Triglyceride to high-density lipoprotein cholesterol and low-density lipoprotein cholestrol to high-density lipoprotein cholesterol ratios are predictors of cardiovascular risk in Iranian adults: Evidence from a population-based cross-sectional study

Background: The superiority of TG/HDL-C and LDL-C/HDL-C ratios in predicting  CVD risk is a matter of debates. Thus, the objective of this study was to compare TG/HDL-C and LDL-C to HDL-C ratios in predicting the risk of CVD events. Methods: In a population-based cross-sectional study, 567 representative participants aged 40 years or older were entered in the study in Babol, North of Iran. The demographic data, anthropometric measures, and the cardio metabolic risk factors were measured. The individual risk of CVD events was assessed by ACC/AHA risk model. ROC analysis was applied to estimate the diagnostic accuracy and the optimal cut-off points of TG/HDL-C and LDL-C/HDL-C ratios. Results: The AUC of TG/HDL-C and LDL-C/HDL-C ratios were rather similar and both parameters significantly predicted CVD risk in men comparably, and TG/HDL-C at optimal cutoff point of 3.6 produced 75 sensitivity and 39 specificity. However,in women TG/HDL-C with AUC of 0.65( p= 0.091) at optimal cutoff value of 3.4  produced a sensitivity of 82 and specificity of 51. The LDL-C/HDL-C ratio had no discriminative ability in predicting CVD risk in women. The adjusted OR of TG/HDL-C at 2nd quartile was significant (OR=3.22, 95CI:1.25-8.29) and a greater association was found with 3rd and 4rth quartiles Conclusion: Both TG/HDL–C and LDL-C/HDL-C ratios comparably predict CVD risk in men, whereas in women only TG/ HDL-C is a significant predictor but not LDL-C/HDL-C. &#160

Female sexual outcomes in primiparous women after vaginal delivery and cesarean section

Background: Sexual function is an essential component of life and yet very little is known about the relationships between the female sexuality and the mode of delivery.Objective: To compare sexual outcomes after vaginal delivery and cesarean section.Methods: A cross-sectional study was conducted on women in two stages; early pregnancy and 3 to 6 months after delivery in health centers. Female sexual outcomes evaluated were female Sexual Function Index scores and the time required to resume sexual activities after delivery.Results: Sexual function did not differ significantly among two groups vaginal delivery n=90 and cesarean section n = 113 with regard to duration of marriage, educational level, contraception methods, and occupational status p = 0.8.The mean timing of the resumption of sexual activity was 8.9 ± 1.3, and there was no substantial conflict between the two groups. Mean frequency of intercourse in the post-partum period was 1.8±1.2 times per week with significant difference compared to pre pregnancy P<0.05. The individual domain scores after the delivery was significantly lower in comparison with pre-pregnancy p<0.004.Conclusion: No differences in sexual outcomes between vaginal delivery and cesarean section. Consequently cesarean section cannot be recommended in the view of maintenance of normal sexuality after child birth.Keywords: Women’s health, cesarean section, post-partum, vaginal delivery, female sexual functio

Influence of knee osteoarthritis on physical function, quality of life and pain in elderly people

OBJECTIVE: Osteoarthritis is the most common age-related joint disease, affecting more than 80% of the elderly, and it is one of the main reasons for outpatient visits elderly in the hospital. Data about physical function and its correlation to quality of life (QOL) and some clinical variables in knee osteoarthritis (KOA) in Iranian elderly is limited.METHOD: A cross-sectional study composed of 332 patients with KOA was conducted. KOA were diagnosed based on the clinical criteria of the American College of Rheumatology. Demographic and clinical variables were recorded. QOL, disability, and pain were assessed using the SF-36, the Western Ontario and McMaster (WOMAC) index, and VAS scale. For statistical analysis we used X2, Independent t-test and Pearson’s correlation.RESULTS: The mean age of the patients was 68.35±5.51 years, of which 213 (64.2%) were women. QOL domains were significantly associated with disability in all three domains of pain, stiffness and function (p<0.001). A significant negative correlation was also found between the QOL domains and the VAS pain (p<0.001). QOL was lower and the disability and pain intensity was higher in women than in men. A weak correlation was shown between some QOL domains and BMI. Age, comorbidity, polypharmacy and sedentary leisure time were associated with lower QOL scores.CONCLUSION: Individual differences in predictors of QOL and function suggest KOA management strategies should be individualized based on patient characteristics.peer-reviewe

The effect of chronic obstructive pulmonary disease’s severity on complications after coronary artery bypass graft surgery

