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Abstract Background Previous studies have suggested a significant association between diet quality and mental health. However, a limited number of studies have utilized the Prime Diet Quality Score (PDQS) to examine this association. Additionally, no study has yet compared the PDQS and Healthy Eating Index-2015 (HEI-2015) in terms of their association with depression and anxiety. Aim This cross-sectional study aimed to investigate the association between diet quality, measured by the PDQS and HEI-2015, and the odds of depression and anxiety in adults. Methods This study utilized data from the LIPOKAP study, which was conducted between February 2018 and July 2019 in five cities in Iran. We included 1994 adults aged 18 and above who were selected through a multistage cluster sampling method. Participants completed a validated semiquantitative food frequency questionnaire (FFQ) to evaluate their dietary intake. The FFQ was used to calculate the PDQS and HEI-2015. Depression and anxiety levels were determined using the Hospital Anxiety and Depression Scale (HADS). Results The participants had a mean age of 39.79 ± 13.87 years, with females accounting for 1,041 (52.2%) of the total population. PDQS showed a significant inverse association with the odds of depression (OR = 0.45, 95% CI: 0.28–0.71) and anxiety (OR = 0.40, 95% CI: 0.25–0.62) in the fully adjusted model. Similarly, the highest quartile of HEI-2015 showed a significantly lower odds of depression (OR = 0.60, 95% CI: 0.40–0.90) and anxiety (OR = 0.62, 95% CI: 0.42–0.92) compared to the lowest quartile. Conclusion Both PDQS and HEI-2015 were associated with a reduced risk of depression and anxiety. However, the PDQS demonstrated a stronger inverse association with these risks compared to the HEI-2015. This suggests that the PDQS could be a more beneficial dietary pattern for preventing depression and anxiety compared to HEI-2015. Further large-scale studies are required to confirm these findings.

Abstract Background As acute myocardial infarction (AMI) prevalence is increasing because of lifestyle changes, the incidence of atypical symptoms in acute coronary syndrome (ACS) is rising and making misdiagnosing of this fatal event more probable. To better approach the patients with atypical symptoms, we tend to present a rare case of AMI with wrist pain. Case report A 41-year-old man presented to the emergency room (ER) with severe both-hand wrist pain and mild epigastric pain. His electrocardiogram (ECG) showed anterior ST-elevation myocardial infarction (MI) with an ejection fraction of 35–40%. His angiography showed severe left anterior descending artery (LAD), and first obtuse marginal artery (OM1) artery stenosis. He underwent Primary percutaneous coronary intervention (PCI). The patient recovered without serious complications and was discharged the day after PCI. Discussion In this rare case of AMI with wrist pain, it is important to know that atypical symptoms can be present at various levels of symptoms, which prevents future misdiagnosis.

Background: Physiological changes during pregnancy cause complications in mothers with mitral stenosis and their infants. This study was designed to assess maternal and fetal pregnancy outcomes in women with rheumatic mitral valve stenosis and compare them with the control group. Materials and methods: This study is a case-control study on 153 pregnant women, including 51 with mitral stenosis (MS) and 102 without MS as the control group, between 2007–2022. For each studied patient, two control participants were selected and matched in residence, age, and year of pregnancy. SPSS version 22 was used for data analysis. Results: The mean age was 31.7 ± 4.6 years in cases and 31.6 ± 4.7 in the healthy controls. Demographic variables were not significantly different between the case and control groups. The rate of stillbirth (5.9% vs. 0.0%), %), NICU admission (13.7% vs. 2.0%), and IUGR (5.9% vs. 0.0%) were higher in the fetal case group compared with the control group. On the other hand, maternal outcomes, including pulmonary edema (13.7% vs. 0.0%), ICU admission (23.5% vs. 0.0%), limb edema (15.7% vs. 0.0%), dyspnea (37.3% vs. 0.0%), pulmonary hypertension (9.8% vs. 0.0%), palpitations (21.1% vs. 0.0%) and hospital admission during pregnancy (37.2% vs. 4.9%) were statistically more common in the case groups. Conclusions: Pregnancy is associated with significant fetomaternal morbidities in women with mitral valve heart disease. So they need a multidisciplinary approach in preconception and antenatal care.

