فهرست مطالب behzad hajimoradi

COVID-19 is a novel infectious disease, which has challenged people all around the world. As of today, healthcarepractitioners and researchers have made great effort to understand the characteristics and clinical presentationsof the disease; however, the existing literature is still incomplete in this regard. A growing body of evidence in-dicates that coagulopathies and thromboembolic events are of utmost importance in COVID-19 patients andare related to poor prognosis. Here, we report three ICU admitted cases of COVID-19, in which massive pul-monary thromboembolism (PTE) occurred a few days after disease onset. Unfortunately, one of the patients didnot survive and two were treated; one with thrombectomy and other with antithrombotic agents. It seems thatsevere cases of COVID-19 are at risk for developing PTE and in-charge physicians should be prepared and planfor anticoagulant prophylaxis using low-molecular-weight heparin (LMWH).

This study aimed to evaluate reduced drug consumption, risky behaviors, depression, and anxiety and improved quality of life in addicts on methadone maintenance therapy (MMT) at baseline and six months after therapy. In this descriptive cross-sectional study, 275 addicts were selected by a random sampling method in 2017. The data collection tools consisted of four questionnaires including a demographic information questionnaire, the Beck depression inventory questionnaire, WHOQOL-26, and Spielberger Anxiety Inventory. Data analysis was done by SPSS20 software at a confidence level of 95%. Based on the obtained results, after six months, MMT efficiency was 50.5% and no cases of intravenous injection were reported. The consumption of other drugs was significantly reduced (P < 0.05). The highest prevalence of depression was observed in cannabis and opium users. Depression decreased from 85.81% to 63.27%. The mean scores of quality of life and anxiety after MMT increased to 89.6 and 20.41, respectively. The most improvement was in the physical health domain (mean score of 64.11). The results showed improvements in all the four domains of physical health, psychological health, social relationship, and environment and reductions in depression and anxiety.

In massive pulmonary embolism (PE), fibrinolytic therapy is a potential lifesaving treatment; therefore, if other treatments are not available, the physicians encounter this question: can we accept the risk of complications from fibrinolytic therapy, especially intracranial hemorrhage, in the presence of absolute contraindication, in order to save the patient’s life? Here, we describe three cases of massive PE with absolute contraindication for fibrinolytic therapy who presented to emergency department following dyspnea. Since, surgical or catheter embolectomy were not available and patients were very high risk for transferring to another hospital, systemic fibrinolytic was administered. The patients improved clinically and were discharged from hospital. It seems that, if no other acceptable treatments are available, physicians could consider fibrinolytic therapy, even at the presence of contraindication, to save the patient’s life.

: anabolic androgenic steroids (AAS) abuse for improving physical appearance and performance in body builders are common and have been considered responsible for serious cardiovascular effect. Due to disagreement about cardiovascular side effects of these drugs in published articles, this case control study was designed to evaluate the echocardiographic finding in body builder athletes who are current and chronic abuser of these drugs. body builder athletes with continues sport for preceding two years and at least twice weekly training selected and divided into AAS abuser and non user and compared with age and BMI matched non athletic healthy volunteers(15 cases in each group). There was no significant difference in left ventricular size or function either systolic or diastolic in comparison of cases and control groups. The only difference was in diastolic size of septum and free wall but observed differences were only significant (P value=0.05) between first (athletic with AAS abuser) and third group (non athletic and nonuser). The difference between the above mentioned indexes were not significant between two groups of athletics. Observed differences in diastolic size of septum and free wall is in favor of that long term abuse of anabolic steroid results in accentuation of physiologic hypertrophy due to long term sport most probably due to higher rate pressure product. Furthermore long term abuse and supra pharmacologic doses does not have significant effect in size and left ventricular function.

Many factors influence the prognosis of patients with (CHF) among these; more attention has been focused on the Role of left Bundle Branch Block (LBBB). The present study was performed to find out the prevalence of CHF in LBBB patients. In this cross-sectional study 246 were diagnosed consecutive patients with LBBB pattern in ECG during July 2004 until October 2006 at Imam Ali Heart Hospital in Kermanshah. At the first step ECG was recorded and according to its result chest X-ray and echocardiography were obtained if necessary. Data analysis was made using dependent sample t-test and P 0.05 was considered significant. 246 consecutive patient with mean age 64 10 years and the age range of 38-85 years old were studied. 46% of patients were men and 54% women. There was no statically difference between the mean age of men and women with CHF. Etiology of LBBB in this study included; CAD Hypertension dilated cardiomyopathy and valvular heart disease. Significant difference was seen in LV dysfunction between men and women (P 0.05). EF for men was 35% and for women was 37.9% other wise relation between duration complex of QRS and reduction in EF was statically significant. We concluded that the incidence of wide QRS is very high in CHF patients and patients with LBBB were associated with a clinical and homodynamic feature of greater impairment of cardiac function especially in those patients with duration of QRS complex more than 140 MS.