Can opium abuse be a risk factor for carotid stenosis in patients who are candidates for coronary artery bypass grafting?

Background: Over the centuries, opium has been the most frequent substance abused in the Middle East. There are many controversial aspects about the effects of opioids on the atherosclerosis process, which is still unclear. Methods: All patients who were candidates for coronary artery bypass graft in Tehran Heart Center were registered and evaluated for risk factors such as diabetes mellitus, hypertension, smoking status and duration, opium abuse, involved coronary arteries and left main branch lesion > 50%, carotid stenosis &#8805; 70%. Results: A total of 1,339 patients were enrolled in the study, of whom 400 (29.9%) were female and the other 939 (70.1%) male. Female patients were omitted from analysis due to the low numbers of female opium addicts. Our study revealed that in the addicted population, the risk of diabetes and hypertension was lower than in the non-addicted group (p < 0.05 for each variable) and fasting blood sugar tended to be less in addicted ones, but the number of involved coronary arteries, left main stenosis > 50% and extent of carotid stenosis was not significantly different between the two groups. Conclusions: Our investigations demonstrate that opium is not cardioprotective, as has been claimed by some previous studies, and does not even decelerate atherosclerosis of carotid arteries in opium-addicted patients, but more evidence is still needed to completely prove the case. (Cardiol J 2010; 17, 3: 254-258

Evaluation of Therapeutic Properties of Sidr (Zizhyphus Spina-Christ) in the Teachings of Islamic, Persian Medicine and its Conformity with the New Findings of Medical Sciences

زمینه و هدف: سدر گیاهی از خانواده عنابیان است كه چندین جنس دارد و در نقاط مختلف ایران و کشورهای خاورمیانه می‌روید. در متون پزشكی و دارویی كهن و نیز از نگاه دانشمندان ایران و اسلام سدر از جایگاه ویژه‌ای برخوردار بوده است. در روایات و احادیث و همچنین قرآن کریم به گیاه سدر و خواص درمانی آن اشاره شده است. در علم داروسازی، این گیاه و تركیبات موجود در اسانس آن شناسایی و مورد استفاده قرار گرفته‌اند، در حال حاضر فرآورده‌های مختلفی از سدر به اشكال افشره و شامپو در بازار وجود دارد. این مطالعه با هدف بررسی خواص دارویی و زیستی اثبات‌شده این گیاه صورت گرفت. مواد و روش‌ها: در این مطالعه مروری، علاوه بر قرآن كریم، احادیث و كتاب‌های طب سنتی ایران، از پایگاه‌های اطلاعاتی قابل دسترس مانند Ovid، ISI، Magiran، IranMedex، Scopus، ISC، PubMed و Google Scholar استفاده شده است. یافته‌ها: قسمت‌های مختلف سدر مانند پوست، عصاره و میوه حاوی ترکیبات دارویی مؤثر همانند آنتی‌اکسیدان‌ها و ترکیبات ضد میکروبی می‌باشند که اثر قابل توجهی در مقابله با انواع سرطان‌ها و بیماری‌های عفونی دارند. نتیجه‌گیری: یافته‌های علمی جدید همسو با روایات اسلامی و طب سنتی خواص درمانی سدر را اثبات می‌کنند که مارا به تفکر هرچه بیشتر در آیات و روایات اسلامی وامی‌دارد. پیشنهاد می‌شود كه با انجام مطالعات بالینی بیشتر خواص سدر در مقالات علمی تأیید گردد.Background and Aim:&nbsp;Sidr belongs to the Rhamnaceae family that contains many genera and it grows in various parts of Iran and Middle East countries. In ancient medical and pharmaceutical texts and in the view of Iranian and Islamic scholars, Sidr has a special place. The traditions and hadiths as well as the Holy Quran refer to the Sidr plant and its therapeutic properties. In the field of pharmacy, the compounds present in this plant and its essential oils have been identified and used. Currently there are various products of Sidr in the form of spray and shampoo at the market. Materials and Methods:&nbsp;In this review study aimed at investigating the therapeutic and biological properties of this plant, in addition to the Holy Quran, hadiths and traditional medicine books, databases such as Ovid, ISI, Magiran, IranMedex, Scopus, ISC, PubMed and Google Scholar were also reviewed. Findings:&nbsp;Different parts of Sidr as skin, extract and fruit contain effective pharmaceutical compounds such as antioxidants and antimicrobial compounds that have a significant effect in preventing various cancers and infectious diseases. Conclusion:&nbsp;New scientific findings, in line with Quranic references and traditional medicine, prove the therapeutic effects of Sidr, which makes us think more and more about Islamic notifications and traditional medicine. It is recommended that further clinical studies confirm the therapeutic effects of Sidr in scientific papers. &nbsp; Please cite this article as:&nbsp;Khorsandi LS, Rahbar N, Shirani M. Evaluation of Therapeutic Properties of Sidr (Zizhyphus Spina-Christ) in the Teachings of Islamic, Persian Medicine and its Conformity with the New Findings of Medical Sciences.&nbsp;Med Hist J&nbsp;2019; 11(40): 79-87

