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Association of vitamin D deficiency and premature coronary artery disease
Get PDFBackground: Evidence suggests hypovitaminosis D is associated with increased risk of coronary artery disease (CAD) and its extent and related risk factors. However, some investigations have produced contrary results. Therefore, we aimed to evaluate the association between serum vitamin D levels and the severity of premature coronary artery involvement. Methods: This randomized prospective, case-control study was conducted in Babol from April 2013 to June 2017. We collected the demographic data and measured serum 25-OH-D levels of 294 patients (age≤50 years) diagnosed with CAD with coronary angiography as case group as well as 438 age and sex-matched controls. CAD severity was assessed using the Gensini score. Statistical analyses were used to assess the associations and p<0.05 was considered as significant. Results: The mean serum level of 25-OH-D was 13.12±11.13 and 18.28±8.34 in case and control groups, respectively (P=0.036). In the case group, mean serum vitamin D levels were significantly lower among hypertensives (P=0.018), those with a family history of CVD (P=0.016) and those who used aspirin (P=0.036). The mean Gensini score of patients in the case group was 45.02±23.62 and was higher among men (P=0.022). There was a weak significant correlation between the serum vitamin D levels and the Gensini score (P=0.001 & R=-0.543). The mean Gensini score was not significantly different between patients with deficient (47.02±22.78), insufficient (26.0±21.72) and sufficient (39.0±43.84) vitamin D levels (P>0.05). Conclusion: The results showed that the lower levels of vitamin D is associated with increased risk and extent of coronary artery involvement as well as some of the risk factors of CAD, including male gender, hypertension and positive family history for CVD
The Effect of Oral Intake of Honey Syrup on the Pain Intensity of Active Phase of Parturition of nulliparous women: A Randomized clinical trial
Get PDFBackground: Labor is a natural pain despite the fact that the severity of the pain and response to it differ in various people, but most women refer to labor as an unpleasant experience of their lives. The present study was carried out to determine the effect of honey on the severity of labor in primigravida women. Methods: In this study, 80 healthy volunteer primigravida women were entered to the research as randomized clinical trial (40 subjects in each group) after studying and signing consent form and they were randomly divided into two intervention honey group and control group. The data gathering tool comprised four main parts of the personal profile questionnaire, controls performance in the labor, records fluid intake rate and pain intensity using a 0-10 cm ruler. Results: The mean of pain intensity in the honey syrup intervention group was significant. Conclusion: Honey syrup consumption without side effects significantly affected the severity of labor
Fever of unknown origin and Q-fever: a case series in a Bulgarian hospital
Get PDFBackground: Fever of unknown origin (FUO) is a perplexing medical problem. The causes for FUO are more than 200 diseases. The aim of the study was to present human clinical cases of Coxiella burnetii infection debuting as FUO. Methods: The following methods were conducted in the study: literature search, laboratory, imaging, and statistical methods. Criteria of Durack and Street were applied for FUO definition. For the etiological diagnosis indirect immunoenzyme assay (ELISA) for antibodies detection against Coxiella burnetii was used (cut-off = 0.481–0.519). Results: From 2008 until 2015, nine patients with FUO caused by C. burnetii were hospitalized at the Military Medical Academy of Sofia. Male gender was predominant (male/female – 77.8 /22.2), mean age was 48.78±14.52 years (range: 26–67), hospital stay was 9.78±2.95 days (range: 5–15), fever duration was 54.33±56.23 days (range: 21–180). Laboratory investigations estimated the elevation of erythrocyte sedimentation rate 49.11±31.74mm/h (95CI = 13.09–111.31), C-reactive protein 37.68±37.62mg/L (95 CI = 36.07–111.42) and fibrinogen 5.69±1.59g/L (95 CI=2.57–8.81). The mean values of liver enzymes were in reference range. Among imaging tests, abdominal ultrasound and X-ray demonstrated 33.3 contribution to the final diagnosis. Transthoracic echocardiography found 22.2 contribution. Serological methods presented 100 contribution. Conclusion: C. burnetii infection was accepted as a final diagnosis among 9 patients with FUO based on the integrated information from the applied methods. Active search and establishment of this pathogen among FUO should lead to avoiding potential complications and consequences in case of untreated patients infected with C. burnetii
