Undiagnosed Depression among Hypertensive Individuals in Gaza: A Cross-sectional Survey from Palestine

BACKGROUND፡ The aim of this study was to estimate the prevalence and to determine the associated factors of undiagnosed depression amongst hypertensive patients (HTNP) at primary health care centers (PHCC) in Gaza.METHODS: A cross-sectional survey was conducted including 538 HTNP as a recruitment phase of a clustered randomized controlled trial. Data were collected through face-to-face structured interview, and depression status was assessed by Beck's Depression Inventory (BDI-II). Data were analyzed by STATA version 14 using standard complex survey analyses, accounted for unresponsiveness and clustering approach. Generalized linear regression analysis was performed to assess associations.RESULTS: The prevalence of undiagnosed clinical depression was 11.6% (95% confidence interval [CI]: 8.1, 16.3). Moreover, prevalence of 15.4% (95% CI: 10.8, 21.6) was found for mild depression symptoms. We found that non-adherence to antihypertensive medications (AHTNM) (β = 0.9, 95% CI: 0.17, 1.7), having more health-care system support (β = 2.8, 95% CI: 1.6, 3.9) and number of AHTNM (β = 1.5, 95% CI: 0.6, 2.5) remain significantly positively associated with BDI-II score. On the other hand, older age (β = -0.1, 95% CI: -0.2, -0.02), having better social support (β = -6.8, 95% CI: -8.9, -4.7) and having stronger patientdoctor relationship (β = -4.1, 95% CI: -6.9, -1.2) kept significantly negative association.CONCLUSION: The prevalence of undiagnosed depression was about one-quarter of all cases; half of them were moderate to severe. Routine screening of depression status should be a part of the care of HTNP in PHCC

An Analysis of Anger in Adolescent Girls Who Practice the Martial Arts

The effect of martial arts on adolescents' behavior, especially aggression, is controversial. The aim of this study was to assess and compare anger ratings among adolescent girl athletes of different martial arts. 291 female adolescents between the ages of 11 and 19 were assessed according to the Adolescent Anger Rating Scale designed by DM Burney. In the case group, the martial arts practiced were either judo (n = 70) or karate (n = 66), while the control group was composed of swimmers (n = 59) and nonathletes (n = 96). Total anger scores showed statistically significant differences between the groups (P = 0.001) decreasing from girls who practiced judo to nonathletes, karate, and swimmers. Instrumental and reactive anger subscales also showed significant differences between the groups, but this difference was not found for anger control. As a conclusion, the anger rate did not differ between judoka and nonathletes, but that both of these groups received higher scores in total anger than karateka and swimmers

The Effect of Path and Beginning Time of Ascending on Incidence of Acute Mountain Sickness around Mount Damavand in Iran (5671 m)

Background. This study was designed to evaluate the incidence of acute mountain sickness (AMS) occurring on different climbing routes on Mount Damavand and the effect of beginning time of ascent in Iranian trekkers. Methods. This study was a descriptive cohort investigation, performed in summer 2007. All trekkers who ascended Mount Damavand from northern, western, eastern, and southern paths and passed 4200 m altitude were included in the study. Two questionnaires were completed for each trekker (personal information and Lake Louise score questionnaire). Multiple logistic regression analysis was used to explore the independent predicting variables for AMS. Results. Overall incidence rate of AMS was 53.6%. This rate was the highest in south route (61.5%) (P < 0.001). There was no difference in the incidence of AMS on other paths. AMS history, AMS history on Damavand, the beginning time of climbing, sleeping at 4200 m altitude, and home altitude had significant effect on AMS incidence, but by multiple logistic regression analysis south route and AMS history on Mount Damavand had positive effect on incidence of AMS (P = 0.019 and P < 0.001). Conclusion. The path and the beginning time of ascent can affect incidence of AMS. The risk of occurrence of AMS was 1.9 times as large for trekkers who ascended from southern route

The association between serum lipids profile and HbA1c in type 2 diabetes mellitus in Tehran, Iran

Background and aims: Dyslipidemia is one of the major factors implicated in the development of the vascular complications of diabetes. In this study, it was evaluated the association between serum lipids profile and Hemoglobin A1c (HbA1c) in type 2 diabetes mellitus. Methods: In this cross-sectional study, the serum lipid profile and HbA1c was studied on 562 Iranian patients who were older than 30 years and had type 2 diabetes identified from the diabetes and metabolic diseases clinic of endocrinology and metabolism research institute. A Multiple Linear Regression analysis was also done with the HbA1c as outcome variable and serum lipids profile as predictor variables; adjusted for potential confounders (age, sex, diabetes duration and Body Mass Index (BMI)). Results: In 1966, 6.34 of the national total population was over 60 years compared to mean age of the participants that was 61.6±10.4 years, with a range of 32 to 89 years. The results confirmed that the Triglyceride (TG) (β: 0.11, 95 CI: 0.000-0.004, P=0.01) and cholesterol (β: 0.13, 95 CI: 0.000-0.009, P=0.04) were correlated with the HbA1c value but there were no significant association between HDL and LDL. Conclusion: This study demonstrated that in persons with type 2 Diabetes Mellitus (DM), HbA1c value is a good predictor of lipid profile. Therefore, lipid profiling for all persons with type 2 DM should be a routine test

The Effect of Home based Exercise on Treatment of Women with Poly Cystic Ovary Syndrome; a single-Blind Randomized Controlled Trial

