Shahid Madani Hospital Research Articles

Asessment of blood urea nitrogen to creatinine ratio as a predictor of mortality in ST-elevation myocardial infarction patients undergoing thrombolytic therapy: a cross-sectional study

Objectives: Given the increasing number of ST-elevation myocardial infarction (STEMI) and the related healthcare expenses and medical outcomes, as well as the frequent occurrence of kidney problems in this patient population, the current research aims to explore the effect of blood urea nitrogen to creatinine (BUN/Cr) ratio on the in-hospital mortality (IHM) of STEMI patients undergoing thrombolytic therapy. Methods: This study is a cross-sectional analytical study conducted in 2021 at Shahid Madani Hospital, affiliated with Tabriz University of Medical Science, which investigated the relationship between the BUN/Cr ratio and IHM in patients with STEMI who received thrombolytic treatment between 2017 and 2019. Patients with other causes of ST elevation, those undergoing dialysis, or those with incomplete medical records were excluded. Data were collected from patient medical records. The primary outcome was in-hospital mortality, with secondary outcomes including the occurrence of heart failure and the need for blood transfusion—chi-square tests for categorical and t-tests for continuous variables. A p-value of less than 0.05 was considered statistically significant. Results: A total of 398 patients were diagnosed with STEMI and treated with thrombolytic 330 (82.9%) patients were men. High BUN and Cr had a significant correlation with high mortality rates (P <0.01). However, BUN/Cr didn’t have a substantial relationship with IHM and one-year mortality (P-value = 0.46). The most common in-hospital complication was heart failure (HF), and a higher need for blood transfusion was significantly related to high rates of BUN/Cr (P <0.01). Conclusions: While high BUN and Cr levels were significantly associated with increased mortality rates, the BUN/Cr ratio was not significantly related to IHM. These results suggest that although elevated BUN and creatinine indicate poor prognosis, the BUN/Cr ratio may not be a standalone predictor of in-hospital mortality. Further research is needed to validate these findings and identify other factors affecting patient outcomes.

Investigating the average duration between hospitalization and surgery and discharge of orthopedic patients with peritrochanteric fracture in patients over 60 years old in Shahid Madani Hospital in 2022

Investigating the average duration between hospitalization and surgery and discharge of orthopedic patients with peritrochanteric fracture in patients over 60 years old in Shahid Madani Hospital in 2022

Complications of blood transfusion in patients who are candidates for heart surgeries patients in Shahid Madani Hospital of Tabriz

Complications of blood transfusion in patients who are candidates for heart surgeries patients in Shahid Madani Hospital of Tabriz

Evaluation of Clinical Characteristics and Outcomes of Chest Trauma Patients with COVID-19 Infection Undergoing Emergency Surgeries.

This study aims to examine the clinical characteristics and prognosis of patients with chest trauma who were infected with COVID-19 and underwent emergency surgery. In light of the COVID-19 pandemic, this research investigates the impact of COVID-19 on patients with chest trauma who underwent emergency surgery. This retrospective cohort study was conducted on 56 patients with chest trauma in two groups with COVID-19, and no covid who underwent surgery in Shahid Madani Hospital. Among the trauma patients, 21 were infected with COVID-19, and 35 were not. The predominant causes of trauma were car and motorcycle accidents. Among COVID-19 patients, 3.3% exhibited symptoms of fever, chills, cough, shortness of breath, and gastrointestinal symptoms, while 5.9% had severe lung involvement confirmed by CT scan. Following surgery, 1.57% (12 individuals) of COVID-19 patients were transferred to the ICU, with an average hospitalization duration of 1.11 days. In contrast, the average hospitalization duration for non-COVID-19 chest trauma patients was 1.9 days (p =0.015). Patients with chest trauma who underwent surgery and were infected with COVID-19 demonstrated significant differences in average length of stay, ICU admissions, and pneumonia incidence. However, there was no significant distinction in the mortality rate between the two groups.

