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Background Despite extensive research, the effects of L-carnitine supplementation in treating obesity are still unclear and equivocal. L-carnitine transports fatty acids into mitochondria for oxidation and is marketed as a weight loss supplement. The purpose of the present research is to investigate the efficacy of L-carnitine during concurrent training on the functional capacities and body composition in obese men. Methods Thirty nonactive, obese males (age = 37.2 ± 1.5 years; body mass index = 33.8 ± 2.5 kg/m 2) participated in this research. The participants were randomly divided into three groups: experimental group 1 (EXP1)—concurrent training with L-carnitine supplementation; experimental group 2 (EXP2)—L-carnitine supplementation without training; and control group—without training or L-carnitine supplementation. Concurrent training was performed for 8 weeks, three sessions per week, with a training intensity ranging from 60 to 75% of the maximum heart rate reserve and one-repetition maximum. Both experimental groups were supplemented with 35 mg L-carnitine supplement per kilogram body weight. Various functional and body composition variables were collected at three time points (pre-test, mid-test, and post-test). Results A number of variables were significantly improved in EXP1 after 4 and 8 weeks (systolic blood pressure, maximal oxygen consumption, weight, body mass index, and one-repetition maximum) and only after 8-weeks (diastolic blood pressure, resting heart rate, percentage of body fat, and fat-free mass). No significant changes were observed for EXP2 and the control group. Conclusion L-carnitine supplementation, in conjunction with concurrent training, emerges as a highly effective approach for enhancing body composition and boosting functional capacities in obese adult men. Therefore, it is recommended that overweight male individuals integrate concurrent training into their regimen while taking L-carnitine. [ABSTRACT FROM AUTHOR]

Introduction: Angiography is associated with anxiety, stress, and changes in patients' vital signs. The role of the liaison nurse is to bridge gaps and solve problems between departments, thereby preventing the occurrence of undesired complications during patient transfers. Proper preparation of patients by the liaison nurse may lead to an improvement in the hemodynamic status of patients. The present study was conducted to investigate the effect of liaison nurse on hemodynamic status during transfer process to angiography. Method: This randomized controlled trial was conducted from December 2019 to March 2020 on 62 patients who were candidates for elective angiography at Imam Reza Hospital in Mashhad. Participants were selected using a convenience sampling method and then randomly assigned to either the control or intervention group using a lottery system. In the intervention group, patients benefited from the presence of a liaison nurse from the moment the transfer order was issued by the doctor. Tools used included a demographic information questionnaire and a hemodynamic signs checklist. Data were analyzed using SPSS 25 with independent T-tests, paired T-tests, Wilcoxon, Mann-Whitney test, chi-squared, and Fisher's exact test. Result: Following the intervention, the mean systolic blood pressure, heart rate, and respiratory rate in the intervention group were found to be significantly lower than those in the control group (p < 0.05). In contrast, the mean body temperature, diastolic blood pressure and the percentage of arterial blood oxygen saturation did not exhibit a statistically significant difference between the two groups (p > 0.05). Conclusion: The liaison nurse role emerges as a valuable strategy for enhancing patients' hemodynamic stability, and its implementation can have a positive impact on patient outcomes in hospital settings. [ABSTRACT FROM AUTHOR]

Background: Considering that few studies have investigated the differences in clinical, laboratory, and imaging symptoms of patients with coronavirus disease 2019 (COVID-19) during different peaks of the disease in Iran, the present study compares the patients who were admitted to the COVID-19 departments of Imam Reza Hospital during the first, second, and third peaks of the disease. Methods: In this cross-sectional study, data were collected by reviewing the files of patients with a definite diagnosis of COVID- 19 based on the RT-PCR test in Imam Reza Hospital in Mashhad. The patients were divided into three groups based on the time of admission: The first peak from March 2020 to June 2020, the second peak from July to September 2020, and the third peak from October to December 2020. The variables evaluated in this study included demographic information, clinical signs and symptoms, and laboratory and radiological findings. Descriptive qualitative data were reported using frequency tables, while quantitative descriptive data were reported using measures of central tendency and dispersion. A comparison of qualitative data among the three peaks was conducted using the chi-square test, while for quantitative data, the ANOVA test was used followed by appropriate post-hoc tests. Results: A total of 561 patients with an average age of 58.90 ± 16.80 years were included in the study, of which 336 (59.9%) were male. Regarding underlying diseases, significant differences were found in age (P < 0.001), smoking (P < 0.001), diabetes (P = 0.003), high blood pressure (P < 0.001), asthma (P = 0.025), and ischemic heart disease (P < 0.001). For vital signs, significant differences were observed in heart rate (P < 0.001), respiration rate (P < 0.001), diastolic blood pressure (P = 0.010), and SPO2 (P < 0.001). In clinical characteristics, significant differences were found in fever (P < 0.001), nausea (P = 0.011), vomiting (P = 0.031), headache (P < 0.001), weakness (P < 0.001), and sore throat (P < 0.001). In laboratory characteristics, significant differences were observed in white blood cell (WBC) count (P = 0.024), neutrophil percentage (P < 0.001), lymphocyte percentage (P < 0.001), and C-reactive protein (CRP) (P = 0.001). The CT score values of the patients were significantly different between the three peaks. Patient mortality was significantly different across the three peaks. Less than 15% of hospitalized patients died in the first peak, while over 24% died in the second peak and nearly 40% of inpatients died in the third peak. In our study, the first and third surges and the second and third surges had different mortalities. Conclusions: The third and first peaks had the highest and lowest mortality rates, respectively. Underlying diseases and unstable vital signs were more common in the second and third peaks. Patients in the second peak had significantly higher CT scores compared to the other peaks. [ABSTRACT FROM AUTHOR]

Introduction: Coronary artery bypass surgery (CABG) is a common procedure for patients with coronary artery disease. This study aimed to investigate the effect of selected physical exercises on the expression of FGF-2 and VEGF-A in patients post-CABG. Material & Methods: In this semi-experimental study, 20 male patients from Afshar Hospital (Yazd City) who had undergone CABG were selected and randomly divided into two groups: a combined training group and a control group. The combined training group performed an 8-week program consisting of endurance training (15-20 minutes at 50-60% of HRmax) and resistance training (10-20 minutes, including three upper limb and two lower limb movements, each with three sets of 10 repetitions at 3060% of 1RM), conducted three times per week. Gene expression of Fibroblast Growth Factor 2 (FGF-2) and Vascular Endothelial Growth Factor A (VEGF-A) was measured using Real-Time PCR. Data were analyzed using paired t-tests and one-way ANOVA with a significance level set at P<0.05. Results: An increase in the expression of VEGF and FGF-2 genes was observed in the combined training group post-test compared to pre-test (p=0.019). Additionally, there was a significant difference in VEGF gene expression between the control and training groups (p=0.016). Significant differences were also found in FGF-2 expression between the combined exercise group and both the healthy control and patient control groups (p=0.001 for both). Conclusion: The results suggest that combined exercises may enhance physiological adaptations and improve the functional capacity of the heart and vessels in CABG patients by increasing growth factor expression. [ABSTRACT FROM AUTHOR]

BACKGROUND: Using medical gowns with high protection against COVID-19 among healthcare workers (HCWs) may limit heat exchange, resulting in physiological challenges. OBJECTIVE: This study aimed to compare the physiological and neurophysiological responses of female HCWs when using two typical medical gowns at different temperatures during the COVID-19 pandemic. METHODS: Twenty healthy female HCWs participated in this study. Participants wore two types of medical gowns: Spunbond gown (SG) and laminate gown (LG). They walked on a treadmill in a controlled climate chamber for 30 minutes at three different temperatures (24, 28, and 32°C). Heart rate (HR), skin surface temperature (ST), clothing surface temperature (CT), ear temperature (ET), blood oxygen percentage (SaO2), galvanic skin response (GSR), and blood pressure were measured before and after walking on a treadmill. The study's results were analyzed using SPSS26. RESULTS: The study found that LG led to an average increase of 0.575°C in CT compared to SG at the same temperatures (P < 0.03). The average HR increased by 6.5 bpm in LG at 28°C compared to SG at a comfortable temperature (P = 0.01). The average ET in SG and GSR in LG at 32°C increased by 0.39°C and 0.25μS, respectively, compared to the comfortable temperature (P < 0.02). CONCLUSION: The study recommends maintaining a comfortable temperature range in hospitals to prevent physiological challenges among HCWs wearing medical gowns with high protection against COVID-19. This is important because using LG, compared to SG, at high temperatures can increase HR, ET, CT, and GSR. [ABSTRACT FROM AUTHOR]

Background: Maintaining an optimal mean arterial pressure (MAP) is vital for cerebral blood flow and the overall health of patients undergoing coronary artery bypass graft (CABG) surgery. This study investigated the impact of low MAP on cerebral blood flow and in-hospital clinical outcomes in CABG candidates at our hospital. Methods: We compared a convenience sample of 55 patients with a low MAP (55 mmHg) and 54 patients with a high MAP (75 mmHg) who underwent CABG at Tehran Heart Center in 2023. We recorded the patients' demographic and clinical characteristics by measuring cerebral oximeter readings and lactate levels pre- and post-operation. We then compared the baseline and postoperative characteristics between the 2 groups and determined the impact of MAP on their postoperative changes. Results: The groups were statistically similar at baseline, except for a lower pH in the low MAP group (55 mmHg) (P=0.016). The preoperative and postoperative measurements (including lactate levels and cerebral oximeter readings) did not differ between the groups. However, heart rate was significantly higher in the high MAP group (75 mmHg) (P=0.034). The adjusted effect of baseline MAP on selected postoperative characteristics showed that it could significantly but inversely influence heart rate (β coefficient=-5.952; P=0.017) and had a borderline effect on troponin (β coefficient=1.734; P=0.051) and HCO3 (β coefficient=0.785; P=0.062). Conclusion: MAP did not significantly influence clinical outcomes in our study. Nonetheless, maintaining an optimal MAP is essential for preventing cerebral injury and ensuring adequate cerebral oxygenation in CABG patients. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the risk factors of death caused by COVID-19 in Iran. Methods: This study was a retrospective cohort study from February 20, 2020, to August 22, 2022, in the hospitals in Isfahan, Iran. The data were collected through a researcher-made checklist. To determine the risk factors of the death, logistic regression and Cox regression models were used. For each variable, the odds ratio and 95% confidence interval were also reported. Results: 1 885 Patients were included. The age of deceased persons was significantly higher than that of the surviving persons. The risk of death for the age group above 60 years was about 14 times higher than that of people aged 19-35 years [95%CI: 14.41 (2.02-102.99), P<0.01]. Hypertension [95%CI: 1.92 (1.47-2.5), P<0.01], diabetes [95%CI: 1.62 (1.23-2.13), P<0.001], and chronic obstructive pulmonary disease [95%CI: 1.92 (1.47-2.50), P<0.01] were also risk factors of mortality. Conclusions: This study reveals that the mortality rate due to COVID-19 is associated with old age, longer hospitalization in the ICU, increased length of stay, and comorbidities of high blood pressure, diabetes, and chronic pulmonary disease. [ABSTRACT FROM AUTHOR]

