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Mohajer Mr, Karvandian K, Hussain Khan Z, Jafarzadeh A, Dabiran S,
Volume 69, Issue 7 (10-2011)
Volume 69, Issue 7 (10-2011)
Abstract
Background: Patients who require surgery on the lower extremities are considered to be a high risk group from the point of anesthesia. This study was performed to compare sitting and lateral positions in spinal anesthesia method with hyperbaric bupivacaine 0.5% for hemodynamic status and analgesic period in patients under vascular surgery of the lower limbs in Imam-Khomeini Hospital Complex affiliated to Tehran University of Medical Sciences in 2009.
Methods: In this study 40 patients were divided into two groups of 20 to undergo spinal anesthesia with 3 ml of hyperbaric bupivacaine 0.5% injected into the subarachnoid space in sitting or lateral positions. The anesthesia was performed at T10 level and the hemodynamic status and analgesic periods were compared in the two groups.
Results: The changes in mean arterial blood pressure and systolic and diastolic blood pressures were different between the two groups (P<0.05). Except in the first and thirtieth minutes, the changes in heart rate (HR) were significantly different throughout the study between the two groups (P<0.04) and they were higher in sitting position. The duration of analgesia was significantly longer in lateral position (P<0.04) and the use of fluid was significantly larger in the sitting group (P<0.05).
Conclusion: According to the obtained results, the changes in hemodynamic variables were significantly lower in the group in lateral versus sitting position in patients undergoing spinal anesthesia with bupivacaine for vascular surgery of the lower limb.
Yousefi Aa, Madani M, Azimi Hr, Farshidi H,
Volume 69, Issue 7 (10-2011)
Volume 69, Issue 7 (10-2011)
Abstract
Background: Vascular complications, as the most common complications of diagnostic catheterization and percutaneous coronary intervention (PCI), are important factors in the morbidity of patients undergoing such procedures thus, this study was done to evaluate the prevalence of these complications and their related factors.
Methods: This is a descriptive study composed of 2097 consecutive patients who underwent percutaneous coronary intervention in Shahid Rajaei Cardiovascular Center in Tehran, Iran from January 2008 to January 2009. Occurrence of vascular complications in course of hospitalization and the related factors leading to the complications were investigated.
Results: Out of 2097 patients, 1544 (73.6%) were male and 553 (26.4%) were female, and the mean age of the participants was 57±10 years. Vascular complications from the time of PCI to the time discharge were observed in 19 (0.9%) patients. The other complications included: hematoma in 10 cases (52.6%), pseudoaneurysm in five cases (26.3%), retroperitoneal hemorrhage and arteriovenous fistula in 2 (10.5%) patients each. The complications were significantly more common in female patients (P=0.003), in patients with a history of hypertension (P=0.02), people of shorter stature (P=0.004), and being on gp IIIa/IIb inhibitors (P=0.003).
Conclusion: The rate of vascular complications post-percutaneous coronary interventions is low and it is considered to be a good treatment option for patients with coronary stenosis provided that sufficient compression is applied on the vascular access point in the right time after removal of the arterial sheath. PCI is of fewer vascular complications, especially in female patients, history of hypertension, and higher anticoagulant concentrations.
Aalami S, Nikoui V, Irani M, Bakhtiarian A,
Volume 70, Issue 7 (10-2012)
Volume 70, Issue 7 (10-2012)
Abstract
Background: There are conflicting reports about zinc, a trace element, in the pathogenesis of hypertension and other cardiovascular diseases. The aim of this study was to evaluate the role of zinc in high blood pressure.
Methods: We conducted this study on 80 patients with primary (idiopathic) hypertension and 80 normotensive people with similar age who attended to Tehran Heart Center between 2007 and 2008. We examined the effect of zinc concentration on blood pressure in both sexes in four age groups (41-50, 51-60, 61-70 and 71-80 years old). We measured plasma zinc concentration by atomic absorption.
Results: The mean plasma zinc concentrations were 0.456±0.04 µg/ml and 0.551±0.055 µg/ml in patients with hypertension and in normotensive people, respectively, (P≤0.05). Nevertheless, the mean plasma zinc concentrations were 0.494 µg/ml and 0.486 µg/ml in men with and without hypertension, respectively. The mean plasma zinc concentrations of women with and without hypertension, respectively were 0.415 µg/ml and 0.596 µg/ml, showing a significant difference between two groups (P≤0.001). Moreover, there was a significant difference in plasma zinc concentration between hypertensive and normotensive people in 51 to 60 years age group (P≤0.05), but difference were not significant between other age groups.
Conclusion: The results of this study revealed the relationship between the decrease in plasma zinc concentration and increase in blood pressure in women and in the men aged 51 to 60 years.
Sabeti M, Naser Moghadasi A, Aloosh M, Paknejad Sm, Toghae M,
Volume 70, Issue 7 (10-2012)
Volume 70, Issue 7 (10-2012)
Abstract
Background: Finding an acute brain lesion by diffusion-weighted (DW) MRI upon an episode of transient ischemic attack (TIA) is a predictor of imminent stroke in the near future. Therefore, exploring risk factors associated with lesions in DW-MRI of the brain is important in adopting an approach to TIA management. In the current study, we tried to determine the risk factors associated with lesions in DW-MRI of the brain in patients experiencing TIA episodes.
Methods: Fifty patients with TIA were recruited consecutively in Sina Hospital, Tehran, Iran, over a 6-month period between July 2008 and January 2009. All of the patients underwent a complete neurological examination and laboratory tests. Brain DW-MRIs were performed for all the patients within 72 hours of a TIA episode.
