Utilizing the health belief model to predict preventive behaviors for heart diseases in the students of Islamic Azad university of Sabzevar [2010]

In Iran, over 19% of the population are suffering from heart diseases. Understanding and modifying its risk factors can decrease its morbidity and mortality rate. Planning requires information about present knowledge and performance of the people. The purpose of this study was to determine factors related to preventive behaviors for heart diseases in the students of Islamic Azad university of Sabzevar based on Health Belief Model [HBM]. This cross-sectional study was carried out on 270 students of Islamic Azad University of Sabzevar.The subjects were selected using stratified random sampling. Data collection was performed through a questionnaire designed according to HBM and was completed by self-administeration. A panel of experts approved the validity of the questionnaire and its reliability was verified by means of cronbach alpha test [N=30,alpha=0.68%-0.86%].The data were then analyzed by SPSS versionlS.O software using descriptive and analytical statistics [t-test, ANOVA, Regression analysis and Pearson correlation]. According to the results, the mean score of preventive behaviors for heart diseases among students was 10.41 out of 16. The subjects mostly followed preventive behaviors for heart diseases [65%].of the subjects, 23.8% were overweight or obese most of whom were males over 24 years and married. Perceived barriers, guide for action and preventive behaviors of heart diseases were related to parent education. Among the extended health belief model variables, there was a significant correlation between the presence of guide for action and self efficacy on preventive behaviors for heart diseases .These variables explained 14.6% of variance of preventive behaviors of heart diseases. Mass media [TV and Radio] was the most important source of information. The mean of heart diseases preventive behaviors was moderate among students, however, a significant percentage of students were overweight. Based on the results, using mass media and increasing self efficacy in the field of training programs can improve the preventive behaviors for heart diseases

Thromboelastography analysis after autologous transfusion in patients undergoing coronary artery bypass surgery

Acute normovolemic hemodilution [ANH] includes the removal of blood from a patient either immediately before or shortly after the induction of anesthesia and the simultaneous replacement with an appropriate volume of plasma substitute to maintain normovolemia. Thromboelastography [TEG] is a non-invasive diagnostic approach designed to monitor and analyze the coagulability state of a blood sample in order to assist clinical assessment of the haemostatic condition of the patient. The aim of this study was to use the ANH technique in patients requiring coronary artery bypass graft [CABG] surgery and to confirm the advantages of the ANH technique along with TEG. A controlled randomized clinical trial was conducted in 130 patients [32 females mean age 57 +/- 9.0 years, range 38 to 79 years] who were scheduled for CABG surgery with cardiopulmonary bypass [CPB]. They were equally divided into two equal-sized ANH and control groups [n=65]. Patients in group A underwent ANH with an average of 500 ml whole blood removal after the inducting of anesthesia and their removed blood was replaced with crystalloid solution; blood was not removed in the subjects of the control group. Serum levels of hemoglobin and platelets, TEG parameters analysis, homodynamic changes before and after the operation, and the amount of blood transfused during surgery and in the ICU were checked in both groups. Statistical analysis was performed using repeated measures ANOVA models. After the surgery, there were significant decreases in hemoglobin and platelets levels [p < 0.005], but the decrease was less in the ANH group. However, no difference was found in the amount of platelets decrease between the two groups. Changes in TEG parameters - K, ANGLE, EPL and CI- in the ANH group were statistically significant before and after the surgery [all p-values < 0.05]. Also, there were significant differences in Ma, EPL, and CI parameters between the ANH and control groups [all p-values < 0.05]. Use of ANH in patient undergoing CABG surgery results in greater preservation of coagulation factors and platelets that may reduce the amount of bleeding

[Comparison of the effects of preemptive gabapentin and dextromethorphan on the postoperative pain after open prostatectomy]

Preemptive administration of gabapentin and dextromethorphan has been shown to be effective for reduction of postoperative pain; but the effect of these two drugs has not yet been compared. The aim of the present study was to compare the effects of administration of gabapentin and dextromethorphan on the postoperative pain after open prostatectomy. In a randomized clinical trial, 80 adult males with ASA class of I, II and III who were candidate for open prostatectomy under spinal anesthesia in Shahid Hasheminejad Educational Center [in Tehran] were enrolled and randomly allocated to two groups of gabapentin [n=40] and dextromethorphan [n=40]. In dextromethorphan group, 60 mg of dextromethorphan syrup and in gabapentin group, 300 mg of gabapentin syrup were administered 2 hours preoperatively. During operation, the maximum height of block was determined at 5, 10 and 15 minutes after spinal anesthesia establishment. In postoperative period, at 1, 2, 12, and 24 hours, the pain intensity was measured through Visual Analogue Pain Scale [VAS]; and, overall opioid consumption and the time to first analgesic request were recorded as well. While the pain intensity in all the measurements was comparable between groups, at the 2nd hour, the pain was significantly lesser in gabapentin group [2.70 +/- 1.51 vs. 3.74 +/- 1.77, P=0.006]. Also, the time for the first analgesic request was comparable between study groups; however, the total dose of postoperative opioid consumption was lesser in gabapentin group [45.0 +/- 39.32 vs. 64.45 +/- 32.12 mg, P=0.018]. Moreover, the height of block showed no significant difference. Preemptive oral administration of 300 mg of gabapentin syrup in patients undergoing open prostatectomy under spinal anesthesia significantly lessens the pain intensity and the total dose of opioid consumption compared with 60 mg of dextromethorphan syrup. Meanwhile, the level of spinal anesthesia and the time for the first analgesic request were comparable between groups

[Evaluation effect of acute normovolemic Hemodilution [ANH] on hemostasis in coronary artery bypass surgery [CABG] under cardiopulmonary bypass with thromboelastography [TEG] analyzer]

Recognizing that allogenic transfusion is best avoided in all patients, we implemented a policy of transfusion avoidance in coronary artery bypass graft surgery with use of acute normovolemic hemodilution [ANH] technique. ANH is a blood conserving technique and a form of pre-operative autologous donation [PAD].Blood stored at the bedside at room temperature [up to 6 hrs.] ANH technique preserves factors and coagulation of stored blood and also has several advantages in physiologic aspect. Thrombelastogrphy is a noninvaive diagnostic instrument designed to monitor and analyze the coagulation state of a blood sample in order to assist in assessment of patient clinical haemostatic condition. A prospective, randomized, clinical trial conducted in 130 patients scheduled surgery with CPB, that divided to two 65 persons, A [ANH] and B [non-ANH] group. Patients underwent ANH with avg. of 500 ml whole blood removed after induction of anesthesia and hemodilution was replaced with crystalloid solution. Hemoglobin, platelets, TEG analysis and homodynamic changes pre and post operation, amount of blood transfusion during surgery and in ICU checked in both groups. This study shows that amount of Hb, pit, in ANH group was greater than B group. Changes in components of R, K, ANGLE, MA in ANH group were statistically significant, that show greater preservation of coagulation factors, platelets,[actors, platelets, [amount and function] and fibrinogen in ANH group. Changes in homodynamic postoperatively were less in ANH group. performance of ANH in CABG is effective in reduce in blood transfusion and post operation bleeding