Conventional and Two-dimensional Strain Echocardiography in Predicting Postoperative Atrial Fibrillation after Coronary Artery Bypass Grafting Surgery in Shahid Madani Hospital of Tabriz, Iran

Objectives: Atrial fibrillation (AF) is a common complication of heart surgery with favorable short- and long-term outcomes. Preoperative left atrial (LA) dysfunction may be a significant component in identifying patients at risk for postoperative atrial fibrillation (POAF) after coronary artery bypass grafting (CABG (surgery. Advances in imaging technologies and an understanding of AF pathophysiology can lead to more definitive potential therapeutic approaches. The paper has the aim to present the role of conventional echocardiography and LA two-dimensional (2D) strain. 2D Strain echocardio graphies in assessing LA function in predict POAF after CABG surgery.
 Materials and Methods: In this study, all patients with sinus rhythm who underwent CABG surgery were selected. All the patients had undergone conventional echocardiography and LA 2D-strain echocardiography 24 hours before surgery. In addition to demographic, clinical, and intraoperative features, other assessments, including electrocardiogram (ECG) and Holter monitoring, were recorded. The obtained information was recorded, and the study results were reported using descriptive statistics (mean, standard deviation, and percentage frequency). A Chi-square test was used to evaluate the qualitative variables, and a t-test was used to compare the quantitative variables. Given the multi-factorial nature of AF, univariate and multivariate methods were used to analyze the data and the effect of STRAIN. In this study, P < 0.05 was considered significant.
 Results: According to the findings, 85 patients (81%) were male with a mean age of 60.26 ± 10.61 years. 50% of the patients underwent off-pump CABG surgery, and 50% underwent on-pump surgery with a mean time of 98.52 ± 22.44 minutes. POAF was seen in 22.9% of patients during hospitalization, and AF's duration was 13.85 ± 14.41 hours. AF patients had higher LA volume index (LAVI) than non-AF patients (p = 0.018). There was no significant difference between the two groups in terms of left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), left ventricular ejection fraction (LVEF), E/e, E/A,and deceleration time(DT) . Non-AF patients had higher rates of LA reservoir (26.97 ± 6.87 VS. 20.46 ± 4.27, p <0.001), LA contractile (14.98 ± 3.68 VS. 12.76 ± 3.72, p =0.012) and LA global (24.28 ± 6.57 VS. 17.71 ± 4.11, p <0.001) than AF patients. The results of the multivariate logistic regression showed that LAVI (p= 0.014) and LA global (p = 0.027) were significant predictors of AF detection. Thus with increasing LAVI, the probability of developing AF increases, and with decreasing LA global, this probability decreases.
 Conclusions: Compared to conventional echocardiography, 2D-strain echocardiography is a more effective diagnostic tool in predicting the possibility of post-CABG AF.

The Effect of E-learning on Knowledge, Attitude, and Practice Regarding COVID-19 in Heart Patients: A Quasi-experimental Study Without a Control Group

Background: The recent coronavirus disease 2019 (COVID-19) epidemic is the worst crisis since World War 2. Because no successful cure for this disease has been reported, efforts to improve knowledge, perspective, and performance in vulnerable groups, such as heart disease patients, are very important for managing this epidemic. Objectives: The present study was conducted to determine the effect of e-learning on COVID-19-related knowledge, attitude, and performance in heart disease patients. Methods: This was a quasi-experimental before and after study without a control group, which was conducted on 80 patients in Lorestan Heart Center (Shahid Madani Hospital, Khorramabad,) selected by random sampling method. The intervention included 10 15-minute educational sessions in 4 weeks, about COVID-19 prevention programs, such as general knowledge about COVID-19, disinfection methods, using facemasks and gloves, the correct way of washing hands, prescribed medication, and nutritional recommendations. Data collection tools were a demographic information questionnaire, a knowledge evaluation questionnaire, and a COVID-19-related performance questionnaire. The data were analyzed using SPSS 26 software by descriptive and statistical methods and paired t-test and analysis of variance (ANOVA). Results: The patients’ mean age was 55.22 ± 11.05 years. The mean knowledge of patients before the educational intervention was 13.25, and after the intervention was 17.42, and a significant statistical difference was observed (P = 0.00). Also, the patients’ mean attitude and practice before the intervention were 38.32 and 11.79, respectively, and reached 40.90 and 13.51 after the intervention, and a meaningful statistical difference was observed (P = 0.00). Conclusions: E-learning improves COVID-19-related knowledge, perspective, and practice in patients with heart disease. We suggest that some nurses should be educated in this area and, using the right equipment, vastly perform E-learning for groups susceptible to COVID-19.

