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Comparing measurements of mitral valve area by two-dimensional planimetry and continuity equation in patients with mitral stenosis
R Sattarzadeh Badkoobeh,L Derakhshan,A Farhang Zand Parsa,A Pasha Meysamie
Tehran University Medical Journal , 2012,
Abstract: Background: Measurements of mitral valve area (MVA) are essential to determine the severity of mitral stenosis (MS) and adopt the best management strategies. The aim of the present study was to compare MVA determined by two-dimensional (2D) planimetry to MVA measured by continuity equation (CE) in patients with moderate to severe MS. Methods: We evaluated 73 consecutive patients with the diagnosis of MS scheduled for balloon mitral valvuloplasty or with moderate to severe rheumatic MS admitted at the echocardiography clinic of Imam Khomeini Hospital in 2010. Using 2D images of mitral valve obtained from paraesternal short axis view, 2D planimetry of the mitral orifice area was performed by an experienced cardiologist. MVA by CE was calculated from aortic forward stroke volume divided by transmitral time-velocity integral.Results: The mean value of MVA by 2-D planimetry was 1.0±0.3 cm2. The average values of MVA measured by PHT and CE were 1.0±0.3 cm2 and 0.9±0.4 cm2, respectively. The MVA determined by planimetry correlated well with CE (r=0.832, standard error of estimation [SEE]= 0.166, P<0.001). The mean values of MVA calculated by CE highly correlated with those calculated by 2-D planimetry in patients presenting with both non-significant (r=0.701) and significant (r=0.761) AIs. Conclusion: When planimetry is not feasible, such as in severe calcification of mitral valve or after percutaneous balloon valvuloplasty, CE could be an alternative method for MVA measurement in comparison with PHT.
Right Bundle Branch Block Is not a Predictor of Coronary Artery Disease
Amir Farhang Zand Parsa,Ladan Haghighi
Acta Medica Iranica , 2012,
Abstract: Right bundle branch block (RBBB) is considered as an important predictor of poor outcome in patients with acute myocardial infarction, but the prognostic implication of RBBB in patients with suspected coronary artery disease (CAD) is unclear. Furthermore, the association between RBBB and incidence of CAD also its influence on the severity of stenosis in coronary arteries has not been established. This study was designed to assess the relationship between RBBB and the presence and the severity of CAD in patients with suspected CAD. The study population consisted of 172 patients with RBBB and 174 patients with normal resting electrocardiography (ECG). Severity of CAD was defined as estimated Gensini score according to the degree, quantity and distribution of lesions in angiographic study. According to our study based on angiographic investigations, in patients with RBBB the prevalence of CAD was 77.3 percent versus 70.1 percent in patients with normal resting ECG (P=0.13). Also, there was no significant association between the presence of RBBB and magnitude of Gensini score (OR=0.87, P=0.62). However, male gender and history of diabetes mellitus were associated with higher Gensini score (OR=3.41; 95% CI: 1.96-5.93, P<0.0001 and OR=3.22; 95% CI: 1.77-5.87, P<0.0001 respectively). This study suggests that although RBBB was associated with more severity of stenosis in left coronary system (LAD&LCX), but as a whole there was no association between RBBB and the presence and severity of CAD.
