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Ali Fakhr-Movahedi , Abbasali Ebrahimian , Majid Mirmohammadkhani , Saeedeh Ghasemi ,
Volume 74, Issue 2 (5-2016)
Volume 74, Issue 2 (5-2016)
Abstract
Background: Coronary artery disease is considered as main factor for patients’ hospitalization. Chest pain is the most common symptoms of patients and its assessment is an important factor in coronary artery disease. So, this study aimed to determine the relationship between the severity of chest pain with physiological indexes in patients with coronary artery disease.
Methods: This study was a descriptive-analytical design that performed on 80 patients with that were hospitalized in coronary care unit of Shahid Mofatteh Hospital in Varamin city, Iran, from March to September, 2014. In this study, the relationship between the chest pain severity and blood pressure, pulse rate, respiratory rate, O2 saturation and ST segment alterations were assessed. Finally, the gathered data were analyzed by descriptive and inferential statistics.
Results: The mean of chest pain severity was 6.51±2.14 in patients. Patients’ age was between 26 to 85 years old and the mean of age was 60.79±13.79 and there was no significant correlation between age and chest pain severity (P=0.985). Also male and female patients were equal. There was no significant difference between chest pain severity of men and women (P=0.471). The findings of study showed no correlation between chest pain severity and heart rate (r=-0.174 and P=0.122), respiratory rate (r=-0.013 and P=0.909), O2 saturation (r=0.051 and P=0.651), ST segment alterations (r=0.07 and P=0.539). Also, there was no significant difference between chest pain severity and systolic pressure (P=0.353), diastolic blood pressure (P=0.312) and body mass index (P=0.256) among patients.
Conclusion: In this study, there were not enough evidences for relation between chest pain and physiological indexes in patients with coronary artery disease. So performing more studies in another settings and conditions recommended.
Bakhtyar Tartibian , Rogayee Afsar Garebag , Abbas Malandish , Zeinab Sheikhlou ,
Volume 74, Issue 8 (11-2016)
Volume 74, Issue 8 (11-2016)
Abstract
Background: Hypertension is one of the major risk factors for cardiovascular disease. The studies show that factors such as vitamin D, parathyroid hormone, calcium and phosphorus are involved in the regulation of blood pressure. The purpose of this study was to investigate the relationship between blood pressure with vitamin D, parathyroid hormone, calcium, and phosphorus in sedentary postmenopausal women.
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Methods: This investigation is in the form of a descriptive correlational study that was performed in September 2015. The statistical population was all healthy and sedentary postmenopausal women 50-70 years old in Urmia city, Iran. Fifty-four sedentary postmenopausal women were selected as subjects and voluntarily and bona fide participated in this study. General and anthropometric characteristics of height, weight, and body mass index (BMI) in subjects were measured by wall-meter with an accuracy of one millimeter, digital scale with precision of 100 g (Beurer, Germany), and dual emission X-ray absorptiometry (DXA) (Hologic, USA) machines, respectively. Diastolic and systolic blood pressure was measured by indicator machine. Serum levels of vitamin D, parathyroid hormone, calcium, and phosphorus were measured by ELISA and Auto-analyzer (BT 1500, Biotecnica, Italy machines, respectively. Results: The mean general, anthropometric, and physiological/laboratory variables of subjects were: age 54 yr, height 156 cm; weight 72 kg; BMI 29 kg/m2; systolic and diastolic blood pressure 76.20 and 110.70, respectively; vitamin D 25.22 ng/ml, parathyroid hormone 33.29 ng/ml, calcium 9.44 ng/ml, and phosphorus 3.26 ng/ml. Moreover, results showed that there was no significant relationship between systolic and diastolic blood pressure and vitamin D (P>0.581 and P>0.619, respectively). There was no significant relationship between systolic and diastolic blood pressure and parathyroid hormone (P>0.623 and P>0.341, respectively). There was no significant relationship between systolic and diastolic blood pressure and calcium (P>0.704 and P>0.141, respectively). There was no significant relationship between systolic and diastolic blood pressure and phosphorous (P>0.058 and P>0.357, respectively). Conclusion: The results suggest that there is no relationship between systolic and diastolic blood pressure with serum levels of vitamin D, parathyroid hormone, calcium, and phosphorous in sedentary postmenopausal women 50-70 years old. |
Khosro Barkhordari , Samaneh Yaghooti , Sepideh Nikkhah , Afsaneh Aein , Arash Jalali , Akbar Shafiee ,
Volume 74, Issue 9 (12-2016)
Volume 74, Issue 9 (12-2016)
Abstract
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Background: We retrospectively compared the clinical outcome of post-cardiac surgery tracheal extubation between patients extubated with a lower than normal pH and patients extubated according to our routine institutional protocol. Our main goal was to clarify that strict adherence to the current criteria is dispensable. Methods: In this retrospective cohort study, we recruited 256 patients who met our study criteria and divided them into the exposed group (n= 95) and the control group (n= 161). The inclusion criteria consisted of coronary artery bypass grafting alone and age> 18 years. The exclusion criteria comprised the use of corticosteroids in the preceding 2 weeks, Serum creatinine (SCr)> 2 mg/dL, uncontrolled diabetes, liver dysfunction, Glasgow coma scale <13, and acetazolamide and sodium bicarbonate use. The arterial blood gas (ABG) characteristics before and 6 hours after extubation, extubation failure rate, length of stay in the in ICU, length of stay in the hospital and mortality were compared between the two groups. Results: In the control group, the males outnumbered the females and the ejection fraction was higher relative to that in the exposure group (P= 0.01 and P= 0.02, respectively). There were more patients with chronic obstructive pulmonary disease in the exposure group (P< 0.005) and also the euroSCORE was higher (P< 0.002). There were no significant differences between the groups regarding the ABG values at the time of ICU admission. Significantly higher levels of FiO2 and PaCO2 (P< 0.001 for both) as well as lower HCO3 and pH (P< 0.001 for both) were observed in the exposure group immediately before extubation. Following extubation, there was a significant increase in pH and a significant reduction in FiO2 need in the exposure group (P< 0.001 for both). The extubation failure rate, length of stay in the in ICU, length of stay in the hospital, and mortality rate were not different between the 2 groups. |
Conclusion: The patients with a lower than normal pH, tracheal extubated at the discretion of the ICU anesthesiologist did not have a clinical outcome worse than that of the patients extubated in accordance with our routine institutional protocol.
Masoud Mohammadi , Masoud Mirzaei ,
Volume 74, Issue 10 (1-2017)
Volume 74, Issue 10 (1-2017)
Abstract
Background: Hypertension is one of the most important chronic illness worldwide and one the major risk factors for cardiovascular diseases. Obesity and abdominal obesity are risk factors for high blood pressure. Population attributable fraction (PAF) answers the question of how much of the disease burden in a certain population may be reduced if a risk factor like obesity is removed from the population. It implies that reducing prevalence of obesity as a risk factor of hypertension, may reduce the burden of hypertension and its consequences. The aim of this study was to determine the population attributable fraction of hypertension associated with obesity, abdominal obesity and joint effect of them in the men of Mazandaran Province, North of Iran.
