Qazvin University of Medical Sciences
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Improving Door-to-Balloon Time for Patients With Acute ST-Elevation Myocardial Infarction: A Controlled Clinical Trial
Get PDFAccording to the latest guidelines, the best intervention to restore blood flow through occluded
coronary arteries is angioplasty at a time less than 90 minutes. Thereby, the present study was
conducted to determine the impact of implementing ST-elevation myocardial infarction (STEMI)
code on door-to-balloon time in patients with ST-segment elevation myocardial infarction. This
clinical trial was conducted in 2019 at Booali Sina heart center hospital in Qazvin, Iran, in 2019.
Fifty-eight patients with STEMI were purposively and consecutively enrolled in the study. Patients
were then divided into control and intervention groups, based on their referral period. In both
groups, patients were observed since their Arrived by emergency medical services to emergency
department until inflating the balloon in the occluded coronary artery, and the intended times were
recorded by the researchers. For Participants in the intervention group the “STEMI code” was
designed and activated by an emergency physician once there is a patient experiencing a chest pain
and early confirmed as a myocardial infarction. The SPSS program (v. 16) was used for data
analysis at a significance level of less than 0.05. The difference in the door-to-balloon mean time
in both control (113.5 ± 43.6 minutes) and intervention (79.3 ± 27.4 minutes) groups, was
statistically significant (P = 0.001). Regarding other parameters, the reduction in the mean between
Cath lab time (26.2 ± 18.2 minutes) and balloon time (15.5 ± 7.8 minutes) was also statistically
significant (P = 0.008). In this study, implementation of the “STEMI code” could greatly prevent
parallel work and squandering time while treating patients with acute myocardial infarction. As
the door-to-balloon time gets shorter, the bed occupancy rate in the emergency department had
reduced which in turn allowed more patients to be admitted
Phenotypic Identification and Genotypic Characterization of Plasmid-Mediated AmpC beta-Lactamase-Producing Escherichia coli and Klebsiella pneumoniae Isolates in Iran
Get PDFOne of the mechanisms of Klebsiella pneumoniae and Escherichia coli resistance to β-lactam
antibiotics is the production of β-lactamase enzymes. Among these are the AmpC β-lactamases,
which confer resistance to a class of antibiotics. However, little is known about the AmpC βlactamases of K. pneumoniae and E. coli clinical isolates in Qazvin, Iran. This study was designed
to assess the AmpC β-lactamases-producing strains and also identify the prevalence
of AmpC β-lactamases genes. Antimicrobial susceptibility tests were performed on 435 K.
pneumoniae and E. coli isolates using disk diffusion technique. Plasmid-mediated AmpC genes
were studied using a multiplex PCR assay. The AmpC β-lactamase-producer isolates were studied
by employing cefoxitin disk diffusion test, AmpC induction test, AmpC cefoxitin-EDTA test, and
boronic acid disk test. Our results showed that of 46 (18.4%) cefoxitin-insensitive E. coli isolates,
10 (21.7%) were positive for AmpC β-lactamase genes, among them 4 (8.69%) isolates were
positive for blaDHA genes and 6 (13%) for blaCIT genes. Of 57 (30.4%) cefoxitin-insensitive K.
