ABSTRACT
Background: Chronic wounds are a serious problem for the patient and can increase the socioeconomic burden on the healthcare system and community. This study aimed at investigating the effect of angioplasty on chronic ischemic wound healing
Methods: This study was conducted in Sina Hospital, affiliated to Tehran University of Medical Sciences. Thirty-eight patients with chronic ischemic wounds and a suspicion of the narrowing or blockage of arteries underwent peripheral angiography. Arteries under angioplasty in different patients comprised the aorta and the iliac, superficial femoral, popliteal, and tibial arteries. The patients were evaluated in terms of wound healing in weekly and monthly visits. Wound healing was measured based on the Bates-Jensen criteria
Results: The patients were followed up at a median of 4.5 months. The mean age of the patients was 61.1 +/- 7.5 years. Of 38 patients, 12 [31.6%] were female. The involvement of arteries on angiography consisted of 16 [42.2%] cases of total occlusion and 22 [57.8%] cases of stenosis. Following angioplasty, the level of the narrowing of arteries and the wound score showed a significant reduction in all the patients [p value < 0.001]. Wound healing was observed in 29 [76.3%] patients. Hematoma, pseudoaneurysm, and thrombosis comprised the complications. No significant differences were observed in terms of age, gender, and history of risk factors between the 2 groups of wound healing and nonhealing. The wound evaluation scores before [p value = 0.044] and after [p value < 0.001] angioplasty were lower in the wound healing group than in the nonhealing group
Conclusion: Angioplasty of the aorta and lower limb arteries improved the healing of chronic ischemic wounds in our patients
ABSTRACT
The lack of a proper sewage collection and disposal system, the water and sewerage project, in the city of Rasht, became a priority by Guilan province Urban Water and Sewerage Company with the government partnership and World Bank financial support. The objective of this research was to complete the first phase of a two-phase study, to determine the impact of using an urban sewerage system on acute diarrhea in children under five years old, in Rasht city in the Guilan province. The study is a concurrent control before and after field trial which is carried out in two phases: before [phase I] and after [phase II]. Sampling for phase I was performed in the middle month of each season, November and February 2009 and May and August 2010. The incidence of acute Diarrhea was measured with the participation of 1560 mothers of children under 5 years old. This was done in two groups: the intervention group [inside the sewerage system project perimeters] and the control group [outside the project perimeters]. Data was collected by local female general practitioners and medical students by doorto- door interviews with mothers. Data was analyzed using the SPSS 11.5 software package. The Pearson Chi-Square was used to compare qualitative variables between groups, whilst the t-test and One-Way ANOVA was used to compare quantitative variables. The average annual incidence of acute diarrhea in children under five years old was 10.4% [9.4% in the intervention group and 11.4% in the control group]. The seasonal pattern of acute diarrhea incidence was 10.5% [9.3% in the intervention group and 11.7% in the control group] in May, 12.5% [11.5% in the intervention group and 13.4% in the control group] in August, 9.3% [8.1% in the intervention group and 10.5% in the control group] in November, and 9.1% [8.5% in the intervention group and 9.8% in the control group] in February respectively. The study showed the incidence of acute diarrhea in children under five years old in Rasht city is moderate and it follows a seasonal pattern. The highest rate was seen in summer and the lowest rate in winter. It is expected to decrease with the initiation of the sewerage system program