Publications by authors named "Babak Manafi"

9 Publications

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Portable Chest Radiography Immediately after Post-Cardiac Surgery; an Essential Tool for the Early Diagnosis and Treatment of Atelectasis: a Case Report.

Tanaffos 2020 Dec;19(4):418-421

Department of Surgery, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.

Atelectasis after endobronchial intubation (ETT) is a known complication of general anesthesia. In-bed auscultation of lungs and use of the 21/23 rule are the two suggestive, but not reliable, methods for the early detection of this event; however, none of them guarantees its prevention. The portable chest radiograph (CXR) is a simple, quick method to detect atelectasis and proper placement of the endotracheal tube in the intensive care unit (ICU). A case of postsurgical, ICU-admitted patient was presented in the report, demonstrating left (LT) lung atelectasis in immediate portable CXR without any evidence of respiratory or hemodynamic abnormality. Portable CXR showed that the tip of the endotracheal tube was located in the lumen of the right main bronchus, leading to LT lung total atelectasis. After repositioning of ETT to the lumen of the trachea, atelectasis was disappeared in early follow-up CXR.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8088149PMC
December 2020

The Effect of Home Care Training on Anxiety and Vital Signs Levels in Coronary Artery Bypass Grafting Patients: A Randomized Clinical Trial.

J Perianesth Nurs 2021 Mar 10. Epub 2021 Mar 10.

Farshchian Hospital, Hamadan University of Medical Sciences, Hamadan, Iran.

Purpose: Patients after coronary artery bypass grafting (CABG) require special care at home, and not being aware of this need before surgery can result in anxiety. This study aimed to determine the effect of home care training on the level of anxiety and vital signs in CABG patients.

Design: The study was a randomized clinical trial study.

Methods: The study included 80 patients undergoing CABG surgery in January 2020. Samples were selected by convenience sampling and were randomly divided into intervention and control groups. The control group received only routine training, whereas the intervention group received two additional training sessions on home care. Data were collected using the Spielberger situational anxiety questionnaire and a checklist of vital signs, and then analyzed using descriptive and inferential statistics.

Findings: Results showed that before the intervention, the mean anxiety scores, heart rate, respiratory rate, temperature, and systolic and diastolic blood pressure between the two groups were not significantly different (P > .05). However, after the intervention, the mean anxiety score, heart rate, respiratory rate, and systolic and diastolic blood pressure in the intervention group was significantly (P < .05) lower than the control group, but the mean temperature of the two groups showed no significant difference (P > .05).

Conclusions: Home care training before surgery reduces anxiety and improves vital signs. The use of home care training before surgery is recommended for this patient population.
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http://dx.doi.org/10.1016/j.jopan.2020.09.018DOI Listing
March 2021

Imbalance in thioredoxin system activates NLRP3 inflammasome pathway in epicardial adipose tissue of patients with coronary artery disease.

Mol Biol Rep 2021 Feb 10;48(2):1181-1191. Epub 2021 Feb 10.

Department of Clinical Biochemistry, Faculty of Medicine, Hamadan University of Medical Sciences, Shahid Fahmideh Street, Hamadan, Iran.

Atherosclerosis is the leading cause of death worldwide and has in part an inflammatory basis. Since epicardial adipose tissue (EAT) is in close contact with coronary arteries we hypothesized that an imbalance in thioredoxin-1 (TRX-1) and thioredoxin interacting protein (TXNIP) in EAT, activates NLRP3 inflammasome and promotes production of IL-1β, leading to the development of atherosclerosis. Thirty-eight patients with coronary artery disease (CAD) and thirty patients with no clinical signs of atherosclerosis who underwent open-heart surgery for valve replacement were classified as CAD and control groups, respectively. Biopsy samples from EAT were collected and expression of TXNIP, TRX-1, NLRP3 and IL-1β genes were assessed using qRT-PCR. Tissue protein levels of TXNIP and TRX-1 were determined by Western blotting while ELISA was applied to measure IL-1β. Haematoxylin and eosin staining was used for histological examination. mRNA and protein levels of TXNIP in EAT were significantly higher in patients with CAD compared with control group, whereas CAD patients showed lower TRX-1 gene and protein expression. In addition, in CAD patients the NLRP3 gene expression was almost doubled and IL-1β significantly increased at the both mRNA and protein levels. Enhancment in NLRP3 gene expression and TXNIP protein levels were accompanied with the increase in IL-1β protein level whereas TRX-1 protein content showed a negative correlation with IL-1β level. Concurrent increase in TXNIP, NLRP3, and IL-1β suggests possible involvement of thioredoxin system in the activation of NLRP3 inflammasome, production of IL-1β, and the presence of inflammation in CAD patients.
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http://dx.doi.org/10.1007/s11033-021-06208-0DOI Listing
February 2021

Downregulation of Sirt1 is correlated to upregulation of p53 and increased apoptosis in epicardial adipose tissue of patients with coronary artery disease.

