Assessment of risk factors of premanturity among neonates born in Bandar Abbas shariati hospital

Prematurity remains the main cause of mortality and morbidity in infants and a problem in the care of pregnant women world-wide. This study describes the risk factors for having a live preterm delivery in Bandar Abbas Shariati Hospital. In this case-control study, we studied 300 neonates who were borned in Shariati hospital in 2011 and divided them into two groups: case group [100 mothers with premature neonates] and control group [200 mothers with term infants]. Risk factors that were studied include maternal age and job, parent's knowledge, the history of preterm birth, uterine abnormality, maternal systemic and infectious disease, prenatal care, placental abnormality, trauma in pregnancy, maternal low weight gain in pregnancy, the number of previous pregnancy, inter pregnancies gap, maternal smoking, membrane abnormality, previous abortion, pregnancy with assisted reproductive therapy. Data collection and analysis were performed using SPSS 16 and t-test and Chi-Square were used to analyze the significance of the results. The results show that in mothers with preterm birth, prolong premature rupture of membrane 27.92 times, uterine and cervical anomaly about 15 times, preeclamcia 5.26 times, the history of preterm birth 4.96 times, family dependency 2.67 times, urinary tract infection 2.24 times and diabetes 2.18 time more exposed to prematurity than mothers with term birth [P<0.05]. According to this study prolong premature rupture of membrane, uterine and cervical anomaly, preeclamcia and history of preterm birth are the most important risk factors for preterm delivery

Diagnostic value of NT-BroBNP in HF patients admitted with dyspnea in Emergency Department

Considering the increasing prevalence of patients with dyspnea and the possibility of heart disease, as well as unavailability of echocardiography specially in primary care situations and unreliability of echocardiography findings in some diseases and finding NTProBNP as a diagnostic factor in heart failure in these patients, this study was done to determine the accuracy of NTProBNP in comparison to echocardiography in the diagnosis of heart failure in Modarress Hospital, in Tehran, between 2006 and 2007. This study, with a clinical trial diagnostic design, was performed on patients with chief complaint of dyspnea. The NTProBNP marker of serum was determined by Elecsys and patients were categorized according to age adjusted reference book values into two groups of with and without heart failure. Then, the patients underwent Simpson Echocardiography and Tissue Doppler; and the positive and negative predictive value for NTProBNP in relation to the echocardiography was determined and analyzed by statistical tests. One hundred patients were analyzed. Mean age was 59 +/- 11.8 years and 70% were male. PPV was 84%, NPV was 70.4%, false positive was 16%, while false negative was 29.5%. Sensitivity was 78%, specificity 77%, and accuracy was equal to 78%. It seems that NTProBNP marker is a good test for screening patients with dyspnea and besides clinical criteria it has an acceptable diagnostic value. It would be good to perform other studies, using more precise laboratory methods and reevaluation of cut point especially for Iranian patients considering factors other than age to obtain a rapid, easy, and costeffective test in primary care

Diagnostic precision of the electrocardiogram for detection of culprit lesion of infarct related artery in acute st elevation myocardial infarction

Despite impressive advances in diagnosis over the past decades, ST elevation myocardial infarction [STEMI] continues to be a major public health problem in the many countries. In majority of patients with some STEMI, changes can be documented when serial electrocardiography [ECG] are compared: however, many factors limit the ability of ECG to diagnose and localize myocardial infarction [MI]. The aim of this study was to evaluate accuracy of ECG in diagnosis and localization of MI. This prospective study was conducted on patients with STEMI who were admitted in Modarress Hospital, in Tehran. All patients underwent electrocardiography and angiography. Then, findings of these two noninvasive and invasive diagnostic methods were described with two independent operators. 140 STEMI patients [80 patients with anterior and 60 patients with inferior MI] were enrolled in this study. Presence of complete right bundle branch block [CRBB] in ECG of patients with anterior MI had the least negative predictive value [NPV=69%]. ST segment depression more than 1mm in lead d1 had the most positive predictive value [ppb=97%] for right coronary artery involvement. ST segment elevation in leads v5 and v6 had the least positive value [ppv= 81%] for LCX involvement. ST segment depression in inferior leads had the most negative predictive value [94%] for LAD involvement. In patents with STEMI, electrocardiography alone is not a good diagnostic method to diagnose and localize MI