Search

"n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Coronary artery anomalies may be seen in 1-5% of coronary angiographies. Origin of the left coronary artery from right aortic cusp is a very rare anomaly and its incidence is about 0.15%. This anomaly could be presented by myocardial ischemia and even sudden cardiac death during exercise in young patients. For the diagnosis of coronary anomalies different diagnostic modalities such as, echocardiography, angiography and CT angiography can be helpful."n"nCases: We report 3 cases with this anomaly and two of them did not have any lesion in their coronary arteries One of these patients had severe coronary artery disease and underwent coronary artery bypass graft surgery."n"nConclusion: Although abnormal origin of left coronary artery from right aortic valsalva sinus is a rare anomaly, due to causing ischemic cardiac symptoms and the possibility of sudden cardiac death it is considered an important anomaly. For definite diagnosis of this anomaly coronary angiography and/or CT angiography is useful.

Due to the increase in the average age and metabolic diseases in the Iranian population, an increase in the prevalence of atherosclerotic aortic valve stenosis is expected. In severe and symptomatic cases of this disease, if the valve is not replaced, the death rate increases by 50% with every two years of age. Non-invasive intervention of aortic valve implantation through catheter (TAVI) is suitable for patients in whom open heart surgery is impossible or associated with high risk. Despite the widespread use of the TAVI method around the world and in some medical centers of the country, until now this method has not been started and performed in the Mazandaran Heart Center, a specialized and sub-specialized referral center for cardiovascular patients in Mazandaran province and other parts of the north of the country; Also, provision of a 3D esophageal echocardiography device is necessary as a basic prerequisite. In this policy brief, evidence-based solutions in this field and the challenges ahead have been proposed and presented to policymakers and managers in the field of cardiovascular health by the researchers of the Cardiovascular Research Center of Mazandaran University of Medical Sciences. Therefore, the officials pay sufficient attention to the necessity of equipping the Mazandaran heart center with a 3D transesophageal echocardiography device and funding it, providing physical facilities including a dedicated operating room and training facilities to form a specialized team skilled in TAVI procedure and insurance coverage for this Service is emphasized.

Background and Aim: Core needle biopsy (CNB) is less invasive and has fewer side effects compared to surgical procedures, and provides accurate information about the nature of the tumor. The aim of this study was to evaluate the efficacy of CNB in the diagnosis of the cause of lymphadenopathy. Materials and Methods: In this study, 153 patients with lymphadenopathy underwent CNB from 2014 to 2018. Immunohistochemistry staining with appropriate markers was performed. Excisional biopsy, clinical and radiological data were evaluated using spss-21 softwere, data were analyzed by one way ANOVA and tukey test (p

BACKGROUND AND OBJECTIVE: Recently, the efficiency of thyroid fine needle aspiration (FNA) as a method of choice in evaluation and management of thyroid nodules has been questioned. The aim of this study was to determine the diagnostic value of FNA as compared to pathology results in diagnosis of thyroid nodules in Shahid Behashti Hospital of Babol, Iran, within 22 years. METHODS: This cross-sectional study was performed on cytology samples of 225 patients who were undergoing thyroidectomy at Shahid Beheshti Hospital of Babol during 1990-2012. Patients’ age and gender, physician's experience in performing FNA, type and location of surgery, FNA samples and pathology results were recorded. According to the pathology reports, FNA results were divided into four groups i.e. inadequate, benign, malignant and suspicious. The pathology results were divided into benign and malignant groups. The results of both methods were compared with each other. FINDINGS: The sensitivity and specificity of FNA in diagnosis of thyroid nodules were 60% and 96%, respectively. Also, its positive and negative predictive values and diagnostic accuracy were 65%, 95% and 81.8%, respectively. Among the 225 cytology samples, 127 (56.7%), 47 (20.9%), 27 (12%) and 24 (10.7%) were benign, suspicious, malignant, and inadequate, respectively. Additionally, pathology results were benign and malignant in 150 (66.7%) and 75 (33.3%) patients, respectively. CONCLUSION: FNA was comparatively effective in diagnosis of thyroid nodules.

