Objectives:In cirrhotic patients, despite presence of significant metabolic abnormalities and enlarged left atria, we have seldom observed atrial fibrillation (AF) rhythm. The aim of this study was to evaluate the prevalence of AF among cirrhotic patients and comparing it with that reported in the general population.Materials and Methods:Medical documents of 1302 adult cirrhotic patients, booked in the waiting list of liver transplantation, were evaluated retrospectively. Electrocardiograms were reviewed for the presence of AF rhythm, and echocardiographies were reviewed to obtain left atrial (LA) size.Result:Only two patients (0.15%) were detected to have AF rhythm, which was significantly lower than that reported in our general population, even after age and sex adjustment. Six hundred and sixty-eight patients (51%) had enlarged left atria (LA diameter more than 39mm); both AF patients belonged to this group.Conclusion:The result of this study suggests the protective effect of liver cirrhosis on development of atrial fibrillation. Further studies are needed to verify the possible mechanisms.

Atherosclerosis, and its most common manifestation, coronary artery disease (CAD), are rather common causes of morbidity and mortality worldwide. Recognition of its various risk factors is important to planning effective preventive measures. After the homocysteine theory was presented in 1969, attention has been directed toward the serum homocysteine level as a coronary artery disease risk factor. The authors aimed to assess the relationship between hyperhomocysteinemia and CAD in an Iranian population. In a case control study, 197 individuals (male: 123 [62.4%]) who were scheduled for coronary angiography were selected. Venous samples were taken from the patients in fasting state before angiography. Data about age, sex, risk factors (eg, hypertension, diabetes, smoking, hyperlipidemia, obesity) were obtained from prepared questionnaires. Homocysteine levels in patients were measured by ELISA method. A homocysteine level above 15 mumol/liter was considered high. Angiography reports and homocysteine levels were analyzed by independent sample t test, one-way ANOVA, multiple linear regression, and stratified analysis. In comparison with the patients with normal angiography reports (32.5%), patients with abnormal angiography reports (67.5%) had increased levels of homocysteine (p = 0.001). About 28.1% of patients with normal angiography reports had hyperhomocysteinemia. After further evaluation, linear correlations were detected between the numbers of involved vessels and homocysteine level (p = 0.000). Multiple linear regression analysis of data detected that in individuals without any risk factors, the relationship was stronger and more meaningful (p = 0.000). These data show that hyperhomocysteinemia is related to CAD as an independent risk factor. In individuals without any risk factors a linear correlation between homocysteine level and numbers of coronary artery involvement was present. If this equation is confirmed prospectively in other studies, the level of plasma homocysteine may he used as a noninvasive way of predicting the number of diseased coronary arteries.

Background: Age estimation is a fundamental part of forensic science. Considering the fact that pulp size decreases throughout the life because of secondary dentine apposition, many researchers have used it as a method for age estimation with great results. This study aimed to determine the applicability of tooth to pulp ratio in mandibular second premolars in an Iranian population using panoramic radiographs. Methods: The sample consisted of 153 digital panoramic images of male and female Iranians aged 13-70 years, and the tooth to pulp ratio of both left and right mandibular second premolars was obtained using AutoCAD software. Analysis of variance (ANOVA), Pearson’s correlation, and regression analysis were used to analyze the data. A total of 20 images were reexamined after 30 days to test intra-observer error. Results: ANOVA test showed that gender had no effect on age estimation, and there was a significant correlation between age and tooth/pulp ratio (r=0.679 for right premolar, r=0.712 for left premolars, and r=0.736 for both premolars). Linear regression formulae were created based on the results and the mean differences between the estimated and actual age were reported to be 10.35±0.51, 9.17±0.54, and 8.83±0.52 for right, left, and both premolars, respectively. Intra-observer error showed no significant difference between repeated measurements. Conclusions: Tooth/pulp ratio of mandibular second premolars is a reliable and repeatable method for age estimation in Iranian population and using premolars of both sides yields the best results.

Dispersion of the QT interval (QTd) is a measure of inhomogeneity of ventricular repolarization, and its prolongation may provide a suitable substrate for life-threatening ventricular arrhythmias. The present study was performed to determine the onset time of change in the corrected QT (QTc) interval and QTd in patients with stable angina and single vessel coronary artery disease. Electrocardiograms of 60 patients with successful stenting, obtained 1 h before and 1 h, 6 h, 12 h and 24 h after the procedure were analyzed. The QTc interval, QTc maximum, QTc minimum and QTd were measured. All electrocardiograms were scanned, and then underwent computer-based analysis. There was a significant reduction in the mean QTc interval as early as 12 h after the procedure (from 474±41 ms to 460±31 ms; P<0.001), which persisted to the 24 h follow-up. This was associated with a significant reduction in mean QT maximum (from 496±31 ms to 418±66 ms; P<0.001) and a significant prolongation in mean QT minimum (from 403±21 ms to 444±12 ms; P<0.001) at the same time intervals. Therefore, successful stenting of coronary arteries in patients with single vessel coronary artery disease and stable angina decreases QTd as early as 12 h after the procedure. This phenomenon may be the result of improved regional myocardial circulation, and reduced ischemia. A persistently low QTd in the following months may therefore have prognostic significance, and can be used as a noninvasive marker of stent patency. Further studies are necessary to define the clinical applicability of QTd in the assessment of long-term stent patency in such patients.