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Background & objectives: Asthma is one of the most common chronic diseases in the world and Iran. Despite appropriate treatment, recent researches indicate that asthmatic patients have poor asthma control. The aim of this study was to determine the correlation between educational level of asthmatic patients and asthma control indices. Methods: This retrospective cross-sectional study was performed on 80 asthmatic patients admitted to Shahid Labbafinejad hospital. ESMAA questionnaire was used to collect data to assess the level of asthma control, according to ACT (Asthma Control Test) and 2016 GINA (the Global Initiative for Asthma) guidelines. Patient medication compliance was evaluated based on Morisky medication adherence scale (MMAS). ANOVA test (Regression and Pearson correlation) and Chi-Square test were used for analysis of quantitative and qualitative variables, respectively. The P - value less than 0.05 was considered statistically significant. Results: Eighty asthmatic patients with an average age of 54.65 were entered to this study that of them 32 patients were at primary school level, 26 patients at high school level and 22 patients at university state. According to ACT test, 52.5% and 47.5% of patients were in control and uncontrolled state, respectively. According to GINA classification, 30% of patients were in control, 45% in partially control and 25% in uncontrolled state. According to MMSA scale, 20% of patients were high adherent to medicine, 40% were moderate adherent and 40% were low adherent. In this study, there was no significant correlation between the asthma control in terms of ACT and patients' educational level. Also, there was no significant relationship between sex, asthma control and medication adherence. In addition, there was no significant relationship between educational level and drug adherence. Conclusion: The results suggest that there was no relationship between asthma control indices and patient's educational level. Perhaps other factors, other than education, affect the asthma control indices and medication adherence which requires more studies.

Introduction: Inappropriate body composition represents impaired energy and nutrient intake and can be a risk factor for many diseases, especially for cardiovascular disease. Different methods have been suggested for the estimation of body fat volume and its distribution. However, they may be either expensive or hazardous for some groups of patients. Sonography is a very accessible technique, which may be used for the evaluation of visceral and subcutaneous fat volume. The purpose of this study was to evaluate the sonographic prediction of body fat and its distribution in subcutaneous and visceral compartments.Methods: During a three-month period, we conducted sonographic evaluations for visceral and subcutaneous fat in 106 patients who were admitted to our hospital. The subcutaneous fat was measured at the para-umbilical region and visceral fat was measured in the right para-renal space. The results were compared with the data obtained from the body mass index (BMI) and bioelectric impedance analysis.Results: The mean age of the patients was 58.8 years, and the mean BMI was26.48 +/- 0.33. The mean values of fat percent and fat mass obtained by the electric-method were 31.07 +/- 0.81% and 22.12 +/- 0.68 kg, respectively. The respective mean values of subcutaneous and visceral fat obtained by sonography were 20.50+/-0.56 mm and 24.14 +/- 0.58 mm. The correlation between BMI and subcutaneous fat was 0.85 (p value < 0.0001) and the correlation between BMI and visceral fat was0.46 (p value < 0.0001).Conclusion: Sonography is a reliable and available method for the estimation of body fat and its distribution in cardiovascular patients, in subcutaneous and visceral compartments. [ABSTRACT FROM AUTHOR]

Spiral CT is a rapidly growing method for noninvasive visualization of post-operative complications, including post-operative complications in CABG (coronary artery bypass graft). In the recent years, several different, yet more efficient types have been introduced with progressive improvement in the diagnostic accuracy in the detection of post-operative complications. The introduction of 64-slice technology, which allows high resolution as well as reconstructed images, has resulted in further progress in the diagnostic process. This kind of diagnostic equipment will spread rapidly in the world. Although studies with large numbers of patients regarding spiral CT as a routine diagnostic method have not been reported, there is great need for it all over the world. In this article, we intend to review the spiral CT findings of non-graft complications in patients after cardiac surgery. [ABSTRACT FROM AUTHOR]

