Determination of the incidence of cardiovascular composite events in Patients with Obstructive Sleep Apnea: A 3-year follow-up

Background: The occurrence of obstructive sleep apnea (OSA) and its health-related issues, especially cardiovascular diseases (CVD), are increasing in developing countries. With a 3-year follow-up study, the present study aimed to determine the incidence of cardiovascular events in patients with OSA in an Iranian population.Methods: In this prospective cohort study, 415 adults (300 patients with OSA and 115 patients without OSA) with a history of snoring and/or witnessed apneas or other suspected sleep breathing disorders were consecutively enrolled and followed up for three successive years to evaluate the development of cardiovascular events including acute coronary syndrome, cerebrovascular accidents (including ischemic or hemorrhagic strokes or transient ischemic attacks), death due to cardiac causes and all-cause mortality. Results: 415 patients were studied with a mean age of 56.2 ±15.7 years, 211 (50.8) of whom were male. Cardiovascular events developed in 15 participants (5%) of the OSA group, and 3 participants (2.6 %) of the OSA negative group. No significant differences were observed between the two groups in terms of the incidence of any of these events (P-value> 0.05). Using multiple logistic regression model (with P-value <0.2 as the significance level), age, OSA, and history of CVD remained as significant predictors for the development of cardiac composite events (incidence of CVD, CVA, death due to cardiac causes, and all-cause mortality) with the odds ratios of (95% confidence interval) 1.03 (1.01, 1.06), 2.41 (1.02, 5.76), and 7.40 (2.91, 18.67), respectively.Conclusions: The present study showed that OSA is associated with a more than twofold increased risk of cardiovascular events. Thus, obstructive sleep apnea should be considered an independent cardiovascular risk factor

Effects of Cardiac Rehabilitation on Sexual Dysfunction of Post Myocardial Infarction Patients

Objective: The common sexual complains in patients with coronary heart disease and post myocardial infarction are decrease in libido, impotence, and premature or delay ejaculation. Cardiac rehabilitation could decrease many of the psychological features of myocardial infarction and also increase exercise capacity of patients. Rehabilitation may also improve sexual disturbances in these patients directly or indirectly. This study is a clinical trial that evaluate the effect of rehabilitation on sexual problem of post MI patients. Materials & Methods: 60 patients took part in this study. All of them were men aged between 35 and 65. All patients had myocardial infarction one month ago. 30 patients were referred for cardiac rehabilitation (Case), and 30 people were patients who were not recommended to take part in rehabilitation because their physician did not believe on rehabilitation. Questioner for anxiety, depression, impotency, libido and premature ejaculation were evaluated by before and after study period. The cardiac rehabilitation composed of 24 sessions. Each session consisted of one hour of aerobic exercise (10 min warm up, 10 min cool down and 40 min isotonic exercise). Results: After cardiac rehabilitation the scores for anxiety, depression, premature ejaculation and impotency were decreased and the scores of libido were increased. In both case and control groups, the changes were significant by paired t test P<0.05. The differences between case and control were significant for depression, libido and impotency by independent t test. Conclusion: Cardiac rehabilitation could improve sexual problems in post myocardial infarction patients directly and indirectly by effect on psychological characteristics

Association between sleep duration and metabolic syndrome in a population-based study: Isfahan Healthy Heart Program

Abstract BACKGROUND: Recent epidemiologic studies have found that self-reported sleep duration is associated with components of metabolic syndrome (MS) such as obesity, diabetes and hypertension. This relation may be under influence of regional factors in different regions of the world. The association of sleep duration and MS in a sample of Iranian people in the central region of Iran was investigated in this study

A STUDY OF THE RELATIONSHIP BETWEEN MYOCARDIAL PERFORMANCE INDEX AND LEFT VENTRICULAR END-DIASTOLIC PRESSURE IN PATIENTS WITH LEFT VENTRICULAR SYSTOLIC DYSFUNCTION

AbstractINTRODUCTION: Doppler echocardiography is used to evaluate global myocardialperformance. An index of myocardial performance (Tei Index) can be of great prognosticvalue in heart failure. This study was performed to assess the correlation between Tei Index(TI) and left ventricular end diastolic pressure (LVEDP).METHODS: The study group consisted of 38 patients. Each patient underwentventriculographic evaluation (all had EF&le;45). Eighteen patients had LVEDP&lt;15 (14 males,4 females, 57&plusmn;6 years old) and 20 subjects (15 males, 5 females, 56&plusmn;7 years old) hadLVEDP&ge;15. Using Doppler echocardiography, TI was determined for all patients andcompared.RESULTS: Mean TI value was significantly different between subjects with LVEDP&lt;15 andthose with LVEDP&lt;15 (0.55&plusmn;0.18 vs. 0.76&plusmn;0.19, P&lt;0.001, T=4.1).DISCUSSION: In patients with systolic heart failure (EF&le;45), TI was significantly lower insubjects with LVEDP&lt;15 compared to those with LVEDP&ge;15. Thus, TI may be useful fornoninvasive assessment of LVEDP in heart failure.Keywords &bull; Tei index &bull; Ventricular performance &bull; Heart failur

