Health care seeking behaviors in type 2 diabetic patients in East Azerbaijan

Background. Timely and effective use of health care services is essential to delay or prevent complications and reduce the burden of diabetes. Positive health care seeking behaviors can improve diabetes control and, as a result, reduce the incidence of the complications. So, this study aimed to investigate the status of health care seeking behaviors and affecting factors in type 2 diabetic patients. Materials and methods. This was a cross-sectional study. There were 1139 patients with type 2 diabetes aged > 18 years selected who referred to educational hospitals, Endocrinologist office, primary health care centers, and Clinics. Data collected using a researchermade questionnaire and analyzed using SPSS software version 22. Results. 36.3% of diabetic patients initially referred to a physician in the event of illness symptoms, and 70.7% of patients referred to a physician in case of exacerbating of disease symptoms. 58.4% of patients preferred to consult a specialist directly. 78.85 of patients reported that they had referred to a physician on a regular basis and 59.9% of patients followed up their treatment process on a regular basis. The physician was the main source of information for the majority of patients. Income, education and health insurance status, disease severity, chronicity of DM, the history of hospitalization due to DM were the affecting factors on health care seeking behaviors (p < 0.05). Conclusion. Most of the diabetics often did not follow the official structure of health care providing to manage their illness, and despite the referral system and family practitioner program more than half of the patients went directly to the specialist physician’s office. Factors related to the patient (an income and education status), disease characteristics (disease severity, chronicity of DM and the history of hospitalization due to DM) and health care system factors (type of the basic insurance and supplementary insurance status) affect the health care seeking behaviors

Comparison of the Efficacy of Atorvastatin and Rosuvastatin in Preventing Atrial Fibrillation after Coronary Artery Bypass Grafting: A Double-blind Randomized Comparative Trial

Background: Atrial fibrillation (AF) is a supraventricular tachyarrhythmia characterized by disorganized atrial activity and subsequent mechanical atrial failure. Postoperative AF is a frequent complication of coronary artery bypass grafting (CABG). Although there is evidence of decreased AF after CABG with statin usage, information is scarce regarding a direct comparison between atorvastatin and rosuvastatin. The present study was conducted to compare the efficacy of rosuvastatin and atorvastatin in preventing post-CABG AF. Methods: The present double-blind randomized comparative clinical trial selected CABG candidates with stable ischemic heart disease or acute coronary syndromes. Atorvastatin (40 mg per day) or rosuvastatin (20 mg per day) was prescribed 1 week before surgery, and the outcomes were compared. Results: Two-hundred patients, 100 cases in each group, completed the study. Twenty-five patients in each group were female, and the mean age was 59.30±8.42 years in the rosuvastatin group and 60.13±9.40 years in the atorvastatin group (P=0.513). The frequency of AF was 31% in the atorvastatin group and 27% in the rosuvastatin group (P=0.534). No significant differences existed between the groups concerning the length of hospital and ICU stay (P=0.333 and P=0.161) and in-hospital and 3-month mortality (P=0.315 and P=0.648). A subgroup analysis of only patients with stable ischemic heart disease could not detect a significant difference between the study groups in any of the investigated outcomes. Our logistic regression analysis showed an association only between age and the incidence of AF after CABG (OR, 1.12; 95% CI, 1.05 to 1.20; P<0.01). Conclusion: Rosuvastatin and atorvastatin are similar concerning the prevention of post-CABG AF, but there is a need for future well-designed multicenter studies on this topic.