Background: The incidence of stroke after coronary artery bypass grafting (CABG) is between 0.9% and 6.7%, which significantly increases in-hospital and out-hospital costs. This study was designed to evaluate the prevalence of significant carotid stenosis and its risk factors in CABG.Methods: In total, 2044 consecutive patients undergoing elective CABG were investigated through a pre-operative duplex scanning of the carotid arteries. The relation of age, sex, smoking, hypertension, diabetes, dyslipidemia, and coronary disease with carotid stenosis was evaluated.Results: The prevalence of carotid stenosis was 7.6%. The multivariate analysis showed that age over 55 and left main coronary disease were significant independent risk factors for carotid stenosis. Female gender, smoking, hypertension, and diabetes were the risk factors in the univariate logistic regression model.Conclusion: Carotid stenosis is prevalent in CABG candidates. It seems that age >/=55 years and left main coronary disease are the independent risk factors for carotid stenosis in CABG patients. [ABSTRACT FROM AUTHOR]

Objective: To establish weather the ABO blood group is related to ischemic heart disease in Iranian ethic patients awaiting coronary artery bypass graft (CABG) surgery. Methods: Prospective study of 10,621 patients enlisted for CABG with a known ABO blood group was selected from the Tehran Heart Center cardiovascular databank between December 2001 and February 2008. ABO blood group, gender, and standard cardiovascular risk factors were determined upon entry to the study. Results: Our study group consisted of 71.9% male and 28.1% female patients, with a mean age of 58.98 ± 9.61. Blood group O was the most common in these patients (35%). Furthermore, we found a significant difference between gender and ABO blood group distribution (P=0.074 for O and P=0.031 for A). We also detected that those patients with B blood were less susceptible for hyperlipidemia compared to other blood groups (P=0.024). Conclusions: Our results demonstrated the prevalence of CHD in blood group O is markedly higher than in all other ABO blood groups, which is in contrast with other studies done in Europe and the United States. Variations between distribution of blood groups in various parts of the world may justify the results. [ABSTRACT FROM AUTHOR]

Highlights: [•] The ferrocene group decorated nano-organo SiO2–Al2O3 as a novel adsorbent. [•] The application of nano-adsorbent was studied to remove methyl orange. [•] It effectively removes 85% methyl orange from contaminated water under 25min. [•] The novel nano-adsorbent was very stable and easily separated from the purified water. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the effect of topical Polyvinylpyrrolidone-iodine (PVP-I) 0.6% on the clinical course of adenoviral keratoconjunctivitis compared with PVP-I 1% and artificial tears., Methods: We prospectively enrolled all patients over 18 years of age with a polymerase chain reaction (PCR)-confirmed diagnosis of adenoviral keratoconjunctivitis who presented to the hospital between November 2022 and June 2023. Patients were randomized into 3 groups: artificial tears (control), PVP-I 1%, and PVP-I 0.6% eye drops, 4 times daily for 5 days. Clinical signs at presentation and at 6 follow-up visits during the 1 st 3 weeks of the acute phase were recorded. Patients were also followed up at 1 and 3 months., Results: Ninety-four patients completed the study, of which 30, 31, and 33 were in the control, PVP-I 1%, and PVP-I 0.6% groups, respectively. The mean age of the patients was 37.2 years (interquartile range: 25-46). The PCR result was positive in 75.6% of patients with the clinical suspicion. PVP-I, regardless of the concentration, was superior to the artificial tears in terms of time to resolution of lid swelling, discharge, and incidence of subsequent subepithelial infiltrates ( P < 0.05). However, a concentration of 0.6% was equivalent to 1%. No significant adverse events were reported in any group., Conclusions: The PVP-I 0.6% topical drops are safe and well tolerated in patients with acute adenoviral keratoconjunctivitis. It can be substituted for the 1% solution as it has comparable effects in improving the clinical course and reducing subsequent complications., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Current Ophthalmology.)

