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Showing 34 results for Pulmonary
Respiratory and blood responses following intratracheal instillation of titanium dioxide nanoparticles in rabbits
Ostadhadi S, Bakhtiarian A, Azizi Y, Nikoui V,
Volume 71, Issue 1 (4-2013)
Abstract

Background: Nowadays, nanomaterials are used in daily life extensively. One of the most common of these materials is nano titanium dioxide (TiO2) which is used to purify the air and also sunscreens, shampoos and other hygienic products. Although nano-particles are useful, can also have potential hazards. The aim of this study is to evaluate the effects of TiO2 on lung tissue in rabbits.
Methods: We divided 18 male rabbits into three groups randomly. The first group recei-ved 50 µl of TiO2 with dose of 50 mg/kg by intratracheal instillation. The second group received 50 µl of TiO2 with dose of 100 mg/kg and the third group received 50 µl of nor-mal saline by the same route. Chest X-rays were taken from all rabbits before injection and on days of 10, 17 and 24 after injection. Twenty four days after injection, rabbits anesthetized and histopathological assays, blood samples and biochemical factors were evaluated.
Results: Radiographic assays showed a progressive pulmonary fibrosis in rabbits recei-ved TiO2 rather than the control group and this lesion developed to maximum at 24th day of the experiment. We also showed pulmonary emphysema and inflammation in histo-pathologycal study of groups treated with TiO2. Moreover, we observed a significant increase in the amount of liver enzymes, white blood cells and hematocrit in TiO2 treat-ed groups compared to control group (P≤0.05). There were no significant differences between plasma levels of creatinine in different groups (P>0.05).
Conclusion: Results showed that nanotitanium dioxide particles can lead to pulmonary fibrosis and inflammation and also increasing liver enzymes and inflammatory cells.