Background: We aimed to evaluate the effect of glucose-containing crystalloid infusion before anesthesia induction on hemodynamics and postanesthesia complications. Methods: This double-blind, randomized clinical trial was conducted on 60 parturient cases scheduled for elective Cesarean delivery under spinal anesthesia who were referred to the teaching hospitals of Mashhad University of Medical Sciences (Iran). The parturients were randomized into two groups. Both groups received 5 - 7 mL/kg of intravenous bolus serum before spinal anesthesia. The parturients in the glucose-containing normal saline (GcNS) group received 1% glucose solution in normal saline. The normal saline (NS) group received only normal saline. Systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), blood glucose concentrations, neonatal Apgar scores, postanesthesia complications, and ephedrine and atropine consumption were evaluated. Results: Sixty patients were recruited (30 in each group), with a mean age of 29.14 ± 6.01 and 29.76 ± 6.15 years in the GcNS and NS groups, respectively. There was no significant difference between the two groups in SBP, DBP, or HR after baseline adjustment. The incidence of hypotension was higher in the NS (70.0%) compared to the GcNS group (46.6%), but the difference was not significant. There was no significant difference in Apgar scores. The incidence of nausea, vomiting, pallor, and shivering was higher in the NS group. However, only nausea and vomiting 10 minutes after anesthesia induction were significant. Ephedrine and atropine consumption was higher in the NS group, but not significantly. Conclusions: The present study did not show any clear benefit for adding 1% glucose to normal saline solution preload for hypotension in parturients undergoing Cesarean delivery with spinal anesthesia. [ABSTRACT FROM AUTHOR]

Introduction: Rhinoplasty is one of the most challenging cosmetic surgeries. The nature of surgery itself and hemodynamic instability in patients causes bleeding during surgery, which affects the quality of the surgical field of view, complications during and after surgery, and the outcome of surgery. Therefore, the purpose of this study is the effect of tranexamic acid drug on hemodynamic changes in patients undergoing septorhinoplasty surgery. Materials & Methods: This double-blind randomized clinical trial study was conducted on 51 patients aged 18 to 44 years with anesthesia class І, II who were candidates for septorhinoplasty surgery. The patients were randomly divided into two groups of tranexamic acid and control. Hemodynamic parameters at times; before induction, after induction, 1 minute after induction, 5 minutes after induction, 30, 60, 90 and 120 minutes during the operation, entry into recovery and exit from recovery were measured. Data analysis was done using spss software version 21 and descriptive statistics (mean and standard deviation) and inferential statistical tests. Results: The average trend of systolic and diastolic blood pressure from the time before induction to outside of recovery in the control and tranramic acid groups showed a significant difference (P<0.001). In the times before and after induction, 5 minutes, 15 minutes, 30 minutes, 60 minutes, 90 minutes, 120 minutes, a significant difference in the average heart rate between the two groups was observed (P<0.05). In the control group and the tranamic acid group, the mean trend of O2SAT from the time before induction to the time outside of recovery showed a significant difference (P<0.001). Conclusion: The results of the present study showed that the use of a dose of 250 mg of tranexamic acid had a decreasing trend in the average hemodynamic changes over time, and during these times, the decreasing changes in heart rate were significant. Therefore, it seems that tranexamic acid can be used in septorhinoplasty surgery to maintain hemodynamic stability. [ABSTRACT FROM AUTHOR]

Background: Despite the widespread use of extracorporeal shock wave lithotripsy (ESWL) as a treatment for kidney stones, it is essential to apply methods to control pain and improve patient comfort during this procedure. Therefore, this study aimed to investigate the effect of acupressure at the Qiu point on pain intensity and physiological indices in patients undergoing ESWL. Methods: This randomized, sham-controlled clinical trial was conducted at the Shahid Beheshti Educational-medical Center in Hamadan City (western Iran) from May to August 2023. Seventy-four eligible patients were split into intervention (n = 37) and sham (n = 37) groups. Ten minutes before lithotripsy, the intervention group received acupressure at the Qiu point, while the sham group received touch at a neutral point. The primary outcomes were pain intensity measured by the Visual Analog Scale (VAS) and physiological indices such as blood pressure and heart rate at baseline, 1, 10, 20, 30, 40, and 50 min after the intervention. The secondary outcomes included lithotripsy success and satisfaction with acupressure application. Results: The analysis of 70 patients showed no significant differences in the demographic and clinical information of the patients across the two groups before the study (P > 0.05). Generalized estimating equations revealed that the interaction effects of time and group in pain and heart rate were significant at 30 and 40 min (P < 0.05). The results of this analysis for systolic blood pressure revealed a significant interaction at 30 min (P = 0.035). However, no significant interaction effects were found for diastolic blood pressure changes (P > 0.05). Conclusions: Acupressure at the Qiu point positively impacts pain in patients undergoing ESWL treatment and increases their satisfaction. However, these results for physiological indices require further studies. Thus, acupressure can be considered a simple, easy, and effective option for pain management in patients during this procedure. Trial registration: [https://en.irct.ir/trial/69117], identifier [IRCT20190524043687N4]. [ABSTRACT FROM AUTHOR]

Background: Patients with Acute Coronary Syndrome (ACS) experience high levels of anxiety that may cause instability of hemodynamic indices, increased risk of ischemia, myocardial infarction and poor quality of life. Aromatherapy can affect patients' anxiety levels and improve hemodynamic indices. This study aimed to evaluate the efficacy of aromatherapy on anxiety and hemodynamic indices in ACS patients. Methods: This study was a double-blind, randomized clinical trial conducted on 154 ACS patients. The participants were classified into two equal groups of intervention and placebo through the block randomization method. The data collection tools consisted of demographic information, a shortened 6-item version of the Spielberger questionnaire and a form of hemodynamic indices. For two consecutive nights, the intervention group inhaled 7 drops of the chamomile essential oil (%10) and the placebo group inhaled 7 drops of the sesame oil poured on a sterile cotton ball. The hemodynamic indices were collected half an hour before, one and four hours after the intervention until the next morning. The Spielberger questionnaire was completed once before the intervention and once after the end of the intervention, by the researcher through an interview. The number of heart rate (HR) was counted for a full minute. Also, the blood pressure (BP) of all the samples was measured by the researcher. Data analysis was done using Chi-square, paired t-test, and analysis of variance (ANOVA) in SPSS22. Results: The mean and standard deviation of the age of patients were 58/2 ± 11.6 and 59.7% of them were female. The results of ANOVA showed a significantly lower anxiety score as well as systolic blood pressure (SBP), diastolic blood pressure (DBP) and HR in the intervention group compared to those of the placebo group (P < 0.001). The decrease in anxiety score after the intervention, in the intervention and placebo groups was (5.2 ± 1.9) and (1 ± 1. 18) respectively. In the intervention group, the SBP and DBP after the intervention, was significant (P < 0.05). Also, the HR was significant (P < 0.001) after the intervention. Conclusions: Aromatherapy could reduce anxiety and improve hemodynamic indices in ACS patients. Trial registration: IRCT20080825001083N11. [ABSTRACT FROM AUTHOR]

Background & Aim: Delirium is a multifactorial phenomenon that can be influenced by demographic factors. The present study was conducted with the aim of determining the relationship between demographic and clinical components with the occurrence of delirium in patients hospitalized in the intensive care unit of hospitals affiliated to Kurdistan University of Medical Sciences. Maerial & Methods: The present study was conducted between June 2021 and August 2022 in Kurdistan province and on the number of 118 patients hospitalized in the intensive care unit who were selected by available sampling method. The evaluation of delirium between the hours of 4 and 8 in the afternoon was checked by the researcher. The patients were divided into two groups and both groups were evaluated for delirium with the CAM (ICU) tool. The data were analyzed with the help of STATA version 12 software. A significance level of P<0.05 was considered statistically significant. Results: Most of the patients participating in the study did not have delirium (56.78%). A significant relationship was observed between marital status, education level and the reason for hospitalization with delirium (p<0.05). Also, body temperature, blood pressure and heart rate had a statistically significant relationship with the occurrence of delirium (p<0.001). Conclusion: Because the core of delirium management protocols is based on prevention and diagnosis, evaluation and compilation of the accurate history of patients in the form of demographic components can play a significant role in the prevention and management of delirium. [ABSTRACT FROM AUTHOR]

Background: Resting heart rate (RHR) has been found to be a potential risk factor for developing type 2 diabetes mellitus (T2DM), with a highly significant heterogeneity among previous studies. Therefore, we examined the association of RHR and risk of incident T2DM among non-diabetic and prediabetic adults. Methods: The study population included 2431 men and 2910 women aged ≥ 20 years without T2DM at baseline (2001–2005). Participants were followed for incident T2DM by about 3-year intervals up to April 2018. The multivariable Cox proportional models were applied to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs). The models were adjusted for age, body mass index, waist circumference, educational level, physical activity, smoking, hypertension, family history of diabetes, triglycerides/ high-density lipoprotein cholesterol ratio, and fasting plasma glucose. Results: During a median follow-up of 12.2 years, 313 men and 375 women developed T2DM. Interestingly, a significant sex-difference was found (all P-values for sex interaction < 0.025). Among men, compared to the first quintile (< 68 bpm: beats per minute), those who had RHR of over 84 bpm were at higher T2DM risk with a HR (95%CI) of 1.69 (1.16–2.47). Furthermore, considering RHR as a continuous variable, an increase of 10 bpm caused 17% significantly higher risk among men with a HR of 1.17 (1.05–1.30). However, among women, there was no significant association between incident T2DM and RHR. Moreover, among prediabetic participants at baseline, the association of RHR and risk of T2DM progression was generally similar to the general population, which means higher RHR increased the risk of T2DM development only among men with a HR of 1.26 (1.09–1.46) for 10 bpm increase. Conclusions: Among men, being either non-diabetic or prediabetic at baseline, higher RHR can be associated with incident T2DM; however, women didn't show a significant association. Further studies are needed to determine the added value of RHR as a potential modifiable risk factor in screening and risk prediction of incident T2DM. [ABSTRACT FROM AUTHOR]

