مجله دانشگاه علوم پزشکی گیلان
پیاپی 85 (بهار 1392)

Smoking is one of the major factors threatening the health of community، especially the young. It is a complex behavior associated with psycho-social، biochemical and economic factors. Health Belief Model tries to describe health behaviors focusing on beliefs and attitudes.

This study aims to determine the relationship between four constructs of the Health Belief Model (HBM) (Perceived Severity، Perceived Susceptibility، Perceived Barriers and Perceived Benefits)، and cigarette smoking among male students at Guilan University of Medical Sciences.

This cross-sectional study was carried out on 222 male medical university students of Guilan in 2011. Data were collected using a two part questionnaire including items about demographic features (age، study major، number of children in family،…) and the four HBM constructs. Data analysis was performed using the Chi-square and Mann-Whitney U tests.

Mean age of the students was 22. 3±3. 2 years and 87. 4% were single. In total، 51 students (23%) were current smoker. Results of Mann- Whitney test showed significant differences in perceived barriers (P=0. 002) and perceived benefits (P=0. 000) between male smokers and nonsmokers. Results of multivariable logistic regression analysis also indicated that having smoker friends (OR=16. 68)، age (OR=1. 32)، mother with high education level (OR=7. 51)، more perceived barriers (OR=2. 195) and low perceived benefits toward non-smoking (OR=0. 621) are closely related with smoking.

The results suggest that constructs of HBM can be considered when examining the related Factors with cigarette smoking and developing smoking prevention programs.

The side effects of first line anti TB drugs may lead to a huge waste of money and as a result the patients may refuse to continue the treatment and in some cases even leads to death.

To find the side effects coming from such drugs among the patients admitted in Giulan Province، northern Iran.

This is a cross-sectional study on the patients with tuberculosis who were hospitalized in Razi hospital from 2002 to 2008. The information contained in the respective medical files was extracted and entered into the questionnaire.

Results showed that 61% of the total 387 TB patients were male. The average age of the participants was 45/5±19/3 years and 56 cases (14/5%) were with complicated condition. As observed، %27. 3 of the cases were with more than one complication. Of the patients with complications، 27 patients (48/2 %) were with liver disease (hepatitis drug)، 1 patient (1/7 %) with ocular complications، 46 patients (82%) with gastrointestinal side effects (anorexia، nausea، vomiting، pain epigastric، ichter، diarrhea) and 3 patients (5/3 percent) had skin conditions. Also، treatment was discontinued for 1. 8% of the total 387 patients with tuberculosis due to the drug side effects.

Timely consideration and management of the side effects can help inhibit the progression and prevention of respective complications.

Despite several improvements in cardiovascular interventional procedures، the limitation due to their complications has made the cardiologists doubtful about them and much interest has focused on the acute outcome and complications of such interventions. Few surveys have been done in Iran on the complications and outcomes of cardiovascular interventional procedures as substitutes for costly surgical managements.

To investigate success rate and outcomes and intrahospital complications of the patients undergoing cardiovascular interventions in Eman-Khomaini Hospital in 2010-2011.

In a descriptive retrospective survey، the medical files of 412 patients who underwent cardiovascular interventional procedures in Emam-Khomeili Hospital in 2010-2011، were studied and their clinical procedural and demographic data were derived. The respective laboratory data including Hb، HCT and CPK-MB before and after procedure and their post-procedural EKGs were assessed. Any major port-procedural major complications of the patients were registered.

The most common procedure was coronary artery angioplasty (352 patients)، while other procedures were PTMC in 24 patients (5. 8%)، renal artery angioplasty in 14 patients (3. 4%)، ASD closure by Occluder in 7 (1. 7%)، lower limb vascular in and carotid artery angioplasties in11 (2. 66%) and 1 (0. 24%) patients، and PS valvuplasty in 3 patients (0. 7%). Among the patients who underwent coronary angioplasty، 8 (2. 27%) showed asymptomatic rise of CK-MB without any significant change in EKG. One case of coronary artery perforation in CTO plasty was detected while two patients were complicated with no reflow during 18 months. In thosewho underwent PTMC، only one case (4. 2%) of asymptomatic mild MR was detected. Totally، no mortality was reported and no other complications were detected in the patients.

As the survey indicates، if the patients are chosen properly and the operators are competent and experienced، cardiovascular interventional procedures can be used with high efficacy، low risk and acceptable complication rate in the treatment of many cardiovascular disorders.

Traumatic Arteriovenous Fistula (AVF) Called to an abnormal relationship between artery and vein which occurs in 10% of arterial traumas. If treatment of AVF due to trauma delayed، different outcomes including Heart failure، Varices and Varicose ulcers may accure. In case of chronic traumatic AVF، open surgery may lead to remarkable outcomes، Presence of many lateral veins and varicose veins in fistula، noticeably increases the risk of bleeding during surgery. Endovascular methods such as Fistula Embolization are appropriate alternates with fewer computations instead of open surgeries and easily done by local anesthesia. Case Repot: The patient was a 53-year-old man who was hit by shrapnel pieces in war. In CT angiography، AVF of lower limb was reported. He underwent right lower limb angiography and the fistula between peroneal artery and peroneal vein was amended by edndovascular method with embolization.

Edndovascular techniques are more appropriate for treatment of arteriovenous fistula instead of open surgery.