[ Comparison of clinical signs and symptoms presentation in men and women with myocardial infarction attending in Mashhad hospitals of Imam Reza and Ghaem]

Myocardial infarction is the leading cause of death in Iran and the world. Differences in signs and symptoms sometimes delay the diagnosis. This study aims at comparing clinical signs and symptoms of acute myocardial infarction in men and women. This analytic - descriptive research was carried out on 110 patients [36 women and 74 men] with MI experience who referring in emergency wards of Imam Reza [PBUH] and Ghaem hospitals. The subjects were selected randomly sampling. Data were collected from sample forms, individual information forms; the pain characteristics record forms, electrocardiogram and laboratory forms, pain numerical rating scale, Mc-Melzac pain questioner and electrocardiogram machine. The results showed that Chest pain was the most common initial symptom in both men and women so that 77% of women and 89% of men complained of chest pain. Intensity of infarction angina in women was more rigorous than men [P=0.04] .Quality of pain described as sharp pain by most women and burning pain by men [P=0.01]. Concerning accompanying signs, 63% of women and 75%, 55%of men reported sweat and nausea respectively which was not significant difference [P= 0.1].For other symptom [shortness of breath] chi square showed significant difference [P=0.03]. Pain was reported to spread to back and left shoulder in most women and to left shoulder in most men. findings showed that women who have MI are different on comparing by men from view of intensity, quality and location of pain.

Exploring the needs and perceptions of Iranian families faced with brain death news and request to donate organ: a qualitative study

Learning that one of your beloved ones is passing away and you have to decide on organ donation is a very stressful experience. To explore the specific needs of families with a brain-dead patient during organ donation process. A qualitative research using content analysis was used to obtain data from 26 purposely selected families in a transplantation center in Mashhad, northeastern Iran, regarding how they would face organ donation decisions. Data saturation was reached after 38 unstructured in-depth interviews and field notes, once data was transcribed and tabulated. Four major themes emerged as 1] family needs for emotional support, 2] empathy and compassion, 3] team efforts to assure family, and 4] shouldering grief. Study results highlighted the essential need for an expert team with specialized training to help families in despair deciding in favor or against organ donation. Moreover, discovering and explaining these specific needs help policy makers and administrators to plan interventions in relation to conditionbuilding to facilitate safe passing of the families through this difficult situation

Studying the effect of entonox gas on the APGAR of the neonates

Delivery is one of the greatest events in the life of a pregnant woman. Although it is considered to be a natural phenomenon, it is potentially dangerous. Entonox gas used for pain relief and is reasonably effective in labor analgesic practice. The purpose of this study was to compare the APGAR score of the neonates were born to mothers who treated with entonox gas with those who their mothers did not received this gas. In this semi-experimental study, 270 pregnant women hospitalized at the labor ward of Shahidan Mobini Hospital of Sabzavar were included using simple available sampling method. They were then separated into two groups, case and control, based on their specifications. The data gathering tool for this study was a questionnaire of [investigating the effect of entonox gas as a no-pain labor agent on Neonates' APGAR] which is individually filled out for each patient by obstetrician colleagues. The APGAR scores of infants were recorded at 1[st], 5[th], and 20[th] minutes. The statistical analysis of data was performed by t-test, Chi-Square and Fisher tests using SPSS software. That there were no significant differences between the two groups in terms of age, pregnancy period, and using labor induction. The APGAR scores of the case group at 1[st], 5[th], and 20[th] minutes postpartum were significantly higher than the control group [p< 0.05]. Regarding the importance of controlling pain during delivery and its effect on reducing the mother's stress, using of entonox gas can be a good option for relieving pain during delivery moreover, it can improve the APGAR score

[Evaluation of radiation dose received by operating room personnel during radiological procedures]