Background and aims: Smoking is an important etiologic factor for cardiac and pulmonary diseases. Chronic Obstructive Pulmonary Disease (COPD) is common in candidates for Coronary Artery Bypass Graft (CABG) surgery. Severity of COPD is determined with spirometry. The aim of this study was comparison of complications after CABG in COPD patients with different severity and without COPD. Methods: This study is a cross sectional research. We divided 125 CABG patients more than 40 years old based on preoperative spirometry to four groups: without COPD (60), mild (29), moderate (24) and severe (12). Spirometry was done using spirometer MIR, made in Italia. Mortality and postoperative complications including cardiovascular and respiratory were recorded until 30 days after the surgery. Data were analyzed by SPSS, fisher exact test and 2χ, and P˂0.05) was considered significant. Results: Complications with significant difference between groups were atrial fibrillation (AF) and delirium. Frequency of AF was: Without COPD 6 (10%), mild COPD 6 (20.70 %), moderate COPD 7 (29.20%), and severe COPD 5 (41.70%) (P=0.02), and delirium was: Without COPD 3 (5%), mild COPD 1 (3.40%), moderate COPD 3 (12.5%), and severe COPD 5 (41.70%) (P=0.003). Conclusion: Based on our results, COPD even moderate and severe is not contraindication of CABG. These patients should be carefully evaluated before surgery and must be treated preoperative completely by the specialist. Under this condition, patients can tolerate and benefit from surgery with acceptable risk

Metabolic syndrome and different obesity phenotypes in the elderly women population: Iran’s Health System on aging

Background: Current literature has been focused on types of obesity with normal BMI (body mass index), but metabolically unhealthy.This study evaluates the prevalence of metabolical phenotypes of obesity. We also identified the best obesity index in predicting the components of metabolic syndrome (MetS). Methods: A cross-sectional study has been conducted on 164 women over 60 years. Anthropometric parameters, body fat percentage (%BF), and biologic criteria were measured to assess the types of obesity. Unhealthy metabolic was defined by modified Adult Treatment Panel III, and obesity based on BMI≥25.ANOVA and logistic regression were utilized for the association of MetS components and obesity phenotypes, and linear regression logistic for finding the best MetS related obesity index. Results: The prevalence of metabolically unhealthy was 45.7%, out of which 33.3% was among the individuals with normal BMI.Logistic regression has shown that triglyceride (TG) (OR=3.30, p<0.001) and high density lipoprotein (HDL-C) (OR=2.15,p<0.01) was independently related to metabolically healthy and normal weight(MHNW) phenotype. Moreover, TG (OR=3.92,p<0.001), HDL-C (OR=2.18,p<0.001), fasting blood glucose(FBG) (OR=1.73,p<0.01) and waist circumference(WC) (OR=3.18,p<0.001) are correlated significantly with metabolically unhealthy and overweight/obese (MUO) and also TG (OR=2.88,p<0.001) and WC (OR=2.67,p<0.001) with metabolically unhealthy and overweight/obese(MHO).WC followed by %body fat (BF) showed to be highly correlated with the prognosis of MetS components. Conclusions: There is a high prevalence of unhealthy metabolic among the elderly women,even with normal weight.There were different associations between MetS components and various obesity phenotypes.TG was the most powerful indicator for the prognosis of unhealthy metabolic phenotypes which was independently correlated with the WC, %BF and BMI

Female sexual outcomes in primiparous women after vaginal delivery and cesarean section

Background: Sexual function is an essential component of life and yet very little is known about the relationships between the female sexuality and the mode of delivery. Objective: To compare sexual outcomes after vaginal delivery and cesarean section. Methods: A cross-sectional study was conducted on women in two stages; early pregnancy and 3 to 6 months after delivery in health centers. Female sexual outcomes evaluated were female Sexual Function Index scores and the time required to resume sexual activities after delivery. Results: Sexual function did not differ significantly among two groups vaginal delivery n=90 and cesarean section n = 113 with regard to duration of marriage, educational level, contraception methods, and occupational status p = 0.8.The mean timing of the resumption of sexual activity was 8.9 \ub1 1.3, and there was no substantial conflict between the two groups. Mean frequency of intercourse in the post-partum period was 1.8\ub11.2 times per week with significant difference compared to pre pregnancy P&lt;0.05. The individual domain scores after the delivery was significantly lower in comparison with pre-pregnancy p&lt;0.004. Conclusion: No differences in sexual outcomes between vaginal delivery and cesarean section. Consequently cesarean section cannot be recommended in the view of maintenance of normal sexuality after child birth

Restorative dentistry considerations in the geriatric dentistry : systematic review

