Heart Valves Prolapse in Population Referred to Heart Clinic in Ilam, West of Iran

Objective: Valvular heart diseases have gained importance in the field of cardiovascular medicine in recent years. The prevalence of heart valves prolapse has been reported in various studies. The present study was conducted to determine the prevalence of heart valve prolapsein patients referred to Ilam, Western Province of Iran, an outpatient heart clinic in 2013-2014. Materials and Methods: In this cross-sectional study, samples were randomly chosen from patients referred to Ilam outpatient heart clinic. Data were gathered using questionnaire, physical examination, echocardiography, and electrocardiography. Data were analyzed by using the SPSS-17 software. Results: The study was conducted using 600 participants with mean age of 44.16 +/- 15.34. 233 men with body mass index (BMI) of 25.23 +/- 3.94 and 367 women with BMI of 27.32 +/- 5.14 participated in this study. The prevalence of mitral valve prolapse (MVP) in Ilam was 4.5 and women's share was more. MVP was mostly observed in patients aged 20 to 30 (12.5). There was a significant relationship between this disorder and patent foramen ovale (PFO) (P = 0.001), redundant interatrial septum (P = 0.001), weight (P = 0.001), height (P = 0.001), BMI (P = 0.001), family history of MVP (P = 0.009), and the prevalence of tricuspid valve prolapse (TVP) and aortic valve prolapse (AVP) was 16, often observed in 50 to 60-year-old women. Conclusion: Prevalence of heart valves prolapse in this study was similar to the studies in other countries and is more common in women. Due to a preventing program, early diagnosis and screening are recommended

A comparative study on the efficacy of Atorvastatin on change CRP, LDL by systematic review and meta-analysis

Background: Coronary artery disease today is a major contributor to mortality and morbidity from cardiovascular disease. The drug, interventional and surgical methods are used to treat coronary artery stenosis. Statins are the most commonly used drugs for stenosis and coronary artery disease. Low-density lipoprotein (LDL) The purpose of this study was to evaluate the effect of atorvastatin on LDL and C-reactive protein (CRP) reduction in patients. Methods: This study was a systematic review and meta-analysis. Articles were selected using the keywords of atorvastatin, LDL, C-reactive protein (CRP) and reduction, and searches in Scopus, Google Scholar and PubMed databases from March 2003 to February 2018. For this purpose, all analytical, clinical trials, cross-sectional, and case-control studies were searched and collected in association with the efficacy of atorvastatin on low density lipoprotein and CRP. Results: In the initial search, 90 papers were found and evaluated. Finally, 20 papers were analyzed. The studies were published. The total sample size was 21609 persons with an average sample size of 1080 in each study. Twenty studies were entered into the final analysis. The LDL-lowering rate was 51 mg/dl with atorvastatin (I2=98.48, P<0.001). Also, CRP reduction before and after administration of atorvastatin was 1.99 (0.96-3.03) and 0.76 (0.08-1.43), respectively. The results of meta-regression of age-related studies showed that LDL levels were low in studies with lower age, and LDL levels were low in studies with higher age. The results of a meta-regression study of atorvastatin in terms of body mass and the association of low-density lipoprotein with atorvastatin showed that in those with a higher body mass, low-density lipoprotein decreased. Conclusion: According to the results, the use of atorvastatin reduces the amount of C-reactive protein (CRP). The rate of low density lipoprotein (LDL) reduction was better and faster in young and obese people. It is recommended that people have a proper diet and regular exercise in their daily schedule. © 2019 Tehran University of Medical Sciences. All rights reserved

The prevalence of anemia in first, second and third trimester of pregnancy in Iran: A systematic review and meta-analysis

