Background:Atrial fibrillation (AF) is a frequent and serious complication of coronary artery bypass graft (CABG) surgery.Methods:We undertook a retrospective review of the records of patients undergoing CABG at Imam Ali Hospital between February 1, 2003 and February 1, 2006. The patients were divided in two groups, ie, Group A (AF) and Group B (no AF). The association between the occurrence of AF following CABG and other variables was compared with respect to continuous or categorical variables by t-test and χ2-test.Results:Multivariate logistic regression analysis of potentially predictive factors in univariate analysis showed that opium use, type of operation, and crossclamp time were predictors of AF following CABG.Conclusion:This study identifies some new predictors of postoperative AF, control of which could lead to a lower incidence of AF and reduced morbidity, mortality, and resource utilization for patients undergoing cardiac surgery.

Background: Coronavirus illness (COVID-19) has spread globally and is affecting everyone severely. The evaluation of educational needs (knowledge, attitudes, and practices) is important in controlling COVID-19 situations. The goal of this study is to find out what adults in Ardabil City know, how they feel, and what they do about the COVID-19 infection. Methods: In November 2021, a cross-sectional descriptive-correlational survey of 384 people was conducted using stratified-cluster sampling in Ardabil. The researchers created a self-reported questionnaire with 23 items as the data collection technique. The quantitative data were evaluated using descriptive statistics, the chi-square test, the correlation coefficient, and regression analysis. Results: The correct answer rate for this research found that 73.17% of participants ( n = 281) had appropriate knowledge, 61.19% ( n = 235) had favorable attitudes, and 69.53% ( n = 267) had enough practice behavior. However, knowledge was related to gender, employment, and location of residence. Age, marital status, education level, and location of residence were all connected with attitude. Age, gender, and marital status were all related to the behavior. The findings of linear regression analysis revealed that knowledge and attitude influence behavior. Conclusion: The study findings revealed a high degree of understanding of COVID-19, a positive attitude, and a strong commitment to good practices. Knowledge, attitudes, and behaviors were influenced to varying degrees by age, marital status, education level, employment, and location of residence. Furthermore, knowledge and attitudes influenced behaviors.

BackgroundCoronary sinus rupture (CSR) is a rare preventable complication of cannula insertion for retrograde cardioplegia. In the hands of an inexperienced surgeon, this complication has the risk of potential mortality and morbidity, and its repair is technically challenging. Techniques for repairing CSR have been reported previously. In this study, we determined predictors of CSR following coronary artery bypass graft (CABG) surgery.MethodsOver a four-year period, we retrospectively analyzed 1500 patients in whom a retrograde coronary sinus catheter was used to administer cardioplegic solution. CSR occurred in 15 patients. (12 women and 3 men). Variables such as age, weight, body mass index, gender, aortic clamp time, pump time, cardiomegaly, ejection fraction, and number of grafts were determined for each patient. Factors correlated with CSR were analyzed using multiple regression analysis, and odd ratios of significant variables were determined.ResultsIn multiple regression analysis, factors such as female gender, age, weight, and body mass index showed a significant correlation with CSR, and their odd ratios were 4.2, 1.0, 0.96, and 2.2, respectively.ConclusionIn all 15 cases, a retrograde cannula with a self-inflatable balloon was used and 12 patients were woman with low body mass index. Forceful insertion due to coronary sinus web, fragility of arteries in thin patients, or a small coronary sinus caused CSR in the hands of an inexperienced surgeon.

Abstract:Ventricular Septal Defect (VSD) after blunt chest trauma is a very rare traumatic affection. We report here a case of blunt chest injury-related VSD and pseudoaneurysm. A 30-year old male truck driver was referred from a trauma center to our hospital seven days after a blunt chest trauma and rib fracture. The patient had severe pulmonary edema and echocardiography showed large VSD. Several mechanisms are involved in the pathogenesis of this affection including an acute compression of the heart muscle between the sternum and the spine, leading to excessive changes in the intrathoracic and most likely the intracardiac pressure after blunt chest injury. Traumatical patients with the same symptoms may be at risk of sudden death. Therefore, a high grade of suspicion is mandatory even without solid evidence of myocardial damage on the initial evaluation. In continue some hidden angles of this case was discussed. Given the prognostic implications of traumatic VSD with associated pseudoaneurysm, its detection has critical value for preventing its clinical sequelae.