pneumoniae isolates, 10 (17.5%) were positive for AmpC gene with 4 (6.34%) and 6 (9.5%)
isolates positive for blaDHA and blaCIT genes, respectively. However, no MOX, ACC, FOX,
or EBC genes were detected in the isolates. Considering the results of different confirmatory
phenotypic tests, the AmpC cefoxitin-EDTA test showed a higher discriminatory power for
detecting AmpC β-lactamase-producing strains. The specificity and sensitivity of AmpC cefoxitinEDTA were 77%, 100% for K. pneumonia and 70%, 90% for E. coli higher than the other two
tests, respectively. Also, the authors demonstrated high prevalence rate for resistance to certain
antibiotics, such as cefuroxime, trimethoprim-sulfamethoxazole, ampicillin, and cefotaxime. In
conclusion, our study provided valuable information regarding the plasmid-mediated AmpC βlactamase gene content, antibiotic resistance, and confirmatory phenotypic tests for AmpC βlactamases in E. coli and K. pneumoniae isolates from clinical sources
Randomized, double-blind, placebo-controlled clinical trial studying the effects of Turmeric in combination with mefenamic acid in patients with primary dysmenorrhoea
Get PDFPrimary dysmenorrhea (PDM) is one of the common complaints in women. This study aimed to
assess the effects of turmeric and mefenamic acid and a combination compared with placebo on
PDM. This clinical trial was conducted on dormitory students with PDM. Subjects completed the
visual analog scale (VAS) before randomization. One hundred twenty-eight patients, randomly
assigned to one of following groups: Turmeric group (n = 32), mefenamic acid group (n = 32),
turmeric and mefenamic acid group (n = 32), and placebo group (n = 32). Turmeric and
mefenamic acid were administrated in 500 mg and 250 mg, respectively. Pain severity was
assessed in the baseline and the end line by VAS. Statistical analysis was performed using SPSS
software. The combination of turmeric and mefenamic acid, dramatically, alleviated
pain in comparison to other groups. Our results illustrated that combination of turmeric and
mefenamic acid would be better in pain alleviation in PDM
What is the impact of cinnamon supplementation on blood pressure? A systematic review and meta-analysis
Get PDFAim: This study was designed to make a systematic review and meta-analysis on randomized controlled trials (RCTs) assessing the effect of cinnamon on blood pressure (BP).
Methods: A systematic computerized literature search of PubMed, Scopus, Web of Science, Cochrane Library and Google Scholar databases was conducted up to August 2019. All RCTs using cinnamon supplements in adults were included in this systematic review and metaanalysis.
Results: Out of 927 records, 8 trials that enrolled 582 participants were included. The pooled effect size showed that SBP did not change following cinnamon supplementation. (WMD: 0.61mmHg; 95% CI: -1.36, 0.14, P= 0.111). Also cinnamon supplementation in long-duration (≥ 8weeks) had a significant effect on SBP (WMD: -1.25 mmHg; 95% CI: -2.22, -0.28, P= 0.012). Pooled analysis showed that cinnamon had a significant effect on DBP (WMD: -0.93mmHg, 95% CI: -1.55 to -0.32, P= 0.003). In addition, results from both duration subsets and high dose (>1500 mg/day) of cinnamon supplementation were significant.
Conclusion: Our findings revealed that cinnamon supplementation has favorable effects on DBP although results of SBP were not the same. Nonetheless, further studies are required
بررسی دیدگاه دانشجویان دندانپزشکی نسبت به استفاده از log book به منظور بهبود کیفیت آموزش بخش دندانپزشکی ترمیمی
Get PDFFire Pathology in a Military Hospital Using the FRAME Technique
Get PDFBackground and Aim: Hospitals are One of the vital and sensitive places as well as practical that maintaining their function in normal conditions and in times of crisis is one of the biggest concerns of health system managers. By using the principles of fire safety, hospitals' vulnerability can be reduced. Fire is one of the risks that can lead to many human and financial losses as well as disruption of hospital performance. Fire risk assessment is a more effective way to assess the vulnerability, capacity and capability of the hospital. The aim of this study was to evaluate the risk of fire in one of the hospitals in Tehran to analyze the vulnerability of these uses.
Methods: This cross-sectional study was performed by using the Fire Risk Assessment Method for Engineers (FRAME) in the hospital building of a military hospital. Fire risk was calculated using the formulas of the mentioned method in EXCEL software. Factors influencing the level of risk obtained were identified and evaluated.
Results: The level of fire risk for residents in all units was higher than one. Level factor, fire load factor and normal protection factor were identified as effective factors that result in the existing fire risk level.