The association between anemia and postpartum depression: A systematic review and meta-analysis
Get PDFBackground: The association between anemia and postpartum depression (PPD) has been reported to be controversial in different studies. Therefore, this study aimed to provide a comprehensive assessment of anemia and PPD. Methods: This review study was conducted according to the MOOSE protocol and results have been reported according to the PRISMA guideline. We searched epidemiologic studies published until January 2018 in nine English databases including Scopus, PubMed/Medline, Science Direct, Embase, Web of Science, CINAHL, Cochrane Library, EBSCO and Google Scholar using English MeSH keywords. The heterogeneity of the studies was assessed using the Cochran’s Q test and I2 index. Data were analyzed using a random effects model and comprehensive meta-analysis (CMA) software version 2. Results: In the 10 studies, the association between postpartum anemia and PPD was significant (heterogeneity test: P<0.001, I2=74.62), and RR=1.887 (95CI: 1.255-2.838, P=0.002). In 8 studies, anemia during pregnancy significantly increased the risk of postpartum depression (heterogeneity test: P=0.116, I2=36.422), RR=1.240 (1.001-1.536, P=0.048). The subgroup analysis of postpartum anemia and PPD was not significant for the variables of quality of studies, study design, and the period of evaluating depression and anemia. The subgroup analysis of anemia during pregnancy and PPD was not significant for the period of evaluating depression. Publication bias did not affect the results of the studies. Conclusion: Meta-analysis results showed anemia during pregnancy and after pregnancy that significantly increased the risk of postpartum depression. Therefore, prevention, identification and treatment of anemia in pregnant women seem necessary
Western medical acupuncture is an alternative medicine or a conventional classic medical manipulation
Get PDFWestern medical acupuncture is an alternative medicine or a conventional classic medical manipulatio
Therapeutic options to treat mustard gas poisoning – Review
Get PDFAmong the blistering (vesicant) chemical warfare agents (CWA), sulfur mustard is the most important since it is known as the “King of chemical warfare agents”. The use of sulfur mustard has caused serious damages in several organs, especially the eyes, skin, respiratory, central and peripheral nervous systems after short and long term exposure, incapacitating and even killing people and troops. In this review, chemical properties, mechanism of actions and their effects on each organ, clinical manifestations, diagnostic evaluation of the actions triage, and treatment of injuries have been described
Effect of levothyroxine on cardiac function in children with subclinical hypothyroidism: A quasi-experimental study
Get PDFBackground: Because of the importance of thyroid function and its effect on different organs, such as the heart, this study was aimed to evaluate the effect of levothyroxine on cardiac function in children with subclinical hypothyroidism. Methods: This quasi-experimental study was performed on children aged 4-12 years old with diagnosis of subclinical hypothyroidism in Amirkola Children's Hospital during 2018-2019. Cardiac functional parameters, including ejection fraction (EF), fractional shortening (FS), ratio of early filling velocity to early diastolic mitral annulus velocity (E/E'), myocardial performance index (MPI), left ventricular end-diastolic diameter (LVEDD), and left ventricular end-systolic diameter (LVESD), were measured by echocardiography at baseline and 6 months after levothyroxine treatment. Results: Out of the 30 subjects, 19 (63.3) were boys and 11 (36.7) were girls. The mean age was 6.60±2.13 years old. The mean EF index was 63.13±3.01 percent before treatment, which increased to 69.07±4.50 percent after treatment (p<0.001). Also, the mean FS was 31.83±1.62 percent before treatment, which improved to 35.10±1.13 percent after treatment (p<0.001). The mean MPI was 0.28±0.02 before treatment, which increased to 0.33±0.03 after treatment (p<0.001). On the other hand, no significant difference was found in the mean E/E' before and after treatment. The mean LVEDD decreased from 3.47±0.46 cm before treatment to 3.05±0.40 cm after treatment (p<0.001), whereas LVESD non-significantly decreased after treatment versus before treatment. Conclusion: The results showed that treatment with levothyroxine may improve cardiac functional parameters in children with subclinical hypothyroidism
Are 25(OH) D concentrations associated with asthma control and pulmonary function test?