Low molecular weight heparin versus Unfractionated heparin in patients with non ST-elevation acute coronary syndrome: a randomaized clinical trial
Zand parsa A,Jafari H,Tabatabai A
Tehran University Medical Journal , 2007,
Abstract: Background: Despite the overwhelming progress that has been accomplished in the prevention of mortality due to cardiovascular disease, coronary artery disease (CAD) is the leading cause of death in the world.The aim of this study was to compare of the effects of enoxaparin versus unfractionated heparin (UFH) on major clinical events, including mortality, myocardial infarction (MI), and recurrent angina, as well as bleeding in patients with non ST elevation acute coronary syndrome (NSTEACS). We also studied the need for coronary angiography and revascularization (PCI or CABG) in these patients. Method: Two-hundred patients were enrolled in this study, 100 of whom received intravenous UFH (an initial bolus of 5000 U followed by continuous infusion of 1000 U/h) and 100 received enoxaparin subcutaneous injections of 1mg/kg twice daily for a minimum of 72 h. During their admission we recorded data regarding death, MI, recurrent angina, need for angiography and revascularization, and major and minor bleeding.Results: The incidence of recurrent angina, total mortality and the need for revascularization were significantly lower in patients receiving enoxaparin compared to those receiving UFH, at 17% vs. 39% (p=0.002), 0% vs. 3% (p=0.035), 14% vs. 33% (p=0.001), respectively. However, there was no significant difference regarding the incidence of MI, major bleeding and cardiac death between the two groups. Conclusions: This study showed that, in patients with NSTEACS, enoxaparin was superior to UFH regarding the prevention of major in-hospital clinical events, especially recurrent angina and the need for revascularization. We therefore recommend enoxaparin as an alternative antithrombotic agent to UFH in patients with NSTEACS.
Evaluation of MSM Model and Its Application for Prediction of Water Requirements, Planting Dates and Forage Production of Maize
A. Majnooni-Heris,Sh. Zand-Parsa,A. R. Sepaskhah,A. A. Kamgar-Haghighi
Journal of Science and Technology of Agriculture and Natural Resources , 2006,
Abstract: Agricultural investigations use computer models for simulation of crop growth and field water management. By using these models, the effects of plant growth parameters on crop yields are simulated, hence, the experimental costs are reduced. In this paper, the model of MSM (Maize Simulation Model) was calibrated and validated for the prediction of maize forage production at Agricultural College, Shiraz University in 1382 and 1383 by using maize forage yield under furrow irrigation with four irrigation and three nitrogen treatments. Irrigation treatments were I4, I3, I2, and I1, with the depth of water 20% greater than, equal to, 20% and 40% less than potential crop water requirements, respectively. Nitrogen treatments were N3, N2, and N1, with the application of N as urea equal to 300, 150, and 0 kg N ha-1, respectively. After calibration and validation of MSM, it was used to estimate suitable planting dates, forage yield and net requirement of water discharge for planting at different dates. The results indicated that the net requirement of water discharge was reduced by gradual planting at different planting dates. By considering different planting dates for maize, from Ordibehest 20th to Tir 10th, the planting area might be increased 17.9%, compared with single planting date on Ordibehesht 30th under a given farm water discharge and full irrigation.
Comparison of MSM Model for Prediction of Potential Evapotranspiration of Maize with FAO Methods
A. Majnooni-Heris,Sh. Zand - Parsa,A. R. Sepaskhah,A. A. Kamgar-Haghighi
Journal of Science and Technology of Agriculture and Natural Resources , 2007,
Abstract: Optimal crop water requirement is needed for precise irrigation scheduling. Prediction of crop water requirements is a basic factor to achieve this goal. In this study, maize potential evapotranspiration (ETp) was prediced by maize simulation model (MSM). Then, it was evaluated and validated using experimental field data obtained in Agricultural Research Station of Shiraz University (Bajghah, Fars province) during 2003 and 2004. Comparison of measured volumetric soil water content with predicted values by MSM model in 2003 and 2004 indicated that this subroutine (prediction of maize evapotranspiration) did not need modification. Also, daily potential evapotranspiration of maize was estimated by using Penman-Monteith equation considering single and dual crop coefficients. Comparison between the results of predicted ETp by MSM model, calculated ETp by Penman-Monteith, and measured irrigation water and soil water content indicated that the prediction of ETp by MSM model was satisfactory. Model prediction of seasonal ETp, potential transpiration (Tp) and soil evaporation (E) were 831, 536 and 329 mm, respectively, in 2003, and 832, 518 and 314 mm, respectively, in 2004. The values of ETp, Tp and E calculated by Penman-Monteith method using dual crop coefficients were 693, 489 and 205 mm, respectively, in 2003, and 700, 487 and 213, respectively in 2004. Maximum rate of predicted potential ETp, Tp and E were 11.1, 8.2 and 5.1 mm d-1, respectively in 2003 and 13.0, 9.0 and 4.0 mm d-1, respectively in 2004. The values of calculated seasonal ETp by Penman-Monteith method using single crop coefficient were 615 and 632 mm in 2003, and 2004, respectively. Comparison between the results of predicted ETp by MSM model, calculated ETp by Penman-Monteith equation with single and dual crop coefficients (FAO-56) and measured values of irrigation water and soil water contents of root depth indicated that FAO-56 methods underestimated the ETp.