Effect of Topical Application of the Cream Containing Magnesium 2% on Treatment of Diaper Dermatitis and Diaper Rash in Children A Clinical Trial Study

Introduction: Diaper dermatitis is referred to the inflammation in outer layers of the skin in the perineal area, lower abdomen, and inner thighs. The lesions are maculopapular and usually itchy, which could cause bacterial or candida infection, and predispose the infants to penis or vaginal and urinary infection and lead to discomfort, irritability, and restlessness. The drugs which have been so far administered for this disease (topical steroids) cause special complications for the sensitive skin in this area. Magnesium (Mg) is known for its anti-inflammatory and wound-healing properties. Aim: The aim of the present study was to study the effect of the cream containing Mg 2% on treatment of diaper dermatitis and diaper rash in children. Materials and Methods: In this clinical trial study, 64 children aged less than two years old with diaper dermatitis referring Paediatric Ward of Hajar Hospital were randomly assigned to two groups of 32. Group one was treated with the combined cream Mg 2% and Calendula and group two with Calendula cream alone. The duration of recovery was compared between the two groups. Results: The duration of recovery was significantly lower in the intervention group than the control group (p-value<0.001), but there was no significant difference in the lesions size and diapers' number between the two groups. Conclusion: Based on the finding of this study, Mg is effective on treatment of diaper dermatitis and could be used for treating diaper dermatitis and other types of dermatitis

Affecting Factors on the Quality of Resident Education in Emergency Department; a Cross-Sectional Study