The changes in the causes of death in South Khorasan province, Iran, during 2002-2022 were examined in the present research. According to the data available in the “Mortality Data Registery” during these 20 years, cardiovascular diseases (CVD) was the most common cause of death, and its rate has increased from 20% in 2002 to about 37.8% in 2022. Even during the COVID pandemic, CVD was the first cause of death in the province. In 2022, the most common causes of death were CVD (37.8%), respiratory diseases (15.2%), cancers (14%), and accidents (9.2%). One of the most effective factors in preventing CVD is paying attention to"Life’s essential 8 Cardiovascular Health", i.e., having normal blood glucose, blood pressure, serum lipids, body mass index, sufficient physical activity, healthy diet, sufficient night sleep, and being a non-smoker. In addition to individuals’ attention to these factors, it is necessary for healthcare system decision-makers to have systematic and continuous planning to enhance people's awareness and attitude regarding these eight factors.

Abstract Objective: The cardioprotective effects of nuts are well established. However, the positive impacts of nuts in preventing CVD at a younger age, a condition known as premature coronary artery disease (PCAD), is still debated. Therefore, we aim to determine the association between nuts and PCAD occurrence and its severity in different Iranian ethnicities. Design: This case–control study was conducted within the framework of the Iran-premature coronary artery disease (I-PAD) study, an ongoing multi-centric study on Iranian patients of different ethnicities. Setting: This multi-centric case–control study was conducted in among 3253 persons under the age of 70 years in women and 60 years in men from different ethnicities in Iran. Participants: Information on nut consumption was collected using a validated FFQ. Subjects were selected from among the candidates for angiography. Cases were those whose coronary angiography showed stenosis of more than 75 % in at least one vessel or more than 50 % of the left main artery, while the control group participants had normal angiography results. Results: In the crude model, compared to the first quartile, the highest quartile of nut consumption was significantly associated with a lower risk of PCAD (OR = 0·26, 95 % CI (0·21, 0·32); P for trend = 0·001). In the top quartile of nut intake, a substantial decrease in PCAD was observed after controlling for putative confounders (OR = 0·32; 95 % CI (0·24, 0·43); P for trend = 0·001). Additionally, a 75 % decrease in the risk of severe PCAD was observed in the participants in the highest quartile of nut intake. Conclusion: A significant inverse association was observed between nut intake and the risk and severity of PCAD in the Iranian population. Large-scale clinical trials are required to confirm these findings.

Abstract Background Loss‐of‐function (LOF) variants of the angiopoietin‐like 3 (ANGPTL3) gene are reported to be associated with serum triglyceride (TG) and high‐density lipoprotein cholesterol (HDL‐C) concentrations and thereby affect the risk of cardiovascular disease (CVD). Objective In the present study, we examined the association of rs10789117 in the ANGPTL 3 gene locus and the risk of CVD in the group of people who were part of the Mashhad‐Stroke and Heart‐Atherosclerotic‐Disorders (MASHAD) cohort. Methods One thousand and two healthy individuals enrolled in this study of whom 849 subjects were healthy and 153 subjects developed CVD outcomes after 6 years of follow‐up. After a 12‐h overnight fasting, 20 mL of blood samples were collected for the measurement of fasting blood glucose and lipid profile. DNA was extracted, and the Tetra‐ARMS PCR (amplification refractory mutation system) was used for genotyping of rs10789117 in the ANGPTL3 gene. The genotype frequencies of the variant of rs10789117 in the ANGPTL3 gene were estimated using χ2 tests. Eventually, the statistical analysis was done by SPSS version 20. Results Individuals with AC/CC genotypes (rs10789117) were found to have to greater risk of CVD events compared to AA genotype (OR = 1.43, 95%CI = 1.01–2.02, p = 0.041). There was a 1.3‐fold increase in cardiovascular events in individuals carrying the C allele of rs10789117 variant compared to non‐carriers (OR = 1.32, 95%CI = 1.06–1.72, p value = 0.038). There were significant differences between different genotypes for serum triglyceride levels within the control group, but this difference was not significant in the group with CVD. Moreover, there was a significant association between CC genotype and CVD risk in the individuals with a normal serum HDL‐C. Conclusion We have found that a rs10789117 C>A in ANGPTL3 gene polymorphism was associated with incident CVD events, and this may be of value as a risk stratification biomarker in CVD in the Iranian population.

Background and Aims: Athletic activities, along with the consumption of herbal supplements, can control excess weight and associated diseases. The present study aimed to investigate the effect of pomegranate supplementation and exercise at home on lipid profile and cardiac electrical activity in overweight and obese postmenopausal women. Materials and Methods: This applied research was conducted based on a single-blind quasi-experimental design. A total of 60 overweight and obese postmenopausal women with a body mass index greater than 25 (kilograms per square meter) and an age range of 65-45 years were selected and randomly assigned to four groups: supplement + exercise (n=15), exercise(n=13 ), supplement (n=14), and placebo (n=14 ). Participants took one 225 mg pomegranate capsule and a placebo daily for 28 days. Due to the Covid-19 pandemic, resistance exercises were performed at home. Shapiro-Wilk, ANOVA, Kruskal-Wallis, and Lune tests were used in this research. Statistical calculations were performed in SPSS software (version). Results: Based on the results, there was no significant difference in fasting blood sugar, weight, triglycerides, low-density lipoprotein (LDL-C), systolic and diastolic blood pressure, heart rate, fat percentage, cholesterol, high-density lipoprotein (HDL-C), PR interval, QRS wave amplitude, and QT interval (P>0.05). Conclusion: It seems that a short period of four weeks of exercise at home with the consumption of pomegranate supplements did not significantly change the lipid profile and electrical activity of the heart. It is suggested that the same study with long-term training periods and different doses of pomegranate supplements should be repeated.

Abstract Purpose There is a paucity of evidence regarding the influential factors on Iranian children’s diet quality. To assess this issue, we explore the relationship between parental diet quality, socioeconomic status (SES), and nutritional knowledge with their children’s diet quality using a cross-sectional sample of the Iranian population. Methods In this study, paired parents along with one of their children (aged 6–18 years old) who lived with them were included. Dietary intake was assessed using a food frequency questionnaire (FFQ) and diet quality was determined using an Alternative Healthy Eating Index-2010 (AHEI). Nutritional knowledge and SES were also explored using validated questionnaires. Multiple linear regression analysis was used and beta (β) and corresponding 95% confidence interval (CI) were reported. Results After controlling for potential confounders, the parents’ AHEI was significantly associated with their children’s diet quality (β = 12.34, 95% CI: 10.75, 13.93; P

Introduction: Considering the importance of diagnosing and prescribing the right medicine by physicians, it is important that due to the shortness of the training period, this is not possible. Clinical pharmacology is increasing the awareness of medical students in managing the use of drugs. Methods: In the year 2021, 34 interns and stagers entered the study at the Razi Specialized-Subspecialized Hospital of Birjand University of Medical Sciences. During the one-month cardiac course, the students visited the patients in the cardiac training clinic one day a week with the presence of a cardiologist and a clinical pharmacologist. There was a discussion about how to prescribe drugs, their side effects, and drug interactions. To evaluate the course, a test before and after the course was conducted to check their learning level. Data were analyzed using descriptive statistics and paired t-test. Results: Thirty-four students (22(65%) stagers, 12(34%) interns, 14(41%) women, 20(59%) men) were included in the study. The results showed that the scores of the students increased after the course (before the course 6±1 and after the course 11±2) and this increase was significant (p

Abstract Background and Aims Marfan syndrome (MFS) is an autosomal dominant genetic disorder caused by pathogenic variants of the fibrillin‐1‐encoding FBN1 gene that commonly affects the cardiovascular, skeletal, and ocular systems. This study aimed to evaluate the clinical features and genetic causes of the MFS phenotype in a large Iranian family. Methods Seventeen affected family members were examined clinically by cardiologists and ophthalmologists. The proband, a 48‐year‐old woman with obvious signs of MFS, her DNA sample subjected to whole‐exome sequencing (WES). The candidate variant was validated by bidirectional sequencing of proband and other available family members. In silico analysis and molecular modeling were conducted to determine the pathogenic effects of the candidate variants. Results The most frequent cardiac complications are mitral valve prolapse and regurgitation. Ophthalmic examination revealed iridodonesis and ectopic lentis. A heterozygous missense variant (c.2179T>C/p.C727R) in exon 19 of FBN1 gene was identified and found to cosegregate with affected family members. Its pathogenicity has been predicted using several in silico predictive algorithms. Molecular docking analysis indicated that the variant might affect the binding affinity between FBN1 and LTBP1 proteins by impairing disulfide bond formation. Conclusion Our report expands the spectrum of the Marfan phenotype by providing details of its clinical manifestations and disease‐associated molecular changes. It also highlights the value of WES in genetic diagnosis and contributes to genetic counseling in families with MFS.

Abstract Objective: To identify ultra-processed foods (UPF) contribution to daily energy and nutrient intake in Iranians and examine whether UPF intake is associated with nutrient profile and diet quality. Design: In this cross-sectional study, a validated FFQ was used to evaluate usual dietary intake over the preceding year. NOVA system was applied to categorise foods based on their levels of processing. Diet quality was evaluated using the nutrient adequacy ratio (NAR), Nutrient Rich Food Index (NRF) and hybrid nutrient density. Setting: The LIPOKAP study conducted in five cities of Iran (Isfahan, Birjand, Bandar Abbas, Kermanshah and Shahrekord). Participants: A total of 1994 adults aged ≥18 years were recruited using stratified multistage random cluster sampling method. Results: UPF were responsible for 8·5 % of daily energy intake. In the adjusted model, UPF consumption was inversely associated with carbohydrate, protein, refined and whole grains, fibre, fruit and meat, but was positively linked to energy, total fat, saturated and trans fatty acids and cholesterol. Compared with those in the lowest tertile, individuals in the highest tertile of UPF had smaller NAR for Ca, Mg, Zn, Fe, phosphorus, thiamin, niacin, folate and vitamin C. Both NRF and hybrid nutrient density decreased when the share of daily energy intake from UPF increased. Conclusion: The higher consumption of UPF is associated with poorer diet quality and lower nutrient intake. It is recommended that UPF be replaced with minimally processed foods to improve diet quality and nutrient profile.

BACKGROUND: To investigate the effects of comprehensive, integrated interventions on dyslipidemia Knowledge and Practices (LIPOKAP) using population and high-risk approaches.METHODS: The baseline of this national, multicentric community trial was conducted on three groups: the general population (adults over the age of 18 and their children aged 6-18), patients with dyslipidemia and their caregivers, and health professionals (physicians, nurses, health providers, and health workers). The general population was selected using multi-stage random sampling, while patients and health professionals were recruited using the consecutive sampling method. The research was carried out in urban and rural areas of five Iranian counties. The sampling method and sample size were similar in baseline and post-intervention surveys. Approximately 8-month intervention programs were carried out on the target groups, which generally included educational strategies. The intervention activities addressed the management, prevention, and control and were tailored to each target group, focusing on lifestyle and self-care. RESULTS: All questionnaires’ content validity ratio, content validity index, and Cronbach’s alpha were over 0.68, 0.83, and 0.73, respectively. We enrolled 2456 adults and 850 of their children, 3331 dyslipidemia patients, 1699 caregivers, and 1800 health professionals.CONCLUSIONS: The validity and reliability of all developed questionnaires that can examine knowledgeand practice changes as a result of intervention activities were acceptable.

