Mashhad University of Medical SciencesJournal of Cardio-Thoracic Medicine2345-24472420141101Role of Conservative Management in Neck Trauma: A Case Series Study211214348910.22038/jctm.2014.3489ENSeyed Ziaollah HaghiThoracic Surgeon, Endoscopic and Minimally Invasive Surgery Research Center, Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranMohammad GhaemiGeneral Surgeon, Surgical Oncology Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranReza BagheriThoracic Surgeon, Cardio-Thoracic Surgery & Transplant Research Center, Emam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranAli SadrizadehThoracic Surgeon, Cardio-Thoracic Surgery & Transplant Research Center, Emam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranMaryam SalehiCommunity Medicine Specialist, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranJournal Article20140510<strong>Introduction:</strong> There are significant gender differences in the epidemiology and presentation of cardiovascular diseases (CVDs), physiological aspects of CVDs, response to diagnostic tests or interventions, and prevalence or incidence of the associated risk factors. Considering the independent influence of gender on early dire consequences of such diseases, this study was conducted to investigate gender differences in patients' beliefs about biological, environmental, behavioral, and psychological risk factors in a cardiac rehabilitation program. <br/><strong>Materials and Methods:</strong> This study has cross sectional design. The sample was composed of 775 patients referred to cardiac rehabilitation unit in Imam Ali Hospital in Kermanshah, Iran. The data were collected using clinical interview and patients’ medical records. The data were analyzed using descriptive statistics such as mean, standard deviation, and chi-square test. To do the statistical analysis, SPSS version 20 was utilized. <br/><strong>Results:</strong> As the results indicated, there was a significant difference between the beliefs of men and women about risk factors of heart disease (X2= 48.36; P<0.01). Men considered behavioral (55.1%) and psychological (33.7%) risk factors as the main causes of their disease, respectively. On the other hand, women regarded psychological (38.2%) and behavioral factors (26.6%) as the most common causes of cardiac conditions, respectively. Both men and women considered stress as the most important heart disease risk factor (21% and 22.3%, respectively). Also, women were less aware of the risk factors, compared to men. <br/><strong>Conclusion:</strong> From the patients’ perspective, psychological and behavioral risk factors were the most important causes of cardiovascular diseases (CVDs); moreover, stress was the most influential risk factor for developing cardiac diseases. Thus, learning to control and manage these risk factors can help to prevent the development of CVDs and reduce the occurrence of subsequent cardiac events. <br/> <br/>Mashhad University of Medical SciencesJournal of Cardio-Thoracic Medicine2345-24472420141101Gender Differences in Patients' Beliefs About Biological, Environmental, Behavioral, and Psychological Risk Factors in a Cardiac Rehabilitation Program215220349010.22038/jctm.2014.3490ENMozhgan SaeidiMaster of Clinical Psychology, Cardiac Rehabilitation Center, Imam Ali Hospital, Kermanshah University of Medical Sciences. Kermanshah, IranSaeid KomasiMaster of Clinical Psychology, Cardiac Rehabilitation Center, Imam Ali Hospital, Kermanshah University of Medical Sciences. Kermanshah, IranAli SoroushSports Medicine and Lifestyle Intervention, Imam Reza Hospital, Kermanshah University of Medical Sciences ,Kermanshah.IranAli ZakieiResearcher of Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, IranJalal ShakeriPsychiatrist, Kermanshah university of Medical Sciences,Kermanshah,IranJournal Article20140521<strong>Introduction:</strong> There are significant gender differences in the epidemiology and presentation of cardiovascular diseases (CVDs), physiological aspects of CVDs, response to diagnostic tests or interventions, and prevalence or incidence of the associated risk factors. Considering the independent influence of gender on early dire consequences of such diseases, this study was conducted to investigate gender differences in patients' beliefs about biological, environmental, behavioral, and psychological risk factors in a cardiac rehabilitation program. <br/><strong>Materials and Methods</strong>: This study has cross sectional design. The sample was composed of 775 patients referred to cardiac rehabilitation unit in Imam Ali Hospital in Kermanshah, Iran. The data were collected using clinical interview and patients’ medical records. The data were analyzed using descriptive statistics such as