Methods: In this epidemiological study, the data of non-communicable disease surveillance system in 2009 has been achieved. Then measure of association between obesity and hypertension (Odds Ratio) was extracted from Tehran Lipid and Glucose Study (TLGS). After standardizing the data, the population attributable risk for men based on the above formula (Levin's attributable fraction formula) has been calculated.
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Results: In our study based on population attributable fraction, results in blood pressure caused by obesity were 14.5 (CI 95%: 10.7-17.2), the effect of abdominal obesity was 7.4 (CI 95%: 2.04-11.3) and deductions attributable joint effect both obesity and abdominal obesity was 22.6 (CI 95%: 9.7-25.6) respectively. Conclusion: Given the high prevalence of hypertension and obesity in Mazandaran men and the impact of obesity on blood pressure is necessary to prevent the spread of the disease. It is recommended that health promotion programs focus on men with high blood pressure due to obesity could be performed. |
Karolin Abashzadeh , Fereydoun Siassi , Mostafa Qorbani , Fariba Koohdani , Negin Farasati , Gity Sotoudeh ,
Volume 74, Issue 12 (3-2017)
Volume 74, Issue 12 (3-2017)
Abstract
Background: Nurses are prone to continuous stress due to their job situation that lead to many physical and psychological disorders. this job stress also affects their personal life and career. The aim of this study was to evaluate the association between major dietary patterns and anthropometry in nurses.
Methods: We conducted a cross-sectional study from February to October 2014. In this cross-sectional study, 320 female nurses were selected randomly from eight hospitals affiliated to Tehran University of Medical Sciences in 2014. This research project carried out with the code 24371 Tehran University of Medical Sciences in Research Ethics Committee approved. Anthropometry and blood pressure measurement was done. Data on physical activity were obtained using the short version of international physical activity questionnaire.
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Results: Three dietary patterns were identified using factor analysis and labeled: healthy, unhealthy and traditional. The healthy dietary pattern score was significantly related to weight and body mass index (BMI) of participants after adjusting for confounders (P=0.05, P=0.01, respectively). There was not significant association between the unhealthy dietary pattern and anthropometry measures. The unhealthy dietary pattern score was inversely related to systolic and diastolic blood pressure after adjusting for confounders (P=0.001, P=0.03, respectively). There was not any significant association between the traditional dietary pattern and anthropometry and blood pressure measures (P>0.05). Conclusion: According to the result of this study, three dietary patterns including, healthy, unhealthy and traditional were identified in nurses. The healthy dietary pattern was associated with weight and BMI and the unhealthy dietary pattern was inversely associated with blood pressure. The traditional dietary pattern had no effect on anthropometry and blood pressure measures. |
Ehteramolsadat Hosseini , Amin Shahbaz Ghasabeh , Mehran Ghasemzadeh ,
Volume 75, Issue 2 (5-2017)
Volume 75, Issue 2 (5-2017)
Abstract
Blood transfusion is commonly implemented to manage life and health-threatening conditions on a rapid and short-term basis. Over the years, ongoing technical advances have dramatically improved transfusion medicine to provide more safety and effectiveness. However, transfusion is still complicated with different adverse events that mainly induced by the presence of allogeneic leukocytes in the blood products. Several lines of evidence have shown that leukocytes in blood components are involved in the induction of febrile nonhemolytic transfusion reactions (FNHTRs), HLA alloimmunization and platelet refractoriness as well as the increased risk of the infectious diseases transmitted by leukotropic viruses including cytomegalovirus (CMV), human T-lymphotropic virus (HTLV)-I/II and Epstein-Barr virus (EBV). During current decades, introducing various leuko-reduction techniques have shown to be associated with less transfusion related adverse events and improved clinical outcomes. The lower incidence and severity of febrile transfusion reactions; reduced risk of transfusion related transmission of CMV or other leukocyte-associated infections, lowered incidence of alloimmune platelet refractoriness in addition to reducing risk of mortality and morbidity in patients are considered as clinical benefits of leuko-reduced products. Currently, by the use of 3rd and 4th generation of filters, the highest levels of leukoreduction in blood components have been achieved. Filtration techniques have also the advantages of being performed shortly after preparation of components (pre-storage) or post-storage even at the patient’s bedside. However, it seems that pre-storage depletion of leukocytes provides better protection than post-storage techniques due to the elimination of leukocyte-derived cytokines effects which are increasingly released during storage. Particularly in platelet products, the earlier depletion of leukocyte also favors less platelet-induced leukocyte activation which may be triggered by the interaction between either activated platelets or their released chemokines and residual leukocytes during storage. Despite the benefits attributed to leukoreduction of blood components, the global use of leukoreduced products is commonly hampered by its high cost especially in developing countries in which leukoreduction of blood components is usually limited to some patients with special conditions. In this review, after briefly introducing of some transfusion adverse events that are attributed to allogeneic leukocytes existed in blood products, the effects of leukoreduction process in the attenuation of these events will be discussed.
Hajieh Borna , Shiva Rafati , Fathemeh Haj Ebrahim Tehrani , Someieh Gadimii ,
Volume 75, Issue 3 (6-2017)
Volume 75, Issue 3 (6-2017)
Abstract
Background: Blood transfusion is common in infants. Due to the weakened immune system of newborns and the risk of blood transfusion complications, it is necessary to pay more attention following or after to blood transfusion. The aim of this study was to evaluate the frequency and risk factors of blood transfusions in hospitalized neonates.
Methods: A cross-sectional study was performed on 1106 infants admitted in the neonatal intensive care unit (NICU) of Mustafa Khomeini University Hospital, Tehran, Iran, from spring 2009 to 2012. Frequency and the reason for of blood components transfusion including fresh frozen plasma, platelets, whole blood, packed red blood cells, cryoprecipitate and relationship with gestational age, sex, birth weight, Apgar score, duration of hospitalization, use of mechanical ventilation were assessed. Statistical analysis was performed with SPSS statistical software, version 16 (IBM, Armonk, NY, USA) and statistical test, chi-square test, independent t-test and analysis of variance (ANOVA).
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Results: Among 1106 infants admitted to the neonatal intensive care unit, 221 infants (%19.98) received blood products. 82 of all (37%) were female and 139 (%63) were female. 113 (51%) of neonate were preterm and 108 (48%) were term. From 361 times of blood transfusions, 121 infant (54.75%) received at least one blood product. The frequency of blood transfusion was between 39 and 1 times, with an average of 3.65 times per infant. Frequency of fresh frozen plasma infusion was 173 (47.9%), packed cell 122 (33%), platelet 32 (8.8%), cryoprecipitate 20 (5.1%) and whole blood 3 unit (0.83%). The most common causes for fresh frozen plasma transfusion was replacement therapy 140 (80%), for packed cell, to correct symptomatic anemia 68 (55.6%), for platelet transfusions was to prevent bleeding in neonates with thrombocytopenia 20 (62.5%) and cryoprecipitate for bleeding caused by DIC in 18 infant (90%). There was significant relation between frequency of blood transfusions with gestational age (P=0.002), birth weight (P=0.01), cause of hospitalization (P=0.001) using of ventilator (P=0.002), and length of hospital stay (P=0.001). |
Conclusion: With attention to the guidelines of blood transfusions and controlling factors affecting premature birth and low weight infants, reducing length of hospital stay and duration of mechanical ventilation, frequency and complications of blood transfusion can be effectively decreased.
