Introduction: The right use of Blood is necessary because of the high cost of correct Blood screening, Blood grouping, and cross match. The purpose of this study is to evaluate the rate of the reserved and cross matched Blood before elective surgeries which were done in Bahman 22nd Hospital. It also aims at evaluating the standard guideline for ordering Blood.Materials and Methods: This is a retrospective study from 1380 to 1388 that evaluates evaluating 6145 files of the patients hospitalized in 22 Bahman 22nd Hospital for surgery during the years of 1380 to 1388. The elective operations include General surgery, Gynecology, orthopedic, ENT, Urology and Neurosurgery. The number of patients, the number of reserved and cross matched units and the number of transfused units was recorded for each group of patients collected in each groups. Finally, the number of reserved Blood units in that period of time and in each group was compared with the standard guideline. Also the number of transfused Blood units was evaluated. The ratio of cross matched to transfused Blood units lower than 2.5 was considered as standard. And The obtained data were analyzed, using with SPSS.Results: A total of 1557 Blood units of Blood were reserved for 772 patients.1305 units (66.47%) were cross matched, but just 126 units (8.1%) were transfused. The effective factors in increasing the possibility of transfusion were the ages<20 & >80 years old, Hb £ 12, the type of surgery and the surgeon. Although after the application of the guidelines in1385, there was 64.44% decrease in the rate of cross matching rate due to the decrease in the number of patients who were cross matched, but the average of cross matched units for each patient did not change. The total of C/T index of the hospital decreased from 14.1 to 3.7.Conclusion: The appropriate correct Blood reserving can decrease the unnecessary Blood reserves, lower the pressure on Blood banking centers and prevent Blood wastage.

Pediatric hypertension (HTN) is a growing concern and should be diagnosed and treated aggressively to reduce the global disease burden. Ambulatory Blood pressure monitoring (ABPM) is a useful clinical tool providing a more accurate description of the patient's Blood pressure (BP) than office BP measurements, and can be considered the "gold standard" in the evaluation of the pediatric patient with a concern for HTN. Routine use of ABPM is recommended among clinicians to better evaluate and assess the severity of a child's HTN, and for proper management in order to prevent target organ damage and the resulting sequelae, thereby reducing the burden of cardiovascular risk in hypertensive children and adolescents. Significant data exist that link elevated BP levels measured in childhood and future target-organ damage. Untreated hypertensive children had lower cerebral artery reactivity than normotensive control subjects, which may explain the lower scores on cognitive tests found in children with elevated BP. Indications for routine performance of ABPM: To confirm the diagnosis of hypertension (R/O WCH), To evaluate for the presence of masked HTN, To assess BP patterns in high-risk patients, To evaluate effectiveness of drug therapy for HTN. Expert opinion in pediatric ABPM recommends that at least 1 or 2 valid readings should be obtained per hour over the entire 24 hours. Interpretation of ABPM studies is usually based on a combination of criteria, including mean SBP or DBP and BP loads. BP load is then calculated as the proportion of readings above a threshold (usually the pediatric 95th percentile).

INTRODUCTION: The study was conducted to define the determinants of suboptimal Blood pressure (BP) control among hypertensive patients under treatment and explore a predictive model for detecting the patients at risk for increased BP.METHODS: We enrolled 97 patients (40 males, 57 females) under treatment for hypertension between June 2006 and May 2007 in Shafa hospital, Kerman, Iran. BP was measured at clinic twice within 5-minute intervals. After setting up ambulatory Blood pressure monitoring (ABPM), BP was measured at 30-minute intervals during the day and 60-minute intervals during the night. The frequency of increased BP (more than 140/90 mmHg) was included in a regression model as dependent variable and all the others such as age, sex, body mass index (BMI), drugs and baseline clinical measurements as the predictors.RESULTS: Increased BP was detected in 44% (95% CI: 38.79%-49.65%) of all measurements during 24-hour monitoring. The frequency of increased BP had a significant relationship with BMI (β=0.35, P=0.001). Clinic's pulse pressure was a significant predicting factor for BP increase (P=0.02).CONCLUSION: BMI and pulse pressure are the best predictors for being hypertensive during lifetime. Ineffective treatment of hypertension is frequent among the hypertensive patients.

Background: Proper Blood pressure (BP) measurement frequency method is less evaluated to optimize hypertension (HTN) status among different nations due to cultural patience variations. The aim of this study was to compare the first (BP1), second (BP2), and the mean of first and second (BP1, 2) and all the three (BP1, 2, 3) with the second and third BP measurements in Iranian individuals. Materials and Methods: This cross‑ sectional study was done on 2264 individuals aged 18 years or more living in Isfahan city, Iran. Their BPs were assessed from right arms by the standard tools and methods after 5 min of rest in a quiet room by a trained staff. The mean second and third readings were considered as reference, and the other aforementioned variables were compared with it. Results: The mean age of total population was 40. 9 ± 16. 1 years (males: 52%). Men had significant higher means of systolic BP (SBP) and diastolic BP (DBP) with any measurement frequency methods than women (P < 0. 001 and P = 0. 009). Considerable clinical significant (≥ 5 mmHg) ranges were mostly observed in BP1 compared with BP2, 3. SBP2 and DBP2 indices showed insignificant differences compared with reference mean. Moreover, abnormal BP levels (≥ 140/90 mmHg) were mostly observed in terms of BP1 measurement with no remarkable variability in BP2 reading in comparison to the reference. Conclusion: Our considerable data suggested that BP2 could appropriately categorize BP status similar to BP2, 3 and it may be rational for physicians considering this mean and excluding the first BP measurement as a sole criterion for HTN assessment in Iranian adults. Multiple researches are necessary quantifying appropriate frequencies of BP reading.