Knowledge levels and attitudes of health care professionals toward patients with hepatitis C infection

AIM: To study knowledge levels and attitudes of health care providers toward patients with hepatitis C virus infection in Guilan, a northern province of Iran.METHODS: This cross-sectional study was performed on 239 health care professionals from the Razi Hospital, including doctors, nurses, and operating room technicians. The questionnaires consisted of questions on demographic characteristics, knowledge levels, and attitudes toward hepatitis C patients. The questionnaire was tested in a pilot study and validated by Cronbach’s alpha coefficient. Data were analyzed using SPSS16 software.RESULTS: The mean ± SD knowledge score was 17.43 ± 2.65 (from a total of 22). 51.9% of the participants achieved scores higher than the mean. There was a significant relationship between knowledge score and age (P = 0.001), gender (P = 0.0001), occupational history (P = 0.0001), and educational history (P = 0.027). There was also a significant relationship between attitude level and age (P = 0.002), gender (P = 0.0001), occupational history (P = 0.0001), and educational history (P = 0.035). Physicians were significantly more knowledgeable and showed more positive attitudes. There was a positive correlation between knowledge and attitude scores (P = 0.02).CONCLUSION: Discriminatory attitudes are common among health care providers toward hepatitis C patients. It is therefore necessary to improve their knowledge level and attitude toward this disease.     

Opioid receptors mediate inotropic and depressor effects of apelin in rats with 2K1C‐induced chronic renovascular hypertension

Apelin receptors (APJ) cross‐talk with other G‐protein‐coupled receptors. However, the role of APJ interaction with opioid receptors (OPR) on the cardiovascular effects of apelin in hypertension is not clear. Renovascular hypertension was induced by placing a Plexiglas clip on the left kidney of rats. After 16 weeks, F13A (an APJ antagonist), naloxone (a general OPR inhibitor), and nor‐binaltorphimine dihydrochloride (nor‐BNI; a selective inhibitor of KOR) were given prior to injections of apelin at doses of 40 and 60 μg/kg. The arterial systolic/diastolic blood pressure and left ventricular contractility responses were then evaluated. The arterial systolic/diastolic blood pressure in sham and 2K1C rats was 110/71 mm Hg and 171/124 mm Hg, respectively. The hypotensive effects of apelin at both doses were inhibited by F13A and naloxone. Nor‐BNI completely inhibited the effects of apelin 40 on arterial pressure, and decreased the effects of 60 μg/kg. KOR inhibition also prevented the compensation for the decrease in the left ventricle +dp/dt max and ?dp/dt max caused by apelin 60. The simultaneous inhibition of OPR and APJ reduced arterial pressure and increased cardiac contractility. Findings showed that the OPR, particularly KOR, mediate the inotropic, lusitropic, and depressor effects of apelin. The interaction of the OPR and APJ augments the inotropic and vasodepressor effects of apelin. This interaction may have potential clinical applications in cardiac failure since opioids are currently used in the treatment of myocardial infarction and stroke, and apelin has been introduced as a potential therapeutic agent in cardiovascular complications.     

Canine Visceral Leishmaniasis in Boyer Ahmad District,Kohgiluyeh & Boyer Ahmad Province,Southwest of Iran

Background

Mediterranean type of visceral leishmaniasis (VL) is present in different parts of Iran. Several studies have identified dogs as the main reservoirs of the VL caused by Leishmania infantum in Iran and other Mediterranean regions. This study aimed to determine the seroprevalence of canine visceral leishmaniasis as animal reservoir host for human visceral leishmaniasis in Boyer Ahmad district in southwest of Iran.

Methods

A seroepidemiological study was carried out to determine the seroprevalence of canine visceral leishmaniasis (CVL) among ownership dogs by using direct agglutination test (DAT) in 23 of 182 villages of Boyer Ahmad district, during August 2009 to August 2010. One hundred and seventy serum samples from ownership dogs were selected by multi-stage cluster sampling in villages of Boyer Ahmad district. All samples were tested by DAT and anti-Leishmania antibodies titers at ≥ 1:320 was considered as positive.

