Relationship between changes in heart rate variability indices and blood glucose control in Type 2 Diabetes Mellitus

Diabetes mellitus (DM) is one of the mostcommon health problems in the community.DM is associated with pathologicchanges in the cardiovascular system due to alterations inthe autonomic nervous system (ANS). Dysfunction of thecardiovascular ANS can lead to fatal arrhythmias and suddendeath. The aim of this study was to investigate the relationshipbetween changes in heart rate variability (HRV)indices and blood glucose control status in patients withtype 2 DM. Patients with type 2 DM who presented toour university Diabetes Clinic were eligible to be included.Fasting blood glucose (FBG), 2-hour postprandial bloodglucose test (2PPG), and hemoglobin A1C (HbA1C) weremeasured. According to the HbA1C the patients werecategorized as euglycemia (HbA1C <7%) and poorly controlledDM (HbA1C >7%). HRV indices were determinedby 24-hour Holter monitoring. There were 41 patientswith euglycemia and 39 patients whose blood glucosewas poorly controlled. pNN, SDANN, and SDNN indiceswere significantly higher in the euglycemia group thanin the group with poorly controlled glucose. There wassignificant and inverse correlation between pNN, SDANN,and SDNN with serum levels of HBA1C. However, no significantcorrelation was observed between FBS and 2PPGwith HRV indices. HRV indices were significantly lowerin diabetic patients with poorly controlled blood glucosewhen compared to diabetics with good control of bloodglucose. These findings reflect dysfunction of the ANS inpatents with poorly controlled blood glucose

Is 8860 variation a rare polymorphism or associated as a secondary effect in HCM disease?

Introduction: mtDNA defects, both deletions and point mutations, have been associated with hypertrophic cardiomyopathies. The aim of this study was to establish a spectrum for mtDNA mutations in Iranian hypertrophic cardiomyopathy (HCM) patients. Material and method: The control group was chosen among the special medical centre visitors who did not have hypertrophic cardiomyopathy or any related heart disease. Hypertrophic cardiomyopathy (HCM) is widely accepted as a pluricausal or multifactorial disease. Because of the linkage between energy metabolism in the mitochondria and cardiac muscle contraction, it is reasonable to assume that mitochondrial abnormalities may be responsible for some forms of HCM. Point mutations and deletions in the two hot spot regions of mtDNA were investigated by PCR and sequencing methods. Results: Some unreported point mutations have been found in this study but no deletion was detected. Meanwhile some of these point mutations have been investigated among HCM patients for the first time. Conclusions: A8860G transition was detected in a high proportion, raising the question whether this rare polymorphism is associated as a secondary effect in HCM disease. Copyright © 2011 Termedia & Banach

The role of social media literacy in infodemic management: a systematic review

BackgroundThe term infodemic refers to the proliferation of both accurate and inaccurate information that creates a challenge in identifying trustworthy and credible sources. Among the strategies employed to mitigate the impact of the infodemic, social media literacy has emerged as a significant and effective approach. This systematic review examines the role of social media literacy in the management of the infodemic.MethodsSix databases, including SID, Magiran, Scopus, PubMed, Google Scholar and Web of Science were systematically searched using relevant keywords. We included the relevant publications between 2012 and 2023 in our analysis. To ensure a qualitative assessment of the studies, we used the STROBE and AMSTAR checklists as evaluation tools. The Preferred Reporting Items for Systematic Reviews (PRISMA) guideline was used for the design of this review study. Finally, we organized the studies into groups based on similarities and retrieved and analyzed evidence pertaining to the challenges and opportunities identified.ResultsEleven papers were included in this study after reviewing the retrieved studies. Five of them examined the effect of social media literacy and health literacy on acceptance of health behaviors. Four studies investigated the role of media literacy in managing misinformation and fake news related to health. Two studies focused on infodemic management and promoting citizen engagement during health crises. Results showed that health-related infodemics are derived from the users' lack of media knowledge, distrust of government service systems, local influencers and peers, rapid circulation of information through mass media messages, weakness of solutions proposed by health care providers, failure to pay attention to the needs of the audience, vertical management, and inconsistency of published messages.ConclusionThe findings of this study highlight the importance of increasing social media literacy among the general public as a recognized strategy for managing the infodemic. Consequently, it is recommended that relevant organizations and institutions, such as the Ministry of Health, develop targeted training programs to effectively address this need

The effect of heparin after primary percutaneous coronary intervention on short-term clinical outcomes in patients with ST-segment elevation myocardial infarction

