ISSN 2415-1297 (Online)   ISSN 2415-1300 (Print)
Volume : 27 Issue : 3 Year : 2019
Med J Islamic World Acad Sci: 13 (3)
Volume: 13  Issue: 3 - 2000
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1.Comparison of Serum Markers of Myocardial Ischemia in Coronary Artery Bypass Grafting by On-pump and Off-Pump Techniques
R. Parvizi, M. Rahbani-Nobar, N. Samadi, F. Khatibi
Pages 103 - 108
Coronary artery bypass grafting (CABG) is usually performed with cardiopulmonary bypass (CPB). However CPB has been associated with several adverse effects. Recently off-pump CABG technique is offered as an alternative to the standard on-pump technique. The purpose of this study was to evaluate the safety of the techniques by estimating and comparing serum markers of myocardial ischemia; CK, CK-MB, LDH, AST, Cardiac Troponin I and some peri- and postoperative complications after the two types of surgical procedures.
Seventy-three patients (58 males and 15 females) with angiographically defined CAD admitted to the hospital for CABG were selected. The off-pump technique was performed in 38 patients with mean age of 60±10.5 years. In 35 other patients with mean age of 55±10.4 years, the on-pump technique was applied. CK, CK-MB, LDH and AST activities and cardiac Troponin I concentration were measured peri- and postoperatively until 24 hours. Characteristics of the patients and some peri- and postoperative data regarding incidence of complication were also recorded.
The activities of serum cardiac enzymes; CK, CK-MB, LDH and AST after on-pump CABG technique were higher than those of off-pump technique (p<0.05 in all cases). The levels of Troponin I were significantly higher after on-pump CABG throughout the entire measurement period (p<0.01) compared off-pump procedure. In the both groups of the patients no preoperative myocardial infarction was observed. In the off-pump technique procedural time was shorter and transfusion of blood and blood products was less than those of on-pump technique, but no differences were noticed between the other recorded data.
Significantly lower release of the enzymes and Troponin I during operation by off-pump technique suggests that the technique causes less myocardial injury. On the basis of little change in the activities of cardiac enzymes and Troponin I in serum and presented data including a marked decrease in blood transfusion and shorter procedural time it is concluded that off-pump CABG is a safe and effective technique in selected patients with appropriate coronary lesions.

2.Comparative Bioavailability of Two Test Brands of Theophylline; Tablets and A Reference Quibron®-T/Sr Under Fasting and Limited Food Conditions
Mutasem Al-Gahzawi, Sawsan A.S. Majali
Pages 109 - 114
Comparative bioavailabilities of two test formulations containing 300 mg Theophylline/sustained release tablets were compared with a reference Quibron®-T/SR 300 mg/SR tablet of Mead Johnson. From the concentration-time profiles, the primary pharmacokinetic parameters were evaluated under fasting and under limited food effect conditions in healthy subjects (N=24). The statistical evaluation of the average pharmacokinetic parameters of AUC0, AUC0‡t and Cmax, demonstrated lack of statistically significant difference between the average pK characteristics from two test formulations versus the reference. The study demonstrated the absence of food effect on Theophylline disposition.

3.The Amniotic Membrane: A Suitable Biological Dressing to Prevent Infection in Thermal Burns
A. A. Ghalambor, Mohammad H. Pipelzadeh, A. Khodadadi
Pages 115 - 118
The development of wound sepsis is the most common cause of mortality and morbidity among burn patients. A variety of dressings have been used to cover, reduce burn wound sepsis and promote wound healing. The aim of this study was to compare the effectiveness of amniotic membrane with the classical method of treatment in thermal burn patients in reducing wound sepsis. Two-hundred patients, with less than 20% of total body surface, who suffered from second degree superficial and deep-thickness burns, were selected randomly and divided into two groups of 100 patients each. The first group was treated with classical method of antibiotic ointment and gauze bandage. The second group was covered with amniotic membranes procured from hepatitis-, syphilis- and HIV-seronegative mothers having undergone cesarean deliveries. The wounds were inspected for any signs of infection daily for 10 days, then on weekly basis for 4 weeks and finally monthly for 6 months. All cases were treated on an outpatient basis. In the amnion and classical methods, 2 and 17 cases of infection were respectively observed. These were hospitalized and treated successfully by debridement and administration of appropriate systemic and local antibiotics. Despite possible dangers of disease transmission, which can be overcome with appropriate precautions, we recommend the widespread use of this procedure.

