فهرست مطالب

  • Volume:13 Issue:3, 2019
  • تاریخ انتشار: 1398/07/17
  • تعداد عناوین: 6
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  • Anita Sadeghpour, Mehrdad Azimi, Hamid Reza Pouraliakbar, Majid Kyavar, Azin Alizadehas, Hossein Nazari, Reza Hajizadeh* Page 1
    Background

    By estimating the total coronary plaque burden, the Coronary Artery Calcium (CAC) score determines the risk of Coronary Artery Disease (CAD). The presence of a zero CAC score may be highly predictive of very low risk patients for Major Cardiac Adverse Events (MACEs) due to its close relation with the severity of CAD.

    Objective

    The present study aimed to evaluate the value of a zero CAC score for predicting MACEs in patients older than 60 years suspected of CAD.

    Methods

    Between April 2011 and March 2012, 128 patients aged > 60 years with a zero CAC score on admission without a previous history of CAD were consecutively included in this study with a mean follow-up period of 45.7 months. The continuous variables were compared using t-test or Mann–Whitney U test and the categorical ones were compared using chi-square test. The statistical analyses were done using the SPSS statistical software, version 23.0.

    Results

    This study was conducted on 128 patients (35 males and 93 females). The incidence of MACEs was 2.3% in a mean follow-up period of 45.7 months and 0.6 per 100 patient-years. Additionally, the MACE-free survival rates were 99.1%, 99.1%, and 87.7% in one, three, and five years, respectively. The negative predictive value of a zero CAC score for predicting long-term MACEs was 100% in the patients older than 70 years and 96.8% in those aged between 60 and 70 years. No cardiac-related death was recorded within the follow-up period.

    Conclusion

    A zero CAC score had a high negative predictive value for predicting long-term MACEs in elderly patients with mild to moderate pretest probability of CAD, which reached 100% among the patients older than 70 years

    Keywords: Computed Tomography Angiography, Aging, Coronary Artery Disease, Calcium Scoring
  • Obaydah Yaser Tahboub, Umran Dal Yilmaz * Page 2
    Background

    Electrocardiogram (ECG) is a diagnostic tool that is routinely used non-invasively to assess the electrical and muscular functions of the heart. All nurses should be able to recognize basic ECG rhythms.

    Objective

    This study aimed to determine the ECG knowledge and practice among nurses in university hospitals in North Cyprus.

    Methods

    This descriptive study was conducted on the registered nurses who worked in critical care units, including intensive care unit, coronary care unit, emergency department, recovery department, and cardiology department in two university hospitals (Near East University Hospital and Dr. Suat Günsel Hospital). Totally, 72 registered nurses worked in both hospitals 65 one of whom took part in the study voluntarily. The study data were collected using a researcher-made questionnaire. The questionnaire was prepared in Turkish and was used after being reviewed by three specialist nurses and one cardiologist. The questionnaire contained three sections and 15 questions.

    Results

    The majority of the nurses had B.Sc. degrees (93.8%) and recorded ECGs for patients (89.2%). The majority of the participants had passed ECG training courses (60.0%). Considering the nurses’ knowledge of ECG, the total frequency of correct answers was 69%. Considering their practice of ECG interpretations, the total frequency of correct answers was 67%. Cardiology department nurses had the highest percentage of correct answers (P = 0.002). Indeed, the lowest and highest means of correct answers were observed among the nurses with less than one year and more than six years of work experience, respectively.

    Conclusion

    The study results showed a high level of ECG knowledge and practice among the nurses. The hospital unit and passage of previous ECG training courses played an important role in the nurses’ experience of ECG interpretation. Hence, ECG training

    Keywords: Electrocardiography, Nursing, Translational Medical Research
  • Samane Sistani, Mohammad Reza Hassibian, Mahmoud Tara, Hamed Tabesh, Sepideh Hasibian *, Somayeh Norouzi, Mostafa Dastani Page 3
    Background

    Ischemic Heart Disease (IHD) is the leading cause of mortality in both developed and developing countries. It accounts for more than 15% of the total mortality worldwide. At the global scale, the massive occurrence of this disease can have tremendously negative effects on economy, especially among young people.

