babak nasiri

The purpose of the current research is to analyze the dimensions and components of organizational culture based on normative and individual variables in the managers of education headquarters in Tehran province. According to its purpose, the research method is applicable; and in terms of execution method, it is qualitative, descriptive-exploratory; and in terms of its nature, it is among foundation data research. The statistical population of this research includes 12 experts who are well-informed and proficient in the subject of research in the field of management and have a valid scientific background in this field. Sampling method used in this research was non-random purposeful. The method of data collection is referring to documents, semi-structured interviews and questionnaires. For data analysis, Atlas ti software was used to code the interviews. The results showed that in the normative dimension, there are 10 categories: organizational justice, work maturity, ambiguity avoidance, external supervision, decision-making, job promotion, masculinity or feminism, concentration (power distance), customer orientation, productivity with 57 indicators; and in the Individual dimension also has 10 categories: sense of belonging, responsibility, individual creativity, communication, participation (teamwork), identity, self-control, motivation, conflict, interaction in 61 indicators and in 6 categories that include causal conditions, communication conditions, background factors, intervener factors, strategies, consequences were identified.Extended abstractIntroductionJust as people in the society have certain beliefs, values ​​and behaviors that represent their personality; organizations also have common assumptions and basic beliefs that shape their culture. Culture has been defined as the set of spiritual achievements of a nation. Culture is a human invention and made by human hands. This finding reflects the existence and identity of a society (Mirza Mohammadi, 2021). Organizational culture is the personality of the organization and it is considered as the basic infrastructure for transformation and change, and managers should understand its relationship with national culture and strive for organizational cohesion by taking advantage of its strategic role. Organizational culture is an interwoven set of basic assumptions, common inferences and collective wisdom that is formed in the context of previous experiences and findings in facing internal or external issues and serves as a guiding light and an invigorating source plays a role in shaping the behavior of employees and architecture of the present and future of the organization (Mohammadiyan & Shahsavari, 2019).Education is a continuous activity, comprehensive and for everyone, which leads to human growth and development, cultural enrichment and the excellence of society, and therefore, innovation should always be created in it. In other words, education is not specific to an exclusive period and time of life and has no time limit, so it must always be renewed and updated (Safaei et al, 2020). For organizational innovation, development and transformation, one of the important organizational conditions that must be considered in policies and implementation of programs is related organizational culture. The author's many years of experience in executive affairs shows that lack of paying attention to organizational culture has not always led to the desired results of innovation, development, organizational transformation and change in organizations (Hamzeh & Hamzeh, 2016). An organizational culture able to respond to environmental changes can lead to optimal organizational performance.According to the above materials, the researcher asked the main question: what are the dimensions and components of organizational culture based on normative and individual variables in the managers of education headquarters in Tehran province? Theoretical FrameworkOrganizational CultureCulture is a set of customs, standards and individual and social behaviors; therefore, while culture is the effect of many parts of religious views, it is also considered the cause of many conditions and situations. Due to the progress of communication tools and the ever-increasing expansion of their use in many social phenomena and developments, the role of culture has become far greater than in the past; in such a way that culture now plays a decisive role at the domestic, regional and international levels and is one of the tools that governments use to achieve their goals and objectives; in this way, cultural dominance is not a new phenomenon. Cultural policy in the general and customary sense includes a set of goals, principles, priorities and executive policies (Mirza Mohammadi, 2021).Normative and individual variablesIn the conceptual definition of norms, most sociologists are more or less unanimous that norms (forms) are the rules of social behavior that guide a person in social actions. Observing these patterns and rules of behavior expected by the society's culture, and avoiding them is punishable (Khabbaz Yazdiha et al, 2020).Zebardast et al, (2022) investigated the relationship between the transformational leadership factors of educational group managers on the effectiveness of university faculty members through organizational culture. The results showed that the relationship between transformational leadership style of managers and organizational culture was significant and the mediating variable of organizational culture has a significant effect on the relationship between transformational leadership style and the effectiveness of faculty members. It can be said that transformational leadership does not have a direct and significant effect on effectiveness in the final research model. However, transformational leadership affects the effectiveness of faculty members through organizational culture.Yusefi et al, (2022) investigated the impact of individual and normative variables on ethical leadership. The results of the research show that value, job satisfaction, motivation, personality, creativity, components were individual components, and organizational communication, organizational culture, organizational structure, decision-making styles, roles and expectations, goals and strategy were normative components that had a significant impact on ethical leadership.Research methodologyThis research is applicable in terms of purpose, qualitative in terms of execution