Results: DW-MRI revealed an acute lesion in 16% of the participants. There was a significant correlation between presence of an acute lesion in DW-MRI and TIA duration, history of diabetes mellitus and presence of unilateral facial palsy (P=0.0003, P=0.02 and P=0.008, respectively). Other variables such as age, hypertension, hyperlipidemia, past history of TIA, headache, vertigo, and sensory or visual disturbances had no significant relation with the presence of an acute lesion in DW-MRI.
Conclusion: Duration of TIA, presence of diabetes mellitus and unilateral facial palsy are risk factors for an acute lesion in DW-MRI, meaning that patients with such risk factors are at risk for stroke in the near future.
Samaneh Asgari , Davood Khalili , Fereidoun Azizi , Fatemeh Eskandari , Narges Sarbazi , Farzad Hadaegh ,
Volume 72, Issue 12 (3-2015)
Volume 72, Issue 12 (3-2015)
Abstract
Background: In Nov 2013, the instruction for controlling high cholesterol has been released by the American College of Cardiology (ACC) and the American Heart Association (AHA) which need to be assessed in the different communities. Methods: Of total 6275 individual aged 40-75 years who entered at the Tehran Lipids and Glucose Study from March 1999 to 20 March 2010 in first examination cycle, 5153 with the median follow-up of more than ten years were eligible to enter in this study. The 10-year risk of hard cardiovascular disease (Hard CVD) for Statin therapy based on ACC/AHA clinical guideline was calculated and this risk was calculated for each subgroup of the guideline who recommended for statin therapy comparing to the risk in individuals with prevalent CVD. Results: Of nearly 6.5 million urban population of Iran (according to the 1996 census) about 4 million individuals (2.55 million men and 1.4 million women) were eligible for statin therapy. With respect to the urban population growth from the 1996 to the 2011 census (about 2.5 percent increases) the number of individuals for receiving statin increased by 50% (5 million men and 3 million women). Also, the risk in non-diabetic men with calculated risk of 5-7.5% and diabetic women with calculated risk of <5% for hard CVD was lower than 0.2. By removing these people from total eligible population, the burden of statin therapy will reduced about 8% which is about 540.752 persons, according to the Census 1996 and 1.155.079 individuals based on the census 2011. Conclusion: The new guideline of ACC/AHA for statin therapy is relatively reasonable except for some subgroups. To reduce the burden of medical expenses, statin prescription can be ignored by physicians in these subgroups. Of course further research is required to calculate the net benefit for estimating the clinical usefulness of statin therapy in recommended guideline subgroups.
Mahbobeh Alizadeh , Majid Mousavi Movahed , Shokrollah Sadredini , Ashrafalsadat Mostafavi , Mohsen Fathi ,
Volume 74, Issue 9 (12-2016)
Volume 74, Issue 9 (12-2016)
Abstract
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Background: Cardiopulmonary resuscitation, commonly well-known as CPR, is an emergency technique that includes chest compression often with artificial ventilation in an exertion to manually preserve complete brain task until additional measures are taken to return spontaneous blood circulation and breathing in a person who is in cardiac arrest. According to the International Liaison Committee on Resuscitation Guidelines, CPR includes chest compressions for adults between 5 cm (2.0 in) and 6 cm (2.4 in) deep and at a rate of at least 100 to 120 per minute. Cardiopulmonary resuscitation is aimed to reverse vital organs as like as heart, lungs and for subsistence of patients. Several researches showed that different factors affect the resuscitation results. The current study was designed to assess the results of resuscitation and its association factors. |
Methods: This retrospective, descriptive and analytic study was carried out in Baharloo Hospital, Tehran, Iran during March 2014 and February 2015. In current work, all resuscitated patients were imported and patients with uncompleted files and died before entrance to hospital were excluded. The data was obtained from medical records units, office files unit and the unit of quality improvement. Data were analyzed by use of SPSS version 22 (Armonk, NY, USA) software and Chi-square test and Student’s t-test.
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Results: From 891 patients, 813 cases were entered the study that 498 (61.3%) were male and 315 (38.7%) were female. 41.1% of resuscitation were successful and 58/9% were unsuccessful. The mean and standard deviation time of resuscitation was 28.80 and 12.6 minutes; the most frequent primary diagnosis was cardiovascular disease. In this study there was a significant difference between age and duration of the resuscitation with successful resuscitation (P= 0.02) but, in the variables of ward and resuscitation team were not significant (P> 0.05). Conclusion: The results of this study showed that resuscitation in younger group, short duration of resuscitation and patients without heart diseases are more successful. |
Majid Kermani , Mohsen Dowlati , Ahmad Jonidi Jafari , Roshanak Rezaei Kalantari ,
Volume 74, Issue 12 (3-2017)
Volume 74, Issue 12 (3-2017)
Abstract
Background: Air pollution, especially the phenomenon of dust and particulate matter can cause mortality of many civilians, and causes various diseases including cardiovascular and respiratory diseases. One of the major pollutants in the air is particulate matter that concentration has increased over recent years. So, present study with aim of Quantification Health Endpoints Attributed to particulate matter in Tehran, Capital of Iran during the past decade (2005-2014) by AirQ software, version 2.2.3 (WHO European Centre for Environment and Health) was performed.
Methods: This study is a descriptive-analytic investigation. The process of performance this study lasted 12 months. Subject of this the study and research was in Environmental Health Engineering Department of Iran University of Medical Sciences. Exact data of every hour pollutants were taken from Department of environmental (DOE) Islamic Republic Iran and Air Quality Control Company of Tehran. Then validated according to the World Health Organization (WHO) guidelines and Statistical parameters for quantifying health effects were calculated in excel software. Finally, assessment of cases total mortality, cardiovascular mortality, respiratory mortality and cardiovascular disease and respiratory disease, with AirQ software was performed.
