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Introduction & Objective: The previous investigations show that cardiovascular diseases, which are spreading all over our country, account for most health and social problems. The objective of this study was to determine the relation between demographic factors, medical history as well as para clinical factors and Coronary Artery Disease (CAD) within a period of 30 days for patients with chest pain. Materials & Methods: This was a prospective cohort study. Patients referred to the emergency department of Tehran heart centre with a chief complaint of chest pain without ST ـ segment elevation were followed for 30 days. The outcome variable was coronary artery disease. The Poisson Regression Model was applied in order to identify significant predictors of outcome. Applying this model, we could calculate Adjusted Risk Ratio and 95% confidence interval. The data were analyzed by standard statistical tests using SAS and Stata software. Results: 609 eligible patients were enrolled. Of these 51% were male and 49% female. Based on the final model of Poisson Regression, variables like sex, blood pressure history, heart disease history, changes in electrocardiogram, WBC and CRP had meaningful relationship with CAD. Conclusion: We concluded that prognosis in patients with chest pain needed considering clinical factors (acquired through interview), electrocardiogram and lab findings. Also we were conducted not to rely on traditional risk factors such as history of diabetes, hypercholesterolemia, smoking and family history of heart disease for prediction of the disease.

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ABSTRACT: Introduction & Objective: Fever of Unknown Origin (FUO) has different etiologies due to new diagnostic procedures and geographic areas. This study aimed to evaluate the patients with FUO in hospitals of Shahid Beheshti Universty of Medical Sciences. Materials & Methods: In this survey case series admitted patients with impression of FUO in infectious diseases wards of Shahid Beheshti University of Medical Sciences of Iran in 2003 were studied. 52 patients had fever over 38.3 ºC for 3 weeks and their disease was not diagnosed after 3 visits or 3 days of admission. Results: 54% of the patients were male and 46% were female. 85% of the cases were under the age of 60 years. The most common etiology of FUO was Infectious diseases (36.5%), and neoplasm (21%), miscellaneous (17.5%), undiagnosed (13.5%), and connective tissue diseases (11.5%) respectively.Tuberculosis (7.7%), Intra-abdominal abscess (7.7%), lymphoma (11.5%), drug fever (5.8%) and autoimmune hepatitis (3.8%) were the most common infectious diseases. Conclusion: Results of this study are comparable with those in other developing countries and infectious disease is the most common causative agent of FUO.

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Background & Aim: Aging is a biological process influenced by biological, physiological, social and environmental factors. This study was conducted to determine the health status of elderly people resident in Yasouj, Iran. Methods: This cross-sectional study was conducted in Yasouj during 2008. A number of 428 people, aged over 60, were selected based on cluster and random sampling. A researcher made questionnaire, based on existing literatures and current studies, was designed in four domains known as activities of daily living (ADL), physical health, psycho-spiritual health and status of socio-economic. Its content validity, face validity and reliability were reviewed and confirmed. The collected data was analyzed by the SPSS software version 17 using descriptive statistics such as frequency, tables, the central and dispersion statistical indicators as well as inferential statistics like independent t-test with considering α= 0.5. Results: In this study, the total mean scores of four domains of health were 106.63 ± 6.49 (range 82-134), which has 99 percent of their health status were totally described as moderate. Based on four areas of health status, the mean score of activities of daily living, physical health, psycho-spiritual health and socio-economic status were 23.72± 4 (range 16-34), 25.40± 3.21(range 13-34), 34.03± 4.71 (range 14-46) and 23.71± 4.20 with range of 15-37, respectively. Compared mean scores of activities of daily living and psycho-spiritual health showed significant statistical differences according to age groups and sex variables. Conclusion: Health status of the majority of elderly people in this study was moderate which require further attention and holistic support from the family, community, and health authorities in the field.

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Abstract Background & aim: MRI is a new and expensive diagnostic technology which has been increasingly used globally. This aim of study was to determining the administration of MRI for the Lumbar vertebrae using the appropriate RAND Method. Methods: This qualitative study was based on consensus. The population study included 9 professionals involved in prescribing the procedure based on Rand. Two criteria were identified: Valid clinical guidelines and expert opinion. Scoring criteria were the numbers 1 to 9. Numbers in the range of 1 to 3 unfit, 4 to 6, unreliable, and 7 to 9, placed in an appropriate range. An agreement was done when 7 specialists agreed marked the same range. Results: 97 scenarios were selected for the lumbar spine MRI in the extracting phase. 18 other scenarios were added by panel members. Finally, a total of 115 scenarios were identified. After implementing two rounds, the scenarios were categorized into three ranges. Sixty eight (%59.1) of the scenarios were considered as appropriate, 44(%38.2) as uncertain, and 3(%2.6) as inappropriate. Conclusion: A developed scenario in this project for MRI lumbar vertebrae treated with Guide is perfect for specialists. It is recommended that insurance companies and other institutions use this as a benchmark for the payment of MRI lumbar vertebrae fees. RAND appropriateness Method is useful for identifying stakeholder views in settings with limited resources. Key words: Lumbar Spine, Low Back Pain, RAND Appropriateness Method

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Background & aim: Transurethral resection of the prostate (TURP) is) is a routine telescopic surgery for the treatment of benign prostatic hyperplasia, which results in an unpleasant sensation due to the presence of a urinary catheter. Studies have shown that muscarinic receptor antagonists and opioids can reduce the incidence and severity of this unpleasant sensation. Therefore, the aim of the present study was to determine the effect of localized prostate blockade using bupivacaine on the unpleasant sensation caused by a urethral catheter after prostate resection surgery.
 
Methods: The present study was a double-blind randomized clinical trial research. The statistical population included 42 patients scheduled for TURP in the hospitals of Shiraz University of Medical Sciences. Patients were divided into two groups: one bupivacaine treatment group (0.5mg/kg) by trans-perinatal method in periprostatic space on both sides and two (control group). In this study, the degree of discomfort until recovery was evaluated every half hour, the duration of Aldrete score to 9 and the degree of dissatisfaction caused by urethral catheter in patients undergoing prostate resection. The collected data were analyzed using statistical tests of Kolmogorov-Smirnov test, t-test, Mann-Whitney.
 
Results: Both study groups were similar in terms of baseline characteristics. Urinary catheter dissatisfaction was assessed after surgery and a significant difference was seen between the two groups. The mean time of patients in the recovery room in group two groups of control was significantly longer than group one (p≤0.165) and these patients reached the Aldrete score of 9 in a longer period of time. The mean duration of patients in the control groups in the recovery room was 118.81±56.45 minutes and in the treatment group were 97.14±27.90 minutes. No statistically significant difference was observed in morphine use between the two groups and no specific complication was observed in either groups.
 
Conclusion: Consuming bupivacaine for localized blockade of the prostate in patients undergoing prostate resection surgery can reduce the discomfort caused by the presence of a urinary catheter, the length of time in the recovery ward and the level of dissatisfaction in recovery ward patients.
 
Keywords: Transurethral Resection of the Prostate, TURP, Benign Prostatic Hyperplasia, Bupivacaine, Pain, Recovery, Localized Blockade
 

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Background & aim: Non-REM parasomnias are a relatively common condition in the general population. Current treatment plans are usually based on small case series and reports. Considering the effects of sleep disorders on different aspects of human life and the failure of pharmacological therapies, the present study was designed to investigate the effect of biofeedback therapy on cardiovascular and respiratory parameters in a case of Non-REM parasomnias with obstructive sleep apnea.
 
Methods: The present case study was conducted in 2020 on a 60-years-old man with a family history of sleepwalking disorders. The treatment plan in the present study was as follows: execution of the principles of sleep hygiene by the patient, use of continuous positive airway pressure machine (CPAP), and eight weekly biofeedback therapy sessions (including the use of mental exercises for the patient with the use of heart rate sensors, respiration rate per minute, and coordination of respiratory and cardiovascular events). Before the start and after the treatment period, cardiovascular parameters such as blood pressure, arterial blood oxygen saturation, heart rate, and respiratory parameters (apnea, hypopnea, etc.) were measured. Statistical analyses were performed using the delta calculation of changes in indicators and scores obtained from the patient at different stages of the study.
 
Results: Prior to the interventions, the number of obstructive sleep apneas was 34 times, the number of obstructive hypopneas was 106 times, and the incidence of oxygen desaturation events was 389 times, which accounted for 24% of the total sleep time. After the therapeutic interventions, the obstructive sleep apnea completely disappeared, the number of obstructive hypopneas was reported only 12 times, and the rate of oxygen desaturation events was reduced to 102 times.
 
Conclusion: The treatment plan in the present study resulted in complete improvement in some parameters such as obstructive sleep apnea and relative improvement in others such as arterial blood oxygen pressure and heart rate. The present study was able to explore and clarify new aspects, both in terms of identifying the mechanisms of the disorder and in terms of treatment.