descriptive-exploratory type, and data-based in terms of its nature. The statistical population includes 12 experts and specialists who are well-informed and proficient in the subject of research in the field of management, and have a valid scientific background in this field. Non-random purposeful sampling method is used to determine the samples and determine the experts.Research findingsThree types of coding were used to analyze the data obtained from the interview as well as theoretical foundations, which are: open coding, axial coding and selective coding. For analysis, Atlas ti software was used to code the interviews. The results showed that in the normative dimension, 10 categories were identified: organizational justice, work maturity, ambiguity avoidance, external supervision, decision-making, job promotion, masculinity or feminism, concentration (power distance), customer orientation, productivity with 57 indicators; and in the individual dimension also 10 categories: sense of belonging, responsibility, individual creativity, communication, participation, identity, self-control, motivation, conflict, interaction in 61 indicators, and in 6 categories that include causal conditions, communication conditions, background factors, intervener factors, strategies, consequences.ConclusionThe present research was conducted with the aim of analyzing the dimensions and components of organizational culture based on normative and individual variables in the managers of education headquarters in Tehran province. The results of this research are correspond with the results of Turki et al, (2021), Eimani et al, (2021), Van Dung HA (2020), Yusefi et al, (2020), Mohebbi et al, (2023), Zebardast et al, (2022). Mohebbi et al, (2023) showed that in educational organizations, organizational culture plays an important role in producing teamwork culture and achieving the benefits of the process of participation and collaboration. Educational systems have a special place according to their goals and mission, the most important of which is the training of efficient human resources for other institutions of society; and universities are the most important and key educational organizations that, in addition to training human resources, respond to the social needs for the acquisition and dissemination of knowledge and technology.According to the results obtained in three dimensions, the following suggestions are presented:- The motivation of managers to create team and collaborative activities should be improved. The opportunity to grow, develop and acquire new effective professional skills and knowledge for managers should be provided for the managers. The conditions of sustainable competitive advantage should be designed. The ground for continuous improvement of organizational intelligence in order to realize the learning organization should be prepared. Individual development and strengthening positive behaviors of managers should be considered. By creating a positive organizational atmosphere, the cooperative structure of the organization should be strengthened. Agility of the organization structure according to the suitability of the job and competence of the people and increasing the efficiency and effectiveness of the rules and regulations by simplifying matters should be considered. By supporting individual values ​​and de-stressing people, internal motivation and sense of belonging to the organization should be improved. Influence in decision-making and implementation by delegating authority should be considered. The position of managers in the organization should be changed to facilitator and leader. Try to create an active, effective and sustainable teaching and learning environment. Macro vision, goal setting, strategic planning and management, foresight, future research and future-recording and problem solving ability should be taken into consideration as important points for choosing staff managers.

The purpose of this article, extracted from the thesis, was to present the model of organizational culture based on normative and individual variables in the managers of the education staff of Tehran province. In terms of field position, and in terms of nature, it is among the foundation data research. The statistical community of the qualitative part included management experts using the principle of saturation and targeted non-random sampling method, and in the quantitative part, it also included the director general, deputies, and heads of departments of the general administration. and managers and vice presidents of education districts of Tehran province were selected as the sample size. Presentation of the organizational culture model based on normative and individual variables is considered a central category in the paradigm model of the research and other concepts in the form of categories of causal, contextual, and intervening conditions. Strategies and outcomes were included in the model and 10 categories with 57 indicators were introduced in the normative dimension and 10 categories were introduced in the individual dimension with 61 indicators. The evaluation findings based on Shannon's entropy method show; maliciousness and suspicion towards each other Self-esteem, sense of ownership over the organization, enjoyment of work, self-motivation, improvement of job skills and knowledge, personal development, and attention to positive points and job achievements, innovative decisions, and accountability are of the highest importance in realizing organizational culture.

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). 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. 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). 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.

The occurrence of arrhythmias after myocardial infarction is associated with an increased risk of mortality. The purpose of this study was to investigate tachyarrhythmias after streptokinase therapy in myocardial infarction patients.

