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Background: The
aim of this study was to evaluate the mid-term outcomes of concurrent total correction of
Tetralogy of Fallot (TOF) after pulmonary valve (PV) replacement and its relation to QRS duration and MRI results.
Methods: In
this study, 51 patients with TOF who
had the TOF surgery and PV
replacement enrolled the study. Demographic data, MRI
results such as, right ventricular end diastolic volume, right ventricular end
systolic volume, systolic and diastolic indexes noted. Moreover, QRS
duration and the patients' cardiac functional class were evaluated immediately
before and 6 months after the surgery.
Results: From
51
patients, 27.5% were female and 72.5%
were male. The mean age of participants was 23.48 (SD=5.82)
years. Functional class changes were statistically different (P<0.001)
comparing the status before and after the surgery. The mean QRS
duration before surgery was 130.20 (SD=16.89) ms
which was in significant contrast with post-surgical states, 122.45
(SD=16.90) ms (P<0.001). Mean QRS
duration before and after surgery was statistically lower in asymptomatic
patients (P=0.028 and P=0.025,
respectively). There was a statistical relationship between pre-surgical
systolic and diastolic indexes to post-surgical functional class as
asymptomatic patients had lower systolic and diastolic indexes (P=0.005 and
P=0.028,
respectively).
Conclusion: This study demonstrated
that QRS duration before and after
surgery can be an indicator to evaluate the cardiac function after surgery for
Tetralogy of Fallot. Moreover, systolic and diastolic indexes are factors
affecting the good prognosis of patients therefore, PVR surgery needs to be done
before the deterioration of systolic and diastolic indexes and cardiomegaly.
Background: Measurements of mitral valve area (MVA) are essential to determine the severity of mitral stenosis (MS) and adopt the best management strategies. The aim of the present study was to compare MVA determined by two-dimensional (2D) planimetry to MVA measured by continuity equation (CE) in patients with moderate to severe MS.
Methods: We evaluated 73 consecutive patients with the diagnosis of MS scheduled for balloon mitral valvuloplasty or with moderate to severe rheumatic MS admitted at the echocardiography clinic of Imam Khomeini Hospital in 2010. Using 2D images of mitral valve obtained from paraesternal short axis view, 2D planimetry of the mitral orifice area was performed by an experienced cardiologist. MVA by CE was calculated from aortic forward stroke volume divided by transmitral time-velocity integral.
Results: The mean value of MVA by 2-D planimetry was 1.0±0.3 cm2. The average values of MVA measured by PHT and CE were 1.0±0.3 cm2 and 0.9±0.4 cm2, respectively. The MVA determined by planimetry correlated well with CE (r=0.832, standard error of estimation [SEE]= 0.166, P<0.001). The mean values of MVA calculated by CE highly correlated with those calculated by 2-D planimetry in patients presenting with both non-significant (r=0.701) and significant (r=0.761) AIs.
Conclusion: When planimetry is not feasible, such as in severe calcification of mitral valve or after percutaneous balloon valvuloplasty, CE could be an alternative method for MVA measurement in comparison with PHT.
Background: Rheumatoid Arthritis (RA) is a chronic inflammatory disease presenting with inflammation, tenderness and destruction of the synovial joints, resulting in severe disability and early death due to complication of disease. Previous diagnostic criteria are not useful for identifying patients who need early treatment. Thus, new diagnostic criteria for faster diagnosis of disease are introduced in 2010. The aim of this study was to compared 1987 ACR (American College of Rheumatology) criteria and 2010 ACR/EULAR (European League Against Rheumatism) classification criteria for diagnosis of rheumatoid arthritis.
Methods: In this Cohort prospective study, patients with early arthritis were evaluated according to the old and new diagnostic criteria and followed-up every two monthly for one year (2012-2013) in Hazrat-e Rasool University Hospital, Tehran. Inclusion criteria of this study were age more than 18 year and indefinite diagnosis of arthritis. For all of patients physical examination by expert rheumatologist was done and lab data include erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), anti-cyclic citrullinated peptide (Anti-CCP) and rheumatoid factor was requested. The sensitivity, specificity, positive and negative predictive values were then determined for each diagnostic criteria. Results: In this study 104 patients including 28 males (26.9%) and 76 females (73.1%) with the mean age of 44.2±13.7 years were included. At the end of one year follow-up, 82 were diagnosed to have RA while other 22 patients were not categorized as RA. Sensitivity for ESR, CRP, Anti-CCP and rheumatoid factor in 2010 ACR/EULAR criteria was 52%, 19%, 48%, 28% and specificity for them was 45%, 71%, 27%, 79% respectively. Number of small and large joint arthritis were more in patients with Rheumatoid Arthritis (RA) rather than other arthritis (P=0.0001). Sensitivity and specificity for small joints involvement was 87% and 54% and for large joints involvement was 81% and 59%. The sensitivity, specificity, positive and negative predictive values for 2010 ACR/EULAR criteria were 65%, 40%, 81%, and 23%, respectively. The sensitivity, specificity, positive and negative predictive values for 1987 ACR criteria were 51%, 62%, 83%, and 25% respectively. Conclusion: In comparison to the old diagnostic criteria, the new one has higher sensitivity and lower specificity. |
Background: Cancer diagnosis is the biggest stress for the child and his family. Diagnosis and treatment of cancer in children can cause stress, which often has a negative effect on the health of parents. Psychological reactions such as anxiety, depression, denial and loss of confidence in parents observed that because of the fear of recurrence and future of children. This study aimed to determine the level of stress and anxiety and depression in parents of children with leukemia who were in the maintenance phase of treatment.
Methods: This cross-sectional study has been conducted on 48 parents have referred to the clinic of Dr. Sheikh Hospital of Mashhad City, Iran, whom selected using easy sampling method. DASS-21 questionnaire was used for data collection. Another questionnaire containing demographic information such as age, sex, income, educational level and duration of illness was filled under supervision of the psychologist and pediatric physician. Data with SPSS software, ver. 20 (IBM, Armonk, NY, USA), descriptive statistics and Pearson correlation analysis was performed. Results: The results showed that in this study, 37% had abnormal stress levels (33% and 2% of mild stress, moderate stress and severe stress 2%) and 79% had abnormal anxiety level (mild 19%, moderate 31% and severe 29%) and 67% had abnormal depression level (mild 33%, moderate depression 33%) tests, respectively. In our study, there was no relationship between age, sex and duration of illness with these variables. |
Conclusion: According to this study, in addition to the classic treatment of patients, parent’s mental performance should be paid attention.
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