EXCLI J 2020 2;19:1387-1398. Epub 2020 Oct 2.

Department of Clinical Biochemistry, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.

The higher expression level of p53 in epithelial adipose tissue (EAT) has previously been reported in atherosclerosis. Since we hypothesized that the expression of p53 is modulated by Sirt1, the aim of this study was to determine the expression levels of Sirt1 and p53 and to investigate their correlation to apoptosis in EAT of patients with coronary artery disease (CAD). Thirty-five patients with more than 50 % stenosis in at least one of the main coronary arteries were considered as CAD group while 29 patients with no clinical signs of atherosclerosis who underwent open-heart surgery for valve replacement were classified as control group. EAT biopsy samples were collected from all participants during surgery. Sirt1, p53, Bax, and Bcl-2 gene expression levels were determined in EAT by qRT-PCR and Western blotting was carried out to assess Sirt1 and p53 protein levels. Hematoxylin and eosin staining was used for histopathological analysis. mRNA and protein levels of Sirt1 in EAT were significantly lower in patients with CAD compared with control group, whereas CAD patients showed greater p53 gene and protein expressions. In addition, inverse correlations were observed between Sirt1 and p53 at both mRNA and protein levels. The Bax and ratio of Bax/Bcl-2 gene expressions were higher in CAD group, but no difference was observed in Bcl-2 expression. Histopathological analysis showed apoptotic bodies and infiltrated immune cells in EAT of CAD group. Our results suggest that the Sirt1-p53 axis may involve in atherosclerosis by promotion of apoptosis.
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http://dx.doi.org/10.17179/excli2020-2423DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7689241PMC
October 2020

The interactive effect of preoperative consultation and operating room admission by a counselor on anxiety level and vital signs in patients undergoing Coronary Artery Bypass Grafting surgery. A clinical trial study.

Invest Educ Enferm 2020 Jul;38(2)

Hamadan University of Medical Sciences, Hamadan, Iran,

Objectives: The purpose of this study was to provide appropriate preoperative supportive conditions to improve anxiety and vital signs for patients undergoing Coronary Artery Bypass Grafting -CABG- surgery.

Methods: This clinical trial study was performed on 90 patients undergoing CABG surgery in Farshchian Hospital of Hamadan, Iran in 2019. Sample was selected by convenience and were randomly divided into three groups: control (n=30), intervention1 (n=30), and intervention2 (n=30). The control group received only the routine preoperative counseling of ward and admitted to the operating room as usual; the intervention1 and intervention2 groups in addition received another two counseling sessions, then the intervention1 group was admitted in the operating room as usual, but the intervention2 group was admitted by the counselor in the operating room. Data were collected using a three-part questionnaire including demographic characteristics, vital signs chart, and the Spielberger's State-Trait Anxiety Inventory.

Results: The results showed that there was a significant difference in the mean anxiety of the three groups after admission in the operating room (intervention2 was lower than intervention1 and control groups, p<0.001; and intervention 1 group was lower than control group, p<0.001) and also there was a significant difference between the mean systolic blood pressure, heart rate and respiratory rate of the three groups (p <0.001) but the mean of the variables of temperature and diastolic blood pressure in the three groups were not significantly different (p=0.59 and p=0.225, respectively).

Conclusions: Our results revealed preoperative consultation and admission in the operating room by the consultant can reduce the level of anxiety and stability of vital signs of patients undergoing CABG.
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http://dx.doi.org/10.17533/udea.iee.v38n2e07DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7883918PMC
July 2020

Designing and fabricating a novel medical insole with universal fluid layer with auto-customizability.

Proc Inst Mech Eng H 2020 Aug 19;234(8):864-873. Epub 2020 May 19.

Faculty of Engineering, Islamic Azad University-Tehran North Branch, Tehran, Iran.

Medical insoles play a significant role in pressure reduction, proper stress-strain distribution, and correcting some deformities in the foot. The aim of the present research is to design and fabricate new medical insoles with universal fluid layer. After fabricating two types of insoles including flat silicone insole with shore 17 and flat silicone insole with universal fluid layer (medical silicone with shore 17 and silicone gel with shore 0), PEDAR test using one person in two standing and walking positions in three conditions comprised without the use of medical insole, using of flat medical silicone insole, and flat silicone insole with universal fluid layer was performed. These insoles were also modeled and solved in Abacus software according to the results obtained from mechanical properties testing of silicone and PEDAR test. The results of the finite element analysis showed that absorption of stress and strain in the static state by the silicone insoles with universal fluid layer was 63% and 63%, and in the dynamic state was 84% and 89% more than those obtained by the flat silicone insoles, respectively. The experimental results of the PEDAR system also showed that in the standing state, the silicone insoles with universal fluid layer and the flat silicone insoles had 58% and 30% pressure reduction, respectively, in comparison with without insole condition. Also, in the gait state, the silicone insoles with fluid layer and the flat silicone insole showed 37% and 9% pressure reduction, respectively, in comparison with without insole condition. Eventually, it was found out that the silicone insoles with fluid layer reduce plantar pressure well in comparison to the flat silicone insoles.
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http://dx.doi.org/10.1177/0954411920926345DOI Listing
August 2020

Association between incidence of atrial fibrillation and duration of cardiopulmonary bypass in coronary artery bypass graft surgery (CABG): a cohort study.

