Amniotic membrane dressing vs conventional topical antibiotic dressing hospitalized brun patients

Different natural and synthetic materials were used for temporary burn wound coverage; however, they are associated with disadvantages including high price which prohibit their widespread use, especially in developing countries. Among all, human amniotic membrane is the only easily available and cost free coverage. Its effects on burn wounds have been studied in this survey. One-hundred and twenty four patients with 20-50% second and third degree burns and without any other disease were randomly assigned into two groups. The first 61 patients [control group] underwent traditional method of dressing with silver sulfadiazine and gauze which were changed twice a day. The remaining 63 patients underwent dressing with human amniotic membrane [amnion group], being changed every 3-4 days. Patients in the control group had significantly lower albumin and needed more albumin infusion [231.80 +/- 234 gr. versus 111.51 +/- 143.82 gr.], received more blood transfusion [1.75 +/- 2.52 bags versus 0.65 +/- 1.18 bags], had significantly more intense pain and so received more narcotics than amnion group [7.97 +/- 12.85 doses versus 3.84 +/- 7.56]. Wound infection was higher in the control group [65.66% versus 46.91%] and so was the incidence of sepsis [24.62% versus 6.10%]. There was 8.53% mortality in the control group versus 0% in the amnion group. All of the above-mentioned differences were statistically significant. Amniotic membrane dressing in deep and more extensive burns leads to better homeostatic, immunologic and local results and because of its low price, its use is strongly recommended

Self-burning: a common and tragic way of suicide in fars province, Iran

Self-burning is the most devastating burn injury. It is a common social and medical problem in Iran. In a longitudinal prospective study, from April 2003 to March 2006, all burn patients admitted to Ghotb-eddin burn Hospital were enrolled in this study. Suicide attempts by burning accounted for 283 [21.9%] of all burn patients admitted to the hospital. Most [68.2%] of self-burning patients were female. Self-burn patients had significantly large burned body surface area [64.8 +/- 29%]. Suicidal burns occurred predominantly in the age group 15-24 years [44.6%]. The mortality rate for suicidal burns was [60.4%]. Fars is a province composed of many different tribes and cultural minorities whereby major decisions are made by forums of clergymen. It is important to involve those clergymen in burn prevention programs to achieve a meaningful reduction in Self-burning prevalence

Prognostic value of infection and inflammation markers for late cardiac events in an Iranian sample

We evaluated the serum levels of IgG antibodies to Helicobacter pylori, Chlamydia pneumonia and cytomegalovirus and the level of the inflammatory markers C-reactive protein and fibrinogen in 57 patients with acute coronary syndrome, 65 with unstable angina, 60 with stable angina and 44 healthy controls, and whether these markers were associated with cardiac instability 6 months after admission. There was a significant increased risk of late coronary events [cardiac death or readmission with acute coronary events] associated with seropositivity to C. pneumoniae [adjusted odds ratio 2.12; 95% confidence interval: 1.16-4.08]. Other parameters were not significantly associated with late cardiac events after adjustment for age, sex, diabetes mellitus, hypertension, hyperlipidaemia and smoking behaviour

Surgical management of combined perforated and bleeding duodenal ulcer

Peptic ulcer is one of the most frequent diseases of the alimentary tract, while mortality from perforated peptic ulcer still remains high. We conducted this retrospective study to determine the adverse operative risk factors for perforated hemorrhagic peptic ulcers in Shiraz, southern Iran. 896 patients with peptic ulcer were enrolled. A questionnaire was used to collect the data on age, gender, site of ulcer, presentation, endoscopic findings, type of peptic ulcer complications, method of treatment, surgical procedure, and results of the treatment. Complicated duodenal ulcer was 15% in period I, and 11.5% in period II [P>SD of the age of +/- 0.05]. The mean 11 years. The age of the patients with perforated duodenal the patients was 42.7 8.6 years. Perforation with 12.5 and in hemorrhagic patients 37.4 +/- ulcer was 48 hemorrhagic duodenal ulcer in the first period was 1.2% and in second period, 0.2%. In the second period, simple closure was done in 29 [74%] patients, and in perforated DU cases, conservative management was done in 23 [56%] patients. Although the number of complicated duodenal ulcer cases increased from period I to period II, complications of duodenal ulcer [Kissing disease] significantly decreased

