The output estimation of a DMU to preserve and improvement of the relative efficiency

In this paper, we consider the inverse BCC model is used to estimate output levels of the Decision Making Units (DMUs), when the input levels are changed and maintain the efficiency index for all DMUs. Since the inverse BCC problem is in the form of a multi objective nonlinear programming model (MONLP), which is not easy to solve. Therefore, we propose a linear programming model, which gives a Pareto-efficient solution to the inverse BCC problem. So far, we propose a model for improvement of the current efficiency value for considered DMU. Numerical examples are, also, used to illustrate the proposed approaches

Estimation of left ventricular end diastolic pressure (lvedp) in patients with ischemic heart disease by echocardiography and compare it with the results of cardiac catheterization

<strong>BACKGROUND:</strong> Doppler echocardiography has been proposed as an appropriate non-invasive<br />assay to estimate left ventricular end diastolic pressure (LVEDP). The aim of present research<br />was to estimate the LVEDP in patients with ischemic heart disease by echocardiography and<br />compare it with the results of cardiac catheterisation and to determine the effect of different<br />echocardiographic variables on its measurement.<br /><strong>METHODS:</strong> In this descriptive-analytic study, patients with diagnosed ischemic heart disease<br />were selected by nonrandomized sampling method. Selected population underwent M-mode<br />and pulse doppler echocardiographic evaluation and parameters such as Q-Mitral valve E<br />(Q-MVE), Q-Aortic valve closure (Q-AVC), Aortic valve closure-E (AVC-E), Q-Mitral valve<br />closure/Aortic valve closure-E (Q-MVC/AVC-E), left ventricle-deceleration time (LV-DT), peak<br />velocity-deceleration time (PV-DT) and A/E velocity time integral (A/E VTI) were evaluated.<br />Immediately after echocardiography all patients underwent left heart catheterization for LVEDP<br />measurement. The relation between different echocardiographic measurements and LVEDP,<br />obtained by cardiac catheterization, was evaluated.<br /><strong>RESULTS:</strong> In this study, 47 patients with ischemic heart disease with mean age (&plusmn;SD) of<br />53 &plusmn; 13 were studied. There was a significant correlation between LVDEP and A/E VTI (r=0.44,<br />P = 0.001, and also between LVEDP and PV-DT in patients with A/E VTI &ge;1.1(r = -0.58, P = 0.02).<br />There was a significant correlation between LVEDP and Q-MVC/AVC-E in patients with LVEDP<br />&gt;18mmHg (r = 0.76, P= 0.03) and those with LVEDP &le;18 mmHg and A/E VTI &lt; 1.1<br />(r = 0.37, P= 0.03). The correlation between LVEDP and A/E VTI was more significant in men,<br />in patients aged &gt; 50 years with EF &gt; 55%, without LVH, without MR and those with coronary<br />artery disease (P &lt; 0.05).<br /><strong>CONCLUSION:</strong> Some echocardiographic indices such as A/E VTI, Q-MVC/AVC-E and PV-DT<br />are able to measure LVEDP especially in male patients aged &gt; 50 years, without LVH, without<br />MR and those with coronary artery disease but it is necessary to determine specific conditions<br />and factors affecting these indices, by further studies.<br /><strong>Keywords:</strong> LVEDP, Coronary Artery Disease, Echocardiography

Sero-epidemiological study of family-members of HBsAg positive chronic carriers in Zahedan city (Southeastern Iran)