Background: In coronavirus disease 2019 (COVID-19)-associated hypoxemic acute respiratory failure (ARF) may require continuous positive airway pressure (CPAP), and having an appropriate criterion for early diagnosis and prediction of CPAP failure or success can significantly reduce the mortality of these patients. Objectives: This study was conducted to evaluate the diagnostic accuracy of heart rate, acidosis, consciousness, oxygenation, and respiratory rate (HACOR) score in predicting the success rate of CPAP in patients with COVID-19 induced hypoxemia. Methods: This retrospective cross-sectional study was conducted on 200 adult patients aged 63.23 ± 16.23 years with mild to moderate acute respiratory failure (COVID-19), partial pressure of oxygen in arterial blood (PaO2) < 300 mmHg, and partial pressure of carbon dioxide in arterial blood (PaCO2) < 45 mmHg from March 21 to November 21, 2021. The patients were admitted to the respiratory intensive care unit (RICU) of Khatam Al-Anbia (PBUH) Hospital in Shoushtar (southwestern Iran) and were subjected to CPAP for respiratory support. The HACOR score was calculated one hour after the CPAP onset. Data were analyzed by SPSS software (version 22) using Kolmogorov-Smirnov, t-test, pair t-tests, receiver operating characteristic (ROC) curve, sensitivity, specificity, and predictive value indices were used to determine the diagnostic performance of the method. The significance level was set at P ≤ 0.05. Results: The mean HACOR score one hour after the onset of CPAP was 3.50 ± 1.57 (P < 0.001), with a mean of 153.84 ± 7.4 mmHg PaO2/fraction of inspired oxygen (FiO2) ratio (P < 0.001). The cut-off point for the HACOR score one hour after CPAP was 5, which had a sensitivity of 98.06% (94.45% - 99.60%) and a specificity of 83.33% (68.64% - 93.03%). Out of 200 patients, 157 patients (78.5%) had CPAP failure, and 43 patients (21.5%) underwent treatment. The diagnostic accuracy values of the HACOR score and PaO2/FiO2 ratio for predicting CPAP failure were 94.9% and 95.96%, respectively. Conclusions: Our findings support that although the HACOR score had a good diagnostic performance in predicting the success rate of CPAP in patients with COVID-19-induced hypoxemia, PaO2/FiO2 ratio was also shown to be a good predictor of success. [ABSTRACT FROM AUTHOR]

Background: Rhinoplasty is a complex but popular surgery in Iran. The main complications of the surgery are post-operative bleeding and nasal septal hematoma due to poor intra-operative controlled hypertension. This study aimed to compare the efficacy of isoflurane-remifentanil (I-R) versus propofolremifentanil (P-R) to induce controlled hypotension and to assess surgeon satisfaction with each of these combinations during rhinoplasty. Methods: In 2020-2021, a single-blind clinical study was conducted on 98 patients aged 18-50 years undergoing rhinoplasty at Mother and Child Hospital (Shiraz, Iran). Patients were randomly divided into P-R (n=48) and I-R (n=50) groups. Changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and heart rate (HR) were assessed during surgery and in the recovery room. A questionnaire was used to evaluate the level of surgeon satisfaction. Data were analyzed using independent samples t test, Chi-square test, and repeated measures ANOVA with SPSS software. P<0.05 was considered statistically significant. Results: Five minutes after anesthesia induction, the P-R combination had a greater effect on reducing SBP (P=0.010), DBP (P=0.007), MAP (P=0.003), and HR (P=0.026) than I-R. However, from the 40th minute to the end of surgery and after 30 minutes of recovery, the I-R combination had a slightly better effect on blood pressure reduction than P-R. There was no difference in surgeon satisfaction with either of the two drug combinations. Conclusion: Both P-R and I-R combinations are recommended to induce hypotension during rhinoplasty. However, I-R is more effective than P-R in inducing the desired controlled hypotension. [ABSTRACT FROM AUTHOR]

PURPOSE: This study aimed to compare the result of the six-minute walk test (6MWT) in patients with cystic fibrosis (CF) aged < 20 years old and individuals without CF. METHODS: In this cross-sectional study, 50 children and adolescents with CF and 20 children and adolescents without CF underwent the 6MWT. Vital signs before and immediately after the 6MWT and six-minute walk distance (6MWD) were evaluated. RESULTS: The mean change in heart rate, percentage of peripheral oxygen saturation (SpO2%), systolic blood pressure, respiratory rate, and dyspnea severity during the 6MWT was significantly higher in patients with CF. In the case group, 6MWD was associated with regular chest physical therapy (CPT) and forced expiratory volume (FEV)> 80%. Patients with CF receiving regular CPT or mechanical vibration and with FEV in the first second > 80% showed better physical capacity during the 6MWT (smaller Sp02% decline and lower dyspnea perception). CONCLUSION: Children and adolescents with CF have lower physical capacity compared to individuals without CF. CPT and mechanical vibration could be used to increase physical capacity in this population. [ABSTRACT FROM AUTHOR]

Objectives Sedation and stability during electroencephalography (EEG) in pediatrics have high clinical importance. This study compares the sedative properties of oral chloral hydrate (OCH) and intranasal fentanyl (INF). Materials & Methods This study was a randomized clinical trial conducted in 2020 in Isfahan City on sixty-two pediatric candidates for EEG. Patients were randomized into two groups receiving 50 mg/kg OCH and 2 µg/kg INF thirty minutes before the process. The heart rate (HR), mean arterial pressure (MAP), respiratory rate (RR), and oxygen saturation (O2 sat) of patients, sedation, and physician's satisfaction were measured and compared between groups. Results The HR of patients decreased significantly in both groups (P< 0.001), and the patients that received INF had significantly lower HR 15, 30, 45, and 60 minutes after drug administrations (P< 0.05). RR evaluation indicated significantly decreased RR in both groups (P< 0.001), and patients receiving INF had lower RR 30, 45, and 60 per minutes after drug administrations (P< 0.001). Both groups showed significantly increased sedation levels during the study (P< 0.001), and patients treated with INF had higher sedation levels 15, 30, and 45 minutes after drug administration. Satisfaction rates were higher among the group that received INF (P= 0.020). Conclusion The use of INF had significant analgesic and sedative effects on pediatrics undergoing EEG. [ABSTRACT FROM AUTHOR]

Background: Considering the lack of studies to investigate the effect of atropine administration on delirium incidence in a post-anesthesia care unit (PACU) in children, this study was conducted with the aim of investigating the effect of atropine administration on delirium incidence and other complications in children undergoing surgery. Methods: The present double-blind, randomized clinical trial was conducted on 70 children aged 1 - 6 years that were candidates for lower abdominal surgery. The patients were assigned to two groups, each consisting of 35 patients. Before induction of anesthesia, 0.02mg/kg of atropineand0.02mg/kg of normal saline were administered intravenously in the first (atropine) and second (control) groups, respectively. Patients' mean arterial blood pressure (MAP), heart rate (HR), and incidence of complications after surgery were recorded. Results: The results of the present study revealed that the two groups had no significant difference in terms of the mean MAP in any of the studied times (P-value> 0.05). However, the mean HR during surgery was significantly higher in the atropine group compared with the control group (P-value < 0.05). In addition, although the incidence and severity of delirium in the atropine group were insignificantly higher than that of the control group, respiratory complications such as decreased saturation and laryngospasm were lower in the atropine group compared with the control group (P-value > 0.05). The volume of suctioned secretions in the atropine group, with a mean of 6.26 ± 2.47 cc was significantly lower than its volume in the control group, with a mean of 14.57 ± 4.27 cc (P-value < 0.001). Conclusions: According to the findings of the present study, although the administration of atropine slightly increased delirium incidence, it could reduce the incidence of respiratory complications and secretions after surgery. However, more studies are required to make a more definitive conclusion in this respect. [ABSTRACT FROM AUTHOR]

Background Considering that no study on the efficacy of dexmedetomidine during endoscopic retrograde cholangiopancreatography (ERCP) has been performed in Iran so far, we decided to evaluate the efficacy and effectiveness of dexmedetomidine and patient satisfaction in patients undergoing ERCP. Materials and Methods: A double-blind clinical trial was performed (2020) among 80 patients undergoing ERCP grade ASA I, and II who had no asthma, cardiovascular diseases, and no history of allergies to propofol and dexmedetomidine. The patients were randomly divided into two groups (fentanyl and propofol) and (fentanyl and dexmedetomidine). Their heart rate per minute, mean arterial pressure, respiration rate per minute, and blood oxygen saturation at intervals of 5 and 15 minutes after the start and end of the procedure, the level of patient cooperation, and endoscopies satisfaction were compared. Results: Mean age of the propofol group was 63/13±17/88 and the dexmedetomidine group was 16/99±58/55 (P=0.191). Mean heart rate and respiration rate per minute were not different significantly in any of the time intervals. Mean arterial pressure in the propofol group before, 5, and 15 minutes after the start and end of ERCP were higher than dexmedetomidine group (105/95±15/91, 123/75±25/54, 118/10±13/06 and 14/61±117/50, respectively). The percentage of oxygen saturation at 5 minutes and at the end of the procedure was higher in the propofol group (P=0.01 and P=0.03, respectively) Conclusion: Due to fewer side effects and more satisfaction of patients receiving propofol; this drug is preferred for these patients. [ABSTRACT FROM AUTHOR]