This study aims to investigate the changes in ocular biomechanical factors in patients with inactive thyroid eye disease (TED) who undergo orbital decompression surgery. This observational prospective study include 46 eyes of 31 patients with inactive TED undergoing orbital decompression at a tertiary university hospital from October 2021 to September 2023. All participants underwent a full ophthalmic examination, and a biomechanical examination was performed using corvis ST at baseline, 1 month, and 3 months postoperatively. The study participants had a mean age of 45 ± 11.6 years, and 58.1% of them were female. The second applanation time (A2T) increased from baseline to postoperative month 1 and continued to increase to postoperative month 3 (P < 0.001). The first applanation velocity (A1V), highest concavity (HC) peak distance, and pachymetry parameters also increased from postoperative month 1 to postoperative month 3 (P = 0.035, P = 0.005, and P = 0.031, respectively). The HC time increased from baseline to postoperative month 3 (P = 0.027). Other changes were statistically insignificant. The P-values were adjusted according to biomechanically corrected intraocular pressure (bIOP). Baseline Hertel significantly influenced A2 time (P < 0.001). Our findings suggest that ocular biomechanical parameters may change following decompression surgery in patients with inactive TED. Specifically, an increase in A2T, A1V, and HC peak distance suggests a decrease in corneal stiffness, although the increased HC time contradicts this. It is recommended to postpone keratorefractive or intraocular lens implantation surgeries until corneal biomechanics stabilize after decompression surgery for optimal results., (© 2024. The Author(s).)

Background: Considering the various manifestations of coronavirus disease 2019 and its imperative importance in terms of the right clinical approach and early management, we sought to present a hemicentral retinal vein occlusion case, with a history of heterozygosity of methylenetetrahydrofolate reductase (MTHFR) genes and potential for clotting complications as a late manifestation of coronavirus disease 2019, and provide a brief review of reported retinal vein occlusion cases in patients with coronavirus disease 2019., Case Presentation: A 35-year-old Iranian patient presented with a visual impairment in the left eye 4 months after recovering from coronavirus disease 2019. He reported a mild blurring of vision in the same eye a few days after admission due to coronavirus disease 2019. The ophthalmic evaluation was compatible with hemicentral retinal vein occlusion. Systemic and laboratory workups were negative except for borderline protein C activity, homocysteine levels, and heterozygosity of MTHFR genes. The patient was scheduled to receive three monthly intravitreal antivascular endothelial growth factor injections., Conclusion: We present a case of inferior hemicentral retinal vein occlusion case with an MTHFR mutation with sequential loss of vision 4 months after coronavirus disease 2019 to make clinicians aware of the possibility of late ocular coronavirus disease 2019 manifestations., (© 2024. The Author(s).)

