What Every Cardiologist Should Know about H1N1?

The world is witnessing ever fastest growing pandemic with high morbidity and mortality that excessive volume of airline travels spread influenza infection; so physicians with various specialties should know and consider the impact of current pandemic on their daily practice. Among influenza A viruses that infect humans, an influenza A virus emerged that had shifted to H1N1. Primarily, the results of pandemic of H1N1 were in younger humans without preexisting immunity. Attack rates of swine influenza are relatively high, but mortality is relatively low and mortality rate is highest in the very young, the very old, and the immunosuppressed. In this new pandemic, there is not more evidence of the interface of H1N1 with chronic diseases; however, we expect that the Swine flu such as the previous influenza pandemics can change the course of many chronic diseases

Demographic, Life Style and Job-Related Determinants of Quality of Life of Industrial Manufacturing Employees: An Application of Multilevel Latent Class Regression on a Large Cross-Sectional Study

BACKGROUND: Employees are one of the key elements of an organization and measure the quality of life (QoL) provides reliable assessment of health and wellbeing in this population. This study aimed at investigating the QoL in a large sample of Iranian industrial manufacturing employees and its determinants.METHODS: In a cross-sectional study conducted was in 2015, 3063 people were selected among 16000 Esfahan Seal Company's employees using multistage cluster sampling. QoL was evaluated by EQ-5D questionnaire, mental health by GHQ-12, physical activity by IPAQ, job stress by Effort–Reward Imbalance questionnaire. Self-report questionnaire was used for gathering demographic characteristics. Multilevel latent class regression analysis was used for data analysis using R (3.4.3).RESULTS: The mean (SD) age of the study participants was 36.74 (7.31), and 91.5% of them were males. The mean (SD) sleep duration was 7.11 (1.17), and 95.4% of the participants had normal mental health. Latent class analysis classified employees into two classes (high (82.4%) and low QoL (17.6%)). Also employees’ job categories classified into high and low QoL classes (79.55% and 20.45%, respectively). Latent class regression showed that lower age (OR=0.93; P< 0.0001), being male (OR=1.75; p=0.009), lower levels of education (OR=2.1; P< 0.0001), normal mental health (OR=12.4; P< 0.0001), higher sleep duration (OR=1.2; P< 0.0001) and lower BMI (OR=0.96; P=0.016) were significant predictors of being in high QoL class.CONCLUSION: Our study provides data about the QoL of industrial manufacturing employees along with its significant determinants. The findings picture the ways for improving QoL, finally increasing the efficiency and productivity of workforce by directing health policies appropriately.

Trend of atherosclerosis risk factors in children of Isfahan

The prevalence of major atherosclerosis risk factors in Iran was evaluated in 1993 and again in 1999 in 4500 randomly selected children aged 2 to 18 years. Serum lipid levels were significantly higher than standard values in both sexes and in all age groups in the 1993 and 1999 studies. The increase in serum lipid levels was most marked in teenagers. High-density lipoprotein cholesterol was significantly lower than standard values in both studies. There were no significant differences in blood pressure percentiles or the prevalence of hypertension compared to standard values in 1993 and 1999. No case of diabetes mellitus was found. Although the prevalence of obesity was low in these studies (0.2% in 1993, and 0.35% in 1999), a two-fold rise in overweight subjects was noted (4% in 1993, 8% in 1999; p < 0.05), especially in school-aged and adolescent girls. In view of these results and the increasing incidence of coronary artery disease among young people, special attention should be paid to primary prevention

The Relationship Between Ankle-Brachial Index and Number of Involved Coronaries in Patients with Stable Angina