Shahnaz Nazari , Majid Shahabi , Kamran Mousavi Hosseini ,
Volume 75, Issue 4 (7-2017)
Volume 75, Issue 4 (7-2017)
Abstract
One of the main sources of a wide range of biological products as starting material is the human blood. These biological human plasma derived medicines play essential role in prevention and treatment of a variety of life threatening diseases. Mention to the starting material of these medicines which is blood or in another word human plasma, possibility of contamination by blood borne viruses cannot be omitted.
In recent years possibility of contamination by blood borne viruses such as hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) is an important concern. Nowadays most of developed countries the risk is minimum, although in developing countries it is still a challenge. Despite measures for human plasma biological derived medicines safety, such as donor selection, testing of donations, and polymerase chain reaction (PCR) testing on pooled plasma, still more actions are needed to inactivate or remove viruses such as HBV, HCV and HIV. During the process of manufacturing of biological human plasma medicines, there is several production steps which may contribute to viral reduction. These steps consist of precipitation by centrifugation, ethanol, polyethylene glycol, octanoic acid, or ammonium sulphate, chromatographic methods such as immunoaffinity chromatography or ion exchange chromatography, adsorption by aluminum hydroxide, and separation by filtration. All these steps are considered to be weakly effective as viral reduction treatment, and more effective viral inactivation methods are needed to be implemented in line of production of human plasma derived biological medicinal products. These safety measures included virus inactivation by different techniques such as acidic pH, solvent/detergent method, pasteurization and heat treatment, beta-propiolactone plus U/V and also virus removal by nanofiltration, which all these virus inactivation or virus removal methods before implementation in line of production of plasma derived biological medicines, should undergo for validation study.
In recent years possibility of contamination by blood borne viruses such as hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) is an important concern. Nowadays most of developed countries the risk is minimum, although in developing countries it is still a challenge. Despite measures for human plasma biological derived medicines safety, such as donor selection, testing of donations, and polymerase chain reaction (PCR) testing on pooled plasma, still more actions are needed to inactivate or remove viruses such as HBV, HCV and HIV. During the process of manufacturing of biological human plasma medicines, there is several production steps which may contribute to viral reduction. These steps consist of precipitation by centrifugation, ethanol, polyethylene glycol, octanoic acid, or ammonium sulphate, chromatographic methods such as immunoaffinity chromatography or ion exchange chromatography, adsorption by aluminum hydroxide, and separation by filtration. All these steps are considered to be weakly effective as viral reduction treatment, and more effective viral inactivation methods are needed to be implemented in line of production of human plasma derived biological medicinal products. These safety measures included virus inactivation by different techniques such as acidic pH, solvent/detergent method, pasteurization and heat treatment, beta-propiolactone plus U/V and also virus removal by nanofiltration, which all these virus inactivation or virus removal methods before implementation in line of production of plasma derived biological medicines, should undergo for validation study.
| Nowadays by screening and testing of donations and implementation of different measures of virus inactivation or virus removal, a good level of safety of plasma derived biological medicines has been achieved. Due to the possibility of emerging new pathogens investigation in this subject should be continued. |
Sajad Rezvan, Mohammad Aghaali, Behnam Fallah Bafekr Lialestani, Leili Iranirad, Fariba Pirsarabi,
Volume 75, Issue 10 (1-2018)
Volume 75, Issue 10 (1-2018)
Abstract
Background: Blood pressure decreases during sleep and is markedly increased in the morning in healthy individuals. Lack of nocturnal blood pressure fall (non-dipping) has been associated with cardiovascular morbidity, mortality and other organ damage. However, their importance in chronic renal failure is unclear. This study aimed to investigate relationship between circadian rhythm of blood pressure and renal failure severity in patients with chronic kidney disease.
Methods: This cross-section study was done in April 2016. The study population was 95 patients, more than 30 year old with hypertension and chronic renal failure. Patients were selected from clinics of two private and university hospitals affiliated to Qom University of Medical Sciences Shahid Beheshti Hospital and Vali-e-Asr Hospital, Iran. Checklist containing data such as age, sex, duration of renal failure and cause of renal failure were filled. Serum creatinine and serum urea levels were measured and entered in the checklist. The circadian rhythm of blood pressure in all patients was assessed by Holter monitoring. patients who had less than 10% decrease in blood pressure overnight were considered non-dipper and those who had 10% or more decrease in blood pressure overnight were considered dipper.
Results: Average (SD) 24-hour ambulatory systolic and diastolic of blood pressure was 136.56 (16.66) and 84.84 (10.86) mmHg, respectively. 70 patients (73.7%) had non-dipper blood pressure pattern and 25 patients (26.3%) had dipper blood pressure pattern. There was no significant difference between two groups (dipper and non-dipper) based on distribution of gender (P=0.744), age (P=0.407), serum creatinine (P=0.569), serum urea (P=0.689) and renal failure duration (P=0.812). Mean of glomerular filtration rate in dipper group was 68.64±4.13 and in non-dipper group was 65.09±16.27 (P=0.337).
Conclusion: The results of this study did not show a significant relationship between circadian rhythm of blood pressure and renal failure severity. In addition, patients with chronic renal failure showed higher rates of non-dipping pattern of blood pressure.
Methods: This cross-section study was done in April 2016. The study population was 95 patients, more than 30 year old with hypertension and chronic renal failure. Patients were selected from clinics of two private and university hospitals affiliated to Qom University of Medical Sciences Shahid Beheshti Hospital and Vali-e-Asr Hospital, Iran. Checklist containing data such as age, sex, duration of renal failure and cause of renal failure were filled. Serum creatinine and serum urea levels were measured and entered in the checklist. The circadian rhythm of blood pressure in all patients was assessed by Holter monitoring. patients who had less than 10% decrease in blood pressure overnight were considered non-dipper and those who had 10% or more decrease in blood pressure overnight were considered dipper.
Results: Average (SD) 24-hour ambulatory systolic and diastolic of blood pressure was 136.56 (16.66) and 84.84 (10.86) mmHg, respectively. 70 patients (73.7%) had non-dipper blood pressure pattern and 25 patients (26.3%) had dipper blood pressure pattern. There was no significant difference between two groups (dipper and non-dipper) based on distribution of gender (P=0.744), age (P=0.407), serum creatinine (P=0.569), serum urea (P=0.689) and renal failure duration (P=0.812). Mean of glomerular filtration rate in dipper group was 68.64±4.13 and in non-dipper group was 65.09±16.27 (P=0.337).
Conclusion: The results of this study did not show a significant relationship between circadian rhythm of blood pressure and renal failure severity. In addition, patients with chronic renal failure showed higher rates of non-dipping pattern of blood pressure.