Introduction: Anemia is a common health problem during pregnancy worldwide. The studies performed in Iran have reported different prevalence of anemia in various gestational age, and there is no overall estimate of it. This study was performed with aim to evaluate the prevalence of anemia in Iranian pregnant women by systematic review and Meta-analysis method. Methods: This systematic review study was performed based on information databases of Magiran, Iran medex, SID, Medlib, IranDoc, Scopus, Pubmed, Science Direct, Cochrane, Embase, Web of Science, Springer, Online Library Wiley and also search engine of Google Scholar using standard key words from 1991 to 2015. All reviewed papers which had inclusion criteria were evaluated. Random effect model by meta-analysis method was used to combine the studies' results. Data was analyzed using Stata software (Version 11.1). PResults: In systematic review, 12 studies with sample volume of 7087 pregnant woman were entered to the meta-analysis. The prevalence of anemia in first, second, and third trimester of pregnancy was estimated 19.6 (CI: 95, 8.4-30.9), 10.1 (CI: 95, 3.7-16.4) and 16.1 (CI: 95, 10.2-22), respectively. Conclusion: The prevalence of anemia in first trimester of pregnancy is more than second and third trimester. This shows that pregnant women require more care including proper nutrition and supplements of iron and folic acid during first trimester of pregnancy. © 2015. Journal Management System

Investigating the effect of lavender essential oil on sleep quality in patients candidates for angiography

Inadequate sleep quality is one of the most common problems in patients admitted to Cardiac care units (CCUs). Therefore, this research aimed to investigate with the effect of lavender essential oil in sleep quality in candidates for angiography who were hospitalized in an CCU in Iran. This randomized clinical trial was conducted in 60 patients undergoing angiography who were hospitalized in the CCU of a hospital in Ilam City, Iran. Patients were randomly assigned 1:1 to either a case group or a control group (each group, n = 30). Data were collected using the St. Mary's Hospital Sleep Questionnaire, which was completed before and after the intervention. The case group received 15 drops of lavender essential oil 24 hours prior to angiography and every 8 hours thereafter; the control group received its previous routine care. After the intervention, the data were analyzed via descriptive and inferential statistical tests using SPSS statistical software v19. The demographic characteristics of the case and control groups were similar (P>0.05). There was no statistically significant difference before the intervention in sleep quality between the case group and the control group (P>0.05). Additionally, no statistically significant difference was observed in the case or the control group with respect to sleep quality before and after the intervention (P>0.05). Due to the lack of effect shown by lavender essential oil in sleep quality, further studies should be conducted to the effects of lavender and other essential oils

Awareness and observance of bill of rights among patients with heart disease

Advances and developments in medical science have greatly extended the scope of medical interventions in recent decades, which has raised numerous ethical challenges in this domain. Therefore, the present study investigated levels of awareness of a patient's bill of rights and its observance in 2015 in hospitals in the city of Ilam in Iran among patients with heart disease. In this cross-sectional descriptive study, 200 patients with heart problems admitted to hospitals in Ilam were recruited using the convenience sampling method. The research instrument was a three-part questionnaire about a patient's bill of rights completed using the interview method. The data were analyzed via SPSS Version 21 with respect to descriptive statistics (means and standard deviations), inferential tests (Pearson's correlations), and interpreted at a statistical significance cutoff of 0.05. Analysis of awareness of a patient's bill of rights revealed that 38 (76) had poor awareness, 59.5 (119) had moderate awareness, and five participants (5) had good awareness. Regarding observance of a patient's bill of rights, 22 (44) had a poor level of awareness, 34.5 (69) reported moderate awareness, and 43.5 (69) had high awareness. Moreover, no statistically significant difference was found between the level of awareness of a patient's bill of rights and its observance. Only a small number of patients had good levels of awareness of a patient's bill of rights. Thus, healthcare policymakers must take the necessary steps regarding patients' awareness of a patient's bill of rights