Thyroid hormones play an important role in the growth and function of the kidneys. Hypothyroidism has known role in kidney filtration system disorders. We reported hypothyriod patients with nephrotic syndrome recruited by hypothyroidism treatment. Although hypothyroidism coincidence with nephrotic syndrome has been recognized but often is missed in regard with nephrotic syndrome.

BACKGROUND AND OBJECTIVE: Stent fracture (SF), in peripheral vessels and although in coronary arteries has been reported. Very late and after one year stent thrombosis in drug eluting stent (DES) is a rare phenomenon and its most frequent cause is discontinuation of clopidogrel. Considering SF and stent thrombosis occurring together could result in lethal cardiac events its recognition has considerable importance. This report presents a case of stent fracture and very late stent thrombosis.CASE: In this report a 59-year-old male patient was presented for whom coronary angiography and angioplasty were performed. We put a stent for him. While he was in good condition until 15 months after angioplasty, he was suddenly presented with chest pain and cardiac arrest and was admitted in the hospital. His life was saved with DC shock. Repeat coronary angiography was performed for him which showed SF accompanied by thrombosis as the cause of acute myocardial infarction.CONCLUSION: Stent thrombosis may occur lately after DES and although it is rare, one of its causes is SF and the clinical presentation is usually dangerous and lethal.

BACKGROUND AND OBJECTIVE: Changes in the copper (Cu) and zinc (Zn) concentrations have been reported previously in ischemic cardiomyopathy (ICMP). Due to controversial results, the aim of this study was to determine the Cu and Zn concentrations of ISCMP and to evaluate the probable role of these elements in patients with ICMP.METHODS: This case-control study was conducted on 30 ICMP patients and 27 healthy volunteers. ICMP was diagnosed with a history of myocardial infarction and also vascular diseases confirmed by angiography. Exclusion criteria were renal or hepatic insufficiency, alcohol usage and intake of supplements containing Cu or Zn within one week ago. 15 ml of vein blood has been taken from patients and healthy volunteers. Samples were centrifuged, and separated serums were kept at 20 oC. Cu and Zn levels were assayed with atomic absorption spectrophotometry. T-test was used to compare the levels of Cu and Zn between ICMP and normal subjects. FINDINGS: The mean Cu level of ISCMP group (1.5±0.5 mg/Lit) was significantly more than Cu levels of healthy volunteers (1.3±0.2 mg/Lit) (p= 0.048). The mean Zn levels for ISCMP and healthy volunteers were 1.1±0.3 mg/Lit, and 1.1±0.4 mg/Lit, respectively, that no significant difference was seen. CONCLUSION: Considering the results of this study, Cu may have a role in the development of ICMP. Interventions such as administration of Cu chelators to relieve the symptoms or to decrease the progress of ISCMP would need to be examined in large clinical trials. This study indicated that Zn may not have any role in the development of ICMP.

Background and Objective: Diurnal variation in the onset of acute myocardial infarction with a peak in the morning has been demonstrated. Few data are available concerning about the left ventricular systolic dysfunction according to the infarct time. Regarding importance of onset of heart failure following acute myocardial infarction, this study was done to survey the effect of the time of acute myocardial infarction on left ventricular systolic dysfunction. Methods: This prospective study was performed on 100 patients with acute myocardial infarction (AMI). Left ventricular systolic dysfunction (LVSD) was defined by echocardiography when ejection fraction (EF) was less than 55%. Findings: Of these patients, 72 had EF

Objective: Congestive heart failure and other cardiac complications are the most important causes of death in patients with beta Thalassemia major. Iron overloads and chronic anemia are the major causes of cardiac involvement. The purpose of this study was to evaluate the ability of echocardiographic systolic function for diagnosis of cardiac involvement in patients with Thalassemia major. Methods: This descriptive study was done on patients with Thalassemia major (Over 12 years old) who referred to Booali Sina hospital in Sari. They were evaluated according to their ages, sex, age at beginning of transfusion of deferoxamine, the amount of deferoxamine, serum ferritin level, clinical manifestations, electrocardiogram, chest radiography and echocardiographic systolic function. Data was statistically analyzed by T-test. Findings: 55% of patients were male and the average age was 18±6 years. 22% of patients had systolic dysfunction. The difference of ejection fraction and fractional shortening between patients with and without cardiac involvement was significant (p