Pulmonary regurgitation after balloon valvuloplasty in children with pulmonary stenosis
Mehdi Ghaderian , Mahmood Meraji , Mohammad-Yoosef Arabi Moghadam, Mojtaba Keikha,
Volume 72, Issue 5 (8-2014)
Abstract
Background: Pulmonary valve stenosis (PS) is one of the most common congenital heart disease in children. Isolated pulmonary stenosis is the most common form of pulmonary stenosis. Isolated Pulmonary stenosis is responsible for 8 to 10 percent of congenital heart disease. Balloon valvuloplasty is the choice of treatment for this cardiac disease. One of the most important complications of this disease is pulmonary regurgitation in follow-up. The purpose of this study was to characterize the status of pulmonary regurgitation on follow-up after pulmonary valvuloplasty by balloon. Methods: We studied pulmonary regurgitation after balloon valvuloplasty retrospectively in children less than 14 years old age and isolated pulmonary stenosis. These patients had not complex congenital heart disease and admitted for balloon valvuloplasty during period of September 2001 to September 2011 in Shahid Rajaee Cardiovascular Research Center. The mean time of follow-up was 7±2.5 years. Results: Four hundred and fifty-eight patients with mean age of 10.3±8.6 months were studied. Two hundred and fifty-five patients were male and 230 were female. Right ventricular pressure was decreased from 82.3±42.2 mmHg before procedure to 45.2±22.4 mmHg after procedure (P= 0.043). Pressure gradient between right ventricle and pulmonary artery was decreased from 75.4±18.2 mmHg to 25.7±15.13 mmHg during procedure (P= 0.032). The day after procedure, 180 (37.1%) patients had no pulmonary regurgitation echocardiographic evaluation, 175 (36.08%) had mild, and 118 (24.3%) had moderate pulmonary regurgitation. In patients with moderate pulmonary regurgitation, 7 (0.14%) of those improve to severe pulmonary regurgitation. In echocardiographic exam, 12 (2.4%) patients had severe regurgitation the day after balloon valvuloplasty. During long-term follow-up (7±2.5 years) for 3 patient pulmonary valve replacement were performed. In our study, balloon to annulus ratio in three groups of pulmonary regurgitation (mild, moderate and sever) had significant correlation (P=0.012). Conclusion: Pulmonary regurgitation was seen after balloon valvuloplasty in some patients.In most patients it had no symptoms and long-term follow-up is necessary
The prevalence of left ventricular heart failure in chronic obstructive pulmonary disease patients: brief report
Shirin Izadi , Hounaz Akbari , Behzad Farahani , Shahrokh Izadi ,
Volume 73, Issue 4 (7-2015)
Abstract
Background: Chronic obstructive pulmonary disease (COPD) and heart failure are prevalent comorbidities affecting a vast proportion of the world population, responsible for significant morbidity and mortality, their coexistence is more frequent than previously recognized that poses important diagnostic and therapeutic challenges. We intend to determine the prevalence of concomitant left ventricular dysfunction in COPD patients. Methods: We performed a cross-sectional study in patients who had referred to Firuzgar University Hospital in Tehran from March 2011 to March 2013 in period of 2 years. All participants were compatible for including and excluding criteria’s. In all cases of COPD, pulmonary function test was done also Echocardiography was performed as the diagnostic assessment of heart failure. Results: Out of 74 participants there was 56(75.7%) male and 18(24.3%) female with the mean age of 67.712.9 (SD), the prevalence of left ventricular systolic dysfunction (LVSD) was 25.70%, also the prevalence of left ventricular diastolic dysfunction (LVDD) was 74.60% among 71 patients. The prevalence of LVSD in patients with and without history of coronary artery disease (CAD) was 33.30% and 15.60% respectively. The prevalence of LVDD was 85.40% in patient with history of CAD and 60% in patients without it. The presence of ventricular dysfunction (neither systolic nor diastolic) in COPD patients was not statistically associated with presence of CAD or the intensity of underlying COPD disease. Conclusion: Knowledge about the prevalence of concomitant left side heart failure in COPD patients is limited, but it seems the presence is rather common, so more attention should be paid to coexistence of ventricular dysfunction in COPD patients disregarding presence of CAD or COPD intensity in clinical practice.
A patient with isolated pancreatic tuberculosis: case report
Ramin Ebrahimian , Davod Tasa ,
Volume 73, Issue 6 (9-2015)
Abstract
Background: Although Tuberculosis (TB) is prevalent in developing countries, visceral TB is rare. Most cases of pancreatic tuberculosis are seen in association with disseminated TB (miliary) but isolated pancreatic infection is very rare. Especially when present in immunocompetent hosts. In clinical and radiological evaluation, pancreatic TB may present as a pancreatic abscess, acute or chronic pancreatitis, and cystic or solid pancreatic masses, so can confused with neoplasm in most cases. Case presentation: In winter of 2013, a 52-year-old woman was admitted to this hospital with epigastric pain. She also mentioned a history of weight loss during previous three months. Liver transaminases and total bilirubin were within normal range. Chest X-ray performed was negative for any cardiopulmonary process, and lung fields were noted to be clear. A purified protein derivative (PPD) skin test for tuberculosis yielded an induration of less than 1 centimeter. An abdominal CT- scan with IV and oral contrast was done. A 2×2 cm mass was seen in the pancreatic head. A diagnostic laparotomy was done. Conclusion: During surgery, a completely necrotic mass was in the pancreatic head. samples were sent for frozen section. The tuberculosis granuloma was diagnosed. Four drug anti-tuberculosis medication was started and continued for six months. Repeat imaging of the abdomen performed 6-months after the initiation of anti-TB therapy revealed complete resolution of the pancreatic mass, and antitubercular therapy was discontinued after a 6-month duration. Pancreatic tuberculosis can present with a variable spectrum of imaging findings. Furthermore, TB should be considered as a cause of any suspicious pancreatic lesion, especially in patients from areas where the infection is endemic.
Neonatal varicella pneumonia, surfactant replacement therapy
Mousa Ahmadpour-Kacho , Yadollah Zahed Pasha , Hojatollah Ehteshammanesh , Alireza Yahyaei Shahandashti , Fatemeh Heydari , Tahereh Jahangir , Faezeh Aghajanpour ,
Volume 73, Issue 9 (12-2015)
Abstract

Background: Chickenpox is a very contagious viral disease that caused by varicella-zoster virus, which appears in the first week of life secondary to transplacental transmission of infection from the affected mother. When mother catches the disease five days before and up to two days after the delivery, the chance of varicella in neonate in first week of life is 17%. A generalized papulovesicular lesion is the most common clinical feature. Respiratory involvement may lead to giant cell pneumonia and respiratory failure. The mortality rate is up to 30% in the case of no treatment, often due to pneumonia. Treatment includes hospitalization, isolation and administration of intravenous acyclovir. The aim of this case report is to introduce the exogenous surfactant replacement therapy after intubation and mechanical ventilation for respiratory failure in neonatal chickenpox pneumonia and respiratory distress.