Background and Aims: The household transmission of hepatitis B virus (HBV) is a major health problem. The prevalence rate of this infection is reported about 11% to 57% among family members of HBsAg carriers. This study conducted to evaluate serological determinants of chronic hepatitis B infection, especially HBsAg positivity among family members of asymptomatic HBsAg positive carriers in Zahedan city (Southeastern Iran).Materials and Methods: In a cross-sectional study, data were collected for a total of 454 HBsAg – positive cases and 1817 members of their family by trained interviewers and a validated questionnaire. Additionally blood samples were obtained and tittered to detect serologic markers of hepatitis B.Results: In this study totaly, 454 chronic HBsAg carriers (66% male and 34% female) with an average age of 36 ± 10 years and 1817 of their family members were included. The prevalence rate of HBsAg and HBc-Ab positivity among household members were 19.3% (n = 351) and 51% (n = 573), respectively. The frequency of HBV markers was different by age groups. The highest prevalence rate of HBsAg (35%) and HBc-Ab (32%) positivity were found in the age group of 21-30 years old. Importantly, the mothers of index cases had the highest prevalence of HBsAg positivity compared with their spouses who had the lowest proportion (53.2% vs. 8.4%, p&lt;0.001).Conclusion: In family members, HBsAg-positivity was greater than the general indigenous population. Suggesting the importance of close contacts for transmission. It was more prevalent in mothers of index cases than their spouses. Suggesting the more efficient mother to child transmission than sexually transmission of HBV. And in those having a history of hepatitis B in maternal family in comparison with the paternal one, which may be due to more efficient transmission from infected mothers to children.Key words: Hepatitis B, Transmission, Intra-familial, Prevention, Zahedan

Diagnostic performance of 64-row coronary CT angiography in detecting significant stenosis as compared with conventional invasive coronary angiography

BACKGROUND: The aim of the present study is to evaluate the accuracy of 64-multidetector-row computed tomography angiography (CTA) in comparison to conventional invasive angiography (CIA) in the diagnosis of significant stenosis (≥ 50) of coronary artery tree. METHODS: Assessment of CTA in the detection of coronary artery disease (CAD) was performed in patients referred because of symptoms or stress studies suggestive of ischemia. For this purpose, among more than 1000 cases of coronary CTA in a 20 months period a study population of 54 patients suspected to have significant stenosis of the coronary artery tree was investigated. The CIA procedure was performed in these patients one month after CTA. The accuracy of CTA in detecting significant stenosis was compared to CIA. RESULTS: For vessel based analysis of 179 coronary vessels, CTA had a sensitivity of 96, specificity of 87.5, positive predictive value of 90.5, and negative predictive value of 94.6. For patient-base analysis, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of CTA were 97.9, 28.6, 66.6, and 90.2, respectively. CONCLUSION: The findings of this study reveal that CT angiography with 64-slice scanner could be considered as a suitable technique for rapid triage of patients presenting to hospitals with chest pain. High values of sensitivity and PPV reveal the good performance of CTA in detecting CAD

The Influence of Composite Thickness with or without Fibers on Fracture Resistance of Direct Restorations in Endodontically Treated Teeth

Introduction: This in vitro study evaluated the influence of composite thickness (with or without fiber reinforcement) on fracture resistance of direct restorations in endodontically treated teeth. Methods and Materials: Fifty-six intact human premolars were chosen and randomly divided into four groups (n=14). After preparation of a mesio-occluso-distal (MOD) cavities and cusp reduction, the teeth were endodontically treated. Subsequently, the samples were restored with composite resin using the following protocols: group 1; composite onlay with cusp coverage of 1.5 mm, group 2; composite onlay with cusp coverage of 2.5 mm, group 3; composite onlay (including resin-impregnated fiber) with cusp coverage of 1.5 mm and group 4; composite onlay (including resin-impregnated fiber) with cusp coverage of 2.5 mm. The fracture resistance of teeth in all test groups was calculated by subjecting them to a progressively increasing compressive axial force in the universal testing machine with the cross-head speed of 1 mm/min to the point of fracture. The data were analyzed using the Kruskal-Wallis test. Results: The mean fracture strengths and obtained standard error were 1263.85±74.03 N, 1330.26±128.01 N, 1344.92±64.40 N and 1312.54±75.63 N for groups 1 to 4, respectively. Statistical analysis revealed no significant difference between groups. Conclusion: Cusp coverage of 1.5 and 2.5 mm in MOD access cavities with or without insertion of resin impregnated fiber had similar fracture rates in the endodontically treated teeth