Background: Central serous chorioretinopathy (CSC) is characterized by focal serous detachment of the retina, primarily affecting the macula. Photodynamic therapy (PDT) is the best choice for treatment of chronic and recurrent patients. In this study we aim to evaluate the early effects of the half dose protocol (3 mg/m 2 verteporfine) of PDT laser treatment on the micro vasculature of choroid., Methods: Among thirty-one patients (62 eyes), twenty eyes were in the control group and forty-two eyes received PDT laser treatment. Vision log MAR, CMT (central macular thickness), SRF (sub retinal fluid), BCT (baseline choroidal thickness), CVI (choroidal vascular index), and laser treated area were compared between two groups., Results: Results show that no strong correlation was detected between the impact of laser treatment and resolution of SRF in the first week in the fovea. The mean best corrected visual acuity (BCVA) of the patients significantly increased from 20/63 at the beginning of the study, according to the Snellen chart, to 20/49 in the first week and 20/38 in the sixth week. PDT can significantly reduce SRF and CMT in 6 weeks compared to the control group. Although there was initially a small, non-statistically significant increase in choroidal thickness and CVI after 1 week, a dramatic decrease occurs after 6 weeks. Therefore, after 6 weeks of PDT laser, all the indicators such as SRF, CMT, choroidal thickness, and CVI significantly reduced., Conclusion: PDT laser can significantly reduce SRF and CMT at 1 and 6 weeks and choroidal thickness and CVI at 6 weeks in chronic CSC patients. Also, a larger laser treated area has no impact on the final outcome. Therefore, it seems that the mechanism of PDT in CSC disease is the recovery of choriocapillaris circulation., Competing Interests: Declaration of Competing Interest We have no competitive interests with any institution or individual., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Purpose: To introduce a novel technique for small-incision levator resection in ptosis surgery and evaluate its efficacy in a pilot study among patients affected by congenital or aponeurotic ptosis., Methods: We prospectively enrolled congenital and aponeurotic ptosis patients if their levator function was not poor (≥5 mm) from June 2021 through October 2022. Surgical technique involved a 1-cm lid crease incision, minimal dissection, and creating a loop passing through the tarsus and levator aponeurosis. Success was defined as postoperative MRD-1 ≥3 mm and inter-eyelid MRD-1 difference ≤1 mm. Eyelid contour quality was scored excellent, good, fair, and poor according to its curvature and symmetry., Results: Sixty-seven eyes (35 congenital and 32 aponeurotic) were included in the study. Mean age was 34±19 years (range, 5-79 years). Mean preoperative levator function and levator resection amount were 9.53 mm and 8.39 mm in the congenital group and 12.34 mm and 4.15 mm in the aponeurotic group, respectively. Mean pre- and postoperative MRD-1 was 1.61 mm and 3.27 mm respectively (P<0.001). The overall success rate was 82.1% (95% C.I: 71.7-89.8%); the result was failure in 12 cases, of which 11 had under-correction. Preoperative MRD-1 was correlated with a success rate (P=0.017)., Conclusion: The described technique shows non-inferior results to the previously described surgical methods and also it shows very good lid contour outcome and minimal lag. The findings suggest that the double mattress single suture technique can be used in both congenital and aponeurotic ptosis., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Keratoconjunctivitis is one of the most common pathologies worldwide, caused by several infectious and noninfectious factors. This study aimed to determine the effect of povidone-iodine 2% eye drops in treating adenoviral keratoconjunctivitis., Methods: This analytic cross-sectional study was conducted on patients referred to Farabi Eye Hospital Records of patients with adenoviral keratoconjunctivitis, more than 12 years of age, and no allergy to iodine who were treated by povidone-iodine 2% eye drops four times a day were assessed. Data included demographic characteristics, family history of adenoviral keratoconjunctivitis, follicular conjunctivitis, petechial conjunctival hemorrhages, periauricular lymphadenopathy, and the presence of conjunctival pseudomembrane were collected from the records. Discharge decrease, injection decrease, swelling decrease, pseudomembrane formation, periauricular lymphadenopathy, and subepithelial infiltration on the 7 th day of assessment by physical examination were reported., Results: Patients with a mean (±standard deviation) age of 33.77 (11.01) years were assessed. At the baseline, 95 (99.0%) follicular conjunctivitis, 94 (97.9%) petechial conjunctival hemorrhages, 29 (30.2%) periauricular lymphadenopathy, and 5 (5.2%) conjunctival pseudomembrane were recorded. On the 7 th day of treatment, the discharge decreased in 92.7% of patients, and the injection decreased in 90.6%. The swelling decrease was also detected in 79.2% of patients. Subepithelial infiltration was only seen in 21.9% of the study population. Results showed that 2.1% of patients had periauricular lymphadenopathy, and only 13 out of 96 patients (13.5%) had pseudomembrane formation after 7 days., Conclusions: Based on the safety, availability, and tolerability of povidone-iodine and its promising effects on patients with adenoviral keratoconjunctivitis, further clinical trials assessing the impact of this drug in a longer duration of follow-up can be recommended., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Oman Ophthalmic Society.)

Millions of cataract surgeries with intraocular lens (IOL) implantation are performed worldwide. Although cataract surgery brings many benefits to the patients, the risk of various complications is still a concern. One of the infrequent adverse events but potentially affecting on patients' visual acuity and contrast sensitivity is losing the transparency of IOL. IOL opacification may lead to IOL removal or exchange, which is unpleasant to both the patient and the surgeon. Several reports of acute IOL clouding are available in the literature describing various etiologies of this phenomenon, however, the exact mechanism remained unclear in some cases. Herein, we aimed to review the causes and outcomes of intraoperative and early postoperative IOL opacification., (International Journal of Ophthalmology Press.)