Case Presentation: A seven-day-old neonate boy was admitted to the Neonatal Intensive Care Unit at Amirkola Children’s Hospital, Babol, north of Iran, with generalized papulovesicular lesions and respiratory distress. His mother has had a history of Varicella 4 days before delivery. He was isolated and given supportive care, intravenous acyclovir and antibiotics. On the second day, he was intubated and connected to mechanical ventilator due to severe pneumonia and respiratory failure. Because of sever pulmonary involvement evidenced by Chest X-Ray and high ventilators set-up requirement, intratracheal surfactant was administered in two doses separated by 12 hours. He was discharged after 14 days without any complication with good general condition.

Conclusion: Exogenous surfactant replacement therapy can be useful as an adjunctive therapy for the treatment of respiratory failure due to neonatal chickenpox.


The evaluation of the resuscitation results and its associated factors
Mahbobeh Alizadeh , Majid Mousavi Movahed , Shokrollah Sadredini , Ashrafalsadat Mostafavi , Mohsen Fathi ,
Volume 74, Issue 9 (12-2016)
Abstract

Background: Cardiopulmonary resuscitation, commonly well-known as CPR, is an emergency technique that includes chest compression often with artificial ventilation in an exertion to manually preserve complete brain task until additional measures are taken to return spontaneous blood circulation and breathing in a person who is in cardiac arrest. According to the International Liaison Committee on Resuscitation Guidelines, CPR includes chest compressions for adults between 5 cm (2.0 in) and 6 cm (2.4 in) deep and at a rate of at least 100 to 120 per minute. Cardiopulmonary resuscitation is aimed to reverse vital organs as like as heart, lungs and for subsistence of patients. Several researches showed that different factors affect the resuscitation results. The current study was designed to assess the results of resuscitation and its association factors.

Methods: This retrospective, descriptive and analytic study was carried out in Baharloo Hospital, Tehran, Iran during March 2014 and February 2015. In current work, all resuscitated patients were imported and patients with uncompleted files and died before entrance to hospital were excluded. The data was obtained from medical records units, office files unit and the unit of quality improvement. Data were analyzed by use of SPSS version 22 (Armonk, NY, USA) software and Chi-square test and Student’s t-test.

Results: From 891 patients, 813 cases were entered the study that 498 (61.3%) were male and 315 (38.7%) were female. 41.1% of resuscitation were successful and 58/9% were unsuccessful. The mean and standard deviation time of resuscitation was 28.80 and 12.6 minutes; the most frequent primary diagnosis was cardiovascular disease. In this study there was a significant difference between age and duration of the resuscitation with successful resuscitation (P= 0.02) but, in the variables of ward and resuscitation team were not significant (P> 0.05).

Conclusion: The results of this study showed that resuscitation in younger group, short duration of resuscitation and patients without heart diseases are more successful.

