[Comparison of durability of cardiac bioprosthetic valves between pregnant and non pregnant patients]

Since anticoagulant therapy during pregnancy has high fetal and maternal risks, using bioprostheses valve is recommended for young women with cardiac valve disease who hope to have Children. Evaluation of the effect of pregnancy on the rate of deterioration of bioprosthetic valve is the aim of this study. This case - control study was done on 53 women in the reproductive age who underwent cardiac valve replacement using bioprostheses during 1977- 2001. Twenty seven patients [mean age 22. +/- 7.73 yr] at the time of valve replacement had pregnancy [Group A], and 26 patients [mean age 26.8 +/- 10.9] had no pregnancy after valve replacement [group B]. Mean time of structural valve deterioration, and need for redo valve surgery compared between the two groups. In group A 81.48% of patients underwent mitral valve replacement [MVR], 14.81 aortic valve replacement [AVR], and 3.71% tricuspid valve replacement [TVR]. In group B 84.6% underwent MVR, 11.6% AV R, and 3.81% both MVR and AVR. Fifty six pregnancy occurred in group A which 19.6% of them ended with abortion, 76.8% had normal infant birth 94.64% of pregnancies had no complications and 5.3% had valve degeneration during or 2-4 months after delivery. Average time of freedom from structural valve deterioration in the patients who had pregnancy was 16.60 years and it was 16.74 years in patients who had no pregnancy [P=0.91]. 55.5% of patients in group A underwent redo valve replacement [14.46. +/- 5.4yr] after first operation and 50% in group B after [10.61 +/- 5.63 yr] underwent redo valve replacement. Our finding didn't show any differences in structural valve deterioration time or need for redo valve operation between pregnant and non pregnant patients

[Evaluation of association between androgenic alopecia and coronary artery diseases in men]

Several stydies have indicated that compared to the men without baldness, bald ones have higher risk for development of coronary artery diseases [CAD], and androgen alopecia [AGA] is some how related to CAD. However, none of the previous reports has considered the coronary angiography as the gold standard for diagnosis of CAD. This study was performed to evaluate the validity of such conclusions from the dermatological and cardiological point of view. This Case-Control study was carried out on 400 men, who underwent angiography procedures for diagnosis of CAD. Sampled subjects were matched through their gender and age. Case group consisted of 200 male subjects who had positive results in their angiography and another 200 male subjects whom were found to have no pathological finding through their angiography were considered as control group. Subjects in both group were matched together as well as they were blindly assessed for scaling their baldness and in following, their data were analyzed by Chi-square test and their Odds ratio was calculated, as well. Androgenetic alopecia was found in 137 [68.5%] of patients in case group, whereas only 88 [44%] patients in control group had AGA. There was a statistically significant correlation between male's AGA and CAD [P=0.001]. [95% CI: 1.8-4.2]. Furthermore, patients with CAD were 2.8 times more than subjects in control group at risk of development of AGA. According to our findings, it seems that patients who have stage III of Vertex type of AGA [or above], have greater risk for developing CAD than patinets without AGA

Management of heat stroke in 304 patients during hajypilgri mage

Three hundred and four patients with different degrees of heatstroke were treated by the Hajj medical team of the Islamic Republic of Iran. Four percent of the patients had associated diseases. A simple method using immersion in iced tap water was used for management of heatstroke. Advantages and wide applicability of the technique are described, achieving good results without using sophisticated and expensive means