Study of age at first myocardial infarction in patients in Iran: A national study

Background and Objectives: Determining and monitoring the age at myocardial infarction (MI) and its comparison in various regions is one of the vital and basic principles for the management of MI. This study was conducted to determine the age at the first MI in Iran. Methods: In this cross-sectional, analytical study at a national level, the data of 20750 new MI patients registered in 2012 in 31 provinces of Iran according to the cardiologist’s diagnosis, World Health Organization criteria, and the codes ICD10: 121-122 were used. The calculations were done using the Stata 12 software. Results: The mean±SD of age at the first MI was 61.2±13.4 years in all patients in Iran. Moreover, 15033 (72.4%) patients were male with a mean age of 59.6±13.3 years. The mean age at MI in men was lower than women (65.4±12.6 years), showing a statistical significance (P<0.001).The mean age at MI was different among Iran provinces, with a statistical significance (P<0.001). The lowest mean age at the first MI was seen in the patients living in Semnan (59.1±12.9 years), followed by Tehran (60.4±13.5 years), Sistan va Balouchestan (60.3±13.9 years), and Lorestan (60.1±14.5 years), with a significant difference from the mean age of the patients in Ardabil (63.2±15.1 years) and Zanjan (64.4±112.8 years) (P<0.019). Conclusion: Our study demonstrated that the age at MI was approximately five years younger in men than women. This studyprovided the ground for monitoring the age at MI, and more effective management of cardiovascular diseases in Iran

Survey of quality of life of patients with breast cancer among women at Shahid Beheshti University of Medical science and Health service 2017

Background and Aims: Breast cancer is the most common type of cancer diseases among women. The survival rate of breast cancer patients is long and, as a result, patients are greatly affected by cancer, its complications and consequences.Materials and Methods: The research design was descriptive – cross sectional. About 150 patients (women) with breast cancer were candidate for chemotherapy referred to the ward of Oncology in Shohada Tajrish and Taleghani Hospitals, both under the auspicious of Shahid Beheshti University of Medical science, 2017. The standard Quality of life Questionnaire (EROTC QLQ_C30) and its breastcancer supplementary measure (QLQ-BR 23) Questionnaire developed by the European Organization for Research and treatment of cancer were respectively used to measure the quality of life and for demography, within one stage. Finally, the data was analyzed using SPSS16 statistical software through ANOVA and Pearson tests. All ethical issues were considered throughout the study.Results: The average age of women whom surveyed was 47.81±8.21, which 74.7 percent of them were married. The average score of the global health status of respondents undergone the survey was 538818.20±. Among the functional scores, the highest score was related to cognitive indexes 68.77± 30.30. Economic difficulties showed the highest score of 69.11 27.33± among symptom scales. Physical,emotional and cognitive functioning, and also the disease symptoms such as fatigue, nausea and vomiting, pain, dyspnoea, insomnia, constipation and economic difficulties were among the variables demonstrating significance relationship with quality of life in Univariate Analysis.Conclusion: The results of this study show the inappropriate conditions regarding the quality of life in some general and specific symptom scales of the patients under the survey. Therefore, the importance of paying more attention to this matter and designing of suitable actions for enhancing the quality of theirlife is expected. Keyword: Breast cancer, Quality of life, Wome

Geographical pattern of in-hospital mortality due to myocardial infarction in Iran

Background and purpose: So far, no spatial analysis of in-hospital mortality due to myocardial infarction (MI) has been conducted in Iran. The present study was performed to determine the geographical pattern of mortality due to myocardial infarction in Iran. Materials and methods: In a prospective hospital-based study, we used the data of cases with MI registered by Myocardial Infarction Registry of Iran, 2012. For spatial analysis, LISA, Global Moran’s I, and Getis-Ord’s statistics were used. Data was analyzed using Stata software and ArcGIS 9.3 Results: A total of 20,750 patients was admitted to hospital due to MI and 2511 (12.1%) deaths occurred (median age at death: 65.2 ± 15.2). The incidence of death from MI did not follow a particular pattern (Moran's Index: 0.141, P-value = 0.126). The highest standardized incidence rates of in-hospital mortality from MI in 100,000 population were observed in Ardebil (31), North Khorasan (23.7), Yazd (20.2), West Azerbaijan (19.1) and Khuzestan (18.4). The lowest incidence rates were found in Sistan-Baluchestan and Khorasan provinces. Conclusion: This study supports the hypothesis of random pattern of mortality due to myocardial infarction in Iran

