مجله دانشگاه علوم پزشکی مازندران
پیاپی 24 (پاییز 1378)

Back ground and

Heart failure in one of the most prevalent causes of heart disease and mortality in heart patients. Taking into consideration its rising number in recent days as compare to last two decates. It has been bried to determine the reasons for rehospitalization of heart failure patients. The main point in this study is to find out the precipitating factors of heart failure in these patients.

140 heart patients admitted to Imam Khomeini Hospital in Sari were studied by new data of case study, retrospectively. 111 patients were males and 24 of them were females. 44% of males and 38% of the females were from urbon areas, and the others were from rural areas. The mean age was (64.8 ± 12.2), the mean time of onset of the disease was 3.8 years and.In this period, four times they were hospitalized.

The risk factors which were the main cause of hospitalization were identified in 47.76% of patients. Diet, inproper intake or avoidance of prescribed druge were observed in 38.6% of the patients which are known as prevalent risk factors of heart malfunction. The other predisposing factors were anemia 35% cardiac arrythmias 33%, uncontrolled hypertension 22%, pulmonary infection 21%, in appropriate prescribed drugs 15%, emotional stress 15%, acute myocardial infarction 6.4%, extra physical activity 4.3%, prolonged travelling 2.9%, infections of the other organs (excluding lung), Iatrogenic causes and thyrotoxicosis 2.1%, multiple myeloma and exacerbation of a non cardiac illness 0.7%.

Regarding the statistical results of the heart patients. It is attempled to reduce the number of the heart patients. The simplest and most applicable way is to insist in regular administration of drugs, introduction of all types of relevant medicines and following of proper diet, and reduction of salt consumption

Background and purpouse: Thalasemia major is one the most prevalent congenital anemia. These patients recieved much rate of iron, due to frequent blood transfusion. Indocrine disorders are prevalent due to replacement of iron in indocrinal gland system, example can be of hypogonadism. In this study the delay of puberty in thalasemic patients of Gorgan city and its relevance to the rate of ferritin was evaluated.

This was a case control study conducted on 110 thalasemia major patients in the age group of 8-18 referred to Taleghani pediatric Hospital to receive blood. In 62 control group patients (31 females and 31 males) electeropheresis was done on their blood. The talassemic patients were divided into two groups on the basis of ferritin level. Those with ferritin level less than 1500 mg/dl (31 females, 18 males) In all the groups the stages of sexual puberty was calculated on the basis of Marshal-Tanner table with the 1-5 scale. For better studying of the groups of one and two, they were divided in subgroups of 8- 11, 12- 14, 14- 18 years of age.

There was no significant difference of puberty in the control and case group of age 8- 11 years old. But there was a significant difference (P<0.01) in the case and control group of 12- 14 years old. And in the age group of 14- 18 result was different, that means, none of female case group had complete puberty while in the female control group all had complete puberty. In case of males, onset of puberty was less as compaire to control group and none had complete puberty. Coclusion: This study showed that if the ferritin level in talassemic patient is not under control, it would lead to delayed sexual puberty in both sexes