A STUDY OF THE EFFECT OF RELAXATION AND BIOFEEDBACKASSISTED RELAXATION ON PATIENTS WITH MILD HYPERTENSION

AbstractINTRODUCTION: Hypertension is one of the most prevalent chronic diseases worldwide.Because of its chronicity, hypertension requires life-long therapy. Many patients tend todiscontinue therapy and seek alternative treatments. In this study, we evaluated the efficacyof two behavioral therapeutic techniques, namely relaxation and biofeedback-assistedrelaxation in reducing blood pressure.METHODS: Fifty-six mildly hypertensive men (aged between 30 and 60 years) who did notuse any pharmacological treatment, took part in this study. The participants were randomlydivided into three groups, relaxation (group one), biofeedback-assisted relaxation (grouptwo) and control (group three). The treatment course consisted of ten sessions (every otherday). Relaxation was performed in groups one and two for 15 minutes during each session.In group 2, for another 15 minutes at the end of each relaxation session, blood pressure wasmeasured at 2- to 3-minute intervals and declared to the patient. Heart rate and bloodpressure were measured and recorded before and after each session. In the control group,only blood pressure was measured at each session. Stress was measured using Malekpoorquestionnaire with 67% validity. Anxiety was measured by Ketel's questionnaire. Thepatients filled stress and anxiety questionnaires before and after the study period (20 days).RESULTS: Mean systolic and diastolic blood pressures decreased after the study period ingroups one and two. There was a significant difference between groups one and three(P&lt;0.05) and between groups two and three (P&lt;0.05).DISCUSSION: Relaxation and biofeedback-assisted relaxation techniques can reducesystolic and diastolic blood pressure, hence their benefits in the treatment of hypertensioncan be used in appropriate settings.A STUDY OF THE EFFECT OF RELAXATION AND BIOFEEDBACKASSISTEDRELAXATION ON PATIENTS WITH MILD HYPERTENSIONKeywords &bull; Relaxation &bull; Biofeedback-assisted relaxation &bull; Anxiety &bull; Stress &bull; Hypertensio

Comparison of therapeutic response of keloids and hypertrophic scars to cryotherapy plus intralesional steroid and bleomycin tattoo

Keloids and hypertrophic scars are abnormal responses of body to skin injuries. Overproduction of compacted fibrous tissue is the basic cause of these lesions. In this study the result of treatment of these skin conditions with bleomycin tattoo are compared with cryotherapy and triamcinolone injection. This study involved 45 patients with hypertrophic scar or keloid. Patients were divided into two groups consecutively. Group A (23 patients) was treated with bleomycin tattoo and the group B with cryotherapy and triamcinolone injection. There were four therapeutic sessions one month apart. All patients were followedup for three month after the end of treatment .The therapeutic response was determined as reduction of lesion size or flattening relative to initial size. Therapeutic response was 88.3&#x00B1;14&#x0025; in group A and 67.4 &#x00B1;22.5&#x0025; in group B (p<0.001). In group A 69&#x0025;, but in group B only 49&#x0025; of patients were asymptomatic after the end of treatment. In group A there was no relation between therapeutic response and lesion size (p=0.58) but in group B lesions those were smaller (<100mm2) had better therapeutic response than larger ones (p=0.007). It was concluded that bleomycin tattoo is more effective in treatment of hypertrophic scar and keloid than traditional treatment, cryotherapy plus triamcinolone injection especially in larger ones

Hirsutism and body mass index in a representative sample of Iranian people

&nbsp;&nbsp; BACKGROUND: Hirsutism is the condition of excessive terminal hair growth in women with a typical male pattern distribution. Hirsutism is a common disorder that affects about 5% -10% of women of reproductive age. Adipose tissue contributes up to 50% of the circulating testosterone in premenopausal women Because of excessive androgen production in fat tissue. Therefore, it seems that hirsutism must be more common in people with simple obesity but controversy exist regarding this subject. The aim of this study is to evaluate the relation between Body Mass Index and hirsutism in a representative sample of Iranian woman. &nbsp;&nbsp; METHODS: This is a cross sectional case control clinical trial. The study involved 800 individuals; 400 hirsute females and 400 healthy women as control group. The mean age of the participants was 28 &plusmn; 6.2 years.&nbsp; Hirsutism was determined by the Ferriman-Gallwey scoring system. Height and weight were measured by a Seca scale, Body Mass Index was calculated as weight/height&sup2; (kg/m&sup2;), and collected data were analyzed by SPSS software version 18 using T-test and chi-square statistical test. &nbsp;&nbsp; RESULTS: There were no significant differences between the two groups regarding age and height. However, Body Mass Index and weight were significantly higher in the case group than the control group. The chi square test revealed significant differences between the case and control groups regarding Body Mass Index (P &lt; 0.001). &nbsp;&nbsp; CONCLUSION: In the current study hirsutism was more common in patients with a higher Body Mass Index. The increased frequency of hirsutism in overweight women could be explained by increased insulin resistance and more androgen production by adipose tissue. &nbsp;&nbsp; &nbsp; &nbsp;&nbsp; Keywords: Body Mass Index, Hirsutism, Obesity.</p