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Results: The results of this study showed that the number of total mortality, cardiovascular mortality and respiratory mortality caused by exposure to Particulate matter smaller than 10 microns (PM10) in the past decade is 11776, 12121 and 33066 cases respectively. Also the total number of hospital admission due to cardiovascular disease and respiratory disease in the past decade is 20990 and 54352 cases in 2005-2014 years. Conclusion: According to the results of this study, during the last decade the level of air pollution and Concentration of pollutants in Tehran Increased. Effects and health consequences due to exposure to Particulate matter smaller than 10 microns (PM10) in Tehran Metropolis Is very severe and increased mortality and cardiovascular and respiratory diseases among the citizens of Tehran. |
Mahmoud Ebrahimi , Mohammad Karimi , Faranak Dehghani , Amir Biriaei , Nafiseh Farhadian, Shiva Golmohammadzadeh ,
Volume 77, Issue 3 (6-2019)
Volume 77, Issue 3 (6-2019)
Abstract
Background: Sesame oil can be used to treat cardiovascular diseases, such as atherosclerosis, by reducing the levels of fibrinogen and factor VII. The aim of this study is to prepare a microemulsion containing sesame oil as a drug nanocarrier for improving the aqueous solubility and therapeutic effects of this vegetable oil on the reduction of the fibrinogen and factor VII levels in animal model.
Methods: This experimental study was performed for microemulsion preparation and animal test at Ferdowsi University of Mashhad and Cardiovascular Research Center of Mashhad University of Medical Sciences, Mashhad, Iran, respectively, from April 2015 to January 2017. To prepare the microemulsion samples, Tween 80 and span 80 were selected as surfactant couple and surfactant ratios of 8:1, 9:1 and 10:1 were determined for construction of pseudo-ternary phase diagrams. The Zealand white rabbits were categorized in three groups: receiver of base diet group, high cholesterol diet and high cholesterol diet plus microemulsion.
Results: The average particle size of the samples was in the range of 16.64±0.1 to 21.16±0.2 nm with a uniform particle size distribution. Zeta potential was in the range of -10.7 to 18.4 mV, refraction index was approximately 1.39. Electrical conductivity coefficient was in the range of 297 to 311 μz and pH of all the samples were approximately 6.42 for all samples. All of the microemulsion samples were physically stable and the prepared sample with 9:1 surfactant ratio was selected to investigate the animal test due to the higher oil percentage in comparison with the other samples that be stable over 6 months. Significant decrease in the levels of fibrinogen and factor VII in the third group of rabbits was observed compared to the other groups.
Conclusion: The results of this study showed the effective performance of nanostructured drug delivery systems in the form of microemulsion to improve the aqueous solubility and therapeutic effects of hydrophobic compounds such as vegetable oils.
Methods: This experimental study was performed for microemulsion preparation and animal test at Ferdowsi University of Mashhad and Cardiovascular Research Center of Mashhad University of Medical Sciences, Mashhad, Iran, respectively, from April 2015 to January 2017. To prepare the microemulsion samples, Tween 80 and span 80 were selected as surfactant couple and surfactant ratios of 8:1, 9:1 and 10:1 were determined for construction of pseudo-ternary phase diagrams. The Zealand white rabbits were categorized in three groups: receiver of base diet group, high cholesterol diet and high cholesterol diet plus microemulsion.
Results: The average particle size of the samples was in the range of 16.64±0.1 to 21.16±0.2 nm with a uniform particle size distribution. Zeta potential was in the range of -10.7 to 18.4 mV, refraction index was approximately 1.39. Electrical conductivity coefficient was in the range of 297 to 311 μz and pH of all the samples were approximately 6.42 for all samples. All of the microemulsion samples were physically stable and the prepared sample with 9:1 surfactant ratio was selected to investigate the animal test due to the higher oil percentage in comparison with the other samples that be stable over 6 months. Significant decrease in the levels of fibrinogen and factor VII in the third group of rabbits was observed compared to the other groups.
Conclusion: The results of this study showed the effective performance of nanostructured drug delivery systems in the form of microemulsion to improve the aqueous solubility and therapeutic effects of hydrophobic compounds such as vegetable oils.
Reza Abdollahi , Bahman Vahidi , Mohammad Karimi ,
Volume 77, Issue 9 (12-2019)
Volume 77, Issue 9 (12-2019)
Abstract
Background: Cerebral aneurysm disease causes intracranial hemorrhage by rupturing, which can eventually, lead to organ failure or death. For this reason, it is important to anticipate the reasons for rupturing of a cerebral aneurysm from biomechanical point of view. Investigating this disease may even help the physicians to find treatments and predict the patient’s situation. This research was conducted to understand risks of development and rupture of a patient-specific cerebral aneurysm.
Methods: In a computational simulation, fluid-structure interaction method has been used for a patient-specific case. Also, considering the speed of the systole as the initial condition of the problem, the blood fluid domain has been solved in three types of fluid mathematical models (Newtonian, non-Newtonian Carreau, and non-Newtonian power-law). Then, the pressure results on the wall have been transmitted to ANSYS software, version 15.0 (ANSYS Inc., Canonsburg, PA, USA) and the structure has been solved based on three material models (linear elastic, hyperplastic Neo-Hookean and hyperplastic Mooney-Rivlin, with 5 parameters). The study was done in University of Tehran, Iran, from October 2016 to September 2018.
