Fauna and the distribution of mosquitoes (Diptera: Culicidae) in Chahar Mahal and Bakhtiari province, 2011-2012

زمینه و هدف: پشه‌ها خانواده‌ی بزرگی از دوبالان را شامل می‌شوند که به لحاظ توانایی انتقال انواع عوامل بیماری‌زا در پزشکی و بهداشت اهمیت فراوانی دارند. این مطالعه به منظور تکمیل اطلاعات موجود در زمینه‌ی تنوع گونه‌ای و انتشار پشه‌های بومی استان چهارمحال و بختیاری انجام گرفته است. روش بررسی: این پژوهش توصیفی و مقطعی در طول تابستان 1390 و 1391 در تمامی شهرستان‌های استان چهارمحال و بختیاری انجام گردید. نمونه‌ها به روش ملاقه زنی جمع آوری و با استفاده از کلیدهای معتبر شناسایی شدند. داده‌های تعیین هویت و مختصات جغرافیایی نقاط نمونه برداری در نرم افزار ArcGIS 10 وارد گردید تا نقشه‌ی پراکندگی هر یک از گونه‌ها به دست آید. یافته ها: در این مطالعه، 8335 لارو از 92 زیستگاه لاروی جمع آوری گردید که به 18 گونه شامل کولیستا لانجی آرئولاتا، کولیستا ساب اوکریا، اوکلروتاتوس کاسپیوس سنسولاتو، کولکس تیلری، کولکس تریتانس، کولکس هورتنزیس، کولکس پیپینس، کولکس پرگزیگوس، کولکس میمتیکوس، کولکس ترای تنیورینکوس، کولکس اربیینی، کولکس لاتیسینکتوس، آنوفل ماکولیپنیس سنسولاتو، آنوفل سوپرپیکتوس، آنوفل دتالی، آنوفل مارتری، آنوفل کلاویژر و آنوفل تورکودی تعلق داشتند. کولکس تریتانس به عنوان یک گونه‌ی جدید برای استان چهارمحال و بختیاری گزارش می‌گردد. کولکس تیلری و آنوفل سوپرپیکتوس بیش ترین فراوانی و گسترده ترین انتشار را در استان نشان دادند. نتیجه گیری: این مطالعه نشان می‌دهد که برخی از مهم ترین پشه‌های ناقل بیماری‌ها در سطح استان چهارمحال و بختیاری از تنوع و پراکندگی وسیعی برخوردار هستند. برای تعیین توانایی پشه‌های بومی در انتقال عوامل بیماری زا در استان به مطالعات بیشتری نیاز است

Coexistence of at least three distinct beta-adrenoceptors in human internal mammary artery

The internal mammary artery (IMA) is currently the preferred conduit for myocardial revascularization. However, perioperative vasospasm and a hypoperfusion state during maximal exercise may limit its use as a bypass graft. The mechanism of spasm has not been clearly defined. Since beta-adrenoceptor activation plays a major role in vasorelaxation, the present study was carried out to investigate the beta-adrenoceptor responsiveness of human IMA smooth muscle. Isoproterenol produced a concentration-dependent relaxation in endothelium-denuded IMA segments, precontracted with phenylephrine (maximal relaxation 46.33±5.45%). Atenolol (10 –6 M) and propranolol (2×10 –7 M) inhibited isoproterenol-induced relaxation. While atenolol produced partial inhibition, propranolol caused a complete inhibition in a majority of the segments and a partial inhibition in a minority. BRL 37344, a selective beta 3-adrenoceptor agonist, produced a concentration-dependent relaxation in phenylephrine-precontracted rings of endothelium-denuded IMA (maximal relaxation 40.35±4.07%). Cyanopindolol, a beta-adrenoceptor partial agonist, produced a marked relaxation (58.65±6.2%) in endothelium-denuded IMA rings, precontracted with phenylephrine. Cyanopindolol-induced relaxation was resistant to blockade by propranolol (2×10 –7 M). Spontaneous contractions of IMA rings were also observed in some cases that were inhibited by isoproterenol and BRL 37344. This observation implies the important role of beta-adrenoceptor activation in prevention of human IMA spasm

