Sex differences in conventional and some behavioral cardiovascular risk factors, Analysis of the prevention clinic database

Background: An increase in Cardiovascular Disease (CVD) frequency was observed over the past three decades in low- and middle income countries, especially in Iran. The purpose of the present study was to review and compare the frequencies of conventional and some non-conventional CVD risk factors between men and women in a tertiary level referral cardiovascular teaching hospital in a six month period in the North of Iran.  Methods: A descriptive cross-sectional study was conducted using medical databases including conventional risk factors: opium consumption, physical inactivity, high salt diet, and serum vitamin D level. The chi-square and independent t tests were used to assess the differences between groups.  Results: A total of 740 (55% women) who had available full medical history data were recruited in the study. Approximately 62% of the participants were older than 45 years with the mean age of 54 (14.2) years old. Percentages of hypertension, diabetes, dyslipidemia, and obesity in women were significantly higher than those of men (P<0.05). A total of 50% of all the participants were physically inactive. Men had higher frequency of opium and saltshaker use than women (P<0.05).  Conclusion: The current study indicated that despite the importance of conventional CVD risk factors like diabetes, hypertension, dyslipidemia, and obesity, educational programs should be considered to improve physical activity and reducing salt consumption and awareness about opium use complications

Serum and Cerebrospinal Fluid Lactate Dehydrogenase in Children with Febrile Convulsions

  Objective Tissue damage caused by febrile convulsion has not still been proved or refuted completely. Given the fact that lactate dehydrogenase as an intracellular enzyme can be increased due to tissue damage, we decided to evaluate serum and cerebrospinal fluid lactate dehydrogenase in children with febrile convulsion. Materials & Methods This is a cross-sectional study on 166 children aged 6-24 month, in three groups of simple febrile convulsion (n=56), complex febrile convulsion (n=27) with 3 different subgroups (recurrence in 24 hours, duration >15 minutes, and with focal components), and control (n=83). Patients’ serum and cerebrospinal fluid specimens were collected after meeting the inclusion criteria. Demographic information was documented and patients’ serum and cerebrospinal fluid lactate dehydrogenase and glucose were measured. Data were analyzed using SPSS software. Result The mean serum lactate dehydrogenase in simple febrile convulsion, complex febrile convulsion, and controls were 501.57± 143.70, 553.07±160.22, and 505.87±98.73 U/L, respectively. The mean cerebrospinal fluid lactate dehydrogenase in simple, complex febrile convulsion, and control groups were 22.58±11.92, 29.48±18.18, and 21.56±17.32 U/L, respectively. Only cerebrospinal fluid lactate dehydrogenase difference between complex febrile convulsion and control group (p=0.039) (In the duration >15 minutes subgroup and controls, p=0.028) was statisticallysignificant. There was a significantThere was a significant difference between sex and serum lactate dehydrogenase in the same subgroup of complex group (p=0.012). Conclusion Complex febrile convulsion may lead to increase of lactate dehydrogenase in cns of CNS cellular damag

The family medicine specialty, learning from experience

Family medicine has been accepted as a model for Iranian health-care reform, but many debates have been raised since its establishment. Despite many successes achieved, this area of medicine is very challengeable. Family practice as a specialty is an innovation that has been introduced by the ministry of health and medical education in Iran. Although this approach seems sophisticated, learning from experience is the first step to avoid difficulties that may occur from this selection. Our goal is to declare strengths, weaknesses, opportunities, and threats of family medicine specialty

Cognitive Functioning in Schizophrenia, Methamphetamine-induced Psychotic Disorder, and Healthy People: A Comparative Study

Background: Methamphetamine-induced psychotic disorder (MIP) cannot be easily differentiated from other psychotic disorders. Some studies have reported that patients with MIP and schizophrenia have differences in their cognitive functioning. We hypothesized that their performance would be different on neuropsychological tests which assess executive functions and visual memory. Materials and Methods: In a cross-sectional study, 30 patients with MIP, 31 patients with schizophrenia, and 31 healthy controls were assessed by Rey–Osterrieth complex figure (ROCF) test and visual search and attention test (VSAT). One-way analysis of variance was performed to compare the mean scores of tests. Tukey's HSD test was used for post hoc analysis. Results: Three groups had significant differences according to ROCF test (F = 15.76, P < 0.0001), VSAT (F = 39.78, P < 0.0001), left VSAT (F = 37.96, P < 0.0001), right VSAT (F = 40.40, P < 0.0001), and the time of the test administration (F = 3.26, P = 0.04). The post hoc analysis showed that the mean score of ROCF test and VSAT (total, right, and left) was significantly higher in the control group than in the other two groups. The time of administering the test in the control group was significantly shorter than in the MIP group (P < 0.03) and nonsignificantly shorter than in the schizophrenia group (P = 0.54). The mean score of right side VSAT was significantly higher in the MIP group than in the schizophrenia group. Conclusion: ROCF could not differentiate MIP from schizophrenia. The better performance of patients with MIP on right side VSAT that is reported in this and in the previous study needs to be reevaluated in more controlled studies