Heart Failure, the Outcomes, Predictive and Related Factors in Iran

Background and purpose: Heart failure (HF) is a serious issue concerning public health in all countries. Assessment and monitoring of mortality and influencing factors are of great importance in HF treatment programs. This study was conducted to determine the incidence of HF and the associated factors in Iran. Materials and methods: In this study, we did two main, independent analyses. One was a cohort analysis and the other a nested case-control. The study population included 1691 patients with HF (case group) and 6464 individuals without HF (control group). They were recruited from a hospital-based cohort in cardiology wards of hospitals across Iran in 2012. Results: The incidence rate and the 95 confidence interval of HF was 8.1: 95CI: 7.7-8.5 in study population (per 100 person-year). HF Incidence was higher in women than that of the men (95 8.6: 7.9-9.4 and 95 CI: 7.9: 7.5-8.3, respectively). The highest incidence of HF was observed in Khouzestan and Guilan provinces (9.05 and 7.51, per 100 person-year, respectively) while the lowest incidence was found in Zanjan and Kohgiluyeh and Boyer Ahmad (0.47 per 100 person-year). We found atrial fibrillation (AF), coronary artery bypass grafting, and ventricular tachycardia with highest contribution to mortality in patients with HF. Cerebral vascular attack, diabetes type II, hypertension, and the occurrence of disease in cold seasons were among the main determinants for HF incidence. Conclusion: This study showed different distribution of HF in different parts of Iran. The study suggests that identifying the risk factors predicting the incidence of HF could play a major role in developing efficient programs to reduce the rate of mortality due to HF. © 2014, Mazandaran University of Medical Sciences. All rights reserved

Epidemiological pattern of myocardial infarction and modelling risk factors relevant to in-hospital mortality: the first results from the Iranian Myocardial Infarction Registry

Background: Myocardial infarction (MI) care and treatment contribute greatly to the patients' fatality and mortality. Assessing and monitoring mortalities and the effective factors are necessary in MI care and treatment programs. No comprehensive and population-based study has yet been conducted in Iran to determine the epidemiological pattern of MI, and particularly in-hospital mortality rate and the effective factors. Aim: To determine the epidemiological pattern of MI based on person-, time-, place-, and mortality-associated risk factors. Methods: This was a prospective, population-based cohort study, which analysed the data of 20,750 MI patients in Iran in 2012. MI was diagnosed based on ICD-10: codes I21 and I22. The cohort of the patients was defined in terms of the date at diagnosis, hospitalisation, and the date at discharge (recovery or death due to MI). The in-hospital mortality rate was calculated by Cox regression. Univariate analysis and multiple logistic regression were used to determine the effective factors on the patients' mortality. The odds ratio (95% confidence interval CI]) was reported using Stata software. Results: The relative frequency of in-hospital mortality was 12.1%. The in-hospital mortality rate was higher in women than in men, and 6.74 (95% CI 6.4-7.0) per 100 person-years were at risk of death. The highest relative mortality (13.2%) was obtained in January (11 Dey to 11 Bahman in the Persian calendar) and the lowest (5.9%) in May (11 Ordibehest to 10 Khordad in the Persian calendar). Age of over 84 years, female gender, educational level, smoking, lack of thrombolytic therapy, type 2 diabetes, chest pain prior to arriving in hospital, right bundle branch block, ventricular tachycardia, percutaneous coronary intervention, lateral MIs, and ST segment elevation myocardial infarction (STEMI) were determinants of in-hospital mortality in the patients. The relative frequency of mortality was higher from STEMI (83.7% of deaths in registry) vs. non-STEMI (16.3% of deaths in registry). Conclusions: STEMI, lack of thrombolytic therapy, age of over 84 years, and ventricular tachycardia have the greatest effect on in-hospital mortality in MI patients. The results of this study are helpful in planning for monitoring and promotion of healthcare of the patients

The Survey of Malnutrition Prevalence in Patients With Parkinson Disease In Tehran, Iran

Background: Parkinson disease (PD) introduced as the second most prevalent neurodegenerative disease following Alzheimer disease. A patient’s nutritional status may be compromising in PD. This study aimed to describe the outpatient nutritional status in patients with PD at a third-level hospital in Iran.Methods: The validated Persian version of the Mini-Nutritional Assessment (MNA) questionnaire was used to evaluate the nutritional status of 158 Iranian PD patients (age, 35-85 years). The exclusion criteria were as follows: chronic comorbidities affecting the nutritional status (e.g., diabetes and hypertension); adherence to special diets; and cognitive disorders. Based on the MNA questionnaire, a total score below 17 represented malnutrition, while scores 17-24 indicated a risk of malnutrition.Results: Based on the findings, 26% of the participants had low weight, 67% of whom were over 65 years. According to the MNA questionnaire, 14.3% of the participants showed malnutrition and 26.2% were at risk of malnutrition.Conclusion: Based on our findings, PD can contribute to reduced nutritional status. More than one-fourth of the PD population was at risk of malnutrition, which highlights the need for more attention towards nutritional assessment. Nutritional assessment is essential for the development of nutritional interventions and early detection of PD patients who are at risk of malnutrition

Incidence of acute myocardial infarction in Islamic Republic of Iran: a study using national registry data in 2012

Population-based data on Myocardial infarction rates in the Islamic Republic of Iran have not been reported on a national or provincial scale. In a cross-sectional study, data were collected on 20 760 new cases Of myocardial infarction (ICD10 codes 121-22) admitted to hospitals and registered by the Iranian Myocardial Infarction Registry in 2012 The crude and age adjusted incidence for the 31 provinces and the whole country were directly calculated per 100 000 people using the WHO standard population. Overall males comprised 72.4% of cases and had a significantly lower Mean age at incidence than women 59.6 (SD 13.3) years versus 65.4 (SD 12.6) years]. The male:female incidence ratio was 2.63. The age-standardized Myocardial infarction incidence rate was 73.3 per 100 000 in country (95% Cl: 72.3%-74.3%) and varied Signifitantly from 24.5 to 152.5 per 100 000 across the I.ji provirites. The Study provides baseline data for monitoring and managing cardiovascular diseases in the country

Effect of the Health Belief Model based education on Hypertension Reduction among Elderly Women Affiliated with Shahid Beheshti University of Medical Sciences- 2018

زمینه و اهداف: پرفشاری خون مشکل بهداشتی در سراسر جهان می­باشد. در کشورهای با درآمد کم و متوسط حدود نیمی از افراد مبتلا از بیماری خود آگاه هستند، نیمی از آنان، درمان دریافت می­کنند و اکثر آن­ها فشارخون خود را کنترل نمی­کنند. آموزش بهداشت، به­ویژه استفاده از نظریه­ها و الگوها، مداخله­ای مهم جهت کنترل فشارخون می­باشند. مطالعه حاضر با هدف تعیین میزان تأثیر آموزش مبتنی بر الگوی اعتقاد بهداشتی بر کاهش پرفشاری خون در زنان سالمند تحت پوشش دانشگاه علوم پزشکی شهید بهشتی در سال 97-1396 انجام شد. مواد و روش­ها: مطالعه­ حاضر مطالعه­ای مداخله­ای از نوع قبل و بعد می­باشد که به روش نمونه­گیری در دسترس روی 39 نفر از زنان سالمند 79-60 ساله مبتلابه پرفشاری خون انجام شد. با توجه به تمامی موازین اخلاقی، مشخصات جمعیت شناختی در برگه ثبت یادداشت شد و فشارخون اندازه­گیری شد. مداخله آموزشی طی سه جلسه­ 45 دقیقه­ای انجام شد و فشارخون یک ماه پس از پایان مداخله اندازه­گیری شد. داده­ها با استفاده ازSPSS و به کمک آمار توصیفی و آزمون تی زوجی تجزیه ­و ­تحلیل شدند. یافته‌ها: میانگین فشارخون سیستولیک و دیاستولیک پیش از مداخله 13/7±145/3 و 5/8±93/4 میلی­متر جیوه بود که پس از آموزش به 13/2±142/5 و7±91/4 میلی­متر جیوه رسید که این اختلاف در فشارخون سیستولیک معنادار بود (0/046=p) اما در فشارخون دیاستولیک معنادار نبود. نتیجه‌گیری: آموزش مبتنی بر الگوی اعتقاد بهداشتی در کاهش فشارخون زنان سالمند مبتلا به پرفشاری خون مؤثر بوده است. پیشنهاد می­گردد از این مدل به‌منظور آموزش کنترل پرفشاری خون در زنان سالمند استفاده گردد.Background and Aims:&nbsp;Hypertension is a health problem worldwide. In low and middle income countries, about half of the people with hypertension are aware of their illness, half of whom receive treatment, and most of them do not control their blood pressure. Health education is an important intervention for controlling blood pressure. The aim of this study was to determine the effect of education based on health belief model on hypertension in elderly women affiliated with Shahid Beheshti University of Medical Sciences in 2018. Materials and Methods:&nbsp;The present study is an interventional study of before-after type that was conducted on 39 females aged 60-79 years old with hypertension which were selected with convenient sampling method. According to all ethical standards, demographic data sheets were filled and blood pressure was measured. Educational intervention was performed in 3 sessions of 45 minutes. Blood pressure was measured one month later at the end of the intervention. Data were analyzed by SPSS using descriptive statistics and paired t-test. Results:&nbsp;The mean systolic and diastolic blood pressure before intervention was 145.3 ± 13.7 and 93.4 ± 5.8 mm Hg, and after training was 142.5 ± 13.2 and 91.4 ± 7 mm Hg. This difference was statistically significant in systolic blood pressure (P=0.046), but it was not significant in diastolic blood pressure. Conclusion:&nbsp;Education based on health belief model is effective in reducing hypertension in elderly women with hypertension. It is suggested that this model be used to control blood pressure in elderly women

Association between intoxication with psychoactive substances and adverse effects occurrence in consumers

BackgroundThe prevalence of psychoactive substance use is increasing worldwide and identifying adverse effects of these types of drugs is necessary in intoxicated patients.ObjectiveWe aimed to investigate the association of psychoactive substance intoxication with their adverse effects on the functioning of the bodily organs.MethodsThis was a single-center study between March 2019 and April 2022 on intoxicated patients with psychoactive substances. Inclusion criteria were intoxication with alcohol, opioids, and stimulants, and having available results of laboratory biomarkers. Demographic and clinical data of patients at the time of admission as well as during hospitalization were reviewed, retrospectively. Data were analyzed using a generalized linear mixed model in R software and the Adjusted Odds Ratio (AOR) was estimated.ResultsA total of 800 hospitalized patients in the ICU (n = 400) and general ward (n = 400) were divided into two groups of intoxicated with alcohol (n = 200) and opioids or stimulants (n = 200). Liver (AOR = 0.15, p = 0.033; AOR = 0.13, p = 0.007) and kidney (AOR = 0.46, p = 0.004; AOR = 0.24, p = 0.021) dysfunction occurred less in the ICU and general ward, respectively, in opioids or stimulants intoxication compared to alcohol. Cardiovascular dysfunctions occurred more in opioids or stimulants intoxication compared to alcohol in both ICU (AOR = 10.32, p &lt; 0.0001) and general ward (AOR = 4.74, p &lt; 0.0001).ConclusionKidney dysfunctions had a greater effect on mortality compared to other dysfunctions. During the follow-up, the incidence of dysfunctions increased in those intoxicated with opioids or stimulants. Men experienced more liver and kidney dysfunctions as well as mortality, but psychoactive substance experience was a protective factor in cardiovascular dysfunctions and mortality

Assosition of diabetes and hypertension with the incidence of chronic kidney disease: Tehran Lipid and Glucose Study

زمینه و هدف: بیماری مزمن کلیوی اختلالی شایع است که با افزایش خطر بیماری های قلبی- عروقی، نارسایی کلیه و بروز عوارض دیگر همراه است. پیر شدن جمعیت و رشد شیوع جهانی دیابت و فشار خون بالا باعث افزایش شیوع بیماری مزمن کلیوی در سراسر جهان شده است. در این مطالعه ما به بررسی خطر دیابت، فشار خون بالا و برهمکنش آن ها بر بروز بیماری مزمن کلیوی پرداختیم. روش بررسی: این مطالعه یک مطالعه ثانویه بر داده های مطالعه قند و لیپید تهران است. در این مطالعه یک جمعیت 7342 نفری20 سال و بالاتر (8/46 مرد) مورد بررسی قرار گرفتند. ابتدا شرکت کنندگان به 4 گروه تقسیم شدند: گروه اول: شامل افراد بدون دیابت و بدون فشار خون بالا، گروه دوم: افراد دارای دیابت و بدون فشار خون بالا، گروه سوم: افراد بدون دیابت و دارای فشار خون بالا و گروه چهارم: افراد دارای هر دو عامل دیابت و فشار خون بالا بودند. سپس با استفاده از مدل رگرسیونی چند متغیره کاکس نسبت مخاطره هر گروه نسبت به گروه اول و با تعدیل متغیرهای سن، میزان پالایش گلومرولی، تحصیلات، وضعیت سیگار کشیدن، کلسترول سرم، تری گلیسیرید سرم، HDL سرم، نمایه توده بدنی و نمره گرایش محاسبه شد. یافته ها: در مردان گروه دوم، دیابت (بدون فشار خون بالا) با نسبت مخاطره (69/2-39/1)94/1 و در مردان گروه سوم فشار خون بالا (بدون دیابت) با نسبت مخاطره (96/1-27/1)58/1 هر دو عامل خطر بیماری مزمن کلیوی بودند. به همین ترتیب در زنان نیز نسبت مخاطره دیابت و فشار خون بالا به ترتیب (51/1-93/0)18/1 و (47/1-05/1)24/1 بود. همچنین در مردان و زنان دیابت با فشار خون بالا برهمکنش معنی داری در بروز بیماری مزمن کلیوی نداشتند. نتیجه گیری: یافته های این مطالعه نشان می دهد که فشار خون بالا بدون توجه به حضور یا عدم حضور دیابت در هر دو جنس یک عامل خطر مستقل در بروز بیماری مزمن کلیوی می باشد