Mahboobeh Sadat Hosseini , Mohammad Javad Bahoosh , Gholamhossein Alishiri , Nahid Khalili , Habib Yaribeygi ,
Volume 75, Issue 11 (2-2018)
Volume 75, Issue 11 (2-2018)
Abstract
Background: The prevalence of diabetes mellitus due to existence of various factors is growing rapidly. The insulin resistance phenomenon is one of the main underlying causes of this disease, due to various reasons such as a decrease in serum levels of vitamin D3. In this study, we evaluated the relationship between plasma level of vitamin D3 and some other main plasma factors.
Methods: This clinical trial study carried out on type 2 diabetes mellitus subjects who referred to diabetes clinic of Baqiyatallah Hospital in Tehran city during June to September 2016. First demographic data of all patients were collected. Then the blood samples for evaluation of blood glucose, HbA1c, triglyceride, cholesterol, HDL, LDL and vitamin D3 were obtained. Based on plasma level of vitamin D3, diabetic subjects were divided into two separate treatment groups (with and without vitamin D3 deficiency) and then above-mentioned factors were compared between these two groups. Afterward, in group with vitamin D3 deficiency, treatment by vitamin D3 triggered (50000 unit per week for eight weeks orally) until plasma level of vitamin D3 reached above 30 ng/mL. Then, treatment continued by vitamin D3 (50000 Unit per week orally) and calcium (1.5 g/day PO) until 60 days. Finally, the patients were evaluated about fasting blood glucose, HbA1c, HDL, LDL and blood pressure.
Results: In total, 187 subjects (99 men and 88 women) were evaluated in this study. Total hypovitaminose incidence was 0.65% which was higher in subjects with higher body mass index (BMI). Serum content of vitamin D3 and calcium, significantly changed the values of fasting blood sugar (FBS), HbA1c, HDL and TG, but has no significant effects on other factors.
Conclusion: Our results clearly revealed that hypovitaminose vitamin D3 is one of the main factors that can leading to rise in plasma glucose and dyslipidemia occurrence. Also, our data are demonstrated that treatment by vitamin D3 and calcium can modify fasting blood glucose and dyslipidemia in type 2 diabetes mellitus subjects.
Methods: This clinical trial study carried out on type 2 diabetes mellitus subjects who referred to diabetes clinic of Baqiyatallah Hospital in Tehran city during June to September 2016. First demographic data of all patients were collected. Then the blood samples for evaluation of blood glucose, HbA1c, triglyceride, cholesterol, HDL, LDL and vitamin D3 were obtained. Based on plasma level of vitamin D3, diabetic subjects were divided into two separate treatment groups (with and without vitamin D3 deficiency) and then above-mentioned factors were compared between these two groups. Afterward, in group with vitamin D3 deficiency, treatment by vitamin D3 triggered (50000 unit per week for eight weeks orally) until plasma level of vitamin D3 reached above 30 ng/mL. Then, treatment continued by vitamin D3 (50000 Unit per week orally) and calcium (1.5 g/day PO) until 60 days. Finally, the patients were evaluated about fasting blood glucose, HbA1c, HDL, LDL and blood pressure.
Results: In total, 187 subjects (99 men and 88 women) were evaluated in this study. Total hypovitaminose incidence was 0.65% which was higher in subjects with higher body mass index (BMI). Serum content of vitamin D3 and calcium, significantly changed the values of fasting blood sugar (FBS), HbA1c, HDL and TG, but has no significant effects on other factors.
Conclusion: Our results clearly revealed that hypovitaminose vitamin D3 is one of the main factors that can leading to rise in plasma glucose and dyslipidemia occurrence. Also, our data are demonstrated that treatment by vitamin D3 and calcium can modify fasting blood glucose and dyslipidemia in type 2 diabetes mellitus subjects.
Mehdi Nikseresht , Mahmoud Nikseresht , Valiolla Dabidy-Roshan ,
Volume 75, Issue 12 (3-2018)
Volume 75, Issue 12 (3-2018)
Abstract
Background: Cardiovascular diseases are the leading cause of human mortality worldwide. Myocardial ischemia is a type of cardiovascular disease that increases with age spread. Therefore, the purpose of this study was to compare non-invasive myocardial ischemia in patients with heart problems in different age groups.
Methods: This study is a causal-comparative study was conducted from July to October 2016 in the University of Mazandaran. One hundred and seventy-five (age=45-59 years) and 124 (age=60-77 years) men with heart problem participated in this study. The questionnaires of Rose angina pectoris (for assessing the risk of ischemic myocardium), lifestyle and physical activity level were completed by the participants. In addition, the anthropometric characteristics, blood pressure and peak oxygen uptake (VO2peak) of the participants were measured.
Results: The risk of myocardial ischemia in men aged 60-77 years was significantly higher than men aged 45-59 years (P=0.049). Men aged 60-77 years were significantly lower in good indices (physical activity level, VO2peak and more lifestyle indices) and higher in bad indicators (waist/hip ratio, body shape index, ankle systolic blood pressure, brachial systolic and diastolic blood pressure) than men aged 45-59 years (P<0.031, for all variables). Also, there was no significant difference in the risk of ischemia between groups, when they were similar in physical activity level.
Conclusion: It seems that the higher risk of myocardial ischemia in men aged 60-77 years, as compared to men aged 45-59 years, might be related to aging process and imbalance in the risk factors. Promoting physical activity can favorably affect the risk of myocardial ischemia in the middle-aged or elderly men. It is concluded that physical activity effectively decreased the risk of myocardial ischemia.
Methods: This study is a causal-comparative study was conducted from July to October 2016 in the University of Mazandaran. One hundred and seventy-five (age=45-59 years) and 124 (age=60-77 years) men with heart problem participated in this study. The questionnaires of Rose angina pectoris (for assessing the risk of ischemic myocardium), lifestyle and physical activity level were completed by the participants. In addition, the anthropometric characteristics, blood pressure and peak oxygen uptake (VO2peak) of the participants were measured.
Results: The risk of myocardial ischemia in men aged 60-77 years was significantly higher than men aged 45-59 years (P=0.049). Men aged 60-77 years were significantly lower in good indices (physical activity level, VO2peak and more lifestyle indices) and higher in bad indicators (waist/hip ratio, body shape index, ankle systolic blood pressure, brachial systolic and diastolic blood pressure) than men aged 45-59 years (P<0.031, for all variables). Also, there was no significant difference in the risk of ischemia between groups, when they were similar in physical activity level.
Conclusion: It seems that the higher risk of myocardial ischemia in men aged 60-77 years, as compared to men aged 45-59 years, might be related to aging process and imbalance in the risk factors. Promoting physical activity can favorably affect the risk of myocardial ischemia in the middle-aged or elderly men. It is concluded that physical activity effectively decreased the risk of myocardial ischemia.