Lifestyle interventions for hypertension treatment among Iranian women in primary health-care settings: Results of a randomized controlled trial

Background: Lifestyle factors such as weight, salt intake, and physical activity have shown to be important in treating hypertension. The object of this study was to describe feasibility and to assess the effectiveness of a multicomponent lifestyle intervention on high blood pressure (BP) of Iranian women. Materials and Methods: This randomized controlled trial was conducted in four health centers by recruiting 161 women aged 35-65 years with high BP and randomizing them to a 4-week lifestyle modification (n = 80) or control group (n = 81). BP level and other health behavioral factors were assessed before and after the 4-week intervention and also after 6 months. Results: The mean systolic BP changed from 158.8 (±8.1) mmHg to 153.2 (±6.4) mmHg during 4-week and to 145.5 (±4.6)) mmHg after 6 months in the intervention group (P < 0.001). There was a significant difference between two groups of study after 4-week mean = 5.6 (confidence interval [CI] = 5.1-6.6) and 6 months follow mean (CI = 12.3-14.6).(P < 0.001) A significant correlation was detected between systolic BP (SBP) and diastolic BP (DBP) with weight, body mass index, waist circumference, salt intake, and physical activity level (P < 0.001). Stepwise regression analyses indicated that the weight, dietary salt intake, and physical activity level were significant predictors of SBP and DBP. Conclusion: The results of this study suggest that lifestyle modification program is associated with improvements in BP level in Iranian women

Risk of Developing Diabetes in Patients Undergoing Coronary Artery Angiography Based on American Diabetes Association Risk Score: A Cross-Sectional Study

Aims The high prevalence of undiagnosed diabetes and the high risk for diabetes in the general population is alarming. In addition, the frequency of coronary artery diseases (CAD) in patients with undiagnosed diabetes is higher than in non-diabetic patients. This study aimed to investigate the frequency of people at risk of diabetes in patients undergoing coronary artery angiography (CAG) in a university referral hospital in Guilan Province, Iran. Methods & Materials In this cross-sectional study, data from 300 non-diabetic patients who were candidates for CAG were collected using a simple sampling method. The risk of developing diabetes was calculated according to American Diabetes Association (ADA) risk score. ADA scores higher than five were considered high risk, and ADA scores equal to 4 and lower than 4 were as moderate and low risk, respectively. Findings The mean age of the study population was 59.44±15.7 years. Most subjects were male (59.3%). Only 24.3% of patients were in the low-risk group while 32% were in moderate risk and 43.7% were in the high-risk group. The frequency of patients with at least two coronary artery involvement was significantly higher in the high-risk group (43.1%) than in the moderate group (34.4%), and the low-risk (22.5%) group. Conclusion A high proportion of the patients undergoing CAG were at high risk of developing diabetes. Hence, it seems essential to address cardiometabolic risk factors in coronary artery diseases (CAD) after discharge from the hospital

Association between Metabolic syndrome and Subjective social status in coronary artery disease patients, a cross sectional study: Metabolic syndrome and Subjective social status