High-risk pregnancy due to thyroid storm: case report
Malihe Hasanzadeh , Mina Baradaran Khalkhale , Akram Behroznea, Leila Musavi ,
Volume 75, Issue 12 (3-2018)
Abstract
Background: Graves' disease is the most common cause (85% of all cases) of thyrotoxicosis in women in childbearing age. Many of the symptoms are similar to hyper-metabolic status during pregnancy. The cause of the disease is autoantibodies that stimulate the thyroid-stimulating hormone (TSH) receptor. Hyperthyroidism is uncommon in pregnancy and its prevalence is 0.1-%0.4. In this paper we introduce a patient who was admitted with a primary diagnosis of pulmonary embolism and treatment with final diagnosis of thyroid storm and was discharged with good condition.
Case presentation: In the first pregnancy of a 29-year-old woman with gestation age of 31 weeks was referred to obstetric emergency unit Ghaem Hospital, Mashhad, Iran in March 2015. She had Grave’s disease in her past medical history which was treated with methimazole before pregnancy and propylthiouracil (PTU) during pregnancy. In admission, she presented with tachycardia and tachypnea and hypertension and lower extremity edema. During pregnancy, she used propantheline instead of propylthiouracil due to pharmacy mistake. She admitted in Intensive care unit. After rule out of pulmonary embolism, ultrasonography showed a fetus with 30 weeks of gestational age with an approximate weight of 1680 grams. The amniotic fluid was reduced. She was treated with thyroid storm diagnosis due to a medication error. In serial obstetric visits fetal heart rate was not detected. Due to the fetal death, the pregnancy was terminated. Hyperthyroid therapy continued with PTU after delivery. She was discharged with a good general condition.
Conclusion: Despite the rarity of thyroid storm during pregnancy, in the event of unstable hemodynamic condition and cardiac dysfunction in pregnant women, rule out of thyroid disorders should be considered. Clinician should be paid attention to past drug history and underline disease of patient.

Epidemiology, diagnosis and treatment of pulmonary thromboembolism: review article
Yaser Jenab, Kaveh Hosseini,
Volume 78, Issue 9 (12-2020)
Abstract
High incidence and mortality rate of pulmonary thromboembolism urge physicians to be aware of its occurrence and treatment. Pulmonary thromboembolism (PE) typically manifests itself with acute dyspnea and tachycardia and may occur along with deep vein thrombosis. However, syncope, chest pain and heart failure decompensation in previously stable patients might be another presenting signs and symptoms.  Although there are several guidelines about PE prophylaxis both in medical and surgical patients, guideline adherence is not good enough. The most important reasons are; inappropriate PE risk scoring, insufficient prophylaxis dosage and the fear of probable bleeding. Both unfractionated and low-molecular-weight heparin has been suggested as prophylactic agents. The role of echocardiography in the diagnosis of PE has been challenged; however, it is mandatory to do an echocardiogram to define the prognosis and also the proper treatment approach. Based on the severity of right ventricular dysfunction, biomarker levels and hemodynamic status of the patients, they will be categorized as low, moderate and high-risk. Moderate to high risk patients should be planned for more invasive treatments such as thrombolytic therapy. In conclusion, PE is the third common cardio-vascular acute condition after myocardial infarction and cerebrovascular accident. The most important reason for death in PE is right-side heart failure. Besides, PE is the most preventable fatal disease in hospitalized patients. Long hospital stay, inappropriate thromboembolic prophylaxis and baseline comorbidities predispose patients to this fatal event. Sometimes, the fear of probable bleeding precludes guideline-based thromboprophylaxis, especially in post-operative patients. If PE occurs; it will be hard to manage and treat. New oral anticoagulants are advised as fixed-dose which does not need to be closely monitored. Drug and food interaction is significantly lower in New oral anticoagulants (NOACs). Thrombo-prophylaxis is better than mechanical thrombo-prophylaxis. Post-discharge thromboprophylaxis is also advised in orthopedic patients. It is mandatory to advise patients to walk after discharge and avoid long-term bedrest if possible. A too early discharge may also be an important risk factor and prone patients to PE at home.

Evaluation of the confounding factors disturbing the quality of CT images of pulmonary angiography
Pooya Iranpour , Azadeh Sharifzadeh Yazdi , Rezvan Ravanfar Haghighi , Mahdi Saeedi-Moghadam ,
Volume 79, Issue 4 (7-2021)
Abstract
 