Introduction: The most common method of choice for orthopedic lower extremity surgery is intrathecal anesthesia. Despite the benefits of using spinal anesthesia, this method has complications such as headache in the acute postoperative period. Therefore, this study aims to compare Madin and Parmadin methods. The incidence of PDPH (Post-Dural-puncture headache) in patients undergoing orthopedic lower limb surgery was performed by spinal anesthesia. Materials and Methods: This double-blind clinical trial was performed on 60 orthopedic surgery patients referred to Pimayeh Hospital in Jahrom. Inclusion criteria included expressing consent to participate in the study, ASA class 1 and 2, no migraine and chronic headaches, no cardiovascular disease, no coagulation disease. Patients accidentally throwing coins into two groups 1) Medin And 2) paramedins were divided. Vital signs were recorded before and after spinal anesthesia at 5, 15, 30, 45, 60, and 90 minutes during surgery and in recovery. PDPH was collected in patients after surgery for 7 days and once a day by an uninformed person in the form of a questionnaire. After collecting data, the data were statistically analyzed using SPSS software version 21. To report descriptive statistics, qualitative variables were reported using frequency and percentage, and quantitative data were reported using mean and standard deviation. Analysis of variance with repeated measures and Chi-square test were used. P <0.05 will be considered as a significant level. Results: A total of 60 patients undergoing orthopedic surgery were evaluated by spinal anesthesia in the age range of 16 to 90 years (in two groups of 30). In pre-spinal anesthesia, immediately after spinal anesthesia, 5 minutes, 15 minutes and 30 minutes after spinal anesthesia, and in recovery, there was no significant difference between median and paramedic groups in mean systolic and diastolic blood pressure. (05/0> P). In the periods before spinal anesthesia, immediately after spinal anesthesia and 5 minutes after spinal anesthesia, there was a significant difference in mean heart rate between Medin and Paramedin groups (P <0.05). On the first and fourth days, the incidence of PDPH was higher in the paramedin group than in the medin group. But the results of statistical analysis showed that there was no significant difference between the two groups in the incidence of PDPH at different times (p <0.05). Conclusion: Although different benefits have been mentioned for each of Madin and Paramedin methods, but in relation to the incidence of headache, in this study, no significant difference was reported between Madin and Paramedin groups. Therefore, with more studies and more studies related to patient satisfaction, the best method can be used in choosing intrathecal anesthesia technique. [ABSTRACT FROM AUTHOR]

Objectives: This study was done to find out the impact of a pre-operative physical therapy plan with inspiratory muscle training on functional capacity, kinesiophobia, and post-operative intensive care unit (ICU) stay in subjects with coronary artery disease (CAD) candidates for coronary artery bypass grafting (CABG). Methods: Fifty subjects who fulfilled the inclusion criteria were recruited and randomly distributed into the intervention and control group by concealed envelop method. Participants in the experimental group were provided with inspiratory muscle training (IMT) with breathing exercises and chest clearance techniques, while the control group received breathing exercises and chest clearance techniques. Both groups received three treatment sessions before their scheduled surgery. The assessment was done at three-time intervals: At baseline, after three sessions, and after surgery. The outcome measures were oxygen saturation, heart rate, respiratory rate, Borg scale of perceived exertion (Borg PRE), Tampa scale of kinesiophobia for the heart (TSKH), and days spent at ICU after CABG. Results: Oxygen saturation, respiratory rate, functional capacity, and pulmonary endurance improved significantly among the treatment groups with a P<0.001 and a large effect size. The pulse rate showed no significant improvement; P and effect size were 0.38 and 0.60, respectively. Kinesiophobia and ICU stay also showed significant changes with a P<0.001. The effect size was large for both kinesiophobia and ICU stay. Discussion: IMT as a component of a pre-operative physical therapy plan can improve oxygen saturation, respiratory rate, functional capacity, and pulmonary endurance in CAD patients going for CABG. IMT reduces the level of kinesiophobia and duration of ICU stay after CABG. [ABSTRACT FROM AUTHOR]

Background & aim: Hospitalization in the Intensive Care Unit (ICU) is associated with side effects such as anxiety, pain and fear of an unknown environment and causes hemodynamic instabilities (increased blood pressure, pulse and breathing rates, etc.) These hemodynamic instabilities lead to the use of sensory stimulation programs which can be prevented, however knowing and using the best sensory stimulation program is of particular importance. The current study was carried out with aim of comparing the effect of auditory stimulation and tactile on the physiologic parameters in patients with Level of Consciousness hospitalized in the ICU in Ali-Ebne-Abitaleb Hospital in Zahedan in 2021. Methods: In this single-blind semi experimental study, at first 80 patients in the ICU in Ali-Ebne-Abitaleb Hospital who met the inclusion criteria were selected and then randomly allocated by permutation block into two groups of auditory stimulation and tactile. In the auditory stimulation group, a prepared auditory file was used for 15 minutes for three days. In the tactile group, touching the hands patients was done for 15 minutes for three days. Physiologic parameters such as heart rate, respiratory rate, systolic and diastolic pressure, mean arterial pressure and O2 saturation was measured and recorded 5 minutes before and after the intervention by Cardio Set LX110 monitoring. Results: Findings revealed that the mean of systolic pressure and O2 saturation was not significantly different after the intervention between the two groups (P>0.05). However, in terms of the variables such as heart rate, respiratory rate, diastolic and mean artery pressure, the independent- T- test showed a significant difference after the intervention between the two groups (P <0.05). Conclusion: The application of the two stimulation methos can adjust some physiologic parameters in patients in ICUs. Furthermore, these methods can be used as simple, cost-effective and applicable methods for managing pain and recovering the physiologic parameters. [ABSTRACT FROM AUTHOR]

Background & Aims: Neural activation is associated with increasing energy requirements, and increasing peripheral Lactate (LA) concentration in response to severe exercise, enhances LA supply as an energy substrate to meet acute neurological needs. The acute speed and football exercises may affect cognitive function by increasing LA concentration and nervous activation. Increasing the neurocognitive performance of growing adolescent boy players an important role in their physical performance. Therefore, the aim of the present study was to investigate the effect of speed and plyometric training activity on the concentrations of nerve proteins in blood circulation. Although speed interval and plyometric training in football players may lead to progressive fatigue and activate the central nervous system and subsequent cognitive disorders, it may also positively increase neurotrophines such as BDNF or IGF-1 and affect brain neutrophils and neurological function. According to this evidence, we assumed that BDNF, BNG and IGF-1 increase in response to a football training session, which may be associated with increasing neurological function of adolescents. Therefore, the purpose of the present study was to investigate the effect of an acute speed and plyometric football-based exercise on plasma concentrations of BDNF, BNG and IGF-1 neural proteins, which may play an important role in enhancing cognitive abilities. And the effect of speed and plyometric training activity on the concentrations of nerve proteins in blood circulation. Methods: The present study is a semi-experimental type with a pre-test and post-test design, which was conducted in two sessions, including an intervention and control session. After calling in Tehran's schools, 20 adolescents 14-15 years of age were selected and accessible as a sample, and randomly participated in 2 sessions of speed and plyometric exercises and control sessions. All subjects are familiar with how to perform speed exercises (RAST Test) during a familiarization period (two sessions). On the day of the main test, after 12 hours of fasting, the test was referred to the test site and the first blood sample (5 cc) was taken from the antiquiobital vein. After the standard breakfast of the subjects, we were wearing sportswear and after ten minutes of general warming up the speed training included six times a maximum of 35 meters with a 10-second recovery between each run. After the test was performed, the plyometric exercise was executed, including a pair jump and one -foot barriers, jump on barriers with 180 degrees rotation, zigzag jump and one foot forward, jump on obstacles with both legs and legs Single-tofoot jumping on the barriers of single -foot and throwing a medicine ball, on the sides, with 12 repetitions. The active rest between turn was considered two to three minutes (29). The subject's heart rate was performed during the controlled exercise (Polar heart rate monitor) and the exercise in the range of 80-90 % of the heart rate. The second blood sample was taken immediately after the training session was completed. All sampling steps for each subject were performed under the same conditions and the BDNF and NGF levels were measured through the USA-made Kit. The IGF-I levels were measured through the ELISA methods and IGF-I Kit. Cognitive neurological function was also measured through the Stroop test (ST) before and after the training session. In this study, the Polish paper version of ST was used. ST consisted of 71 words written with colored ink. The task of the participants was to name the font color regardless of the written word. For statistical analysis, the research data are first described using the mean and standard deviation, then the changes before and after all the variables of the two sessions were calculated and analyzed using the dependent stroop test. A significant level was considered to be P≤0.05 and SPSS 16 was used to perform statistical calculations. Results: The mean and standard deviation of the somatic specifications of the research subjects was as follow: Weight (59.7±3.2), Body mass index (21.4±1.3), Fat percentage (21.7±2.8), and Fat free mase (41.10±4.1) The results of the present study showed that BDNF data changes were significantly different in training and control session (t19=12/89, p<0/001). In the exercise session, the BDNF rate increased by approximately 2.5 times compared with control session. NGF data also showed significant differences in both sessions before and after acute speed and Plyometric training (t19=4.89, p<0/001). Regarding the plasma levels of IGF-1 also the results showed a quite significant difference in comparison of two sessions (t19 =2.89, p=0.019). The time of implementation of the stroop test at two sessions of training and control in the preceding and later times also showed significant differences that in the exercise session the test was significantly reduced than the control session (t19 =3.89, p=0/009). The test time in the exercise session decreased from 59.3s to 53.1s. There was no significant change in the control session at the time of stroop performance (58.6 s and 59.3 s). These findings show that acute speeds and plyometric exercise are useful for improving post exercise cognitive performance in adolescent. Skeletal muscle contraction during high-intensity exercise increases BDNF levels in the brain, and the speed and plyeometric exercise protocol is a more effective and preferred intervention to raise BDNF levels than traditional exercise mode, with moderate intensity. Acute speed and plyometric exercises increase human cognitive function. Improvement of cognitive function may be the synthesis or release of neurological proteins that are adjusted by high blood LA after exercise. Conclusion: In summary, the current findings suggest that acute plyometric and speed training enhances human cognitive performance. The improvement in cognitive performance may be from the synthesis or release of neuroprotective proteins modulated by high blood LA concentrations after exercise. [ABSTRACT FROM AUTHOR]

Background: Heart rate variability (HRV) is calculated by electrocardiography (ECG-HRV) or blood pressure (BP-HRV). The purpose of this study was to determine the validity of the above methods in rats with normal and ischemic hearts during the baroreflex maneuver. Methods: The study was conducted at Shiraz University of Medical Sciences, Shiraz, Iran, in 2021. Sprague-Dawley rats were divided into a sham group and an isoproterenol-mediated cardiac ischemia (ISO) group. Saline and isoproterenol (150 mg/kg) injected subcutaneously for 2 consecutive days in the sham and ISO groups, respectively. Then, the animals were anesthetized with an intraperitoneal injection of sodium thiopental (60 mg/kg), and the femoral artery and vein were cannulated. Baroreflex was activated using an intravenous injection of phenylephrine (10 µg/100 µL saline). ECG, BP, and heart rate (HR) were recorded, and the time domain of HRV and baroreflex gain were calculated. Results: Baroreflex gain in the ISO group (male, weight=275.8±2.8 g, n=8) was lower than that in the sham group (male, weight=258±2.3 g, n=8) (P<0.05). ECG-HRV indicated an increase in the standard deviation of the RR interval (SDRR), the index of overall HRV, and the parasympathetic index of the root mean square of successive differences (RMSSD) in both groups. However, the rise in SDRR and RMSSD in the ISO group was less than that in the sham group (P<0.05). SDRR and RMSSD obtained from BP did not show a difference between the sham and ISO groups, nor did they correspond with the results seen in baroreflex gain. Conclusion: BP-HRV was not as valuable as ECG-HRV in assessing cardiac ischemia. [ABSTRACT FROM AUTHOR]

The article highlights a study aimed to assess the effects of inhalation aromatherapy with Rosa damascena on stress, anxiety, and hemodynamic parameters of patients undergoing coronary angiography. It discusses that Coronary arteries angiography is used commonly for diagnosing cardiovascular diseases and could lead to stress, anxiety and consequently hemodynamic changes in patients.