4.Interrelationship between Blood Glucose Level and Incidence of Bone Disease in Diabetes
A. A. Moshtaghie, M. Taher, H. Urogi, A. Emami, M. Amini, H. Pourmoghadas, A. Taherian, M. Facori
Pages 119 - 124
Patients, with high blood glucose (diabetes) suffer from a number of disorders including bone disease.
The present investigation was undertaken to study the probable mechanism by which bone disturbances occur in patients with varying levels of serum glucose.
In females with serum glucose within the range of 110-270 mg/dL serum ionized calcium (Ca2+) level decreased from 4.42±0.50 to 3.46±0.48 mg/dL (p<0.05), whereas serum total calcium (Ca) level did not change significantly. Serum phosphorous concentration increased from 4.21±0.56 to 5.19±1.21 mg/dL (p<0.05) and serum alkaline phosphatase (ALP) activity elevated from 69.84±9.70 to 103.53±30.73 IU/L respectively (p<0.05).
In male with the same serum glucose levels (110-270 mg/dL) serum total calcium (Ca) level decreased from 9.77±0.50 to 7.7±2.12 mg/dL (p<0.05) and serum ionized calcium (Ca2+) decreased from 4.18±0.65 to 3.45±0.43 mg/dL (p<0.05). Serum phosphorous concentration elevated from 3.90±0.60 to 5.5 ± 1.58 mg/dL (p<0.05), and serum ALP was elevated from 69.85±9.71 to 106±34.5 IU/L. Elevated serum ALP activity was related to bone fraction isoenzymes as examined by heat stability test (56°C in 10 min). Serum protein level in both male and female patients was decreased in comparison to healthy controls.
The probable relationship between hyperglycemia and occurrence of bone disease in diabetic patients has been discussed in this manuscript.

5.Biochemical Study on The Efficacy of Malaysian Honey on Inflicted Wounds: An Animal Model
A. M. Aljady, M. Y. Kamaruddin, A. M. Jamal, M. Y. Mohd. Yassim
Pages 125 - 132
The efficacy of Malaysian honey on the healing of wounds in Sprague-Dawley rats was investigated on the basis of biophysical and biochemical changes. Equidimensiona full-thickness excision wounds were created on the back of each animal and treated either by topical application or by a combination of topical and oral administration of honey. Control animals received only saline. Development of wound healing was evaluated by measuring the rates of wound contraction and epithelialization. Quantitative assays were performed to determine the amounts of uronic acid, hexosamine, DNA, and collagen content of the granulating tissues. The serum albumin level was also measured. The results obtained showed that honey accelerates wound healing by influencing cell division and proliferation, collagen synthesis and maturation, wound contraction and epithelialization. All the parameters measured showed remarkable consistency with the wound healing property of honey. Honey also improved the nutritional state of the animal when given orally.

6.Assessment of Serum Lipoprotein(A) in Patients with End-Stage Renal Disease
Beman-Ali Jalali-Khanabadi, Hassan Mozaffari, Mohamad-Hosain Dashti
Pages 135 - 138
Increased plasma lipoprotein(a) [Lp(a)] levels are strongly associated with premature atherosclerotic cardiovascular disease. The kidney is purported to play an important role in Lp(a) catabolism. However, race and genetic background to a large extent determine the Lp(a) concentrations in the general population. The aim of present study was to evaluate the effect of end-stage renal disease on serum Lp(a) in a group of Iranian population.
Sixty seven patients with end-stage renal disease treated by hemodialysis and 100 healthy controls were investigated. The lipids were measured by routine laboratory methods and Lp(a) assay was done by electroimmunodifusion.
The serum levels of Lp(a) in patients were significantly higher than controls (median 31 mg/dl versus 20 mg/dl, p=0.016). The Lp(a) in control group did not correlate with age, sex and lipids, but in patients it was found to correlate significantly with age (r=0.28, p=0.033), and cholesterol (r=0.35, p=0.008). In this study, 28% of controls and 54% of patients had serum Lp(a) above 30 mg/dl. This level is considered as cutoff point of high risk for atherosclerosis.
We concluded that end-stage renal disease could affect the serum lipids, Lp(a) and other lipoproteins towards atherogenic state in the Iranian population.

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