<p class="abstract"><strong>BACKGROUND:</strong> Atherosclerosis is the commonest cause of vascular disease which can involve peripheral and/or cardiac vessels. This study was conducted to evaluate the possible link between Ankle-Brachial Index (ABI) and coronary vessel involvement in patients with stable angina.</p> <p class="abstract"><strong>&nbsp;&nbsp; METHODS:</strong><strong> </strong>This cross-sectional study was conducted in 2008 on 120 individuals who were hospitalized in Chamran Heart Center and underwent coronary angiography. A questionnaire was completed to obtain demographic information, history of previous heart disease and smoking. Body height and weight, as blood pressure on hand and foot were measured. The patients underwent angiography and the extent of coronary involvement (&gt; 75%) was determined. After12-14-hour of fasting, blood sugar was obtained to measure total cholesterol, triglyceride, low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C). The Ankle Brachial Pressure Index (ABI) was calculated as the ratio of the blood pressure in the ankles to the blood pressure in the arms. The data were analyzed by SPSS-15 using ANOVA, T-Student test, Spearman's rank correlation coefficient, and discriminant analysis.</p> <p class="abstract"><strong>&nbsp;&nbsp; RESULTS:</strong> Samples were 46 women (38.33%) and 74 men (61.67%) with a mean age of <br /> 55.50 &plusmn; 10.49. Mean and SD of ABI in men and women was 0.72 &plusmn; 0.20 and 0.80 &plusmn; 0.19 with no significant difference (p = 0.012). The correlation between ABI and extent of coronary involvement was 0.47 (p &lt; 0.0001). The group with lower ABI had the highest levels of coronary involvement (triple vessel, p &lt; 0.05).<strong>&nbsp;</strong></p> <p class="abstract"><strong>&nbsp;&nbsp; </strong><strong>CONCLUSION:</strong> ABI had a significant relationship with the degree of coronary involvement and a significant predictive value. Therefore ABI seems to be a reliable indicator of high coronary risk.</p> <p class="abstract">&nbsp;</p><table cellspacing="0" cellpadding="0" align="left"><tbody><tr><td width="35" height="12"><br /></td></tr> <tr><td><br /></td> <td>&nbsp;</td></tr></tbody></table><p class="abstract">&nbsp;</p> <br /> <p class="abstract"><strong>Keywords:</strong> Ankle to brachial index, Coronary involvement, Stable angina.</p> <p class="abstract">&nbsp;</p

The effects of Vaccinium arctostaphylos on lipid profile in mild hyperlipidemia patients- a randomized clinical trial

زمینه و هدف: هایپر لیپیدمی یا افزایش چربی خون، به عنوان یک ریسک فاکتور مستقل و قابل اصلاح در بیماری های قلبی- عروقی (CVD) شناخته شده است. هدف از این مطالعه بررسی اثرات قره قاط (Vaccinium arctostaphylos) بر سطح لیپید پروفایل بیماران مبتلا به هایپر لیپیدمی بود. روش بررسی: در این مطالعه کارآزمایی بالینی دوسو کور، 50 بیمار هایپر لیپیدمی خفیف با محدوده سنی 76-14 سال انتخاب و به طور تصادفی ساده به دو گروه کنترل و مورد (هر گروه 25 نفر) تقسیم شدند. بیماران گروه مورد روزانه 2 عدد کپسول قره قاط (معادل با 2±45 میلی گرم آنتوسیانین) و گروه کنترل کپسول پلاسبو به مدت یک ماه مصرف کردند. میزان سرمی سطح تری گلیسرید (TG)، کلسترول تام (TC) و لیپوپروتئین با چگال کم (LDL) و کاهش سطح لیپوپروتئین با چگال بالا (HDL) قبل و بعد از مطالعه برای دو گروه بررسی و مقایسه گردید. یافته ها: میانگین سن، نمایه توده بدنی (BMI)، TG،HDL ، LDL وTC بین بیماران دو گروه در ابتدای مطالعه تفاوت معنی داری نداشت. میانگین تغییرات در گروه دریافت کننده قره قاط در مقایسه با گروه کنترل در پایان یک ماه، برای فاکتورهای TC(09/32±48/226 در مقابل 81/28±04/192)، LDL-C (76/23±80/132 در مقابل 46/27±36/121) و تری گلیسرید (99/96±20/226 در مقابل 76/46±56/156) کاهش معنی داری نشان داد. ولی برای فاکتورهای HDL-C و BMI تغییرات معنی داری نشان نداد. نتیجه گیری: در این مطالعه مصرف گیاه قره قاط به مدت یک ماه موجب کاهش لیپید پروفایل در افراد مبتلا به هایپر لیپیدمی خفیف شد؛ لذا این گیاه می تواند در پیشگیری از شیوع بیماری های قلبی- عروقی ارزشمند باشد