mean, standard deviation, and chi-square test. To do the statistical analysis, SPSS version 20 was utilized. <br/><strong>Results</strong>: As the results indicated, there was a significant difference between the beliefs of men and women about risk factors of heart disease (X<sup>2</sup>= 48.36; P<0.01). Men considered behavioral (55.1%) and psychological (33.7%) risk factors as the main causes of their disease, respectively. On the other hand, women regarded psychological (38.2%) and behavioral factors (26.6%) as the most common causes of cardiac conditions, respectively. Both men and women considered stress as the most important heart disease risk factor (21% and 22.3%, respectively). Also, women were less aware of the risk factors, compared to men. <br/><strong>Conclusion:</strong> From the patients’ perspective, psychological and behavioral risk factors were the most important causes of cardiovascular diseases (CVDs); moreover, stress was the most influential risk factor for developing cardiac diseases. Thus, learning to control and manage these risk factors can help to prevent the development of CVDs and reduce the occurrence of subsequent cardiac events.Mashhad University of Medical SciencesJournal of Cardio-Thoracic Medicine2345-24472420141101No-Reflow Phenomenon in Patients with ST-Elevation Acute Myocardial Infarction, Treated with Primary Percutaneous Coronary Intervention: A Study of Predictive Factors221226349110.22038/jctm.2014.3491ENSeyed Hashem Danesh SaniCardiologist, Imam Reza Hospital, Faculty of medicine, Mashhad University of Medical Sciences, Mashhad, IranAli EshraghiCardiologist, Imam Reza Hospital, Faculty of medicine, Mashhad University of Medical Sciences, Mashhad, Iran0000-0002-3642-3553Bahram ShahriResident of Cardiology, Imam Reza Hospital, Faculty of medicine, Mashhad University of Medical Sciences, Mashhad, IranMohamad VejdanparastResident of Cardiology, Imam Reza Hospital, Faculty of medicine, Mashhad University of Medical Sciences, Mashhad, IranJournal Article20140510<span style="font-family: Times New Roman;"><span style="font-family: Times New Roman;"> </span></span> <br/><span style="color: black;">Introduction: No-reflow phenomenon in coronary vessels, manifested in some patients with reperfused acute myocardial infarction (MI), is associated with poor clinical and functional outcomes. Therefore, evaluation of predisposing risk factors can be helpful in risk assessment and identification of patients at higher risk. Herein, we aimed to study the predictive factors for the development of no-reflow phenomenon in patients with ST-elevation acute MI (STEMI), following primary percutaneous coronary intervention (PCI).</span><span style="font-family: 'Verdana','sans-serif'; color: black;"> <br/></span><span style="color: black;"><span>Materials and Methods: Overall, 141 patients with STEMI, treated with primary PCI, were enrolled in a cross sectional study.. Angiographic data associated with no-reflow phenomenon including thrombolysis in MI (TIMI) were evaluated. Patients were divided into study and control (TIMI grade 3) groups. Demographic, clinical and laboratory (lab) data including cardiovascular risk factors (e.g., diabetes, hypertension, hyperlipidemia , smoking), door-to-balloon time, serum creatinine and glucose levels, white and red blood cell counts (WBC and RBC counts, respectively), mean platelet volume (MPV), and red cell distribution width (RDW) were evaluated in both groups.</span></span><span style="font-family: 'Verdana','sans-serif'; color: black;"> <br/></span><span style="color: black;"><span>Results: The mean age of the patients was 60.3±11.9 years. No-reflow was observed in 35 (24.8%) cases. WBC count, MPV , serum creatinine, BS, and high-density lipoprotein (HDL) levels were significantly correlated with TIMI flow <br/><span>Conclusion: Certain lab indices including MPV, WBC count, creatinine and HDL levels played significant independent roles in the no-reflow phenomenon. Thus, measuring such parameters might be helpful in predicting the risk of this condition in patients; however, further studies are required.