Background & Aims: The novel coronavirus disease 2019 or Covid-19 is an acute respiratory disease that is closely related to the Sars virus. Although all medical personnel is exposed to corona disease, emergency medical personnel are more exposed to this type of disease due to the special nature of their job. The uncertainty and low predictability of this disease not only threaten the physical health of people but also affects the mental health of emergency medical personnel in terms of emotions and cognition. Long-term negative emotions reduce people's immune function and destroy the balance of their normal defense mechanisms. So people may overreact to any illness, which can lead to destructive behaviors, worry, anger, and fear. According to the review of the sources, it can be stated that the occurrence of a sudden and life-threatening illness can create extraordinary pressure on the medical staff. Medical staff is particularly vulnerable to psychological and mental health problems such as aggression, anxiety, and depression, and their quality of life is affected. Depression, as one of the mental disorders, includes a wide range of emotional and mental states, from sadness and low self-esteem to emotional and physical disability. Anxiety is an unpleasant emotion that is usually described with words such as worry, anxiety, tension, and fear; Emotions that everyone experiences with different intensity. New studies have also shown that anxiety can increase or decrease the level of people's functions. Aggression is often a response to a person's expectations not being met or a response to behaviors that are considered unacceptable to the person. From a psychological point of view, aggression is defined as behavior aimed at hurting, annoying, or harming another person. The increase in psychological and physical problems observed in the life of medical workers leads to the configuration of a large volume of studies on how to increase the health level of this group of people. Measures should be taken to prevent and treat these cases. Among the treatments that can be used in this regard are the treatment focused on compassion and the treatment of acceptance and commitment. In acceptance and commitment therapy, the main goal is to create psychological flexibility. Acceptance and commitment therapy focuses less on reducing symptoms and more on increasing quality of life. On the other hand, some experts believe that the core of helping people is based on a sense of compassion. In compassion-based therapy, people learn not to avoid or suppress their painful feelings, so they can first recognize their experience and feel compassion for it. This plays a significant role in calming the mind and reducing stress and negative spontaneous thoughts. Additionally, self-compassion requires active and patient acceptance of difficult feelings. Due to being on the first line of dealing with this disease, emergency medical workers are more likely than others to be exposed to psychological disorders and extreme fluctuations in physical indicators. A cross-sectional study conducted on medical personnel in China during the outbreak of Covid- 19 has shown that among 512 personnel, about 164 had direct contact with an infected patient. Among them, the prevalence of anxiety was about 12.5%, of which 10.35% experienced mild anxiety, 1.36% experienced moderate anxiety, and about 0.78% experienced severe anxiety. The importance of conducting this research is because the more the number of psychological treatments including compassion-focused therapy and acceptance and commitment therapy increases, the more likely psychological indicators will decrease, including anxiety, stress, aggression, and the level of quality of life-related to their health. It is created and people can do their treatment tasks with more confidence. Methods: The current research was of a semi-experimental type with a pre-test, post-test, and follow-up plan with a control group, which was conducted on 60 medical emergency workers infected with Corona in Mashhad in the year 1400 and the form of three groups (two experimental groups and one control group) was done. The treatment groups were compassion-focused therapy and acceptance and commitment therapy. The list of symptoms of mental disorders and the quality of life questionnaire were used to collect information. The interventions of the two groups were implemented as a group in the Skyroom software, and no intervention was done for the control group. Both experimental groups were exposed to treatment for 8 sessions of 90 minutes, but the control group was placed on the waiting list. After the end of the treatment, the post-test was performed for all three groups, and after three months after the last group meeting, the follow-up was done. After scoring, the obtained data were analyzed using SPSS-26 statistical software. Results: Based on the results of this study, there was a significant difference between the three stages of pre-test, post-test, and follow-up related to psychological indicators and quality of life in the experimental groups of treatment focused on compassion, treatment of acceptance and commitment, and the control group (P<0.05 ). Conclusion: The results of the present study indicated that the treatment focused on compassion and the treatment of acceptance and commitment improve psychological indicators and quality of life. It is suggested that in future comparative studies, the effectiveness of two treatment approaches focused on compassion and acceptance and commitment therapy on physiological characteristics (heart rate and blood pressure) and other psychological outcomes of patients with corona should be studied. The findings of this research were about emergency medical workers in Mashhad, so the generalization of the findings with other samples and statistical societies should be done with caution. The self-reporting of the tools used and the purposeful sampling method are other limitations of this research that must be taken into account. [ABSTRACT FROM AUTHOR]

Background. Induction of general anesthesia may cause hemodynamic instability. Remifentanil is often prescribed to suppress the hemodynamic response to anesthesia. The aim of this study was to investigate the effect of remifentanil on hemodynamic response to induction of anesthesia with propofol fentanyl or propofol ketamine and laryngeal mask airway (LMA) insertion. Methods. This double-blind randomized clinical trial study was performed on 44 candidates for cataract surgery in Feyz Hospital, Isfahan, Iran from March to June 2020. Patients were randomly assigned into two groups using random allocation software. The first group received 1 mcg/kg fentanyl and the second group received 0.5 mg/kg ketamine. Also, both groups received 1 mg/kg propofol and 0.5 mcg/kg remifentanil intravenously. Hemodynamic parameters were measured and recorded at study times, and the results were analyzed statistically. Results. The mean age (P=0.199), weight (P=0.050), height (P=0.9), and frequency distribution of gender (0.763) and American Society of Anesthesiologists (ASA) score (0.069) were not significantly different between the two groups. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) in fentanyl group were significantly lower than the ketamine group immediately before LMA insertion, as well as 1, 3, and 5 minutes after LMA insertion (P <0.050). In addition, the mean heart rate (HR) in the fentanyl group decreased significantly at different time (P<0.001), but no significant difference was observed in ketamine group (P=0.056). In addition, the mean HR did not differ significantly between the two groups in any of the follow-up times (P>0.050). Conclusion. Intravenous administration of remifentanil in induction of anesthesia with propofol-ketamine and propofol-fentanyl reduced changes in hemodynamic responses to LMA insertion. This hemodynamic stability was increased by adding remifentanil to the propofol-ketamine combination. Practical Implications. Remifentanil is associated with weakening of hemodynamic responses to LMA insertion in induction of anesthesia with propofol and ketamine or propofol and fentanyl; this effect can be associated with safety in cardiac patients. [ABSTRACT FROM AUTHOR]

Background & Aims: Diabetes is a chronic progressive disease that has physical, metabolic, social and psychological challenges and increases the risk of concomitant mental health problems (1). Accelerated macrovascular complications in type 2 diabetes are due in part to increased metabolic side effects such as elevated cholesterol and LDL (4). In this regard, research has shown that there is a close relationship between fat percentage, body mass index and insulin concentration (5). Because the challenges of diabetes affect many aspects of patients' daily lives and their families, psychosocial assessment and treatment is a vital part of comprehensive diabetes care. The diabetic must accept that he or she may have diabetes-related complications; The patient should consider themselves an important member of the diabetes care team, not the person being cared for by the treatment team. Emotional stress can cause behavior change so that the other person does not follow their own diet, exercise, and treatment (6). For this reason, researchers have long used various methods to reduce the negative effects of diabetes, so that the effect of physical activity in the treatment of type 2 diabetes has long been known (7). Although a lot of research has been done in this field, but there is a big difference between the results of research (8). Regarding the treatment of mental problems of diabetic patients, considering that the use of sedatives and other drugs is always associated with many side effects, and today in the global medical system, more efforts are made to prevent and treat diseases without the use of drugs. It seems that participating in a regular and codified exercise program can play a major role in reducing the effects of diabetes, improving mental health and reducing the negative psychological effects of diabetes. Due to the conflicting results of research, researchers are trying to use different training methods to get the best results, so it seems necessary to design new protocols and study their impact on various factors. Also, considering that there is little research that in addition to examining the effect of aerobic exercise on metabolic side effects has examined the effect of these exercises on psychological factors in diabetic patients, the researcher seeks to answer the question of whether pyramidal aerobic exercise on cholesterol, HbA1c, LDL, affect anxiety and stress in type 2 diabetic patients? Methods: For the present quasi-experimental study, which was performed with a pre-test-post-test design, 30 patients with type 2 diabetes in Zabol city were selected by convenience sampling and randomly divided into two groups. The research method was that 24 hours before and 48 hours after the last training session from the beginning of the research, the research variables in the pre-test were measured using blood sampling and Beck Anxiety and Stress Questionnaires. The training protocol in the present study included 8 weeks, 3 sessions per week and each training session included 45-60 minutes of pyramidal aerobic training in 3 stages. The volume of each training interval based on the intensity of training and the ability of the subjects started from light intensity in the first interval and increased in each interval. Resistance was also calculated using the reserve heart rate of each individual using the caronene formula (20). In order to observe the principle of overload, the training time was started from 15 minutes and reached 35 minutes in the eighth week. To divide the time in each interval, the total training time was divided into 3 parts; In the first 1.2, light exercise was performed (50-35% of the reserve heart rate). In the second interval, the training, which included the remaining 2.3 of the training time, was performed with an intensity of 50-65% of the reserve heart rate. The rest time between each interval was 3 minutes. Finally, descriptive statistics (tables and graphs) and Shapiro-Wilk tests, paired t-test and independent t-test were used for statistical analysis of data. Results: The results showed that after 8 weeks of pyramidal aerobic training, cholesterol, LDL, HbA1c, depression, anxiety and stress in the experimental group were significantly reduced in the post-test compared to the pre-test. However, in the post-test control group, this value increased compared to the pre-test, but was not statistically significant. The results were compared with the control group to ensure that the decrease in research variables was due to the present research protocol. Control can be confidently reported that the changes were due to the training protocol. Concluson: Findings of this study showed that 8 weeks of aerobic exercise significantly reduced total cholesterol, HbA1C, LDL, anxiety, depression and stress in patients with type 2 diabetes. In the above explanation, it can be said that research has shown that muscle contraction has an insulin-like role and sends a large amount of glucose into the cell to be used for energy production. 33 Muscle contraction increases membrane permeability to glucose, possibly due to an increase in the number of glucose transporters in the membrane. Exercise (Glut4) increases plasma in trained muscles, which improves Glut4 levels of insulin on glucose metabolism (28). In the above explanation, it can be said that physical activity in women increases the level of progesterone and this increase reduces psychological symptoms such as anxiety. In general, physical activity seems to improve mood symptoms, including anxiety, by the mechanism of action on cerebral endorphins (34). Physical activity increases the efficiency of the mind, the feeling of freshness and health, and provides a good mental attitude to life, provides mental health. Women are more affected by the psychological factors of physical activity than men and their sense of well-being increases more than men (35). Research has shown that anxiety and stress are caused by a lack of self-confidence in people. As Farad's social interactions increase in team sports, their self-esteem improves and self-confidence increases. On the other hand, team sports reduce stress and anxiety. Although self-confidence was not examined in the present study, it may be one of the mechanisms related to the findings of the present study. [ABSTRACT FROM AUTHOR]

