[Survival rate and its related factors in patients with acute myocardial infarction]

It has been noted that the myocardial infarction is an increasing episode in Islamic Republic of Iran and there are many procedures and methods which can help to reduce the number of death from this ongoing event. The aim of this study was to determine the survival rate in those patients who have had acute myocardial infarction and its association with different variables. This descriptive analytic study evaluates 111 cases of acute myocardial infarction admitted in Yasuj Imam Sajjad hospital during the year 2004 and 2005. Data were collected using a questionnaire which was completed through direct interviewing by trained personnel. The data were analyzed by standard statistical tests using SPSS software. The mean age of patients was 57 +/- 12 years. The mean time of having access to physician after MI was 4 +/- 2.2 hours. The mean time of reaching hospital after physician order was 5 +/- 4.9 hours. The mean time of hospitalization was 4 +/- 1.67 days. Considering the past history of these patients revealed that 31 percent were smokers, 16 percent had the history of previous ischemic heart disease, 63 percent had hypertension, 8 percent had diabetes mellitus, 95 percent had clip I, 95 percent had no previous block, 82 percent had Ml with Q wave. The survival rate in our study was found to be 0.91 in the first 10 hours, 0.847 in the first day, 0.829 in the first 28 days, 0.820 in the first third months, 0.792 in the first six months and 0.771 in the first 10 months of disease. The mortality rate during the first month among the patients with heart failure turned out to be higher than that of the other similar studies performed in other parts of the country; however, the annual survival rate proved to be less. The most important causes of survival after the stroke are being single, smoking, fatness and angina pain

study on diagnostic value of fine needle aspiration [FNA] test in determination of malignant thyroid nodules based on pathologic findings

thyroid nodules are very common and of course the most important point to approach thyroid nodules is to find out whether the nodule is benign or malignant. biopsy is the most definite way to differentiate malignant nodules from benign ones and this is at least, equal with a labectomy. FNA is a method which was first introduced in 1930 and led to a decrease in the number of thyroidectomy nowadays this is the best way to approach the thyroid nodules this study was performed on 100 cases of thyroidectomy to find out the sensitivity, specificity and accuracy of FNA in diagnosis of malignant thyroid nodules. candidates for thyroidectomy who referred to mofateh clinic in yasuj were evaluated by FNA and also open biopsy. FNA results showed 78% +/- 15% sensitivity, 91% +/- 13% specificity and 89% +/- 13% accuracy. positive predictive value of FNA was 75% +/- 35% and negative predictive value was found to be 93% +/- 20% considering the results of this study, FNA can be used instead of biopsy in approach to thyroid nodules and this will help to prevent unnecessary operations and high dose of radiation to neck

Alfentanil effects on neonatal Apgar score and hemodynamic changes of pregnant women that underwent caesarian section in response to tracheal intubation

Caesarian section is the most common operation in gynecoiogy field. Selection of anesthetic drugs for this operation needs so many considerations. Anesthetic drugs for this operation must prevent sever hemodynamic changes to tracheal intubation in mother and without side effects on neonate. This study was conducted to determine the effect of alfentanil given before induction of anesthesia on cardiovascular response to tracheal intubation in mother and Apgar score of neonate in Yasuj Emam Sajad hospital. In this clinical trial 60 patients who were candidates for elective c/s delivery under general anesthesia, in ASA 1, without fetal distress, after taking knowledgably satisfaction for participant in study were allocated to 2 groups randomly. In both groups anesthesia induced by sodium thiopental, scholin and atracorium but in trial group alfentanil 5 microG/kg was given intravenously one minute before induction of anesthesia. Attenuated systolic blood pressure right after tracheal intubation and 5 minutes after tracheal intubation when compared with control group. Also in study group pulse rate of mothers had a smaller increase in comparison with control group. In this study systolic and diastolic blood pressure decreased 10 minutes after tracheal intubation but this decrease was less in comparison with control group. Apgar score of neonate in study group had not a meaningful difference in comparison with control group. According to this study mothers who received alfentanil before induction of anesthesia had less increase in their systolic blood pressure and heart rates after tracheal intubation but systolic and diastolic blood pressure had decreased more in control group in comparison to trial group ten minutes after tracheal intubation. This phenomenon is due to more narcotic administration after delivery of neonate in control group