Association of Anticardiolipin Antibodies and Extent of Coronary Artery Disease in Military Personnel and Non Military Population With Acute Coronary Syndrome

Introduction: Cardiac involvement is one of the chief complications considerably contributing to the morbidity and mortality of patients with systemic autoimmune diseases. Anticardiolipin antibody is a marker of elevated myocardial infarction risk and it also predicts post cardiac intervention risk. In the current study, we aimed to evaluate the association between anticardiolipin IgM and IgG levels and atherosclerotic involvement of coronary arteries.Methods: Patients with acute coronary syndrome admitted to a military hospital were included in the study. Patients were categorized to military personnel and non-military personnel. Laboratory data including lipid profile, blood sugar, anticardiolipin IgM and anticardiolipin IgG were verified. Existence and the extent of Coronary Artery Disease (CAD) were defined according to angiographic findings. The relationship between anticardiolipin antibody levels and the number of vessels were evaluated.Results: According to our sample population calculation, we performed the study on a total of 92 patients. Measurement of both anticardiolipin antibodies (IgM and IgG) in military personnel and non personnel patients showed no significant difference. In both military personnel and non personnel groups, there was a significant association between anticardiolipin IgM and IgG levels and number of coronary arteries with significant stenosis. The C Reactive Protein (CRP) level was significantly higher in military personnel.Conclusions: According to the study results, anticardiolipin antibody levels were the same in both military personnel and non personnel. Also systolic and diastolic blood pressures were not significantly different in both groups. Increased CRP level in military personnel may be a warning signal about the possibility of premature CAD in this population, hence aggressive risk factor modification is recommended. Paradoxically lipid profile and FBS levels were more favorable in military personnel, which indirectly reflects their higher state of physical activity

The Effect of Hand Reflexology Massage on Pain and Fatigue in Patients after Coronary Angiography: A Randomized Controlled Clinical Trial

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Assessment of Risk Factors and the Effect of Drug Abuse on the Incidence of Ischemic Heart Disease in Patients Less Than 40 Years Old

Background: in this study, we examined the risk factors and the effects of substance abuse on the incidence of ischemic heart disease in patients less than 40 years old in Shahid Rajaei Hospital in Karaj from 2019-2020.Methods: This case-control study was done on 70 patients in the cases and 70 cases in the control groups. All demographic data, including age, gender, place of residence, weight, height, body mass index, cardiovascular (CVD) risk factors, including hypertension, high levels of blood fats, diabetes, a history of smoking cigarettes, tobacco, crystal meth, and cocaine, alcohol consumption, as well as a history of taking supplements for bodybuilding, and sex-enhancing drugs were obtained. Afterward, blood levels of glucose and fats were evaluated and urine analysis for the presence of drugs, such as amphetamine, methamphetamine, buprenorphine, benzodiazepines, cannabinoids, cocaine, morphine, methadone, tramadol, and tricyclic antidepressants (TCA) was done. SPSS software v. 22 was used for data analysis.Results: Among the studied underlying factors and drugs, family history, high blood pressure, diabetes, smoking, and low-density lipoprotein (LDL) levels above 130 mg/dL were significantly associated with a higher risk of acute myocardial infarction (MI) (P<0.05). Interestingly, alcohol consumption and the use of tobacco, opium, methadone, heroin, cocaine, cannabis, amphetamines, methamphetamine, tramadol, benzodiazepines, TCA, buprenorphine, and anabolic steroids were not significantly associated with acute MI under 40 years (P>0.05).Conclusion: according to the results of the present study, it seems that a positive family history of MI under the age of 55, hypertension, diabetes, smoking, and LDL levels above 130 mg/dL are more significant risk factors for acute MI in patients under 40 years of age in comparison with the consumption of alcohol and the use of hookah, opium, methadone, heroin, cocaine, cannabis, amphetamine, methamphetamine, tramadol, benzodiazepines, TCA, buprenorphine, and anabolic steroids. It should be noted that further studies in this area are recommended

A Scoping Review of Components of Physician-induced Demand for Designing a Conceptual Framework

Objectives The current study presents a new conceptual framework for physician-induced demand that comprises several influential components and their interactions. Methods This framework was developed on the basis of the conceptual model proposed by Labelle. To identify the components that influenced induced demand and their interactions, a scoping review was conducted (from January 1980 to January 2017). Additionally, an expert panel was formed to formulate and expand the framework. Results The developed framework comprises 2 main sets of components. First, the supply side includes 9 components: physicians’ incentive for pecuniary profit or meeting their target income, physicians’ current income, the physician/population ratio, service price (tariff), payment method, consultation time, type of employment of physicians, observable characteristics of the physician, and type and size of the hospital. Second, the demand side includes 3 components: patients’ observable characteristics, patients’ non-clinical characteristics, and insurance coverage. Conclusions A conceptual framework that can clearly describe interactions between the components that influence induced demand is a critical step in providing a scientific basis for understanding physicians’ behavior, particularly in the field of health economics

Diagnostic Indicators of ECG for Coronary Slow Flow Phenomenon; a Systematic Review and Meta-Analysis