Association of heart rate at admission and angiographic and clinical results of ST elevation myocardial infarction patients undergoing primary angioplasty on the left circumflex artery

Goal: Heart rate is a factor that predicts cardiovascular diseases such as heart failure, high blood pressure, stroke and coronary artery diseases. This study examined the association between admission heart rate of STEMI[1] patients undergoing PCI[2] on the LCX[3] artery and their clinical and angiographic results. Materials and procedure: This retrospective cross-sectional study was carried out on 155 patients with acute inferior or posterior STEMI who underwent angioplasty on the LCX at the Shahid Madani Hospital of Tabriz, Iran, from 2018 to 2021. To gather data, all the files of the STEMI patients undergoing PPCI[4] on the LCX artery were identified at the Medical Records Department of the hospital, and registered in the questionnaire. Patients’ heart rate at admission was obtained from the ECGs recorded in the files. The patients were divided into three groups of under 70 beats (low), 70-100 beats (normal), and over 100 beats (high) per minute. Findings: The studied group consisted of 155 patients, including 31 ones (20%) with low heart rates, 107 ones (69%) with normal heart rates and 17 ones (11%) with high heart rates.

The Effect of Continuous Care Model on Blood Pressure and Quality of Life in Patients with Hypertension: A Randomized Clinical Trial.

Introduction: Hypertension is one of the most common diseases in all populations. Since people with hypertension have a lower quality of life (QoL) compared to healthy people, it is necessary to follow up these patients according to their conditions. This study aimed to investigate the impact of a continuous care model on blood pressure and QoL in hypertensive patients. Methods: Using a random sampling method, this randomized clinical trial (RCT) included 66 patients with hypertension referring to the clinic of Shahid Madani hospital in Tabriz, Iran in 2019. Data collection tools in this research were demographic information questionnaire, sphygmomanometer control device and stethoscope and Quality of Life questionnaire (The Short Form Health Survey-12, SF-12). The patients were randomly assigned into two groups of control and experimental. After the pre-test, the patients' needs in the experimental group were assessed and the problems were resolved. Then, the post-test was performed one month and two months after the intervention. Data analysis was performed using SPSS software version 13. Results: After the intervention, there was a significant difference in the QoL score and blood pressure in the experimental group. However, this difference was not significant in the control group. Conclusion: Results indicated that using a follow-up care model had a positive effect on the blood pressure and QoL of patients with hypertension. It is recommended that further studies examine the impact of the integrated care model on QoL in other chronic diseases.

Epidemiological Study of Acute Unintentional Poisoning Among Children in Iran.

The occurrence of different types of poisoning and early diagnosis is important for therapeutic measures. In this study, we investigate the epidemiological causes of acute poisoning in children.In this retrospective descriptive study, children presented with acute poisoning during 2010-2019 to Shahid Madani Hospital were included. The Electronic Medical Record system of the hospital was accessed to obtain the data of the patients. The data included was demographic information, type of poisoning, clinical findings, complications, duration of hospitalization, parents' education status, and mortality status.Of 336 patients included in the study, the mean age of patients was 4.90±3.27 years (range: 1-12 years). There was a significant correlation between the age of the child and the type of poisoning, p=0.001. The most frequent age group was 5 years and less (69.6%). The most frequent sex group was male (58.6%). However, there was no significant correlation between the sex of the child and the type of poisoning. Parents' education and ICU admission were also associated significantly with the type of poisoning, p=0.001, respectively. The most common type of poisoning in children was medication (60.6%) which was mainly due to methadone. The mortality rate in the study was 1.2%.Our study showed that pharmacological drugs are the main cause of poisoning in our population. Age of the children is likely to be associated with the type of poisoning however, no gender difference was found in this regard was found in our study.

Effect of hyperglycemia treatment on complications rate after pediatric cardiac surgery.

