[Determining of the factors affecting mortality in burn patients using a decision tree data mining algorithm]

Introduction: Using data mining to develop prediction models from large amounts of data in medicine has become increasingly popular during the recent years. In this study, we intend to use a decision tree data mining algorithm in order to identify factors influencing mortality in burn patients

Methods: The present retrospective descriptive study is based on burning patients' records. Overall, the medical records of 4804 patients were scrutinized. The collected data were analyzed using statistical software [SPSS version 16], data mining software [Clementine version 12], and CHAID algorithm

Results: The resulting model for predicting survival and mortality of burning patients included the percentage of Total Burn Surface Area [TBSA %], degree of burn, length of stay, gender, and age of patients. Other variables including blood cultures, wound cultures, urine cultures, and the months of patient hospitalization had no effect on improving the efficiency of the model

Conclusion: The proposed model is valid and reliable due to its accuracy [approximately 95%]. In fact, the results of this study, some of which are consistent with the results of other studies, can propose a comprehensive, accurate, and reliable local model for predicting mortality and survival of burning patients based on the mentioned variables. Thus, this local model can be used as an important criterion for evaluating the effective treatment of burn patients

[Comparison between primary PCI and thrombolytic therapy results in patients with acute st-elevation MI]

Early revascularization is the main step in treatment of patients with acute MI which since a few years ago has been done via P-PCI. Since thrombolytic therapy is performed as a standard method of therapy of acute MI in all centers not equipped with angiography and angioplasty systems, we decided to compare these two methods in the university centers in Iran. This prospective study was conducted on STEMI [ST Elevation MI] patients referred to emergency department of Shohadaye Tajrish and Shahid Modarres Hospitals, in Tehran, for early revascularization using thrombolytic therapy or Primary PCI. We compared these two methods of revascularization based on the effects on ejection fraction, ST-resolution and complications. 287 patients [144 in T.T group and 143 in P-PCI group] were enrolled in our study. There were no differences in ejection fraction between the two groups, but STresolution was significantly better in the P-PCI group [P< 0.001]. The rate of complications was similar in both groups. It seems the P-PCI is more effective than T.T in patients with STEMI

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

Knowledge, attitude and practice of general physicians in treatment and complications of hypertension in Fars province, southern Iran

Hypertension as a community health problem, showing an increasing trend in many parts of the world. Controlling the disease depends on knowledge, attitude and practice [KAP] of general physicians as the main health providers in the community. In this study, the impact of KAP of general physicians on hypertension, as the first line of treatment of hypertension was evaluated. In a cross-sectional study, 300 general physicians working in health and treatment sectors of Fars Province, southern Iran were entered in our study and their KAP were determined utilizing a validated and reliable questionnaire. The questionnaire consisted of 52 items incorporated in four sections. The mean age of general physicians was 38.2 +/- 3.6 years. 64.2%, 20.3%, and 26.5% of general physicians were visited by four to eight, more than eight, and less than four hypertensive patients per week respectively. Although 99% of physicians believed in the importance of hypertension as a community health problem, but 12% had requested for appropriate paraclinical tests and 20% could handle hypertensive patients properly. Only 45% of physicians had measured their own blood pressure within the last year of practice. Scientific meetings and educational programs were more important than information provided by drug companies and journals in promotion of knowledge, attitude and practice of general physicians. Since the physician's knowledge, attitude and practice are important issues in controlling and prevention of hypertension, promotion of their knowledge on hypertension seems necessary in prevention of subsequent complications