    Objective

    The present study aimed to investigate the relationship between IHD and several important risk factors involved. It also looked into the prevalence of IHD among patients between 20 and 40 years of age.

    Methods

    The present cross-sectional, retrospective survey was conducted in three referral heart hospitals affiliated to Mashhad University of Medical Sciences, Iran. The required data were extracted from integrated Hospital Information System (HIS) from 2010 to 2012. The data included clinical and demographic information, such as age, gender, marital status, occupation, diabetes, blood pressure, blood cholesterol, cigarette smoking, and family history. In the next phase, clustering technique and k-means algorithm were applied using the WEKA (3-6-9) software.

    Results

    Totally, 88623 patients suffered from heart diseases between 2010 and 2012. When the specific inclusion and exclusion criteria were considered, the number of records was restricted to 776, which included 548 males. The clustering technique was done in two phases. Firstly, there were four clusters extracted and secondly, cluster analysis was done in terms of age and gender. According to the findings, cigarette smoking in males aged between 20 and 40 years was the main risk factor.

    Conclusion

    The present research aimed to investigate the risk factors of heart diseases among patients between 20 and 40 years of age. Those below 40 years old were known as the main human resource in the community. The early prevalence of IHD in this population disabled them for the rest of their lives. This disability could also lead to irreparable physiological effects along with financial costs. It could also impose high costs on the society. Recognition of the risk factors of heart diseases at younger ages could contribute to healthcare policies.

    Keywords: Risk Factors, Coronary Disease, Myocardial Ischemia
  • Marzieh Nikparvar, Hossein Farshidi *, Abdoulhossain Madani, Roghayeh Ezati rad, Mohsen Azad, Tasnim Eghbal Eftekhaari, Amin Ghanbarnejad, Iran Rostami, Hussein Heshmat Kassem Page 4
    Background

    Hypertension is an important cause of stroke and heart and kidney diseases, which account for nearly two-thirds of all mortalities worldwide. Studies conducted in different provinces of Iran have shown that hypertension is common in the country. However, awareness, treatment, and control rates of the disease have been reported to be low in developing countries.

    Objective

    This study aimed to assess the prevalence, awareness, treatment, and control of hypertension in Hormozgan province.

    Methods

    This descriptive study was conducted on 5065 participants older than 18 years. A questionnaire was completed and blood pressure was measured according to the ESC/ESH 2018 guidelines. Systolic Blood Pressure (SBP) ≥ 140 mmHg, diastolic Blood Pressure (DBP) ≥ 90 mmHg, or receiving any antihypertensive treatment was considered to be hypertension. The data were analyzed using logistic regression, odds ratio, chi-square, and descriptive statistics.

    Results

    The prevalence of hypertension in Hormozgan province was 23.2%. Only 28.3% of the participants were aware of their hypertension; 17.6% were treated and only 7.2% had controlled hypertension. Hypertension was more prevalent in urban areas (28.8% versus 18.1%), but more controlled among the rural population (13.2% vs. 2.4%). The frequency of hypertension increased from 6.2% to 58.9% in 20 - 29 age group compared to the cases older than 70 years, which indicated a linear trend between the increased risk of hypertension and advanced age.

    Conclusion

    The results showed that hypertension was more prevalent in urban areas in south of Iran. Indeed, nearly less than 30% of the participants were aware of their disease and less than 4% of urban population were controlled. On the contrary, almost 13% of the rural population, particularly females, had controlled hypertension.

    Keywords: Hypertension, Blood Pressure, Prevalence, Awareness, Iran
  • Mohammadreza Edraki, Maryam Sadeghi, Kambiz Keshavarz*, Nima Mehdizadegan Page 5
    Background

    Conduction disturbances can occur early after total correction of Tetralogy of Fallot (TOF). Some of these arrhythmias and alterations like complete right bundle branch block are permanent, while some others like Junctional Ectopic Tachycardia (JET) are transient.