Introduction: SARS-CoV-2 is the novel coronavirus that causes severe acute respiratory syndrome and could afflict individuals from all walks of life. Children are usually asymptomatic or represent non-specific mild to moderate symptoms; therefore, they often remain undiagnosed and could be potential reservoirs and silent carriers of the virus. Despite the global attention to COVID-19 and its importance in public health, some clinical and paraclinical aspects of this disease in children are still unclear. Thus, we conducted a comprehensive systematic review of available literature to reflect on the current knowledge and practice of the disease among children., Methods: This study was a systematic review of current evidence conducted in October 2020. We performed a systematic search using the keywords in online databases. The investigation adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist to ensure the reliability and validity of extracted literature and results., Results: We selected and reviewed 23 most related studies out of 1744 identified papers in an initial online search based on the inclusion and exclusion criteria of the present review; of whom 13 were original research studies, and 10 were letters to the editors, commentaries, viewpoints, consensus statements, and perspectives. Although due to the origin of the current pandemic, China was the country with the most publications (12 articles), data from several countries have been included in this review., Conclusion: COVID-19 can also affect children and cause systemic disease with several internal organ involvements. However, the prevalence, severity, and diversity of the symptoms in children are less than in adults. Cough and fever appear to be some of the most common symptoms, followed by other symptoms such as gastrointestinal manifestations. Comorbidities increase the risk of severe COVID-19 in children, and those without underlying conditions are very unlikely to suffer from severe disease. Mental health issues such as anxiety and depression due to the isolated situation caused by pandemics are common findings in children of early ages and should be seriously considered in current practice., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Introduction: Prisoners represent high-risk behaviors such as injecting drug use, sharing syringes, tattooing, and unprotected sexual intercourse. The authors aimed to study the prevalence of hepatitis B, hepatitis C, and hepatitis D in the prisoners., Methods: We conducted a systematic search using the keywords in online databases of PubMed, Web of Science, Scopus, and Science Direct. Two independent researchers examined the quality of the articles and the probable risk of bias. The most relevant articles by title and abstract were retrieved. Finally, the full text of selected articles was read, and the critical findings were extracted., Results: Reviews of 23 studies showed that most prisoners are susceptible to hepatitis B and hepatitis C. One study also indicated that prisoners could be infected with hepatitis A and hepatitis E. The most common routes of hepatitis transmission in prisons were intravenous drug use, needle sharing, tattooing, and unsafe sex with multiple sexual partners., Conclusion: High-risk sexual behaviors, shared contaminated needles for IV drug injection, and tattooing are the principal routes of hepatitis transmission among prison inmates. Hepatitis treatment is feasible and could be useful for infected prisoners undergoing a well-designed treatment program., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Cloud computing is among the most beneficial solutions to digital problems. Security is one of the focal issues in cloud computing technology, and this study aims at investigating security issues of cloud computing and their probable solutions. A systematic review was performed using Scopus, Pubmed, Science Direct, and Web of Science databases. Once the title and abstract were evaluated, the quality of studies was assessed in order to choose the most relevant according to exclusion and inclusion criteria. Then, the full texts of studies selected were read thoroughly to extract the necessary results. According to the review, data security, availability, and integrity, as well as information confidentiality and network security, were the major challenges in cloud security. Further, data encryption, authentication, and classification, besides application programming interfaces (API), were security solutions to cloud infrastructure. Data encryption could be applied to store and retrieve data from the cloud in order to provide secure communication. Besides, several central challenges, which make the cloud security engineering process problematic, have been considered in this study., (©2021 JOURNAL of MEDICINE and LIFE.)