Advancing prognostic precision in pulmonary embolism: A clinical and laboratory-based artificial intelligence approach for enhanced early mortality risk stratification

Background Acute pulmonary embolism (PE) is a critical medical emergency that necessitates prompt identification and intervention. Accurate prognostication of early mortality is vital for recognizing patients at elevated risk for unfavourable outcomes and administering suitable therapy. Machine learning (ML) algorithms hold promise for enhancing the precision of early mortality prediction in PE patients. Objective To devise an ML algorithm for early mortality prediction in PE patients by employing clinical and laboratory variables. Methods This study utilized diverse oversampling techniques to improve the performance of various machine learning models including ANN, SVM, DT, RF, and AdaBoost for early mortality prediction. Appropriate oversampling methods were chosen for each model based on algorithm characteristics and dataset properties. Predictor variables included four lab tests, eight physiological time series indicators, and two general descriptors. Evaluation used metrics like accuracy, F1_score, precision, recall, Area Under the Curve (AUC) and Receiver Operating Characteristic (ROC) curves, providing a comprehensive view of models' predictive abilities. Results The findings indicated that the RF model with random oversampling exhibited superior performance among the five models assessed, achieving elevated accuracy and precision alongside high recall for predicting the death class. The oversampling approaches effectively equalized the sample distribution among the classes and enhanced the models' performance. Conclusions The suggested ML technique can efficiently prognosticate mortality in patients afflicted with acute PE. The RF model with random oversampling can aid healthcare professionals in making well-informed decisions regarding the treatment of patients with acute PE. The study underscores the significance of oversampling methods in managing imbalanced data and emphasizes the potential of ML algorithms in refining early mortality prediction for PE patients

The effect of traditional Persian music on the cardiac functioning of young Iranian women

In the past few decades, several studies have reported the physiological effects of listening to music. The physiological effects of different music types on different people are not similar. Therefore, in the present study, we have sought to examine the effects of traditional Persian music on the cardiac function in young women. Twenty-two healthy females participated in this study. ECG signals were recorded in two conditions: rest and music. For each of the 21 ECG signals (15 morphological and six wavelet based feature) features were extracted. SVM classifier was used for the classification of ECG signals during and before the music. The results showed that the mean of heart rate, the mean amplitude of R-wave, T-wave, and P-wave decreased in response to music. Time-frequency analysis revealed that the mean of the absolute values of the detail coefficients at higher scales increased during rest. The overall accuracy of 91.6% was achieved using polynomial kernel and RBF kernel. Using linear kernel, the best result (with the accuracy rate of 100%) was attained

Zachowania związane z wyborem usług medycznych u chorych na cukrzycę typu 2 w Azerbejdżanie Wschodnim

Wstęp i cel badania. Zapewnienie terminowych i skutecznych usług medycznych, zwłaszcza na poziomie podstawowej opieki zdrowotnej, ma zasadnicze znaczenie dla zmniejszenia obciążeń związanych z cukrzycą. Pozytywne zachowania zdrowotne mogą poprawić kontrolę cukrzycy, a tym samym zmniejszyć częstość powikłań. Dlatego celem niniejszego badania była ocena zachowań zdrowotnych i wpływających na nie czynników u chorych na cukrzycę typu 2. Materiał i metody. Badanie miało charakter przekrojowy. Do udziału w badaniu wytypowano 1139 chorych na cukrzycę typu 2 w wieku &gt; 18 lat, którzy zgłosili się do szpitali klinicznych, prywatnych gabinetów endokrynologicznych, ośrodków podstawowej opieki zdrowotnej i prywatnych klinik. Dane zbierano, opierając się na kwestionariuszu przygotowanym na potrzeby badania, i analizowano za pomocą oprogramowania SPSS w wersji 22. Wyniki. Wykazano, że 36,3% chorych na cukrzycę udawało się do lekarza w przypadku wystąpienia objawów choroby, a 70,7% chorych zgłaszało się do lekarza w przypadku zaostrzenia objawów. Uzyskane dane wskazują, że 58,4% pacjentów zgłasza się bezpośrednio do specjalisty, 78,85 pacjentów deklarowało, że regularnie odwiedzają lekarza, a 59,9% pacjentów regularnie monitorowało proces leczenia. Głównym źródłem informacji dla większości chorych był lekarz. Czynnikami wpływającymi na zachowania osób poszukujących usług medycznych były: dochody, poziom wykształcenia, rodzaj ubezpieczenia zdrowotnego, ciężkość i czas trwania cukrzycy oraz hospitalizacje z powodu cukrzycy (p &lt; 0,05). Wnioski. Większość chorych na cukrzycę, szukając pomocy medycznej w przypadku problemów zdrowotnych, nie postępowała zgodnie z oficjalną strukturą systemu opieki zdrowotnej i pomimo systemu skierowań oraz programu lekarzy rodzinnych ponad połowa pacjentów udawała się bezpośrednio do lekarza specjalisty. Na zachowania związane z poszukiwaniem usług medycznych wpływają czynniki związane z pacjentem (dochód i poziom wykształcenia), chorobą (nasilenie i czas trwania cukrzycy, hospitalizacje z powodu cukrzycy) i systemem opieki zdrowotnej (rodzaj podstawowego ubezpieczenia i dodatkowe ubezpieczenie)