[Predictive value of coronary artery calcification in coronary artery stenosis]

Early diagnosis of CAD could lead to proper treatment of patients and coronary artery calcification is considered to be a valuable index in detecting coronary artery disease using a noninvasive technique. To evaluate the relation between calcification and stenosis of coronary artery. This was a cross sectional study in which 760 patients suffering from typical chest pain and as candidates for coronary angiography were evaluated for calcification of coronary artery by fluoroscopy. All patients signed a consent form while the whole procedures were fully explained in comprehensible language. Following fluoroscopy and angiography, the results were reviewed by two different cardiologists, separately. The presence of any significant stenosis greater than 75% was considered as a sign for severe CAD. The data were analyzed by x[2] followed by determination of sensitivity and specificity. Abnormal angiogram was found in 402 cases of our patients. In general, the positive and negative predictive values for calcification were 81.8% and 26%, respectively. The positive and negative predictive values were 87.1% and 63.4% in females and 79.7 and 47.3% in males respectively. The highest predictive value was seen in patients below 40 years old [100%]. Coronary calcification in patients with abnormal coronary angiogram was found to be 5.4 times higher than those with normal angiogram. According to our results, the noninvasive fluoroscopic technique for detection of coronary artery calcification could be regarded as a screening tool to reveal significant coronary involvement

Timely versus delayed operation in infants with correctable congential anomalies: a surgery in Isfahan, 2000-2001

Unless performing a timely and appropriate correction, congenital anomalies can conduce to irrecoverable complications. There are different reasons for delay in referring such patients to physician for surgery. By understanding these considerations, we can make an effective approach to reduce the severity of this problem in our community and this is the aim of our study. In a cross sectional study, all 359 eligible cases [neonates and infants suffered from a correctable anomaly which were referred to our centers] and 110 physicians were included for a period of 15 months [2000-2001]. Two main hospitals in our city were set as the data collection centers [Al-Zahra]. Parents' views were extracted by interview. Physicians' knowledge about study subject was assessed by self administered MCQs. In this study 65 percent of all cases who were operated on had been taken to hospital with delay [male to female ratio was 4:1]. Among the cases who received delayed surgical treatment, inguinal hernia was the most prevalent one [39 percent]. Surgery in 32 percent of cases who had delay in their operation caused some degrees of complications. Physicians' misadvise [42 percent], economic problems [25 percent], and hospital terror [17 percent] were accounted as the most prevalent reasons for delayed referrals. Physicians' knowledge about the correctable congenital anomalies in infants was estimated very poor [3 score from 10]. Delay to refer for operation in correctable congenital anomalies is an important dilemma in our community. Public education and also health professional education about this matter can play an admissible role improving the situation. Also, it is needed to make decisions for improving assurance supports in such cases

[Ten years trend of hypertension in over 18 years old persons in Isfahan]