Introduction: The goal of this study was to elucidate harmful complications of intraoperative hyperglycemia following children cardiac surgery and benefits of insulin administration for accurate blood sugar controlling. Methods: this study is a Randomized clinical trial. We conducted this study in the operating room of shahid madani hospital. Fifty patients who were children under 12 years old undergone cardiac surgery using cardiopulmonary bypass (CPB). Intraoperative insulin infusion was administered intravenously targeting blood sugar levels of 110-140 mg/dL. Blood sugar and arterial blood gas (ABG) were measured every 30 min during operation. Results: Inotropes were used less in the study than the placebo group during surgery. The means of hospitalization and extubation time were more in the placebo group than the study group(P =0.03) and (P =0.005), respectively. However, the mean time of hospitalization in the ICU ward did not differ significantly between the two groups. Conclusion: Hyperglycemia has a relation with long time of intubation and hospitalization in ICU. These findings suggest the positive effect of accurate blood sugar control on reducing complication and hospitalization time in children undergoing cardiac surgery.

Epidemiological evaluation of meningitis in hospitalized patients in shahid Madani Hospital in Khorramabad

Background: Bacterial meningitis is an acute infection of the meninges requiring immediate diagnosis and treatment. Clinical, laboratory, and epidemiological findings of meningitis are of utmost importance for rapid diagnosis and treatment. The present study aimed to evaluate patients with meningitis based on their epidemiological, clinical, and laboratory findings and compare these variables between patients with septic and aseptic meningitis. Materials and Methods: In this retrospective cross-sectional descriptive study, all children with suspected meningitis in Shahid Madani Hospital in Khorramabad in 2014-2015 were examined for spinal fluid culture, age, gender, seasonal distribution, and antibiogram results. Results: Among 63 patients with meningitis, 30 (47.6%) cases had septic meningitis, and 33 (52.4%) subjects had aseptic meningitis. Out of 30 patients with septic meningitis, 4 (13.3%) patients had positive microbial culture. Among patients with septic meningitis, only four bacterial isolates were isolated by the microbial culture method, out of which Streptococcus pneumoniae was the most common bacterium and the prevalence was higher in autumn and winter. The most effective antibiotics were cotrimoxazole and vancomycin with a sensitivity of 100%; nonetheless, there was relatively high resistance to cloxacillin, erythromycin, and clindamycin. The number of white blood cells (WBCs), sugar, and protein in cerebrospinal fluid (CSF) in septic meningitis were compared with aseptic meningitis, and a significant difference was observed between the two groups. There was also a significant difference between gender and septic meningitis, and male patients were more likely to suffer from septic meningitis. Conclusion: The prevalence of aseptic meningitis was higher than that of septic meningitis. Microbial tests are very effective in the correct diagnosis and treatment; however, the level of WBC, glucose, and protein in CSF can also be of great help in diagnosing different types of meningitis, especially septic meningitis.

Measurement of mitral valve area by direct three dimensional planimetry compared to multiplanar reconstruction in patients with rheumatic mitral stenosis.