 
Background: Since pulmonary angiography is the only non-invasive method for diagnosing pulmonary embolism, the use of radiation reduction methods without affecting the quality of images seems necessary. One of the simplest reasons for unnecessarily increasing of patient exposure is repetitive imaging due to poor image quality. Therefore, it is necessary to identify and eliminate the factors that reduce the image quality, which leads to duplication of imaging or reduced accuracy.  In this study, the reasons for decreasing the image quality of pulmonary computed tomography (CT) angiography were investigated.
Methods: This cross-sectional study was performed over a period of 6 months (May to November 2018) in a university-affiliated hospital. Data of 75 patients suspected of pulmonary embolism who were referred for CT angiography were collected. All CT scans were performed by a 16-slice CT scanner (Lights Speed, GE Healthcare) with fixed imaging parameters including 100 kVp and 100 mA. In order to evaluate the adequacy of pulmonary artery enhancement, the Hounsfield unit (HU) of the main pulmonary artery was measured in the aortic arch, upper, and lower segmental parts. Also, 8 factors affecting the image quality were examined.
Results: The mean HU of the main pulmonary arteries was 312 in the range of 124 to 677. The mean HU in patients with and without pulmonary embolism was 358 and 302, respectively. Most CT images (61%) had poor quality for the diagnosis of pulmonary embolism. Only 2% of the images were acceptable compared to standard images and protocols. Late imaging was the most common quality confounding factor in this study.
Conclusion: A low-quality image reduces the accuracy of the physician's diagnosis that leads to misdiagnosis. Besides, sometimes poor image quality leads to repetitive imaging, which results in increased patient exposure and therefore increased radiation hazards. Therefore, modifiable confounding factors must be identified and corrected which one of the most important ones is wrong imaging timing protocols after contrast injection.
 

Rivaroxaban versus enoxaparin for treatment of patients with nonhematologic cancer with venous thromboembolism a randomized clinial trial
Seyed Hamid Borsi, Hanieh Raji, Mehrdad Dargahi Malamir , Forogh Nokhostin, Afrooz Kargaran,
Volume 79, Issue 4 (7-2021)
Abstract
Background: Low-Molecular-Weight Heparin (LMWH) is recommended as the first-line treatment in patients with active cancer and venous thromboembolism (VTE), but many patients prefer to take oral anticoagulants and non-injectable forms with more reasonable price. Venous thromboembolism is a very common comorbidity in patients with cancer. Therefore, the aim of this study was to evaluate the efficacy and safety of the rivaroxaban compared with enoxaparin in patients with cancer and VTE.
Methods: This randomized clinical trial was conducted on 50 patients with non-hematologic cancer and deep vein thrombosis (DVP) or pulmonary thromboembolism (PTE) enrolled into Imam Khomeini hospital, from November 2019 to March 2020 in Ahvaz. The participants randomly assigned in two treatment groups (25 patients in each group) of rivaroxaban (15 mg every 12 hours for the first three weeks and then orally at 20 mg daily) or enoxaparin (1 mg/kg by subcutaneous injection every 12 hours) and followed for 6 months to evaluate the efficacy, complications and safety (incidence of recurrent VTE, major bleeding and deaths) of these therapies in Ahvaz.
Results: The three most common cancer diagnoses were breast (n=11, 22%), colon (n=10, 20%), and lung (n=7, 14%). Major bleeding at 6 months was only seen in one patient (4%) in the enoxaparin group and did not occur in the rivaroxaban group (P>0.05). Minor bleeding occurred in 1 patient (4%) in the rivaroxaban group and did not occur in the enoxaparin group (P>0.05). One patient in the enoxaparin group died because of fever and neutropenia. The prevalence of DVT and PTE in cancer patients was not significantly different based on patient age (P=0.154), gender (P=0.430), BMI (P=0.490), underlying disease (P=0.294), smoking (P=0.955), type of cancer (P=0.527), and metastatic cancer (P=0.280).
Conclusion: The results of this study suggest that the efficacy of rivaroxaban is not less than that of enoxaparin and therefore can be a potential option for patients with non-hematologic cancer and VTE. However, further randomized, controlled trials are needed to confirm these results.
 