Development and Evaluation of Global Solar Radiation Models Based on Sunshine Hours and Meteorological Data
A Majnoni-Heris,SH Zand-Parsa,A Sepaskhah,M.J Nazemosadat
Journal of Science and Technology of Agriculture and Natural Resources , 2009,
Abstract: Global solar radiation (Rs) has wide applications in several disciplines. The data of measured or predicted Rs are widely applied by solar engineers, architects, agriculturists and hydrologists. Due to the importance of Rs, several empirical models have been developed to predict its values all over the world. In this study, Angstrom model was calibrated based on the ratio of actual and possible sunshine hours n/N by using measured daily data of Rs at Bajghah meteorological station in Fars province during 2003-2004. The model was modified by using air temperature for considering the effect of cloudy conditions as well as n/N ratios. The results showed that using both the air temperatures and the ratios of n/N led to a higher accuracy. In regard to estimation of the Rs values, the results showed that mean air temperatures have a higher accuracy compared with differences between maximum and minimum air temperatures. Also, a new local model with higher accuracy was developed based on a number of daily meteorological parameters such as deficit vapor pressure, relative humidity, precipitation, mean air temperature, maximum and minimum air temperatures difference and n/N. This new local model that used different meteorological parameters had the highest accuracy in comparison with the other models. Also, a number of models developed by other investigators for estimation of Rs were calibrated for the study area. Finally, different selected models were validated by using the measured data of Rs in 2005. The results showed that the developed local multi-variable model provided higher accuracy results in comparison with the other radiation models.
Effect of carbon dioxide concentration and irrigation level on evapotranspiration and yield of red bean
Sh. Shams,S.M.J Nazemosadat,A.A Kamgar Haghighi,Sh. Zand Parsa
Journal of Science and Technology of Greenhouse Culture , 2012,
Abstract: Increasing atmospheric CO2 concentration affects plant activities directly. In order to investigate the effect of CO2 concentration, an experiment was conducted at Research Greenhouse of College of Agriculture, Shiraz University, Shiraz, Iran. In this research, the effects of increasing CO2 concentration from 350 to 750 mg/L were studied on growth and yield of red bean (Phaseolus vulgaris, cv. Naz) at four irrigation levels (1.2 FC, FC, 0.8 FC and 0.6 FC). In order to control CO2 concentration, at the onset of the 4-leaf stage, pots were moved to wooden chambers covered with plastic. The results showed an average 15% decrease in evapotranspiration due to increasing the CO2 concentration. Also the results indicated an increasing effect of CO2 concentration on growth and yield of bean plants. Reducing the irrigation level to 0.6 FC caused the elevated CO2 concentration not to have any significant effect (P<0.05) on growth and yield of the red bean. By increasing the CO2 concentration, number of seeds/plant at FC and 0.8 FC irrigation treatments increased by 13 and 11%, respectively. Moreover, increasing CO2 concentration caused 20% increase in total seed yield. Total dry matter increased about 15% at higher CO2 level. The conclusion of this research was that increasing CO2 concentration has significant effect on yield and reduction of evapotranspiration of red bean.