Evaluation of Leptin and Adiponectin Levels in Patients with Stable Angina Pectoris

<p class="abstract"><strong>BACKGROUND:</strong> Leptin and adiponectin are two adipose tissue hormones and their association with the incidence of cardiovascular diseases is under evaluation. The aim of this study was to determine the relationship of leptin and adiponectin with coronary artery diseases.</p> <p class="abstract"><strong>&nbsp;&nbsp; METHODS:</strong><strong> </strong>One hundred and seventy patients with angina pectoris and indications of coronary angiography underwent angiography. Serum levels of blood lipids, leptin, and adiponectin were measured. The gathered data was evaluated using SPSS software, V. 15, by multivariate variance analysis.</p> <p class="abstract"><strong>&nbsp;&nbsp; RESULTS:</strong> Analysis of the data demonstrated that 45.1% of the patients had positive angiographic findings. The serum levels of leptin and adiponectin were significantly lower than the minimum levels specified by the kit. However, the two groups, i.e., patients with positive angiographic findings and those with negative findings were not significantly different according to the serum levels of the hormones. Moreover, no significant correlation between the serum levels of the hormones and serum lipids was observed.<strong>&nbsp;</strong></p> <p class="abstract"><strong>&nbsp;&nbsp; </strong><strong>CONCLUSION:</strong> Various studies have demonstrated that high serum level of leptin and the incidence of coronary artery diseases are correlated. On the other hand, they have reported that adiponectin has cardioprotective role. Confirmation of these findings requires more detailed studies.</p> <p class="abstract">&nbsp;</p><table cellspacing="0" cellpadding="0" align="left"><tbody><tr><td width="35" height="12"><br /></td></tr> <tr><td><br /></td> <td>&nbsp;</td></tr></tbody></table><strong>Keywords:</strong> Leptin, Adiponectin, Coronary artery disease<br /

The effect of contrast dye injection and balloon inflation on QTC and QTC dispersion in 12 leads surface ECG during PTCA

BACKGROUND: Considering that determining the effect of both contrast dye injection and balloon inflation on electrophysiological parameters would help us to predict the ischemic event during PTCA, the aim of this study was to determine the effects of these factors on QTc and QTc dispersion during PTCA in Isfahan. &nbsp;&nbsp; METHODS: In this cross-sectional study, consecutive patients undergoing elective PTCA in Chamran hospital in Isfahan enrolled. All patients were in sinus rhythm. A 12-lead electrocardiogram was continuously recorded before (baseline) and during PTCA after dye injection and balloon inflation. QTc and QT dispersion was calculated in all 12 leads of electrocardiogram during the mentioned times and compared with each other. &nbsp;&nbsp; RESULTS: 33 patients with mean age of 49.1 &plusmn; 16.2 years were studied. Anatomic distribution of the coronary artery stenosis was as follows: left anterior descending artery (LAD) in 76.7% patients, left circumflex (Cx) in 16.6% and right coronary (RCA) in 6.66%. Mean of QTc at baseline, after contrast dye injection and after balloon inflation was 423.9 &plusmn; 28.5, 437 &plusmn; 29 and 437 &plusmn; 22&nbsp;msec, respectively (P &lt; 0.05). Mean of QTc dispersion at baseline, after contrast dye injection and after balloon inflation was 92.3 &plusmn; 7.2, 95.4 &plusmn; 8.3&nbsp;&nbsp; and 93.75 &plusmn; 7.5, respectively (P &gt; 0.05). &nbsp;&nbsp; CONCLUSION: The findings of this research supports the fact that during PTCA a transient myocardial ischemia occurs but further studies is recommended to accurately determine the stages at which ischemia occurred and the extent of its effect of it on cardiac depolarization and repolarization periods.Keywords: PTCA, QTc, QTc dispersion, Balloon inflation, Contrast dye injection.</p