Association between dietary salt intake and reservation of renal function in patients with mild hypertension

BACKGROUND: It is now hypothesized whether restricted salt intake can be a potential precursor to renal dysfunction in mild hypertension state. We aimed to study the association between salt intake and renal function in patients with mild hypertension. METHODS: One hundred consecutive hypertensive Iranian patients (with systolic blood pressure 140-160 mmHg and/or diastolic 90-100 mmHg) who were referred to the hypertension research center, Isfahan, Iran, between 2011 and 2014 for screening of hypertension were assessed. Renal function was assessed by measuring serum creatinine (Cr) and creatinine clearance (CrCl). Daily salt intake was assessed on the basis of 24 h urinary sodium excretion. RESULTS: There was no association between the amounts of sodium intake and serum Cr concentration (r = 0.138, P = 0.174), however, an association was revealed between sodium intake and value of CrCl (r = 0.303, P = 0.003). Multivariable linear regression model showed that sodium intake could effectively predict renal function assessed by CrCl (Beta = 0.070, P = 0.016). CONCLUSION: There is an association between sodium intake and reservation of renal function in mild hypertension state and thus by restriction of dietary salt intake, reserving renal function, and preventing appearance and progression of renal insufficiency in higher degrees of hypertension can be facilitated

Psychological Status and Quality of Life in relation to the Metabolic Syndrome: Isfahan Cohort Study

Objective. Current study was designed to investigate the association of metabolic syndrome (MetS) with depression, anxiety, psychological distress, and quality of life (QoL). Design. Two hundred and fifteen contributors with MetS and 253 participants without MetS were randomly selected from 2151 participants of Isfahan Cohort Study who were residents of Isfahan city. Measurements consisted of fasting blood samples, anthropometrics, and self-reported data of 12-item General Health Questionnaire, Hospital Anxiety and Depression Scale, and European Quality of Life-5 Dimension. Binary logistic regression analysis was used to find the association between MetS and four psychological factors. Results. Participants mean age was 56.3 ± 9.8 years. Male/female ratio was 0.86 (217/251). Mean score of depression (P = 0.003), anxiety (P = 0.018), distress (P = 0.047), and QoL (P ≤ 0.001) was significantly higher in MetS group. There were significant increasing relationships between depression (OR 1.10, 95% CI 1.03–1.22), anxiety (OR 1.03, 95% CI 1.05–1.11), and QoL (OR 1.13, 95% CI 1.05–1.23) and MetS when associations were adjusted for other risk factors, but it was not the case for distress (OR 1.03, 95% CI 0.99–1.08). Conclusion. It might be better to consider MetS as a combination of biological and psychological risk factors. Thus, a person with metabolic disease should be recognized as a patient with these factors and be screened for all of them

How can the results of a qualitative process evaluation be applied in management, improvement and modification of a preventive community trial? The IHHP Study

BACKGROUND: This study reports the results of the qualitative process evaluation (PE) of the Isfahan Healthy Heart Program (IHHP), an integrated community-based trial for prevention and control of non-communicable diseases in Iran. METHODS: The study explored the overall quality of program implementation. The participants, including designers of IHHP, stakeholders and community members (n = 60) were purposefully recruited from the intervention areas. Data collected from semi-structured interviews and field notes were analyzed using a modified thematic analysis. RESULTS: Four main themes were identified. Our findings highlighted the key role of the resources as both facilitating and hindering factors. IHHP directors faced incompatibilities arising from negative perceptions/attitudes which resulted in decreased adherence to the program. Hence various strategies were used to motivate, strengthen and organize the human workforce implementing the program. CONCLUSION: Recommendations arising from evaluation of the program were used in subsequent stages of implementation. Qualitative research is an important component of community trials which can improve their implementation