    Objective

    This study aimed to evaluate the early post-operative arrhythmias and their risk factors among pediatric patients with TOF after surgical total correction.

    Methods

    This retrospective study was conducted on pediatric patients aged six months to 15 years old (52.5% male and 47.5% female) with TOF who had consecutively underwent surgical total correction during 2015 - 2017. Patients with additional concomitant cardiac operations, previous arrhythmias before the surgery, or any co-existing cardiac anomalies as well as those with severe post-operative complications were excluded. All pertinent data and Electrocardiographic (ECG) documents were recorded several times right after the operation to detect arrhythmias and ECG changes and to find any association between the related risk factors and the occurrence of arrhythmias.

    Results

    Out of the 118 TOF patients who underwent total correction, 27% were under the age of one year and 73% were above one year old. Among the patients, 78.5% developed permanent ECG changes, mostly complete right bundle branch block and left anterior or posterior hemiblock. Out of these patients, 8.5% had JET together with other permanent arrhythmias and 8.5% had transient JET solely. Therefore 17% of all patients developed JET and 21.5% had no permanent noticeable ECG changes. The most permanent arrhythmia was right bundle branch block followed by left anterior hemiblock and left posterior hemiblock. These arrhythmias mainly manifesed amongst the patients with lower age and those with severe subvalvar pulmonary stenosis. The results showed a significant relationship between the incidence of JET and use of milrinon after the operation. There was no myocardial ischemia or infarction from injury to aberrant coronary arteries passing over the right ventricular outflow tract.

    Conclusion

    Early post-operative permanent arrhythmias after total TOF repair was probably more common amongst the patients who were below one year old with more severe subvalvar pulmonary stenosis. Nonetheless, the occurrence of transient JET was mostly observed in the patients who were given milrinone as a post-operative inotrope medicine

    Keywords: Tetralogy of Fallot, Arrhythmia, Junctional Ectopic Tachycardia, Milrinone, Operation, Bundle-Branch Block
  • Amin Pirooz, Mohammad Mojalli*, Mousa Sajjadi Page 6
    Background

    Intravenous (IV) catheter insertion is the most common invasive hospital procedure and its related complications are costly for both patients and the healthcare system. Phlebitis or inflammation of the vein is an important cause of premature catheter failure.

    Objective

    This study aimed to determine the effect of IV administration with body temperature on indwelling of peripheral venous catheter.

    Methods

    This randomized controlled clinical trial was conducted among 106 patients who required IV administration and were admitted to internal wards of Imam Ali Hospital in Sarayan, Iran in 2016. The patients were randomly divided into an intervention (n = 53) and a control (n = 53) group via permuted block randomization with four blocks. The solutions and medications were infused by infusion pump SN-1500SERIAL at body temperature (37 ℃) in the intervention group and at a mean temperature of 24 ℃ in the control group. The insertion sites were observed every two hours for evidence of phlebitis according to the Infusion Nurses Society. The indwelling of the peripheral vein catheter was also recorded every two hours. The data were collected using an information sheet and were analyzed by t-test and chi-square test using the SPSS 16 software. P < 0.05 was considered to be statistically significant.

    Results

    There were no significant differences between the two groups in terms of age, sex, education level, marital status, underlying diseases, addiction, Body Mass Index (BMI), and the mean received volume of infused fluids. The results also showed no significant differences between the two groups in terms of occurrence of phlebitis (P = 0.28). Despite the increase in the indwelling of the peripheral vein catheter in the two groups, the differences were not statistically significant (P = 0.13).

    Conclusion

    Although IV administration with body temperature has been reported to be slightly effective in indwelling of the peripheral venous catheter, this study showed no significant evidence. Thus, further studies are recommended to be conducted on lower and higher degrees than body temperature (37 ℃).

    Keywords: Catheters, Body Temperature, Indwelling