---

Background and Aim: Blood-borne infections are important threatening problems for health care staff which needs more attention. Heart surgery and invasive heart procedures are major risks for transmission of viruses like HBV, HCV, and HIV to patients and medical staff. Therefore this study was performed to assess prevalence of such infections in these patients. Materials and Methods: This descriptive survey included all the patients who had been admitted for cardiac surgery or invasive cardiac procedures in Emam Ali Hospital in Kermanshah from 1999 to 2003. Data collected from medical records, were analyzed by means of T and X2 tests. P. value <0.005 regarded significant. Results: Among 6820 cases, 112 patients had positive HBV and HCV tests (1.6 percent) with 89 HBV positive (1.3 percent) and 31 HCV positive (0.45 percent) cases. (8 patents were both HCV and HBV positive) 76 patients were male (74%), and the remainder were female. No HIV positive patient was detected. Positive cases were more common in hospitalized patients, those with history of previous surgery and blood transfusion, addicts and housekeepers. Data analysis by means of X2 test showed significant correlation between presence of HCV and HBV infection with history of transfusion (p. value=0.001) and previous surgery (P. value=0.015) but not with addiction (p. value=0.675). The variables of education level and job were not found to be risk factors. Conclusion: prevalence of hepatitis among cardiac Patients is similar to general population, so performing routine HBV, HCV, HIV tests in high risk groups should be regarded more important.

---

Aim and Background: Pain is the most common and unpleasant symptom of diseases, which causes hemodynamic changes if left untreated. Considering the importance of pain, we decided to determine the effect of ketamine infusion on the post-operative pain and hemodynamic status in addict patients undergoing cardiac surgery.
Materials and Methods: In this clinical trial which was performed in Baqiyatallah Hospital in 2020, 72 patients who were candidates for open heart surgery by using cardiopulmonary pump were randomly assigned to two groups. One group received ketamine and the other one received normal saline. Hemodynamic parameters including heart rate, systolic and diastolic pressures were measured before, during and after surgery. We also assessed postoperative pain by visual analogue scale (VAS). Using two sample t-test and repeated measures analysis of variance, we compared the groups with each other in regard to the hemodynamic parameters.
Results: The results showed a significant difference in the intensity of postoperative pain between the control and ketamine groups, which was lower in the ketamine group (P = 0.001). Systolic and diastolic blood pressures were more stable in the ketamine group but the heart rate was higher at most times in ketamine group (P = 0.001).
Conclusion: Continuous infusion of ketamine during heart surgery until 48 hours after surgery seems to reduce postoperative pain significantly and results in decreased use of narcotic drugs after surgery. It also stabilizes and improves hemodynamics and minimizes changes in hemodynamic status.