Different studies have shown that antihypertensive therapy has been associated with reductions of 35-40 percent in stroke incidence, 20-25 percent in myocardial infarction and more than 50 percent in heart failure. This study evaluated the trend of hypertension, the mean systolic and diastolic blood pressure, the patients' awareness of treatment and control of hypertension among over 18 years population of Isfahan This report consisted of 3 cross sectional epidemiological surveys performed in 1991, 1997 and 2000. The trend of hypertension, the rate of awareness of the treatment and control of hypertension were evaluated. The 3 studies were cross-sectional with randomized-clustering sampling. The patients from both sexes were invited to the hypertension clinic of Isfahan Cardiovascular Research center. Student t-test and chi-square test were employed for data analysis. Prevalence of hypertension decreased from 1991 to 2000 [31.8% in 1991 and 17.5% in 2000] but it was insignificant among over 60 years old persons. There was no significant difference between sexes. The mean systolic and diastolic blood pressure of both male and female hypertensive patients significantly decreased from 1991 to 2000 [male: from 132.2/89.5 to 116.8/73.8 and female: from 133.07/88.2 to 113.7/72.8]. The patients' awareness of treatment and control of hypertension increased from 1991 to 2000. Women controlled their hypertension more than men did[16.05% in women and 6.5% in men]. The decreasing prevalence of hypertension, mean systolic and diastolic blood pressure and the increasing trend of patients' awareness of treatment and control of hypertension, from 1991 to 2000 are promising but the high prevalence of hypertension among over 60 years old patients requires implementing more effective methods to control their hypertension

Antioxidant effect of Turmeric and saffron on the oxidation of hepatocytes, LDL and non-enzymatic glycation of hemoglobin

Free radicals especially reactive oxygen species are known as important factors, which by damage to biomolecules like DNA, proteins, membrane, enzymes and lipids produce pathological disorders. Lipid peroxidation of LDL particles and membranes of hepatocytes may be involved in the process of atherosclerosis and liver dysfunction respectively. Also non-enzymatic glycosylation of proteins is involved in the complication of diabetic patients. Due to oxidant/antioxidant imbalance, destructive effects of free radicals may appear over time. Therefore, an investigation about the antioxidant effects of some popular spices including curcuma longa and crocus sativus zeylanicum on three oxidative systems [LDL oxidation, oxidation of cell membranes of liver hepatocytes and non-enzymatic gly cation of hemoglobin] was done. Total extracts of the above-mentioned plants were obtained. Hepatocyte membranes of rat liver were selected as a sensitive system to peroxidation and in the vicinity of tert-butyl hydroperoxide [TBH] [1.5mM] as an oxidant agent, the amount of malondialdehyde [MDA] was measured in the presence and absence of plant extract as a lipid peroxidation marker. Also released Alanine Aspartate Aminofransterase [AST] was measured as a cell membrane damage marker due to peroxidation. Glycosylation changes of hemoglobin and LDL oxidation were evaluated in the presence and absence of extracts. The results showed that curcuma at a concentration of 10microg/ml inhibited MDA formation by 28.8% and AST released by 25.53%. Curcuma at a concentration of Ijug/ml inhibited hemoglobin glycosylation by 25.85%. It has a dose dependent effect at all concentration. Also the plant showed the most antioxidant effect on LDL oxidation at the concentration of microg/ml. Crocus at applied doses has no definite inhibitory effect on MDA and AST formation, [results not shown] but crocus has a minimal inhibitory effect on hemoglobin glycosylation and LDL oxidation. This study showed that curcuma at applied doses has an inhibitory effect on all three oxidative systems in mentioned diseases and probably would be important for prevention of atherosclerosis, diabetes and liver dysfunction. Crocus at the used concentration had not any effect on these oxidative systems

Job satisfaction among the staff in Al-Zahra training hospital

One of the managers' main concerns in maintaining and preserving human resources is developing job satisfaction. Job satisfaction enhances the staffs productivity and efficiency. In this study, staff's job satisfaction in one of the largest training hospitals was investigated. It was a cross - sectional study in which 142 people working in different wards were given a questionnaire. The questionnaire was used for the assessment of job satisfaction and its validity and reliability were checked in a pilot study. 69.8% of the staff had job satisfaction. They were satisfiedhighly [71.6%] with their department head, colleagues and their private life. They were satisfied the least [42.9%] with their income and what they had to do and 8% decided to leave the hospital because of unsatisfactory conditions. Scientific, purposeful and logical study of the staffs needs and punishing and rewarding systems and regarding the staffs views and suggestions to solve their current problems allow managers to develop job satisfaction and consequently promote human productivity