Background: Doing percutaneous coronary intervention (PCI) in the first hours of myocardial infraction (MI) is effective in re-establishment of blood flow. Anticoagulation treatment should be prescribed in patients undergoing PCI to decrease the side effects of ischemia. The aim of this study is to determine the effect of heparin prescription after PCI on short-term clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI). Materials: This randomized clinical trial study was conducted at Imam Ali cardiovascular center at Kermanshah university of medical science (KUMS), Iran. Between April 2019 to October 2019, 400 patients with STEMI which candidate to PCI were enrolled. Patients randomly divided in two groups: intervention group (received 5,000 units of heparin after PCI until first 24 hours, every 6 hours) and control group (did not receive heparin). Data were collected using a checklist developed based on the study's aims. Differences between groups were assessed using independent t-tests and chi-square (or Fisher exact tests).Result: Observed that, mean prothrombin time (PT) (13.30±1.60 vs. 12.21±1.15, p<0.001) and partial thromboplastin time (PTT) (35.30±3.08 vs. 34.41±3.01, p=0.003) were significantly higher in intervention group compared to control group. Thrombolysis in myocardial infarction (TIMI) flow grade 0/1 after primary PCI was significantly more frequently in control group (5.5% vs. 1.0%, p=0.034). The mean of ejection fraction (EF) after PCI (47.58±7.12 vs. 45.15±6.98, p<0.001) was significantly higher in intervention group. Intervention group had a statistically significant shorter length of hospital stay (4.71±1.03 vs. 6.12±1.10, p<0.001). There was higher incidence of re-vascularization (0% vs. 3.0%; p=0.013) and re-MI (0% vs. 2.5%; p=0.024) in the control group.Conclusion: Performing primary PCI with receiving heparin led to improve TIMI flow and consequently better EF. Receiving heparin is associated with lower risk of re-MI and re-vascularization

Prevalence and predictors of slow coronary flow phenomenon in Kermanshah province

Introduction: This study was conducted to investigate prevalence and predictors of slow coronary flow phenomenon (SCF) phenomenon. Methods: This cross-sectional study was performed at Imam Ali Cardiovascular Hospital affiliated with the Kermanshah University of Medical Sciences (KUMS), Kermanshah province, Iran. From March 2017 to March 2019, all the patients who underwent coronary angiography were enrolled in this study. Data were obtained using a checklist developed based on the study’s aims. Independent samples t tests and chi- square test (or Fisher exact test) were used to assess the differences between subgroups. Multiple logistic regression model was applied to evaluate independent predictors of SCF phenomenon. Results: In this study, 172 (1.43%) patients with SCF phenomenon were identified. Patients with SCF were more likely to be obese (27.58±3.28 vs. 24.12±3.26, P&lt;0.001), hyperlipidemic (44.2 vs. 31.7, P&lt;0.001), hypertensive (53.5 vs. 39.1, P&lt;0.001), and smoker (37.2 vs. 27.2, P=0.006). Mean ejection fraction (EF) (51.91±6.33 vs. 55.15±9.64, P&lt;0.001) was significantly lower in the patients with SCF compared to the healthy controls with normal epicardial coronary arteries. Mean level of serum triglycerides (162.26±45.94 vs. 145.29±35.62, P&lt;0.001) was significantly higher in the patients with SCF. Left anterior descending artery was the most common involved coronary artery (n = 159, 92.4%), followed by left circumflex artery (n = 50, 29.1%) and right coronary artery (n = 47, 27.4%). Body mass index (BMI) (OR 1.78, 95% CI 1.04-2.15, P&lt;0.001) and hypertension (OR 1.59, CI 1.30-5.67, P=0.003) were independent predictors of SCF phenomenon. Conclusion: The prevalence of SCF in our study was not different from the most other previous reports. BMI and hypertension independently predicted the presence of SCF phenomenon

Relationship between changes in heart rate variability indices and blood glucose control in Type 2 Diabetes Mellitus