Abstract Subject Cardiovascular disease is now well established as an interaction between genetic and environmental components. Newly identified single nucleotide polymorphisms of angiopoietin-like 3 (ANGPTL3) influence lipid concentrations and risk of coronary artery disease. The current study aimed to determine the association between ANGPTL3 gene variants with incident CVDs in elderly population of the Birjand longitudinal aging study (BLAS). Method Totally, 360 individuals were recruited in baseline of BLAS including 128 patients with CVD and 153 control subjects. DNA extraction of samples and genotyping were performed by Tetra-ARMS PCR (amplification refractory mutation system polymerase chain reaction). The association between three polymorphisms of ANGPTL3 gene (rs1748195, rs11207997, and rs10789117 variants) with CVD and its risk factors were evaluated using multivariate analysis. Results Univariate and multiple analyses showed that individuals carrying the GG genotype of rs1748195 and those carrying the TT genotype of rs11207997 directly increased the risk of CVD. CC genotype of rs1748195 and rs11207997 polymorphisms had a significant negative relationship with the disease. In addition, the findings of this study indicate a significant difference in LDL, HDL, cholesterol levels between different genotypes of the rs1748195 and rs10789117 in the healthy group. Individuals with haplotypes CAC, CCC and CCT showed a significant positive relationship with CVD, CVA, AMI and CHD. As well as haplotype was associated with a 1.7-fold increase in risk of CVA, AMI, and CHD. Conclusion We found that polymorphism of ANGPTL3 gene might support to identify individuals with a cardiometabolic and genetic disorders susceptibility. Three haplotypes CAC, CCC and CCT associated with CVD, CVA, AMI and CHD were reported.

BackgroundUltra-processed foods (UPF) consumption may affect the risk of PCAD through affecting cardio metabolic risk factors. This study aimed to evaluate the association between UPFs consumption and premature coronary artery disease (PCAD).MethodsA case–control study was conducted on 2,354 Iranian adults (≥ 19 years). Dietary intake was assessed using a validated 110-item food frequency questionnaire (FFQ) and foods were classified based on the NOVA system, which groups all foods according to the nature, extent and purposes of the industrial processes they undergo. PCAD was defined as having an stenosis of at least single coronary artery equal and above 75% or left main coronary of equal or more than 50% in women less than 70 and men less than 60 years, determined by angiography. The odds of PCAD across the tertiles of UPFs consumption were assessed by binary logistic regression.ResultsAfter adjustment for potential confounders, participants in the top tertile of UPFs were twice as likely to have PCAD compared with those in the bottom tertile (OR: 2.52; 95% CI: 1.97–3.23). Moreover, those in the highest tertile of the UPFs consumption had more than two times higher risk for having severe PCAD than those in the first tertile (OR: 2.64; 95% CI: 2.16–3.22). In addition, there was a significant upward trend in PCAD risk and PCAD severity as tertiles increased (P-trend

Background: Obesity is one of the most public health challenges in the 21st century, which has increased in most countries during the last decade. This study aimed to determine factors affecting the prevalence of obesity, overweight, and central obesity among urban adults referred to Birjand health centers in 2017. Methods: In this cross-sectional study, we investigated the data of all individuals who were registered in the Integrated health application system of Birjand (SIB) from April 2016 until March 2017 by census method. A checklist was designed to include the participants’ demographic characteristics, weight, height, and waist circumference. After coordinating with the health department of Birjand University of Medical Sciences, the authors logged in to the SIB system, collected and entered the data into the checklist. Then, the authors analyzed data using chi-square, independent sample T-test, and ANOVA tests by SPSS-22 software. Results: In the present study, 10,000 people participated. Their average age was of 44.3±11.8 years. The majority were females 7190 (71.9%) out of which 4827 (48.3%)were in the age group of 30 to 40 years old. The prevalence of overweight, obesity, and central obesity in urban adults who registered in the SIB system in Birjand was 3539 (35.4%), 1968 (19.7%), and 4847 (48.5%), respectively. These features for women were significantly higher than men in all age groups. Conclusion: These findings revealed that obesity and abdominal obesity were high in urban adults in Birjand, which requires immediate intervention to improve the obesity status.