INTRODUCTION: Over the past decades, the pattern of diseases in human societies had changed from infectious diseases to noncommunicable diseases (NCDs), and according to the report by the World Health Organization, the highest burden of disease is attributed to NCDs. The study was conducted to determine the status of hypertension, type-2 diabetes, lipid disorders, and body mass index (BMI) among the patients aged over 30 years admitted to health centers of Karaj, Iran. MATERIALS AND METHODS: In this cross-sectional study, the population included 2947 men and women aged 30 years and above admitted to six health-care centers in Karaj. The questionnaire includes demographic characteristics and had the questions on hypertension, diabetes and their risk factors, like lipid disorders and BMI was administered. The data were analyzed in SPSS, version 23, software using descriptive (frequency, percentage, mean, and standard deviation) and analytical (Chi-square and analysis of variance) tests ( P < 0.01). RESULTS: About 10% of the participants had diabetes and 15% of the participants had hypertension. About 32% of the participants had dyslipidemia and 87% of the participants were overweight or obese and over 35% were obese. Furthermore, with the increase in BMI, the prevalence of lipid disorder, hypertension, and type-2 diabetes increased in the studied population ( P < 0.01). CONCLUSION: According to the results, a high percentage of people had hypertension, type-2 diabetes, hyperlipidemia, and BMI in the population. Gender segregation showed that lipid disorders, overweight, and obesity in women were more than in men and percentage of people with hypertension among male were significantly higher than in females. In the case of type-2 diabetes, the results showed no statistically significant differences between men and women. The results may be helpful in developing educational strategies and prevention and control of these diseases.

Use of an intra-aortic balloon pump (IABP) is helpful for maintaining hemodynamic stability in patients with low cardiac output and compromised left ventricular function undergoing coronary artery bypass grafting. Although the incidence of complications has decreased significantly as experience with the device has increased, IABP use still carries a risk of complications. The most common complication is limb ischemia, mainly as a result of IABP entrapment and thromboembolism. Here we report a case of IABP entrapment in a nonatherosclerotic common iliac artery where forced removal caused fracture of the catheter.

Context: The purpose of this study was to investigate the research framework on the effect of physical activity on cardiovascular markers (C-reactive protein (CRP) and Homocysteine (HCY)), and to conduct an optimal compilation to present better information from previous studies. Evidence Acquisition: In this study, a number of articles were searched in specialized databases and 30 articles were selected based on entry and exit criteria. Then the responses to one bout of aerobic activity and one bout of resistance activity and adaptability with aerobic training and resistance training were studied. Results: Various studies have shown a reverse and significant relationship between regular physical activity and inflammatory indices, and reported that those who are physically more active and have better physical fitness have lower levels of inflammatory indices. Conclusions: The present study showed that regular physical activity has a beneficial effect on the prevention and treatment of coronary artery disease. Regarding the anti-inflammatory effects of physical activity, regular exercise and regular physical activity play an important role in reducing inflammatory indices, and aerobic exercises can be a useful and appropriate strategy for coping with inflammatory and cardiovascular risk factors.

The aim of this study was to compare the effect of anesthesia with midazolam-fentanyl versus propofol-remifentanil on the BIS (bispectral index) in patients undergoing coronary artery bypass grafting (CABG). Sixty-four patients undergoing CABG were randomly assigned to one of two study groups: midazolam-fentanyl (MF, N= 32) or propofol-remifentanil (PR, N= 32). The BIS was measured before induction of anesthesia, five minutes after induction of anesthesia, at skin incision, sternotomy, pericardiotomy, aorta cannulation, onset of cardiopulmonary bypass, during rewarming, five minutes after separation from cardiopulmonary bypass, at thorax closure, and at the end of the surgery. There were no significant differences between the two groups with regard to age and gender. The difference in mean BIS between the two groups was significant (P < 0.05) at all times, except before induction, five minutes after induction, at skin incision and on rewarming. Changes in the BIS were lower in the PR group than in the MF group. Both techniques can provide adequate anesthesia in patients undergoing CABG. However, the probability of awareness during anesthesia is lower with propofol-remifentanil than with midazolam-fentanyl.