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  Background & Objectives: Hypertension is one of the major factors of cardiovascular diseases among hemodialysis patients which shoes its effect along with vascular changes. 75-80% of the patients with ESRD are hypertensive. Despite many available druge to decrease the blood pressure, many of these patients remain hypertensive. The major cause Of Hypertension is the increase in the blood volume which is due to the water and salt retention in the body. It doesn't seem that the uptake of body's fluid for a short period can have a remarkable effect on the pressure.

  Methods: This descriptive analytic study was done on 80 hemodialysis patients who were under trearment at Buali hospital. First patients were investigated according to age, sex, frequency of dialysis in the week and dialysis duration. These for each patient the blood pressure before and during dialysis and weight changes before and after dialysis with two consectiue sessions were measured. Calculated and MAP was determined. Finally data was analyzed through SPSS.

  Results: 48 out of 74 patients (64.9%) had hypertension. Blood pressure was controlled in 41 patients (55.4%). Age, sex, dialysis period and sessions of dialysis did not have a significant relationship with hypertension control. The study showed a high prevalence of high blood pressure in hemodialysis patients (64.9%). The blood pressure was not controlled in the majority of patients (44.6%).

  Conclusion: Patients' weight changes have no significant effect on hypertension. This shows that the causes for blood pressure can be due to other causes different from increase in the blood volume among hemodialysis patients and perhaps the chronic blood volume increase is not related to hypertension.

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  Background & Objectives: With regards to the importance of health and Quality of Life improvement in the elderly in relation with physical activity and self esteem, the aim of this study was to determine the effect of programmed exercise on the self esteem of elderly residents in the nursing home of Rasht city in 2008.

  Methods: This study included a pretest and post test on 32 qualified samples. The Rosenberg self esteem scale were filled by them. Then, they attended a programmed exercise for one month. The scale was filled again by participants. The collected pre-test and pot-test data were analyzed using a-t-test SPSS software.

  Results: The average age of the participants was 73.53 (± 8.31). Most of them were widowed, 43.8% had no children, 87.5% were uneducated and the rest (12.5%) had a primary level of education. 37.2 of them had resided in the nursing home for less than one year and their average of residence was 1357±17.11 days. The source of income for 59.4% of participants was through children and relations. 27 persons (84.4%) had frequent visits with relations. 34.4% of them had a disease in history. There were significant correlations between number of children, marriage, education and job and number of previous jobs, gender job and education and number of previous job, visit frequency and education and time of the last visit. The correlation between sums of self esteem scores before and after the exercise was positive and significant and 22.81±4.84 Average of self esteem score before and after programmed exercise was 26.84±4.35.

  Conclusion: Regular exercise is effective in improving the self-esteem among the elderly and it can recommend to the elderly as a safe and cheap method.

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Background & objectives: Endoscopy is an invasive and painful procedure. The use of sedatives, especially in children, is expanding. The aim of this study was to compare the sedative effects of ketofol and the combination of midazolam-ketamine in upper endoscopy in children aged 1 to 14 years who referred to Taleghani Hospital in Gorgan.
Methods: In this study, 55 children entered the study 1 to 14 years after obtaining parental consent. They were then divided into two groups, ketamine-propofol (KP) and ketamine-midazolam (KM), by simple randomization. At all stages of the work, patients underwent cardiac and respiratory monitoring. All hemodynamic parameters and ramsy sedation score (RSS) were recorded for all participants in the 5 time periods before, during and after endoscopy. ANOVA test and bonferroni tracking test were used in spss software to analyze and compare data.
Results: 54.5% were male patients. The ANOVA test showed that the scores of the two groups at the time of the study had a statistically significant difference (p=0.02). In the KM group, the mean blood pressure and heart rate of patients increased at all times compared to before the intervention (p=0.005). Blood pressure in the KP group had a steady trend over time (p<0.001).
Conclusion: There was a statistically significant difference between the scores of the two groups and the group (KM) had higher scores, but the use of two drug regimens Propofol-Ketamine and Ketamine-Midazolam caused a good sedation in pediatric endoscopy. The propofol-ketamine compound resulted in greater hemodynamic stability in cardiovascular parameters during and after endoscopy

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Background & Objective: Bleeding is a common complication during heart surgery, and management of heparin and protamine consumption during operation affects hemeostasis. The dosage of protamine sulfate is variable based on the amount of heparin used and studies have reported different results. The aim of this study was to evaluate the effect of protamine sulfate administration after cardiac surgery on the drainage of the patient's blood secretions.
Methods: In this retrospective cross- sectional study, required data from 120 medical records patients, from 2011 to 2020 undergoing heart surgery, for example CABG, was extracted and examined. Patients were grouped (60 people in each group) and compared based on protamine sulfate intake and not receiving it, in the intensive care unit and body mass index, age, sex, ACT values ​​and blood drainage rate.
Results: 76 (63.37%) patients were male and 44 (36.66%) patients were female. Most patients were in the age range of 50-70 years and most patients were overweight. Blood drainage in the protamine group was significantly lower than the control group. There was no statistically significant difference between the two groups in terms of ACT values. Blood drainage in the protamine group was significantly lower in normal BMI and overweight individuals than in the control group. The amount of blood drained in the protamine group in women and in people over 70 years was significantly lower than the control group.
Conclusion: despite previous studies, our study showed a reduction in the amount of postoperative bleeding following re-prescribing of protamine sulfate in the intensive care unit, which eliminated the effect of heparin and the coagulation disorder caused by heparin. The limitations of the present study included patients under 12 years of age, patients weighing more than 120 kg, and patients requiring hypothermia treatment less than 28 Cº.