Association between sleep duration and metabolic syndrome in a population-based study: Isfahan Healthy Heart Program

Background: Recent epidemiologic studies have found that self-reported sleep duration is associated with components of metabolic syndrome (MS) such as obesity, diabetes and hypertension. This relation may be under influence of regional factors in different regions of the world. The association of sleep duration and MS in a sample of Iranian people in the central region of Iran was investigated in this study. Methods: This cross-sectional study was conducted as a part of the Isfahan Healthy Heart Program (IHHP). A total of 12492 individuals aged over 19 years, 6110 men and 6382 women entered the study. Definition of National Cholesterol Education Program was used to define MS. Sleep duration was reported by participants. Relation between sleep duration with MS was examined using categorical logistic regression in two models; unadjusted and adjusted for age and sex. Results: In our study, 23.5 % of participants had MS. Compared with sleep duration of 7-8 hours per night; sleep duration of less than 5 hours was associated with a higher odds ratio for MS. This association remained significant even after adjustment for age and sex (OR: 1.52; 95%CI: 1.33-1.74). However, sleep duration of 9 hours or more showed a protective association with MS (OR: 0.79; 95%CI: 0.68-0.94). Conclusions: There was a positive relation between sleep deprivation and MS and its components. This relation was slightly affected by sex and age

Epicardial fat thickness and severity of coronary heart disease in patients with diabetes mellitus type II

BACKGROUND: Clinical imaging studies have demonstrated a strong direct correlation between epicardial fat and abdominal visceral adiposity. There are several studies about positive correlation of epicardial fat and atherosclerotic coronary disease in general population. This study aimed to evaluate the association of epicardial fat thickness with atherosclerotic coronary disease in patients with diabetes mellitus type II.METHODS: This cross-sectional observational study involved 80 patients with diabetes mellitus type II. The patients were chosen using simple sampling method from patients with diabetes mellitus who were referred for angiography because of suspected coronary artery disease. The severity of coronary atherosclerotic lesions was evaluated using modified Gensini scoring system. Epicardial fat thickness was measured by transthoracic echocardiography within 90 days after coronary angiography. Multiple linear regression method was used to evaluate the association between mean epicardial fat thickness and Gensini score.RESULTS: After adjustment for the effects of body mass index (BMI), age, angina, and sex, there was a significant association between Gensini score and epicardial fat thickness (β = 0.825; P &lt; 0.001). Patients with higher blood pressure and higher body mass index also had a higher Gensini score (P &lt; 0.010)CONCLUSION: In patients with diabetes mellitus type II, there is a positive association between epicardial fat thickness and severity of coronary artery disease. So, by echocardiography evaluation of epicardial fat thickness, we could have an estimation of the severity of coronary arteries diseases before using more invasive techniques.</p

Relation between usual daily walking time and metabolic syndrome

Background: There are several studies about the positive relation between physical inactivity or low cardio respiratory fitness with development of metabolic syndrome (MS). In contrast, physical activity had favourable effects on all components of MS but the quantity and the frequency of physical activity necessary to produce this beneficial effect has not been defined as yet. The aim of this survey was to study the association of regular physical activity, measured by patient′s estimation of walking time per day, with MS. Materials and Methods: This cross-sectional study was conducted as a part of Isfahan Healthy Heart Program (IHHP). Persons who had no component of MS were considered as reference group. Demographic data were collected by questionnaire. Relation between walking time and MS was evaluated by using logistic regression adjusted by age, sex, socioeconomic status (SES), life style and food item. Results: The study populations consisted of 4151 persons. Lower physical activity was associated with higher prevalence of MS (P < 0.001). There was a negative relation between the usual daily walking time and MS. Adjusted odds ratio for age groups, sex, SES, life style and food items (fat and oil, sweet and sweet drink, rice and bread, fried food) revealed that MS decreases with increasing walking time (P < 0.05) [OR = 0.70 (0.52-0.94)]. Conclusion: Total daily walking time is negatively associated with MS and increasing daily walking time is an effective way for preventing MS