Utilization of ionizing radiation in some surgery operations [especially orthopedic operations] is inevitable. One of the main occupational hazards of physicians and other personnel could be radiation exposure risks. This study aimed to evaluate the exposure doses received by operating room personnel in such surgery operations. 30 personnel of operation room in university affiliated hospitals of Hamadan city [excluding physicians and nurses] were studied as they received radiation doses. 3 TLD [thermoluminescent dosimet ers] chips were fixed on the apron of each staff member. To estimate the high risk examinations, staff members also completed a questionnaire about the type and number of the radiological examinations that they had participated. Minimum and maximum level of doses received by the participants were between 0.24 and 0.56 mSv in a four month period. Therefore, amount of annual doses received by the personnel would be between 0.73 and 1.7 mSv, respectively [without reduction of background radiation]. As the accuracy of TL dosimeters is normally about 0.1 mSv; therefore, it can be claimed that the received doses by the personnel was very low and comparable with background radiation. The results indicated that the radiation doses received by operating room personnel were very low. They were less than maximum predicted doses reported by the International Commission of Radiation Protection. However, the use of dose recording systems for awareness about absorbed doses beyond permitted limits is necessary

[Epidemiologic features of admitted patients with infectious diseases in Qom]

Despite decades of dramatic progress in their treatment and prevention, infectious diseases remain a major cause of death and debility responsible for worsening the living conditions of millions of people around the world. This study was conducted to determine the epidemiologic features of patients admitted with infectious disases at Kamkar Hospital in Qom. A routine data base study was carried out to obtain relevant data from medical records of patients admitted with infectious diseases at the Kamkar Hospital during summer 2007. The epidemiologic features of patients were obtained and analyzed using chi-square, t-test and Mann Whitney statistical tests. Out of 2907 admitted cases at the Kamkar hospital 331 [11.3%] pertained to infectious diseases. The most frequent infections were urinary tract infection, septicemia and pneumonia; 61cases [18.4%], 48cases [14.5%] and 45cases [13.6%], respectively. The most common involved systems were respiratory tract and urogenital tract, with each one having 73cases [22.05%].This study confirms the continuing importance of infectious diseases especially urinary tract infection, septicemia and pneumonia in Qom, which requires more research to be done to better identify their epidemiology and pathogenesis

Evaluation of intelligence quotient in children with early first permanent molar eruption

There are many unknown systemic and local factors influencing tooth growth and development. Likely, tooth eruption may be under such influence as well. Despite delayed tooth eruption, studies on early tooth eruption are very scarce. Therefore, this study was conducted in order to evaluate the relationship between intelligence quotient [IQ] and early tooth eruption in normal children [with no disease or disorder]. By using study criteria, 44 children were recruited after oral examination of 652 children [337 boys and 315 girls]. Oral examination was conducted by one dentist using plastic disposable mirror, under day light. The Raven's test was taken blindly under standard conditions for all subjects by a psychologist. [Case] subjects were defined as individuals who had partially or fully erupted molars earlier than the expected normal time. [Control] subjects were similar to [cases] but without erupted molars. Statistical analysis was conducted using student T-test. The intelligence test was performed on 44 subjects consisted of 22 boys [IT'case] and 1 T'control]] and 22 girls [11 [case] and 11 [control]]. IQ in two sexes did not have significant difference [P<0.05]. But the mean IQ difference between [case] and [control] groups was about 11 points that was statically significance [P<0.01]. Healthy children with early first permanent molar eruptions, have higher IQ compared to their peers [P<0.01]. This criterion may be used to identify high IQ children for provision of special care and training for faster advancement of individual and society

[Sleep disorders in patients with congestive heart failure hospitalized in Hajar hospital, Shahrekord, 2003]

Sleep is an important regular and repeated biologic period and leads to refreshment of human life both physically and mentally. One third of human life is spending in sleep and lack of it, endangers human well being. This phenomenon usually is affected by both internal and external factors such as age, sex, drug, disease and surgery. Therefore, the aim of this study was to assess the sleep disorders in congestive heart failure patients in Hajar hospital of Shahrekord in 2003. This descriptive-analytical study was performed on 205 patients with an ejection fraction less than 40%. The sampling was conducted using simple method from September to November, 2003. Data were collected using a questionnaire comprising two parts of questions and expresses, which was filled in by the researchers. Data were analyzed by Chi-square test using SPSS. Prevalence of sleep disorders in congestive heart failure patients was%51. The most prevalent disorder for start sleep stage was disturbing thoughts [62%] and for co-sleep, stage was sleep rising by slight noise [77.1%] and for sleep-raising stage was sleep raising 2-3 hours sooner [57%]. The statistical test showed that the more sleep disorder, the less sleep consent [p<0.001]. Sleep disorders were more abundant in women [p<0.001]. There was no significant correlation between sleep disorder score and age, but with aging, the sleep complications will be increased [p<0.05]. Based on our results, the prevalence of sleep disorder in heart failure patients was higher than that of the general population. Regarding the importance of sleep in these patients providing good physical condition for sleep is necessary

[Brain computed tomography scan nessecity before lumbar puncture in meningitis patients with more than 60 years age]

Central Nervous System [CNS] infections especially meningitis is a medical emergency that once suspected should be proved through Lumbar Puncture [LP] and cerebrospinal Fluid [CSF] analysis. On the other hand due to life - threatening complications such as brain herniation in the people older than 60, the procedure safety is debated. This study was done in order to determine the necessity of the Lumbar Puncture [LP] in the patients older than 60 years old who are suspected to meningitis. This descriptive study was done in Infectious Clinic of Imam Reza Hospital, Mashad, Iran from fall 2003 to fall 2005. 90 patients who were suspected to meningitis and undergone brain CT scanning and LP were studied. The results of patient's history, physical examination, demographic information, CT scanning and LP all collected in a questionnaire and analyzed by spss and statistics examinations. Among 90 patients suspected of meningitis who underwent Brain CT-scan and LP, 81 suffered from loss of consciousness, 2 were chronic course and 7 without clinical LP contraindication other than age. 75 had normal CT-scan and 15 had abnormal CT-scan, among which was no space occupying lesion with mass effect or midline shift. Final diagnosis was acute bacterial meningitis in 14 cases and aseptic meningitis in 7 cases and other causes of meningitis in 7 cases, Encephalitis in 1, and 61 cases other CNS infection. Despite other clinical contraindications for LP in most of the patients, in 75 cases. [83%] brain CT-scan was normal and in only 15 cases [17%] there was abnormal CT-scan among which none was a contraindication for LP [i.e space occupying lesion with mass effect or midline shift]. Therefore the role of "age over sixty" as an absolute indication for Brain CT-scan, regarding the existing medical facilities and conditions in our country, did not seem acceptable

[ relationship between severity of the systemic inflammatory response syndrome [SIRS] and its etiology and outcome]

SIRS is known as a condition with the presence of four criteria of: Fever or hypothermia. Tachypnea. Tachycardia. Leukocytosis or leukopenia or bandemia. Sepsis is defined as the SIRS with an infectious etiology. Incidence rate is increasing during the recent 15 years. The key point in treatment of sepsis is early diagnosis and beginning of treatment according to the signs before the occurrence of complications like hypotension. This study was done to evaluate the relationship between the severity of SIRS and its etiology and outcome. This descriptive study was carried out in the year 2004 on 306 cases of SIRS, referring to Infectious Ward of Imam Reza Hospital, Mashhad, Iran. The study was accomplished through completing questionnaires, after getting medical history, physical and laboratory examinations [including CBC, urine analysis, platelet count, and ESR] of patients. Then the sensitivity, speeififity and positive predictive values for SIRS regarding differentiation of infectious from non- infectious diseases were studied. In addition, the severity of SIRS and its effects on mortality, also, the effects of severe SIRS on any infection in platelet count and ESR were evaluated. The Results were arranged as charts, graphs and described by MANN-WHITENY, T-student. According to the number of patients final diagnosis included pneumonia [n=56], meningitis [n=35], unknown origin infections [n=34], urosepsis [n=25], and miscellaneous etiologies such as brucellosis, hepatitis, etc. There were 23 non-infectious patients and 17 mortal cases. The highest mortality rate was in pneumonia [n=7] that often had serious leukocytosis. Severe SIRS has 20.1% sensitivity and 95% positive predictive value for diagnosis of infection. There was no statistically significant difference between the two groups, regarding the primary vital signs, laboratory findings, age, sex, and mortality rate. The mortality rate didn't have any relationship with thrombocytopenia, increased ESR or sex; but was related to hypotension, serious leukocytosis and severity of SIRS. Based on the primary vital signs and laboratory findings, the severity of SIRS has a clear correlation with the mortality rate. Heuce it is recommended that much attention should be paid to the documents of vital signs and routine laboratory findings for the early diagnosis and treatment

[Native Tricuspid valve endocarditis in the absence of intravenous drug use]

We presented two non-addicted patients with Tricuspid valve endocarditis. The first patient was a 38-year-old diabetic female with; fever chills, anemia, and microscopic hematuria and pyuria that occurred during several weeks. The plain radiography of chest was normal and high resolution computed tomography [HRCT] of chest, was done because of predominant pulmonary symptoms and signs that revealed consolidation and cystic formation in the left parynchyma. Based on these findings in HRCT we decided to start anti-tuberculosis treatment, but no significant response was seen. Tran's Thoracic Echocardiography [TTE] was done and revealed large vegetation of Tricuspid valve. The second patient was a 45 -year-old man who admitted with acute fever and left lower lobe infiltrate and systolic murmur. TTE was normal but Trans Esophageal Echocardiography showed large vegetation on the Tricuspid valve. Staphylococcus aurous grew in 2/3 blood cultures. We suggest that right-sided endocarditis must be considered in any patient with fever and recurrent pulmonary symptoms and signs, with or without abnormal chest X- ray, heart murmur or intravenous drug addiction

[Anaesthesiologists H attitude towards preoperative patients education needs in 2005]

lack of information about anaesthisia and fear of post operation contiousness, pain, nausea and vomiting increases the patientsH anxiety. There are various reports about patiensH desire for preoperation information in Iran and other countries. However, there is no study related to anaesthesiologistsH view about patientsH needs before anaesthesia and operation in the literature. This descriptive [cross- sectional] study was done in 2005 on 110 anaesthesiologists working in hospitals of Mazandaran province. Questionnaire containing 4 questions about demographic and 18 questions related to anaesthesia was prepared. Attitude of the anaesthesiologists was divided into 5 categories based on Likert rating scale as follows: completely agreed, agreed, partially agreed, not agreed, completely not agreed. Chi-square test was used for the statistical analysis of the data. Results of this study showed that the most positive attitude of anaesthesiologists about patient teaching was related to the proper explanation about duration of N.P.O before operation [%97.3].%52.7 of anaes the siologists were against giving explanation of the duration of N.P.O and post operation possible problems. In this regard no significant difference was observed between educational and non educational hospitals [P<0.018]. No significant difference in terms of attitude was observed between anaesthesiologists at different level of education [P<0.07]. Considering the positive attitude of the anaesthesiologists towards education and preoperation of the patients, it is recommended that such education be implemented and the patients be charged for preoperation consultation in order to give explanation about anaesthesia at proper time, when needed

[ status of blood pressure in urban population of sabzevar in 1382]

Knowledge of the normal blood pressure [BP] in every region and its distribution by age and sex can help planners compile programs to control and prevent hypertension. This study was planned evaluate the BP in the urban population of Sabzevar.In a cross sectional study, 844 subjects from different age groups were selected through cluster sampling from the population covered and supported by health centers in Sabzevar. Their systolic and diastolic BP were measured in the standard format using ALPK2 sphygmomanometer and Littman stethoscope.According to the results of this study, 54% of the subjects were female and 46% were male; with the mean age of 30.9 +/- 17.8. In the age group less than 15 years, systolic and diastolic BP were 106.8 +/- 13.7 and 68.1 +/- 11.8mmHg respectively. Corresponding figures in the age group more than 55 years were 144.6 +/- 23.8 and 87.1[ +/- 12.3]mmHg respectively. Findings revealed that there was an ascending trend of systolic and diastolic BP as age increased. Prevalence of systolic and diastolic hypertension were observed to be 21.5% and 25.8%, respectively, with a higher prevalence in women than in men.No significant difference was found between mean systolic and diastolic BP of men and women. High BP requiring continuous interventional programs to make changes in the personal behaviors and lifestyle of the people