BACKGROUND AND AIM: As the number of elderly people visiting dental clinics increases, it is essential to have sufficient information on the correct treatment as well as the appropriate treatment plan for these patients. Therefore, the present study aimed at reviewing the most important restorative considerations for the elderly.METHOD: In this systematic review study, databases such as Pubmed, Embase, Web of Science, Scopus, ProQuest, Google scholar, as well as Iranian databases were searched with the keywords of elderly dentistry and restorative considerations. Inclusion criteria were original articles and reviews related to restorative dentistry considerations for the elderly without a time limit and being written in either English or Persian. In order to combine the results of the research, a thematic content analysis method was applied.RESULTS: The total number of documents recovered was 4208, the number of duplicate documents was 2042, and the number of documents reviewed was 17. The most important considerations related to the elderly included giving due attention to medical and social conditions, medication use, type of restorative teeth, level of restoration involved, use of dentures, age and gender, oral cancer screening, tooth decay education and prevention, and oral hygiene. The most important considerations related to restorative methods and materials were applying minimally invasive methods such as ART, more durable restorative materials, and giving due attention to the aesthetic and non-aesthetic needs of the elderly in choosing restorative materials. The most important considerations related to dentists were the differences in applying restorative methods and materials by experienced dentists in comparison younger dentists and the rate of referral of elderly people to dental centers.CONCLUSION: The most important dental considerations of the elderly are using minimally invasive methods and restorative materials with easy maintenance which are washable according to their social, economic, medical, gender, and age conditions. It is also necessary to consider the prevention of tooth decay and provide the required training for families and their caregivers in nursing homes. The elderly people are also required to avoid change their dentists frequently to maintain their oral health.peer-reviewe

The Relationship between Depression and Metabolic Syndrome in the Elderly Population: The Cohort Aging Study

Objective: Metabolic syndrome (MetS) and depression are two important causes of disability in the elderly. The association between MetS and depressive symptoms in Iranian elderly is unclear. In this population-based study, we aimed at evaluating the relationship between MetS and its components with depression in Iranian elderly population. Method: This cross sectional study was derived from Amirkola Health and Ageing Project (AHAP).The participants of this study included 1560 elders over the age of 60 during 2012 and 2013. MetS was diagnosed based on Adult Treatment Panel III report and depressive symptoms according to Geriatric Depression Scale. Odds ratio (OR) and 95% confidence interval (CI) based on age and gender were estimated using regression logistic model. Results: Depressive symptoms were observed in 28.7% of men and 46.2% of women. Age- and gender-adjusted OR of depressive symptoms did not show a significant difference among the participants with or without MetS. A significant association between MetS components (including waist circumference, HDL-C, fasting blood glucose, triglyceride) and depressive symptoms was observed, but this association no longer existed after age and gender adjustment. Elevated blood pressure revealed a significant relationship with depressive symptoms in men only (OR, 0.665; 95% CI, 0.469-0.943). Conclusion: Depressive symptoms were associated with blood pressure component but not MetS in the elderly population of Amirkola, Iran. This association highlights the relevance of norepinephrine signal and sympathetic nervous activity disturbance for the emergence of depressive symptoms in the elderly. Therefore, it is reasonable to consider depression in hypertensive patients, especially in men

Effectiveness of Group Psychosexual Training for Marital Adjustment and Sexual Self-Efficacy of Infertile Women: A Randomized Controlled Trial

Objective: Infertility can be associated with unfavorable psychological consequences such as a sense of marital incompatibility and sexual inadequacy. To address these issues, this study aimed to assess the effectiveness of group psycho-sexual training in improving marital adjustment and sexual self-efficacy of infertile women. Method: A randomized controlled clinical trial (RCT) study was conducted in Babol, Iran, with 72 infertile women, randomly assigned to either the intervention group (n = 36) or the control group (n = 36). The intervention group underwent psychosexual training, while the control group received routine care. The Dyadic Adjustment Scale (DAS) and Sexual Self-Efficacy Scale (SSES) were used to assess their marital adjustment and sexual self-efficacy. Data analysis was performed using various tests, including the independent t-test, Chi-squared test, paired t-test, ANCOVA, and MANCOVA. Results: Most infertile women had moderate sexual self-efficacy (80%). The intervention group had a significantly better response to group psycho-sexual training compared to the control group. This intervention improved sexual self-efficacy and marital adjustment and its subscales including marital consensus, satisfaction, cohesion (P < 0.0001), and affectional expression (P < 0.001). The mean pre-to-post treatment scores of sexual self- efficacy, marital adjustment, and its subscales increased significantly in the intervention group, while no significant difference was observed in the control group (P < 0.0001). Conclusion: Based on the findings, it is recommended to provide educational services alongside the infertility treatment process for enhancing the quality of marital adjustment and promoting sexual self-efficacy

Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017

A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1–70.8) million) to 6.4% (58.3 (47.6–70.7) million), but is predicted to remain above the World Health Organization’s Global Nutrition Target of <5% in over half of LMICs by 2025. Prevalence of overweight increased from 5.2% (30 (22.8–38.5) million) in 2000 to 6.0% (55.5 (44.8–67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic