Heat Shock Proteins 27 and 60 Serum Levels in Patients with Gastrointestinal Cancer and Acute Myocardial Infarction in Birjand, Iran

Introduction: Cancer and myocardial infarction are lethal diseases. Their prevalence is increasing worldwide. In both diseases, the level of oxidative stress rises because of tissue damage. The aim of this study was to evaluate the serum levels of heat shock protein 27 and heat shock protein 60 in patients with cancer and myocardial infarction, and then compare them with healthy individuals.Materials and Methods: After blood samples were collected from the participants, plasma and serum were separated from these samples for further examination. The serum levels of heat shock protein 27 and heat shock protein 60 were measured with related kits in 30 patients with cancer and 30 patients with acute myocardial infarction, followed by 30 healthy individuals. The collected data were then analyzed in the Statistical Package for the Social Sciences software (version 22).Results: The mean serum levels of heat shock protein 27 in cancer patients (25.21 ± 5.57 ng/mL) and in patients with myocardial infarction (45.23 ± 7.43) were significantly higher than those in healthy individuals (10.61 ± 3.11; P<.05). In addition, the mean serum levels of heat shock protein 60 in patients with cancer (19.23 ± 3.41 ng/mL) and patients with myocardial infarction (22.23 ± 2.25 ng/mL) were significantly higher than those in healthy individuals (8.38 ± 2.53; P<.05).Conclusion: An increase in the serum levels of heat shock proteins 27 and 60 was observed in patients with cancer and myocardial infarction. Therefore, we can suggest that these biomarkers should help surgeons or physicians to diagnose the diseases

Serum HDL cholesterol uptake capacity in subjects from the MASHAD cohort study: its value in determining the risk of cardiovascular endpoints

Background: The efficiency of high-density lipoprotein (HDL) to efflux cholesterol contributes to the reverse cholesterol transport (RCT) pathway as one of HDL’s proposed functions and depends on the ability of HDL to uptake cholesterol. We aimed to investigate cholesterol uptake capacity (CUC) by a newly developed assay in samples from the MASHAD (Mashhad Stroke and Heart Atherosclerotic Disorders) cohort study. Method: The study population comprised 153 individuals developed CVD diagnosed by a specialist cardiologist, over 6 years of follow-up, and 350 subjects without CVD. We used a modified CUC method to evaluate the functionality of HDL in serum samples. Result: The CUC assay was highly reproducible with values for inter- and intra-assay variation of 13.07 and 6.65, respectively. The mean serum CUC was significantly lower in the CVD group compared to control (p = 0.01). Although, there were no significant differences in serum HDL-C between the groups and there was no significantly association with risk of progressive CVD. Multivariate logistic regression analysis showed that there was a significantly negative association between CUC and risk of CVD after adjustment for confounding parameters (OR = 0.57, 95% CI = 0.38–0.87, p = 0.009). The CUC was also inversely and independently associated with the risk of CVD event using Cox proportional hazards models analysis (HR = 0.62; 95% CI = 0.41–0.94, p = 0.02). We determined the optimum cutoff value of 1.7 a.u for CUC in the population. Furthermore, the CUC value was important in determining the CVD risk stratification derived from data mining analysis. Conclusions: Reduced HDL functionality, as measured by CUC, appears to predict CVD in population sample from north-eastern Iran

Association of ANGPTL3 polymorphisms with high-density lipoprotein cholesterol uptake capacity in patients with cardiovascular disease

Introduction Previous studies have shown the importance of angiopoietin-like 3 (ANGPTL3) as a modulator of lipid profiles. Cholesterol uptake capacity (CUC) is one means for assessing high-density lipoprotein (HDL) functionality. This study for the first time has investigated the relationship between genetic ANGPTL3 polymorphism and CUC in patients with cardiovascular disease. Methods Five hundred three subjects comprising 350 healthy subjects and 153 individuals who developed a cardiovascular disease (CVD) event during follow-up were recruited as part of the Mashhad Stroke and Heart Atherosclerotic Disorder (MASHAD) cohort study. A modified CUC method was used to determine the CUC of serum samples. Applied amplification refractory mutation system PCR was performed for ANGPTL3 variants genotyping including: rs10789117, rs1748195, and rs11207997. Sanger sequencing was applied to confirm the genotypes. Results The results showed that there was a significant relationship between the rs1748195 genotypes and HDL concentration in the CVD group (p = 0.02). Moreover, individuals with a GG genotype of the rs1748195 were associated with a lower risk of CVD (OR = 0.49, 95% CI = 0.24–0.98, p = 0.04) compared with CC genotype in the CUC ≤ 1.7 a.u subgroup. Moreover, the CT genotype of rs11207997 was associated with a lower risk of CVD (OR = 0.74, 95% CI = 0.41–1.3, p = 0.01) compared with CC genotype in CUC > 1.7 a.u subgroup. Conclusion The results showed that the CT genotype of the rs11207997 variant was associated with a lower risk of incident CVD in patients with higher HDL functionality. As well, the rs1748195 gene variant may contribute to a reduced risk of CVD

The relationship between ultra processed food consumption and premature coronary artery disease: Iran premature coronary artery disease study (IPAD)

BackgroundUltra-processed foods (UPF) consumption may affect the risk of PCAD through affecting cardio metabolic risk factors. This study aimed to evaluate the association between UPFs consumption and premature coronary artery disease (PCAD).MethodsA case–control study was conducted on 2,354 Iranian adults (≥ 19 years). Dietary intake was assessed using a validated 110-item food frequency questionnaire (FFQ) and foods were classified based on the NOVA system, which groups all foods according to the nature, extent and purposes of the industrial processes they undergo. PCAD was defined as having an stenosis of at least single coronary artery equal and above 75% or left main coronary of equal or more than 50% in women less than 70 and men less than 60 years, determined by angiography. The odds of PCAD across the tertiles of UPFs consumption were assessed by binary logistic regression.ResultsAfter adjustment for potential confounders, participants in the top tertile of UPFs were twice as likely to have PCAD compared with those in the bottom tertile (OR: 2.52; 95% CI: 1.97–3.23). Moreover, those in the highest tertile of the UPFs consumption had more than two times higher risk for having severe PCAD than those in the first tertile (OR: 2.64; 95% CI: 2.16–3.22). In addition, there was a significant upward trend in PCAD risk and PCAD severity as tertiles increased (P-trend < 0.001 for all models).ConclusionHigher consumption of UPFs was related to increased risk of PCAD and higher chance of having severe PCAD in Iranian adults. Although, future cohort studies are needed to confirm the results of this study, these findings indicated the necessity of reducing UPFs intake

The need for reviewing log books in Birjand University of Medical Sciences clinical wards: Letter to Editor

Clinical education can be taken as a facilitating activity for learning in the clinical settings in which students gain experiences from patients’ bedside and apply their previously learned concepts through their interactions with their teachers and routine works. Clinical education provides an opportunity for students to transform their theoretical knowledge into diverse intellectual and psychomotor skills essential to patient care. The evaluation process of teaching and learning is one of the noticeable activities in educational institutions because the training of skilled and competent manpower, to a large extent, is dependent on this process. The use of modern educational techniques, increasing productivity, and ultimately enhancing the effectiveness of educational centers is the goal followed all over the world but, this is more emphasized in the field of medical sciences that are directly connected with maintaining and improving the health of people and society. This is why for more effectiveness of medical education applying new methods is necessitated. One of the evaluated and structured methods focusing on learning experiences in education is “logbook”. Logbook is a simple means for learners, a framework for organizing various educational activities and recording them. One of the unique characteristics of a logbook is that it requires students acquire a certain number of skills. This causes the students to do their tasks as planned and objectively too; and thanks to repetition and practice they would prevent probable errors. At present, a lot of clinical education aspects are different than in the past. Technology development, changes in the pattern of people’s lifestyle and higher exposure to environmental risk factors (Such as the development of chemical industry, natural or synthetic chemicals, biological agents including viruses and other microorganisms, behavioral factors including psychological stress and drug addiction) cause changes in the pattern of diseases in general and particularly in the domain of communicable and non-communicable diseases. Therefore, in accord with these changes, the graduates and scholars are expected to promote their skills and abilities. Since, identification and analysis of the effectiveness of educational needs are prerequisite for a successful educational system, revision and continuous reviewing of educational programs based on the possibilities, conditions, and new needs are inevitable. Thus, the results of a study on 233 medical students passing their clinical stage (externs or interns) in Birjand University of Medical Sciences in the academic year 2016-2017 showed that 24.5% of them knew high or very high helpful completion of their log books activities in attaining of clinical wards skills and 74.5% expressed the necessity of reviewing available log books in clinical wards. According to the obtained results the necessity of reviewing log books used in clinical wards of BUMS considering the latest clinical issues, diseases- including emerging and reemerging ones- and diagnostic -therapeutic methods in accordance with changes in diagnostic - therapeutic guidelines using the newest resources is critically felt. Furthermore, due to the pervasive use of electronic log books in recent years in medical universities across the country that are in line with developments and innovations in medical education, it is recommended that the log books at this university too, should be presented and evaluated electronically. Electronic log books with ongoing record of activities and clinical techniques based on educational objectives, in addition to learning consolidation, determine unavailable measures to achieve clinical objectives and, thus, cause regular monitoring and evaluation on the part of students

Effect of four weeks of pomegranate supplementation and exercise at home on cardiac electrical activity and lipid profile in overweight and obese postmenopausal women

Background and Aims: Athletic activities, along with the consumption of herbal supplements, can control excess weight and associated diseases. The present study aimed to investigate the effect of pomegranate supplementation and exercise at home on lipid profile and cardiac electrical activity in overweight and obese postmenopausal women. Materials and Methods: This applied research was conducted based on a single-blind quasi-experimental design. A total of 60 overweight and obese postmenopausal women with a body mass index greater than 25 (kilograms per square meter) and an age range of 65-45 years were selected and randomly assigned to four groups: supplement + exercise (n=15), exercise(n=13 ), supplement (n=14), and placebo (n=14 ). Participants took one 225 mg pomegranate capsule and a placebo daily for 28 days. Due to the Covid-19 pandemic, resistance exercises were performed at home. Shapiro-Wilk, ANOVA, Kruskal-Wallis, and Lune tests were used in this research. Statistical calculations were performed in SPSS software (version). Results: Based on the results, there was no significant difference in fasting blood sugar, weight, triglycerides, low-density lipoprotein (LDL-C), systolic and diastolic blood pressure, heart rate, fat percentage, cholesterol, high-density lipoprotein (HDL-C),  PR interval, QRS wave amplitude, and QT interval (P>0.05). Conclusion: It seems that a short period of four weeks of exercise at home with the consumption of pomegranate supplements did not significantly change the lipid profile and electrical activity of the heart. It is suggested that the same study with long-term training periods and different doses of pomegranate supplements should be repeated

The Effect of Using Cardiology Ward Logbook on Students Training in Birjand University of Medical Sciences

Introduction: Being competent in performing clinical skills is necessary in medical profession. Acquiring essential competencies requires for time, patience, and practice in an appropriate context. Logbook is an instructional notebook in which there is a list of skills students must learn. These skills have been organized according to the opinion of faculty members of each ward and the international objectives set by ministry. The educational process could be evaluated continuously by means of these logbooks. This study was performed to evaluate the effect of using log books on clinical skills learning in cardiology ward. Methods: This quasi-experimental study was performed on 60 clerkship and internship students of cardiology ward in 2007-2008. In the first phase, students entering cardiology ward were selected as the control group. They received the usual instructions on clinical skills of the ward. In the second phase, logbooks were distributed among the next group of students as the experiment group and necessary explanations were provided for them. Students were asked to fill the required parts in the logbook and confirm them by their teacher. The educational content for both groups was the same. At the end of the course, students of each group were evaluated by their teachers using checklists for every single competency. Scores achieved for each competency were added up separately. The Mean scores of competencies achieved by students of both groups were compared using t-test. Results: The mean scores of all competencies achieved by the experiment group were significantly higher compared to those of the control group (α<0.05). In addition to comparing mean scores, total scores of competencies of clerks and interns in both groups were summed up and ranked qualitatively. So, the control group was ranked as average and the experiment group as good. Conclusion: Identifying educational objectives and providing guidelines through logbook could be an effective model for directing students towards clinical goals and improving the quality of education

The Effect of a Blended Learning with the Simultaneous Presence of a Clinical Specialist and a Pharmacist on the Learning Rate of Medical Students in the Heart Department of Birjand University of Medical Sciences

Introduction: Considering the importance of diagnosing and prescribing the right medicine by physicians, it is important that due to the shortness of the training period, this is not possible. Clinical pharmacology is increasing the awareness of medical students in managing the use of drugs. Methods: In the year 2021, 34 interns and stagers entered the study at the Razi Specialized-Subspecialized Hospital of Birjand University of Medical Sciences. During the one-month cardiac course, the students visited the patients in the cardiac training clinic one day a week with the presence of a cardiologist and a clinical pharmacologist. There was a discussion about how to prescribe drugs, their side effects, and drug interactions. To evaluate the course, a test before and after the course was conducted to check their learning level. Data were analyzed using descriptive statistics and paired t-test. Results: Thirty-four students (22(65%) stagers, 12(34%) interns, 14(41%) women, 20(59%) men) were included in the study. The results showed that the scores of the students increased after the course (before the course 6±1 and after the course 11±2) and this increase was significant (p<0.001). Besides, the increase in the group of stagers (12±1) was significant (p<0.001), while it was not significant (p = 0.092) in the group of interns (8±1); that is to say, in the group of interns there is a difference in the score before and after the course was not observed, while this difference was significant in the group of stagers. Conclusion: Integrated educational methods with the presence of clinical expert and clinical pharmacist can play an effective role in improving drug therapy management among medical students and it is recommended to do this method in different groups

Cardiovascular Diseases, The Leading Cause of Death in South Khorasan Province: A two-decade study: Editorial Article

The changes in the causes of death in South Khorasan province, Iran, during 2002-2022 were examined in the present research. According to the data available in the “Mortality Data Registery” during these 20 years, cardiovascular diseases (CVD) was the most common cause of death, and its rate has increased from 20% in 2002 to about 37.8% in 2022. Even during the COVID pandemic, CVD was the first cause of death in the province. In 2022, the most common causes of death were CVD (37.8%), respiratory diseases (15.2%), cancers (14%), and accidents (9.2%). One of the most effective factors in preventing CVD is paying attention to"Life’s essential 8 Cardiovascular Health", i.e., having normal blood glucose, blood pressure, serum lipids, body mass index, sufficient physical activity, healthy diet, sufficient night sleep, and being a non-smoker. In addition to individuals’ attention to these factors, it is necessary for healthcare system decision-makers to have systematic and continuous planning to enhance people's awareness and attitude regarding these eight factors