Relationship of some risk factors and symptoms in patients with acute coronary syndrome

Acute coronary syndrome (ACS) is one of the major causes of death in the worldwide. Clinical manifestations are different. So it's necessary to have knowledge about the types of symptoms experienced by patients with ACS. This study was performed to assay the Relationship of some risk factors and symptoms in patients with acute coronary syndrome. This cross-sectional study, were studied 294 patients with acute coronary syndrome at least 24 hours after admission had survived. Data was collected by a questionnaire that included demographic data form and check list of some symptoms and history of risk factors. There was a significant relationship between STEMI with vomiting (OR=1.94) and anxiety (OR=1.83) and UA with vomiting (OR=0.42). Between sex with weakness (OR=2.29) and anxiety (OR=1.82), diabetes with dyspenea (OR=1.8), weakness (OR=1.02) and tinnitus (OR=2.06) and hyperlipidemia with weakness (OR=2.35) and tinnitus (OR=2.49) was available significant difference. The findings of this study indicate that the appearance of symptoms of acute coronary syndrome were different as for ECG changes and risk factors, and more focused on those symptoms that they are common with any other diseases. Since, many of the symptoms of acute coronary syndrome can be potentially dangerous and life threatening, accurate diagnosis and timely action is crucial for the patients

Psychometric properties of the king spiritual intelligence questionnaire (KSIQ) in physical veterans of Iran-Iraq warfare

Aims: The study's purpose was to determine reliability and validity of the King spiritual intelligence questionnaires in veterans of Iran-Iraq Warfare. Methods: In this cross sectional study, 300 veterans of the Iran-Iraq war completed the King spiritual intelligence questionnaires. Principal components analysis (PCA) with varimax rotation was used to assess domain structure of the King spiritual intelligence questionnaires. Internal and external consistency reliability was assessed with Cronbach's alpha and intra-class correlation coefficient (ICC). Results: Internal consistency of King spiritual intelligence questions estimated with Cronbach's alpha, 0.872 and intra-class correlation coefficient (ICC).872 (CI 95%: 0.84 -0.89). The construct validity of the questionnaire was calculated using exploratory factor analysis that showed 3 factors with Eigen values of greater than one, which explained in total 44.7% of the variance. (1, 8 items, α= 0.87; 2, 5. items; α = 0.89; 3, 2 items, α= 0.51). Conclusion: The Persian version of King spiritual intelligence questionnaire demonstrated suitable validity and reliability among the Veterans of Iran-Iraq Warfare. With the consideration of the proper psychometric characteristics, this questionnaire can be used to further research spiritual intelligence in this population

Community-based physical activity interventions among women: A systematic review

Objective: Review and assess the effectiveness of community-based physical activity interventions among women aged 18-65 years. Design: Systematic review Methods: To find relevant articles, the researcher selected reports published in English between 1 January 2000 and 31 March 2013. Systematic search was to find controlled-trial studies that were conducted to uncover the effect of community-based interventions to promote physical activity among women 18-65 years of age, in which physical activity was reported as one of the measured outcomes. The methodological quality assessment was performed using a critical appraisal sheet. Also, the levels of evidence were assessed for the types of interventions. Results: The literature search identified nine articles. Four of the studies were randomised and the others studies had high methodological quality. There was no evidence, on the basis of effectiveness, for social cognitive theory-based interventions and inconclusive evidence of effectiveness for the rest of interventions. Conclusions: There is insufficient evidence to assess the effectiveness of community-based interventions for enhancing physical activity among women. There is a need for high-quality randomised clinical trials with adequate statistical power to determine whether multicomponent and community-based intervention programmes increase physical activity among women, as well as to determine what type of interventions have a more effective and sustainable impact on women's physical activity. © 2015, BMJ. All rights reserved

What the policy and stewardship landscape of a national health research system looks like in a developing country like Iran: a qualitative study

BACKGROUND: The health research system (HRS) is an important national priority that requires a systematic and functional approach. Evaluating the HRS of Iran as a developing country and identifying its challenges reveals the stewardship-related role in how the whole system is operating well. This study aims to assess the HRS in terms of stewardship functions and highlight the enhancement points. METHODS: This study was carried out between March 2020 and April 2021 using a systematic review and meta-synthesis of evidence to examine the Iranian HRS stewardship challenges and interview 32 stakeholders, using a critical case sampling and snowballing approach which included both semi-structured and in-depth interviews. The interviewees were selected based on criteria covering policy-makers, managers, research bodies and nongovernmental organizations (NGOs) in health research-related fields like higher education, research, technology, innovation and science. All data were analysed using content analysis to determine eight main groups of findings under three levels: macro, meso, and micro. RESULTS: Analysis of the findings identified eight main themes. The most critical challenges were the lack of an integrated leadership model and a shared vision among different HRS stakeholders. Their scope and activities were often contradictory, and their role was not clarified in a predetermined big picture. The other challenges were legislation, priority-setting, monitoring and evaluation, networking, and using evidence as a decision support base. CONCLUSIONS: Stewardship functions are not appropriately performed and are considered the root causes of many other HRS challenges in Iran. Formulating a clear shared vision and a work scope for HRS actors is critical, along with integrating all efforts towards a unified strategy that assists in addressing many challenges of HRS, including developing strategic plans and future-oriented and systematic research, and evaluating performance. Policy-makers and senior managers need to embrace and use evidence, and effective networking and communication mechanisms among stakeholders need to be enhanced. An effective HRS can be achieved by redesigning the processes, regulations and rules to promote transparency and accountability within a well-organized and systematic framework