Mitral valve area (MVA) measurement by three-dimensional transesophageal echocardiography (3D-TEE) has a crucial role in the evaluation of mitral stenosis (MS) severity. Three-dimensional direct (3D-direct) planimetry has been proposed as a new technique to measure mitral valve area. This study aimed to compare the 3D-direct mitral valve planimetry to conventional three-dimensional multiplanar reconstruction (3D-MPR) in severe MS using 3D-TEE. In this cross-sectional, prospective study; 149 patients with severe MS who were referred for transesophageal echocardiography in Shahid Madani Hospital (Tabriz Iran), just before percutaneous transmitral commissurotomy (PTMC), recruited consecutively. All patients underwent 2D transthoracic echocardiography (2D-TTE) and 3D-TEE in a single session before PTMC. During 2D-TTE planimetry, pressure half time (PHT), and proximal isovelocity surface area (PISA) were applied to measure the MVA. Transmitral mean pressure gradient (MPG) was measured. During 3D-TEE, MVA planimetry was carried out with both 3D-direct and 3D-MPR methods. 3D-direct was applied from both atrial and ventricular views. The consistency of MVA measurements with 3D-direct, 3D-MPR, and 2D-TTE methods was statistically investigated. Our sample consisted of 109 (73.2%) women and 40 (26.8%) men. The mean age was 51.75 ± 9.81years. The agreement between 3D-direct and 3D-MPR planimetry was significant and moderate (0.99 ± 0.29cm2 vs. 1.12 ± 0.26cm2, intraclass correlation = 0.716, p value = 0.001).The accuracy of the 3D-direct method reduced significantly compared to the MPR method at MVA > 1.5cm2. The maximum difference between two methods was observed in cases with MVAs larger than 1.5cm2. MVA measured with the 3D-MPR method was significantly correlated with a 2D-TTE method, with a moderate agreement (intraclass correlation = 0.644, p value = 0.001). Also, 2D-TTE and 3D-direct TEE techniques yielded significantly consistent measurements of the MVA (1.06 ± 0.026cm2 vs. 0.99 ± 0.29cm2, intraclass correlation = 0.787, p value = 0.001); however, with a slight overestimation of the MVA by the former with a net difference of 0.06 ± 0.013cm2. Mitral valve pressure gradient (MPG) had no significant correlation with planimetry results. A significant inverse correlation was seen between the MVA and pulmonary arterial systolic pressure. 3D-direct planimetry has an acceptable agreement with 3D-MPR planimetry at MVA less than 1.5cm2, but their correlation decreases significantly at MVA above 1.5cm2. 3D-direct planimetry underestimates MVA compared to 3D-MPR, especially at MVA above 1.5cm2. It seems that the saddle shape of mitral valve, interferes with 3D-direct measurement of commissures at moderate MS. The 2D-TTE planimetry has generally acceptable accuracy, but its correlation to the 3D-TEE methods is significantly reduced in cases with moderate to severe MS (i.e. MVA > 1.0cm2).

Complications in Patients with Cardiac Penetrating Trauma.

Cardiac penetrating trauma is a medical emergency that mostly affects young people. Based on the type of injury and associated complications, it can present as a surgical challenge and can lead to mortality. The aim of this study is to evaluate the complications of penetrating heart trauma among patients referred to Shahid Madani Hospital. In this retrospective descriptive study, the data of penetrating cardiac trauma patients referred to Shahid Madani hospital, Karaj, Tehran, from 2016-2019, were investigated. Information, including age, sex, cause of trauma, traumatized area and complications, was extracted and recorded in a data collection form. The data were evaluated statistically using SPSS v18. A total of 44 patients were included in the study, where the mean age of the patients was 25 years. 73.3% of these patients were men and 26.7% were women. Knife stab wounds were the most prevalent cause of the trauma, present in 93.3% of patients. 73.3% of the patients had cardiac tamponade and 20% had a pneumothorax. The right ventricle was the most common site of the injury in 46.7% of the patients. A mortality rate of 3.4% was reported in this study. The results of this study showed that the highest penetrating heart rate trauma occurred among young people, and the most common cause of the trauma was a knife stab. The most common area of the injury was the right ventricular, and cardiac tamponade was the most common complication.

Frequency of Cardiac Arrhythmias in Children with Cardiological Consulting and Containing Electrocardiogram.

Heart diseases are the leading causes of mortality and Congenital Heart Disease (CHD) is the most common birth defect reported worldwide. The aim of this study was to evaluate the incidence of arrhythmias and CHD and the association between the two, among infants and children reported to our center. This cross-sectional study included infants and children who were referred to Shahid Madani Hospital, Khorramabad. Electrocardiogram (ECG) was performed in these children to determine the type of arrhythmia and records were used to obtain demographic data and the data regarding CHD. Of 200 children enrolled in the study, 10 children had arrhythmias, 12 had tachycardia, 5 had bradycardia, and 31 had congenital disease. Among children with arrhythmias, 1 had atrial fibrillation, 4 patients had paroxysmal supraventricular tachycardia, 1 person had right bundle branch block, 1 had ventricular tachycardia, 2 had premature ventricular contractions and 1 had junctional ectopic tachycardia. Of the 31 children with CHD, 9 patients were presented with small ventricular septal defect, 4 children had patent foramen ovale, 2 had pulmonary stenosis and 1 of the children had tetralogy of fallout, arterial and ventricular septal defects and transposition of greater arteries, respectively. We reported a positive correlation between the arrhythmias and CHD. A larger number of studies collecting focusing on different age groups are therefore required to verify our findings.

