Assessment of normal hemodynamic profile of mechanical pulmonary prosthesis by doppler echocardiography: a prospective cross-sectional study.

OBJECTIVES: Very few reports have described the Doppler-derived echocardiographic parameters for mechanical pulmonary valve prosthesis (MPVP). This study aims to describe the normal Doppler hemodynamic profile of MPVP using Doppler echocardiography. METHODS: The current prospective, single center observational study enrolled 108 patients who underwent pulmonary valve replacement (PVR) surgery for the first time and had a normally functioning prosthesis post-operation. The hemodynamic performance of MPVPs, considering flow dependent and flow independent parameters, was evaluated at two follow-up points, at week one and week four post-operation. All assessments were conducted by an experienced echocardiographer. RESULTS: The mean age (±SD) of the participants was 26.4 (±8.98). Tetralogy of Fallot (ToF) was the most common underlying disease leading to PVR, with a prevalence of 88%. At first week post-operation, measurement of indices reported the following values (±SD): peak pressure gradient (PPG): 18.51(±7.64) mm Hg; mean pressure gradient (MPG): 10.88(±5.62) mm Hg; peak velocity (PV): 1.97(±0.43)m/s; doppler velocity index (DVI): 0.61(±18); pulmonary velocity acceleration time (PVAT): 87.35(±15.16) ms; effective orifice area (EOA): 2.98(±1.02) cm2;and effective orifice area to body surface area ratio (EOA/ BSA): 1.81(±0.62) cm2/m2. Comparing these measurements with those obtained from the second follow-up (at week four post-op) failed to hold significant difference in all values except for PVAT, which had increased from its primary value (p = 0.038). Also, right ventricular (RV) function showed significant improvement throughout the follow up period. CONCLUSION: The findings of this study help strengthen the previously scarce data pool and better establish the normal values for Doppler hemodynamics in mechanical pulmonary prosthesis.

A report of outbreaks of measles on the southern coast of Iran from 2009 to 2015.

INTRODUCTION: Immunogenicity assessment figures of the measles vaccine is approximately 90%, and decreases over time. Therefore, the immunity level of measles vaccine is variable which can result in outbreaks of measles in a population. The aim of current study was to report the outbreaks of measles in Hormozgan province from 2009 to 2015. METHODS: This cross-sectional study was carried out in Hormozgan Province on the southern coast of Iran. The documented data of all cases suspected of measles are included in this study. We used a checklist including gender, age, area, place of residence, contact history, and vaccination status to extract required data. Data was analyzed using IBM SPSS statistics software version 21.0. RESULTS: Eight hundred fifty-one suspicious cases of measles were determined from 2006 to 2015. Of those, 135 infected cases were reported. Among patients, 49% were male, 79% were Iranian, 18% were Afghans, and 3 % were Indians or Pakistanis. Also, 31% of cases were reported from Bandar Abbas, 25% were reported from Minab, 18% from Qeshm, 17 % from Jask and other cases were reported from other areas of the Hormozgan Province. Thirty percent of the cases were reported from urban areas. CONCLUSION: A high percentage of cases with measles in rural areas were reported in the areas which were covered by complete vaccination. This shows interruption of cold continuum. Also, increasing the number of under one-years-old cases reported, could be due to poor nutritional status of the children and insufficient immunization of mothers. Further studies are required for identifying the causes of cold continuum interruption. Further studies are required for the assessment of immunization in children and mothers and various vaccination protocols.

Prevalence of night blindness in Bashagard district in Hormozgan, Iran, in 2011.

BACKGROUND: Night blindness is a visual disorder associated with unusual vision during the night or in darkness. Vitamin A deficiency (VAD), which is easily preventable, is the main known etiology of night blindness. Malnutrition is a common health issue in Bashagard and some other areas in the Hormozgan province of Iran. The aim of the current study was to determine the prevalence of night blindness in Bashagard. METHODS: This descriptive cross-sectional study was done on 814 Bashagard residences. Data was analyzed using SPSS software and descriptive studies. RESULTS: About 60% of the study participants were uneducated people or people with low education. Thirty-two out of 814 people that were studied had problems with night vision. Therefore, the prevalence of night blindness in Bashagard was 3.93%. CONCLUSION: Prevalence of night blindness in Bashagard is three times higher than its prevalence in all of Iran. Therefore, preventive interventions such as dietary regimes with vitamin A enrichments or supplementations are recommended.

Malaria situation in an endemic area, southeastern iran.

BACKGROUND: Malaria is an endemic infectious disease in southeastern parts of Iran. Despite years of efforts and intervention programs against malaria, transmission still occurs in Jask County. METHODS: The epidemiological perspective of malaria in Jask County was conducted by gathering data from Jask County health center, during 2006-2010. A knowledge, attitude and practice study was also carried out. Data analysis was conducted using SPSS ver. 11.5. RESULTS: A total of 2875 malaria cases were recorded, with highest and lowest numbers in 2007 and 2010, respectively. The number of cases had a decreasing trend from 1022 cases in 2006 to 114 cases in 2010. The main causative parasitic agent was Plasmodium vivax. Blood examination rate and slide positive rate were also decreased from 39.5% and 4.3% in 2006 to 15.6% and 1.4% in 2010, respectively. Most of people interviewed in the KAP study had a good knowledge about malaria transmission and symptoms but their use of the bed net for prevention was low (35%). CONCLUSION: Malaria incidence had significant reduction during the study years. The main reason for this may be due to changing environmental condition for Anopheline breeding and survival because of drought. Another reason may be integration of vector management by using long lasting insecticide treated bed nets, active case detection and treatment by implementation of mobile teams and increasing in financial sources of malaria control program. Knowledge, attitude and practice of people were good in malaria control and prevention, but needs to do more activities for health education and awareness.

Demonstration of malaria situation analysis, stratification and planning in Minab District, southern Iran

OBJECTIVE@#To demonstrate malaria situation analysis, stratification and planning for an endemic area in southern Iran.@*METHODS@#Data on health system, population, meteorological parameters, malaria cases, anopheline vectors, and control activities during 2005-2007 was obtained from Minab Health Center, Minab Meteorological Station and published documents about malaria elements in the study area. A datasheet was created in excel 2003 for analysis.@*RESULTS@#There were 644 health staff working in Minab District including 99 health staff in malaria control program. The health facilities are distributed as follow: 1 hospital with 96 beds, 23 health centers including private centers (10 in Minab city and 13 in rural area of Minab District) and 119 health houses in rural areas of Minab District. A nopheles stephensi was the dominant species in Minab District, however, Anopheles dthali, Anopheles superpictus, Anopheles fluviatilis, Anopheles multicolor, Anopheles pulcherrimus and Anopheles turkhudi can also be found in the area. Anopheles stephensi was reported susceptible to malathion, propoxur, primphos-methyl, lambda-cyhalothrin permethrin and deltamethrin, and resistant to DDT and dieldrin in the area. During the study period a total of 10 665 positive cases were reported, mainly due to local transmission (99.6%). Plasmodium vivax was the main causative agent followed by Plasmodium falciparum. There were reports about drug resistance of Plasmodium falciparum in the area.@*CONCLUSIONS@#Using different parameters, Minab was classified into 3 strata. A plan was designed based on described goal, objectives and targets. The approaches of this plan were categorized into: health education, early detection and correct treatment, and vector control. Main constraints of these approaches are population movement between Iran, Pakistan and Afghanistan; vector control challenges at district, inadequate skilled medical staff in malaria case management and weak inter-sectorial coordination for malaria control, especially in urban areas.