A comparison of elderly （20-65 yrs） life style with body mass index （BMI）〈and〉25

Objective：compare the habits and features of obese （BMI〉25） and normal （BMI〈25） individuals and express a method to ameliorate the life styles using a cross-sectional experiment. Methods：A total of 220 randomly selected cases were divided into case group （n= 110） and control group （n= 100） according to the calculated BMI level. Samples with BMI〉25 kg/m^2 were assigned to the case （obsess） group and those with BMI ranging from 20 to 25 were assigned to control （normal） group. The Miller-Smith life style questionnaires consisting 20 questions each with 5 different answers were given to both groups. Data of the questionnaires were collected and analyzed using t-test and Chi-square with SPSS. Results：No significant differences were found among the two groups in terms of the mean age, gender, level of education, marital status, insurance, breakfast, lunch or dinner, fried meat, legumes, eaffeinated beverages, the length of sleep during 24 h, cigarette smoking and losing job or spouse. However, in regards to use of vegetables, sausage, fried potatoes, enriched breads, low fat milk, low salt, candies and chocolates significant relations were found （P〈0.05）. Conclusion： The present study suggests one way to control obesity and prevent diseases is to ameliorate the life styles. There is a relation between health and stress and irregularity of meals, such as breakfast skipping, is associated with overweight and obesity in adolescence.     

Validation Study of a Quality of Life (QOL) Questionnaire for Usin Iran.

Introduction: Recently, it has been recognized that a more comprehensive assessment of the cancer patient is necessary and that the evaluation of outcomes must move beyond traditional biomedical endpoints to include assessments of the impact of disease and its treatment on patients' quality of life. The European Organization for Research and Treatment of Cancer has developed a 30-item quality of life questionnaire to obtain information about the impact of disease and treatment on the daily living of cancer patients. This questionnaire has been translated into many languages and used in various countries. However, version 3.0 has not yet been validated for use with Iranian patients. The aims of the present study were therefore to evaluate the reliability and validity of the new QLQ-C30 questionnaire. Method: We conducted a cross-sectional study on 132 random samples of breast cancer patients. Reliability was evaluated through the internal consistency of multi-item subscales. Pearson's correlations of an item with its own scale (corrected for overlap) and other scales were calculated to evaluated convergent and discriminant validity. Clinical validity was evaluated by known-group comparisons. All calculations were performed using SPSS.V.13 software. Results: In the reliability analysis, most scales fitted the criteria except the fatigue (Alpha 0.65), pain (Alpha 0.69) and nausea and vomiting scales (Alpha 0.66). Convergent validity was evidenced by item own subscale correlation above 0.40 for all multi-item subscales. Item discriminant validity was successful in all analyses except for item 4 of the physical functioning scale. Results of the group based analysis show significant differences in QLQ-C30 functioning and symptom scores, where patients with higher grade have the worst outcome(P<0.05). Conclusion: The Iranian version of EORTC QLQC30 is a reliable and valid QOL measure for cancer patients which indicates that it can be used in clinical and epidemiological cancer research.     

Investigating the potential contribution of community pharmacists in identifying,understanding and meeting the bone health needs of patients in collaboration with GPs

Evidence‐based patient‐completed questionnaires were used to assess patients' risk of osteoporosis Community pharmacists significantly increased patient bone health knowledge which was sustained over a 10‐week period; pharmacists significantly contributed to increasing patients' daily calcium intake in line with national recommendations Patients at high‐risk of osteoporosis were identified, appropriately managed in the pharmacy or referred to GPs and followed‐up Patients indicated satisfaction with the programme and felt they had become more aware of bone health All the programme standards were met and gave a mandate for the roll‐out of revised and improved community‐pharmacy based programmes that could meet the bone health needs of patients     

Effect of relaxation on the level of nursing internshipstudents＇ stress

Objective： To explore how relaxation reduce the effect of stress in Iranian nursing students. Methods： A total of 40 nursing students were randomly selected and divided into two groups of test and control each with 20 students. An exam questionnaire consisting of the stress test of Spilberger and control of physiological determinants （blood pressure, pulse respiration, temperature） was performed to two groups. The practice of relaxation continued for two weeks and three times a day. Data were collected and analysed using t-test and Chi-square. Results： Two groups did not show any difference in relation to the average of physiological determinants before and after investigation. However, pulse was significantly different between the two groups. The average scores of stress before and after relaxation were significantly differed between the two groups investigation so that the level of stress was reduced in the test group （t= 2.5, df =39, P= 0.02）. Conclusion： To alleviate stressors associated with clinical practice and create a healthy work environment for practice it is recommended that nursing students have some relaxation before entering practical environments.     

Test-retest reliability of Motricity Index strength assessments for lower extremity in post stroke hemiparesis

Background

The Motricity Index was used to measure strength in upper and lower extremities after stroke. The weighted score based on the ordinal 6 point scale of Medical Research Council was used to measure maximal isometric muscle strength. There is dearth of articles dealing with the reliability of this method. Therefore, the aim of this study was to determine the test retest reliability of Motricity Index strength assessments for paretic lower limb in 20 chronic stroke patients with one week interval.

Methods

In a cross sectional study, intrarater reliability of lower extremity Motricity Index strength assessments with one week interval were measured.

Results

The SPSS 18 was used for analysis of data. Two-way random-consistency model of ICC was used for assessment of test-retest reliability. The ICC values showed high reliability of strength measurement of Motricity Index (ICC=0.93).

