Introduction: World Health Organization (WHO) introduced hypertension as an epidemic in developing countries. However, hypertension is adequately controlled in only 12.5% of patients. The aim of this study was to evaluate the relationship between Ramadan fasting and mean arterial pressure (MAP).Method: This clinical, observational study was carried out at Medical O.P.D of Jinnah Medical College Hospital (JMCH), Korangi, Karachi, Pakistan. A total of 150 hypertensive patients (120 males and 30 females) and 150 healthy adults (75 males and 75 females) were evaluated during the month of Ramadan (from August to September 2010). Blood pressure was measured in patients’ right arm in the sitting position. The measurements were taken a week before Ramadan and during each week of this month. The average of measurements was calculated, and the results were analyzed by SPSS version 17.Results: A reduction was observed in the MAP of hypertensive patients (from 117.3±4.2 in the first week to 108.3±4.2 in the fourth week). In the control group, the MAP was 93.1±0.6 in the first week and 92.4±0.6 in the fourth week.Conclusion: This study showed that MAP reduces during Ramadan fasting. This effect of fasting may help control blood pressure in hypertensive patients.

Background: The effect of low pressure pneumoperitoneum in laparoscopic cholecystectomy on partial pressure of carbon dioxide in the arterial blood (PaCO2) is an important subject which has not been completely defined.Methods: In a double-blind clinical trial, we randomly studied 202 ASA (The ASA physical status classification system) class 1, 2 patients aged between 20 and 85 years who were candidates for elective laparoscopic cholecystectomy. They were randomly divided into two groups of low pressure pneumoperitoneum (6-8 mm Hg) and standard pressure pneumoperitoneum (12-14 mm Hg). By the same general anesthesia protocol in the two groups, PaCO2 was assessed before CO2 insufflation and desufflation. Mean Arterial blood Pressure (MAP) was measured in the two groups.Results: PaCO2 was not significantly different between the 2 groups before CO2 insufflation. But, PaCO2 was statistically lower in low pressure pneumoperitoneum group before CO2 desufflation (P=0.001). Mean Arterial Pressure (MAP) in standard pressure pneumoperitoneum group was lower than the low pressure pneumoperitoneum group at 5 and 10 minutes after CO2 insufflation and before the time of CO2 desufflation (P=0.001, P=0.006 and P=0.001, respectively). While, MAP was not statistically different between the two groups before CO2 insufflation (P=0.55).Conclusion: Low pressure pneumoperitoneum during laparoscopic cholecystectomy can be an effective protocol to prevent the rise of PaCO2 by preserving the hemodynamic status in such cases.

Background: cardiometabolic disorders in several kinds of fruits, vegetables, and herbal sources. In this study, we assessed the effects of anthocyanin supplements on systolic and diastolic blood pressure values and mean arterial pressure in athletes. Materials and methods This randomized double-blind clinical trial conducted on 54 athletes. Participants in intervention group were taken 100 mg anthocyanin supplements, daily for 6 weeks and control group received similar placebo. Systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP) were determined before and after performing treadmill test. Dietary intake and physical activity of subjects had been assessed at baseline and after intervention period. Data analyzed using analysis of covariance (ANCOVA) test by using SPSS software (version 21.0). Pvalue lower than 0.05 was set as significant level. Results SBP is similar between two groups before intervention while its mean value increased after performing treadmill test. SBP and DBP increase was not affected by taking treatments after exercise.SBP increase was higher in placebo group in compare to anthocyanin group, after exercising. MAP was not different before and after taking pills, significantly. Anthocyanin supplements did not affect SBP, DBP and MAP values after performing treadmill exercises in non-professional athletes, significantly. Conclusion Data shows that performing the mentioned exercise causes a significant increase in MAP values in both groups, while this enhancing did not show a statistically significant difference between intervention and control groups.Background and aim cardiometabolic disorders in several kinds of fruits, vegetables, and herbal sources. In this study, we assessed the effects of anthocyanin supplements on systolic and diastolic blood pressure values and mean arterial pressure in athletes.Methods: This randomized double-blind clinical trial conducted on 54 athletes.Participants in intervention group were taken 100 mg anthocyanin supplements, daily for 6 weeks and control group received similar placebo. Systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP) were determined before and after performing treadmill test. Dietary intake and physical activity of subjects had been assessed at baseline and after intervention period.Data analyzed using analysis of covariance (ANCOVA) test by using SPSS software (version 21.0).Pvalue lower than 0.05 was set as significant level.Results: SBP is similar between two groups before intervention while its mean value increased after performing treadmill test. SBP and DBP increase was not affected by taking treatments after exercise. SBP increase was higher in placebo group in compare to anthocyanin group, after exercising.MAP was not different before and after taking pills, significantly. Anthocyanin supplements did not affect SBP, DBP and MAP values after performing treadmill exercises in non-professional athletes, significantly.Conclusions: Data shows that performing the mentioned exercise causes a significant increase in MAP values in both groups, while this enhancing did not show a statistically significant difference between intervention and control groups.anthocyanin, blood pressure, obesity

