مجله دانشکده پزشکی اصفهان
پیاپی 689 (هفته اول آذر 1401)

The coronary artery calcium score is a reliable measure of coronary atherosclerosis. This study evaluated the relationship between coronary artery calcium score, cardiovascular events, and metabolic syndrome.

This cross-sectional study was performed in Al-Zahra Hospital in 2019 and included patients who referred to the emergency department of Al-Zahra Hospital with a complaint of typical and atypical chest pain and admitted to the emergency ward of the hospital. Those with a pre-test probability between 5-15 percent underwent coronary CT angiography and their coronary calcium score was calculated and recorded. The data were analyzed using Mantel-Haenszel Chi-square statistical tests of two domains and correlation test (Bivariate Correlations).

The correlation between metabolic syndrome and coronary artery calcium score was meaningful. The odds ratio of men with metabolic syndrome with a coronary artery calcium score was about 4 times higher than women. After adjusted for gender by Mantel-Haenszel method, the chance of developing metabolic syndrome and coronary artery calcium score of 1 or above was 9.96. With bivariate correlations test, the correlation between coronary artery calcium score and metabolic syndrome was statistically significant.

Coronary artery calcium score is more common in patients with metabolic syndrome (MetS) and these are two valuable predictors for coronary artery disease.

Regional anesthesia with mild effects on vital organs is a common method of anesthesia that increases the competence of surgery. This study aimed to investigate the effects of adding magnesium, neostigmine, and fentanyl to ropivacaine alongside placebo on motor-sensory block properties in lower extremity surgeries under spinal anesthesia.

This current triple-blind clinical trial study was conducted on 100 patients who were candidates for lower limb surgery at Kashani Hospital in Isfahan during 2020-2021. These patients were randomly divided into four groups of 25 cases: Group1: ropivacaine plus fentanyl, Group2: ropivacaine plus magnesium sulfate, Group3: ropivacaine plus neostigmine and in the fourth group: ropivacaine plus 5% sugar solution that was injected into the cerebrospinal fluid space from L3-L4. The time of activity initiation and duration of sensory and motor block, and the maximal block height were recorded in all groups. Also, pain during recovery and the occurrence of common complications such as nausea, vomiting, hypotension) were evaluated and analyzed.

There is no significant difference between all groups in terms of the time interval between injection and motor block, sensory motor return, sensory block, and maximal block height and frequent distribution of nausea, vomiting, and hypotension. The shortest time interval between drug injection and sensory block occurred in ropivacaine plus fentanyl group. At the same time, the shortest length of stay in recovery was observed in the placebo group with ropivacaine. The lowest pain intensity was significantly recorded between 30 and 60 minutes of recovery in the fentanyl and neostigmine group compared to the other three groups.

Fentanyl, magnesium sulfate, neostigmine, along with ropivacaine, improved the onset of regional anesthesia with better anesthetic quality, but increased recovery time by reducing the consumption of analgesics compared to placebo. However, it seems that according to these data, a combination of ropivacaine with fentany in spinal anesthesia could be a better alternative for inducing a faster sensory block and controlling pain.

Cystic fibrosis (CF) is a deadly genetic disease that causes various symptoms and complications. This study aimed to evaluate the demographic, clinical and para clinical characteristics among patients with CF.

This cross-sectional study was performed in Imam Hossein (AS) Children's Hospital for one year, from February 1, 2017 to February 1, 2018. About 100 patients referred to Imam Hossein (AS) Children's Hospital in Isfahan diagnosed of cystic fibrosis were included in the study, and all demographic, clinical and laboratory information of the patients was recorded.

Among the CF patients in this study 58% were boys and 42% girls. The average age of the patients was 102 months and within the age range of 5-15 years. The average age of children with CF at the time of diagnosis was 15 months. Around 62% of patients in whom expiratory volume was measured by pressure in one second showed mild involvement, 28% moderate involvement and 10% severe involvement. Gastroesophageal reflux disease (GERD) with 26%, nasal polyp and asthma with relative frequency of 13% and 10%, respectively, were the most common complications among CF patients. Only 18% of CF patients had done genetic testing. Only one patient in the present study used Dornaz alfa. In terms of longevity, only 5% of patients were over 18 years old.

Compared to developed countries that have newborn screening, patients with CF in this study were diagnosed late. Also, CF patients benefited less from the primary drugs that control the disease, and had a shorter lifespan.