Diabetes mellitus (DM) is one of the mostcommon health problems in the community.DM is associated with pathologicchanges in the cardiovascular system due to alterations inthe autonomic nervous system (ANS). Dysfunction of thecardiovascular ANS can lead to fatal arrhythmias and suddendeath. The aim of this study was to investigate the relationshipbetween changes in heart rate variability (HRV)indices and blood glucose control status in patients withtype 2 DM. Patients with type 2 DM who presented toour university Diabetes Clinic were eligible to be included.Fasting blood glucose (FBG), 2-hour postprandial bloodglucose test (2PPG), and hemoglobin A1C (HbA1C) weremeasured. According to the HbA1C the patients werecategorized as euglycemia (HbA1C &lt;7%) and poorly controlledDM (HbA1C &gt;7%). HRV indices were determinedby 24-hour Holter monitoring. There were 41 patientswith euglycemia and 39 patients whose blood glucosewas poorly controlled. pNN, SDANN, and SDNN indiceswere significantly higher in the euglycemia group thanin the group with poorly controlled glucose. There wassignificant and inverse correlation between pNN, SDANN,and SDNN with serum levels of HBA1C. However, no significantcorrelation was observed between FBS and 2PPGwith HRV indices. HRV indices were significantly lowerin diabetic patients with poorly controlled blood glucosewhen compared to diabetics with good control of bloodglucose. These findings reflect dysfunction of the ANS inpatents with poorly controlled blood glucose

Can ICAM and VCAM predict the severity of CAD instable angina?

&nbsp;BACKGROUND: Ischemic heart disease is the leading cause of mortality and morbidity in the world. Vascular inflammation is the noticeable risk factor of ischemic heart disease. In this study, the relation between the intracellular adhesion molecule (ICAM) and vascular adhesion molecule (VCAM) were evaluated as the inflammation indicators of the coronary involvement extent.METHODS: In this cross-sectional study, 82 patients with stable angina were studied. Patients were all candidates for angiography. Individuals with acute coronary syndrome, recent surgery, inflammatory disease, drug consumption, kidney and liver disease, phlebitis and pulmonary thromboembolism (PTE) were excluded. Blood sampling was performed for biochemical analysis of VCAM and ICAM. Coronary angiography was then conducted via standard method.RESULTS: Mean age of the patients was 58.4 &plusmn; 10.1 years and males constituted 72% of the studied population. Mean values of ICAM and VCAM were 183.9 &plusmn; 78 and 150.3 &plusmn; 136 ng/dl, respectively. There was not any correlation between VCAM and ICAM and the severity of coronary artery disease. In linear regression analysis, even with considering hypertension, hyperlipidemia, and diabetes as cofounders, there was not any relation between these factors and cardiovascular disease.CONCLUSION: According to our findings, inflammatory markers (VCAM and ICAM) did not add any further information about the extent of cardiovascular disease.Keywords: Intracellular Adhesion Molecule, Vascular Adhesion Molecule, Stable Angina, Severity of Cardiovascular Disease&nbsp;</p

Daily, Monthly, and Seasonal Pattern of ST-Segment Elevation Myocardial Infarction (STEMI) Occurrence in Western Iran; a Cross-Sectional Study

Introduction: Acute myocardial infarction (AMI) is a leading cause of death and disability worldwide. Determining seasonal pattern of AMI may contribute to disease prevention and better treatment.&nbsp;Objective: The present study was conducted to investigate daily, monthly, and seasonal pattern for symptoms҆ onset in the patients with ST-segment elevation myocardial infarction (STEMI), and also other possible associated factors.&nbsp;Methods: This cross-sectional study was conducted on 777 patients diagnosed with STEMI admitted at the Imam Ali Cardiovascular Hospital affiliated with Kermanshah University of Medical Sciences (KUMS), Kermanshah province, Iran from March 2018 to February 2019. Data were collected using a checklist developed based on the study's objectives. Differences between subgroups were assessed using one-way analysis of variance (ANOVA) followed by Tukeys҆ post‐hoc test and Chi-Square test (or Fishers҆ exact test).&nbsp;Results: Out of 777 patients, 616 (79.3%) of them were male. Mean age of the patients was (mean±SD) equal to 60.93±12.86 years old. Occurrence of STEMI was most common in winter (38.4%), followed by autumn (27.8%), spring (22.9%), and summer (10.9%), respectively. Monthly occurrence of AMI was at the highest level in January (10.8%) and December (9.9%), and it was at the lowest level in July (4.9 %). Most patients were admitted on Fridays (15.8%) and Wednesdays (15.6%). Hypercholesterolemia, prior congestive heart failure (CHF), prior MI, prior stroke, prior atrial fibrillation (AF), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides, total cholesterol, creatine phosphokinase (CPK), and creatine kinase myocardial band (CK-MB) were significantly associated with seasonal pattern of STEMI (p-value&lt;0.05).&nbsp;Conclusions: Results of the present study on Iranian patients with STEMI revealed that AMI occurred more frequently on Wednesdays and Fridays and during winter from December to January compared to the other days of the week, months, and seasons