The effects of continous positive airway pressure on LV diastolic function in patients with obstructive sleep apnea

Background and aims: One of the main problems of health is Obstructive Sleep Apnea (OSA). The aim of the present study was to determine the effects of Continous Positive Airway Pressure (CPAP) on Left Ventricular (LV) diastolic function in patients suffering from OSA. Methods: The study is a quasi-experimental clinical trial. In this study, 32 patients who have OSA and diastolic dysfunction at the same time selected by convenience sampling. Based on the results of polysomnography and echocardiography, patients undergo a period of 3 and 6 months using CPAP. They were reevaluated for LV diastolic function parameters using echocardiography. Results: The evaluation of LV diastolic function parameters at the beginning and at the 3rd and 6th month of using CPAP shows that the late diastolic phase (Peak A) decreased and Premature ventricular diastolic filling rate during the phase values (Peak E), ventricular filling ratio of early to late phase during diastole E/A ratio and e' significantly increased (P<0.05). Conclusion: The result of this study showed that after using CPAP in patients with OSA and LV diastolic dysfunction; the LV diastolic function parameters improved

DEMOGRAPHIC AND MEDICAL PREDICTORS OF THE ONSET OF POST-MI DEPRESSION

&nbsp; Abstract INTRODUCTION: Depression is common amongst post-myocardial infarction (MI) patients and it has been associated with adverse clinical events in these patients. Post-MI depression has also been shown to be an independent risk factor for mortality. However, many questions about risk factors of post-MI depression remain unanswered. The purpose of this study was to identify the medical and demographic predictors of post-MI depression, in so far these are routinely available during MI hospitalization. methods: 176 consecutive patients admitted to the CCU wards following MI were selected based on the inclusion and exclusion criteria. Baseline measures were conducted during hospitalization using a standardized history that included questions about demographic characteristics and medical information, and all patients were underwent a physical examination. Severity of MI index was assessed by a cardiologist using the Killip Class. Also CPK levels were measured on admission and over the 2 subsequent days as additional measures of the severity of MI. The diagnosis of depression (including major and minor depression) at three months after MI was assessed using a standardized, semistructured research interview by a psychiatrist and a clinical psychologist. This interview provided DSM-IV diagnoses based on the patients&rsquo; psychiatric symptoms. results: The findings showed that 46/6% suffered from post-MI depression three months following MI. In multivariable analysis, beta-blocker (OR 2.987; CI 1.254-7.116), history of depressive disorders (OR 2.838; CI 1.271-6.340), log max CPK (creatinine phosphokinase value) (OR 2.410; CI 1.075-5.404), and age &lt;60 (OR 2.652; CI 1.061-6.626) were factors significantly associated with post-MI depression. This predictive model also yielded 74.4% maximum predictive efficiency with 67.1% sensitivity and 80.9% specificity rates respectively, for differentiating those with and those without high risk for developing post-MI depression. CONCLUSIONS: Beta-blocker, history of depressive disorders, log max CPK (creatinine phosphokinase value), and age comprise demographic and medical predictors for post-MI depressive symptoms. Thus, considering the above model, clinicians may able to identify MI patients with a high risk for subsequent development of depression so that these patients may be targeted for screening and potentially for psychosocial intervention. The association found between depression and creatinine phosphokinase (CPK) value begs the questions why two seemingly unrelated conditions should be related, and what mediators or common biological pathways could link the two phenomena.&nbsp; &nbsp; &nbsp; Keywords: Depression, myocardial infarction, demographic and medical predictors.</div

The effect of cyproheptadine on prevention of Vomiting and Nausea induced by contrast agent during coronary angiography and ventriculography of left ventricle