مقدمه: با توجه به تفاوت در زیرساخت های سیستم بهداشت و درمان کشورمان با کشور های پیشرفته، نیاز است که آموزش دستیاری طب اورژانس به گونه ای جهت دهی گردد که ضمن پاسخ دهی به نیازهای درمانی جامعه، اهداف آموزشی مشخص شده برای دستیاران این رشته را نیز با راهنمایی و کمک اعضای هیئت علمی پوشش دهد. شاید اولین قدم در این راه بررسی وضعیت موجود و نظرسنجی از دستیاران و اعضای هیئت علمی فعال در رشته تخصصی طب اورژانس باشد. بنابراین، مطالعه حاضر با هدف بررسی عوامل موثر بر کیفیت آموزش دستیاری در بخش اورژانس طراحی و اجرا گردید. روش کار: ابتدا گروهی متشکل از ۵ عضو هیئت علمی باتجربه نظرات خود را در مورد عوامل مؤثر بر آموزش دستیاری در قالب مصاحبه بیان کردند که منتج به طراحی پرسشنامه ای با 27 سرفصل گردید که در نهایت و بعد از بررسی روایی و پایایی، پرسشنامه ای شامل ۲۳ آیتم تهیه شد. این آیتم ها در سه گروه عوامل فردی، عوامل محیطی و عوامل مربوط به بیماران طبقه بندی شدند. نمونه گیری به روش سرشماری انجام شد و کلیه دستیاران و اعضای هیئت علمی گروه طب اورژانس دانشگاه علوم پزشکی تهران که در محدوده زمانی اجرای این مطالعه در این رشته تخصصی فعالیت داشتند قابلیت ورود به مطالعه را داشتند. نظر سنجی کمی با استفاده از مقیاس لیکرت 5 امتیازی انجام شد. سپس داده ها مورد تحلیل آماری قرار گرفت تا میزان توافق در هر مورد در گروه دستیاران و اعضای هیئت علمی بررسی شود. یافته ها: در مجموع ۵۷ دستیار با میانگین سنی 12/6 ± ۷۵/۳۲ سال و ۲۳ عضو هیئت علمی با میانگین سنی 54/5 ± ۶۵/۳۹ سال در مطالعه شرکت کرده و پرسشنامه ها را تکمیل نمودند. میانگین امتیاز سه دسته از عوامل مورد بررسی شامل عوامل فردی، محیطی و مربوط به بیمار از نظر کلیه شرکت کنندگان به ترتیب برابر با 12/0 ± 17/1، 15/0 ± 09/1 و 22/0 ± 52/1 بود. میانگین این امتیازات به تفکیک سه دسته از عوامل مورد بررسی بین دستیاران و اعضای هیئت علمی رشته طب اورژانس شرکت کننده در مطالعه تفاوت معنی داری نداشت (05/0 &lt; p). از نظر اعضا هیئت علمی کم کردن تعداد شیفت ها باعث بهبود کیفیت آموزش دستیاری نمی شود. ولی ایشان معتقد بودند که شیفت های ۱۲ ساعته، راندهای بالینی در بخش اورژانس و آموزش دستیاران به یکدیگر در بهبود کیفیت آموزش موثر است که اختلاف نظر دستیاران با اعضای هیئت علمی در این موارد معنی دار بود (05/0 &gt; p). نتیجه گیری: اعضای هیئت علمی و دستیاران طب اورژانس نظر یکسانی درباره ساعات کاری و تعداد شیفت های بالینی و تاثیر  آن بر آموزش دستیاری ندارند. اعضای هیئت علمی طب اورژانس معتقد بودند شیفت های ۱۲ ساعته در مقایسه با شیفت های ۸ ساعته امکان آموزش بیشتری را فراهم می کنند و کاهش تعداد شیفت های بالینی کیفیت آموزش را خواهد کاست.Introduction: Considering the differences between the infrastructures of healthcare systems in Iran and advanced countries, there is a need for directing the education of emergency medicine residents in a way that not only meets the treatment needs of the society, but can also cover the determined educational goals for the residents of this specialty with the guidance and help of the faculty members. The first steps might be evaluating the present status and surveying the residents and faculty members who are active in emergency medicine specialty. Therefore, the present study was designed and performed with the aim of evaluating the factors affecting the quality of resident education in emergency department (ED). Methods: Initially, a group that consisted of 5 experienced faculty members expressed their opinions on the factors affecting the quality of resident education in an interview, which resulted in the design of a questionnaire with 27 topics that led to preparation of a 23-item questionnaire after validity and reliability evaluation. These items were classified in 3 groups of personal factors, environmental factors, and patient-related factors. Consecutive sampling was done and all the residents and faculty members of emergency medicine in Tehran University of Medical Sciences who were active in this specialty during the study period were eligible to participate in the study. A quantitative survey was done using 5-point Likert scale. Then the data were statistically analyzed to evaluate the agreement rate of the residents and faculty members in each item. Results: In total, 57 residents with the mean age of 32.75 ± 6.12 years and 23 faculty members with the mean age of 39.65 ± 5.54 years participated in the study and filled out the questionnaires. Mean scores of the 3 categories of evaluated factors, namely personal, environmental, and patient-related factors from the viewpoint of all participants were 1.17 ± 0.12, 1.09 ± 0.15, and 1.52 ± 0.22, respectively. The mean scores calculated for the 3 studied categories were not significantly different between the residents and faculty members of emergency medicine who participated in the study (p &gt; 0.05). In the opinion of faculty members, decreasing the number of shifts does not lead to improvement in the quality of resident’s training. However, they believed that 12-hour shifts, clinical rounds in ED and the residents teaching to each other are effective in improvement of the quality of their education and the opinion of residents and faculty members were significantly different in these cases (p &lt; 0.05). Conclusion: Faculty members and residents of emergency medicine do not share the same opinion on working hours, and the number of clinical shifts and their effect on resident training. The faculty members believed that 12-hour shifts provide more opportunities for education compared to 8-hour shifts and reducing the number of clinical shifts would decrease the quality of education.

Etiology and outcome of burns in Hamadan, Iran: A registry-based study

Background: Burn prevention strategies are most effective when they are based on knowledge of etiological patterns of burn injuries and considering the geographical variations and socioeconomic differences in burn epidemiology. In this regard, this study aimed to investigate the etiology and outcome of burns in Hamadan, Iran. Materials and Methods: This registry-based, cross-sectional study was conducted on 798 burn patients admitted to the Besat Hospital from March 2013 to February 2018. The medical records of all the patients were extracted from hospital information system. Results: In males, the most common cause of burn was gas explosion (41.4), whereas in females, the most common cause was hot liquids (37.1). In below 5 years and 6-15 years age group, burning with hot liquids was the common cause of burn, whereas in other age groups, gas explosion was the common cause of burn. In the present study, 6.9 of the patients died because of their burns. With increasing age, the odds of death increases, so that patients between 30 and 59 years had 2.2 fold (P = 0.02) and patients 60 years had 3.5 fold (P = 0.006) higher odds of death compared to patients aged Conclusion: Findings of the present study show that males and people aged 26-40 years and children 0-5 years were at a greater risk of burns. Furthermore, this study shows that self-immolation with a high rate of case fatality should be considered as a mental health challenge, and it is necessary to design preventive strategies to reduce it

