Comparing the efficacy of N-acetylcysteine plus carvedilol versus carvedilol in the prevention of atrial fibrillation following coronary artery bypass graft surgery.

BACKGROUND: Atrial fibrillation (AF) is the most common arrhythmia following open-heart surgery. Agents with antioxidant properties may reduce postoperative complications like postoperative AF (POAF) in patients undergoing open-heart surgery. This study was conducted to assess the effect of N-acetylcysteine (NAC) in prevention of AF following coronary artery bypass graft (CABG) surgery. METHODS: Three hundred patients who underwent CABG surgery were entered in the study. Patients with contraindications for beta-blockers and patients were simultaneously replacing or repairing the valve with open-heart surgery were excluded. The patients were randomly divided into two groups (n = 150) and they were received NAC plus carvedilol or carvedilol. The patients were monitored for 5 days after surgery and the incidence of AF during hospitalization was recorded. RESULTS: AF was detected in 14 patients in the NAC with Carvedilol group (9.33%) and 23 patients in Carvedilol group (15.33%). There was no significant difference in the incidence of POAF between the two groups (p value = 0.112). The result of multivariable regression model represented that although the incidence of POAF was lower in NAC plus carvedilol group, it wasn't statistically significant (p value = 0.10). CONCLUSIONS: NAC was not associated with a decreased incidence of AF following CABG surgery.

Novel coronavirus disease 2019: predicting prognosis with a computed tomography-based disease severity score and clinical laboratory data.

INTRODUCTION: Currently, there are known contributing factors but no comprehensive methods for predicting the mortality risk or intensive care unit (ICU) admission in patients with novel coronavirus disease 2019 (COVID­19). OBJECTIVES: The aim of this study was to explore risk factors for mortality and ICU admission in patients with COVID­19, using computed tomography (CT) combined with clinical laboratory data. PATIENTS AND METHODS: Patients with polymerase chain reaction-confirmed COVID­19 (n = 63) from university hospitals in Tehran, Iran, were included. All patients underwent CT examination. Subsequently, a total CT score and the number of involved lung lobes were calculated and compared against collected laboratory and clinical characteristics. Univariable and multivariable proportional hazard analyses were used to determine the association among CT, laboratory and clinical data, ICU admission, and in­hospital death. RESULTS: By univariable analysis, in­hospital mortality was higher in patients with lower oxygen saturation on admission (below 88%), higher CT scores, and a higher number of lung lobes (more than 4) involved with a diffuse parenchymal pattern. By multivariable analysis, in­hospital mortality was higher in those with oxygen saturation below 88% on admission and a higher number of lung lobes involved with a diffuse parenchymal pattern. The risk of ICU admission was higher in patients with comorbidities (hypertension and ischemic heart disease), arterial oxygen saturation below 88%, and pericardial effusion. CONCLUSIONS: We can identify factors affecting in­hospital death and ICU admission in COVID-19. This can help clinicians to determine which patients are likely to require ICU admission and to inform strategic healthcare planning in critical conditions such as the COVID­19 pandemic.

Nanoethosomal formulation of gammaoryzanol for skin-aging protection and wrinkle improvement: a histopathological study.

BACKGROUND: Free radical scavengers and antioxidants, with the main focus on enhanced targeting to the skin layers, can provide protection against skin ageing. OBJECTIVE: The aim of the present study was to prepare nanoethosomal formulation of gammaoryzanol (GO), a water insoluble antioxidant, for its dermal delivery to prevent skin aging. METHODS: Nanoethosomal formulation was prepared by a modified ethanol injection method and characterized by using laser light scattering, scanning electronic microscope (SEM) and X-ray diffraction (XRD) techniques. The effects of formulation parameters on nanoparticle size, encapsulation efficiency percent (EE%) and loading capacity percent (LC%) were investigated. Antioxidant activity of GO-loaded formulation was investigated in vitro using normal African green monkey kidney fibroblast cells (Vero). The effect of control and GO-loaded nanoethosomal formulation on superoxide dismutase (SOD) and malondialdehyde (MDA) content of rat skin was also probed. Furthermore, the effect of GO-loaded nanoethosomes on skin wrinkle improvement was studied by dermoscopic and histological examination on healthy humans and UV-irradiated rats, respectively. RESULTS: The optimized nanoethosomal formulation showed promising characteristics including narrow size distribution 0.17 ± 0.02, mean diameter of 98.9 ± 0.05 nm, EE% of 97.12 ± 3.62%, LC% of 13.87 ± 1.36% and zeta potential value of -15.1 ± 0.9 mV. The XRD results confirmed uniform drug dispersion in the nanoethosomes structure. In vitro and in vivo antioxidant studies confirmed the superior antioxidant effect of GO-loaded nanoethosomal formulation compared with control groups (blank nanoethosomes and GO suspension). CONCLUSIONS: Nanoethosomes was a promising carrier for dermal delivery of GO and consequently had superior anti-aging effect.

Late Pleistocene human remains from Wezmeh Cave, western Iran.

Paleontological analysis of remains from Wezmeh Cave in western Iran have yielded a Holocene Chalcolithic archeological assemblage, a rich Late Pleistocene carnivore faunal assemblage, and an isolated unerupted human maxillary premolar (P(3) or possibly P(4)). Species representation and U-series dating of faunal teeth place the carnivore assemblage during oxygen isotope stages (OIS) 3 and 2, and noninvasive gamma spectrometry dating of the human premolar places it at least as old as early OIS 2. The human premolar crown morphology is not diagnostic of late archaic versus early modern human affinities, but its buccolingual diameter places it at the upper limits of Late Pleistocene human P(3) and P(4) dimensions and separate from a terminal Pleistocene regional sample. Wezmeh Cave therefore provides additional Paleolithic human remains from the Zagros Mountains and further documents Late Pleistocene human association with otherwise carnivore-dominated cave assemblages.