Introduction: Coronavirus Disease-2019 (SARS-CoV-2) started its devastating trajectory into a global pandemic in Wuhan, China, in December 2019. Ever since, several variants of SARS-CoV-2 have been identified. In the present review, we aimed to characterize the different variants of SARS-CoV-2 and explore the related morbidity and mortality., Methods: A systematic review including the current evidence related to different variants of SARS-CoV-2 and the related morbidity and mortality was conducted through a systematic search utilizing the keywords in the online databases including Scopus, PubMed, Web of Science, and Science Direct; we retrieved all related papers and reports published in English from December 2019 to September 2020., Results: A review of identified articles has shown three main genomic variants, including type A, type B, and type C. we also identified three clades including S, V, and G. Studies have demonstrated that the C14408T and A23403G alterations in the Nsp12 and S proteins are the most prominent alterations in the world, leading to life-threatening mutations.The spike D614G amino acid change has become the most common variant since December 2019. From missense mutations found from Gujarat SARS-CoV-2 genomes, C28854T, deleterious mutation in the nucleocapsid (N) gene was significantly associated with patients' mortality. The other significant deleterious variant (G25563T) is found in patients located in Orf3a and has a potential role in viral pathogenesis., Conclusion: Overall, researchers identified several SARS-CoV-2 variants changing clinical manifestations and increasing the transmissibility, morbidity, and mortality of COVID-19. This should be considered in current practice and interventions to combat the pandemic and prevent related morbidity and mortality.

Malenchus geraerti n. sp., recovered from natural regions of northern Iran, is described and illustrated based on morphological, morphometric and molecular data. The new species is characterized by having females with a short body, an anteriorly wide S-shaped amphidial opening narrowing posteriorly, cuticle with prominent annuli, lateral field a plain band with smooth margins, muscular metacorpus with well-developed valve and corresponding plates, spermatheca filled with small spheroid sperm cells, vulva sunken in body with large epiptygma and no flap, and conical tail tapering gradually to a more or less pointed tip. Males of the new species are characterized by having a short body, tylenchoid spicules, adcloacal bursa with smooth margin and tail similar to that of the female. Morphologically, the new species is similar to five known species of the genus: M. fusiformis, M. machadoi, M. pachycephalus, M. solovjovae and M. undulatus. It most closely resembles M. pachycephalus, but as a cryptic species it can be differentiated using morphological and molecular characteristics. Comparisons with the four other aforementioned species are also discussed. Molecular phylogenetic studies using partial sequences of small and large subunit ribosomal DNA fragments reveal that the new species forms a clade with the species M. neosulcus in the small subunit (SSU) rDNA, and two species of Lelenchus in the large subunit (LSU) rDNA tree.

A selective and sensitive electrochemical sensor was studied for determination of levodopa (LD) in the presence of uric acid (UA) and ascorbic acid (AA) using poly-dianix blue and multi-walled carbon nanotubes (PDB/MWCNTs) modified glassy carbon electrode. Cyclic voltammetry, differential pulse voltammetry, and chronoamperometry methods were applied to investigate the electrocatalytic oxidation of LD, UA and AA in aqueous solutions. By DPV technique, LD, UA and AA give oxidation peaks at 0.380, 0.520 and 0.180 V, respectively. Under the optimized experimental conditions LD, UA and AA give a linear response in the range of 0.09-75 μmol L-1, 0.3-110 μmol L-1 and 10-160 μmol L-1, respectively. Accordingly, the obtained detection limits were 0.003, 0.002 and 0.023 μmol L-1. The method provides a simple electrochemical sensor for successful determination of LD in human blood serum samples.

Background: Ramadan fasting is associated with some lifestyle changes. A lack of nutritional needs knowledge or the improper performance of fasting, particularly in relation to time, type and amount of food intake, can cause disorders such as indigestion, bloating, constipation, headaches and other clinical problems., Objectives: To investigate the general knowledge regarding dietary factors associated with Ramadan fasting and its related complications., Patients and Methods: This prospective, non-interventional, observational study was conducted from April to July, 2012 to coincide with the month before and the month of Ramadan. The initial participants were 600 fasting and 588 non-fasting people (aged 18 - 65 years, BMI 18.5 - 40 kg/m 2 ) chosen by random cluster sampling in Tehran, Iran. A questionnaire of Ramadan fasting nutritional knowledge was developed and validated in a pilot study. The Likert scale was used two weeks before Ramadan and during the third and fourth weeks of Ramadan to estimate Ramadan-related complications. Seven-day, 24 - hour food recalls were used to assess food intakes., Results: The lowest level of general knowledge was identified in the context of foods associated with hunger (22.1%) and hypoglycemia (24.8%) and the highest level of general knowledge was identified in reference to unsuitable foods for Sahar (91.4%). During Ramadan, all attributed complications increased in fasting subjects (P < 0.001). High calorie, carbohydrate, fat and protein intakes in the Ramadan diet were associated with some gastrointestinal and sleep complications (P < 0.05)., Conclusions: Despite the relatively high level of knowledge in the context of the general principles of a diet to prevent Ramadan-related complications, practical training in regard to the amounts of nutrients associated with Ramadan-related complications is both necessary and recommended.