Evaluation of effective factors in the success of resuscitation of patients with in-hospital cardiopulmonary arrest
Mohammad Nasr Esfahani , Aref Javari, Farhad Heydari, Majid Javari,
Volume 80, Issue 4 (7-2022)
Abstract
Background: Previous studies have shown that several factors affect the outcome of cardiopulmonary resuscitation. In this study, we have evaluated the factors associated with the outcome of resuscitation in in-hospital cardiopulmonary arrest patients (IHCA) 002E.
Methods: This cross-sectional non-probability study was performed on patients with in-hospital cardiopulmonary arrest between 2015 and 2020 in the emergency department (ED) of Al-Zahra Hospital, Isfahan, Iran. Data were then collected from medical records to describe patient characteristics, arrest profile, and survival details. Factors associated with the dependent variable were examined Logistic regression.
Results: Among 848 in-hospital cardiopulmonary arrests, 18 patients (2.1%) survived and were discharged from the hospital. The mean age of patients was 62.74±21.17 years, 583 (68.8%) were male, and 265 (31.2%) were female. The mean age of patients with successful resuscitation and those with unsuccessful resuscitation was 62.33±21.79 (6 to 116 years) and 61.58±21.20 (1 month to 108 years) years, respectively. The rate of unsuccessful resuscitation increased with increasing age (P=0.04). Also, the rate of unsuccessful resuscitation increased if there was an underlying disease (P=0.01). In frequency analysis of resuscitation services, emergency medicine with 633 (57.3%) resuscitation is in the first place in the number of resuscitations, of which 22.9% of them have been successful (ROSC). In the anesthesia service, of 2 resuscitations performed, both were successful. In the general surgery service, 36.5% of 63 resuscitations were successful, and the success rate for the neurosurgery service was 32.4% of 102 resuscitations. Analyzing the duration of successful and unsuccessful resuscitation has great importance. In successful resuscitation, the average time was 18.98 minutes and in unsuccessful resuscitation was 39.20 minutes. Also, the maximum and minimum time for successful resuscitations was 63 and 1 minutes. The maximum and minimum time for unsuccessful resuscitations was recorded as 60 and 10 minutes.
Conclusion: The results showed that several factors were influential in cardiopulmonary resuscitation. Increasing age and underlying disease reduced the success of cardiopulmonary resuscitation.

Frequency of cardiopulmonary resuscitation levels in the neonates delivered in Moheb Yas hospital of Tehran
Mahbod Kaveh, Mohammad Kaji-Yazdi , Mohsen Jafari, Armen Malekiantaghi, Seyed Yousef Mojtehedi , Kambiz Eftekhari,
Volume 80, Issue 7 (10-2022)
Abstract
Background: The neonate's Cardiopulmonary resuscitation (CPR) is the most important and common emergency condition in the delivery room. Approximately 10% of newborns are unable to initiate effective breathing and require assistance. The aim of this study was to evaluate the frequency of CPR levels of the neonates delivered during a year in Moheb Yas Hospital who were resuscitated.
Methods: This was a retrospective cross-sectional descriptive study. The sampling method in this study was census. In this study, all the live neonates born during the year (April, 2010 to April, 2011) in Moheb Yas Hospital who were resuscitated, were enrolled in the study. The information of these infants was recorded in separate checklists. This checklist included the following information: mother's age, gestational age, gender of the baby, method of the delivery, multiple births, complications of the placenta and umbilical cord, amount of amniotic fluid, fetal presentation, meconium excretion, fetal heart rate pattern, Apgar of the baby, resuscitation levels, underlying diseases of the mother, maternal diseases during pregnancy, drug use by the mother and premature rupture of the amniotic sac. Finally, the data were analyzed by SPSS software. P-values less than 0.05 were considered statistically significant.
Results: There were 2,176 live births during the study. Of these infants , a total of 322 neonates (15.27%) underwent CPR. 51.8% were male. The mean gestational age was 36.08 weeks. The first minute Apgar was less than 5, between 5-7, and above 8 respectively in 10.5%, 33.4%, and 56% of neonates. About 42% of neonates needed initial resuscitation (warming, drying, and respiratory stimulation). 48% required respiratory ventilation with bag and mask, 5% endotracheal tube, 2.7% cardiac massage, and 1.3% needed medication. In 96.7% of cases, the CPR team was ready for resuscitation before delivery.
Conclusion: If resuscitation is performed in a timely and appropriate manner, very few of these infants will need advanced resuscitation. On the other hand, the high need for resuscitation by bags and masks can be secondary to the educational nature of this hospital.