Results: Shear stress, pressure, flow velocity, wall displacement and von-Mises stress have been extracted from the simulations. The average wall displacement of the aneurysm was 1.8 mm. Also, no significant difference was found in the amount of arterial wall displacement, with constant wall material model and different blood models. However, a significant difference has been observed in the case of considering constant blood model and different wall material models in the value of displacement.
Conclusion: With regard to the amount of displacement of the aneurysm wall in this particular patient, with the geometry and location of the specific aneurysm, the brain nerves 3 and 6 were under stress and exposed to damage. The minimum shear stress was in the aneurysm neck, which stimulates the endothelial cells in the area of aneurysm. In addition, the blood model didn’t had a significant effect on the displacement calculations, while the wall material model played a more decisive role.
Methods: In a computational simulation, fluid-structure interaction method has been used for a patient-specific case. Also, considering the speed of the systole as the initial condition of the problem, the blood fluid domain has been solved in three types of fluid mathematical models (Newtonian, non-Newtonian Carreau, and non-Newtonian power-law). Then, the pressure results on the wall have been transmitted to ANSYS software, version 15.0 (ANSYS Inc., Canonsburg, PA, USA) and the structure has been solved based on three material models (linear elastic, hyperplastic Neo-Hookean and hyperplastic Mooney-Rivlin, with 5 parameters). The study was done in University of Tehran, Iran, from October 2016 to September 2018.
Results: Shear stress, pressure, flow velocity, wall displacement and von-Mises stress have been extracted from the simulations. The average wall displacement of the aneurysm was 1.8 mm. Also, no significant difference was found in the amount of arterial wall displacement, with constant wall material model and different blood models. However, a significant difference has been observed in the case of considering constant blood model and different wall material models in the value of displacement.
Conclusion: With regard to the amount of displacement of the aneurysm wall in this particular patient, with the geometry and location of the specific aneurysm, the brain nerves 3 and 6 were under stress and exposed to damage. The minimum shear stress was in the aneurysm neck, which stimulates the endothelial cells in the area of aneurysm. In addition, the blood model didn’t had a significant effect on the displacement calculations, while the wall material model played a more decisive role.
Narges Khodaparast, Nazila Malekian, Zahra Vahabi, Davood Fathi, Shahram Oveisgharan, Farzad Fatehi, Siamak Abdi,
Volume 78, Issue 5 (8-2020)
Volume 78, Issue 5 (8-2020)
Abstract
Background: Alzheimer dementia as the most common cause of dementia is a chronic, progressive, irreversible and incurable disease. The second most common cause of dementia after Alzheimer is vascular dementia. One of the systems involved in dementia is the visuospatial system and visual evoked potential (VEP) can be one of the diagnostic methods for this disease. Therefore, the present study aims to compare visual evoked potential changes in Alzheimer dementia, vascular dementia and patients with minimally conscious impairment (MCI) with healthy people.
Methods: A case-control study was performed on referred clients to Shariati Hospital, Tehran, Iran, from April 2015 to September 2016. Patients with cognitive impairment went through Montreal cognitive assessment (MOCA) test and divided into three groups of Alzheimer dementia, vascular dementia and patients with minimally conscious impairment. Subjects with normal cognition were included in the control group. The visual evoked potential test was performed on all participants in two Methods: pattern shift visual evoked potential (Ps-VEP) and flash visual evoked potential (f-VEP) and results were compared between groups.
Methods: A case-control study was performed on referred clients to Shariati Hospital, Tehran, Iran, from April 2015 to September 2016. Patients with cognitive impairment went through Montreal cognitive assessment (MOCA) test and divided into three groups of Alzheimer dementia, vascular dementia and patients with minimally conscious impairment. Subjects with normal cognition were included in the control group. The visual evoked potential test was performed on all participants in two Methods: pattern shift visual evoked potential (Ps-VEP) and flash visual evoked potential (f-VEP) and results were compared between groups.
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Results: Forty patients were studied in four groups (three patient groups and one control group). 70 percent in Alzheimer group and 60 percent in vascular dementia group had abnormal pattern shift visual evoked potential. Only in Alzheimer group visual evoked potential P100 latency was significantly higher than control group and in other groups, there was no significant difference. Also there was no significant difference between groups in the study of flash visual evoked potential variables including P1, N2, P2 and N3.
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Conclusion: This study showed that only Alzheimer was associated with a significant increase in visual evoked potential P100 latency. On the other hand the other hand, there was no significant difference in flash visual evoked potential variables including P1, N2, P2 and N3 between different groups which shows that flash visual evoked potential cannot differentiate between Alzheimer dementia, vascular dementia, patients with minimally conscious impairment and normal people.
Zeinab Saremi, Mohammad Khodashenas Roudsari, Zahra Tanaki,
Volume 78, Issue 6 (9-2020)
Volume 78, Issue 6 (9-2020)
Abstract
Background: Chronic kidney disease is considered as one of the most common health problems in the world. High mortality and morbidity in these patients, are due to cardiovascular disease and infections. Neutrophil to lymphocyte ratio is recently known as an inflammatory marker. This study aimed to determine the ratio of neutrophil to lymphocyte count in hemodialysis patients in Birjand Special Disease Center, and its role in mortality and morbidity during one-year follow-up.
Methods: This is an analytical descriptive study that was performed on 59 End-Stage Renal disease patients referred to the dialysis department of Special Disease Center, Birjand University of Medical Sciences Birjand, Iran. The levels of neutrophil to lymphocyte ratio, erythrocyte sedimentation rate, and C reactive protein were measured and cases divided into 4 groups according to the NLR: less than 1, 1-1.5, 1.5-2.5, 2.5-3.5, and>3.5. All patients were followed up for one year to determine rate of mortality, cardiovascular and infectious events.