Introduction: Currently, epicardial coronary angiography is still the only diagnostic tool for Coronary Slow Flow Phenomenon (CSFP). This study aimed to systematically review studies that compared Electrocardiogram (ECG) findings between patients with and without CSFP. Methods: Using relevant key terms, we systematically searched MEDLINE, Scopus, Embase, and Web of Science to find relevant studies up to February 5th, 2023. Effect sizes in each study were calculated as mean differences and crude odds ratio; then, random-effect models using inverse variance and Mantel-Haenszel methods were used to pool standardized mean differences (SMD) and crude odds ratios, respectively. Results: Thirty-two eligible articles with a total sample size of 3,937 patients (2,069 with CSFP) were included. CSFP patients had higher P-wave maximum (Pmax) (SMD: 1.02 (95% confidence interval (CI): 0.29 - 1.76); p=0.006) and P-dispersion (Pd) (SMD: 1.63 (95% CI: 0.99 - 2.27); p<0.001) compared to the control group. CSFP group also showed significantly longer QT wave maximum duration (SMD: 0.69 (95% CI: 0.33 - 1.06); p<0.001), uncorrected QTd (SMD: 1.89(95% CI: 0.67 - 3.11); p=0.002), and corrected dispersion (QTcd) (SMD: 1.63 (95% CI: 1.09 - 2.17), p<0.001). The frontal QRS-T angle was significantly higher in the CSFP group in comparison with the control group (SMD: 1.18 (95% CI: 0.31 - 2.04; p=0.007). While CSFP patients had a significantly higher T-peak to T-end (Tp-e) (SMD:1.71 (95% CI: 0.91, 2.52), p<0.001), no significant difference was noted between groups in terms of Tp-e to QT (p=0.16) and corrected QT ratios (p=0.07). Conclusion: Our findings suggest several ECG parameters, such as P max, Pd, QT, QTc, QTd, QTcd, Tp-e, and frontal QRS-T angle, may be prolonged in CSFP patients, and they could be employed as diagnostic indicators of CSFP before angiography

Pulmonary Manifestations of SARS Co V 2 Infection in Mild/Severe Patients

The coronavirus disease 2019 (COVID-19) caused viral pneumonia in Wuhan City in China in December of 2019. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) primarily targets the lungs with severe hypoxia, which usually results in death. COVID-19 is highly heterogeneous regarding severity, clinical phenotype, and more importantly, global dispersal. The respiratory system in all aspects such as respiratory airways, endothelium of pulmonary vessels, conducting airways, the alveoli, neuromuscular breathing structure, and pulmonary circulation are affected by this virus. A comprehensive concept of the source and dynamic action of the SARS-CoV-2 and the possible causes of heterogeneity in COVID-19 is required for predicting and managing the illness in acute and chronic stages of the pulmonary sign

2nd National Congress on Clinical Case Reports, December 26 and 27, 2018

The second annual meeting of Clinical Case Report (CCR) has been held in Karaj, Iran from the 26th to the 27th of December, 2018 (Figure 1). The congress was organized by the Clinical Research Development Center of Shahid Rajaei Educational and Therapeutic Center, Alborz University of Medical Sciences together (Figure 2), with a Scientific Committee including some of the faculty members of the university (Table 1). The conference program was organized into the following sessions: · Cardiovascular · Nursing · Pediatrics · Obstetrics and Gynecology · Internal Medicine · Surgery · Urology · Neurology and Neurosurgery · Orthopedics · Psychiatry · Laboratory Sciences · Infectious diseases · Traditional Medicine This meeting brought together clinician and researchers from several prestigious universities and research centers throughout Iran including Rasht, Torbat Heidarieh, Qazvin, Neyshahpour, Ardebil, Isfahan, Khorramabad, Tabriz, Hamedan, Marand, Bushehr, Mashhad, Ahvaz, Sanandaj, Bojnourd, Sabzevar, Kashan, Gorgan, Ilam, Dezful, Yazd, Tehran, Urmia and Semnan, as well as leading researchers from countries such as Turkey. Participants were invited to submit scientific contributions, as oral presentations or posters. After evaluation of the 858 abstracts received, the Scientific Committee selected 40 of them for oral presentations, and accepted 231 as posters

Acquired craniomeningocele in an infant with craniosynostosis: a case report

<p>Abstract</p> <p>Introduction</p> <p>Craniosynostosis can affect the skull in various ways. The most common forms are abnormal skull shape and beaten copper pattern, while Lückenschädel (or lacunar skull) is one of the least common forms.</p> <p>Case presentation</p> <p>We report the case of a 3-month-old Caucasian boy with multiple suture craniosynostosis and with acquired craniomeningocele presenting as a bulging mass in the lateral occipital area.</p> <p>Conclusion</p> <p>To the best of our knowledge, this is the first report of a patient with multiple suture craniosynostosis and acquired craniomeningocele.</p

Incidental Finding of a Large Mobile Aortic Arch Mass during Conventional Angiography

Thromboembolism occurs commonly in general practice and leads to significant health burden. Apart from cardiac sources, aortic atherosclerotic plaques contribute considerably to thromboembolism. A 63-year-old diabetic hypertensive woman referred to our center due to exertional chest pain unresponsive to optimal medical therapy and underwent coronary angiography. Owing to resistance during guide-wire advancement, an aortography was performed. Aortic arch injection demonstrated a large suspended mass distal to the left subclavian artery with free movement in the descending thoracic aorta. Echocardiography revealed widespread atherosclerotic changes in the aortic arch with a large hypermobile mass. Dual-source multi-slice (2 × 128:256) computed tomography angiography of the whole aorta revealed a large floating mass (in favor of a thrombus) in the distal portion of the arch. The patient underwent coronary artery bypass grafting due to severe coronary artery disease. The intra-aortic mass, which was actually a large atherosclerotic plaque, was resected at the same session. She was discharged uneventfully and during a 1-year follow-up, she had no embolic events