Get PDFBackground: The relationship between vitamin D and asthma is still under investigation. We aimed to evaluate the association between serum vitamin D levels and clinical characteristics of asthma, and the impact of vitamin D deficiency on the clinical manifestations, as them being the issues of debate. Methods: Patients who were admitted to the outpatient clinics of Chest Diseases Department of Akdeniz University Hospital between January 2014 and December 2014, have been diagnosed as asthma according to the GINA 2014 guidelines were included in this study. Subjects with COPD, bronchiectasis, pneumonia or tuberculosis were excluded. Asthma exacerbation was defined, according to the GINA guidelines, as episodes of progressive shortness of breath, cough, wheezing or chest tightness accompanied by PFT abnormalities such as decreased PEF or FEV1. Results: A total of 158 patients with mean age of 48.8 years were included in the study. Twenty-seven (17.08) of the patients demonstrated sufficient vitamin D serum levels (i.e. ≥30 ng/mL), while the remaining 131 (82.92) patients had vitamin D insufficiency (i.e. <30 ng/mL). When these two patient groups (vitamin D sufficient vs. insufficient) were compared with each other, the patients showing sufficient levels of vitamin D were found to reveal significantly higher FEV1 (L) and FVC (L) values. When the patients were grouped into 4 categories with regard to their serum vitamin D measurements, hospitalization numbers were found to significantly increase with decreasing vitamin D levels. Conclusion: Vitamin D deficiency was significantly associated with poorer pulmonary functions and higher hospitalization numbers
A 25-year trend in gastrointestinal cancers in northern Iran (1991-2016)
Get PDFBackground: Identifyng the incidence of cancer helps in planning and prioritizing resources for its screening, prevention, treatment and diagnosis. This study aimed at investigating a 25-year trend in gastrointestinal cancer in Northern Iran in the time span of 1991-2016. Methods: This research was a trend analysis. Study population was one thousand five hundred and thirty-five cancer patients referring to Shahid Rajai Hospital in Babolsar, northern Iran, as the only center for radiotherapy in the North of Iran, during 1991-2016. Results: The highest incidence of stomach cancer was 111 (35) in 2011 and the lowest incidence was 44 (16.3) in 1996, The highest frequency of esophageal cancer was reported 137(56.1) cases in 1991 and the lowest frequency was 78 (26.3) cases in 2016, while the highest incidence of colorectal cancer was 109 (36.7) cases in 2016 and its lowest frequency was 32 (16.3) in 1996. There was also a significant difference in the frequency of gastrointestinal cancers in different studied years (p <.001). Conclusions: The trends in the incidence of stomach and colorectal cancers in northern Iran were increasing and esophageal cancer was decreasing.  
The Effectiveness of Cognitive – Behavioral Group Therapy On Pain Perception And Pain Severity Among Patients With Chronic Neuropathic Pain
Get PDFBACKGROUND AND OBJECTIVE: The experience of pain consists of two sensory and emotional dimensions. The sensory dimension of pain indicates pain severity and the emotional dimension indicates pain perception. Since cognitive–behavioral therapy is an evidence-based treatment and emphasizes on the correction of dysfunctional thought processes and changing the maladaptive behaviors, this study was designed to investigate the effectiveness of cognitive – behavioral group therapy on pain perception and pain severity among patients with chronic neuropathic pain.
METHODS: This quasi-randomized trial was performed among 30 patients with chronic neuropathy referring to Rouhani Hospital in Babol in two groups of case and control (15 patients in each group). Cognitive – behavioral group therapy was performed in ten 120-minute sessions, held once a week for the experimental group. Participants were examined before the experiment and 45 days after the sessions, and the perception of pain was evaluated by the components of belief in pain permanence, self-blame, belief in pain constancy, mysteriousness of pain, and pain severity. The attainable score in The Pain Beliefs and Perceptions Inventory was 30 to -30, and in The West Haven-Yale Multidimensional Pain Inventory was 0 to 6.
FINDINGS: The results showed that there was a statistically significant difference between the two groups in the total score of pain perception (-8.87±7.40 vs. 1.6±93.30) (p=0.001), and the subscales of belief in pain permanence
(-4.13±1.76 vs. 0.93±3.30) (p=0.04), belief in pain constancy (0.80±3.16 vs. -2.13±3.50) (p=0.04), mysteriousness of pain (-2.73±3.67 vs. 1.33±3.95) (p=0.003), and pain severity (2.19±1.28 vs. 3.64±1.27) (p=0.003).
CONCLUSION: The present study showed that cognitive–behavioral group therapy could be an effective intervention for reducing the pain perception and pain severity in patients with chronic neuropathic pain