Conclusion: The numerical value of the risk for the residents was at an unfavorable level. The results of this study showed that the use of FRAME method in assessing the risk of health facilities such as hospitals, by determining the strengths and weaknesses of the assessed locations, the possibility of identifying effective factors to predict and prevent accidents and maintain the performance of these centers at times. Be sensitive to such man-made or natural emergencies
Cardioprotective effects of mebudipine in a rat model of doxorubicin-induced heart failure
Get PDFBackground: Mebudipine, a dihydropyridine calcium-channel
blocker (CCB), shows greater time- and voltage-dependent
inhibitory effects than nifedipine. Its significant negative
chronotropic effects without having considerable negative
inotropic properties may make it a suitable candidate for the
pharmacotherapy of heart failure (HF). This study aimed to
investigate the possible beneficial action of mebudipine in a rat
model of HF.
Methods: The present study carried out in the Department of
Pharmacology at the Iran University of Medical Sciences during the
years of 2009-2011. An experimental model of HF was induced in
male Wistar rats using doxorubicin (DOX). The rats were divided
into five groups with seven animals in each group: normal control
group, DOX-induced HF control groups, and treatment groups.
The animals were administered DOX for 15 days. A consistent
deterioration occurred after a four-week rest period. The animals
were then treated with intraperitoneal mebudipine (0.5 mg/kg)
and intraperitoneal amlodipine (0.35 mg/kg), as well as an equal
volume of distilled water for 15 days. The plasma levels of big
endothelin-1 (BET-1), creatine kinase-myocardial band (CKMB), lactate dehydrogenase (LDH), aspartate aminotransferase
(AST), and alanine aminotransferase (ALT), as well as the clinical
status (heart rate and blood pressure), were assessed before and
after treatment. Statistical analysis was performed with SPSS
software using parametric and nonparametric ANOVA.
Results: Mebudipine and amlodipine reversed the increased
plasma BET-1 values in the treated animals when compared
with the HF control group (0.103 and 0.112 vs 0.231 pg/
mL, respectively). The increased plasma levels of AST, ALT,
CK-MB, and LDH were also reversed in the HF animals that
received mebudipine or amlodipine.
Conclusion: The administration of mebudipine to HF animals,
akin to amlodipine, palliated the clinical and biochemical signs
of the disease in the present study.
The abstract was presented in the Iranian Congress of Physiology
and Pharmacology as a poster and published in the Scientific
Information Database as a supplement (2015; Vol 22)
Randomized double blind clinical trial evaluating the Ellagic acid effects on insulin resistance, oxidative stress and sex hormones levels in women with polycystic ovarian syndrome
Get PDFObjective: The design of this study was due to the report of the antioxidant properties of Ellagic acid (EA) for its
evaluation on the Insulin resistance (IR), oxidative stress and sex hormones levels in women with polycystic ovarian
syndrome (PCOS).
Methods: In this randomized, double-blind, placebo-controlled clinical trial, 60 patients were recruited. Patients were
randomly allocated consumed a capsule containing 200 mg of EA per day (n=30) or placebo (n=30) for 8 weeks.
The fasting blood sugar (FBS), insulin, IR, total cholesterol (TC), triglycerides (TG), low density lipoprotein (LDL), high
density lipoprotein (HDL), total antioxidant capacity (TAC), Malondialdehyde (MDA), C-reactive protein (CRP), Tumor
necrosis factor-alpha (TNF-α), sex hormones and anti-mullerian hormone (AMH) were measured at the beginning and
end of the study.
Result: At the end of the study, the mean of FBS, insulin, IR, TC, TG, LDL, MDA, CRP, TNF-α, total testosterone, prolactin
and AMH were signifcantly decreased in the intervention group compared to the placebo group (P<0.05). Also, there
was a signifcant increase in the mean of TAC after supplementation with EA (P<0.05). At the end of the study, no
signifcant changes were observed in the mean of anthropometric factors, physical activity and food intake (P>0.05).
Conclusion: EA supplementation can be helpful as a diet supplement in women with PCOS through improvement
in insulin resistance. This supplement may be used to reduce metabolic disorders in women