Possible factors affecting the mortality rate in patients undergoing surgery for aortic type A dissection

Objectives: Aortic dissections of type A are clinical emergencies that can prove fatal if not managed promptly in specialized care facilities. Poor clinical management is the cause of approximately 1% of deaths in patients; however, with advances in clinical practice, diagnostic imaging and clinician awareness, the mortality rate has been dramatically reduced to below 30% in most international centers. We examined the potential factors involved in mortality after surgery for type A dissections. Methods: In this descriptive-analytical study, patients who underwent acute aortic dissection surgery in the Shahid Madani Hospital of Tabriz, Iran, between March 2009 and March 2020 were evaluated. Exclusion criteria included those who died before the surgery, patients with descending aortic dissection, and high-risk patients for surgery who were candidates for medical treatment. Among 185 operated patients, 137 were included. Males comprised 62.8% of the patients. Their mean (±SD) age was 53.9 (±15.3) years. Results: Age (p-value < 0.0001), the presence of hypertension (p-value = 0.015), the amount of packed red blood cell transfusion (p-value = 0.024) and the amount of platelet transfusion (p-value = 0.018) were associated with increased mortality. Duration of intubation, use of fresh frozen plasma, postoperative drainage, duration of intensive care unit recovery, high serum creatinine, duration of aortic clamping, brain protection method, and smoking were not associated with increased mortality. Conclusions: These findings suggest that participants' mortality is dependent on several variables. Mortality of the patients with type A dissection can be reduced by interventions and reducing those factors.

The study of the prevalence of vitamin D3 deficiency and its relationship with blood glucose level after coronary artery bypass graft operation among patients with diabetes

Objectives: Nowadays, vitamin D3 (VitD3) deficiency is among the most common dietary deficiencies around the world. Researchers have paid more attention to VitD3 because it is a vital element of the body and has a plausible relationship with various diseases such as diabetes mellitus type II. This study was conducted to examine the prevalence of vitamin D3 deficiency and its relationship with blood sugar levels in people with diabetes undergoing coronary artery bypass grafting (CABG). Methods: An observational study was conducted in 2017 in Shahid Madani Hospital, Tabriz, Iran, for 8 months. Due to the use of census sampling, only 115 patients with diabetes and open-heart surgery were enrolled in the study. A questionnaire collected information on the participants' demographics, medical history, VitD3 levels and blood glucose levels. Data were analyzed using SPSS ver. 25. Independent t-test was used to compare quantitative data, and chi-square test was used to compare categorical variables. Results: One hundred and fifteen out of 348 patients who had CABG surgery were diabetic. Moreover, 24.7% of patients with diabetes had VitD3 deficiency. The results of the coefficient-correlation test indicated that there was a significant relationship between the mean blood glucose level and VitD3 level (p < 0.05). Conclusions: The results of this study suggest that patients with diabetes can improve their blood glucose control after CABG surgery by taking sufficient VitD3. Therefore, it should be considered as a principle of the hospital operation to prescribe VitD3 prior to surgery for these patients.

Comparison of clinical outcomes of patients treated with Cre8TM versus Resolute Onyx™ stent

Introduction: This study aims to compare the clinical outcomes of patients treated with Cre8TM versus Resolute Onyx™ stent. Material and Methods: In this retrospective study, all patients who underwent Stenting in the catheterization department of ShahidMadani Hospital between 2015 and 2018, were included. Angiographic and angioplasty findings were recorded. The primary end point, which includes total mortality, myocardial infarction, revascularization (adverse events) were recorded. Results: The mortality rates were similar in both groups. Moreover the myocardial infarction and repeated revascularization did not differ in both groups (p>0.05).The rates of adverse events wasn't significantly different between the two groups. Conclusion: Our study showed that efficacy and safety of Cre8™ stents is non-inferior to the Resolute Onyx™ stent.