This study was a case-control study. Among 262 patients with myocardial infarction who received streptokinase, 168 patients with ventricular tachyarrhythmia, ventricular fibrillation, or both (case group), and 94 patients without arrhythmia (control group) were selected. Their clinical information were collected by questionnaire. Data were analyzed using SPSS 20 software through chi-square test and Wilcoxon rank-sum.

There was no relationship between demographic variables or electrocardiogram changes and the type of arrhythmia in 168 participants in the group 1 (p > 0.05). However, there was a significant relationship between age (p = 0.04), sex (p = 0.049), diabetes (p = 0.039), hypertension (p = 0.037), history of beta-blocker use (p = 0.028), history of aspirin use (p = 0.023), number of the leads involved (p = 0.023) and occurrence of arrhythmia among the participants in the group 2.

According to the findings of this study, patients with myocardial infarction who need to receive thrombolysis and who have any of the following conditions should be monitored by the health care staff to prevent development of ventricular tachyarrhythmias: old age, male gender, history of diabetes mellitus, hypertension or more lead involvement in their electrocardiogram.

According to cardiologists’ experiences, there is possibly a relationship between clinical symptoms and the type of coronary artery involvement in patients with the acute coronary syndrome (ACS). Given the significance of the issue, the present study was conducted to explore the relationship between clinical symptoms and the type of coronary artery involvement in ACS patients.

In general, 720 ACS patients hospitalized in Shahid Madani hospital of Tabriz were enrolled in this descriptive, cross-sectional study from August 2011 to February 2012. Participants were selected by means of convenience sampling and according to inclusion criteria. Data collection tools were a demographic questionnaire and ACS indices. The results were analyzed using SPSS16 and P<0.05 was considered statistically significant.

The findings showed that following the diagnoses through coronary artery angiography, 289 (40.1%), 201 (27.9%), 227 (31.5%), and 18 (2.5%) patients had single-vessel disease, two-vessel disease, three-vessel disease, and the left main disease, respectively. A total of 416 patients (57.8%) suffered from left anterior descending (LAD) disease while involvement rates were 142 (19.7%), 208 (28.9%), 8 (1.1%), 73 (10.1%), 17 (2.4%), and 21 (2.9%) patients for patent ductus arteriosus, obtuse marginal artery 2, obtuse marginal artery 1, diagonal 2, diagonal 1, right coronary artery (RCA), and left circumflex (LCX), respectively.

Based on pathological findings, retrosternal pain was the most common symptom to all coronary occlusions regarding ACS symptoms. LAD, as the most involved vessel, had varying manifestations. Finally, referred pain to teeth was only observed in RCA involvement. The results can be helpful for timely and accurate diagnosis of cardiac patients who refer to emergency rooms and thus reduce the mortality rate by taking appropriate therapeutic measures.

Given the role of platelets in thrombus formation, markers of platelet activation may be able to predict outcomes in patients with acute pulmonary thromboembolism (PTE).

In a prospective cohort study, 492 patients with acute PTE were enrolled. Patients were evaluated for platelet indices including mean platelet volume (MPV), platelet distribution width (PDW), and platelet-lymphocyte-ratio (PLR), as well as for the simplified Pulmonary Embolism Severity Index (PESI) risk score. The primary endpoint was in-hospital all-cause mortality. Major adverse cardiopulmonary events (MACPE, composite of mortality, thrombolysis, mechanical ventilation and surgical embolectomy during index hospitalization) and all-cause death during follow-up were secondary endpoints.

MPV, PDW and PLR were 9.9±1.0 fl, 13.5±6.1%, and 14.7±14.5, respectively, in the total cohort. Whilst MPV was higher in those with adverse events (10.1±1.0 vs 9.9±1.0 fl; P=0.019), PDW and PLR were not different between two groups. MPV with a cut-off point of 9.85 fl had a sensitivity of 81% and a specificity of 50% in predicting in-hospital mortality, but it had lower performance in predicting MACPE (Area under the curve: AUC 0.58; 95%CI 0.52-0.63) or long-term mortality (AUC 0.54; 95% CI 0.47-0.61). The AUC for all these three markers were lower than the AUC calculated for the simplified PESI score (0.80; 0.71-0.88).