Background: Hyperbilirubinemia, a common illness in neonates, imposes a risk of arrhythmia and sudden death, particularly during blood transfusions. The present study aimed to evaluate the electrocardiographic parameters in term newborns with hyperbilirubinemia in Gorgan, northeast Iran. Methods: This cohort study was conducted on 101 term neonates admitted to our academic hospital with hyperbilirubinemia (direct bilirubin> 20 mg/dL). Those with sepsis, TORCH[(T)toxoplasmosis, (O)ther Agents, (R)ubella (also known as German Measles), (C)ytomegalovirus, and (H)erpes Simplex], congenital heart disease, polycythemia, and asphyxia were excluded. An electrocardiogram (ECG) was taken before the initiation of phototherapy, and heart rate, PR interval, QRS duration, QTc interval, and ST-T changes were recorded after every 8 h during the phototherapy. Results: In this population of neonates with a mean age of 6.09±3.57 days, the results demonstrated that after 32 h of phototherapy, bilirubin decreased to less than 20 mg/dL. Following that, intensive phototherapy was replaced with the conventional method. Changes in ECG parameters were not significantly related to changes in bilirubin levels (P> 0.05). Conclusion: As evidenced by the results of this study, there was no significant relationship between ECG parameters and serum level of bilirubin; nonetheless, changes in cardiovascular parameters along with bilirubin levels were remarkable. [ABSTRACT FROM AUTHOR]

Purpose: Toxoplasma gondii is transmitted congenitally or acquired by consumption of food and water contaminated with cysts or oocysts. This study aimed at genotyping T. gondii strains from slaughtered goats in Jahrom. Methods: A total of 561 specimens (heart, diaphragm, and tongue) from 187 slaughtered goats were collected from Jahrom slaughterhouse. After DNA extraction, the T. gondii strains were genotyped by the nested PCR–RFLP based on GRA6 and 3ʹ, and 5ʹ ends of the SAG2 gene. Results: T. gondii infection was present in 18.2% of cases. Among the examined organs, the diaphragm was more disposed to the infection (10.2%). Furthermore, infection rates of the heart and tongue were 8.6% and 3.7%, respectively. Concurrent infection in the heart and diaphragm, tongue and diaphragm, and heart and tongue were 3.2%, 0.5%, and 0.5%, respectively. In genotyping experiments, genotype I was the most frequent genotype of T. gondii (58.8%), followed by type II (23.5%), type III (11.8%), and a combination of type I and II (5.9%). Conclusions: The results of this study showed the presence of different genotypes of T. gondii in goats including three major and mixed genotypes. These results can be useful in toxoplasmosis control and prevention. [ABSTRACT FROM AUTHOR]

Short QT-interval is a condition that bear the suspicion of short QT syndrome (SQTS). SQTS is known to increase risk of life-threatening arrythmias and sudden cardiac death (SCD). Due to the insufficient population-based studies and use of various QT cut-off values, it accounts for as an undiagnosed condition. In this study, we sought for prevalence of short QT interval in Kherameh cohort study, one of the southern branches of the Prospective Epidemiological Research Studies in Iran (PERSIAN). Data of 4363 adult subjects were analyzed from phase 1 of the cohort during 2014–2017. The corrected QT (QTc) intervals were calculated and electrocardiograms (ECGs) with QTc of less than 370 ms (msec) were reanalyzed for bradycardia, early repolarization, atrial fibrillation (AF), arrhythmias, and other electrical conduction abnormalities. Seventy-two subjects (1.65%) had a QTc of less than 370 ms (mean QTc of 360.72 ± 11.72). A male predominance and a lower mean heart rate observed in SQTS susceptible group (M/F of 1/0.26 vs. 1/1.145, p-value < 0.0001; 58.389 ± 9.787 vs. 70.899 ± 11.775; p-value < 0.0001) compare to the subjects with normal QTc. At least, 2 subjects with high-probability SQTS and 3 with intermediate-probability SQTS identified. The frequency of AF, syncope, bradycardia, early repolarization, low voltage ECG, and infantile SCD in first- and second-degree relatives were 16.67, 4.17, 33.33, 11.11, 11.11, 11.11%, respectively. The prevalence of short QT interval in our cohort was in line with previous studies. The incidence of cardiac symptoms/events, familial SCDs and ECG derived specific findings were high amongst SQTS-susceptible index persons. However, these variables could not predict the symptomatic subjects, which emphasizes gene studies and family screening. [ABSTRACT FROM AUTHOR]

Background: QT interval as an indicator of ventricular repolarization is a clinically important parameter on an electrocardiogram (ECG). QT prolongation predisposes individuals to different ventricular arrhythmias and sudden cardiac death. The current study aimed to identify the best heart rate corrected QT interval for a non-hospitalized Iranian population based on cardiovascular mortality.Methods: Using Fasa PERSIAN cohort study data, this study enrolled 7071 subjects aged 35-70 years. Corrected QT intervals (QTc) were calculated by the QT interval measured by Cardiax® software from ECGs and 6 different correction formulas (Bazett, Fridericia, Dmitrienko, Framingham, Hodges, and Rautaharju). Mortality status was checked using an annual telephone-based follow-up and a minimum 3-year follow-up for each participant. Bland-Altman, QTc/RR regression, sensitivity analysis, and Cox regression were performed in IBM SPSS Statistics v23 to find the best QT. Also, for calculating the upper and lower limits of normal of different QT correction formulas, 3952 healthy subjects were selected.Results: In this study, 56.4% of participants were female, and the mean age was 48.60 ± 9.35 years. Age, heart rate in females, and QT interval in males were significantly higher. The smallest slopes of QTc/RR analysis were related to Fridericia in males and Rautaharju followed by Fridericia in females. Thus, Fridericia's formula was identified as the best mathematical formula and Bazett's as the worst in males. In the sensitivity analysis, however, Bazett's formula had the highest sensitivity (23.07%) among all others in cardiac mortality. Also, in the Cox regression analysis, Bazett's formula was better than Fridericia's and was identified as the best significant cardiac mortality predictor (Hazard ratio: 4.31, 95% CI 1.73-10.74, p value = 0.002).Conclusion: Fridericia was the best correction formula based on mathematical methods. Bazett's formula despite its poorest performance in mathematical methods, was the best one for cardiac mortality prediction. Practically, it is suggested that physicians use QTcB for a better evaluation of cardiac mortality risk. However, in population-based studies, QTcFri might be the one to be used by researchers. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Military Medicine is the property of Baqiyatallah University of Medical Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: We aimed to compare the effect of dexmedetomidine with remifentanil on hemodynamic stability, surgical field quality, and surgeon satisfaction during rhinoplasty. Methods and materials: In this double-blind randomized controlled-trial, 60 participants scheduled for rhinoplasty at the Mother and Child Hospital, Shiraz, Iran, was randomely divided into the dexmedetomidine group (IV infusion of 1 μg/kg dexmedetomidine over 20 min before induction of anesthesia then 0.6 μg/kg/hr. dexmedetomidine from the time of induction until the end of the operation) or in the the remifentanil group (an infusion rate of 0.25 μg/kg/min from the time of anesthesia induction until the end of the operation). Bleeding volume, surgeon satisfaction, postoperative pain (visual analog scale (VAS)), Level of sedation (Richmond Agitation Sedation Scale (RASS)), Patient satisfaction, Vital signs & recovery, and the Aldrete Score (used to discharge the patients from recovery) were measured for all participants. Results: The patients in the dexmedetomidine group had less bleeding (p = 0.047) and shorter time to return of respiration, extubation, and the postoperative recovery time (p < 0.001). The surgeon satisfaction was higher in the dexmedetomidine group (p < 0.001). Patient satisfaction was significantly different between the two groups (p < 0.001). VAS scores, intaking paracetamol, and RASS score were significantly lower in the remifentanil group (p < 0.001). SBP, DBP, MAP, and heart rate were lower in dexmedetomidine group. Conclusion: Dexmedetomidine was associated with relatively stable hemodynamics, leading to decreased intraoperative bleeding, recovery time, and greater surgeon satisfaction and the level of consciousness in the recovery ward. However, painlessness and patient satisfaction were greater with the use of remifentanil. Trial registration: IRCT20141009019470N112. [ABSTRACT FROM AUTHOR]

