ABSTRACT
Introduction: Post-coronary angiography vascular complications [PCAVC] may cause serious life threats, thus recognition of related factorse is needed to prevente complication
Objective: This study was conducted to determine correlation between hypertension and vascular complications after coronary artery angiograph among hospitalized patients therapeutic- educational center in Rasht
Methods: This descriptive analytical correlational study was performed on 400 patients admitted in angiography wards at Dr Heshmat therapeutic- educational centers by sequential sampling method in 2013. Data were gathered by a 3-part tool including; demographic information questionnaire, blood pressure recording forms and PCAVC occurance [Hematoma, ecchymosis and bleeding] during 24h after angiography until heet removal through interview and observation methods. Data were analyzed by using descriptive and analytic X[2], independent T and ANOVA] statistics tests
Results: Majority of samples [56.2%] had history of Hypertension. Mean of pre-angiographic systolic and diastolic blood pressure were 129.46 +/- 21.63 and 76.85 +/- 1.15 and pre-sheat extraction were 132.96 +/- 18.02 and 78.85 +/- 1.02mmHg. Vascular complications were observed in 24 percents of samples that majority of them were ecchymosis [71.4%]. A significant relationship was seen between history of HTN and overall PCAVC [p<0.005], ecchymosis [p<0.006] and hematoma [p<0.046]. The statistical tests showed a significant relation between mean of systolic BP before sheet removal with overall PCAVC [p<0/003] and ecchymosis [p<0.004] and diastolic BP with overall PCAVC [p<0.0006], ecchymosis [p<0.0009]
Conclusion: Screen of high occurance of PCAVC among patients after angiography with history of hypertension and systolic and diastolic BP before sheet removal is required to diagnose high risk patients who need special and highy quality of care
ABSTRACT
Introduction: Invasive breast cancer is the most common carcinoma in women. Immunohistochemistry classification now plays a key role in prognostic identification and prediction of outcome in this disease. Based on recent gene expression studies, immunohistochemical subtypes are as follows: Luminal A [ER+ and /or PR+, HER2-], luminal B [ER+ and /or PR+, HER2+], HER2+/ ER-, PR-, and basal-like [ER-, PR-, HER2-]. These molecular differences have been shown to correlate with clinical features, such as survival, and sensitivity to treatment. In this study we evaluated the association between different subtypes with histological type, grade, tumor stage, lymph node positive ratio, lymph node status, recurrence, and survival
Patients and methods: We retrieved the clinical records of 580 patients with breast cancer who were treated at Mahdieh Institute of oncology in Hamadan, Iran, between Oct 2004 and Oct 2011, and we evaluated clinicopathological data of these patients
Results: Mean age of patients was 47.22 +/- 11.1 years. Of 573 patients, 116 [20.2%] were ER /PR+, HER2+, 257 [44.9%] were ER /PR+, HER2-, 72 [12.6%] were ER /PR-, HER2+, 124 [21.6%] were ER /PR-, HER2- and 4 were undefined. The estimated median follow up period for all subjects was 4.9 years [range 3 months to 6.9 years]. The overall survival for all patients was 88.21% and the disease free survival was 83.7%. The interesting result of this study was the lower incidence of positive axillary lymph nodes in triple negative subtypes. Five-year relative survival rates were higher for patients with ER/PR+ and negative lymph nodes [p< 0.05]
Conclusion: This study highlighted the importance of immunohistochemical subtypes. As our patients were good representatives of breast cancer in western Iran and this study showed some differences with literature, further research should be directed at standardization of molecular and immunohistochemical methods in our country
ABSTRACT
Spinal Anesthesia [S.A] is currently becoming a more common and popular method for orthopedic surgeries. Unfortunately, Backache [BA] and Post Dural Puncture Headache [PDPH] are both frequent and troublesome. Several factors [including needle shape and size, frequency rates of puncture attempts, and age and gender] have been shown to affect the rates of such complications. To determine these factors and evaluate some modalities to prevent them. This is a prospective study on 200 patients- 15 to 65 years old with class type 1 and 2 A.S.A [American Society of Anesthesiology], who were candidates for orthopedic lower extremity surgeries. Anesthetic procedure was performed using a standard 24G needle L idocaine 5% plus Epinephrine. Symptom questionnaire was filled for the history of Headache and Backache and history of former S.A. postop puncture complications of 1[st] day, 1[st] week and 1[st] month were added to the forms. Statistical analysis was performed using SPSS version 16 and the results were considered significant at p<0.05. Rates of BA and PDPH were 12.5% and 17%, respectively. Post anesthetic BA for first day, week, and month were 16%, 9%, and 3.5%, respectively and PDPH were 6.5%, 3.5% and 1% respectively with no significant differences. History of former spinal anesthesia with BA and PDPH revealed notable differences [p<0.001]. The results of this study support the idea that history of previous spinal anesthesia could be a triggering factor for backache and headache in prior Spinal anesthetic procedures