Determination of Optimum Irrigation Depth of Corn in Sprinkler Irrigation
S.H. Zand-Parsa,GH.R. Soltani,A.R. Sepaskhah
Journal of Science and Technology of Agriculture and Natural Resources , 2001,
Abstract: In this study, the optimum irrigation depths for corn grain production under different conditions, i.e. maximum grain yield production and maximum benefit under limited land and water conditions, were determined under sprinkler irrigation in Bajgah (15 km. north of Shiraz). The results showed that, the optimum depth of irrigation for maximum grain yield production was 77.0 cm. Because of low price of irrigation water and sensitivity of corn crop to water deficit, the optimum depths of water were 76.8 and 73.4 cm under land and water limitations, respectively. Therefore, under limited water conditions, only 4.7 percent of the full irrigation water (maximum corn grain production) can be saved for maximum profits.
"Initial success and in hospital results of coronary angioplasty of more than one lesion per procedure in patients with multivessel coronary artery disease "
"Zand Parsa AF "
Tehran University Medical Journal , 2001,
Abstract: In the past, coronary artery bypass grafting was the treatment of choice for patients with symptomatic multi vessel coronary artery disease, but in recent years per cutaneous transluminal coronary angioplasty (PTCA) accepted as an alternative approach to revascularization. To assess the initial success and in hospital results of coronary angioplasty of more than one lesion per procedure in patients with multi vessel coronary artery disease, a retrospective analysis of patients who underwent selective coronary angioplasty at Imam Khomeini medical center from 1994-1997 were peformed. From 1994 to 1997 per cutaneous transluminal coronary angioplasty (PTCA) were done in 257 patients, that 201 (78.2 percent) were male and their age range 23-73 years. The numbers of patients with multi vessel coronary artery disease were 98 (38.13 percent), that complete revascularization (PTCA of more than one lesion per procedure) underwent in 34 (13.58 percent) of them (27 men, 7 women, age: mean±SD 48±9.8 range 30-70). A total of 71 lesions were tried, that 22 (31 percent) were type A, 45 (63.4 percent) were type B, and 4 (5.6 percent) were type C. Among patients 21 (61.8 percent) had unstable angina and 13 (38.2 percent) had stable angina. Procedures were successful in 68 (95.8 percent) of lesions and 31 (91.2 percent) patients were discharged fro procedural complications included 3 (8.8 percent) non-Q wave myocardial infarction and no mortality. Without any complication, (success defined as residual stenosis <50 percent). As a conclusion, in selected patients with multi vessel coronary artery disease PTCA of more than one lesion per-procedure is effective and safe.
The relationship between cardiovascular risk factors and the site and extent of coronary artery stenosis during angiography
Zand Parsa AF,Ziai H,Fallahi B
Tehran University Medical Journal , 2010,
Abstract: "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Coronary Artery Disease (CAD) is one of the leading causes of mortality and morbidity all over the world. One of the most important predictors of the outcome of the coronary stenosis is the site of the lesions i.e. Proximal versus nonproximal lesions. This study designed to evaluate the relationship between CAD risk factors and site of stenosis."n"nMethods: In this case- control study in the patients undergone coronary angiography (CAG) in Imam Khomeini Hospital, Tehran, Iran a total of 125 CAD patients with proximal lesion in CAG enrolled the study as case group and equal sex and age matched number of patients with non proximal lesion selected as control group. Two groups were compared based on presence or absence of DM, hypertension, hyper cholestrolemia, hypertriglyceridemia and cigarette smoking."n"nResults: Relative frequency of DM was 33.6% and 10.4% in case and control group respectively (p< 0.0001). Relative frequency in two groups were 33.6 vs 28.8% For HTN (p= 0.41), 30.4% vs 29.6% for hyper cholestrolemia (p= 0.89), 19.2% vs 16.8% for hypertriglyceridemia (p= 0.062) and 28.8 vs 39.2 for C/S (p= 0.08). Multivessle disease was significantly more prevalent in diabetics compared with non diabetic patients 89.1% vs 61% (p< 0.0001), no relationship was seen with HTN (p= 0.41), Hyper cholest-rolemia (p= 0.052) hypertriglyceridemia (p= 0.38) and cigarette smoking (p= 0.375)."n"nConclusion: Proximal involvement of coronary arteries and multivessle disease in CAD patients is related to history of DM but not to history of hypertension, hypercholestrolemia, hypertriglyceridemia and cigarette smoking.
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