</span></span></span> <br/> Mashhad University of Medical SciencesJournal of Cardio-Thoracic Medicine2345-24472420141101The Evaluation of Survival in Patients Who Need Intra Aortic Balloon Pump (IABP) after Cardiac Surgery227230349210.22038/jctm.2014.3492ENBehrooz MottahediCardiac Surgeon , Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran0000-0003-0868-4366Jamil EsfehanizadehCardiac Surgeon , Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranKambiz AlizadehCardiac Surgeon , Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranZahra Abbasi ShayeResident of community Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranJournal Article20140519<strong>Introduction</strong>: Insome cases, assist devices are required to ensure an adequate cardiac output after cardiac surgery. Intra-aortic balloon pump (IABP) is the most commonly used cardiac assist device, which provides first-line support for patients with heart failure. The aim of this study was to determine factors affecting the mortality rate of patients receiving IABP. <br /><strong>Materials & Methods:</strong> In this retrospective cohort study 235 patients requiring LABP support were analyzed over 14 years period (between January 1999 and December 2013) from which 137 patients survived the 30 days follow-up. Perioperative and demographic factors such as age, weight, underlying disease, ejection fraction, ventricular aneurysm and cardiopulmonary bypass and cross clamp time were recorded and analyzed. <br /> <br /><strong>Results:</strong> The overall operative mortality was reported to be 41.7%. Male-to-female ratio was 131:104 and the mean age of the subjects was 57.58 ± 11.07 years. Early mortality rate was higher among young subjects and those with prolonged CBP (162.71±35.25, P<0.001) and ACC (129.94±54.39, P<0.001). In addition, mortality rate was higher among females (P=0.04). Patients’ weight, comorbidity, preoperative ejection fraction, ventricular aneurysm and stenosis of the left main coronary did not affect the mortality rate (P>0.05). <br /><strong>Conclusion:</strong> IABP is a simple, effective method for temporary cardiac support, especially for aged patients. In addition, lower duration of surgery is associated with better surgical outcomes.Mashhad University of Medical SciencesJournal of Cardio-Thoracic Medicine2345-24472420141101Metabolic Syndrome in Chemical Warfare Patients with Chronic Obstructive Pulmonary Disease231237349310.22038/jctm.2014.3493ENShahrzad M. LariPulmonologist , Cardio-Thoracic Surgery & Transplant Research Center, Emam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranDavood AttaranPulmonologist,COPD Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.0000000188136487Haleh RokniYazdiEndocrinologist,Endocrinology Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.Mohammad TowhidiPulmonologist,COPD Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.Omid ShadkamInternist,COPD Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.Abbas AsadiInternist,COPD Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranMohammad KhajehdalueeSpecialist in Community Medicine,School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.Hossein AyatollahiPathologist, Cancer Molecular Pathology Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.Majid Ghayour-MobarhanClinical Nutrician, Cardiovascular Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, IranJournal Article20140520<span> </span> <br/><span style="color: black; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"><strong>Introduction:</strong> Sulfur mustard (SM), a toxic alkylating gas, can cause serious long-term pulmonary complications such as chronic obstructive pulmonary disease (COPD). Metabolic syndrome (MetS) is one of the important comorbidities of COPD. This study was designed to evaluate the frequency of metabolic syndrome in Iranian chemical warfare patients (CWPs) with COPD. </span><span style="color: black; mso-ascii-font-family: 'Times New Roman'; mso-ascii-theme-font: major-bidi; mso-hansi-font-family: 'Times New Roman'; mso-hansi-theme-font: major-bidi; mso-bidi-font-family: 'Times New Roman'; mso-bidi-theme-font: major-bidi;"><br/><strong>Materials and Methods</strong>: Thirty CWPs with a mean age of 46.93± 6.8 were enrolled in this study. The following parameters were studied in: complete pulmonary function tests, health-related quality of life, serum triglycerides (TG), high density lipoprotein (HDL) and fasting blood sugar (FBS) levels. Additionally, 32 COPD patients and 56 healthy persons were considered as control groups who were matched to CWPs. <br/><strong>Results:</strong> We found a statistically significant difference in the frequency of MetS between the COPD patients and the healthy control group (p=0.04). Additionally, we observed a statistically significant difference in the mean HDL levels among these groups (p=<0.001). In the CWPs, the frequency of MetS was significantly decreased in severe to very severe stages (p<0.001). <br/><strong>Conclusion:</strong> Our data indicate that metabolic syndrome is frequent in chemical warfare patients, and special attention to this condition in mild to moderate stages is recommended. </span>Mashhad University of Medical SciencesJournal of Cardio-Thoracic Medicine2345-24472420141101The Impact of Treatment on Serum Level of Procalcitonin in Patients with Active Pulmonary