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Showing 2 results for Dostkami

Hosein Dostkami , Effat Mazaheri ,
Volume 6, Issue 3 (Autumn 2006)

  Background & Objective: Myocardial infarction is a comman cause in hospitalized patients with mortality rate of about 30%. Ontime diagnosis, earlier management and simply (time) factor have very important role in effective treatment, prevention of progression of injury and improvement of prognosis in the patients. Nearly 60% of mortality in this disease is in the first hour after onset of symptoms. Therefore this study was done to evaluate the refferal process, admission and hospitalization in patients with myocardial in farction at Buali hospital Ardabil.

  Methods: This descriptive and cross-sectional study was done on 77 patients with primary diagnosis of acute myocardial infarction based on clinical findings and ECG changes in the form of 1mm ST segment elevation in two adjacent leads or new LBBB or LBBB with unknown onest. Fourteen subjects were excluded from the study based on subsequent examination of continuous ECG and enzymatic evidence rulling out the presence of MI. Data were analyzed with descriptive and inferential statistics.

  Results: Referral time of patients after onset of symptom was 6.72 ± 5.53 hours. 73.02% of the patients referred with delay (90 minutes after onset of symptom). Mean referral time after onset of symptoms was 7.15±7.07 hours, 60.32% of the patients were outpatients, 34.92% were samples referred by other medical centers and 4.76% by emergency service in the latter group there was no delay in referring time. Mean admission time from emergency room to CCU was 1.04±0.94 hours. 47.62% of the patients underwent thrombolytic therapy with stereptokinase. In this group mean time from entrance to emergency until beginning thrombolytic therapy (Door to Needle time) was 1.22±0.34 houre.

  Conclusion: Because earlier beginning of thromolytic therapy had important role in decreasing mortality and morbidity in patients with myocardial infarction, we can increase survival rate in these patients by recognizing factors delaying, admission and earlier initiation of treatment.

Hasan Anari , Hosein Dostkami, Mehrdad Ashayer ,
Volume 7, Issue 3 (Autumn 2007)

  Background & Objectives: Heart failure (HF) is a pathophysiologic state in which cardiac dysfunction leads to insufficient pumpage of blood for metabolic needs of body. One of the important problems in primary approach to patients with HF, is estimation of HF severity. The present research is an attempt to investigate the accuracy of CXR in diagnosis of HF severity especially in emergency wards.

  Methods: This sensitivity analysis study was conducted on 59 patients admitted to emergency ward of Buali Hospital during March–September 2003, with primary diagnosis of HF. One randiologist used to observe and report radiologic findings without knowing the results of each cardiography.Then cardiologists used to check on the reports and selected patients whose EF was under 50% and eventually sensitivity and specificity of radiologic findings in diagnosing severity of HF (EF ≤ 35%) were calculated.

  Results: 59 patients (53% female and the rest male) were investigated whose age mean was 65.6±10.9 EF mean was 33.4±9.09. In the diagnosis of pulmonary arterial hypertension, CXR had 72% sensivity and 18% specifity, considering the reliance on the CXR in diagnosis of severe HF (EF ≤ 35%) findings were: cardiomeglay (94%), pulmonary artery congestion (75%), interstitial edema (78%) and alveolar edema (76%) with high specifity the reliance on the combination of pulmonary cephalization, interstitial edema and pleural effusion was to have 92% sensivity and 10% specifity.

  Conclusion: According to high sensitivity of cardiomegaly, pulmonary arterial congestion, interstitial edema and pleural effusion, lack of there findings in CXR reduce probability of severe HF. Alveolar edema because of its high specificity increases probability of severe HF. CXR also has high sensivity in diagnosis and R/O of PAH.

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مجله دانشگاه علوم پزشکی اردبیل Journal of Ardabil University of Medical Sciences
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