Complete Heart Block after open Heart Surgery in Children with Congenital Cardiac Diseases Feasibility of more waiting time before PPM administration

Introduction: Congenital cardiac disorders are the most prevalent congenital disorders which require interventional or surgical treatments. The most common causes of complete heart block (CHB) are degeneration of cardiac conduction system, acute myocardial infarction and congenital cardiac disorders. CHB after congenital heart surgery is of paramount importance which causes post-operation death and heart failure. Application of a pacemaker is a standard treatment for CHB. The purpose of this paper is to study the frequency of early postoperative CHB in patients with congenital cardiac diseases and also the need for temporary (TPM) and permanent (PPM) pacemakers. Materials and methods: This descriptive-analytical and cross-sectional study was conducted on children with congenital heart defects who had undergone open-heart surgery in Tabriz’s Shahid Madani Hospital from 2011 to 2016. Patients with early postoperative CHB were included in the study. Those who had improved on their own and those who needed TPM and PPM were identified and at the end, the frequency of CHB and the need for TPM and PPM were assessed. Results: Of the 2100 operated patients, 109 patients developed early postoperative heart block. The frequency of early CHB after open heart surgery was 5.19%. Of the 109 patients, 69 patients (63.3%) with early postoperative CHB needed TPM, 9 patients needed PPM and 22 patients improved without pacemaker. Conclusion: The prevalence of early CHB in patients operated for congenital cardiac diseases was 5.19%. The need for TPM was high and most of the patients had improved cardiac rhythm with no need for PPM or TPM.

Frequency of Pathological Types of Hyperthyroidism in Thyroid Scan Patients.

Hyperthyroidism is a common systemic disorder where Graves' disease is known as the leading cause of the disease. Thyroid stimulating hormone, T4 and T3 antibody assay is usually performed for the diagnosis of the pathology. However, with uncertainty in the results and in order to estimate the magnitude and the exact cause of the disease, radioactive iodine uptake (RAIU) test is recommended. The aim of this study is to evaluate underlying pathology in the patients presenting hyperthyroidism using RAIU test results. This is a cross-sectional retrospective study conducted on the patients with hyperthyroidism referred to Shahid Madani Hospital in Khorramabad. Data regarding the biochemical analysis and RAIU test was collected from the records and a questionnaire based on demographic and clinical information was completed for each patient. Of 137 patients presenting hyperthyroidism, 62.04% presented with Graves' disease, 24.08% with toxic multinodular goiter and 13.86% with toxic adenoma. 24-hour RAIU test showed that the percent of radioiodine uptake was most in toxic adenoma with 67.7%, Graves' disease 53.5% and multinodular goiter 39%, respectively. From the age-based analysis, we found that Graves' was most common in 20-30 years old individuals accounting for 34%, multinodular goiter in 50+ aged individuals with 36.3% and toxic adenoma was most prevalent in 30-40 and 50+ aged patients, with 26.3%. In our population of interest, 81.8% toxic multinodular goiter patients were females. Our study presents the outcome of RAIU tests in hyperthyroidism based on the underlying pathologies. We also conclude, in light of other findings, that Graves' disease is the most common cause of hyperthyroidism in our population.

Prevalence of Congenital Heart Disease among Children in Khorramabad (West of Iran).

Congenital heart disease is among the most common congenital anomalies in pediatrics. The aim of this study was to evaluate the prevalence of congenital heart disease in children in Khorramabad, Iran. This is a descriptive-cross sectional study where all the children diagnosed with congenital heart disease by echocardiography were enrolled to the Shahid Madani Hospital. Patient information was collected by means of a questionnaire. Of 1600 children who underwent cardiac counseling, 9.75% presented congenital heart disease. These were most prevalent among the children of 0-28 days of the age (14.7%) and least in children aged 1 month-1 year. According to this study, atrial (20.3%) and ventricular septal defect (10.5%) were the most common heart defects, respectively. Among signs and symptoms of cardiac disease, 49.1% of children had cyanosis, 89.7% with increased CT (cardiothoracic)-ratio, and 82.7% of had heart murmur. Congenital heart disease was more prevalent in male infants (58%) and 6.6% patients had heart failure and 1.4% had other congenital conditions, such as Down syndrome. According to our findings, atrial and ventricular septal defects are the most common congenital heart anomalies, respectively, in pediatric patients in Khorramabad.