Comparison of plasma levels of anticardiolipin and antiphospholipid antibodies in male patients with or without response to streptokinase following acute myocardial infarction

Streptokinase therapy is a medical approach for reperfusion therapy but with variable responses among patients which may be associated with antistreptokinase antibodies or other antibodies such as antiphospholipid or anticardiolipin antibodies. To compare the blood levels of anticardiolipin and antiphospholipid antibodies and also responses to streptokinase in patients with acute myocardial infarction. In this case-control study, 52 male patients with myocardial infarction were studied in two groups marked as responsive and non-responsive to streptokinase. The patients' responses to streptokinase were measured according to their first ECG and the ECG taken 90-180 minutes following the administration of streptokinase. Reduction of more than half of the ST elevation was considered as being responsive to the treatment. The antibody titers against anticardiolipin and antiphospholipid were further checked by ELISA method. Correlation between each antibody and the response to streptokinase was analyzed using Mann Whitney test [T-test]. The relationship between the antibodies mean values and the responses to streptokinase was investigated. The Mean level of IgG anticardiolipin in responsive patients was significantly lower than the non-responsive group [P=0.009], however, the mean levels of other antibodies such as IgM anticardiolipin, IgG antiphospholipid and the IgM antiphospholipid were statistically insignificant respectively. Based on the results found in our study, it seems that the anticardiolipin antibody has an effect on the response to streptokinase. This antibody inhibits the fibrin

Trends in blood pressure level, prevalence of hypertension and its care in Isfahan

This study evaluated the trend of HTN in population of isfahan who are above 18 years. Current study measured the trend of HTN, the mean systolic and diastolic blood pressure, the rate of patients awareness, treatment and control of HTN. This study consists of 4 cross sectional surveys which have been performed in 1991, 1993, 1997 and 2000. All 4 surveys measured the trend of HTN, the rate of awareness, treatment and control of HTN in patients. All studies were cross- sectional. The health supplier went to patients home and invited them to refer to HTN clinic of Isfahan Cardiovascular Research Center. When data were collected,, they given to computer and analyzed using SPSS by t-test. The trend of HTN has decreased since 1999 to 2000 [31.8% in 1991 and 17.5% in 2000] but this trend hasn't significantly decreased in population, also the trend of HTN between sexes had no significant differences [P>0.05]. The mean systolic and diastolic BP of both male and female hypertensive patients have been significantly decreased since 1991 to 2000. Percentile patients' awareness, treatment of HTN, and control of HTN have increased from 46%, 23% and 2.8% to 50%, 33.9% and 12% since 1991 to 2000 respectively. Women controlled their hypertension better than men [16.5% in women and 6.5% in men]. Considering decreasing of HTN, and the mean systolic and diastolic BP, it is essential to design and implement proper community-based intervention for primary and secondary prevention of HTN. The decreasing trend of HTN, mean systolic and diastolic BP and the increasing trend of patients' awareness of treatment, and control of HTN, are helpful to develop this process by these mechanisms. Considering the trend of HTN among patients above 60 years it is essential to implement more effective methods to control their HTN

Comparison of fasting plasma insulin level between acute coronary disease and non-coronary disease

Hyperinsulinemia is related to obesity, diabetes and hypertension, but its relation to coronary artery disease, as an independent risk factor, is questionable. This study was conducted to compare the insulin level in patients with acute coronary and non coronary diseases. This is a cross-sectional study in which two groups of hospitalized patients in emergency department, 32 patients in each group [acute coronary and non coronary disease] were evaluated for fasting insulin level. Diabetes or a family history of it, previous history of coronary artery disease or family history of it, pancreatic origin of abdominal pain, hypertension, overweight or obesity, or using steroids were exclusion criteria for this study. Collected data were analyzed using Mann-Withney test. There was not any statistical difference in age and sex of both groups. No significant difference was noted in insulin level of coronary and non coronary patients in this study. Having these results, we can not include hyperinsulinemia as an independent risk factor for CVD