Azadeh Vahedi , Akram Baghani , Zohre Baseri , Mohammad Reza Pourmand ,
Volume 75, Issue 12 (3-2018)
Volume 75, Issue 12 (3-2018)
Abstract
Background: Bloodstream infections are the most important causes of morbidity and mortality in hospitalized patients. Blood culture plays an important role in identifying most of bacterial agents of bloodstream infections. Knowledge about bacterial agents of bloodstream infections and also antibiotic resistance of these bacteria are important. Antibiotic resistance among bacterial agents of bloodstream infection including Acinetobacter, Klebisella, Pseudomonas, Escherichia coli, Enterobacter, Enterococcus, Staphylococcus aureus and Staphylococcus coagulase negative (CoNS) is one of the major challenges faced by physicians in treating. Therefore, this study was aimed to determine the frequency and antibiotic resistant patterns of bacterial isolates from hospitalized patient's blood cultured samples in the hospital, Tehran, Iran.
Methods: This research is a descriptive and retrospective study based on recorded data in Shariati hospital laboratory and under the supervision of Tehran University of Medical Sciences. The bacterial isolates were collected from positive blood cultures from October 2013 to March 2014. The frequency of bacterial isolates were determined by phenotypic and biochemical tests. The antibiotic resistance patterns of isolated bacteria were found by disk diffusion agar method. The diameters of inhibition zone were recorded and interpreted according to Clinical and Laboratory Standards Institute (CLSI) 2013.
Results: The frequency of bacterial isolates was determined among 595 positive blood cultures as followed: 41% Pseudomonas, 20% Staphylococcus epidermidis, 10% Escherichia coli, 6% Acinetobacter lwoffii, 6% Staphylococcus aureus, 5% Stenotrophomonas, 3% Acinetobacter baumannii. The antibiogram test showed that 96.2% of Acinetobacter lwoffii, 92.8% of Acinetobacter baumannii, 66% of Pseudomonas aeruginosa, 85.7% of Staphylococcus epidermidis, 65% of Staphylococcus aureus, 75% of Klebsiella, 73.7% of Escherichia coli, and 50% of Stenotrophomonas were resistant to imipenem, piperacillin, piperacillin, erythromycin, erythromycin, ciprofloxacin, trimethoprim-sulfamethoxazole, and ceftazidime respectively.
Conclusion: The most prevalent bacterial isolate among the blood cultures of patients was Pseudomonas. The patients more than 50 years were more susceptible to blood stream infections. The most bacteria were isolated from the internal medicine department of hospital. The antibiotic resistance was also increasing especially in Acinetobacter, Staphylococcus coagulase negative, Escherichia coil and Klebsiella
Methods: This research is a descriptive and retrospective study based on recorded data in Shariati hospital laboratory and under the supervision of Tehran University of Medical Sciences. The bacterial isolates were collected from positive blood cultures from October 2013 to March 2014. The frequency of bacterial isolates were determined by phenotypic and biochemical tests. The antibiotic resistance patterns of isolated bacteria were found by disk diffusion agar method. The diameters of inhibition zone were recorded and interpreted according to Clinical and Laboratory Standards Institute (CLSI) 2013.
Results: The frequency of bacterial isolates was determined among 595 positive blood cultures as followed: 41% Pseudomonas, 20% Staphylococcus epidermidis, 10% Escherichia coli, 6% Acinetobacter lwoffii, 6% Staphylococcus aureus, 5% Stenotrophomonas, 3% Acinetobacter baumannii. The antibiogram test showed that 96.2% of Acinetobacter lwoffii, 92.8% of Acinetobacter baumannii, 66% of Pseudomonas aeruginosa, 85.7% of Staphylococcus epidermidis, 65% of Staphylococcus aureus, 75% of Klebsiella, 73.7% of Escherichia coli, and 50% of Stenotrophomonas were resistant to imipenem, piperacillin, piperacillin, erythromycin, erythromycin, ciprofloxacin, trimethoprim-sulfamethoxazole, and ceftazidime respectively.
Conclusion: The most prevalent bacterial isolate among the blood cultures of patients was Pseudomonas. The patients more than 50 years were more susceptible to blood stream infections. The most bacteria were isolated from the internal medicine department of hospital. The antibiotic resistance was also increasing especially in Acinetobacter, Staphylococcus coagulase negative, Escherichia coil and Klebsiella
Kianoush Saberi , Shahnaz Sharifi, Mehrdad Salehi , Paniz Mihandoost,
Volume 76, Issue 11 (2-2019)
Volume 76, Issue 11 (2-2019)
Abstract
Background: Coronary artery bypass surgery is one of the surgeries in which high blood transfusions are needed. About 20% of all surgical operations require a blood transfusion. Packed cell administration increases perioperative morbidity and mortality. In the United States, from every 1000 people, one has undergone a coronary artery bypass graft surgery, and it is estimated that around 800,000 coronary artery bypass grafts undergo each year. Knowledge about relative blood administration during coronary artery bypass graft surgery improves the ability of blood transfusion centers in healthy and adequate blood donations. For this purpose, this study was conducted to determine the effective factors in the need for blood in a coronary artery bypass graft surgery.
Methods: This cross-sectional study was performed on 317 patients undergoing coronary artery bypass graft surgery in the heart surgery operating room of Imam Khomeini Hospital in Tehran, Iran, from September 2017 to February 2018. Sampling method has been available. The data of this study were extracted from patient files. The products analyzed in the study included packed cell, fresh frozen plasma and platelets. Demographic data, type of surgery, transfusion of blood and products, and hemoglobin level have been reported. P-value less than 0.05 was reported as meaningful.
Results: In this study, 317 patients underwent coronary artery bypass graft surgery. 236 cases (74.4%) were male and the rest were women. The mean of administration of packed cell in women was 2.74±1.3 and in men it was 2.29±1.09 (P<0.001). The mean packed cell administration in patients with hemoglobin levels less than 10 g/dl was 3.27±1.8 and in patients with hemoglobin levels greater than 10 g/dl was 0.99±2.25 (P<0.0001).
Conclusion: The present study showed that the mean transfusion of packed cells in women were more than men in coronary artery bypass graft surgery. Also, hemoglobin levels were the only factor that had a significant effect on infusion of packed cells.
Methods: This cross-sectional study was performed on 317 patients undergoing coronary artery bypass graft surgery in the heart surgery operating room of Imam Khomeini Hospital in Tehran, Iran, from September 2017 to February 2018. Sampling method has been available. The data of this study were extracted from patient files. The products analyzed in the study included packed cell, fresh frozen plasma and platelets. Demographic data, type of surgery, transfusion of blood and products, and hemoglobin level have been reported. P-value less than 0.05 was reported as meaningful.
Results: In this study, 317 patients underwent coronary artery bypass graft surgery. 236 cases (74.4%) were male and the rest were women. The mean of administration of packed cell in women was 2.74±1.3 and in men it was 2.29±1.09 (P<0.001). The mean packed cell administration in patients with hemoglobin levels less than 10 g/dl was 3.27±1.8 and in patients with hemoglobin levels greater than 10 g/dl was 0.99±2.25 (P<0.0001).
Conclusion: The present study showed that the mean transfusion of packed cells in women were more than men in coronary artery bypass graft surgery. Also, hemoglobin levels were the only factor that had a significant effect on infusion of packed cells.