Examining the results of cardiopulmonary resuscitation and its influencing factors with emphasis on the cause of cardiac arrest and 1-year prognosis of rescued patients
Siros Norozi , Paniz Poursiabidi ,
Volume 80, Issue 12 (3-2023)
Abstract
Background: Cardiopulmonary resuscitation is a quick and immediate intervention to prevent death in a person who has suddenly suffered cardiorespiratory arrest. This study aims to investigate the results of cardiopulmonary resuscitation and the factors affecting it with emphasis on the cause of cardiac arrest and 1-year prognosis of the saved patients.
Methods: Materials and methods: This research is a retrospective descriptive-analytical study that was conducted for 24 months, from April 1, 2017 to the end of March 2018, in Shahid Mostafa Khomeini Hospital in Ilam, from July 2022 to September 2022. The necessary information was collected based on the data available in the patients' files. Data analysis was done using SPSS24 software.
Results: Out of 152 patients, 64(42.1%) were men and 88(57.9%) were women. The average in the group that had a successful CPR was 60.75 years and in the group that had an unsuccessful CPR was 68.27 years. 13.7% of all CPRs occurred during shift change. The number of CPR was 11 cases (7.2%) in changing night shift to morning, six cases (3.9%) in changing evening shift to night, and four cases (2.6%) in changing evening to night shift. Most of the patients who underwent CPR were patients with internal diseases.
Conclusion: In this study, the final success rate of CPR was close to other studies. These results indicate that performing CPR is considered at any time. However, the reasons for the failure of the rehabilitation operation should be looked for in other factors. These factors can include updating nursing and medical team’s knowledge in the field of resuscitation, experience and skills of the resuscitation team, and periodic training of the resuscitation team, which should be considered regularly in order to reduce unsuccessful cases.

Two asthma control test for children and asthma control questionnaire in pediatric asthma patients referred to taleghani hospial clinics, Gorgan
Mohsen Ebrahimi, Zahra Valipour Moghadam , Seyed Ali Aghapour, Azam Rashidbaghan,
Volume 81, Issue 7 (10-2023)
Abstract
Background: Asthma is a chronic inflammatory disease of the airways. Various tests and questionnaires are designed to monitor the severity of asthma and help the therapist and the health system prescribe the best treatment to control it. This study was designed to compare two methods Asthma Control Questionnaires (ACQ) and Asthma Control test-child (ACT-CHILD) in children with asthma.
Methods: This descriptive cross-sectional study was conducted on 92 children with asthma referred to the Taleghani hospital, Gorgan, in 2022-2023. Patients were in a range of age 4-16 years. Asthma control was evaluated and compared by two methods ACT-CHILD and ACQ. ACT-CHILD included one version for 4-11-year patients completed by their parents and another one for 12-16 –year patients completed by the patients. The clinical symptoms, age, gender and the parents' records related to asthma were completed during the clinical interview. Data was analyzed using Chi-square and Spearman correlation tests. The degree of agreement between two questionnaires was determined using the Kappa coefficient.
Results: 84 children aged 4-11 years (91.3%) and 8 children aged 12-16 years (8.7%) were included in the study. According to the ACT-CHILD, 40.2% of children (n=37) had controlled asthma, 44.6% (n=41) had partially controlled asthma, and 15.2% (n=14) had uncontrolled asthma. Based on the ACQ, controlled asthma was observed in 18.5% (n=17), partially controlled asthma in 35.8% (n=33), and uncontrolled asthma in 45.7% (n=42) of children. Asthma control results based on two questionnaires were significantly different from each other (P<0.001). The agreement between the ACT-CHILD and ACQ methods in evaluating children's asthma was at a weak level (P=0.014, κ=0.157), however, a significant negative correlation was observed between the scores of the ACT-CHILD and ACQ questionnaires (r=-0.588, P>0.001) which after categorizing based on age group, this correlation was confirmed only in children aged 4-11 years (r=-0.627, P>0.001).
Conclusion: Our findings showed that there is a poor agreement between ACT-CHILD and ACQ results in the assessment of asthma control. Further studies are recommended.

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