Background and purpose: Annually heart failure includes about three million emergency outpatient visits in the United States. In heart failure NT-proBNP will be released in response to increased myocardial stretch Materials and methods: This study was conducted in 80 individuals attending Fatemeh Zahra Hospital, in Sari, 2010-2011. Patients with GFR≤60, age≥75, atrial fibrillation (AF) and hypertension (BP≥160.100) were excluded. The patients were carefully examined and 60 patients with DHF were divided into three groups; Group1 LVEF≤30%, group 2 LVEF≤31-39%, group 3 LVEF≤40-49%. Twenty healthy people with normal LVEF≥50% were also studied to determine the cut point. Results: The highest level of NT-pro BNP was observed in group 1 (5370.10 ± 1781.90) and the lowest level was seen in group 4 (36.75 ± 24.32). Significant differences were found between the groups in NT-pro BNP level (P<0.001). Also, incomplete and reverse correlation was observed between LVEF values and serum level NT-pro BNP (R= -0.699). Conclusion: When LVEF reduced NT-pro BNP levels increased significantly which indicates an incomplete and reverse correlation between them. This finding allows using NT-pro BNP level for approximate estimation of ejection fraction in clinical practices. [ABSTRACT FROM AUTHOR]

Building RCC dams involves pouring and compacting concrete in small layers (30 cm), one on top of another, creating a joint between each layer. This joint could potentially become the “ideal” joint depending on the temperature and lag time between each layer. To check the concrete s temperature using smart sensor is undeniable. Furthermore we use these sensors for RCC dam’s structural health monitoring. The objective of this paper is to introduce a novel model for arranging the smart sensors for RCC dam’s structural health monitoring .The authors suggest a flow chart and prove it with a real case study. This is useful for RCC dams all around the world. The case study is Zirdan RCC dam (located in Iran), and the verification is upon Kinta RCC dam (raised in Malaysia). Step 1, the Zirdan dam is modeled in Abaqus . The program outputs give the actual temperature, the thermal stresses of each node. Step 2,The ANN (Artificial neural network) converts discontinuous results in a continuous estate. Step 2, we use the Monte Carlo to achieve a point in each layer, representative of others. the chosen coordinates are fed into GA (genetic algorithm). Next, we define the parameter of importance coefficient as the temperature arrived from the site divided by the model temperature. finally, assimilating it with cost function will allow for having fewer sensors and sensors being placed further apart. All of the above result in the optimum placement of the thermal sensors in RCC dams.

Background and purpose: Social support is an important feature that can play a major role in creating, maintaining, and promoting health in addition to neutralizing and influencing stressors. Therefore, social factors affecting health are of great importance. This study aimed at investigating the correlation between social support and lifestyle components in patients with myocardial infarction. Materials and methods: We performed a descriptive/analytical cross-sectional study in patients (n=176) with myocardial infarction in 2019. Patients were selected by purposive and convenience sampling. The Health Promoting Lifestyle Profile-II (HPLP-II) and Social Support Appraisals Scale (SS-A) were administered and data were collected via direct interviews and patients’ records. Results: The mean scores for social support and lifestyle were 18.32 ± 0.31 and 147.47 ±7.01, respectively. The study showed that social support was significantly associated with physical activity (r = 0.31, P