Background: There has been no data on population based dietary patterns during the Ramadan fasting month., Objectives: The purpose of this study was to detect Ramadan major dietary patterns among those who fast in Tehran., Materials and Methods: This cross-sectional study included 600 subjects, aged 18-65 with body mass index (BMI) of 18.5-40, who had decided to fast during Ramadan. Anthropometric measurements, usual physical activity level and educational status were collected two weeks before Ramadan. Information on Ramadan dietary intakes was obtained using a food frequency questionnaire and factor analysis was used to identify major dietary patterns., Results: We identified four major dietary patterns: 1) Western-like pattern; high in fast foods, salty snacks, nuts, potato, fish, poultry, chocolates, juices; 2) high cholesterol and high sweet junk food pattern; high in pickles, sweets and condiments, butter and cream, canned fish, visceral meats and eggs; 3) Mediterranean-like pattern; high in vegetables, olive oil, dates, dairy, dried fruits, fruits, red meats, tea and coffee and 4) Ramadan-style pattern; large consumption of Halim, soups, porridges, legumes and whole grains, soft drinks, Zoolbia and Bamieh. Age was positively and inversely associated with Mediterranean-like (P = 0.003; r = 0.17) and Ramadan style (P = 0.1; r = -0.13) dietary pattern, respectively. Pre-Ramadan physical activity level was associated with a Mediterranean-like dietary pattern (P < 0.0001; r = 0.20)., Conclusions: This study showed a Ramadan-specific dietary pattern has unique characteristics, which has not yet been identified as a model of dietary pattern. Also, among identified dietary patterns, Mediterranean-like was the healthiest.

Background: There is controversy over the potential benefits/harms of the usage of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) as regards the postoperative mortality of coronary artery bypass grafting (CABG). This study investigates the correlation between the in-hospital mortality of CABG and the preoperative administration of ACEI/ARB., Methods: Out of 10055 consecutive patients with isolated CABG from 2006 to 2009, 4664 (46.38%) patients received preoperative ACEI/ARB. Data were gathered from the Cardiac Surgery Registry of Tehran Heart Center. In-hospital mortality was defined as death within the same admission for surgery. Adjusted for confounders, multivariable logistic regression models were used to evaluate the impact of preoperative ACEI/ARB therapy on in-hospital death., Results: The mean age of the patients was 60.04 ± 9.51 years and 7364 (73.23%) were male. Eighty-seven (0.86%) patients expired within 30 days. Multivariate analysis revealed that the administration of ACEI/ARB significantly protected against in-hospital deaths inasmuch as there were 33 (0.70%) vs. 54 (1.0%) deaths in the ACEI/ARB positive and negative groups, respectively (OR: 0.628; p value = 0.09). Patients without ACEI/ARB were more likely to have a higher global ejection fraction., Conclusion: Preoperative ACEI usage in patients undergoing CABG can be associated with decreased in-hospital mortality. Large-scale randomized clinical trials are suggested.

Objective: To describe the etiological characteristics of intellectual disability in one Iranian center., Methods: In a cross-sectional study, 64 cases with mental retardation (MR) were examined in the Intellectual Rehabilitation & Welfare Care Center of Vardavard, Iran between April and September 2008. Cases were diagnosed with MR or showed delay/regression of developmental milestones. We studied the records of patients and interviewed their families., Results: A total of 64 cases were screened (most were children). The number of male patients was 19 (29.7%) and the females was 45 (70.3%). First degree relatives with mental retardation were found in the families of studied patients, among these relatives 48% were female and 52% were male. Up to 77% of the marriages were between relatives, approximately half between first cousins. The illiteracy rate reached 34% in the families of MR children. Hard labor, hypoxia during labor, mother`s preexisting systemic disease, and maternal and neonatal infection were the most important factors for MR. Furthermore, most of the families were found to have low socioeconomic class., Conclusion: Cognitive disabilities in children are multifactorial. Consanguinity was the main risk factor for MR and considering its high rate in our country due to traditional marriages, it should be modified.

