Background:Due to the heterogeneity of traumatic brain injury (TBI), many of single treatments have not been successful in prevention and cure of these kinds of injuries. The neuroprotective effect of progesterone drug on severe brain injuries has been identified, and recently, the neuroprotective effect of vitamin D has also been studied as the combination of these two drugs has shown better effects on animal samples in some studies. This study was conducted to examine the effect of vitamin D and progesterone on brain injury treatment after brain trauma.Materials and Methods:This study was performed on patients with severe brain trauma (Glasgow Coma Scale (GCS) ≤ 8) from April to September, 2011. The patients were divided to 3 groups (placebo, progesterone, progesterone-vitamin D), each with 20 people. Upon the patients’ admission, their GCS and demographic information were recorded. After 3 months, they were reassessed, and their GCS and GOS (Glasgow outcome scale) were recorded. The collected data were analyzed using SPSS 18 software (SPSS Inc., Chicago IL, USA).Results:Before intervention, GCS mean of the placebo, progesterone, and progesterone-vitamin D groups were 6.3 ± 0.88, 6.31 ± 0.87, and 6 ± 0.88, respectively. They increased to 9.16 ± 1.11, 10.25 ± 1.34, and 11.27 ± 2.27, respectively 3 months after intervention. There was a significant difference among GCS means of the 3 groups (P-value = 0.001). GOS was classified to 2 main categories of favorable and unfavorable recovery, of which, favorable recovery in placebo, progesterone, and progesterone-vitamin D was 25%, 45%, and 60%, respectively which showed a statistical significant difference among the groups (P-value = 0.03).Conclusion:The results showed that recovery rate in patients with severe brain trauma in the group receiving progesterone and vitamin D together was significantly higher than that of progesterone group, which was in turn higher than that of placebo group.

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Sumac; a novel adjunctive treatment in Blood Pressure.

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Introduction. The use of medicinal plants has dramatically increased in recent years. Given the increasing rate of hypertension and medical plants usage by these patients and considering drug interactions due to concomitant use with drugs, the present study aims to evaluate the rate of medicinal plants usage in hypertensive patients. Methods. This is a cross-sectional study (descriptive-analytical) in which 650 hypertensive patients referring to the subspecialty clinic of Kerman were questioned about medicinal plants usage by a medicinal plants questionnaire. Among these patients, there were 612 who consented to participate. After the variables were described, the data were finally analyzed using Stata 12. Results. The average age of those using these drugs in the past year was 58.8 + 10 years. Of the total number of participants using medicinal plants, there were 58 males (23.5%) and 122 females (33.4%). There were 129 participants (72.5%) using medicinal plants through self-administration, 17 participants (9.5%) on experienced users' advice, 16 participants (9%) as administered by herbalists, and 11 participants (6%) as administered by doctors. However, the most important resources for using a drug that prevents hypertension were family and friends (74 participants; 41.5%) and doctors (13 participants; 7.3%). According to the results, there was no significant difference between the level of education and medicinal plants usage (P ¼ .95); however, there was a significant difference between gender and medicinal plants usage (P ¼ .009). Discussion. According to the results indicating the relatively high prevalence of medicinal plants usage and their arbitrary use by hypertensive patients without consulting a specialist, it seems necessary to plan for more effective and secure public education and train people to provide herbal drug services for various diseases with hypertension being the most common one.

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A 37-year-old man, known case of mitral valve replacement, was referred for ablation. Meticulous mapping showed the earliest signal in the distal coronary sinus (CS). Endocardial ablation via transseptal approach failed to permanently ablate the accessory pathway. Similarly, ablation within the CS was unsuccessful. Finally, the mapping catheter was introduced into the vein of Marshall (VoM) and a very early signal was obtained. In the first 3 seconds of the radiofrequency energy application within the VoM, delta wave disappeared. During 1-year follow-up, the patient had no recurrence of the palpitations and electrocardiogram showed no delta wave.