Background and purpose: Contrast-induced nephropathy (CIN) as a common complication of administration of contrast media (CM) is a major source of hospital morbidity and mortality. The aim of this study was to determine the incidence of CIN after contrast-enhanced CT scan and identifying the related risk factors. Materials and methods: A cross-sectional study was carried out in 100 patients attending Sari Imam Khomeini Hospital who underwent contrast-enhanced CT scan in 2016. Predictors of CIN were evaluated in four general categories, including demographic variables, underlying diseases, concomitant medications, and laboratory findings. Data were analyzed in SPSS V20. Results: In this study, increase in the concentration baseline serum creatinine of more than 25% or 0.5 mg/dl within 48 hours after the injection of contrast material was considered as an indicator of the incidence of CIN. Accordingly, the incidence rate was 7%. The incidence of CIN was significantly different in patients with and without hypertension (P= 0.028) and patients taking angiotensin II receptor blocking drugs (ARBs) (P= 0.019). Compared to creatinine, BUN and eGFR were both observed to be more accurate in predicting the incidence of CIN. BUN was found to have higher sensitivity and lower specificity while eGFR showed higher specificity and lower sensitivity. Conclusion: In addition to hypertension and the use of ARBs as the major risk factors for the incidence of CIN, BUN was observed to be a better predictor for CIN than eGFR. Higher Efficacy of BUN could have been due to its larger size and therefore fewer laboratory errors.

Background and purpose: Coronary artery disease is a major cause of death and disability in any society. The aim of this research was to evaluate the factors causing delay in admission of patients who need cardiac care. Materials and methods: In this descriptive analytic study, we used the files of patients attending a heart hospital affiliated with Mazandaran University of Medical sciences within 6 months (March-September 2015). Data analyses were done applying Quantile regression in STATA V13 and SPSS V20. Results: from 401 patients, 59.35% referred to hospital within the first 3 hours after imitation of pain, while 20.45% and 20.2% attended the hospital after 3 hours and 6 hours following the onset of pain, respectively. The average hospitalization waiting time was 238 min (almost 4 hr). Our results showed that waiting time was lower for male patients, people with higher education, those with health insurance, individuals with history of cardiac diseases, married cases and urban patients. These variables had significantly affected the hospitalization waiting time (P

, 1 2 (Received 11 January, 2009 ; Accepted 22 July, 2009)AbstractBackground and purpose: Considering some restrictions of serum low density lipoprotein (LDL) as a marker for Coronary Artery Disease (CAD) risk factor and also the importance of apo B as a signinificant risk factor for CAD, measurement of non-HDL cholesterol has great value as a risk factor for CAD. Non-HDL cholesterol (total cholesterol minus HDL cholesterol) contains all lipoproteins including apo-lipoproteins.Materials and methods: In this study, 200 hospitalized patients (100 men and 100 women) with the diagnosis of CAD, documented by coronary angiography and 100 persons with normal angiography were recruited as case and control groups, respectively. Non-HDL cholesterol non-HDL-c was compared with LDL- cholesterol as a risk factor for CAD.Results: Measured levels of triglyceride, total cholesterol, lipoprotein atherogenic a (Lpa) and non-HDL-c were significantly higher than those in control group. HDL level was lower in patients group. Correlation analysis showed that non-HDL-c (and not LDL cholesterol) had a higher reverse correlation Triglyceride level.Conclusion: Measurement of non-HDL-c could be a good marker in atherogenic lipoproteins. Furthermore, due to potential power of its other atherogenic lipoproteins, it cannot be measured by LDL alone.J Mazand Univ Med Sci 2009; 19(71): 80-83 (Persian)

(Received 29 Sep, 2008 ; Accepted 14 Feb, 2009)AbstractStent thrombosis as a complication of percutaneous coronary intervention frequently is associated with deadly events such as myocardial infarction and sudden death.Definitions of stent thrombosis have not been in a uniform manner in different clinical studies.Two episodes of acute ST elevation myocardial infarction nearly two years after implanting a drug – eluting stent in a 58-year-old male patient is reported here .The presence of stent thrombosis was confirmed by coronary angiography.