Conclusion

The Motricity Index can be a reliable instrument for measuring the strength of involved lower extremity when assessment is done by one rater following chronic stroke.     

Factors-related to quality of life in post myocardial infarction patients

Objective： To identify factors related to quality of life in post myocardial infarction patients. Methods： The subjects were 150 post myocardial infarction patients who were receiving follow up care at Hajar Hospital. Self-administered questionnaires consisting of physical-and mental health-quality of life （QoL） during a 14-month follow-up were designed. A X2 test was used to determine relationships between variables. Results： There was significant corretation between demographic variables such as insurance and retirees between the subjects tested. In addition, a significant relationship between the pain intensity, fatigue, reducing or losing job performance and QoL was found. Conclusion ： The role of nurses to fulfill all social, psychotically and mental requirements of the patients with myocardial infarction is highly appreciated.     

Household cardiovascular screening of high-risk families: a school-based study.

BACKGROUND: A parental history of cardiovascular disease has a strong relationship with risk factor clusters in the offspring. This study was performed to identify major cardiovascular risk factors in middle school-aged children and their parents in both high and low-risk families. DESIGN: A school-based, cross-sectional study. METHODS: The middle schools of the 6th district of Tehran were divided randomly into two groups. A total of 169 high-risk children with their families were recruited from the first group and 105 low-risk children with their families were recruited from the second group of schools. Anthropometric and metabolic measurements were performed. RESULTS: The means of the waist circumference and waist-to-hip ratio were significantly higher in high-risk fathers. The means of total and low-density lipoprotein (LDL) cholesterol were significantly higher in both parents and children of the high-risk group. The means of the fasting plasma glucose were significantly higher in fathers and offspring of high-risk families. More fathers in high-risk families were smokers. The prevalence of increased total cholesterol, LDL-cholesterol and hyperglycemia (> or = 100 mg/dl) were higher in high-risk parents and children. The prevalence of increased body mass index (> or = 25 kg/m for parents and 85th percentile for children) was higher in fathers and children of high-risk families. CONCLUSIONS: Cardiovascular risk factors are more prevalent and clustered in high-risk families. The screening of high-risk families is essential to prevent the progression of atherosclerosis from childhood and reduce the burden of cardiovascular disease in adulthood.     

In-hospital and mid-term adverse clinical outcomes of a direct stenting strategy versus stenting after predilatation for the treatment of coronary artery lesions

Background

Direct stenting without balloon dilatation may reduce procedural costs and duration, and hypothetically, the restenosis rate. This study was designed to compare the in-hospital and long-term outcomes of direct stenting (DS) versus stenting after pre-dilatation (PS) in our routine clinical practice.

Methods

The 1 603 patients treated with stenting for single coronary lesions were enrolled into a prospective registry. Patients with acute myocardial infarction (MI) within the preceding 48 hours, and those with highly calcified lesions, total occlusions, or a lesion in a saphenous graft were excluded. The baseline, angiographic and procedural data, inhospital outcomes and follow-up data were recorded in our database and analysed with appropriate statistical methods.

Results

Eight hundred and fifty-seven patients (53.5%) were treated with DS and 746 (46.5%) underwent PS. In the DS group, lesions were shorter in length, larger in diameter and had lower pre-procedural diameter stenosis. Type C and diffuse lesions and drug-eluting stents were found less often (p < 0.001). With univariate analysis, dissection and non-Q-wave MI occurred less frequently in this group (0.2 and 0.6% vs 3.9 and 2.1%, p < 0.001 and p = 0.01, respectively). However, the cumulative major adverse cardiac events (MACE) did not differ significantly (4.9 vs 4.6%, p = 0.79). With multivariate analysis, direct stenting reduced the risk of dissection (OR = 0.07, 95% CI: 0.01–0.33, but neither the cumulative endpoint of MACE (OR = 1.1, 95% CI = 0.58–2.11, p = 0.7) nor its constructing components were different between the groups.

Conclusions

Direct stenting in the real world has at least similar long-term outcomes in patients treated with stenting after pre-dilatation, and is associated with lower dissection rates.     

Endothelial nitric oxide synthase VNTR (intron 4 a/b) polymorphism association with type 2 diabetes and its chronic complications

Subject and aims

Endothelial derived nitric oxide (eNOS) is involved in several functions playing important role in development of type 2 diabetes and insulin resistance. The aim of this study was to examine the association between eNOS intron 4 VNTR polymorphism and type 2 diabetes in an Iranian population.

Methods

A total of 220 patients with type 2 diabetes and 96 healthy control subjects were recruited from the same area. Genotyping was performed using PCR.

Results

A significant difference was found in genotype frequencies of eNOS polymorphism between patients and controls (aa + ab vs. bb p = 0.02, OR 2.0 95% CI; 1.05-3.96). Also allele a frequency was significantly increased in patients with diabetes compared with controls (p = 0.007, OR 2.1 95% CI; 1.19-4.08). We found that in patients with diabetic neuropathy the frequency of ‘a’ allele was significantly increased compared to the controls p = 0.03, OR = 1.8 95% CI (1.00-3.7). Both genotype and allele frequencies were significantly different between patients who were complication free compared to the controls [aa + ab vs. bb p = 0.007, OR = 2.6 95% CI (1.2-5.8) and p = 0.001, OR = 2.8 95% CI (1.4-5.9)] respectively with the a allele conferring the risk.

Conclusion

The association between eNOS VNTR polymorphism and T2DM seems to be stronger in patients without diabetic complications indicating diverse effect of eNOS polymorphism on diabetes and diabetic microvascular complications.