Tuberculosis238242349410.22038/jctm.2014.3494ENHassan GhobadiPulmonologist, Department of Internal Medicine (Pulmonary Division) Ardabil University of Medical Sciences, Ardabil, Iran.Shahrzad M. LariPulmonologist, COPD Research Center, Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranFirouz AmaniCommunity Medicine Specialist , Ardabil University of Medical Sciences, Department of Community Medicine, Ardabil, Iran.Shahram HabibzadehInfectious Disease Specialist, Department of Infectious Disease, Ardabil University of Medical Sciences, Ardabil, Iran.Farhad PourfarziCommunity Medicine Specialist , Department of Community Medicine, Ardabil University of Medical Sciences, , Ardabil, Iran.Journal Article20140816<strong>Introduction:</strong> About one third of the world's population is infected with tuberculosis (TB) and each year, about 1.5 to 2 million people die from TB. Procalcitonin (PCT) is an inflammatory marker that its level has variable <br/><strong>Materials and Methods:</strong> This conducted on patients with pulmonary TB. Data were collected using a check list. The serum level of PCT was measured by ELISA test at the beginning and after six months of treatment. All data were analyzed using SPSS 16.
<br/><strong>Results:</strong> There are some discussions in the utilization of PCT as a diagnostic marker in active pulmonary TB. The aim of this study was to compare serum PCT before and after treatment in patients with pulmonary TB. <br/>Results: Forty-two patients with active pulmonary TB entered in this study. The mean age of the patients was 45.48 ± 12.54 years and 54.8% of them were male. Most of the patients (59.5 %) were rural inhabitants. There was a family history of TB in 26% of patients. The most common symptom (45.2%) was cough. Mean PCT prior to treatment was 1.25 ± 0.98 ng/ml. and 81% of the patients had PCT higher than 0.5 to 5. After treatment PCT level reduced significantly (P<0.001). The mean erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) before treatment were 45.88 ± 21.87 and 7.16 ± 3.98 respectively that were reduced significantly after treatment (P<0.001). Neutrophil counts before treatment was 6221 ± 3161 Cells per ml. and decreased statistically significant after treatment (P=0.01). <br/><strong>Conclusion:</strong> Our results showed that the PCT levels in pulmonary TB were high in active disease and reduced after treatment. PCT level may be used for follow-up as a discriminative marker between active and cured pulmonary TB and predict treatment response, although the PCT assay cannot be substituted for microbiological and pathological data.Mashhad University of Medical SciencesJournal of Cardio-Thoracic Medicine2345-24472420141101A Rare Case of Sudden-Onset Respiratory Distress in an Infant243245349610.22038/jctm.2014.3496ENSohini ChakrabortyJunior resident,Department of Pediatrics,Medical College, Kolkata,IndiaDebalina SarkarJunior resident,Department of Pediatrics,Medical College, Kolkata,IndiaMoumita SamantaPediatricien, Department of Pediatrics, Medical College, Kolkata, IndiaJournal Article20140816Chylothorax is an unusual cause of pleural effusion after the neonatal period in children without a previous history of cardiothoracic surgery. Determination of the causes of this condition can be often challenging. Herein, we present a case of a 6-month-old male infant, presenting with sudden severe breathlessness, which was later diagnosed as spontaneous left-sided chylothorax.Mashhad University of Medical SciencesJournal of Cardio-Thoracic Medicine2345-24472420141101Congenital Aortocaval Fistula from Right Subclavian Artery to Superior Vena Cava in an Adult with Tetralogy of Fallot246248350010.22038/jctm.2014.3500ENSoheila ChamanianCardiologist, Preventive Cardiovascular Care Research Center Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranMohammad Hassan NezafatiCardiac-Surgeon, Department of Cardiac surgery, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranAhmad AmouzeshiCardiac-Surgeon, Department of Cardiac surgery, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranFarveh VakilianCardiologist, Preventive Cardiovascular Care Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences,Mashhad ,IranToktam MoghimanGeneral Practitioner, Preventive Cardiovascular Care Research Center, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IranJournal Article20140519Congenital aortocaval fistula in association with complex congenital heart disease has never been described before. We represent an adult with tetralogy of fallot and an undiagnosed subclavian artery to superior vena cava fistula in previous catheterisms. He underwent surgical correction, successfully. After 8 months post operation he was doing well with improved functional capacity and no cyanosis.