Aims: The&nbsp; purpose&nbsp; of&nbsp; this&nbsp; study&nbsp; was&nbsp; to&nbsp; examine&nbsp; the&nbsp; association&nbsp; of&nbsp; metabolic&nbsp; syndrome (MetS)&nbsp; with&nbsp; subjective&nbsp; social&nbsp; status (SSS)&nbsp; and&nbsp;&nbsp; depression&nbsp; symptoms&nbsp; among&nbsp; coronary artery disease patients (CAD). Materials and methods: in&nbsp; a&nbsp; cross&nbsp; sectional&nbsp; study&nbsp; during&nbsp;&nbsp; 2019- 2020,&nbsp; patients&nbsp; with&nbsp; CAD&nbsp;&nbsp;&nbsp; older&nbsp; than&nbsp; 30&nbsp; through&nbsp; simple&nbsp; sampling&nbsp; method&nbsp; were&nbsp; selected. SSS&nbsp; and&nbsp; depression&nbsp; were&nbsp; assessed&nbsp; using&nbsp; MacArthur&nbsp; scale&nbsp; and&nbsp; Persian&nbsp; version&nbsp; of&nbsp; the 13&nbsp; items&nbsp; beck&nbsp; depression&nbsp; scale,&nbsp; respectively.&nbsp; The components &nbsp;of&nbsp; Metabolic&nbsp; syndrome,&nbsp; ,&nbsp; and&nbsp; demographic&nbsp; factors&nbsp; were&nbsp; collected&nbsp; based&nbsp; on&nbsp; patients&nbsp; medical&nbsp; records. result: data&nbsp; related&nbsp; to&nbsp; 500&nbsp; CAD&nbsp; patients&nbsp; aged&nbsp; 61.81&nbsp; ±&nbsp; 12.25&nbsp; years&nbsp; were&nbsp; assessed. prevalence of&nbsp; MetS&nbsp; was&nbsp; 57 % . Almost&nbsp; 75%&nbsp; of&nbsp; study&nbsp; subjects&nbsp; were&nbsp; in&nbsp; low&nbsp; category&nbsp; of&nbsp; SSS.&nbsp; Univariate&nbsp; logistic&nbsp; regression&nbsp; analysis&nbsp; showed&nbsp; the&nbsp; odds&nbsp; of&nbsp; MetS&nbsp;&nbsp; in&nbsp; patients&nbsp; with&nbsp; higher&nbsp; SSS&nbsp; was&nbsp; 21%&nbsp; less&nbsp; than&nbsp; patients&nbsp; with&nbsp; lower&nbsp; SSS&nbsp; (OR=0.79, 95% CI=0.53-1.19, P=0.274). The&nbsp; odds&nbsp; of&nbsp; MetS&nbsp; was&nbsp; higher&nbsp; in&nbsp; women [OR=1.67(1.16-2.42)] , married&nbsp; subjects[OR=1.55(0.74-3.26)] , in&nbsp; rural&nbsp; area [OR=1.30(0.88-1.91)] ,&nbsp; those&nbsp; without&nbsp; job [OR=0.83(0.58-1.19)]&nbsp; and&nbsp; literacy[OR= 0.83(0.58-1.19)] . There&nbsp; was&nbsp; no&nbsp; significant&nbsp; association&nbsp; between&nbsp; depression&nbsp; and&nbsp; the&nbsp; odds&nbsp; of&nbsp; metabolic&nbsp; syndrome (OR=0.98,&nbsp; 95%&nbsp; CI= 0.63-1.52, P= 0.950). In&nbsp; multivariate&nbsp; logistic&nbsp; regression&nbsp; analysis&nbsp; ,&nbsp; the&nbsp; inverse&nbsp; association&nbsp; between&nbsp; SSS&nbsp; and&nbsp; MetS&nbsp; was&nbsp; still&nbsp; remained&nbsp; (OR= 0.74, 95% CI=0.49-1.12, P=0.163). Conclusions: MetS&nbsp; was&nbsp; more&nbsp; prevalent&nbsp; in&nbsp; lower&nbsp; even&nbsp; considering&nbsp; demographic&nbsp; factors&nbsp; and&nbsp; depression&nbsp; symptoms. More&nbsp; researches&nbsp; need&nbsp; to&nbsp; assess&nbsp; the&nbsp; effect&nbsp; of&nbsp; perceived&nbsp; social&nbsp; standing&nbsp; on&nbsp; cardiometabolic&nbsp;&nbsp; risk&nbsp; factors

Does opium have benefit for coronary artery disease? A systematic review

Opium is a plant with euphoria effect. People from some parts of the world traditionally use opium for cardioprotective effects. We did a systematic review to assess the effect of opium on coronary artery disease (CAD). A systematic database search was conducted in PubMed, Web of Science, Google Scholar, Cochrane library, Scopus, and SID from their onset up to June 2016. The quality of the studies was assessed with a standardized scoring system. Articles assessing the effect of opium consumption as orally or smoked were included in this review. Outcome was defined as age on CAD disease, risk of CAD, and morbidity from CAD. Poor methodological studies, animal studies, and studies on cardiovascular risk factors or serum markers were excluded from the review. Three case–control, three cohort, and eight cross-sectional studies were included in this systematic review. The age at the occurrence of myocardial infarction, coronary bypass surgery, and percutaneous intervention in opium users was signifi cantly lower than that of nonusers. Odds ratio of opium consumption for CAD ranged from 1.3 to 3.8 in different studies. Hazard ratio of opium consumption for ischemic heart disease was 1.90 (1.57–2.29) with modification by sex, ethnicity, education level, marital status, residential place, and cigarette smoking. We concluded, in spite of the traditional belief, that the current evidence did not support the protective effect of opium on CAD. Future well-designed studies concerning probable confounders in Iran and other similar parts of world are required