Platelet indices had only fair-to-good predictive performance in predicting in-hospital all-cause death. Established PTE risk scoring models such as simplified PESI outperform these indices in predicting adverse outcomes.

The purpose of this study was to investigate the impact of organizational excellence  and Maturity on human resource development. The present study is applied in nature by descriptive-survey method. The statistical population consisted of 400 members, including faculty members of Tehran Free and State Universities and Meteorological Organization staff. The sample was selected using Morgan table. Research tools included library studies and questionnaires. The research questionnaire was a combination of the researcher-made questionnaire of human resources developed by Flint et al. (2002), the Strauss and Corbin Questionnaire, and the standard component model validation questionnaire. The validity and reliability of the instruments were assessed and confirmed. Data analysis was performed in two parts: descriptive and inferential (including software Structural Equation Method (PLS) and single group t test). The results of this study showed that maturity and excellence have an impact on the development of human resources in the Iranian Meteorological Organization.

Redo mitral valve replacement (MVR) is an important therapeutic approach in patients with the malfunction of the prosthetic mitral valve, especially in patients with severe dyspnea or a large thrombus burden. Redo replacement (MVR) and thrombectomy are different surgical approaches in these patients. This study evaluated the outcome of the second mitral valve surgery including mechanical MVR (M-MVR), biologic MVR (B-MVR), and surgical thrombectomy.

To this end, 71 patients were included in this study, who underwent second mitral valve surgery following the malfunction of the prosthetic mitral valve in the last 10 years. These patients were divided into M-MVR, B-MVR, and surgical thrombectomy groups and their demographic, clinical, echocardiographic, and laboratory findings were gathered as well. Then, the patients were evaluated for their third MV surgery if it was performed, followed by evaluating the pump time and cross-clamp time

Fifty-seven, 8, and 6 patients underwent M-MVR, B-MVR, and thrombectomy, respectively. Based on the results, the mortality rate was not significantly different between the 3 groups (P = 0.059). In addition, 12 patients underwent the third surgery with the highest (100%) and lowest (0%) rates at thrombectomy and B-MVR groups, respectively. Higher pump time and cross-clamp time were significantly associated with an increased mortality rate (P = 0.014 and P = 0.026, respectively).

In the malfunction of the prosthetic mitral valve, mortality rate failed to significantly differ between the patients undergoing M-MVR, B-MVR, and thrombectomy but third surgery is often needed after thrombectomy. It seems that the replacement of previous prosthetic valve with a new mechanical or biological valve yields better results in the case of prosthetic valve malfunction

Smoking, which is a major modifiable risk factor for coronary artery diseases, affects cardiovascular system with different mechanisms. We designed this study to investigate the association of smoking with location of ST-segment elevation myocardial infarction (STEMI), and short-term outcomes during hospitalization.

In 1017 consecutive patients with anterior/inferior STEMI, comprehensive demographic, biochemical data, as well as clinical complications and mortality rate, were recorded. Patients were allocated into two groups based on smoking status and compared regarding the location of myocardial infarction, the emergence of clinical complications and in-hospital mortality in univariate and multivariate logistic regression analysis.

Among 1017 patients, 300 patients (29.5%) were smoker and 717 patients (70.5 %) were non-smoker. Smokers were significantly younger and had lower prevalence of diabetes, hyperlipidemia and hypertension. Inferior myocardial infarction was considerably more common in smokers than in non-smokers (45.7% vs. 36%, P = 0.001). Heart failure was developed more commonly in non-smokers (33.9% vs. 20%, P = 0.001). In-hospital mortality was significantly lower in smokers (6.7% vs. 17.3%, P = 0.001). After adjustment for confounding variables, smoking was independently associated with inferior myocardial infarction and lower heart failure [odds ratio: 1.44 (1.06-1.96), P = 0.01 and odds ratio: 0.61 (0.40-0.92), P = 0.02, respectively]. However, in-hospital mortality was not associated with smoking after adjustment for other factors [odds ratio: 0.69 (0.36-1.31), P = 0.2].

Smoking is independently associated with inferior myocardial infarction. Although smokers had lower incidence of heart failure, in-hospital mortality was not different after adjustment for other factors.

Cardiovascular diseases (CVDs) are a major cause of hospital admission and the main reason for mortality in the world, which are triggered by both genetic and environmental factors. In addition, minerals and trace elements have long been considered potential risk factors for CVD among which calcium and magnesium may play a significant role. Accordingly, the present study aimed to assess the relationship between coronary atherosclerotic diseases and hardness of drinking-water in the residence of patients admitted to Shahid Madani hospital in Tabriz. The population of the study included 780 patients undergoing coronary angiography out of whom 547 cases were entered into this case-control study. The subjects were then divided into 5 groups based on the severity of coronary artery involvement: with the least or no involvement (control group), one artery involved (group 1), 2 arteries involved (group 2), 3 arteries involved (group 3), and severe diffuse involvement of all coronary arteries (group 4). Residences of the patients were located from their medical history and then 200-mL of drinking-water samples were then taken from each area in plastic containers. Next, the levels of calcium and magnesium were measured using the EDTA method. Finally, the samples were divided into 4 groups based on the hardness of water. The mean age of the participants was 59.7 years and the most frequent type of water in the residential areas was the soft water. Further, the highest frequency related to the severity of atherosclerosis belonged to groups 4 and 3, respectively. Based on the results, no significant relationship was found either between the severity of atherosclerosis and calcium level of water or the severity of atherosclerosis and magnesium level of water. In general, the results revealed that there was no significant relationship between the levels of calcium and magnesium in the drinking water of the patients residing in East Azerbaijan province and their severity of atherosclerosis. The findings further suggest that the drinking water of the province can be divided into hard and soft water and the severity of atherosclerosis of the patients is independent of the hardness of the drinking water in their residences.

Both drug use and sex work considered as serious health and social problems. This study aimed to find the relation between them in young Iranian women. A mixed method of data collection applied from 300 young female sex workers in Tehran and 39 in-depth interviews with key informants. Result show that 84.4 % of participants used drugs before sex work. 46.2% of their fathers and 56.6% of their husbands used drug. 13.6% of these women mothers were sex workers. Evidences stated that priority of drug addiction to sex work cannot be generally determined. This study finding indicated that young women use drugs mostly before sex work; but substance abuse after starting sex work was to reduce the mental and physical sufferings to facilitate working through raising sexual potency and to sink in ecstasy and ignorance meanwhile in most cases to be able to obtain drugs.

The entrepreneurship grows up significantly in the last decade, showing new ways to emergent economies. With that development has become the necessity of entrepreneur education. The society look for one guidance to build new opportunities of business or some help to innovate in some way.
Analysis Inthis paper which is organized by analytic and descriptive approach, in order to understand the concepts of the Third Generation University, entrepreneurship, the knowledge-based economy, literature of the subject, has been reviewed by documentary study. To illustrate the impact of the university on the economy and the essential structures toward the third-generation universities, existing records have been reviewed through search on authoritative online sites and the study of the latest articles and related documents. The third-mission of universities depends on its national and institutional context. If university wish to promote the entrepreneurial ideal, then identification of institutional barriers is a necessity. They require the existence of a mass of entrepreneurial models as a pattern to performance. It is important to understand the expectations of industry, government and university and their role. There is no unique and best way to contribute to economic development, rather optimal approaches are contextually dependent. A refined version of the triple-helix model of university– industry–government could improve the performance of universities in economies.

Atrial fibrillation (AF) is the most common arrhythmia in patients with mitral stenosis (MS) and it may increase complications and decreases success rates of percutaneous balloon mitral valvotomy (PBMV). This study aimed to investigate the short and long term results of PBMV in patients with AF compared to sinus rhythm (SR).
In this cross sectional study, 1000 patients with MS who had undergone PBMV between 1999 and 2013 were enrolled including 585 and 415 patients with AF and SR respectively. Patients were followed for a mean of 7.27 ± 3.16 years. Clinical, echocardiographic and hemodynamic data were collected. Procedure success, in-hospital and long-term outcome were evaluated.
Patients with AF were older and had greater symptoms, mitral regurgitation, mitral echocardiographic score, and mitral pressure gradient before PBMV. PBMV success rate were significantly lower in AF group (P AF leads to worse in-hospital and long-term outcome and lower PBMV success rate. Repeated assessment and early decision to PBMV in patients with MS to reduce AF and AF related complication seems necessary.

Myxomas are the most common benign cardiac tumors. Myxomas are more common in the left heart chamber than the right side chamber. An extracardiac origin presenting as a right atrial mass is very rare. We present a case of myxoma originating in the superior vena cava (SVC) in a 24-year-old man, who underwent surgical resection. Preoperative two-dimensional echocardiography demonstrated a mass in the right atrium. Intraoperatively, the tumor was found to have originated from the SVC orifice. The tumor was excised from the SVC by opening the one-third proximal portion of the SVC. Pathological examination revealed a myxoma, and one-year follow-up showed no evidence of the recurrence of any tumors in the SVC.

Right ventricular failure due to right coronary artery disease, right ventricular hypertrophy, stunning, abnormal septal motion, myocardial infarction, or non-homogeneous distribution of cardioplegia is an uncommon but serious complication of open heart surgery. We report a patient with severe right ventricular hypertrophy secondary to severe mitral valve stenosis and another patient with detachment of the right coronary artery due to the dissection of the ascending aorta. The patients developed right ventricular failure, which persisted after surgery and rendered weaning from cardiopulmonary bypass unsuccessful. Through a hemi-Fontan, or bidirectional cavopulmonary shunt, and an intra-aortic balloon pump, the patients were successfully weaned from cardiopulmonary bypass. This shunt may be an alternative to a right ventricular assist device in some patients with right ventricular failure. The long-term outcome and the indication of bi-directional cavopulmonary shunt has not been confirmed, although it is believed to be effective for saving the life of patients with low cardiac output and acute right ventricular failure. In our cases, six months following the operation, there was some degree of recovery of the right ventricular function. In long-term follow-up, however, it would be interesting for the authors to know if the improved right ventricular function, with better antegrade pulsatile flow in the pulmonary artery, in any way interferes with the functioning of the bidirectional cavopulmonary shunt.

Renal failure predisposes patients to adverse outcome after coronary artery bypass grafting (CABG). Renal dysfunction is a predictor of increased morbidity and mortality after CABG, whether it is dialysis-dependent or not. In a retrospective study from April 2000 to December 2010, seventy-six patients (60 male and 16 female with the mean age of 58.57±7.93 years) with different categories of chronic renal failure undergoing CABG in Shahid Madani Hospital, were studied. The cardiac disease leading to the operation was coronary artery disease (CAD) in all patients. Patients demographic, surgical and laboratory data were gathered from hospital records. Data were then analyzed. Mean hospital stay was 10.16±7.16 days. The preoperative mortality rate was 10.5% (15% in non dialysis and 5.6% in dialysis dependant patients with no significant difference). Morbidity rate was 28.9% (respectively 30% and 27.8% in dialysis and non dialysis patients with no significant difference) including in-hospital myocardial infarction (MI) (10.5%), in-hospital stroke (2.6%), in-hospital bleeding (21.1%) and in-hospital infection, pneumonia, (5.3%). Mean creatinine and blood urea nitrogen (BUN) levels were significantly increased after surgery (p<0.001). Postoperative hemodialysis rate was 33.3%. Chronic renal failure whether dialysis-dependant or not increases in-hospital mortality and morbidity in patients undergoing CABG. For CRF patients not on dialysis with a creatinine 2.5 gm/dL, there is a strong likelihood of postoperative dialysis.

Globally, stroke is one of the leading causes of death and disability. The most common type is ischemic stroke. Despite all socioeconomic impacts, there is no efficacious treatment for this devastating disease. Due to limited time window and other obstacles only small numbers of patients are eligible for new treatment like intravenous thrombolytic treatment. Other type of interventions like intra-arterial thrombolysis, retrieval devices are useful in selected cases. In this study we presented ten different cases of acute ischemic stroke treated by intra-arterial thrombolysis and/or stenting.

Ten consecutive patients presented with symptoms and signs of intracranial artery occlusion within 6 and 18 hours respectively for anterior and posterior circulation were treated with intra-arterial thrombolytic (10-20 mg tissue plasminogen activator or Tpa) and stenting. A neurologist obtained the national institutes of health stroke scale (NIHSS) at baseline, and 2 hours, 24 hours, 7 days and 3 months after treatment.