Mansour Bahardoust, Marjan Mokhtare , Shahram Agah ,
Volume 77, Issue 5 (8-2019)
Volume 77, Issue 5 (8-2019)
Abstract
Background: Hepatitis is among the major health problems, especially in developing countries. During past decades, the association between type of blood group (ABO) and hepatitis B and C virus has always been discussed. This study was designed to investigate the possible association between type of ABO blood group and chronic hepatitis B and C infection.
Methods: In the present analytical study, frequency of blood groups and their relationship with hepatitis B and C were evaluated in three groups: group A (patients with hepatitis B), group B (patients with hepatitis C) and group control (subjects with non-hepatitis B and C). The study was done from October 2016 to October 2018 on patients who referred to Rasool-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran. Demographic and laboratory data of all participants were extracted and collected from their medical records.
Results: Overall, 196 and 103 patients in group A, B and three hundred control were included in this study, respectively. The baseline demographic data of patients were not significantly different between treatment groups. The mean age of participants was 35.1±13 years. The O blood group was significantly higher in patients with hepatitis B (46.4%) and hepatitis C (41.9%) compared to control group (34%) (P=0.001). The risk of hepatitis B and C infection were significantly higher among patients with O blood group (OR = 3.9, 95% CI 2.1-5.9; P = 0.001) and (OR = 2.7, 95% CI 1.7-5.6; P = 0.02), respectively] while, the risk of hepatitis B infection was significantly lesser in participants with blood group A (OR = 0.4, 95% CI -1.2-0.8). Rh positive participants significantly were at higher risk of hepatitis (B and C) than Rh negative participants. (P<0.05).
Conclusion: Participants with blood group O were at higher risk for chronic hepatitis B and C B infection and antigen (Rh) positive. Hepatitis B infection was reported lesser in participants with blood group A.
Methods: In the present analytical study, frequency of blood groups and their relationship with hepatitis B and C were evaluated in three groups: group A (patients with hepatitis B), group B (patients with hepatitis C) and group control (subjects with non-hepatitis B and C). The study was done from October 2016 to October 2018 on patients who referred to Rasool-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran. Demographic and laboratory data of all participants were extracted and collected from their medical records.
Results: Overall, 196 and 103 patients in group A, B and three hundred control were included in this study, respectively. The baseline demographic data of patients were not significantly different between treatment groups. The mean age of participants was 35.1±13 years. The O blood group was significantly higher in patients with hepatitis B (46.4%) and hepatitis C (41.9%) compared to control group (34%) (P=0.001). The risk of hepatitis B and C infection were significantly higher among patients with O blood group (OR = 3.9, 95% CI 2.1-5.9; P = 0.001) and (OR = 2.7, 95% CI 1.7-5.6; P = 0.02), respectively] while, the risk of hepatitis B infection was significantly lesser in participants with blood group A (OR = 0.4, 95% CI -1.2-0.8). Rh positive participants significantly were at higher risk of hepatitis (B and C) than Rh negative participants. (P<0.05).
Conclusion: Participants with blood group O were at higher risk for chronic hepatitis B and C B infection and antigen (Rh) positive. Hepatitis B infection was reported lesser in participants with blood group A.
Diagnosis of bacteremia in patients with suspected septicemia using polymerase chain reaction method
Azam Shiralinezhad , Farzaneh Firoozeh , Mansooreh Momen Heravi, Esmat Aghadavod , Mojtaba Sehat ,
Volume 77, Issue 10 (1-2020)
Volume 77, Issue 10 (1-2020)
Abstract
Background: Sepsis or blood stream infection is a clinical lethal syndrome with severe systemic inflammatory response to infection, if not treated quickly, is associated with dangerous consequences and high morbidity and mortality. The traditional and conventional method for identification of sepsis is blood culture method which is so time-consuming and long that it eliminates the possibility of rapid treatment. Although, new molecular methods, due to their high sensitivity, specificity, and speed, lead to the rapid and accurate and exact detection of bacterial sepsis within only a few hours. The aim of this study was diagnosis of bacteremia in patients with suspected sepsis using amplification of 23S rRNA gene by polymerase chain reaction (PCR).
Methods: This cross-sectional study was performed in two clinical and analytical steps at Shahid Beheshti University Hospital in Kashan City, Iran, in twelve months from November 2016 to December 2017. The blood samples of two hundred and fifty-six patients with suspected sepsis admitted to Shahid Beheshti Hospital were studied by PCR method using specific primers of 23S rRNA gene of the bacteria.
Results: The finding of molecular assays using PCR showed that of 256 blood samples that were collected from patients with clinical signs and symptoms of sepsis, 80 (30.2%) diagnosed with bacteremia. Of these patients diagnosed with sepsis, 46 out of 80 (57.5%) were male while 34 out of 80 (42.5%) were female. The most PCR positive results were obtained among patients with diabetes and bedsore as underlying diseases (21.3%). Statistical analysis showed that there was a significant correlation between results of molecular methods by PCR assays and history of antibiotic use.
Conclusion: Overall, the results of the present study showed that the molecular methods such as polymerase chain reaction using universal 23S rRNA primers is an appropriated test for diagnosis of bacteremia in blood samples of patients with suspected sepsis.
Methods: This cross-sectional study was performed in two clinical and analytical steps at Shahid Beheshti University Hospital in Kashan City, Iran, in twelve months from November 2016 to December 2017. The blood samples of two hundred and fifty-six patients with suspected sepsis admitted to Shahid Beheshti Hospital were studied by PCR method using specific primers of 23S rRNA gene of the bacteria.
Results: The finding of molecular assays using PCR showed that of 256 blood samples that were collected from patients with clinical signs and symptoms of sepsis, 80 (30.2%) diagnosed with bacteremia. Of these patients diagnosed with sepsis, 46 out of 80 (57.5%) were male while 34 out of 80 (42.5%) were female. The most PCR positive results were obtained among patients with diabetes and bedsore as underlying diseases (21.3%). Statistical analysis showed that there was a significant correlation between results of molecular methods by PCR assays and history of antibiotic use.
Conclusion: Overall, the results of the present study showed that the molecular methods such as polymerase chain reaction using universal 23S rRNA primers is an appropriated test for diagnosis of bacteremia in blood samples of patients with suspected sepsis.
Alireza Mahoori , Nazli Karami , Shabnam Saeifar ,
Volume 77, Issue 12 (3-2020)
Volume 77, Issue 12 (3-2020)
Abstract
Background: Arterial pressure is one of the most important physiological variables and often needs to be monitored repeatedly or continuously in perioperative period. Arterial pressure monitoring is one of the standard monitoring in operating room. During general anesthesia, blood pressure can be measured by using a noninvasive arterial pressure method or continuous invasive arterial pressure by an invasive arterial line. Comparison of invasive measurements in the patient’s candidate to esophagectomy has not been assessed. The aim of this study was to compare invasive and noninvasive blood pressure in these patients.