Methods: This is an analytical descriptive study that was performed on 59 End-Stage Renal disease patients referred to the dialysis department of Special Disease Center, Birjand University of Medical Sciences Birjand, Iran. The levels of neutrophil to lymphocyte ratio, erythrocyte sedimentation rate, and C reactive protein were measured and cases divided into 4 groups according to the NLR: less than 1, 1-1.5, 1.5-2.5, 2.5-3.5, and>3.5. All patients were followed up for one year to determine rate of mortality, cardiovascular and infectious events.
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Results: The mean NLR was 2.89±1.38. There was no significant difference in mortality rate between groups according to NLR with P=0.052, also no remarkable difference in infectious and cardiovascular morbidity events in groups with P=0.09 and P=0.21, respectively. The mean NLR in patients with cardiovascular or infectious events was 4.2 and 3.75 respectively, which were notably higher than patients without cardiovascular (NLR:2.49) and infectious (NLR:2.68) events, P=0.02 and P=0.03 respectively. In the bivariate correlation analysis, NLR was positively correlated with CRP in hemodialysis patients.
Conclusion: ESRD patients with NLR>2.5 have higher cardiovascular and infectious events than patients with NLR<2.5 but there was no difference in mortality rate between them. |
Hamidreza Mehryar, Omid Garkaz, Peyman Atabaki, Shadi Gharibi, Nasser Khalili, Sahar Paryab,
Volume 79, Issue 2 (5-2021)
Volume 79, Issue 2 (5-2021)
Abstract
Background: Chest pain is the most common reason for patients to be referred to the emergency department of hospitals. This study was performed to compare the GRACE and TIMI scores in predicting important cardiovascular events in patients.
Methods: This descriptive-analytical study was performed on 862 cardiac patients who were referred to the emergency department of Taleghani Hospital in Urmia in the period of April 1, 2016 to the end of September 2016 by census method. A checklist containing demographic information, medical history and risk factors was used to collect data. After scoring patients, we examined and followed up both groups over the next 30 days and recorded any cardiovascular events such as sudden death, AMI or immediate revascularization. The data were tested using SPSS16 and descriptive statistics tests. T-test and ROC curve were analyzed.
| Results: The results showed that in general, out of 862 patients who were studied (50.3%), 433 were female and (49.7%) 429 were male. Most of the patients were under 65 years old 627 (72.7%) and the age range was (17-91). The highest initial diagnosis of nonSTEMI patients was UA with 811 (94.9%) cases. On the other hand, the highest risk factors of patients were HTN 449(52%), CAD 314 (36.425) and DM 22 (25.55). The highest blood pressure was between (100-120) with 328 cases and serum creatinine between (0.6 to 1.3) with 770 cases. MACE after 30 days in GRACE system 17 people (32.69%) were in high risk group and in TIMI 3 people (37.5%) were in high risk group. In MACE evaluation, the specificity of GRACE system (cutoff point=30) was 89.27 vs. 52.24, the specificity of TIMI system (cutoff point=7.3) and the sensitivity of GRACE 93 (cutoff point=10) versus TIMI 85.71 (cutoff point=8.3) is. Conclusion: The results showed that GRACE was more sensitive and characteristic than TIMI. |
Ahmadreza Assareh, Maryam Jozaei, Hoda Mombeini , Nehzat Akiash ,
Volume 79, Issue 10 (1-2022)
Volume 79, Issue 10 (1-2022)
Abstract
Background: In patients with ST-segment elevation myocardial infarction (STEMI), Primary percutaneous coronary intervention (PCI) is the preferred reperfusion therapy. Timely primary PCI is essential in improving the clinical outcomes of these patients. The aim of this study was to evaluate the factors affecting balloon delay in STEMI treated patients by primary PCI and its relationship with major adverse cardiac events (MACE).
Methods: This prospective observational study was conducted on 143 cases of STEMI patients, who had the inclusion criteria and were treated by primary PCI, after obtaining written consent in Imam Khomeini hospital in Ahvaz, between May 2019 to May 2020. All-time components from symptom onset to PCI treatment include symptom-to-balloon time or ischemic time, symptom-to-door time and door-to-balloon time calculated. The incidence of major adverse cardiovascular events (MACE) including decompensated heart failure (DHF), acute coronary syndrome (ACS), sudden cardiac death (SCD) and cerebrovascular accident (CVA) was evaluated during 12 months follow up after primary PCI. left ventricular ejection fraction (LVEF) changes were evaluated 3 months after primary PCI.
| Results: The median symptom-to-door time was 200.5 minutes (IQR: 90-438.75 min), the median ischemic time was 406 minutes (IQR: 231-671 min), and most patients had an ischemic time ≥120 minutes (92.4%) and door-to-device time ≥90 minutes (64.3%). The most common delay for treatment was in the symptom-to-door time (76.9%) and then the decision for primary PCI to transfer to the cat lab (17.5%). Overall, 59 (41.3%) of the patients experienced MACE during 1-year of follow-up, including ACS (13.3%), DHF (22.4%), cardiac death (9.8%) and CVA (2.1%). The patients age (OR: 0.96, P=0.020), LVEF changes (OR: 1.123, P=0.005) and STEMI type (OR: 0.705; P=0.039) predicted in-hospital MACE, while the symptom-to-balloon time (P=0.607) and door-to-balloon time (P=0.347) were not associated with MACE. Conclusion: None of the time intervals were associated with the occurrence of MACE in one-year follow-up, and most STEMI patients were admitted to the hospital with a long delay. Therefore, efforts to shorten the time of hospitalization admission can help improve the MACE in STEMI patients under primary PCI in our medical centers. |
Mohammad Ali Gharaat , Yaghoob Mehri Alvar,
Volume 81, Issue 6 (9-2023)
Volume 81, Issue 6 (9-2023)
Abstract
Background: Angiogenesis is a physiological process leading to capillary density enhancement and better blood distribution in skeletal muscles, which triggers in response to physical training. The present study aimed to investigate the changes in physiological factors involved in angiogenesis in response to circuit or traditional resistance training.
Methods: Thirty-six healthy sedentary students who were studying at Shahid Rajaee Teacher Training University of Tehran (age: 22.1±2.3 years; height: 172.7±5.1 cm) volunteered to participate in the study (from October 2021 to February 2022). Following a pre-test to evaluate one repetition maximum (1RM) of selected movements (Leg Press, Leg Curl, Leg Extension, Bench Pull, Seated Row, Biceps Curl), subjects randomly divided into Circuit Resistance training (CRT) (training protocol included 4 circles/3 times a week/8 weeks circuit performance/50-55% 1 Repetition Maximum (1RM), n=12), Traditional resistance training (RT) (training protocol included 8 repetition/3 set/3 time per week/8 weeks of same movements with 75% 1RM followed by 2 minutes break to rest between the sets; n=12) and the control group without any regular training (n=12). We assessed the level of Vascular Endothelial Growth Factor (VEGF), plasma level of growth hormone (GH), and Basic Fibroblast Growth Factor (BFGF) to the mentioned training methods. Data were evaluated by utilizing SPSS version 14.
Methods: Thirty-six healthy sedentary students who were studying at Shahid Rajaee Teacher Training University of Tehran (age: 22.1±2.3 years; height: 172.7±5.1 cm) volunteered to participate in the study (from October 2021 to February 2022). Following a pre-test to evaluate one repetition maximum (1RM) of selected movements (Leg Press, Leg Curl, Leg Extension, Bench Pull, Seated Row, Biceps Curl), subjects randomly divided into Circuit Resistance training (CRT) (training protocol included 4 circles/3 times a week/8 weeks circuit performance/50-55% 1 Repetition Maximum (1RM), n=12), Traditional resistance training (RT) (training protocol included 8 repetition/3 set/3 time per week/8 weeks of same movements with 75% 1RM followed by 2 minutes break to rest between the sets; n=12) and the control group without any regular training (n=12). We assessed the level of Vascular Endothelial Growth Factor (VEGF), plasma level of growth hormone (GH), and Basic Fibroblast Growth Factor (BFGF) to the mentioned training methods. Data were evaluated by utilizing SPSS version 14.
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Results: Present findings showed that CRT and RT protocols resulted in significant increases in post-test compared to pre-test in VEGF (P=0.00), GH (P=0.04), and BFGF (P=0.00). In addition, the magnitude of changes in VEGF and GH were significantly greater than the magnitude of changes in control group in post-test (P=0.03, and 0.001, respectively). Furthermore, there was a strong correlation between absolute values of GH and VEGF (r=0.74 and r=0.71) following CRT (P=0.01) and RT (P=0.02).
Conclusion: This study demonstrated that CRT and RT might enhance angiogenesis through an increase in VEGF, bFGF and GH, leading to better blood distribution in muscles. |
Shima Kashani, Seyed Masoud Moosavi , Iraj Nazari , Hossein Minaei,
Volume 81, Issue 7 (10-2023)
Volume 81, Issue 7 (10-2023)
Abstract
Background: Vascular traumas are among the important traumas, most of which lead to significant complications due to the lack of correct and timely diagnosis, considering the frequency of penetrating vascular injuries, especially in our country and Khuzestan province, as well as the complications and mortality caused by injuries. This study was designed to investigate the effect of vascular surgery intervention on patients with arterial injury of forearm trauma.
Methods: In this descriptive-analytical study, all trauma patients suspected of penetrating forearm arterial injuries in terms of age, sex, type of trauma, location of trauma, type of intervention, location of arterial repair, angiographic and clinical findings including damaged arteries, type of injury Arterial fracture or dislocation. The proximity of vascular damage and the complications of surgical interventions are investigated.
Methods: In this descriptive-analytical study, all trauma patients suspected of penetrating forearm arterial injuries in terms of age, sex, type of trauma, location of trauma, type of intervention, location of arterial repair, angiographic and clinical findings including damaged arteries, type of injury Arterial fracture or dislocation. The proximity of vascular damage and the complications of surgical interventions are investigated.
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Results: The results of this study showed that among the penetrating trauma patients requiring surgical intervention, 90.4% were men and only 6.9% were women. The average age of the patients was 32 years. The most frequent trauma requiring surgical intervention in this study was primary repair of a stab wound in the ulnar artery and the least was due to explosive. According to the obtained results, there was a statistically significant relationship between the amount of bleeding, the days of hospitalization and the duration of the operation with the type of trauma. The most damaged artery was ulnar artery 7.50% and the most type of arterial damage was arterial cut with active bleeding (7.39%).
Conclusion: According to the results of the present study, the most damage was in the ulnar artery caused by trauma with sharp objects (knives). The incidence of complications in primary repair surgery was higher than other types of surgical interventions, and there was a statistically significant relationship between the amount of bleeding, days of hospitalization, and duration of surgery with the type of trauma. |
Mohammad Parsa Mahjoub , Naser Kechuian, Mohammad Haji Aghajani , Hossein Aghamiri , Ainaz Samadi, Fateme Omidi ,
Volume 82, Issue 7 (10-2024)
Volume 82, Issue 7 (10-2024)
Abstract
Background: Cardiovascular surgery is sometimes associated with brain consequences such as cognitive disorders. Diagnosis of cognitive disorders risk factors in cardiovascular patients is important for increasing patient satisfaction and success after (CABG). In the present study, the frequency of cognitive disorders in cardiovascular patients and its effective factors were investigated.