Background: Over the centuries, opium has been the most frequent substance abused in the Middle East. There are many controversial aspects about the effects of opioids on the atherosclerosis process, which is still unclear., Methods: All patients who were candidates for coronary artery bypass graft in Tehran Heart Center were registered and evaluated for risk factors such as diabetes mellitus, hypertension, smoking status and duration, opium abuse, involved coronary arteries and left main branch lesion > 50%, carotid stenosis > or = 70%., Results: A total of 1,339 patients were enrolled in the study, of whom 400 (29.9%) were female and the other 939 (70.1%) male. Female patients were omitted from analysis due to the low numbers of female opium addicts. Our study revealed that in the addicted population, the risk of diabetes and hypertension was lower than in the non-addicted group (p < 0.05 for each variable) and fasting blood sugar tended to be less in addicted ones, but the number of involved coronary arteries, left main stenosis > 50% and extent of carotid stenosis was not significantly different between the two groups., Conclusions: Our investigations demonstrate that opium is not cardioprotective, as has been claimed by some previous studies, and does not even decelerate atherosclerosis of carotid arteries in opium-addicted patients, but more evidence is still needed to completely prove the case.

Background: To evaluate the prevalence of abdominal aortic aneurysm in Iranian candidates for coronary artery bypass graft surgery and its associated factors., Methods: Totally, 2843 consecutive candidates for coronary artery bypass graft surgery underwent ultrasonography of abdominal aorta. The relation between abdominal aortic aneurysm with gender, age, smoking, dyslipidemia, hypertension, diabetes, and carotid and coronary stenosis was evaluated., Results: The prevalence of abdominal aortic aneurysm was 2.7% and 0.7% in men and women subgroups, respectively. The prevalence was 3.8% in men older than 65 years. The largest diameter of abdominal aortic aneurysm was 61.7 mm. Only two men had aneurysm larger than 55 mm, which led to changing their surgery schedule to stenting. Gender, age, smoking, smoking more than 40 years, diabetes , hypertension, and significant carotid stenosis were associated factors of abdominal aortic aneurysm., Conclusion: Compared with the results sited in Western studies, the prevalence of abdominal aortic aneurysm is lower in Iran (P<0.0001). Its associated factors in our study were similar to previously published studies. Significant carotid stenosis, a factor not reported previously, was an associated factor in our study. Because of the low prevalence of abdominal aortic aneurysm in our population, screening the candidates for coronary artery bypass graft surgery is not recommended.

Objective: Evaluating renal function by calculating creatinine clearance as an alternative measure to serum creatinine may give a better estimation of postoperative renal function in patients undergoing coronary artery bypass grafting., Methods: Using our database, we conducted a retrospective review of the records of all 11,884 patients aged 21 years or older undergoing pure bypass grafting who required cardiopulmonary bypass. Preoperative renal function was categorized as normal renal function (serum creatinine 60 mL/min), occult renal insufficiency (serum creatinine 1.5 mg/dL and creatinine clearance 7 days) was higher in patients with occult renal insufficiency than in the normal group in univariable analysis. Multivariable logistic regression analysis demonstrated that patients with occult renal insufficiency compared with the group with normal renal function were at higher risk for mortality (odds ratio = 2.59, 95% confidence interval 1.15-5.86; P = .022) and prolonged hospital stay (>7 d) (odds ratio = 1.30, 95% confidence interval 1.08-1.57; P = .005)., Conclusions: To identify higher-risk patients requiring special intensive care, and in whom new interventions can be performed to improve outcome, we recommend the preoperative calculation of creatinine clearance, especially in older women with a lower body mass index.