Predictors of Postoperative Atrial Fibrillation after Coronary Artery Bypass Graft Surgery

Objectives The present study was aimed to identify the preoperative, intraoperative, and postoperative predictors of AF in a pure cohort of the patients with coronary artery disease who underwent CABG surgery. Methods Between November 2005 and May 2006, 302 consecutive patients were included in this prospective study. All the relevant clinical, electrocardiographic, echocardiographic, and laboratory data were gathered in the included patients and they were also monitored for development of post-CABG AF.Results Postoperative AF occurred in 46 (15%) of patients. By univariate analysis, older age, P-wave abnormality in ECG, presence of mitral regurgitation, larger left atrium (LA), left main coronary artery involvement, failure to graft right coronary artery (RCA), and adrenergic use in ICU were significantly associated with occurrence of post-CABG AF (all P< 0.05). However, in the logistic regression model, age (OR: 1.067, 95%CI: 1.02-1.116, P=0.005), LA dimension (OR: 1.102, 95%CI: 1.017-1.1936, P=0.017), P-wave morphology (OR: 12.07, 95%CI: 3.35-48.22, P=0.0001), failure to graft RCA (OR: 3.57, 95%CI: 1.20-10.64, P=0.022), and postoperative adrenergic use (OR: 0.35, 95%CI: 0.13-0.93, P=0.036) remained independently predictive of postoperative AF.Conclusion The present study suggested that age, P-wave morphology, LA dimension, failure to graft right coronary artery, and postoperative adrenergic use were independent predictors of post-CABG AF. Therefore, clinical data, ECG and echocardiography may be useful in preoperative risk stratification of the surgical patients for the occurrence of post-CABG A

Performance and Predictive Value of First Trimester Screening Markers for Down Syndrome in Iranian Pregnancies

Objective: To investigate the performance of first trimester Down syndrome (DS) screening markers in Iranian pregnancies.Although sonographic and serum markers are currently recommended for the first trimester screening of Down syndrome, the screening performance of the markers depends on the race and ethnicity. Materials and methods: A retrospective case-control study using first trimester screening results recorded with the prenatal diagnostic multi-centers in Iran. A total of 6,384 pregnant women were examined from March 2012 to February 2017. Totally 100 Down syndrome cases and 266 matched controls were selected and the maternal characteristics, sonographic and biochemical screening data were collected. Statistical analysis was performed using logistic regression and descriptive statistics. A decision tree model was designed using the chi-squared automatic interaction detection method based on serum markers. Results: For screening of DS pregnancies, PAPP-A (cut-off 0.795 MoM) yielded the highest sensitivity (86%) and NB marker presented highest specificity (96.24%). combination of the biochemical markers PAPP-A and β-hCG (cut-off: 1.55 MoM) showed the highest sensitivity over other combined markers. The decision-tree model based on serum markers improved (91% DR For a 5% FPR) first trimester screening performance. Conclusion: The novel decision-tree model base on serum markers revealed a better predictive value to achieve high sensitivity and specificity of first trimester Down syndrome screening in Iranian population

Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017.

The Global Burden of Diseases, Injuries and Risk Factors 2017 includes a comprehensive assessment of incidence, prevalence, and years lived with disability (YLDs) for 354 causes in 195 countries and territories from 1990 to 2017. Previous GBD studies have shown how the decline of mortality rates from 1990 to 2016 has led to an increase in life expectancy, an ageing global population, and an expansion of the non-fatal burden of disease and injury. These studies have also shown how a substantial portion of the world's population experiences non-fatal health loss with considerable heterogeneity among different causes, locations, ages, and sexes. Ongoing objectives of the GBD study include increasing the level of estimation detail, improving analytical strategies, and increasing the amount of high-quality data. METHODS: We estimated incidence and prevalence for 354 diseases and injuries and 3484 sequelae. We used an updated and extensive body of literature studies, survey data, surveillance data, inpatient admission records, outpatient visit records, and health insurance claims, and additionally used results from cause of death models to inform estimates using a total of 68 781 data sources. Newly available clinical data from India, Iran, Japan, Jordan, Nepal, China, Brazil, Norway, and Italy were incorporated, as well as updated claims data from the USA and new claims data from Taiwan (province of China) and Singapore. We used DisMod-MR 2.1, a Bayesian meta-regression tool, as the main method of estimation, ensuring consistency between rates of incidence, prevalence, remission, and cause of death for each condition. YLDs were estimated as the product of a prevalence estimate and a disability weight for health states of each mutually exclusive sequela, adjusted for comorbidity. We updated the Socio-demographic Index (SDI), a summary development indicator of income per capita, years of schooling, and total fertility rate. Additionally, we calculated differences between male and female YLDs to identify divergent trends across sexes. GBD 2017 complies with the Guidelines for Accurate and Transparent Health Estimates Reporting

Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017

The Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017) includes a comprehensive assessment of incidence, prevalence, and years lived with disability (YLDs) for 354 causes in 195 countries and territories from 1990 to 2017. Previous GBD studies have shown how the decline of mortality rates from 1990 to 2016 has led to an increase in life expectancy, an ageing global population, and an expansion of the non-fatal burden of disease and injury. These studies have also shown how a substantial portion of the world's population experiences non-fatal health loss with considerable heterogeneity among different causes, locations, ages, and sexes. Ongoing objectives of the GBD study include increasing the level of estimation detail, improving analytical strategies, and increasing the amount of high-quality data.; We estimated incidence and prevalence for 354 diseases and injuries and 3484 sequelae. We used an updated and extensive body of literature studies, survey data, surveillance data, inpatient admission records, outpatient visit records, and health insurance claims, and additionally used results from cause of death models to inform estimates using a total of 68 781 data sources. Newly available clinical data from India, Iran, Japan, Jordan, Nepal, China, Brazil, Norway, and Italy were incorporated, as well as updated claims data from the USA and new claims data from Taiwan (province of China) and Singapore. We used DisMod-MR 2.1, a Bayesian meta-regression tool, as the main method of estimation, ensuring consistency between rates of incidence, prevalence, remission, and cause of death for each condition. YLDs were estimated as the product of a prevalence estimate and a disability weight for health states of each mutually exclusive sequela, adjusted for comorbidity. We updated the Socio-demographic Index (SDI), a summary development indicator of income per capita, years of schooling, and total fertility rate. Additionally, we calculated differences between male and female YLDs to identify divergent trends across sexes. GBD 2017 complies with the Guidelines for Accurate and Transparent Health Estimates Reporting. Globally, for females, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and haemoglobinopathies and haemolytic anaemias in both 1990 and 2017. For males, the causes with the greatest age-standardised prevalence were oral disorders, headache disorders, and tuberculosis including latent tuberculosis infection in both 1990 and 2017. In terms of YLDs, low back pain, headache disorders, and dietary iron deficiency were the leading Level 3 causes of YLD counts in 1990, whereas low back pain, headache disorders, and depressive disorders were the leading causes in 2017 for both sexes combined. All-cause age-standardised YLD rates decreased by 3·9% (95% uncertainty interval [UI] 3·1-4·6) from 1990 to 2017; however, the all-age YLD rate increased by 7·2% (6·0-8·4) while the total sum of global YLDs increased from 562 million (421-723) to 853 million (642-1100). The increases for males and females were similar, with increases in all-age YLD rates of 7·9% (6·6-9·2) for males and 6·5% (5·4-7·7) for females. We found significant differences between males and females in terms of age-standardised prevalence estimates for multiple causes. The causes with the greatest relative differences between sexes in 2017 included substance use disorders (3018 cases [95% UI 2782-3252] per 100 000 in males vs s1400 [1279-1524] per 100 000 in females), transport injuries (3322 [3082-3583] vs 2336 [2154-2535]), and self-harm and interpersonal violence (3265 [2943-3630] vs 5643 [5057-6302]). Global all-cause age-standardised YLD rates have improved only slightly over a period spanning nearly three decades. However, the magnitude of the non-fatal disease burden has expanded globally, with increasing numbers of people who have a wide spectrum of conditions. A subset of conditions has remained globally pervasive since 1990, whereas other conditions have displayed more dynamic trends, with different ages, sexes, and geographies across the globe experiencing varying burdens and trends of health loss. This study emphasises how global improvements in premature mortality for select conditions have led to older populations with complex and potentially expensive diseases, yet also highlights global achievements in certain domains of disease and injury

Experiences in Surgical Closure of Atrial Septal Defect with AnteriorMini-Thoracotomy Approach

Introduction: The surgeons and their patients are now seeing the benefits and extendedpossibilities of minimally invasive cardiac surgery. Anterior mini-thoracotomy approach is agood alternative to median sternotomy since it reduces operative trauma, accelerates recoveryand yields a better cosmetic outcome. Our purpose is to explain the details of our technique andmanifest the experience results.Methods: Seventy five patients with secundum Atrial Septal Defect (ASD) (52 female and 23 male)were operated with anterior mini-thoracotomy approach in our tertiary research center betweenMarch 2012 and March 2014. The mean age was 14±10 ranged from 2 to 42 years. Outcomes weredefined according to cardiopulmonary and aortic cross-clump time, intensive care unit stay time,morbidity, mortality, the size of incision, the amount of post-operative bleeding, the amount ofblood transfusion, reoperation and the surgical details.Results: Mean Cardiopulmonary bypass time (CPB time) was 49.62 minutes (from 26 to 105minutes) and mean aortic cross clamp time was 22.29±6.77 minutes (between 11 to 47 minutes).The mean amount of blood transfusion was 47.49± 62.22 mm (ranged 0 to 200 cc) and themean chest tube drainage after surgery was 80.17 ±121.06 mm (ranged 0 to 600 cc). One patientre-operated for dehiscence of ASD surgical sutures and there was no reoperation for surgicalbleeding or tamponade drainage in these patients. In 74 cases the defect was secundum type ASD,in 2 patients it was sinus venosus type and in one with associated partial Anomalous repair.Conclusion: Anterior thoracotomy approach is safe and may be the surgical technique ofchoice for secundum ASD repair in all age groups and we can utilize this technique also formore complicated kinds of surgery for instance, sinus venosus type ASD with or without PartialAnomalous Defect

Recurrence rate of different techniques for repair of coarctation of aorta: A 10 years experience

Background and Aim : The main goal of this study was to assess the frequency of recurrent coarctation after repair using different surgical methods. Methods : Surgical results of repairs for coarctation of aorta (Co-A) in 188 patients under the age 14 years who were treated in Rajaee Heart Center, Tehran, Iran, were evaluated retrospectively. The most common methods included patch-graft aortoplasty (59), resection with end-to-end anastomosis (20.7) and subclavian flap aortoplasty (SCFA) (16.5). The remaining patients underwent bypass tube graft and excision with placement of a tube graft. Seventy eight percent had discrete stenosis while 22 had long segment narrowing. The patients were followed for 81.632.8 months. Results : The overall mortality rate was 2.6. The highest incidence rate of recoarctation was found in the patch-graft aortoplasty group (12.7) and the lowest was found in SCFA (3.2). The incidence of recoarctation in long-segment lesions was significantly higher than that in the discrete ones (30 vs. 4, P<0.001). In patients <1 year, the incidence of recoarctation was lower than that in the other age groups. Conclusion : The patch-graft aortoplasty technique had the highest incidence of recoarctation and SCFA had the lowest rate. Long-segment Co-A had a higher chance of recoarctation. In contrast to some previous reports, the incidence of recoarctation was not higher in the age below 1 year

The impact of sub-valvular apparatus preservation on prosthetic valve dysfunction during mitral valve replacement

Background: Sub-valvular apparatus preservation (SAP) during mitral valve replacement (MVR) is not a new concept. Some surgeons prefer to excise the apparatus. Objectives: The aim of this study was to reduce the risk of prosthetic valve dysfunction. Materials and Methods: This retrospective study included 151 patients with the mean age of 46 years who underwent MVR (Female/male = 93/58). In the group I consisting of 39 patients, MVR with chordae preservation was performed (Bi-leaflet preservation = 20; posterior leaflet preservation = 19). In the group II consisting of 112 patients, sub-valvular apparatus was resected completely during MVR. Preoperative patients' characteristics, including age, sex, functional status, left ventricular ejection fraction, and end-diastolic or end-systolic dimensions were statistically similar in both groups. Mean follow-up period was 60.3 ± 26 months. Results: The improvement of functional status was seen in almost all survivors but was more obvious in the group I. In early follow-up, 56.4% of group I cases and 44.1% of group II patients were classified as New York Heart Association class I. These rates were 84.2% and 71.2% in mid-term follow-up, respectively (P < 0.001). Mortality rate was significantly lower in the group I (2.6%) compared to the group II (8.9%) (P = 0.03). There was a trend for higher frequency of postoperative atrial fibrillation in the group II compared to that in the group I (52.7% vs. 38.5%, P = 0.12).The incidence of prosthetic valve dysfunction (PVD) was 5.1% in the group I and 4.5% in the group II, but this difference was not statistically significant (P = 0.56). Conclusions: Preservation of mitral annulus and papillary muscle continuity may enhance post- MVR cardiac performance with low mortality and morbidity rates. The risk of PVD was not significantly higher than conventional MVR in our series

Hyperprolactinemia after laparoscopic ovarian drilling: An unknown phenomenon

<p>Abstract</p> <p>Background</p> <p>The effects of ovarian drilling on the serum levels of gonadotropins and androgens have been studied previously. The aim of this study is to evaluate the effects of ovarian drilling on the serum prolactin levels and its relation to ovulation in women with polycystic ovary syndrome.</p> <p>Methods</p> <p>This is a prospective controlled study. Thirty-six women with PCOS underwent ovarian electrocauterization in university hospitals. Control group consisted of 35 ovulatory women with unexplained infertility. Hormonal assessment performed in early follicular phase of spontaneous or induced cycle before operation in the two groups and repeated one week after operation. Hormonal assay was also performed in the early follicular phase of the first post-operative menstruation, folliculometry and progesterone assay were also performed in the same cycle. Data were analyzed by "repeated measurement design, discriminant analysis, correlation coefficient, and Fisher exact test".</p> <p>Results</p> <p>Six to ten weeks after operation the serum mean +/- SD prolactin levels increased from 284.41 +/- 114.32 mIU/ml to 354.06 +/- 204.42 mIU/ml (P = 0.011). The same values for the control group were 277.73 +/- 114.65 to 277.4 +/- 111.4 (P = 0.981) respectively. Approximately 45% of subjects in PCOS group remained anovulatory in spite of decreased level of LH and testosterone. Prolactin level remained elevated in 73.2% of women who did not ovulate 6–10 weeks after the procedure.</p> <p>Conclusion</p> <p>Hyperprolactinemia after ovarian cauterization may be considered as a possible cause of anovulation in women with polycystic ovaries and improved gonadotropin and androgen levels. The cause of hyperprolactinemia is unknown. Hormonal assay particularly PRL in anovulatory patients after ovarian cauterization is recommended.</p