زمینه و هدف: بیماری های عروق کرونر یکی از مشکلات عمده بهداشت و درمان جوامع امروز است که با تشخیص صحیح بیماری های عروق کرونری و درمان آنها می توان از پیشرفت و توسعه بیماری و فرآیند تصلب شرایین در عروق کرونری جلوگیری نمود. در حال حاضر آنژیوگرافی عروق کرونری استاندارد طلایی تشخیصی بیماری های آترواسکروتیک عروق کرونری می باشد. در این روش مانند هر روش تهاجمی تشخیصی دیگر خطراتی بیمار را تهدید می نماید. از آن جمله می توان به عوارض ماده حاجب حین آنژیوگرافی مانند تهوع و استفراغ اشاره کرد. با توجه به اینکه تهوع و استفراغ از جمله شکایت های شایع بیماران بوده و یکی از معضلات در انجام آنژیوگرافی است که باعث غیر استریل شدن محیط و افزایش طول مدت آنژیوگرافی می گردد و همچنین نقش گیرنده های سروتونین مغز در ایجاد تهوع و استفراغ، لذا در این مطالعه به بررسی اثر قرص خوراکی سیپروهپتادین بر پیشگیری تهوع و استفراغ ناشی از ماده حاجب حین آنژیوگرافی عروق کرونری و ونتریکولوگرافی بطن چپ پرداخته شد. روش مطالعه: در این مطالعه تعداد کل بیماران (400 نفر) به دو گروه مساوی تقسیم شدند. به یک گروه قرص پلاسبو و به گروه دیگر قرص خوراکی سیپروهپتادین mg8 یک ساعت قبل از انجام آنژیوگرافی به بیماران داده شد. این بیماران در طی 12 ساعت بعد از انجام آنژیوگرافی از نظر وجود یا عدم وجود تهوع و استفراغ و دیگر عوارض توسط مجری طرح ویزیت و نتایج در پرسشنامه ثبت می شد و از نرم افزار SPSS و آزمون های آماری t-test و χ2 جهت تجزیه و تحلیل داده ها استفاده گردید. نتایج: عوارض minor ماده حاجب در 78 مورد مشاهده شد که با مصرف قرص سیپروهپتادین این عوارض به 27 مورد کاهش یافت. در گروهی که پلاسبو دریافت کردند 27 تهوع، 5/5 استفراغ و 3 اغ زدن و در گروهی که قرص سیپروهپتادین دریافت کردند 8 تهوع، 2 استفراغ و 1 اغ زدن مشاهده شد. بین میزان شیوع عوارض در جنس مرد و زن، کسر تخلیه و گرفتاری عروق کرونر ارتباط معنی داری مشاهده نشد. نتیجه گیری: داروی خوراکی سیپروهپتادین در کاهش بروز تهوع و استفراغ از عوارض minor ماده حاجب مؤثر بود

SCREENING FOR CLINICAL DEPRESSION IN IRANIAN POST-MI PATIENTS USING THE BECK DEPRESSION INVENTORY FOR PRIMARY CARE

Abstract &nbsp;&nbsp; INTRODUCTION: Clinical depression is common among post-myocardial infarction (MI) patients. There is a need for a suitable instrument independent of MI characteristics to screen MI patients for depression. The purpose of this study was to ascertain psychometric properties of the Beck Depression Inventory for Primary Care (BDI-PC) in screening for clinical depression (including major and minor depressive disorders) in the post-MI patients who were scheduled for routine office visits with cardiologists. &nbsp;&nbsp; METHOD: The BDI-PC and hospital anxiety and depression scale (HADS) were administered to 176 post-MI patients admitted to the CCU wards of nine hospitals in Isfahan, Iran. Also the structured interview for DSM-IV, considering DSM&shy;IV criteria for major and minor depressive disorder, was used to diagnose clinical depression. &nbsp;&nbsp; RESULTS: The internal consistency of the BDI-PC was high (Cronbach's alpha: 0.88), and the construct validity of BDI-PC was confirmed against depression subscale of HADS (r=0.86.8). A BDI-PC cutoff score of 5 and above yielded 91% maximum clinical efficiency with 84% (95% CI 79%-90%) sensitivity and 97% (95% CI 94%-99%) specificity rates, respectively, for identifying patients with and without clinical depression. &nbsp;&nbsp; CONCLUSION: The BDI-PC proved an effective case-finding instrument in screening for clinical depression in post-MI patients. &nbsp; &nbsp;&nbsp; Keywords: Myocardial infarction, Depression, Screening, BDI-PC.</p

The Effect of a Self-Care Program on the Quality of Life of Patients with Permanent Pacemaker

Introduction. Today, the subject of patient education as well as education for their families is mainly about acceptance of self-care by patients. Therefore, proper conditions should be provided for patients to be able to take care of themselves. This study attempts to examine the effects of a self-care program on quality of life of patients having permanent pacemaker. Methods. A quasi-experimental study using two groups/two stages design was performed. Thirty four patients with pacemakers referred to Chamran Hospital Pacemaker Clinic in Isfahan, were selected through convenience sampling and divided to two 17 person groups. One week after installing the pacemaker, the quality of life of both experiment and control groups was studied by a valid and reliable questionnaire. Then, the self care program consisting of individual education, demonstration and practice, was held for the experimental group. After two months, the quality of life was checked again in both groups. The data was analyzed by descriptive statistics, independent and paired t-tests, and Chi square using SPSS software. Results. In both experimental and control groups, there was a significant difference between the qualify of life scores before and after intervention. However, two months after the intervention, the mean score of quality of life in experimental group was significantly more than control group. Conclusion. The self care program is effective in promoting the quality of life of the patients with permanent pacemaker. This is supported by other studies as well. It is suggested to include these educational programs in post-operative care plans of patients having permanent pacemaker

Combined Healthy Lifestyle Is Inversely Associated with Psychological Disorders among Adults.