Results

Of the 170 serum samples, 10% were positive by DAT at titers of 1:320 and higher. No statistical significant difference was found between male (10.7%) and female (8.3%) seroprevalence. The highest seroprevalence rate (15.1%) was observed among the ownership dogs of four to seven years age. Altogether, seventeen (25.4%) of the seropositive dogs had clinical signs and symptoms.

Conclusion

It seems that Boyer Ahmad district is an endemic area for canine visceral leishmaniasis in Iran.     

Cardiovascular effect of nifedipine in morphine dependent rats: hemodynamic, histopathological, and biochemical evidence

Aim. To investigate whether administration of nifedipine has considerable therapeutic effect in morphine-dependent rats. Methods. Sixty animals were randomized into control, morphine, morphine plus nifedipine, and morphine plus dimethyl sulfoxide (DMSO, as nifedipine soluble) groups. Each group consisted of two subgroups, with and without heart injury. The groups were treated with incremental doses of morphine or morphine plus nifedipine daily for 7 days. Myocardial injury was induced by isoproterenol (50 mg/kg i.p.) on the day 7. On the day 8, the heart rate (HR), blood pressure (BP), rate-pressure product (RPP), and the plasma level of cardiac troponin I were measured and the hearts were histopathologically examined. Results. In morphine-dependent rats, nifedipine administration was associated with a significantly higher decrease in the plasma level of cardiac troponin I than the administration of morphine alone. This finding was also significant in dependent animals that received only DMSO. HR, BP, RPP, and histopathological indices did not show significant changes in the presence of nifedipine. Conclusion. Administration of nifedipine failed to show a significant therapeutic effect in morphine-dependent rats, especially in the group with myocardial injury.     

Passive opium smoking does not have beneficial effect on plasma lipids and cardiovascular indices in hypercholesterolemic rabbits with ischemic and non-ischemic hearts

Background

To scientifically test a traditionally belief of some Asian countries residents that opium may prevent or have ameliorating effects on cardiovascular diseases (CVD) we investigated the effect of passive opium smoking (POS) on plasma lipids and some cardiovascular parameters in hypercholesterolemic rabbits with ischemic and non-ischemic hearts.

Methods

40 rabbits were fed for 2 weeks with cholesterol-enriched diet and divided to control (CTL), short-term opium (SO) and long-term opium (LO) groups. SO and LO groups were exposed to POS for 3 days and 4 weeks respectively. ECG, blood pressure (BP) and left ventricular pressure recorded and serum lipid and cardiac troponin I levels were measured. Isoproterenol (ISO) injected for induction of cardiac ischemia and after 4 h the above variables were measured along with cardiac histopathology assessment.

Results

HDL cholesterol decreased significantly in LO compared to CTL group (35 ± 5 vs 53 ± 5 mg/dl). Groups treated with ISO showed significantly higher increments in troponin I level (P < 0.05) except for LO group and reduction of BP was higher in ISO and SO + ISO groups compared to CTL and SO groups respectively (−38 ± 6 vs −23 ± 4 and −37 ± 11 vs −11 ± 3 percent respectively, P < 0.05). Reduction in BP was significantly lower in LO + ISO compared to ISO group. Opium exposure caused a trend of increase in blood pressure, LDL cholesterol and ECG disturbances, attenuated ISO induced myonecrosis but augmented tissue congestion and hemorrhage.

Conclusion

POS can be considered as a CVD risk factor. Opium does not reduce BP or cholesterol level, as is anticipated by its users.     

The effects of Melissa officinalis (lemon balm) pretreatment on the resistance of the heart to myocardial injury

Context: The antihyperlipidemic, antiarrhythmic, neuroprotective and hepatoprotective effects of Melissa officinalis L. (Lamiaceae) have been reported. However, no study has examined its effects on the resistance of the heart to stressful conditions.

Objective: The objective of this study is to evaluate the effects of aqueous extract of M. officinalis aerial parts on Wistar rat heart with/without cardiac injury.