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Methods: In the current cross-sectional study that was conducted from September 2019 to the February 2022, 60 cardiovascular patients undergoing CABG surgery were selected by convenience sampling method. Demographic, clinical, and intraoperative information was recorded for participants in the data collection form. Mini–Mental State Examination quesionary.
Results: The results showed that 15% of participants had cognitive impairment. Gender and age were the actual variables on the incidence of cognitive disorders after CABG surgery. The frequency of cognitive disorders in women was 14 times higher than men and 6.5 times higher in the elderly. Elderely population was considered as 65 years old or above. The clinical variables such as blood transfusion under surgery and ejection fraction<40% were effective factor for incidence of cognitive disorders in cardiovascular patients. Conclusion: The CABG surgery may be associated with cognitive disorders in cardiovascular patients, which is more common in women and the elderly. Further studies are recommended to confirm the results of the present study and identify the related risk factors. |
Iraj Nazari, Seyed Masood Mousavi, Ali Asghar Dastyar , Shaghayegh Sherafatmand , Ali Saeidi,
Volume 82, Issue 8 (11-2024)
Volume 82, Issue 8 (11-2024)
Abstract
Background: Vascular trauma is a life-threatening emergency and the third leading cause of death worldwide. Due to the frequency and importance of distal lower extremity artery injury in lower extremity trauma, the present study aimed to investigate the outcomes of vascular surgical interventions in patients with non-penetrating arterial trauma of the distal lower extremity (sub-trifurcation).
Methods: In this retrospective study, trauma patients with suspected non-penetrating injuries of the lower extremity arteries (sub-trifurcation) who referred to the Vascular Surgery Center of Golestan Hospital, Ahvaz, between September 2021 to September 2023 were evaluated. Data included demographic information, duration of surgery, length of hospitalization, and side effects of surgery.
| Results: Of the total of 86 patients, 76 patients (88.4%) were treated with open surgery. 83.7% of patients (72) were male and in the age range of 30-35 years. The most common surgical method used was bi-artery repair (92.3%). The most complications were in the bi-artery bypass repair method, but only the results of nerve involvement and limb preservation in the Ligation repair or bypass two artery intervention showed a statistically significant difference in the first week after surgery (P=0.05). Among patients, only two cases of mortality were observed one week after surgery, which was in the bi-artery repair group. (5.1%). The bi-artery repair intervention method was the best and least complicated surgical method among patients with vascular injury under blunt trauma. Conclusion: According to the results of this study, the bi-artery repair intervention method had the lowest rate of other complications and was the best and least complicated surgical method among patients with vascular injury under blunt trauma. |
Fatemeh Rasouli Amiri , Khadijeh Ezoji, Seyed Reza Hosseini, Ali Bijani , Kayvan Latifi ,
Volume 82, Issue 8 (11-2024)
Volume 82, Issue 8 (11-2024)
Abstract
Background: People with chronic pain have a shorter life expectancy than the general population, in part as a result of excess mortality from cardiovascular disease (CVD). The purpose of this study was to investigate the relationship between chronic pain and risk factors of cardiovascular diseases.
Methods: In this study, 400 elderly diabetic patients in phase one of the Amirkola Elderly Cohort Study (AHAP), which was conducted between April 2011 to March 2016, were divided into two groups of 200 people, with chronic pain and without chronic pain. Then, the risk factors for cardiovascular diseases that are available in this plan such as physical activity level, body mass index, blood sugar levels, blood lipid profile status, Hypertension and smoking were examined.
Methods: In this study, 400 elderly diabetic patients in phase one of the Amirkola Elderly Cohort Study (AHAP), which was conducted between April 2011 to March 2016, were divided into two groups of 200 people, with chronic pain and without chronic pain. Then, the risk factors for cardiovascular diseases that are available in this plan such as physical activity level, body mass index, blood sugar levels, blood lipid profile status, Hypertension and smoking were examined.
Results: In the study of baseline variables in the elderly with and without pain with diabetes, it was found that women reported more pain with 54.4% than men with 45.6% that there is a significant difference between the two sexes (P=0.0001). Education level was also associated with having pain so that 67.8% of the elderly with having pain were illiterate and this relationship was significant (P=0.006). 82.5% of the elderly with higher physical activity had less pain than the elderly with less physical activity. This indicates the effect of physical activity in reducing pain and the observed relationship was significant (P=0.001). Triglyceride levels and history of underlying disease were lower in painless elderly (P=0.009 and P=0.002). Physical activity in the elderly without pain was higher than the elderly who had pain and this significant difference was reported (P=0.002).
Conclusion: The results of this study indicate a high prevalence of chronic pain in the elderly in Amirkola. In the elderly without chronic pain, there were lower triglyceride levels, more physical activity and fewer underlying diseases. Attention to chronic pain features among elderly to identify vulnerable groups and providing better care can increase the quality of life in this group.
Conclusion: The results of this study indicate a high prevalence of chronic pain in the elderly in Amirkola. In the elderly without chronic pain, there were lower triglyceride levels, more physical activity and fewer underlying diseases. Attention to chronic pain features among elderly to identify vulnerable groups and providing better care can increase the quality of life in this group.