Effect of Yoga on Lipid Profile and C-reactive Protein in Women

Background: Few scientific studies have been conducted about the of of yoga on biochemical variables such as total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), and C-reactive protein (CRP) to lay a scientific foundation regarding benefits of yoga, but its effect is not clearly detected yet. This study was conducted to assess the effect of yoga on lipid profile and CRP in women. Methods: This research was designed as an interventional study. After reviewing inclusion and exclusion criteria, selected biochemical variables such as TC, HDL-C, LDL-C, TG, and CRP were measured for each participant. Yoga instruction was done three times a week for 26 weeks by an experienced yoga instructor. After 26 weeks of yoga intervention, the above-mentioned dependent variables were assessed. SPSS Ver. 16 was used for data analysis. Results: After a 26-week follow-up for participants, only 24 women had the necessary criteria to be included in the study. The mean TG was 157.33 +/- 68.416 mg/dL and 134.33 +/- 58.80 mg/dL before and after the intervention (P = 0.108), respectively. The mean TC was 234.83 +/- 48.47 mg/dL and 183.33 +/- 55.09 mg/dL before and after the intervention (P = 0.014), respectively. The mean HDL-C was 31.58 +/- 14.22 mg/dL and 38.25 +/- 13.5 mg/dL before and after the intervention (P = 0.118), respectively. The mean LDL-C was 171.75 +/- 42.69 mg/dL and 142.91 +/- 36.4 mg/dL before and after the intervention (P = 0.030), respectively. The mean CRP was 0.57 +/- 0.22 mg/L and 0.71 +/- 0.77 mg/L before and after the intervention (P = 0.779), respectively. Conclusions: The result showed that yoga reduced TC and LDL-C significantly, but had no significant effect on TG, HDL-C, and CRP

Investigating the Efficiency of D-Dimer Test in Diagnosis of Aortic Dissection: A Systematic Study and Meta-Analysis

Background: Aortic dissection is a rare and important emergency condition, which usually involves a high mortality rate. Yet, early diagnosis of the disorder would increase the survival rate significantly. Objectives: The present systematic study and meta-analysis aimed at investigating the efficiency of D-dimer test in diagnosis of aortic dissection. Materials and Methods: The data used in this study were extracted from PubMed, Scopus, Elsevier, Springer, and Willey databases. Specificity, D-dimer, Sensitivity, and Aortic Dissection were the valid keywords used to extract the related articles. Totally, 11 papers published during 1998 - 2007 were selected. 12 index was used to assess heterogeneity across the studies. Results: A total of 596 subjects (averagely 54.5 ones in each study) were examined in the present research and 11 articles were entered into the final meta-analysis. According to the findings, the mean of the specificity test was 0.66 (0.54 - 0.78), with 12 index = 74.9 and p-value = 0.001. Additionally, the mean of the sensitivity test was 0.98 with 12 index = 606 and p-value = 0.381. Moreover, the mean D-dimer plasma level was 18.6 ug/mL in patients suffering from aortic dissection. Conclusion: This study showed the high efficiency of D-dimer test in diagnosis of aortic dissection. Thus, physicians are recommended to apply this quick and inexpensive method when a final diagnosis has not been made yet. Early diagnosis of aortic dissection via D-dimer test would result in implementation of the necessary treatments, eventually leading to a significant decrease in mortality rate

Technical efficiency in health production: A comparison between Iran and other upper middle-income countries

Objectives: To achieve sustainable health development, health systems need to constantly enhance their efficiency, through for instance reducing waste of resources. This study aimed to measure the efficiency in producing health in Upper Middle-Income Countries (UMICs) with a focus on Iran. Method: A modified data envelopment analysis (DEA)-based Malmquist Productivity Index (MPI) was used to assess the changes in health productivity. Panel data was extracted from databases of the World Health Organization and the World Bank for the period of 2009�2015. Results: The efficiency score of 13 of countries was higher than 0.8, while the score of all countries was above 0.5. The average score of Iran performance was 0.791 during the period. On average, performance improved in 15 countries, while it declined in 20 countries during the study period. Conclusion: Different countries have implemented various health reforms to improve efficiency. We envisage, policy makers in the UMICs locate their health system performance and plan to improve it in line with the local specifications, along with the global pathway towards universal health coverage and sustainable health development ultimately. © 202