Acta medica Iranica
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Acta medica Iranica · Jan 2013
Venous thromboembolism in medical critically ill patients: prevalence and incidence.
The objective of this study was to determine the prevalence and incidence of venous thromboembolism among critically ill medical surgical patients. In this cross sectional and retrospective study, we observed 243 patients who were first admitted at the intensive care unit. Patients who were diagnosed with deep venous thrombosis or embolism either by clinical or paraclinical methods were enrolled. ⋯ Among 6 VTE cases 3 of them didn't receive any anticoagulant prophylaxis, 2 patients received LDUH 5000 unit twice a day and one patient received LMWH 60 mg daily but all developed VTE although receiving prophylaxis. We found that the prevalence of proximal lower limb DVT among medical-surgical critically ill patients remaining in the ICU for ≥3 days is about 9.4% and the incidence of that is about 5.2%. Further studies should be performed in order to assess the benefits and risks of venous thromboprophylaxis in Iranian patients.
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Acta medica Iranica · Jan 2013
Comparative StudyAir pollution: the knowledge and ideas of students in Tehran-Iran, and a comparison with other countries.
Study of students' knowledge about air pollution can help authorities to have better imagination of this critical environmental problem. This research examines guidance school and high school students' ideas about air pollution and the results may be useful for the respective authorities to improve cultural and educational aspects of next generation. In this cross-sectional study, a closed questionnaire was used to examine knowledge and ideas of 2140 randomly selected school students of Tehran-Iran about composition of unpolluted air, air pollution and its causes and consequences. ⋯ In response to question "most common gas in unpolluted air" nitrogen was mentioned by only 23.7%, While 45.1% of students mentioned oxygen. In general, student's knowledge was not acceptable and there were some misconceptions such as "supposing oxygen as the most prevalent gas in unpolluted air". The findings of this survey indicate that, this important stratum of society of Iran have been received no sufficient and efficient education and sensitization on this matter.
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Acta medica Iranica · Jan 2013
Comparative StudyRisk factors for neonatal mortality among very low birth weight neonates.
The objective of this study is to determine risk factors causing increase in very low birth way (VLBW) neonatal mortality. The medical files of all neonates weighing ≤1500 g, born in Vali-e-Asr hospital (2001-2004) were studied. Two groups of neonates (living and dead) were compared up to the time of hospital discharge or death. ⋯ The causes of death of those neonates weighting over 1250 g should be sought in factors other than weight. Survival rate was calculated to be 80.4% for neonates weighing more than 1000 g. The most important high risk factors affecting mortality of neonates are: low birth weight, need for resuscitation at birth, need for ventilator use and intraventricular hemorrhage.
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Procalcitonin (PCT) is a prohormone that has been used as a marker for the diagnosis of bacterial infections. The aim of this study was to survey PCT levels in patients with cirrhosis. Sixty-four patients with hepatic cirrhosis and 32 healthy blood donors were enrolled in this study. ⋯ Among other cirrhotic patients, positive PCT levels were 77% for hepatitis B, 70% for cancer and 53.3% for unknown groups respectively. Serum procalcitonin levels were significantly higher in cirrhotic patients with bacterial infection (2.65±1.11 ng/ml) than those without infection (0.59±0.16 ng/ml, P=0.0001). PCT assay in cirrhotic patients may help diagnosis of sepsis and reduce unnecessary antibiotic use.
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Acta medica Iranica · Jan 2013
The evaluation of perioperative safety of local anesthesia with lidocaine containing epinephrine in patients with ischemic heart disease.
The use of local anesthesia with lidocaine containing epinephrine in patients with cardiac disease is controversial in the literature. The aim of our study was determining the safety of use the local anesthesia contain epinephrine in patients with ischemic heart disease that undergoing reconstructive surgery. Thirty two patients that had known ischemic heart disease and candidate to undergo reconstructive surgery for skin tumor enrolled in this study. All patients continued their medication for cardiac disease till morning of the operation. 10 ml lidocaine 2% containing 1:100,000 epinephrine was injected in patients for local anesthesia. ⋯ None of our patients have any early complications because of infiltration of local anesthetic containing epinephrine in our patients. The use of 10 ml 2% lidocaine with epinephrine 1:100,000 in patients with cardiac disease represent a safe anesthetic procedure. These patients experienced a more profound anesthesia with hemodynamic stability and without myocardial ischemic changes.