JOURNAL OF ISFAHAN MEDICAL SCHOOL (I.U.M.S)
Year:2017 | Volume:35 | Issue:428|Papers Count:6

Background: Active lead implantation can create injury in myocardium that may be associated with a ST-segment elevation. This ST-segment elevation may be correlated with changes in other parameters such as threshold, sense, amplitude, impedance, and sensitivity. But, the relationship between the numerical elevating of ST-segment with permanent pacemaker device performance is not clear.Methods: In this prospective cohort study, census sampling method was used to enroll 83 patients referred to Bou Ali Sina hospital, Qazvin, Iran, for permanent pacemaker device implantation during December 2010 to May 2012. The procedure was conducted by an electrophisiologist. Data such as ST-segment elevation and device parameters (threshold, sense, and impedance) were collected via recording during active implantation of device and analyzed using SPSS software.Findings: Patients' mean age was 71.7 ± 1.4 years; 48.1% were men and 51.8% were women. Single chamber device was implanted for 25 cases and dual chamber device for 58 others. The mean ST-segment elevation was 3.95 ± 1.27 and 16.71 ± 3.41 mv in atrial and ventricular leads, respectively. The changes in other parameters separately in the atrial and ventricular leads were obtained and compared considering ST-segment changes. ST changes in the right atrium were correlated with sense and threshold (P=0.003).Conclusion: Since we could not find significant correlation between pacemaker parameters and ST elevation, it can be concluded that ST elevation during lead implantation is not a predictor for device performance.

Background: Previous studies showed that mortality rate in intensive care units is high but etiology of this problem has not been studied completely. So, this study aimed to determine epidemiologic and demographic aspects and causes of hospitalization and mortality in patients admitted to intensive care units.Methods: In a cross-sectional study, 400 patients hospitalized during 2011-2015 in intensive care units of Alzahra hospital, Isfahan, Iran, were studied. Demographic data, clinical findings, mortality, and causes of hospitalization were extracted from hospital records and role of the factors on the mortality were investigated. Findings: Of 400 hospitalized patients in intensive care units during 2011-2014, 138 (34.5%) died, 44 (31.9%) of them in the first day, 55 (39.9%) during 1st-6th days, 28 (20.3%) during 7th-12th days, and 11 (8.0%) during 13th-24th days after hospitalization in intensive care units. Among factors that related to mortality, vital signs at the entrance to intensive care unit, underlying disease, time of hospitalization in intensive care unit, and some of laboratory findings had significant effect on mortality.Conclusion: Mortality rate in intensive care units of Alzahra hospital is high. Therefore, special care facilities considering patient characteristics and causes of mortality in this sector should be provided.

Background: The aim of this study was to assess the effects of fractionated radiotherapy (RT) on expression of urothelial tight junction protein (occluding) in patients under prostate radiotherapy. Finding a correlation between occludin expression and bladder dose for patients undergoing prostate conformal external radiotherapy was the second aim.Methods: Urine samples of 64 patients under prostate radiotherapy were collected before and at regular intervals during and 3 months after radiotherapy. Occludin expression analysis of the collected urine samples was performed using chemical methods. The effective uniform dose to bladder was derived from the individually produced dose treatment plan of the patients. Findings: There was a significant change in urine occludin level after initiation of the radiotherapy course compared to the baseline urine samples (P=0.040). The threshold bladder dose that caused significant change in occludin level was 25.5 Gy (P=0.046). This bladder dose was occurred after the 15th radiotherapy session. In addition, change in urine occludin level was compatible with frequency, urgency, and dysuria (P<0.050).Conclusion: Significant change in occludin expression occurred during prostate radiotherapy. Our findings suggest that increase in occludin expression level of the bladder wall can be used as early markers of bladder complications for patients under prostate radiotherapy.

Background: Stigma is a mark of disgrace in the society's attitude that discredits a person or a group because of an attribute such as a deformity, color, or mental illness. Stigma can adversely affect all aspects of life. Depression is one of the most common mental health problems. The goal of the current study was to investigate some factors associated with stigma of depression among university students in Isfahan City, Iran, in order to facilitate possible interventions.Methods: This cross-sectional study was designed to evaluate the stigma of depression in students of University of Isfahan, Isfahan University of Medical Sciences, and Art University of Isfahan, and was conducted among 553 participants. We used a questionnaire designed by Griffiths et al. and translated it to Persian to evaluate the personal and perceived stigma. Findings: Personal stigma was statistically lower in participants with positive history of depression (P=0.007). It was also lower in married participants (P=0.030). Perceived stigma was significantly higher in students of University of Isfahan comparing to other universities (P=0.009).Conclusion: Positive history of depression, being a married person, and being a student of Isfahan University of Medical Sciences or Art University of Isfahan are protective factors against the stigma of depression in university students in Isfahan City.

Background: Pseudomonas aeruginosa is one of the major pathogens causing burnt wound infection in hospitals. This study aimed to evaluate the prevalence of exoenzyme U (exoU) and exoenzyme S (exoS) genes and the antibiotic resistance pattern of Pseudomonas aeruginosa isolated from burn patients' samples in Kermanshah City, Iran.Methods: In this cross-sectional study, 194 samples were tested with conventional bacteriological methods. After evaluation of antibiotic sensitivity with disc diffusion method, specific primers were deployed to assess the frequency of exoU and exoS genes among isolates. The retrieved data were analyzed using SPSS software. Findings: From 91 isolates of Pseudomonas aeruginosa, 72 (79.1%) were multi-drug resistant (MDR) isolates. The most prevalent antibiotic resistances were against gentamicin (79.1%) and ceftazidime (74.7%); the most prevalent sensitivities were against colistin (100%) and polymixin B (92.3%). The frequency of exoU and exoS genes was 80.2% and 68.1%, respectively. There were significant relationships between the frequency of exoU gene and resistance to ceftazidime (P=0.041) and cefotaxime (P=0.050).Conclusion: Considering the role of Pseudomonas aeruginosa in burn wound infections and the role of cytotoxin and antibiotic resistance genes in colonization and survival of this bacteria, avoiding home remedies, accurate detection of virulence factors, and recognition of antibiotic resistance pattern among the isolates in order to choose the appropriate antibiotic regimen to prevent infection seem to be necessary.