Correlation between mitral regurgitation and myocardial mechanical dyssynchrony and QRS duration in patients with cardiomyopathy

Several competing geometric and hemodynamic factors are suggested as contributing mechanisms for functional mitral regurgitation [MR] in heart failure patients. We aimed to study the relationships between the severity of MR and the QRS duration and dyssynchrony markers in patients with ischemic or dilated cardiomyopathy. We prospectively evaluated 251 heart failure patients with indications for echocardiographic evaluation of possible cardiac resynchronization therapy. All the patients were subjected to transthoracic echocardiography and tissue Doppler imaging to evaluate the left ventricular [LV] synchronicity. The patients were divided into two groups according to the severity of MR: /= moderate MR. The effects of different dyssynchrony indices were adjusted for global and regional left ventricular remodeling parameters. From the 251 patients [74.5% male, mean age = 53.38 +/- 16.68 years], 130 had /= moderate MR. There were no differences between the groups regarding the mean age, frequency of sex, and etiology of cardiomyopathy. The LV systolic and diastolic dimensions were greater in the patients with >/= moderate MR [all p values < 0.001]. Among the different echocardiographic factors, the QRS duration [150.75 +/- 34.66 vs. 126.77 +/- 29.044 ms; p value = 0.050] and interventricular mechanical delay [41.60 +/- 29.50 vs. 35.00 ms +/- 22.01; p value = 0.045] were significantly longer in the patients with

Persian, last 7-day, long form of the international physical activity questionnaire; translation and validation study

To translate long form, interview-administered International Physical Activity Questionnaire [IPAQ] from English to Persian and evaluate its validity, reliability and reproducibility. A forward-backward translation procedure was followed to develop the Persian version of the IPAQ. A total of 218 respondents [53.7% women, aged 22-76 yr] completed the Persian version in Tehran, Iran. To examine the test-retest reliability, 48 healthy volunteers completed the IPAQ twice during a 7-day period. The PA indicators derived from the IPAQ were assessed for reliability and were compared with aerobic fitness and body mass index [BM1] for construct validity. n general, the questionnaire was received well and all domains met the minimum reliability standards [intra-class correlation [ICC]> 0.7], except for Leisure-time physical activity [PA]. Aerobic fitness showed a weak positive correlation with all of the PA results derived from the IPAQ. A significant correlation was observed between the IPAQ data for total PA and both aerobic fitness [r=0.33, P<0.001] and BMI [r=0.26, P<0.001]. Performing a known group comparison analysis, the results indicated that the questionnaire was discriminated well between the subgroups of the study samples expected to be different in their physical activity. The Persian version of the long form, interview-administered IPAQ had an acceptable reliability and validity for assessing total PA in our Iranian sample of individuals. It may be a useful instrument for generating internationally comparable data on PA

Vaginal birth after cesarean section: a retrospective study

The rising number of women undergoing elective repeat cesarean has been one of the principal reasons for the steady increase in the cesarean delivery rate. This study aim was to assess vaginal birth rates after cesarean [VBAC] in an educational hospital at Khorramabad, Lorestan. A retrospective analysis was performed on the obstetric data from medical records of 685 deliveries that underwent cesarean section in their previous delivery. VBAC rate among women with previous cesarean section was 10.4% [71 cases]. The most frequent normal vaginal delivery was seen in women with a previous Kerr uterine incision [74.6%] and a history of one previous cesarean [69%]. VBAC delivery rate is low in our set up and proper counseling for trial of labor and evaluation of the cases of women with prior cesarean section has been considered a key method of reducing the cesarean section rate

effect of oral clonidine premedication on nausea and vomiting after ear surgery

Postoperative nausea and vomiting [PONV] is a most distressing adverse event for surgical patients with a considerable economic impact .The aim of the present study was to evaluate the effect of clonidine given orally for PONV in patients undergoing anesthesia for outpatient ear surgery. Sixty patients 30.2 +/- 9.9 years, scheduled for ear surgery, were randomly assigned to one of two groups [clonidine or placebo] in a double-blinded manner. Anesthesia was standardized laryngeal mask airway, fentanyl, propofol, halothane, nitrous oxide. A complete response, defined as no PONV and no need for rescue antiemetic medication, during the first 24h after anesthesia was 33% with placebo and 67% with clonidine, respectively [P. 0.01]. No clinically adverse event was observed in any of the groups. Oral premedication with clonidine reduced the rate of PONV in patients undergoing outpatient ear surgery