Association between latest activated sites in the left ventricle and akinetic segments in patients with ischemic cardiomyopathy

Background: It is not clear whether the latest activation sites in the left ventricle [LV] are matched with infracted regions in patients with ischemic cardiomyopathy [ICM]. We aimed to investigate whether the latest activation sites in the LV are in agreement with the region of akinesia in patients with ICM

Methods: Data were analyzed in 106 patients [age = 60.5 +/- 12.1 y, male = 88.7%] with ICM [ejection fraction 120 ms

Results: A total of 1 272 segments were studied. The latest activation sites [with longest Ts] were most frequently located in the mid-anterior [n = 32, 30.2%] and basal-anterior segments [n = 29, 27.4%], while the most common sites of akinesia were the mid-anteroseptal [n = 65, 61.3%] and mid-septal [n = 51, 48.1%] segments. Generally, no significant concordance was found between the latest activated segments and akinesia either in all the patients or in the QRS groups. Detailed analysis within the segments indicated a good agreement between akinesia and delayed activation in the basal-lateral segment solely in the patients with QRS duration

Conclusion: The akinetic segment on 2-dimensional echocardiogram was not matched with the latest activation sites in the LV determined by TDI in patients with ICM

Mothers' experiences of neonatal jaundice: a qualitative study

The importance of neonatal jaundice is not only for its social, economic, and psychological complications resulted from hospitalization of neonates in the hospital, but also for the permanent neurological handicaps and its consequent high morbidity. Since Iranian mothers have no, in spite of the importance of matter, appropriate approach in coping with their newborn jaundice, this study aimed to explore mother's experiences of neonatal jaundice.This qualitative study was carried out through in-depth semi-structured interviews with 14 mothers whose infants were hospitalized in one of the hospitals affiliated to Shahrood University of Medical Sciences with a diagnosis of neonatal jaundice. The participants were selected purposefully and the data were analyzed using qualitative content analysis.Two main themes and several subthemes emerged from the data. The main themes were as follows: mothers' experiences of jaundice crises and its management, and mothers' present experiences after crisis of jaundice. First theme arranged into four subthemes and second theme was grouped into three subthemes.Mothers' and grandmothers' cultural and dietary beliefs have an important impact on mothers' health-seeking behavior. Educational programs about neonatal jaundice and its management through prenatal care consulting and mass media is recommended as an important priority for health system of country

Neonatal seizures in a rural Iranian district hospital: etiologies, incidence and predicting factors

Current study determined the overall incidence, common causes as well as main predictors of this final diagnosis among neonates admitted to a rural district hospital in Iran. This study was conducted on 699 neonates who were candidate for admission to the NICU. Study population was categorized in the case group, including patients exposed to final diagnosis of neonatal seizures and the control group without this diagnosis. Neonatal seizure was reported as final diagnosis in 25 [3.6%] of neonates. The most frequent discharge diagnosis in the seizure group was neonatal sepsis and in the non-seizure group was respiratory problems. No significant difference was found in early fatality rate between neonates with and without seizures [8.0% vs. 10.1%]. Only gestational age <38 week had a relationship with the appearance of neonatal seizure. Low gestational age has a crucial role for predicting appearance of seizure in Iranian neonates

Cor triatriatum: preoperative diagnosis and successful surgical correction in a four-year-old girl

Cor triatriatum is defined as a membrane within the left atrium, which might lead to restricted pulmonary venous return. Diagnosis is usually achieved by echocardiography in early infancy. Therapy of choice is the excision of the membrane. Herein, successful correction of cor triatriatum in a 4-year-old girl is presented, and the clinical features, echocardiographic findings, and the surgical treatment are discussed

Comparison of short-term clinical outcome of non-ST elevation versus ST elevation myocardial infarction

Studies on the prognosis of ST elevation myocardial infarction [STEMI] versus non-ST elevation myocardial infarction [non-STEMI] have shown different results. The present study was designed to compare the early outcome and left ventricular systolic function of patients with ST and non-ST elevation myocardial infarction. The patients' information was derived from 10,065 consecutive patients hospitalized in Tehran Heart Center with acute MI [2007 patients with STEMI and 8058 with non-STEMI]. The baseline clinical characteristics, post-MI complications, left ventricular systolic functions, and 30-day mortality rates were compared. A history of current cigarette smoking, opium addiction, and brain stroke was more frequent in the STEMI patients, whereas hyperlipidemia, hypertension, and obesity were found more in the non-STEMI group. Ejection fraction was higher in the non-STEMI patients than that in the STEMI group, and anterior wall infarction was detected more frequently in the STEMI cases. A history of coronary artery bypass grafting and also percutaneous coronary intervention was observed more in the non-STEMI group. Amongst the in-hospital complications, ventricular arrhythmias [1.4 vs. 0.5, P<0.001] and pulmonary edema [0.4 vs. 0.1, P=0.002] were more prevalent in the STEMI cases. The 30-day mortality rate in the STEMI group was higher than that in the non-STEMI group [5.5 vs. 2.4, P<0.001]. Early mortality in both groups was dependant on advanced age, diabetes mellitus, post-MI bradycardia, and atrioventricular block. Also, female gender and pulmonary edema in the STEMI group and family history of MI in the non-STEMI patients could predict 30-day mortality. There were several differences in the baseline characteristics and early outcome between the two types of STEMI and non-STEMI. The 30-day mortality rate was higher in the STEMI group than that in the non-STEMI group