Numerical and experimental evaluation of shock dividers

Mitigation of pressure pulsations in the exhaust of a pulse detonation combustor is crucial for operation with a downstream turbine. For this purpose, a device termed the shock divider is designed and investigated. The intention of the divider is to split the leading shock wave into two weaker waves that propagate along separated ducts with different cross sections, allowing the shock waves to travel with different velocities along different paths. The separated shock waves redistribute the energy of the incident shock wave. The shock dynamics inside the divider are investigated using numerical simulations. A second-order dimensional split finite volume MUSCL-scheme is used to solve the compressible Euler equations. Furthermore, low-cost simulations are performed using geometrical shock dynamics to predict the shock wave propagation inside the divider. The numerical simulations are compared to high-speed schlieren images and time-resolved total pressure recording. For the latter, a high-frequency pressure probe is placed at the divider outlet, which is shown to resolve the transient total pressure during the shock passage. Moreover, the separation of the shock waves is investigated and found to grow as the divider duct width ratio increases. The numerical and experimental results allow for a better understanding of the dynamic evolution of the flow inside the divider and inform its capability to reduce the pressure pulsations at the exhaust of the pulse detonation combustor

Xerostomia after radiotherapy and its effect on quality of life in head and neck cancer patients

Background: Xerostomia is one of the one complications following radiotherapy that can affect quality of life (QoL). This study aims to assess the severity of xerostomia in patients with head and neck cancers after radiotherapy and its effect on QoL. Methods: In this longitudinal prospective study, the severity of xerostomia and related QoL was assessed in 63 head and neck cancer patients who referred to the Radiotherapy Ward. Patients completed a xerostomia questionnaire (XQ) at the beginning, and 2, 4, and 6 weeks after treatment over a period of 6 months. Additionally, unstimulated saliva was collected using the spitting method at all 4 visits. Results: QoL significantly worsened with increased time (P = 0.0001); meanwhile, the severity of xerostomia increased significantly (P = 0.0001). However, there was no significant change in the amount of saliva at these 4 time points (P = 0.23). Regression analysis showed that with each milliliter decrease in saliva secretion, the QoL score decreased 2.25. With one score increase in xerostomia, from the QoL mean score there was a 1.65 decrease. Conclusion: The decrease in saliva and xerostomia that resulted from radiotherapy plays an important role in worsening QoL among patients who undergo radiotherapy for head and neck cancers. Although the amount of saliva has a significant association with QoL, the xerostomia score which shows subjects' general feeling also independently impacts QoL. In future studies, we recommend patient assessments for periods longer than 6 months

Roles of oxidative stress and Nrf2 signaling in pathogenic and non-pathogenic cells: a possible general mechanism of resistance to therapy

The coordinating role of nuclear factor erythroid-2-related factor 2 (Nrf2) in cellular function is undeniable. Evidence indicates that this transcription factor exerts massive regulatory functions in multiple signaling pathways concerning redox homeostasis and xenobiotics, macromolecules, and iron metabolism. Being the master regulator of antioxidant system, Nrf2 controls cellular fate, influencing cell proliferation, differentiation, apoptosis, resistance to therapy, and senescence processes, as well as infection disease success. Because Nrf2 is the key coordinator of cell defence mechanisms, dysregulation of its signaling has been associated with carcinogenic phenomena and infectious and age-related diseases. Deregulation of this cytoprotective system may also interfere with immune response. Oxidative burst, one of the main microbicidal mechanisms, could be impaired during the initial phagocytosis of pathogens, which could lead to the successful establishment of infection and promote susceptibility to infectious diseases. There is still a knowledge gap to fill regarding the molecular mechanisms by which Nrf2 orchestrates such complex networks involving multiple pathways. This review describes the role of Nrf2 in non-pathogenic and pathogenic cells

Global burden of human brucellosis : a systematic review of disease frequency

BACKGROUND: This report presents a systematic review of scientific literature published between 1990-2010 relating to the frequency of human brucellosis, commissioned by WHO. The objectives were to identify high quality disease incidence data to complement existing knowledge of the global disease burden and, ultimately, to contribute towards the calculation of a Disability-Adjusted Life Years (DALY) estimate for brucellosis.METHODS/PRINCIPAL FINDINGS: Thirty three databases were searched, identifying 2,385 articles relating to human brucellosis. Based on strict screening criteria, 60 studies were selected for quality assessment, of which only 29 were of sufficient quality for data analysis. Data were only available from 15 countries in the regions of Northern Africa and Middle East, Western Europe, Central and South America, Sub-Saharan Africa, and Central Asia. Half of the studies presented incidence data, six of which were longitudinal prospective studies, and half presented seroprevalence data which were converted to incidence rates. Brucellosis incidence varied widely between, and within, countries. Although study biases cannot be ruled out, demographic, occupational, and socioeconomic factors likely play a role. Aggregated data at national or regional levels do not capture these complexities of disease dynamics and, consequently, at-risk populations or areas may be overlooked. In many brucellosis-endemic countries, health systems are weak and passively-acquired official data underestimate the true disease burden.CONCLUSIONS: High quality research is essential for an accurate assessment of disease burden, particularly in Eastern Europe, the Asia-Pacific, Central and South America and Africa where data are lacking. Providing formal epidemiological and statistical training to researchers is essential for improving study quality. An integrated approach to disease surveillance involving both human health and veterinary services would allow a better understand of disease dynamics at the animal-human interface, as well as a more cost-effective utilisation of resources