Effects of streptokinase on reflow in rescue percutaneous coronary intervention

BACKGROUND: Primary percutaneous coronary intervention (PPCI) is the preferred treatment method for ST elevation myocardial infarction (STEMI). However, the required equipments are not available in all hospitals. Thus, due to shortage of time, some patients receive thrombolysis therapy first. Patients with chest pain and/or persistent ST segment elevation will then undergo rescue percutaneous coronary intervention (PCI). The present study evaluated and compared the frequency of no-reflow phenomenon and 24-hour complications after PCI among patients who underwent PPCI or rescue PCI. METHODS: This cross-sectional study assessed no-reflow phenomenon, 24-hour complications, and thrombolysis in myocardial infarction (TIMI) flow in patients admitted to Chamran Hospital (Isfahan, Iran) with a diagnosis of STEMI during March-September, 2011. Subjects underwent PPCI if they had received eptifibatide. Rescue PCI was performed if patients had chest pain and/or persistent ST segment elevation despite receiving streptokinase (SK). Demographic characteristics, history of diseases, medicine, angiography findings, PCI type, and complications during the first 24 hours following PCI were collected. Data was then analyzed by Student&rsquo;s t-test, chi-square test, and logistic regression analysis. RESULTS: A total number of 143 individuals, including 67 PPCI cases (46.9%) and 76 cases of rescue PCI (53.1%), were evaluated. The mean age of the participants was 58.92 &plusmn; 11.16 years old. Females constituted 18.2% (n = 26) of the whole population. No-reflow phenomenon was observed in 51 subjects (37.1%). Although 9 patients (6.3%) died during the first 24 hours after PCI, neither the crude nor the model adjusted for age and gender revealed significant relations between rescue PCI and death or no-reflow phenomenon. Rescue PCI and no-reflow phenomenon were not significantly correlated even after adjustments for age, gender, history of diabetes, hypertension, hyperlipidemia, coronary artery disease, smoking, platelets number, myocardial infarction level, the extent of stenosis, and the involved artery. CONCLUSION: According to the present study, although SK is more effective than eptifibatide in resolution of thrombosis and clots, rescue PCI did not differ from PPCI in terms of the incidence of no-reflow phenomenon or short-term complications. &nbsp; Keywords: Primary Percutaneous Coronary Intervention, Rescue Percutaneous Coronary Intervention, No-Reflow Phenomeno

Undesired Outcomes of the Catania Stent Compared to the Xience Stent in Patients Undergoing Angioplasty: A Double-Blind Randomized Controlled Trial

Background: The present study tries to compare the unintended outcomes of the Catania stent versus Xience stent in patients undergoing angioplasty. Materials and Methods: In a three month, follow-up, double-blinded, randomized controlled trial, 83 patients undergoing angioplasty, who met the inclusion criteria were entered into the study. After randomization 43 patients were treated with the Xience stent and 40 patients with the Catania stent. Stent-related outcomes such as Cardiac and Non-Cardiovascular Death, Myocardial Infarction (MI), Target Lesion Revascularization (TLR), Stent Thrombosis (ST), Coronary Artery Bypass Grafting (CABG), Peripheral vasculopathy, and Cerebral Vascular Accident (CVA) were compared between the groups. Results: There was no statistically significant difference in the incidence rate of complications and clinical outcomes between the two treatment groups (P > 0.05). The incidence of MI, TLR, CABG operation, peripheral vasculopathy, or CVA was not observed in any patient and there was no statistically difference in mortality (4.7% vs. 2.5%; P = 0.527) and stent thrombosis (2.3% vs. 2.5%; P = 0.735). Conclusion: All in all, the present study could not find the significant differences between the Catania stent and Xience stent in terms of clinical outcomes during the follow-up period