Materials and methods: Animals were grouped as control, isoproterenol (ISO), M. officinalis without (M50, M100, and M200) and with isoproterenol (M50?+?ISO, M100?+?ISO, and M200?+?ISO). The aqueous extract of M. officinalis was orally administered at dosages of 50, 100, and 200?mg/kg/d, respectively, for 7 consecutive days. On the 6th and 7th day, ISO, M50?+?ISO, M100?+?ISO, and M200?+?ISO groups received 85?mg/kg of isoproterenol for myocardial injury induction. On day 8, hemodynamic parameters were recorded and samplings were done.

Results: The extract (50, 100, and 200?mg/kg) significantly reduced the heart rate (264?±?5, 259?±?5 and 281?±?3 versus 377?±?13 in control group, p?<?0.01). Blood pressure was significantly decreased in M50?+?ISO (75?±?5) versus M50 (110?±?6) and M100?+?ISO (72?±?6) versus M100 (105?±?5?mmHg, p?<?0.01). The malondialdehyde levels of the injured hearts were lower in M50?+?ISO and M100?+?ISO groups than in the ISO group (p?<?0.05). Serum cardiac troponin I was higher in the M200?+?ISO group (5.1?±?1.7) than in the ISO group (2.7?±?0.7?ng/ml, p?<?0.05).

Conclusion: The lower dose of extract, by improving the balance of the redox system and by reducing the heart rate, may increase the heart resistance to injury. However, the higher doses of extract may intensify the injury of ischemic heart.     

Low‐intensity endurance exercise plus nandrolone decanoate modulates cardiac adiponectin and its receptors

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The Effects of Nandrolone Decanoate Along with Prolonged Low-Intensity Exercise on Susceptibility to Ventricular Arrhythmias

We examined the influence of chronic administration of nandrolone decanoate with low-intensity endurance swimming exercise on susceptibility to lethal ventricular arrhythmias in rat. The animal groups included the control group, exercise group (EX), nandrolone group (Nan), vehicle group (Arach), trained vehicle group (Arach + Ex) and trained nandrolone group (Nan + Ex) that treated for 8 weeks. Then, arrhythmia induction was performed by intravenous infusion of aconitine and electrocardiogram recorded. Then, malondialdehyde (MDA), hydroxyproline (HYP) and glutathione peroxidase of heart tissue were measured. Chronic administration of nandrolone with low-intensity endurance swimming exercise had no significant effect on blood pressure, heart rate and basal ECG parameters except RR interval that showed increase (P < 0.05). Low-intensity exercise could prevent the incremental effect of nandrolone on MDA and HYP significantly. It also increased the heart hypertrophy index (P < 0.05) and reduced the abating effect of nandrolone on animal weighting. Nandrolone along with exercise significantly increased the duration of VF (P < 0.05) and reduced the VF latency (P < 0.05). The findings suggest that chronic co-administration of nandrolone with low-intensity endurance swimming exercise to some extent facilitates the occurrence of ventricular fibrillation in rat. Complementary studies are needed to elucidate the involved mechanisms of this abnormality.     

Validity and reliability of Persian version of chronic liver disease questionnaire (CLDQ)

Purpose

The aim of this study is to test the psychometric properties of the Persian version of the Chronic Liver Disease Questionnaire (CLDQ) in Iranian candidates for liver transplantation.

Method

One hundred and fifty-five consecutive adult patients awaiting liver transplantation completed the Persian version of CLDQ and the short-form health survey (SF-36). The etiology of cirrhosis, Child Pugh classification and Model for End stage Liver Disease (MELD) scores were taken from medical records.

Results

The scaling success rate for convergent validity was 100% for all domains, and the success rate for item discriminant validity was 95.8% (139/145). The internal consistency (Cronbach ??) for the domains ranged from 0.65 to 0.89. Multitrait?Cmultimethod correlation matrix and factor analysis revealed that the CLDQ and SF-36 measure different constructs of quality of life.

Conclusion

The Persian version of the CLDQ, a disease-specific questionnaire for measuring health-related quality of life, is accepted by liver transplantation candidates with adequate reliability and validity. There is no significant correlation of Child Pugh classification and MELD score with quality of life.