Babak Hooshmand-Moghadam , Abbas Ali Gaeini,
Volume 82, Issue 12 (3-2025)
Volume 82, Issue 12 (3-2025)
Abstract
Background: As survival rates among breast cancer patients improve, cardiovascular disease (CVD) has emerged as a leading cause of long-term morbidity and mortality in postmenopausal survivors. This epidemiological transition from oncologic risk to cardiometabolic vulnerability reveals a critical yet underexplored dimension of survivorship care. Structured exercise training represents a promising intervention, and this narrative review-grounded in a systematic literature search investigates the effects of aerobic, resistance, and combined training modalities on cardiovascular health in postmenopausal women with breast cancer. The review synthesizes evidence across physiological mechanisms, clinical outcomes, and implementation challenges to provide a comprehensive perspective on exercise oncology in this underserved population.
Methods: A systematic search of reputable international databases including PubMed, Scopus, Web of Science, Embase, and Google Scholar as well as Persian databases SID and Magiran was conducted to identify relevant human studies, clinical trials, and randomized controlled trials published between January 2000 and April 2025. Screening, selection, and synthesis of the studies were performed in Iran between October 2024 and January 2025.
Results: Accumulating evidence supports that structured exercise especially combined aerobic and resistance training exerts substantial cardioprotective effects through multiple mechanisms, including reductions in systemic inflammation, improvements in body composition, regulation of blood pressure, enhancement of cardiorespiratory fitness, and improved left ventricular function. Combined interventions consistently outperformed single-modality programs, underscoring the importance of integrative approaches in oncologic rehabilitation. Despite this promise, persistent barriers such as limited access to trained personnel, lack of individualized protocols, and weak institutional support impede translation into routine practice. Notably, few existing reviews have bridged mechanistic, clinical, and operational domains in this population, highlighting a significant gap in the literature.
Conclusion: Exercise training is not merely an adjunct to care it is a clinically potent, physiologically grounded, and policy-relevant strategy for mitigating cardiovascular risk in postmenopausal breast cancer survivors. Given the increasing burden of CVD in this group, integrating personalized, evidence-based exercise into oncologic care pathways is both urgent and essential for advancing survivorship standards and informing future clinical guidelines.
Somayeh Abbaspour , Hassan Karimi, Maryam Farzaneh , Zahra Karimi , Shirin Azizidoost ,
Volume 83, Issue 7 (10-2025)
Volume 83, Issue 7 (10-2025)
Abstract
Background: The duration of hospitalization of patients is considered an important indicator in health resource management and patient evaluation. This study investigated the frequency and causes of readmission in cardiovascular patients
Methods: This was a retrospective study of 105 patients with cardiovascular diseases referred to Imam Khomeini Hospital in Ahvaz who were readmitted from April 2024 until August 2024 within 30 days after discharge due to recurrence of symptoms. Demographic (including age and gender) and clinical information (including duration of hospitalization, regular medication use, regular physician visits, disease diagnosis and dietary adherence) of the patients was extracted from electronic records using a researcher-made checklist.
Results: From 105 patients, 43 (41%) were admitted in the first trimester and 62 (59%) in the second trimester. The mean age of patients in the first trimester was higher than in the second trimester with a statistically significant association with readmission (P=0.038). Most patients were male and their number was higher in the second trimester than in the first trimester and a statistically significant association was observed between the gender of patients with readmission in the first trimester compared to the second trimester (P=0.015). 72 patients with acute coronary syndrome (68.6%) and 33 patients with heart failure (31.4%) were readmitted. The mean length of stay in the first trimester was 1.6 ± 1.15 days and 2.9 ± 2.7 days in the second trimester. A significant association was observed between the duration of hospitalization and readmission (P=0.003). However, no association was observed between regular medication use and regular physician visits in readmitted patients. However, a significant association was observed between dietary adherence in readmitted patients (P=0.045).
Conclusion: Readmission of cardiovascular patients follows a seasonal pattern and is associated with factors such as age, sex, length of stay, and dietary adherence. Routine disease management measures are not sufficient to counteract these effects, and targeted educational programs are necessary at the threshold of high-risk periods.
Methods: This was a retrospective study of 105 patients with cardiovascular diseases referred to Imam Khomeini Hospital in Ahvaz who were readmitted from April 2024 until August 2024 within 30 days after discharge due to recurrence of symptoms. Demographic (including age and gender) and clinical information (including duration of hospitalization, regular medication use, regular physician visits, disease diagnosis and dietary adherence) of the patients was extracted from electronic records using a researcher-made checklist.
Results: From 105 patients, 43 (41%) were admitted in the first trimester and 62 (59%) in the second trimester. The mean age of patients in the first trimester was higher than in the second trimester with a statistically significant association with readmission (P=0.038). Most patients were male and their number was higher in the second trimester than in the first trimester and a statistically significant association was observed between the gender of patients with readmission in the first trimester compared to the second trimester (P=0.015). 72 patients with acute coronary syndrome (68.6%) and 33 patients with heart failure (31.4%) were readmitted. The mean length of stay in the first trimester was 1.6 ± 1.15 days and 2.9 ± 2.7 days in the second trimester. A significant association was observed between the duration of hospitalization and readmission (P=0.003). However, no association was observed between regular medication use and regular physician visits in readmitted patients. However, a significant association was observed between dietary adherence in readmitted patients (P=0.045).
Conclusion: Readmission of cardiovascular patients follows a seasonal pattern and is associated with factors such as age, sex, length of stay, and dietary adherence. Routine disease management measures are not sufficient to counteract these effects, and targeted educational programs are necessary at the threshold of high-risk periods.
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