Prevalence of type 2 diabetes complications and its association with diet knowledge and skills and self‐care barriers in Tabriz, Iran: A cross‐sectional study

Abstract Background and Aims Diabetes can lead to multiple complications that can reduce the quality of life, impose additional costs on the healthcare systems and ultimately lead to premature death. Proper self‐care in diabetic patients can impede or delay the onset of diabetes complications. This study aimed to investigate diabetes complications and their association with diet knowledge, skills, and self‐care barriers. Methods This was a cross‐sectional study. A total of 1139 patients with Type 2 Diabetes Mellitus (T2DM) referring to health centers in Tabriz, Iran, were included from January to July 2019. Data were collected using two questionnaires: (1) a sociodemographic questionnaire and (2) a Personal Diabetes Questionnaire (PDQ). Data were analyzed using SPSS software version 22. χ2 test was used to examine the association between the socioeconomic and disease‐related variables and the prevalence of diabetes complications. T‐test was used to examine the association between diet knowledge and skills, self‐care barriers, and the incidence of diabetes complications. Results In this study, 76.1% of patients had at least one complication, and 30.2% had a history of hospitalization due to diabetes complications during the past year. Approximately 49% and 43% were diagnosed with high blood pressure and hyperlipidemia, respectively. Cardiovascular disease was the most common diabetes complication (15.9%) and the cause of hospitalization (11.01%) in patients with diabetes. Barriers to diet adherence, blood glucose monitoring, and exercise were significantly associated with self‐reported diabetes complications (p < 0.001). Our results showed no significant association between the number of complications and diet knowledge and skills (p = 0.44). Conclusion This study indicated that the prevalence of diabetes complications was higher among patients with more barriers to self‐care. In light of these findings, taking appropriate measures to reduce barriers to self‐care can prevent or delay the onset of diabetes complications

Cardiac hydatid disease; a systematic review

Abstract Background and objectives Human cystic echinococcosis (CE), is a common health problem in low- and middle-income countries. Cardiac involvement is a relatively rare manifestation of Echinococcus infection. This study aims to summarize the evidence regarding the features of cardiac CE. Methods Case series of the patients with cardiac CE, were included in this study. Non-English papers, case reports, reviews, letters, , commentaries, and conference abstracts were not included. A systematic search was conducted in PubMed and EMBASE databases and the risk of bias in the included studies was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist. Results Out of 3985 results of the searches, finally 37 studies were included in this systematic review. Based on available evidence, cardiac involvement is an uncommon but serious presentation of CE which presents with some non-specific signs and symptoms. Dyspnea, chest pain, and palpitation are the most common symptoms of the disease and normal sinus rhythm is the most common Electrocardiogram (ECG) feature. The disease is not associated with high mortality in case of timely diagnosis and appropriate management. Discussion Consecutive and complete inclusion of participants, statistical analysis, and appropriate reporting of the demographics were the sources of bias in the included studies. The exclusion of non-English papers was a limitation during the review process. Funding The research protocol was approved and supported by the Student Research Committee, Tabriz University of Medical Sciences (grant number: 69380). Registration This study was registered in the International prospective register of systematic reviews (PROSPERO ID: CRD42022381204)