Predictive Value of Absent Septal q Wave in Patients with Significant Stenosis of Proximal Left Anterior Descending Coronary Artery

Aims: There is conflicting data about the predictive value of absent septal q wave in patients with significant stenosis of proximal Left Anterior Descending coronary artery. To clarify the exact role of this simple electrocardiographic sign we conducted this prospective descriptive study. Methods: Patients who were referred for coronary angiography in Milad Hospital between December 2008 and September 2009 were chosen randomly. Standard ECG was performed and reviewed for presence or absence of septal q wave, and then the coronary angiography was done and reported by another cardiologist. Results: Of 148 patients with absent septal q wave in ECG, 85 patients (57%) had significant stenosis of proximal LAD in coronary angiography. Statistical analysis showed that significant stenosis of proximal LAD could be predicted by absence of septal q wave in ECG with sensitivity of 59% and specificity of 47%. However, Kappa statistic (Kappa = 0.36) showed low agreement between them. Conclusion: Absence of normal septal q wave in ECG could be a low value predictor of coronary artery disease mainly significant proximal LAD stenosis

Relationship Between Exposure to Industrial Noise and Serum Lipid Profile

Aim of our study was to investigate the effects of exposure to industrial noise on serum lipid profile among workers who are exposed to noise at work. In a historical cohort study, we recruited 154 and 146 male workers as high and low level noise exposure groups respectively. We defined workers with at least one year exposure to noise level more than 90 dB as high exposure group, and those with exposure to less than 80 dB as low exposure group. Afterwards, in the fasting blood specimens of participants we measured serum Triglyceride (TG), total Cholesterol (TC), high and low density lipoprotein (HDL and LDL). Mean of TG, TC, HDL and LDL for low exposure group were 148, 189, 38 and 103 mg/dl and for high exposure group were 237, 189, 37 and 104 mg/dl respectively. Mean serum TG between two groups was different. Even after adjustment for age, BMI, smoking and work hours per week, serum TG among high exposure group was 89 mg/dl higher than low exposure group and this difference was statistically significant (P=0.00). There was no significant difference between two groups in TC, LDL and HDL levels. This study did not find a statistically significant relationship between exposure to noise and serum TC, LDL and HDL, but TG in two groups was different and this difference was statistically significant

Article Commentary: Predictive Value of Absent Septal q Wave in Patients with Significant Stenosis of Proximal Left Anterior Descending Coronary Artery

Aims There is conflicting data about the predictive value of absent septal q wave in patients with significant stenosis of proximal Left Anterior Descending coronary artery. To clarify the exact role of this simple electrocardiographic sign we conducted this prospective descriptive study. Methods Patients who were referred for coronary angiography in Milad Hospital between December 2008 and September 2009 were chosen randomly. Standard ECG was performed and reviewed for presence or absence of septal q wave, and then the coronary angiography was done and reported by another cardiologist. Results Of 148 patients with absent septal q wave in ECG, 85 patients (57%) had significant stenosis of proximal LAD in coronary angiography. Statistical analysis showed that significant stenosis of proximal LAD could be predicted by absence of septal q wave in ECG with sensitivity of 59% and specificity of 47%. However, Kappa statistic (Kappa = 0.36) showed low agreement between them. Conclusion Absence of normal septal q wave in ECG could be a low value predictor of coronary artery disease mainly significant proximal LAD stenosis

A comparative study of aggrecan synthesis between natural articular chondrocytes and differentiated chondrocytes from adipose derived stem cells in 3D culture

Introduction: The main obstacle for tissue engineering is to find the most appropriate cell which is able to produce extracellular matrix (ECM) similar or better than natural chondrocytes in vitro. This study compared aggrecan synthesis′s potential between differentiated chondrocytes (DCs) from adipose-derived stem cells (ADSCs) and natural articular chondrocytes (NCs) in 3D culture in vitro. Materials and Methods: Human ADSCs were isolated from sub-cutaneous adipose tissue and then the surface markers including CD 14, 45 CD105, CD90, CD44 were analyzed by flow cytometry. Also human articular chondrocytes were yielded of non-weight bearing area of Knee cartilage. Both types of the cells were encapsulated in alginate scaffolds and cultured in chondrogenic medium with and without TGFβ3 for 3 weeks. Then the extent of aggercan (AGC) production was evaluated by ELISA on days 14 and 21. Results: Our findings indicated that differentiated chondrocytes (DCs) with and without TGFβ3 synthesized more AGC than natural chondrocytes (NCs) on day 14. But DCs without TGFβ3 had higher production than other groups on day 21. Application of TGFβ3 resulted in an increase of amount of AGC in DCs on day 14 but a decrease on day 21 than same group. Conclusion: Since, aggrecan is an important chondrogenic marker, it was concluded that ADSCs can be possible reliable alternative cell source for cartilage tissue engineering in future

Investigating the diagnostic value of quantitative parameters based on T2-weighted and contrast-enhanced MRI with psoas muscle and outer myometrium as internal references for differentiating uterine sarcomas from leiomyomas at 3T MRI