Injuries induced by the brain trauma from mild to life-threatening therefore prevents these complications need psychological, environmental, and physical support. Acupressure by reduces muscle tension, improves blood circulation and stimulates endorphins secretion naturally reduce pain in these patients therefore the aim of this study was to evaluate effect of acupressure on the level of the blood pressure, respiratory rate, and heart rate in patients with the brain contusion under mechanical ventilation. The present study was a clinical trial with a sample size of 64 brain contusion patients who were selected based on available sampling and then randomly assigned to control and experimental groups. Demographic information and check list of blood pressure, heart rate, and respiratory rate were recorded before intervention in two groups then acupressure at the p6 point for 10 min in both hands at the morning and evening for two consecutive days is done in intervention group while in control group this pressure was applied at the same time point at an inactive point such as thumb hands. After acupressure for both groups, physiological index was measured immediately, half and 1 h after every acupressure. Data were collected using a demographic questionnaire and physiological sheet. Data was analyzed using SPSS 21 software and analytical statistical tests (independent t-test, chi-square, Fisher's exact test). The mean of blood pressure, heart rate, and respiratory rate before acupressure there was no significant statistical difference between two groups (p>0.05). but the mean of two consecutive days of blood pressure, heart rate, and respiratory rate after acupressure in the intervention group than control group was significantly different (p<0/05). Therefore, physiologic index before acupressure than after acupressure in the intervention group was significant statistical difference (p<0.001). The mean difference before the intervention than 12 h after the last intervention between two group was significant statistical difference (p<0/05) which that detected the stability of the effect of acupressure. The results indicate that p6 point acupressure in the brain contusion patients under mechanical ventilation has been associated with improved blood pressure, pulse rate, and respiratory rate. While confirmation of these results requires further studies, but use of complementary medicine in recovery the physical condition and strengthening of the effect of nursing care of these patients should be considered. [ABSTRACT FROM AUTHOR]

Background: Considerable variability in survival rate after ST-segment elevation myocardial infarction (STEMI) is present and outcomes remain suboptimal, especially in low- and middle-income contraries. This study aimed to investigate predictors of 30-day mortality after STEMI, including reperfusion therapy, in a tertiary hospital in western Iran. Methods: In this registry-based cohort study (2016-2019), we investigated reperfusion therapies - primary percutaneous coronary intervention (PPCI), pharmaco-invasive (thrombolysis followed by angiography/percutaneous coronary intervention), and thrombolysis alone - used in Imam-Ali hospital, the only hospital with a PPCI capability in the Kermanshah Province. We estimated hazard ratios (HRs) and 95% confidence intervals (CIs), using Cox proportional-hazard models, to investigate the potential predictors of 30-day mortality including reperfusion therapy, admission types (direct admission/referral from non-PPCI-capable hospitals), demographic variables, coronary risk factors, vital signs on admission, medical history, and laboratory tests. Results: Data of 2428 STEMI patients (mean age: 60.73; 22.9% female) were available. Reperfusion therapy was performed in 84% of patients (58% PPCI, 10% pharmaco-invasive, 16% thrombolysis alone). Only 17% of the referred patients had received thrombolysis at non-PPCI-capable hospitals. Among patients with thrombolysis, only 38.2% underwent coronary angiography/ percutaneous coronary intervention. The independent predictors of mortality were: no reperfusion therapy (HR: 2.01, 95% CI: 1.36-2.97), referral from non-PPCI-capable hospitals (1.73, 1.22-2.46), age (1.03, 1.01-1.04), glomerular filtration rate (0.97, 0.96-0.97), heart rate > 100 bpm (1.94, 1.22-3.08), and systolic blood pressure < 100 mm Hg (4.92, 3.43-7.04). Mortality was lower with the pharmaco-invasive approach, although statistically non-significant, than other reperfusion therapies. Conclusion: Reperfusion therapy, admission types, age, glomerular filtration rate, heart rate, and blood pressure were independently associated with 30-day mortality. Using a comprehensive STEMI network to increase reperfusion therapy, especially pharmaco- invasive therapy, is recommended. [ABSTRACT FROM AUTHOR]

Emergency department (ED) is known as the beating heart of a hospital which operates 24 hours, every day of a year. It provides services to a wide spectrum of patients with various medical conditions. Therefore, it is crucial to simulate and optimize the ED's processes for enhancement of services provided. Improving processes can be challenging, especially when a complex and unpredictable environment such as ED is under study. This research aims to identify an improved allocation of resources in different wards of an emergency department, with the goal of improving the patients and staff workflow. The research approach untaken is a case study at a state hospital in the Semnan province, Iran. The emergency department of this hospital is evaluated for a new layout design by which the average patients waiting time be reduced and the allocation of staff be optimized. The simulation technique, using Arena, is adopted to fulfil these goals. Recommendations are proposed for a layout design which could improve the average waiting time of the Internal-Emergent patients by 23.18% and the Surgical-Emergent patients by 81.7%. This means waiting time reduction of 3.31 minutes for the Internal-Emergent patients and 10.58 minutes for the Emergent patients. [ABSTRACT FROM AUTHOR]

Background: Previous studies suggested that obesity and fat mass are associated with QT interval prolongation, but the role of different body parts' fat mass is unclear. The associations between total and regional fat mass (FM) and corrected QT interval (QTc) were investigated for the first time in this study.Methods: In this sub-analysis of Fasa PERSIAN cohort Study data, 3217 subjects aged 35-70 entered our study. Body fat mass was assessed by bioelectrical impedance analysis and QTc interval calculated by the QT interval measured by Cardiax® software from ECGs and Bazett's formula. Uni- and multi-variable linear and logistic regression was performed in IBM SPSS Statistics v23.Results: In males, the fat mass to fat-free mass (FM/FFM) ratio in the trunk, arms, total body, and legs were significantly higher in the prolonged QTc group (QTc > 450 ms). Trunk (B = 0.148), total (B = 0.137), arms (B = 0.124), legs (B = 0.107) fat mass index (FMI) showed significant positive relationship with continuous QTc (P-value < 0.001). Also, just the fat-free mass index of legs had significant positive associations with QTc interval (P-value < 0.05). Surprisingly, in females, the mean of FM/FFM ratio in trunk and legs in the normal QTc group had higher values than the prolonged QTc group (QTc > 470 ms). Also, none of the body composition variables had a significant correlation with continuous QTc.Conclusion: Our study suggested that FMI ratios in the trunk, total body, arms, and legs were positively associated with QTc interval in males, respectively, from a higher to a lower beta-coefficient. Such associations were not seen in females. Our study implies that body fat mass may be an independent risk factor for higher QTc interval and, consequently, more cardiovascular events that should be investigated. [ABSTRACT FROM AUTHOR]

Copyright of Medical Journal of Tabriz University of Medical Sciences is the property of Tabriz University of Medical Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BACKGROUND: Despite mechanization development, leafy vegetable cultivation (LVC), as a labor-intensive activity in both developed and developing countries, still suffers from heavy physical activities. OBJECTIVE: The present study evaluated the human physiological strains of LVC's workers to identify relationships among contributing factors affecting human physiological strains. METHODS: Thirty male workers were included in this study. Working heart rate (HR) was measured using a heart rate sensor during various operations. The time taken to treat a known area was measured using a stopwatch to calculate work speed (or field capacity (FC)) for each operation. Pearson correlation coefficient and linear regression were used to investigate the relationships among HR, heart rate ratio, FC and mechanization status (MS), and human energy expenditure rate and total energy expenditure per unit area. RESULTS: The highest HR was at seedbed preparing (120.1 beats/min) and lowest at manual harvesting (87.8 beats/min). Manual hoe-used operations (seedbed preparing, manure application and irrigating) were demonstrated as the critical operations concerning physiological strains. The operations performed by machine power corresponded to a high FC. CONCLUSIONS: Variables influencing the area treating speed (i.e. MS and FC) are negatively linked to the human energy consumed per unit area and variable changed in time unit (i.e. HR) was positively linked to the human energy expenditure speed. [ABSTRACT FROM AUTHOR]

Background: There is a positive association between raised resting heart rate (RHR), and all causes of mortality and shorter life expectancy. Several serum biomarkers and some anthropometric factors can affect the resting heart rate. This study aimed to investigate the determinants of resting heart rate in a large random sample of the Iranian population.Material and Methods: It is a standardized, retrospective study and the subjects were chosen from the baseline survey of the Prospective Epidemiological Research Study in IrAN (PERSIAN) Fasa non-communicable disease cohort study. It was conducted from winter 2014 to summer 2019 and after obtaining informed consent from a random sample, all the eligible subjects were enrolled. All anthropometric factors and biologic laboratory factors were collected and analyzed by implement smoothly clipped absolute deviation (SCAD) linear regression and SCAD quantile regression. The comparisons between males and females were done via independent T-test.Results& Conclusion: A total number of 9975 persons from 35 to 90 years old were included. The overall median resting heart rate was 74 (interquartile range:66-80). Mean age has no important difference between males and females (P = 0.79) but, resting heart rate was significantly higher in females (76.6 versus 71.4, P < 0.001). All anthropometric factors except wrist circumference were higher in females (P < 0.05). Age has an adverse effect on resting heart rate and also, there was a direct association between resting heart rate and systolic blood pressure and blood glucose. Alpha-blockers (coefficient = 5.2) and Beta1-blockers (coefficient = - 2.2) were the most effective drugs with positive and negative effects on resting heart rate respectively. Lower hemoglobin, obesity, and more body mass index, and more low-density lipoprotein were associated with more resting heart rate. Continuing the monitoring of this sample via our cohort study and put to action multinational prospective researches with large sample sizes and long follow-ups can lead to more precise results and better scientific judgments. [ABSTRACT FROM AUTHOR]

Background: Visitation is one of the most critical needs of patients in intensive care units (ICUs). Clinicians should enable a more flexible visitation policy to prevent the adverse effects of a restricted approach. Aim and objectives: This study aimed at investigating the relationship between increasing visitation time and patients' physiological parameters in intensive units. Additionally, nurses' beliefs and attitudes towards visiting is examined in this research. Design Parallel randomized clinical trial. Methods: This study was conducted in four general medical ICUs in Iran. In total, 60 patients and 57 nurses participated in this study. The patients' physiological parameters were measured at particular times in both groups. Moreover, the nurses responded to the questionnaire on beliefs and attitudes towards visitation in intensive units before and after the intervention. Results: Among all the physiological parameters, systolic and diastolic blood pressure and heart rate had a significant decrease within the normal range 10 and 30 minutes after visiting in the intervention group (P <.05), and nurses' beliefs and attitudes score were at the middle of the survey scoring range (0‐120). However, no significant difference was found between nurses' belief and attitude score and intervention in any groups (P >.05). Conclusion: The findings indicate that increasing visitation times can lead to a positive effect on the stability and balance of patients' physiological parameters. Relevance to clinical practice: A more flexible visiting policy can provide a therapeutic environment where not only patients' physiological disorders are minimised as much as possible but also a higher level of patients' health and satisfaction are reached. [ABSTRACT FROM AUTHOR]