BACKGROUND AND AIMS:Joint association of lifestyle-related factors and mental health has been less studied in earlier studies, especially in Middle Eastern countries. This study aimed to examine how combinations of several lifestyle-related factors related to depression and anxiety in a large group of middle-age Iranian population. METHODS:In a cross-sectional study on 3363 Iranian adults, a healthy lifestyle score was constructed by the use of data from dietary intakes, physical activity, smoking status, psychological distress and obesity. A dish-based 106-item semi-quantitative validated food frequency questionnaire (FFQ), General Practice Physical Activity Questionnaire (GPPAQ), General Health Questionnaire (GHQ) and other pre-tested questionnaires were used to assess the components of healthy lifestyle score. The Hospital Anxiety and Depression Scale (HADS) was applied to screen for anxiety and depression. RESULTS:After adjustment for potential confounders, we found that individuals with the highest score of healthy lifestyle were 95% less likely to be anxious (OR: 0.05; 95% CI: 0.01-0.27) and 96% less likely to be depressed (OR: 0.04; 95% CI: 0.01-0.15), compared with those with the lowest score. In addition, non-smokers had lower odds of anxiety (OR: 0.64; 95% CI: 0.47-0.88) and depression (OR: 0.62; 95% CI: 0.48-0.81) compared with smokers. Individuals with low levels of psychological distress had expectedly lower odds of anxiety (OR: 0.13; 95% CI: 0.10-0.16) and depression (OR: 0.10; 95% CI: 0.08-0.12) than those with high levels. Individuals with a healthy diet had 29% lower odds of depression (OR: 0.71; 95% CI: 0.59-0.87) than those with a non-healthy diet. CONCLUSION:We found evidence indicating that healthy lifestyle score was associated with lower odds of anxiety and depression in this group of Iranian adults. Healthy diet, psychological distress, and smoking status were independent predictors of mental disorders

Dietary riboflavin intake in relation to psychological disorders in Iranian adults: an observational study

Abstract Findings of earlier investigations on association between dietary riboflavin intake and psychological disorders are contradictory. Therefore, the relation between dietary riboflavin intake and depression, anxiety, and psychological distress was assessed in Iranian adults. In this cross-sectional study, dietary intakes of 3362 middle-aged adults were collected using a validated dish-based food frequency questionnaire. Daily intake of riboflavin for each participant was calculated by summing up the amount of riboflavin contents of all foods and dishes. Hospital Anxiety and Depression Scale (HADS) and General Health Questionnaire (GHQ), as validated questionnaires among Iranians, have been applied to assess depression, anxiety, and psychological distress. After considering potential confounders, adults in the top energy-adjusted quartile of riboflavin intake, compared to the bottom quartile, had decreased odds of depression (OR = 0.66; 95%CI 0.49, 0.88), anxiety (OR = 0.64; 95%CI 0.44, 0.94) and high psychological distress (OR = 0.65; 95%CI 0.48, 0.89). Stratified analysis by sex revealed that men in the forth quartile of riboflavin intake, compared with those in the first quartile, had respectively 51 and 55% lower odds of depression (OR = 0.49; 95%CI 0.29, 0.83) and anxiety (OR = 0.45; 95%CI 0.21, 0.95). In women, riboflavin intake was significantly associated with lower odds of psychological distress (OR = 0.67; 95%CI 0.46, 0.98). An inverse relation was observed between dietary riboflavin intake and chance of psychological disorders in Iranian adults. High intake of riboflavin decreased the chance of depression and anxiety in men and high psychological distress in women. More prospective studies are needed to confirm these findings

Association between food-based dietary inflammatory potential and ulcerative colitis: a case–control study

Abstract Despite several studies on the link between dietary inflammatory potential and risk of several conditions, limited studies investigated the association between pro-inflammatory diet and ulcerative colitis (UC). The objective of the present study was to examine the link between food-based dietary inflammatory potential (FDIP) and odds of UC in Iranian adults. This case–control study was carried out among 109 cases and 218 randomly chosen healthy controls. UC was diagnosed and confirmed by a gastroenterologist. Patients with this condition were recruited from Iranian IBD registry. Age- and sex-matched controls were selected randomly from participants of a large cross-sectional study. Dietary data were obtained using a validated 106-item semi-quantitative food frequency questionnaire (FFQ). We calculated FDIP score using subjects’ dietary intakes of 28 pre-defined food groups. In total 67% of subjects were female. There was no significant difference in mean age between cases and controls (39.5 vs. 41.5y; p = 0.12). The median (interquartile range) of FDIP scores for cases and controls were − 1.36(3.25) and − 1.54(3.15), respectively. We found no significant association between FDIP score and UC in the crude model (OR 0.93; 95% CIs 0.53–1.63). Adjustment for several potential confounders in multivariate model did not change this association (OR 1.12; 95% CIs 0.46–2.71). We failed to observe any significant association between greater adherence to a pro-inflammatory diet and risk of UC in this study. Prospective cohort studies are needed to further assess this relationship

The healthy lifestyle score development.

<p>The healthy lifestyle score development.</p