Abstract Background Post-hysterectomy histopathological examination is currently the main diagnostic tool for differentiating uterine sarcomas from leiomyomas. This study aimed to investigate the diagnostic accuracy of preoperative quantitative metrics based on T2-weighted sequences and contrast-enhanced MRI (CE-MRI) for distinguishing uterine sarcomas from leiomyomas. Materials and methods The institutional review board approved the study. Sixty-five women confirmed to have a total of 105 lesions participated. Routine pelvic MRI sequences, T2 map and CE-MRI images were performed preoperatively using a 3 T MR scanner. Six quantitative metrics—T2 mapping parameter, T2 scaled ratio, tumor myometrium contrast ratio on T2, tumor psoas contrast ratio on T2, tumor myometrium contrast-enhanced ratio, and tumor psoas contrast-enhanced ratio—were extracted from the acquired image sets. Chi-square test was used to compare the percentage of malignant lesions with the central necrosis to the corresponding percentage for the benign masses. Using the area under receiver operating characteristic (AUC) curve, the performance of different metrics for distinguishing uterine sarcomas from leiomyomas was measured. Moreover, for each metric, we extracted the optimal cut-off value. The values of sensitivity, specificity, negative predictive value, and positive predictive value were calculted for the classifiers based on different metrics. Results The average age, average lesion size, and proportion of premenopausal women in benign and malignant groups were comparable in our dataset. The signal intensity of uterine sarcomas at T2-weighted sequences was significantly higher than that of leiomyomas (p < 0.001), while intensity at T1-weighted sequences exhibited no significant difference between the two masses (p = 0.201). Our data also suggested that a central necrosis was ten times more common among malignant lesions compared to benign ones (p < 0.001). Among different metrics, T2 mapping parameter achieved the highest AUC value and accuracy in differentiating two groups. Three measures—T2 scaled ratio, tumor myometrium contrast ratio on T2, and tumor myometrium contrast-enhanced ratio—achieved a sensitivity of 100%, therefore none of the malignant lesions would have been missed if these metrics had been adopted in patient management. Conclusions The findings suggested that the evaluated metrics could be useful in the preoperative assessment of myometrial masses to differentiate uterine sarcomas from leiomyomas. The proposed framework has major implications for improving current practice in the management of myometrial masses

Evaluation of sleep problems in preeclamptic, healthy pregnant and non-pregnant women.

Sleep problems are common complaints among pregnant women. This study was designed to compare subjective sleep problems in non-pregnancy condition, healthy and preeclamptic pregnancy as a major complication of pregnancy. We hypothesized that some sleep problems are more prevalent in females with preeclampsia.In this cross-sectional study, 102 women with preeclampsia, 106 healthy pregnant women in the third trimester and 103 healthy non-pregnant women were selected through random sampling. Age and parity were matched in the three groups. We used Global sleep assessment questionnaire (GSAQ) to check the subjective sleep problems, and then we performed statistical analysis using Analysis of variance (ANOVA) and Pearson Chi-square tests.Our findings revealed significant differences in initial insomnia (p = 0.034), fragmented sleep (p = 0.022), snoring (

Medical Waste Management in the second largest City of Iran (Mashhad) with Three-Million Inhabitants

Introduction: One of the first and important steps to improve medical waste management is awareness and monitoring of the quality and quantity of medical waste. The aim of this study was to determine the present status of waste generation and the process of waste management in hospitals. Materials and Methods:This cross sectional study was performed in ten university hospitals in Mashhad. A standard questionnaire was prepared according to the National Health instructions and completed by the project team members who were environmental health experts.  Results: The total waste which was generated in the studied hospitals was 7683 kg/day. The study showed total waste generation in selected hospitals as (61.85%) general medical waste, (34.90%) infectious waste and (3.25%) sharp waste. The average generation rate for total, general, infectious and sharp waste was (2.6, 1.5, 1.01) and (0.08) kg/bed/day, respectively. Mean scores of the different steps of waste management process with respect to National Health instructions were as follows: waste segregation (64%), waste storage (67%), waste transportation (76 %) and waste treatment 63%. There was no significant difference between the average rate of waste generation per bed in public and specialized hospitals (P=0.34). Conclusion: High rate of infectious waste shows the need for establishing executive rules and standards for medical waste management. Medical managers should update their knowledge and further educating their staff; implying careful and constant monitoring of waste management

Antenatal umbilical coiling index in gestational diabetes mellitus and non-gestational diabetes pregnancy

Objective: Umbilical cord abnormalities increase fetal morbidity and mortality. This study was designed to compare antenatal umbilical coiling index (aUCI) in gestational diabetes mellitus (GDM) and non-gestational diabetes mellitus (non-GDM) pregnancy, considering uncertainties about the best time to perform antenatal ultrasonography scan. Materials and Methods: In this prospective study, 246 parturients were included, 123 with GDM and 123 with non-GDM pregnancy. Gestational diabetes was confirmed at 24–28 weeks of gestation (WG) using one-step strategy. An anatomical ultrasound survey of placenta and umbilical cord was performed at 18–23 as well as 37–41 weeks of gestational age. Results: At 18–23 WG, the frequency distribution (10th, 90th percentiles, mean ± SD) of the aUCI in the GDM and non-GDM groups were (0.13,0.66,0.32 ± 0.19) and (0.18,0.74, 0.4 ± 0.31) respectively. These values were (0.12,0.4, 0.25 ± 0.11) in the GDM group at 37–41 WG and (0.17,0.43, 0.29 ± 0.11) in the non-GDM group. A significant relationship was detected between UCI value and GDM/non-GDM groups at both antenatal evaluations (18–23 WG; P = 0.002, 37–41WG; P 90th) (P = 0.001). However, hypocoiling were significantly more frequent in GDM than non-GDM in both antenatal evaluations (P < 0.001, P = 0.006). Conclusion: Antenatal UCI in pregnancy complicated by GDM were lower in comparison with non-GDM pregnancy. The most abnormal pattern of coiling in gestational diabetes was hypocoiling in both trimesters. In addition, 18–23 WG is the best time to perform ultrasound scan to detect aUCI and umbilical cord pattern. Keywords: Antenatal, Gestational diabetes mellitus, 75-g oral glucose tolerance test, Ultrasonography, Umbilical coiling inde