Ten patients (6 men and 4 women) aged 23 to 74 years were recruited. Eight patients presented with stroke in the anterior circulation territory and two with posterior one. We achieved complete recanalization in 7 patients (70%) and partial in one case (10%) and in two patients with T-type left internal carotid occlusion recanalization was unsuccessful (20%). Clinical improvement and neurological recovery in the patients with complete recanalization was excellent

These results support the efficacy of intrarterial thrombolysis and stenting in the treatment of selected cases of acute stroke ischemic. In patients with T-type carotid occlusion, this type of treatment did not show significant clinical benefits.

Staphylococcus aurous has been known as one of the most common nosocomial pathogens which include as much as %30 to %50 of general population. Regarding to the presence of carrier staff can be considered as one of the infection source; remarking of carrier for prevention purposes is important. In a cross-sectional study we determined the prevalence of staphylococcus aurous carriage among 113 edical staff of Madani Heart Hospital, Tabriz (Iran) 28/08/2009 to 28/09/2009 on (Physicians, nurses, technicians, secretaries, the administrative personnel and services), including surgical wards, laboratory, ICU and CCU. In this study, 113 participants comprised of 60 males (53%) and 53 females (47%), and their mean age of participants in this study was 34.8 years (20-55). Sampling was carried out from nasal of employees. Samples were place on blood agar and mannitol salt agar; suspected colonies have been cultured and identified by catalase, coagulase and DNAase. Generally, of 113 people who entered the study, 30 person (26.5%) had positive cultures and 82 (72.6%) had a negative culture. The incidence of staphylococcus aureus carriage was more in men than women 57% vs. 43% (p<0.05). In this study staphylococcous areous carriage incidence in Tabriz heart centre (Madani hospital) was 50 % to 80% lower than our estimation, unexpectedly.

The purpose of this study is to provide insight into pathology patterns of cardiac valves, which remains a major cause of mortality and morbidity in Iran as a developing country. This prospective study included 3418 consecutive cardiac surgery patients who underwent valve surgery over the past 5 years in 6 major hospitals. Etiologic and pathologic data of the valves were based on either pathologic reports (for replaced valves) or gross detection of the surgeons (for repaired valves). The mean age of subjects was 43.98±14.45 years. 1616(47.27%) of them were male and 1802(52.73%) were female. Approximately 46% (1572) of the patients underwent mitral valve surgery.Mitral valve disease was found to be due to ischemia in 327(9.56), infective endocartidits in 68 (1.99), congenital problems in 71(2.08) and degenerative etiology in 264(7.72). Rheumatic valve disease was most frequent in patients of 40-49 years old. This study shows that rheumatic valvular disease remains the most frequent valvular pathology among patients undergoing valvular surgery in Iran. The relatively high mean age of patients with rheumatic valvular disease emphasizes the priority of this health problem in Iran which requires particular attention, especially in terms of prevention and also treatment.

This report presents a case of right radial artery pseudoaneurysm complicated by arterio-venous fistula and absence of ulnar artery. The patient had history of deep vein thrombosis 18 months earlier and was receiving oral warfarin anticoagulation therapy. Doppler study and angiography finding showed poor collateral supply to distal arterial bed. The etiology of this complication and its treatment is controversial

A 36 years old woman with a history of treated pulmonary tuberculosis (TB) was hospitalized for progressively worsening dyspnea on exertion. She had severe calcification of entire aorta and evidence of old TB on chest roentgenogram. Routine laboratory tests including erythrocyte sedimentation rate (ESR) and C- reactive protein (CRP) were normal and rheumatologic panel was negative. Echocardiography showed severe aortic insufficiency. Work-up for active tuberculosis was negative. The CT scan of the chest was in favor of old tuberculosis and also showed heavily calcified aorta. She underwent aortic valve replacement. Postoperative course was uneventful. At four-year follow-up the patient is doing well. Considering her age and the absence of risk factors of atherosclerosis we postulated that porcelain aorta in this patient could be a sequel of remote tuberculosis aortitis.

