxacin on the intralesional injection of glucantime in treatment of cutaneous leishmaniasis.

This randomized clinical trial study was performed on patients with cutaneous leishmaniasis diagnosed by direct smear or biopsy, who referred to Imam Reza and Ghaem teaching hospitals of Mashhad University of Medical Sciences. Patients were randomly allocated into two groups to receive either topical liposomal ciprofloxacin 2% twice daily plus weekly intralesional glucantime or intralesional glucantime alone, for eight weeks. The size of induration and the rate of healing was assessed every week.

There were no significant differences between the groups in cure rate (decrease in induration size equal or more than 75%) (P = 0.410) and the time of healing (P = 0.050) 45 days after the end of treatment.

 Using topical ciprofloxacin does not have any additive effect on the conventional treatment of cutaneous leishmaniasis.