Study of three common ApoB gene mutations in possible familial hypercholesterolemia patients in Cheharmahal va Bakhtiari province, Iran, 2003

Background and aim: Familial hypercholesterolemia (FH) is an autosomal dominant disorder caused mainly by mutations in the low-density lipoprotein receptor (LDLR) and apolipoprotein B (ApoB).Until now, the molecular basis of FH has been demonstrated in detail in many populations , but there is still very limited molecular data concerning FH in Iran . The aim of this study was to investigate frequency of 3 common Apo-B100 gene mutations in an Iranian population. Method: In this descriptive –lab based study a total of 30 non-related possible FH subjects from Cheharmahal va Bakhtiari were studies. All samples were tested for 3 common Apo-B100 gene mutations including R3500Q, R3500W and R3531C using PCR-RFLP procedure. Result: None of the common Apo-B100 mutations R3500Q, R3500W and R3531C were detected in samples examined using PCR-RFLP. Conclusion: Our data indicated that Apo-B100 gene mutations have not contribution to FH in samples studied here. However, we examined 3 common Apo-B100 mutations in only 30 patients, and to determine the role of mutations of this gene in developing FH in Cheharmahal va Bakhtiari province, more FH samples/populations needed to be investigated

Comparing the effect of cardiac biomarkers on the outcome of normotensive patients with acute pulmonary embolism

Acute pulmonary embolism (PE) is a cardiovascular challenge with potentially fatal consequences. This study was designed to observe the association of novel cardiac biomarkers with outcome in this setting. In this prospective study, from 86 patients with a confirmed diagnosis of PE, 59 patients met the inclusion criteria (22 men, 37 women; mean age, 63.36±15.04 y).The plasma concentrations of N-terminal pro-brain natriuretic peptide (NT-proBNP), growth differentiation factor-15 (GDF-15), heart-type fatty acid-binding protein (H-FABP), tenascin-C, and D-dimer were measured at the time of confirmed diagnosis. The endpoints of the study were defined as the short-term adverse outcome and long-term all-cause mortality. Totally, 11.8% (7/59) of the patients had the short-term adverse outcome. The mean value of logNT-proBNP was 6.40±1.66 pg/ml. Among all the examined biomarkers, only the mean value of logNT-proBNP was significantly higher in the patients with the short-term adverse outcome (7.88±0.67 vs. 6.22± 1.66 pg/ml; OR, 2.359; 95% CI, 1.037 to 5.367; P=0.041). After adjustment, a threefold increase in the short-term adverse outcome was identified (OR, 3.239; 95% CI, 0.877 to 11.967; P=0.078).Overall, 18.64% (11/59) of the patients had expired by the long-term follow-up. Moreover, adjustment revealed an evidence regarding association between increased logNT-proBNP levels and long-term mortality (HR, 2.163; 95%CI, 0.910 to 5.142; P=0.081). Our study could find evidences on association between increased level of NT-proBNP and short-term adverse outcome and/or long-term mortality in PE. This biomarker may be capable of improving prediction of outcome and clinical care in non-high-risk PE

Effects of quercetin on bisphenol A-induced mitochondrial toxicity in rat liver

Objective(s): Recognized as a distinguished environmental and global toxicant, Bisphenol A (BPA) affects the liver, which is a vital body organ, by the induction of oxidative stress. The present study was designed to investigate the protective effect of quercetin against BPA in hepatotoxicity in Wistar rats and also, the activity of mitochondrial enzymes were evaluated. Materials and Methods: To this end, 32 male Wistar rats were divided into four groups (six rats per group), including control, BPA (250 mg/kg), BPA + quercetin (75 mg/kg), and quercetin (75 mg/kg).Results: The BPA-induced alterations were restored in concentrations of alanine aminotransferase (ALT), alkaline phosphatase (ALP), lactate dehydrogenase (LDH), and aspartate aminotransferase (AST) due to the quercetin treatment (75 mg/kg) (all

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

Repositioning of the global epicentre of non-optimal cholesterol

High blood cholesterol is typically considered a feature of wealthy western countries(1,2). However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world(3) and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health(4,5). However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol-which is a marker of cardiovascular riskchanged from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million-4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.Peer reviewe