Estimating the prevalence and incidence of treated type 2 diabetes using prescription data as a proxy: A stepwise approach on Iranian data

Aims: Type 2 diabetes is a serious health challenge, and large-scale studies on its prevalence in Iran are lacking. In pharmacoepidemiology, case-finding can be done by reviewing the prescription databases for specific drug(s) prescribed for a disease. We aimed to determine the prevalence and incidence of type 2 diabetes in Fars province, Iran, using prescription data and a stepwise approach to ascertain the results. Methods: A dataset of 3,113 insured individuals aged ≥35 years were selected. Their Prescription Data Centre records were reviewed for all drugs frequently used in controlling type 2 diabetes available in the Iranian pharmacopeia. Then we used a stepwise method for case-finding. In step one, each individual with a positive drug history for type 2 diabetes was labeled as an individual with diabetes. The next two steps were implemented for ascertainment of step one estimations. Results: Prevalence of type 2 diabetes based on prescription, internist opinion, and phone call verification in 2015 and 2016 was 9.3% and 10.3%, 8.5% and 9.8%, and 7.2% and 8.7%, respectively. An incidence of 1.9% was determined for 2016. Conclusions: We obtained a realistic estimation of prevalence and incidence of treated type 2 diabetes, using prescription data which are large-scale, low cost, and real-time

Prevalence and factors associated with inter-arm systolic and diastolic blood pressure differences: results from the baseline Fasa Adult’s Cohort Study (FACS)

Abstract Background One of the modifiable risk factors for cardiovascular diseases is the inter-arm blood pressure difference (IAD), which can be easily measured. This study aimed to determine the prevalence and factors related to the Iranian population’s inter-arm differences in systolic and diastolic blood pressure. Method This cross-sectional study was conducted on the baseline data of participants who had Iranian nationality, were at least 1 year of residence in the area, aged within the age range of 35–70 years, and willed to participate from the Fasa Persian Adult Cohort Study (FACS). IAD for systolic and diastolic blood pressure was measured and categorized into two groups of difference < 10 and ≥ 10 mmHg. Logistic regression was used to model the association between independent variables and IAD. Results The prevalence of systolic and diastolic IAD ≥ 10 mmHg was 16.34% and 10.2%, respectively, among 10,124 participants. According to the multivariable logistic regression models, age (adjusted odds ratio (aOR): 1.019 [95% CI: 1.013, 1.025]), body mass index (BMI) (aOR: 1.112 [95% CI: 1.016, 1.229]), having type 2 diabetes (aOR Yes/No: 1.172 [95% CI: 1.015, 1.368]), having chronic headaches (aOR Yes/No: 1.182 [95% CI: 1.024, 1.365]), and pulse rate (aOR: 1.019 [95% CI: 1.014, 1.024]) significantly increased the odds of systolic IAD ≥ 10 mmHg. Additionally, high socio-economic status decreased the odds of systolic IAD ≥ 10 mmHg (aOR High/Low: 0.854 [95% CI: 0.744, 0.979]). For diastolic IAD, age (aOR: 1.112 [95% CI: 1.015, 1.210]) and pulse rate (aOR: 1.021 [95% CI: 1.015, 1.027]) significantly increased the odds of diastolic IAD ≥ 10 mmHg. Moreover, high socioeconomic status decreased the odds of diastolic IAD ≥ 10 mmHg (aOR High/Low: 0.820 [95% CI: 0.698, 0.963]). Conclusion The noticeable prevalence of systolic and diastolic IAD in general population exhibits health implications due to its’ association with the risk of cardiovascular events. Sociodemographic and medical history assessments have potentials to be incorporated in IAD risk stratification and preventing programs

Numerical Investigation of the Flow Field in Realistic Nasal Septal Perforation Geometry

The computational fluid dynamics (CFD) are used to evaluate the physiological function of the nose. We evaluated the aerodynamics of the nasal cavity in a patient with septal perforation (SP), pre- and postvirtual repair. Three-dimensional nasal models were reconstructed, and then a wide range of the pressure drops and flow rates were analyzed. The airflow velocity is higher in the central region and is lower around the boundary of the SP. The air velocity in the SP increases as the pressure drop increases. Furthermore, at the anterior part of the SP, the shear stress is higher in the upper part. In addition, the repair of SP does not affect the total nasal airflow rate and the velocity contour patterns. The potential usage of the CFD technique as a predictive technique to explore the details and a preoperative assessment tool to help in clinical decision making in nasal surgery is emphasized