In contrast to conventional on-pump coronary artery bypass grafting (CABG) surgery only mild increase of parameters of oxidative stress is reported during and after off-pump coronary artery bypass grafting. In this study, we attempted to determine the role of off-pump CABG in the myocardial and systemic inflammatory responses. One hundred patients who underwent elective CABG were divided to three groups: 1) patients underwent off-pump CABG or 2) on-pump CABG surgery with controlled reperfusion and 3) on-pump CABG with noncontrolled reperfusion. We took patients systemic venous blood samples for the measurement of serum level malondialdehyde (MDA), TroponinC (cTnI) and total antioxidant (TAC) and blood level superoxiddismotas (SOD), before and after Ischemia and reperfusion. Mean values of decrease left ventricular ejection fraction (LVEF) after surgery in patients group 3 were higher than patients group2 and also (LVEF) in patients group2were higher than patients group1(P<0.0001).There was significant difference in mean increase in CTnI levels among the three study groups (P <0.0001). The Serum concentration of MDA in the patients group3were significantly higher than other two groups (P <0.0001). The decrease SOD, TAC levels in patients patients group3were more than patients patients group2and than patients group1. We conclude that oxidative stress biomarker were increase in on-pump CABG. Controlled reperfusion on-pump CABG in comparison with noncontroled reperfusion on-pump CABG reduces oxidative stress. We conclude that off-pump CABG technique appears to reduce oxidative stress.

This report presents a case of left radial artery pseudoaneurysm developing at the previous site of invasive monitoring. The patient had prosthetic mitral valve replacement one month earlier, and anti-coagulation therapy had started on the first post-operative day. The patient’s radial artery aneurysm with a 4-centimeter diameter was resected and the radial artery was ligated.

Correct data communications with the Imaging Center Departments and HIS is very important in all over the world; in other countries they estab-lished some parts of this connection throw out HL7 standards. At this time none of HIS/RIS software''s in Iran supports this standard, and as well we need to connect these systems at the modalities acquisi-tion segment, which HL7 doesn''t support it.With due attention to EPD Co. experiments in de-sign and Produce of RIS/HIS and PACS and our basic knowledge about HL7 V3, linking these systems together are very important for us. So in the first step, we connect them together over Payvand systems and in the second step we create a standard solution as a service under windows platform for connecting different RIS/HIS to the PACS.This Service is a DICOM-based standard solution that directly links RIS/HIS systems to PACS in workstation level. It transfers patient demographics and study information from RIS systems to PACS by Modality Request. Also radiologists can use this service to get their work list by Dicom Viewer directly. We can denote some benefits of this service as possibility to keep track patient file over the RIS/HIS, eliminating data entry at the modality and in consequence, increasing speed and simplicity of imaging procedure, enabling exams to start on time and assuring that the exam data is cataloged correctly when sent to a PACS.EPD Co. Work list Service runs in the background of Windows operating system. First, it opens a network socket and then answers to all requests from Modalities and DICOM Viewers. The RIS operators work with this service indirectly when they enter patient information. Also this service is not relative to any RIS/HIS and PACS system, so medical imaging centers can use this service with any windows-based RIS/HIS.

Correct data communications with the Imaging Center Departments and HIS is very important in all over the world; in other countries they estab-lished some parts of this connection throw out HL7 standards. At this time none of HIS/RIS software''s in Iran supports this standard, and as well we need to connect these systems at the modalities acquisi-tion segment, which HL7 doesn''t support it.With due attention to EPD Co. experiments in de-sign and Produce of RIS/HIS and PACS and our basic knowledge about HL7 V3, linking these systems together are very important for us. So in the first step, we connect them together over Payvand systems and in the second step we create a standard solution as a service under windows platform for connecting different RIS/HIS to the PACS.This Service is a DICOM-based standard solution that directly links RIS/HIS systems to PACS in workstation level. It transfers patient demographics and study information from RIS systems to PACS by Modality Request. Also radiologists can use this service to get their work list by Dicom Viewer directly. We can denote some benefits of this service as possibility to keep track patient file over the RIS/HIS, eliminating data entry at the modality and in consequence, increasing speed and simplicity of imaging procedure, enabling exams to start on time and assuring that the exam data is cataloged correctly when sent to a PACS.EPD Co. Work list Service runs in the background of Windows operating system. First, it opens a network socket and then answers to all requests from Modalities and DICOM Viewers. The RIS operators work with this service indirectly when they enter patient information. Also this service is not relative to any RIS/HIS and PACS system, so medical imaging centers can use this service with any windows-based RIS/HIS.