Electron Physician 2018 Apr 25;10(4):6624-6630. Epub 2018 Apr 25.

Assistant Professor of Cardiovascular Surgery, Faculty of Medicine, Hamedan University of Medical Sciences. Iran.

Background: Open heart surgery is one of the most common and valuable treatment methods for cardiovascular diseases, a common side effect of which is atrial fibrillation that occurs due to various reasons.

Objective: To determine the relationship between incidence of atrial fibrillation (AF) and duration of cardiopulmonary bypass (CPB) in patients after open heart surgery.

Methods: The present retrospective cohort study was conducted on 330 patients in Farshchian Heart Center through census. The required data were collected from medical records of the patients undergoing coronary bypass surgery using data collection between April 2015 and March 2015. Then, data analysis was performed using SPSS software (ver.16) at error level of p<0.05. The tests used in this study included independent-samples t-test, Mann-Whitney, and chi-squared tests.

Results: Based on the results, mean age of the patients was 61.76±9.2, the majority of the patients (70.1%) were male. The association between Incidence of Atrial Fibrillation and cardiopulmonary pump time (minute) was not meaningful. Incidence of atrial fibrillation had statistically significant relationship with variables of mean age, BMI, PAC, PVC, creatinine and duration of hospitalization (p<0.05); on the other hand, variables of gender, cross clamp time (minute), intubation time (hour), and clinical history had no effect on atrial fibrillation incidence rate (p>0.05).

Conclusion: Since the pathogenesis of AF after cardiac surgery is believed to be multifactorial, including clinical variables and technical intraoperative factors, the relation between incidence of AF with mean age, BMI, PAC, PVC, creatinine and duration of hospitalization was significant. But AF was not related to cardiopulmonary pump time (minute). It is necessary to conduct further research on factors affecting incidence of atrial fibrillation.
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http://dx.doi.org/10.19082/6624DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5984016PMC
April 2018

Cardiac Calcified Amorphous Tumor of the Mitral Valve Presenting as Transient Ischemic Attack.

Case Rep Cardiol 2017 17;2017:2376096. Epub 2017 Jan 17.

Department of Cardiac Surgery, Imam Reza Hospital, Atherosclerosis Prevention Research Center, Faculty of Medical Science, Mashhad University of Medical Sciences, Mashhad, Iran.

Cardiac calcified amorphous tumors (CATs) are an extremely rare nonneoplastic intracardiac masses. They have been reported in the literature in only a few cases. Thus, the incidence, pathogenesis, and best approach to the treatment are not certain. We report a case of CATs on the atrial surface of the anterior mitral valve leaflet in a 37-year-old female who was diagnosed by histopathological examination after surgical removal.
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http://dx.doi.org/10.1155/2017/2376096DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5282427PMC
January 2017

Comparison of the Complications between Left Side and Right Side Subclavian Vein Catheter Placement in Patients Undergoing Coronary Artery Bypass Graft Surgery.

J Cardiovasc Thorac Res 2014 30;6(3):147-51. Epub 2014 Sep 30.

Department of Anesthesiology, Rajaei Heart Hospital, Iran University of Medical Sciences, Tehran, Iran.

Introduction: Percutaneous subclavian vein catheterization is one of the most common invasive procedures performed in cardiac surgery. The aim of this study was to compare left and right subclavian vein catheter placement via the infraclavicular approach in patients who undergo coronary artery bypass graft (CABG) surgery.

Methods: This prospective, randomized clinical trial was performed in193 patients. The technique applied for cannulation was infraclavicular approach for both the right and the left sides. Subclavian vein of other side was attempted only when catheterization at initial side was unsuccessful at two attempts. The success and complication rates were compared for the two sides.

Results: On193 patients, catheterization attempts were performed. Overall 177 catheterizations (91.7%) were successful during the first attempt, 105 (92.1%) on the right side and 72 (91.1%) on the left side. There was no significant difference between success rate and side of catheterization. Malposition of the catheter tip on the right side (9.6%) was significantly more than the left side (0%) (P= 0.003). The differences in other complications on two sides were statistically insignificant.

Conclusion: Compared with the right side, insertion of the cannula on the left side resulted in fewer catheter tip misplacements. Incidence of cannulation failure and other complications were similar on both sides.
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http://dx.doi.org/10.15171/jcvtr.2014.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4195964PMC
October 2014