Epidemiologic study of 80 patients with ulcerative colitis referred to Imam Hospital in Ardabil city during 2004-2011

Background:Ulcerative colitis is one of the inflammatory bowel diseases with unknown etiology. Genetic and environmental factors are thought to be effective in this disease. The aim of this study is to assessment of demographic features and clinical symptoms of ulcerative colitis patients refereed to Emam hospital in Ardabil city.Methods:In this retrospective cross-sectional study, 80 cases of ulcerative colitis referred to Emam hospital in Ardabil city were evaluated during 2004-2011. The diagnosis was confirmed based on clinical features, colonoscopy, and pathology and resulting of other causes. Data were collected through direct interview and analyzed by statistical method in SPSS software.Results:Mean age of patients was 36.4 (SD=18.4). Duration of symptoms onset until diagnosis was 8 months. Male to female ratio was 0.8/1. 38(47.5%) of patients were male and 42 (52.5%) were female. 3 (3.75%) of patients have history of positive UC and 4 (5%) history of appendectomy. According to colonoscopy finding, 1 (1.25%) have rectum involvement, 27 (33.75%) recto sigmoid, 23 (28.75%) left side colon and 4 (5%) have pan colitis.Conclusion:Results showed that in compare with other places, clinical signs of ulcerative colitis in Ardabil province are different and so doing other d epidemiologic studies based on population to determine incidence and prevalence ulcerative colitis in Ardabil province is necessary.

Libman-Sacks endocarditis in patients with systemic lupus erythematosus with secondary antiphospholipid syndrome

Background: Libman-Sacks endocarditis (LSE) is characterized by sterile lesions that commonly affect the aortic and mitral heart valves. Antiphospholipid syndrome (APS) and systemic lupus erythematosus (SLE) have been associated with LSE. Cardiac manifestations including LSE could be interrelated with other manifestations and early diagnosis could help in preventing further complications. Case presentation: Here, we report three cases of LSE in SLE patients with secondary APS. All patients presented with neurological manifestations and LSE was diagnosed by Transesophageal echocardiography (TEE). All three patients were treated for the underlying disease and also received anticoagulant therapy. Conclusion: In all patients with SLE and secondary APS, LSE should be considered if a patient manifests any evidence of neurologic involvement

Economic burden of cardiovascular diseases before and after Iran’s health transformation plan: Evidence from a referral hospital of Iran

Background: Different countries have set different policies to control and decrease the costs of cardiovascular diseases (CVDs). Iran was aiming to reduce the economic burden of different disease by a recent reform from named as health transformation plan (HTP). This study aimed to examine the economic burden of CVDs before and after of HTP. Methods: This cross-sectional study was conducted on 600 patients with CVDs, who were randomly selected from a specialized cardiovascular hospital in the north-west of Iran. Direct and indirect costs of CVDs were calculated using the cost of illness and human capital approaches. Data were collected using a researcher-made checklist obtained from several sources including structured interviews, the Statistical Center of Iran, Iran’s Ministry of Cooperatives, Labor, and Social Welfare, the central bank of Iran, and the data of global burden of disease obtained from the Institute for Health Metrics and Evaluation to estimate direct and mortality costs. All costs were calculated in Iranian Rials (IRR). Results: Total costs of CVDs were about 5571 and 6700 billion IRR before and after the HTP, respectively. More than 62% of the total costs of CVDs accounted for premature death before (64.89%) and after (62.01%) the HTP. The total hospitalization costs of CVDs was significantly increased after the HTP (p = 0.038). In both times, surgical services and visiting had the highest and lowest share of hospitalization costs, respectively. The OOP expenditure decreased significantly and reached from 54.2 to 36.7%. All hospitalization costs, except patients’ OOP expenditure, were significantly increased after the HTP about 1.3 times. Direct non-medical costs reached from 2.4 to 3.3 billion before and after the HTP, respectively. Conclusion: Economic burden of CVDs increased in the north-west of Iran after the HTP due to the increase of all direct and indirect costs, except the OOP expenditure. Non-allocation of defined resources, which coincided with the international and national political and economic challenges in Iran, led to unsustainable resources of the HTP. So, no results of this study can be attributed solely to the HTP. Therefore, more detailed studies should be carried out on the reasons for the significant increase in CVDs costs in the region

ASSESSMENT OF RELATION BETWEEN MICROALBUMINURIA AND ISCHEMIC ELECTROCARDIOGRAM IN IRANIAN GENERAL POPULATION

Abstract &nbsp;&nbsp; BACKGROUND: Enhancement of albumin exertion in urine increases the risk of renal and ischemic heart diseases (IHD). We assessed the association of urine albumin and sub-clinical IHD in a random sample of Iranian general population. &nbsp;&nbsp; METHODS: The random sample in general population in Isfahan County was recruited to the cross-sectional study. From the all sample blood pressure and lipid profile were assessed and morning urine spot was measured for albumin and Creatinine. Microalbuminuria was defined either Albumin-Creatinine Ratio (ACR) was 30-300mg. Also, the standard 12 lead electrocardiogram (ECG) was carried out for all participants. The ECG pattern was divided to two categories; normal or ECG with ischemia. The logistic regression model was determined the odds of albuminuria for ischemic changes in ECG. &nbsp;&nbsp; RESULTS: 999 subjects, age 35-70 years, participated to study. From all, 40.8% were male. Microalbuminuria was detected in 8% and sub-clinical ECG ischemic changes were found in 23.4%. The most frequent ischemic change was T wave inversion. The mean urine albumin levels in subjects with normal ECG was 9.6&plusmn;14.6 mg/ml and in ischemic group was 8.5&plusmn;12.2 mg/ml and they did not have statistically different. The odds ratios of neither Albumin-Creatinine ratio nor microalbuminuria were in significant range for risk to ischemic changes in ECG of apparently healthy participants. They was consecutively OR=0.9 (0.51-1.6), OR=0.99 (0.98-1.004).&nbsp; &nbsp;&nbsp; CONCLUSION: Our finding didn&rsquo;t declare any association between ACR and IHD. Because of showing this association in the other study; it needs more exploration regarding to association between microalbuminuria and cardiovascular diseases incidence. &nbsp; &nbsp;&nbsp; Keywords: Ischemic heart diseases, electrocardiogram, Albumin-Creatinine Ratio, Urine Albumin</p