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Epidermoid tumors comprise 5% of posterior fossa tumors and are the third among tumors of the cerebellopontine region in frequency. In the review of recent literature, there are several case reports but few case series. In this retrospective study, we evaluated the surgical results of our patients, reviewed the existing literature and compared our results with other series. Surgical results of 8 patients with epidermoid tumor that originated mostly in the posterior fossa from 1980-2008 in Mehrad Hospital, in Tehran, are presented. The age, sex, duration, signs and symptoms, topographical location, surgical approach, the extent of resection and outcome are analyzed and compared with other series. This study is based on the clinical data of 8 patients operated from 1980-2008 in Mehrad Hospital, in Tehran, due to posterior fossa epidermoid tumors. 62.5% of the patients were female. The average age of our patients were 34.1 years [range: 2453 years]. The most common symptom was headache [87.5%]. The most common tumor location was cerebellopontine angle. Supratentorial extension was observed in half of our patients. In 37.5% of the cases, the tumor was resected totally. The mean followup period was 31.5 months [range: 1-115 months]. In the post operative period, 37.5% of our patients suffered from complicating events, but we had no mortality in our series. In contrast with other posterior fossa benign tumors, in which the cure is obtained by overcoming surgical technical difficulties, the main problems in the management of epidermoids remain misdiagnosis, incomplete removal at the first operation, and delayed detection of recurrences. With the use of modern microneurosurgical techniques, our surgical results are comparable with other series. Extended multicentric prospective studies are recommended for more definitive results
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Infratentorial Neoplasms/pathology , Treatment Outcome , Retrospective Studies , Carcinoma, Squamous CellABSTRACT
This study was designed to determine the culling rates of 23 Holstein dairy herds [with an average size of 180 cows per herd] in Neyshabur area in northeastern Iran over a period of three years from 2001 to 2003. The average annual culling rate was 13.1%, [98.5% involuntary and 1.5% voluntary]. Of the total disposals [1612 cows], 53.48% were culled by the end of five years of age. Poor fertility was the most important reason for culling [34.9% of disposals], followed by digestive disorders [12.6%], alimentary problems [10.85%], mastitis [9.6%] and lameness [8.3%]. More detailed epidemiological studies are needed to plan and implement healthcare programs. These programs targeted toward diseases that lead to culling would be prerequisite for a profitable farming
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In the study, we evaluated efficacy and complications of T-tubeapplication in treatment of intestinal atresia in newborns. In this randomized clinical trial study, 40 neonates with intestinal atresia were studied. The patients were divided into two comparable groups. After preparation of general conditions for operation, the surgery was applied under general anesthesia. In the first group, primary end-to-end anastomosis with T-tube application and in the second group only primary end-to-end anastomosis was done. Baseline variables [age, sex and birth weight], signs of disease, interval between surgery and beginning of oral nutrition, duration of hospitalization, post operation complications and mortality were compared between the two groups.Age, sex, birth weight, age in operation time, frequency of abdominal distention, bilious vomiting, failure of meconium pass and congenital anomalies were not different significantly. Also interval between surgery and beginning of oral nutrition was not different. In 2 of 20 neonates [10%] in T-tube group post operation complications occurred, but in the other group, 9 neonates of 14 neonates [64.3%] complications were seen after operation [p=0.002]. Two neonates [10%] in T-tube group and 8 neonates [40%] in the other group died during post operation follow up [p=0.03].It seems that primaryend-to-end anastomosis with T-tube application in neonates with intestinal obstruction decreased complications and mortality rate. More similar studies with larger samples are recommended
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Congenital intestinal malrotation as an abnormal embryonic intestinal rotation and fixation leads to various clinical presentations of high complete or incomplete intestinal obstruction, especially midgut volvulus and extensive intestinal loss that may cause short bowel syndrome or death of the patient. we conducted this study to assay clinical presentations, surgical findings, mode of management and outcome of neonates with intestinal malrotation. We studied retrospectively data of 25 neonates with intestinal malrotation in 3 hospitals of the Tehran University of Medical Sciences [1985-2003]. Patients consisted of 17 males and 8 females. 5 [24%] patients had extensive intestinal gangrene that resulted in short bowel syndrome in 2 patients. 7 [20%] patients died, 5 of them due to intestinal volvolus and 2 other due to associated anomalies and sepsis. Most common clinical signs and symptoms were vomitus [96%], bilious vomiting [80%], constipation [24%],], coliky abdominal pain [23%]. Abdominal distention was observed only in patients with volvolus [38%]. Obstipation [31%] and rectorragia were seen only in patients with volvolus and intestinal gangrene. 28% of neonates had associated anomalies. Malrotion was suggested by abdominal X-ray in 3 out of 12 [25%], barium enema in 9 out of 11 [81.8%], and gastrointestinal follow through in 3 out of 4 [75%] examinations. 3 patients were surgically managed according to only one abdominal X-ray. Ladd procedure was performed in all patients and other necessary corrective operations for associated anomalies included intestinal resection with anastomisis in 5 and intestinal resection with entrostomy in 2 cases. To prevent extensive intestinal loss due to intestinal volvolus in neonates with abrupt bilious vomiting, malrotation must be excluded, and if a volvulus is suspected, emergency laparotomy should be undertaken
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Introduction: today, population is the greatest problem in developing countries and family planning is accepted as a strategy against it by all countries and correct education of family planning and improvement of awareness level have a significant role in control of population in this field
Objective: present study was carried out to examine knowledge, attitude and performance of teachers in Rasht- City concerning Family Planning and Contraceptive Methods in 2001-2002
Materials and Methods: this study was performed in all teachers with different degrees. Sample size was 544 individuals and data were collected with questionnaires. In general, 503 questionnaires were analyzed by SPSS software
Results: age range of individuals studied was 25-55 years with mean age 38.4 years. Mean age of marriage was 24.1 with +/-3.7 standard deviation and mean number of children 1.94 with +/-0.9 year standard deviation. 57.5 percent of contributors have license degrees.44.1 percent of subjects regarded physicians and health care workers as the most important reference for achieving information. Mean score of awareness was 4.21 from a total score of 10 and 62.8 percent of them in terms of awareness were in intermediate degree. There was a reliable relationship between age and awareness [P Value 0.000]. Mean score of attitude was 3.73 in range of [-12,12] and 83.3 percent of persons were located in positive attitude group. It was found that there was reliable relationship between children number and attitude. [P.value:0. 005] Most common method for contraception was coitus interruptus [19.7 percent]. 42.7 percent of parents indicated that they had an unexpected childbirth
Conclusion: what was presented in this research revealed positive attitude among persons. In other words, there were strong motivations in the subjects concerning the necessity for family planning and prevention of unwanted pregnancies. However, due to low knowledge level about contraceptives, there was a high rate of unwanted pregnancies that suggest the poor performance of the investigatees
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The ability to use only a few spermatozoa using testicular biopsy and by microinjection technique to achieve fertilization and pregnancy has revolutionized the potentials to treat patients suffering from azoospermia. However, spermatogenesis is defective in men with non-obstructive azoospermia [NOA] resulting in failure to detect spermatozoa. In order to achieve a more sensitive and reliable method for detecting sperm/spermatid in testes of NOA patients, we compared histopathological and cytological methods. Eighty six NOA patients were included in a prospective study. History taking, physical examination and hormonal profile [including FSH] were done initially. Thirty six patients had testis pathology report before enrolling in to our study. The patients underwent multiple bilateral testis biopsies until successful retrieval of sperm/spermatid. Half of each biopsy specimen underwent cytological evaluation [mechanical and enzymatic] and the other half was sent for pathological evaluation [TBX]. The male and female mean ages were 37 [25-59] and 32 [23-42] years, respectively. The mean infertility duration was 7 years. The mean volume of right and left testis were 16.4 and 16.2 ml, respectively. Mean FSH level was 18.1 +/- 14.2 ml U/ml. In cytology, sperms and spermatids were seen in 65 and 18 patients, respectively and in pathology slides in 51 and 16 patients, respectively. In our study, the relationship between visualizing testicular sperm/spermatid and TESE had sensitivity of 80% and negative predictive value of 15%. Sixty one patients had sufficient number of sperm/spermatid for ICSI and with this treatment fifty seven embryos were transferred and seven clinical pregnancies were observed. In conclusion, in men with non-obstructive azoospermia, TESE is more sensitive and reliable than histopathology evaluation. This means that TESE may help in deciding for treatment of severe male factor infertility, even when histopathologic examination is inconclusive