(Received 19 Nov, 2008; Accepted 28 Jan, 2009)AbstractBackground and purpose: Prevalence of over weight and obesity is increasing in the world. Those over weight are more susceptible to cardiovascular diseases than other individual's. Studies indicate that body fat distribution has a determining role in the identification of risk factors. Also, the relation between BMI, cardiac ischemic pains and exercise test condition in such patients, is in need further investigation. The aim of this study was to determine the relation between BMI with exercise tolerance test in patients with cardiac ischemic pains, who were referred to the Cardiac Center of Mazandaran Province, in Sari Township.Materials and methods: In this case control study considering the BMI in ischemic patients, 65 were selected as case and 65 persons as control using Tread mill and according to Bruce Protocol, results and tolerance test time was recorded. Independent T test was used for comparison of quantitative indexes mean, while x2 test using SPSS soft ware was used for comparison of the ratio of persons with the qualitative features.Results: Data indicated mean weight of 57.1 kg and height of 1.64m in the case group. Also, 58.5% had history of hyperlipidemia (Cholesterol higher than 200mg/dl) and 78.8% with history of blood sugar (higher than 120mg/dl (P

AbstractBackground and purpose: Pleural effusion is a common finding in many pulmonary or extrapulmonary diseases and its analysis is essential for differentiating transudates from exudates. Light's criteria is questioned by some researchers and measuring of cholesterol in pleural effusion is proposed due to its simplicity and low cost. This study evaluates the diagnostic value of pleural fluid cholesterol for differentiating transudates from exudates.Materials and Methods: In this prospective study, 70 cases of pleural effusion with definite diagnosis according to clinical gold standards were included and cholestrol, LDH and protein in pleural effusion and simultaneous in blood serum were measured. Pleural cholesterol alone, and its ratio with serum cholesterol, pleural-LDH and its ratio with, serum-LDH, pleural protein and its ratio with serum protein, combination of pleural Cholestrol + LDH were compared with Light,s criteria.Results: Sensitivity and specificity of pleural cholesterol was 85% and 100% , respectively with 90% efficiency, pleural/serum cholesterol showed a sensitivity of 87% , specificity of 95% , with 90% efficiency. Lights,s criteria gave a sensitivity of 87%, specificity 79%, with 91% efficiency. Combination of Pleural + pleural/serum cholesterol showed sensitivity of 87% , specificity of 100% , with 90% efficiency and for Pleural-LDH + pleural-cholesterol sensitivity, specificity and efficiency were 97% , 83% and 92% respectively.Conclusion: The use of pleural fluid cholesterol is useful as Light,s criteria for distinguishing pleural transudates from exudates but not superior. Combination of pleural fluid cholesterol and LDH slightly improves the specifity and efficiency of differentiation. The advantage of cholesterol measuring is its simplicity, low price and that it can be used along with routine diagnostic pleural effusion tests.

Background and purpose: Beside the environmental determinants there are major genetic factors that could cause Myocardial Infarction (MI). The aim of this study was to clarify the relationship between factor V Leiden and prothrombin G20210A with acute MI in patients younger than 50 years of age. Materials and methods: In this case-control study we recruited 101 MI patients and 101 healthy individuals in Fatemeh Zahra Hospital, affiliated to Mazandaran University of Medical Sciences. Demographic information and risk factors including age, past history of MI, diabetes mellitus, hypertension, dyslipidemia, and smoking were recorded. Genes of factor V Leiden and prothrombin G20210A were analyzed using PCR- RFLP method. Results: Among all subjects, 191 (94.55%) had no factor V Leiden gene, 10 (4.95 %) were heterozygous, and one (0.49%) was homozygous. In case group, and control group there were seven (6.9%) and three (2.97%) heterozygous for factor V Leiden, respectively (P= 0.27). There was no mutation of prothrombin G20210A gene in 197 (97.5%) individuals and only five (2.5%) were heterozygous. There was no statistically significant difference between the two groups (P= 0.17). Conclusion: The prevalence of factor V Leiden and prothrombin G20210A gene mutation, in patients was not significantly different from that of the normal individuals. However, further studies are recommended in this age group to investigate these factors. [ABSTRACT FROM AUTHOR]