Methods: In a prospective, cross-sectional, observational study, 42 hemodynamically stable patients candidate for esophagectomy under general anesthesia in supine position were evaluated at Urmia Imam Khomeini Hospital operating room from June 2017 to April 2018. The patients had American Society of Anesthesiologists (ASA) physical status II or III and the patients who had complete heart block and marked arterial blood pressure differences greater than 10 mmHg in the two arms were excluded. After induction of anesthesia and patients monitoring, the radial artery was cannulated for invasive blood pressure monitoring and noninvasive blood pressure was measured via the arm cuff on the other hand at the four-time intervals: after radial artery cannulation (T1), during release of esophagus (T2), during anastomosis (T3) and at the end of operation (T4).
Results: The mean difference between indirect and direct systolic blood pressure was 0.85±2.93, -8.42±2.9, 6.50±3.60 and 2.67±2.6 mmHg and for diastolic blood pressure was 3.53±2.67, 4.57±2.22, 2.10±2.58 and 1.03±1.53 mmHg respectively, at the T1 to T4. At the all-time intervals, there were no statistically differences between systolic and diastolic blood pressure measurement regarding invasive and noninvasive blood pressure (P=0.77)
Conclusion: Noninvasive arterial blood pressure showed acceptable agreement with invasive measurements for systolic, diastolic and mean pressure. According to fhe finding of this study, there were no statistical differences between systolic and diastolic blood pressure measurement regarding invasive and noninvasive blood pressure and these two methods can be used in selected patients.
Methods: In a prospective, cross-sectional, observational study, 42 hemodynamically stable patients candidate for esophagectomy under general anesthesia in supine position were evaluated at Urmia Imam Khomeini Hospital operating room from June 2017 to April 2018. The patients had American Society of Anesthesiologists (ASA) physical status II or III and the patients who had complete heart block and marked arterial blood pressure differences greater than 10 mmHg in the two arms were excluded. After induction of anesthesia and patients monitoring, the radial artery was cannulated for invasive blood pressure monitoring and noninvasive blood pressure was measured via the arm cuff on the other hand at the four-time intervals: after radial artery cannulation (T1), during release of esophagus (T2), during anastomosis (T3) and at the end of operation (T4).
Results: The mean difference between indirect and direct systolic blood pressure was 0.85±2.93, -8.42±2.9, 6.50±3.60 and 2.67±2.6 mmHg and for diastolic blood pressure was 3.53±2.67, 4.57±2.22, 2.10±2.58 and 1.03±1.53 mmHg respectively, at the T1 to T4. At the all-time intervals, there were no statistically differences between systolic and diastolic blood pressure measurement regarding invasive and noninvasive blood pressure (P=0.77)
Conclusion: Noninvasive arterial blood pressure showed acceptable agreement with invasive measurements for systolic, diastolic and mean pressure. According to fhe finding of this study, there were no statistical differences between systolic and diastolic blood pressure measurement regarding invasive and noninvasive blood pressure and these two methods can be used in selected patients.
Fatemeh Nasimi , Hossein Zeraati , Javad Shahinfar , Mohammadreza Safdari , Ali Esmaeili , Maryam Ghorbanzadeh ,
Volume 78, Issue 2 (5-2020)
Volume 78, Issue 2 (5-2020)
Abstract
Background: Premature infants undergo a lot of stressors during treatment procedures in the neonatal intensive care units which causes significant physiological changes in these neonates. Multi-sensory stimulation is a broad category of interventions designed to improve the evolutionary and physiological outcomes of premature infants hospitalized in the neonatal intensive care unit to minimize stress in this environment. So, the study aimed to evaluate the effect of multi-sensory stimulation on physiological parameters in preterm infants.
Methods: This double-blind clinical trial conducted in the neonatal intensive care unit of Shahid Motahari Hospital in Jahrom from April to December 2016. In this study, 80 preterm infants with a gestational age of 34 to 36 weeks were selected by non-probability sampling method and were randomly divided into two groups of multi-sensory stimulation and control. Neonates in the intervention group received a multi-sensory stimulation program for 60 minute. The multi-sensory stimulation program was included a combination of auditory, tactile, motor and visual stimulation. The preterm infants in the control group received only usual care. The data collecting tool was a questionnaire and checklist for physiological parameters of preterm infants.
Results: The results showed that the two groups were homogeneous in terms of fetal age, birth weight, the height of birth, first and fifth minute Apgar score of birth. The results showed that there was no significant difference between the mean of physiological indexes in the two groups before the intervention. Statistical tests showed that there was a decreasing trend in the average of all physiological indices during the intervention (first and second half during the intervention) (P<0.001), However, these changes were not significant in the control group (P<0.05). Also, analysis of variance (ANOVA) with repeated measures showed that there was a significant difference between changes in physiological variables between the two groups at different stages of evaluation (P<0.001).
Conclusion: Multi-sensory stimulation leads to a decrease in heart rate and respiratory rate and the stability of blood pressure in preterm infants.
Methods: This double-blind clinical trial conducted in the neonatal intensive care unit of Shahid Motahari Hospital in Jahrom from April to December 2016. In this study, 80 preterm infants with a gestational age of 34 to 36 weeks were selected by non-probability sampling method and were randomly divided into two groups of multi-sensory stimulation and control. Neonates in the intervention group received a multi-sensory stimulation program for 60 minute. The multi-sensory stimulation program was included a combination of auditory, tactile, motor and visual stimulation. The preterm infants in the control group received only usual care. The data collecting tool was a questionnaire and checklist for physiological parameters of preterm infants.
Results: The results showed that the two groups were homogeneous in terms of fetal age, birth weight, the height of birth, first and fifth minute Apgar score of birth. The results showed that there was no significant difference between the mean of physiological indexes in the two groups before the intervention. Statistical tests showed that there was a decreasing trend in the average of all physiological indices during the intervention (first and second half during the intervention) (P<0.001), However, these changes were not significant in the control group (P<0.05). Also, analysis of variance (ANOVA) with repeated measures showed that there was a significant difference between changes in physiological variables between the two groups at different stages of evaluation (P<0.001).
Conclusion: Multi-sensory stimulation leads to a decrease in heart rate and respiratory rate and the stability of blood pressure in preterm infants.
Salman Daliri, Mohammad Khanbeigi, Reza Heidary Moghadam , Parisa Asadollahi, Khairollah Asadollahi,
Volume 79, Issue 8 (11-2021)
Volume 79, Issue 8 (11-2021)
Abstract
Background: Pulse pressure has recently been considered as a predictor of coronary heart disease. The difference between systolic and diastolic blood pressure is called pulse pressure. Various factors including increased age, vascular stiffness, stenosis, and hypertension are associated with pulse pressure. The present study, therefore, aimed to investigate the relationship between some cardiovascular function indicators such as vascular stenosis, blood pressure and cardiac output with pulse pressure as a predictor of cardiovascular diseases.
Methods: This case-control study was performed on 544 patients who were referred to Imam Ali Hospital in Kermanshah, Iran, from March 2015 to February 2016. In this study, according to the angiographic findings, individuals with artery stenosis were considered as the case group (n=272) and those without artery stenosis were considered as the control group (n=272). Statistical analysis was performed using descriptive statistics, Chi-square and odds ratio estimation by SPSS22 software.