Introduction: Hypertrophied tonsils and adenoids may cause upper airway obstruction and cardio-pulmonary complications due to pulmonary arterial hypertension. The aim of this study was to determine the correlation between mean pulmonary arterial pressure (mPAP) and selected adenotonsilar hypertrophy indexes.Materials and Methods: Thirty two patients with upper-airway obstruction resulting from hypertrophied tonsils and adenoids were included in our study. Mean pulmonary arterial pressure was measured by a non-invasive method using color doppler echocardiography. Upper airway obstruction was evaluated by clinical OSA (obstructive sleep apnea) scoring and also adenoidalnasopharyngeal (A/N) ratio in the lateral neck radiography.Results: Fifty percent of the patients with a normal OSA score, 20% of those with a suspected OSA score and also 50% of cases with OSA had pulmonary hypertension (mPAP>20mmHg) which was not statistically significant (P= 0.198). Mean Adenoidal-nasopharyngeal ratio in patients with a normal mPAP (mPAP £ 20 mmHg) was 0.61±0.048 and it was 0.75±0.09 in those with pulmonary hypertension; the difference was statistically significant (P=0.016).Conclusion: It seems that A/N ratio could be used as a predicting factor for increased mPAP in children with upper airway obstruction and a pediatric cardiologist consultation may be necessary before some surgical interventions.

Background: Coronary artery bypass graft (CABG) is a common surgery aimed at treating coronary artery disease. A vital aspect of CABG is managing hemodynamics during the cardiopulmonary bypass (CPB) phase, especially in terms of maintaining appropriate mean arterial pressure (MAP). Studies indicate that MAP levels during CPB can affect postoperative recovery, particularly regarding respiratory outcomes,however, the optimal MAP for enhanced recovery remains uncertain. This research examines the impact of two MAP targets (60 mmHg and 80 mmHg) on respiratory recovery after CABG surgery. Methods: Eighty-six patients selected for elective on-pump CABG were grouped based on intraoperative MAP: 43 with a MAP of 60 mmHg and 43 with a MAP of 80 mmHg. We compared perioperative and postoperative metrics, such as mechanical ventilation duration, ICU stay, and re-intubation requirements. Statistical analysis used SPSS version 23, with a significance threshold of p < 0. 05. Results: Patients witha mean arterial pressure (MAP) of 80 mmHg experienced a significantly reduced duration of mechanical ventilation, averaging 8. 23 ± 1. 54 hours, in contrast to the 60 mmHg group, which averaged 10. 02 ± 2. 14 hours (p = 0. 001). Additionally, the ICU stays were significantly shorter for the high MAP group, with a markedly lower re-intubation rate at 4. 7%, compared to 27. 9% in the lower MAP group (p = 0. 007). Conclusion: Sustaining a MAP of 80 mmHg during CPB enhances respiratory recovery after CABG. This is demonstrated by shorter mechanical ventilation durations and reduced ICU stays. These results indicate that effectively managing MAP during surgery could facilitate recovery by improving tissue perfusion and reducing ischemic injury, which in turn may lead toimproved pulmonary outcomes.

Background: Postoperative gastrointestinal complications are important in that they lead to increased lengths of hospitalization in the intensive care unit (ICU) and mortality among patients undergoing surgery on cardiopulmonary bypass (CPB). It appears that such gastrointestinal complications may be correlated with the postoperative serum level of amylase among patients. We aimed to determine the relationship between the mean arterial pressure (MAP) during CPB and changes in the postoperative serum level of amylase. Methods: In this observational study, 164 adult patients who underwent cardiac operations and were transferred into the ICU of Rajaie Cardiovascular Medical Research Center (Tehran, Iran) were enrolled via convenience sampling. The patients’ demographic and clinical data, as well as hemodynamic parameters including MAP, were measured during and after CPB in the ICU. Serum amylase levels were assessed after anesthesia induction, after CPB, 12 and 24 hours after CPB. Results: The mean serum level of amylase significantly increased after CPB and continued 24 hours after ICU admission. There was no statistically significant relationship between MAP during CPB and the serum amylase level immediately after CPB and at 12 and 24 hours after ICU admission. A significant relationship was found between gender and age and a serum level of amylase of greater than 125 IU/L at 12 and 24 hours after CPB. Conclusions: The serum level of amylase increased after CPB up to 24 hours following ICU admission. There was no significant relationship between MAP during CPB and the serum amylase level after cardiac surgery.