Background: The most common reproductive endocrine disorder of reproductive age women is a Poly cystic ovary syndrome (PCOS) Metabolic syndrome has been more reported in patients with PCOS in comparison to general population. Few investigations have been performed to evaluate the independent effect of exercise on biochemical and clinical symptoms of patients with PCOS. The aim of the study was to find the effect of home base aerobic-strengthening exercises on anthropometric and hormonal variables of patients with PCOS.MaterialsandMethods:In this randomized controlled trial twenty women in the exercise group performed aerobic, strengthening exercises; the other 20 participants in the control group were advised to continue their previous physical activity pattern. Blood pressure, Waist to Hip ratio (WHR), BMI along with hormonal variables(including insulin related factors, sexual hormones and inflammatory factors) were assessed at baselineand after the 12 week intervention).Results:16patients in the exercise group and 14 patients in control group finished the study. TheWHR (p&lt;0.001) along with the blood level of insulin (p=0.016), FBS (p=0.044), Prolactine (p=0.022) and hsCRP (p=0.035) and HOMA index (p=0.009) were decreased significantly in the exercise group compared with the control group. No significant differences were found in lipid profile and sexual hormones between groups at the end of the study.Conclusion:We can conclude that 12 weeks combined aerobic-strengthening exercise program in women with poly cystic ovary syndrome can lead to a reduction of waist to hip ratio (WHR) and some cardiovascular risk factors (including insulin, FBS, HOMA index and HsCRP) along with an increase of prolactine level in these patients

The association between serum concentration of irisin, glucose-dependent insulinotropic polypeptide and body mass index among women with and without polycystic ovary syndrome

publishedVersio

Clinical Study The Effect of Path and Beginning Time of Ascending on Incidence of Acute Mountain Sickness around Mount Damavand in Iran (5671 m)

Background. This study was designed to evaluate the incidence of acute mountain sickness (AMS) occurring on different climbing routes on Mount Damavand and the effect of beginning time of ascent in Iranian trekkers. Methods. This study was a descriptive cohort investigation, performed in summer 2007. All trekkers who ascended Mount Damavand from northern, western, eastern, and southern paths and passed 4200 m altitude were included in the study. Two questionnaires were completed for each trekker (personal information and Lake Louise score questionnaire). Multiple logistic regression analysis was used to explore the independent predicting variables for AMS. Results. Overall incidence rate of AMS was 53.6%. This rate was the highest in south route (61.5%) (P &lt; 0.001). There was no difference in the incidence of AMS on other paths. AMS history, AMS history on Damavand, the beginning time of climbing, sleeping at 4200 m altitude, and home altitude had significant effect on AMS incidence, but by multiple logistic regression analysis south route and AMS history on Mount Damavand had positive effect on incidence of AMS (P = 0.019 and P &lt; 0.001). Conclusion. The path and the beginning time of ascent can affect incidence of AMS. The risk of occurrence of AMS was 1.9 times as large for trekkers who ascended from southern route

Estimating the Net Survival of Patients with Gastric Cancer in Iran in a Relative Survival Framework

Background: Iran is an Eastern Mediterranean region country with the highest rate of gastric cancer. The present study aimed to evaluate the 5-year net survival of patients with gastric cancer in Iran using a relative survival framework. Methods: In a cross-sectional study, using life-table estimation of relative survival, we reported 1- to 5-year relative survival regarding age, sex, disease stage, pathology, and adjuvant therapies via modeling excess mortality. All the analyses were done applying Stata 11.2 with a confidence level of 95%. Results: Data on 330 patients (aged 32–96 y), who were comprised of 228 (69.1%) men and 102 (30.1%) women with gastric cancer and were followed up for 10 years, were analyzed. Adenocarcinoma was the most common malignancy (281 [85.2%] patients), and 248 (75.1%) patients were at stage 3 or stage 4. The 1- and 5-year net survival rates after surgery were 67.96 (95% CI: 62.35–72.98) and 23.35 (95% CI: 17.94–29.28), respectively. Higher stages (P=0.001), older ages (P=0.007), and less use of adjuvant therapies (P<0.001) were independently associated with excess mortality. Conclusion: It is recommended to use the relative survival framework to analyze the survival of cancer patients as an alternative approach not only to eliminate biases due to competing risks and their dependencies but also to estimate the cure at the population level concerning the most important individual characteristics. Our findings showed that the survival rate of gastric cancer in Iran is lower than that in most developed countries in terms of net survival

Construction and validation of CAPSES scale as a composite indicator of SES for health research: an application to modeling social determinants of cardiovascular diseases

Background The main objective of this study was to construct and validate a composite socioeconomic status indicator containing material capital, human capital, and social capital (CAPSES scale) and also appropriate it for CVDs in a large population-based study. Methods This cross-sectional study, the Urban HEART-2 project, was conducted in Tehran, Iran, in 2011. A total of 34,116 households covering 118,542 individuals were assessed in this study. A 14-parts questionnaire was completed for all selected households. All the gathered data were based on the participants’ self-reports. Literacy, wealth index, expenditure, skill level, and Townsend index were used as SES indexes. CVDs, including Hypertension, Myocardial infarction, and stroke, were considered the main outcomes. A structural equation model (SEM) was used to construct a CAPSES scale and a composition index of SES. Criterion validity and Construct validity were used to assess this scale. Results A total of 91,830 subjects consisting of 33,884 (49%) men were included in this analysis. The mean age of the participants was 41.5 ± 11.37 years. Among the assessed participants, 5904(6.4%) reported hypertension, 1507(1.6%) myocardial infarction, and 407(0.4%) strokes. The overall weighted prevalence of self-reported cardiovascular events (hypertension, stroke, and MI) was 8.03% (95%CI: 7.8–8.2). Inverse associations were seen between the CAPSES scale and its domains with CVDs, adjusted for sex, age, BMI, smoking, and diabetes by a multiple logistic regression model. Conclusion The CAPSES scale was significantly associated with stroke and hypertension. Our findings showed that the CAPSES index could be useful for public health research