Methods: This case-control study was performed on 544 patients who were referred to Imam Ali Hospital in Kermanshah, Iran, from March 2015 to February 2016. In this study, according to the angiographic findings, individuals with artery stenosis were considered as the case group (n=272) and those without artery stenosis were considered as the control group (n=272). Statistical analysis was performed using descriptive statistics, Chi-square and odds ratio estimation by SPSS22 software.
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Results: According to the findings of this study, ages over 50 (OR: 3.3, 95% CI: 2.1-5.2), high systolic blood pressure (OR: 8, 95% CI: 4.3-15.2), high diastolic blood pressure (OR: 4.9, 95% CI: 2.0-11.7), cardiac output less than 50% (OR: 1.8%, 95% CI: 1.3-2.7) and vascular stenosis (OR: 3.5, 95% CI: 2.4-5.1) were associated with high pulse pressure. The male gender had a preventive role in increasing of pulse pressure (OR: 0.7, 95% CI: 0.5-0.9). A significant relationship was demonstrated between systolic blood pressure and pulse pressure (P<0.0001).
Conclusion: Based on the findings of the present study, the chances of having high pulse pressure are high among individuals over 50 years of age, female gender, those with elevated systolic and diastolic blood pressure, and individuals with high coronary artery stenosis. This chance is associated with decreased cardiac output and coronary stenosis. Increased pulse pressure is a predictive indicator of cardiovascular disease and it is recommended that pulse pressure measurements of all referrals, especially those who are being referred to cardiology clinics, are taken into account by medical professionals to prevent adverse clinical outcomes. |
Parisa Zakeri, Masoud Amini, Ashraf Aminorroaya, Fahimeh Haghighatdoost, Awat Feizi,
Volume 79, Issue 9 (12-2021)
Volume 79, Issue 9 (12-2021)
Abstract
Background: Examining the course of changes in predictive indicators of future diabetes, such as blood sugar in high-risk individuals including pre-diabetic patients, can provide valuable information about the incidence of diabetes in these individuals. This study aimed to classify people at risk (pre-diabetes) based on the course of changes in their blood sugar and blood lipid and to investigate the incidence of diabetes in these classes on a sample of patients who were referred to the Endocrine and Metabolism Research Center of Isfahan.
Methods: This cohort study was performed based on the information of the Isfahan Diabetes Prevention Plan (IDPs). This project was implemented from April 2004 to March 2018 in the clinics of the Endocrine and Metabolism Research Center of Isfahan. The subjects in this study include 1228 pre-diabetic patients who participated in this project. Demographic and clinical variables of patients including blood sugar and lipid-blood variables were obtained using a questionnaire and laboratory measurements. Also in this study, the number of clinical variables was recorded 3 times. Data analysis was performed using the latent class growth trees model in R software version v4. (R v4.1.0)
Methods: This cohort study was performed based on the information of the Isfahan Diabetes Prevention Plan (IDPs). This project was implemented from April 2004 to March 2018 in the clinics of the Endocrine and Metabolism Research Center of Isfahan. The subjects in this study include 1228 pre-diabetic patients who participated in this project. Demographic and clinical variables of patients including blood sugar and lipid-blood variables were obtained using a questionnaire and laboratory measurements. Also in this study, the number of clinical variables was recorded 3 times. Data analysis was performed using the latent class growth trees model in R software version v4. (R v4.1.0)
| Results: The mean (standard deviation) age of participants was 44 (6.86) years. Subjects were classified into two classes of low-risk impaired blood sugar (n=1165) and high-risk impaired blood sugar (n=63) based on the trend of changes in blood sugar levels. Blood sugar levels were reported in the first class (104.28) and the second class (132.41). Conclusion: In the present study, it was concluded that there is a significant relationship between the incidence of diabetes and the different classes formed based on the course of changes in blood sugar of at-risk individuals. Therefore, by classifying people at risk, the incidence of this disease can be predicted and thus prevented. Also,measures such as managing the blood sugar and lifestyle variables of pre-diabetic patients through nutrition counseling classes and regular periodic tests can be used to reduce the incidence of diabetes in the future is used in people with pre-diabetes who are at high risk for the disease. |
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Monireh Hosseini, Zahra Manouchehri ,
Volume 79, Issue 12 (3-2022)
Volume 79, Issue 12 (3-2022)
Abstract
Background: Fluctuations in blood pressure after induction of general anesthesia have played a significant role in complications of surgery. Therefore, the present study was performed by identifying the causes of blood pressure fluctuations after induction of anesthesia, predicting and preventing them.
Methods: For this study which is a retrospective cohort, data mining methods in the data set including the information related to 3150 patients who underwent anesthesia and surgery from April 2018 to September 2019 in Imam Khomeini Hospital in Kermanshah were used. The data set included patients aged 18 years and older (age range of 18 to 96) who underwent a general anesthesia induction test using Propofol and subsequently endotracheal intubation for non-cardiac surgery. If patients did not have intubation, data were missing, or patients underwent intubation after repeated trials, they got excluded. In total, 2640 patients were included in this analysis. Preoperative patient clinical information was collected from pre-anesthesia evaluation records. Intraoperative data were obtained from computer anesthesia records. This data from the patient monitoring system and the anesthesia machine was automatically stored in the anesthesia files, while drug doses and anesthesia techniques were recorded manually. The data were then pre-processed using SPSS software, version 26 (IBM SPSS, Armonk, NY, USA).
Methods: For this study which is a retrospective cohort, data mining methods in the data set including the information related to 3150 patients who underwent anesthesia and surgery from April 2018 to September 2019 in Imam Khomeini Hospital in Kermanshah were used. The data set included patients aged 18 years and older (age range of 18 to 96) who underwent a general anesthesia induction test using Propofol and subsequently endotracheal intubation for non-cardiac surgery. If patients did not have intubation, data were missing, or patients underwent intubation after repeated trials, they got excluded. In total, 2640 patients were included in this analysis. Preoperative patient clinical information was collected from pre-anesthesia evaluation records. Intraoperative data were obtained from computer anesthesia records. This data from the patient monitoring system and the anesthesia machine was automatically stored in the anesthesia files, while drug doses and anesthesia techniques were recorded manually. The data were then pre-processed using SPSS software, version 26 (IBM SPSS, Armonk, NY, USA).
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Results: In this study, 53 features of patients' records were used (The maximum number of features used in previous studies were 48 features, which compared to them, 5 new features were included in the study) for which a P-value was calculated. Finally, features with a P<0.05 (Indicates the level of significance of the variable) were selected. Then, three data mining algorithms, logistic regression, neural networks and decision tree (the most repetitive data mining algorithms based on previous studies) were used to predict blood pressure. Also, using the criteria of accuracy, precision, sensitivity and F function, the performance of three prediction algorithms in data mining was evaluated.
Conclusion: Six features with P<0.05 were selected that the logistic regression model was more accurate, which was presented as the final model for predicting increased blood pressure fluctuations with path coefficients. |
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