Background: Ziziphus jujuba Mill (ZJ) is a plant with anti-hypertensive property. In this regard, the present study investigated the effect of aqueous and ethyl acetate fractions of ZJ extract on acute hypertension (HTN) induced by nitro-L-arginine methyl ester (L-NAME). Methods: The current study was carried on 49 hypertensive rats divided into seven groups, including i) control; ii) L-NAME (10 mg/kg); iii) sodium nitroprusside (SNP) (50 µg/kg) plus L-NAME; iv and v) aqueous fraction of ZJ (150 mg/kg and 300 mg/kg) plus L-NAME; vi) and vii) ethyl acetate fractions of ZJ (150 mg/kg and 300 mg/kg) plus L-NAME. The rats were orally treated with both fractions for four weeks and received intravenous L-NAME on the 28th day. The mean arterial pressure (MAP), systolic blood pressure (SBP) and heart rate (HR) of the rats were recorded then maximal changes (Δ) of MAP, SBP and HR were calculated and compared with changes of control and L-NAME. Results: According to the obtained results of the present study, it was shown that the administration of L-NAME significantly increased ΔMAP, ΔSBP and ΔHR, and these effects were significantly attenuated by administration of SNP. The pre-treatment with both doses (150 mg/kg and 300 mg/kg) of aqueous and ethyl acetate fractions could significantly reduce cardiovascular responses induced by L-NAME that comparable with SNP. However, a lower dose of aqueous fractions and higher dose of ethyl acetate fractions were reported with stronger effects. Conclusion: The results of the current study showed that both the aqueous and ethyl acetate fractions of ZJ through the effect on nitric oxide system can prevent the development of HTN induced by L-NAME. [ABSTRACT FROM AUTHOR]

Background: Diabetes mellitus (DM), an increasing health problem worldwide, is associated with severe cardiovascular complications. Then, the aim of this study was to investigate effect of 12 weeks of aquatic aerobic exercises on myocardial structure and function in diabetic female patients with heart failure. Methods: In this semi experimental research, 36 diabetic women with heart failure in age range of 45 to 65 years old referring to shahid Madani medical center in Tabriz voluntarily participated in this study and assigned to one of two groups: control(n=16) and experimental (n=16) group. Aquatic exercises were carried out three sessions a week for 12 weeks, each session lasting 60 minutes with intensity of 5-8 in RPE Borg classification. Patients in control group continued their normal daily living activities. Blood sampling was gathered 48 h before and after training protocol to measure diabetic indexes such as Fasting blood sugar (FBS), serum Insulin, Insulin resistance, HbA1c and diastolic function such as E Velocity (EV), A Velocity (AV), Deceleration Time (DT), E to A ratio (EA), systolic function consisted on Ejection Fraction (EF), Left Ventricular Mass (LVM), Rest Heart Rate (RHR), Systolic pressure (SP) and Diastolic pressure (DP). The obtained data were analyzed using SPSS-18, T independent test at the significant level α<0.05. Results: The results showed that after intervention, LVM (p=0/000), EV (p=0/034), EF (p=0/002) levels were significantly increased and FBS (p=0/006), HbA1c (p=0/012), AV (p=0/002), SP (p=0/042) and RHR (p=0/035) were decreased in Aquatic exercise group. But in DT, EA and DP Levels these differences weren’t significant between two groups (p>0/05). Conclusion: The results showed that aquatic exercises, resistance and aerobic exercises, as a safe and effective exercise Method, could be helpful in improving myocardial structure and function in type 2diabetic females with heart failures. [ABSTRACT FROM AUTHOR]

Obstructive sleep apnea (OSA) is a common disorder which can cause periodic fluctuations in heart rate. To diagnose sleep apnea, some studies analyze electrocardiogram (ECG) signals by adopting chaos-based analysis. This research is going to specifically focus on whether it is possible to use chaos-based analysis of heart rate variability (HRV) signals rather than using chaotic analysis of ECG signals to diagnose OSA. While conventional studies mostly use chaos-based analysis of ECG signals to detect OSA, here, we apply correlation dimension (CD) as a chaotic index to analyze HRV data in OSA patients. For this purpose, 17 patients with OSA and 9 healthy individuals referred to a sleep clinic in Isfahan/Iran are studied, and their HRV time series were extracted from 1-h ECG signals recorded overnight. The preliminary step to calculate CD is phase-space reconstruction of the system based on HRV time series. Corresponding parameters, including embedding dimension and lag time, are estimated optimally using enhanced related methods, and then CD is calculated using Grassberger–Procaccia algorithm. Moreover, to evaluate our results, detrended fluctuation analysis (DFA), one of the well-known nonlinear methods in HRV analysis to detect OSA, is also applied to our data and the result is compared with those obtained from CD analysis of HRV. CD index with P < 0.005 indicates a significant difference in nonlinear dynamics of HRV signals detected from OSA patients and healthy individuals. [ABSTRACT FROM AUTHOR]

BACKGROUND: Considering the high concentrations of pollutants in large cities of Iran and the high prevalence of heart failure (HF) among Iranians, especially with increasing life expectancy, this study investigated the relationship between airborne contaminants with a diameter < 2.5 µm or particulate matter 2.5 (PM2.5) and hospitalization and mortality in patients with HF in Isfahan, Iran, during 2011. METHODS: This ecological study was carried out on a part of data from the CAPACITY study. A total of 275 patients with HF were randomly selected from 840 subjects with International Statistical Classification of Diseases, 10th Revision (ICD-10) diagnosis code I50 in the CAPACITY study. Patients' records were evaluated and their clinical characteristics, disease history, and laboratory and echocardiographic findings were extracted. Air pollution and climatic data were extracted from the CAPACITY study. Poisson regression was used in crude and adjusted models to evaluate the association between PM2.5 and study outcomes. All analyses were performed using crude models and models adjusted for temperature, dew point, and wind speed. RESULTS: 54.9% (n = 151) were men with mean age of 70.4 ± 13.7 years. While most patients (85.8%) were discharged after recovery, 14.2% of the patients died in the hospital. Blood glucose, heart rate, and ejection fraction (EF) were significantly higher on unhealthy days than normal days. Regression analysis revealed no significant relationships between hospitalization and mortality rates and PM2.5 concentrations on healthy days, unhealthy days for sensitive people, and unhealthy days. CONCLUSION: The model used in our study revealed no significant relationships between PM2.5 concentrations and hospital admission on healthy days, unhealthy days for sensitive people, and unhealthy days. [ABSTRACT FROM AUTHOR]

Background: Heat stress is common among workers in hot-dry areas. To take preventive strategies for the protection of workers against heat stress, it is important to choose a suitable index that can accurately explain environmental parameters relative to physiological responses. Objective: To evaluate heat stress and maximum acceptable work time (MAWT) based on physiological and environmental response in hot-dry climate among traditional bakers. Methods: The current study was carried out on 30 traditional bakers of 3 different bread baking systems in Ahvaz, Iran. Environmental and physiological parameters were measured simultaneously for a work shift. The work-rest time was also determined based on the relative heart rate (RHR) and the wet-bulb globe temperature (WBGT) index. Results: The average WBGT index was estimated to be higher than the standard limit for all baking stations. Despite the higher-than-the-recommended-limit WBGT index, there was no significant relationship between the WBGT index and physiological parameters. The results indicated a significant (p<0.05) difference between the percentages of work-rest time estimated using the WBGT and RHR index. Conclusion: Based on the results of environmental and physiological monitoring of this study as well as the limitations of the use of the WBGT index, it seems that using WBGT as a standard index would not suit heat stress management in hot-dry climates. A revision of this standard to adapt to hot climatic conditions should be in order. [ABSTRACT FROM AUTHOR]

Background: These days, most of the admitted infants in neonatal intensive care units (NICU) are premature infants. Infant massage and prone position has been recommended for several decades to have a positive effect on preterm and low birth weight infants. The objective of this study was to determine the effects of neonatal massage with prone positioning in preterm infants on Heart Rate (HR), and Oxygen Saturation (O2Sa) status. Materials and Methods: This is a controlled randomized three-group clinical trial study conducted on hospitalized infants in selected hospitals of Alborz University of Medical Sciences in Karaj-Iran. There are about 75 preterm infants (33-37 weeks) who met inclusion criteria were randomly assigned to groups of position, massage as intervention groups, and a control group. Intervention (prone position and massage) was administrated for five straight days. The repeated measure ANOVA test was performed to evaluate and compare the effect of interventions. p value less than 0.05 was considered as statistical significance. Results: The Repeated Measure two-way Analysis of Variance (RM-ANOVA) result showed a significant difference in HR and SaO2 in different time points among control, position and massage groups with RM-ANOVA (F10,360 = 10.376, p < 0.001). HR values was reduced and SaO2 values was increased in intervention groups with RM-ANOVA (F5,360 = 2.323, p < 0.001). Conclusions: Results showed that massage and prone position equally led to the reduction of HR and increase of SaO2, compared to control group. [ABSTRACT FROM AUTHOR]

Background: exercise induces considerable physiological change in the immune system. The aim of this study was to investigate the effect of a single session high intense interval exercise (HIIE) in hypoxic and normoxic conditions on serum concentration of interleukin-6 (IL-6) and interleukin-10 (IL-10) in active men. Methods: The present study was semi experimental research Ten trained students volunteer in shahid Beheshti University participated in this study. General and clinical information was collected via questionnaire before exercise began. In addition some of body composition indexes of subjects were measured one day before exercise protocol. After determining maximum heart rate of subjects during HIIE which was consisted of three series, each series consisting of three one-minute repetitions with intensity of 80 to 85 percent of maximum heart rate and 2 minute rest between series in both hypoxic and normoxic conditions performed one week apart. Before, immediately after, and 1 h after exercise blood samples were taken from subjects. To measure IL-6 and IL-10 Elisa method was used. Results: Finding showed that despite a significant increase in serum levels IL-6 due to HIIE between the two conditions did not differ significantly (p = 0.078). But with increased serum levels of IL-10 in HIIE there was significant difference between the two conditions (p = 0.003). Conclusion: The short-term exercise under hypoxic conditions with the appropriate intensity could modify the immune system response and increased levels of IL-10. [ABSTRACT FROM AUTHOR]