BackgroundDietary patterns emphasizing plant foods might be neuroprotective and exert health benefits on mental health. However, there is a paucity of evidence on the association between a plant-based dietary index and mental health measures.ObjectiveThis study sought to examine the association between plant-based dietary indices, depression and anxiety in a large multicentric sample of Iranian adults.MethodsThis cross-sectional study was performed in a sample of 2,033 participants. A validated food frequency questionnaire was used to evaluate dietary intakes of participants. Three versions of PDI including an overall PDI, a healthy PDI (hPDI), and an unhealthy PDI (uPDI) were created. The presence of anxiety and depression was examined via a validated Iranian version of the Hospital Anxiety and Depression Scale (HADS).ResultsPDI and hPDI were not associated to depression and anxiety after adjustment for potential covariates (age, sex, energy, marital status, physical activity level and smoking). However, in the crude model, the highest consumption of uPDI approximately doubled the risk of depression (OR= 2.07, 95% CI: 1.49, 2.87; PConclusionsAn unhealthy plant-based dietary index is associated with a higher risk of depression and anxiety, while plant-based dietary index and healthy plant-based dietary index were not associated to depression and anxiety.

Introduction: Obesity is a common risk factor associated with cardiovascular disease (CVD) risk. Curcumin has been reported to exert beneficial effects on lipid metabolism, including HDL functionality. We have examined the effects of curcumin on HDL cholesterol uptake capacity in subjects with obesity.Materials and Methods: 30 obese individuals received curcumin and placebo 1 g per day for a period of 30 days. The subjects were crossed over to the alternative regimen after a 2-week washout period. A modified cholesterol uptake capacity (CUC) assay was used to determine serum HDL functionality.Results: The study groups had similar base line characteristics. We did not find significant effects (p>0.05) of curcumin on serum HDL CUC levels.Conclusion: Curcumin administration at a dose of 1 g per day for 30 days did not affect HDL CUC in subjects with obesity.

Background: Cardiovascular diseases are among the most prevalent causes of morbidity and mortality. This research investigated the relationship between physical activity, lipid profile, and new anthropometric cardiovascular risk factors among men. Methods: This cross-sectional study was conducted on 155 adult men (30-50 years old) who were selected randomly from 250 men called by public announcement. Standard methods were used to measure their anthropometric indices and then they were asked to complete the Baecke questionnaire. ANOVA was used to compare basic anthropometric and clinical characteristics in different age groups followed by Tukey’s posthoc test. A correlation of anthropometric measurements with glucose and lipid parameters was determined by the Pearson correlation coefficient. P

Abstract Aim To determine the relationship between self‐concept and coping styles in patients with heart failure in an Iranian population. Design This study had a correlational design. Methods In this study, 100 HF patients hospitalized in the CCU and cardiac ward of Vali‐Asr Hospital of Birjand, Iran were selected by convenience sampling method. Two validated and reliable questionnaires including Cognitive Perception of Self‐Concept and the Coping Styles questionnaires were completed by each patient. Results There were significant associations between emotion‐oriented and threat to self‐concept in total and physical sensation and self‐consistency dimensions. Also, a significant association was observed between avoidance‐oriented and threat to self‐concept in total and body sensation dimension (p

Background and Aim: Failure to follow the drug is common in patients with myocardial infarction. However, it has been reported in various studies that family support can improve adherence to drug in chronic diseases. The purpose of this study was to investigation the impact of education of family support behaviors on adherence to the drug in patients with Myocardial Infarction. Materials and Methods: This controlled clinical trial study was performed on 70 patients with myocardial infarction, which had criteria for entering the study. Patients were randomly divided into intervention and control groups and demographic information and adherence to the drug was completed questionnaire for two groups. Individuals who received inadequate the drug follow-up based on this questionnaire were completed their family support questionnaire. In order to intervene, in the form of at least three educational sessions, based on the needs assessment of the two previous questionnaires, training was provided to the key member of the intervention group family and three months after the intervention, the two drug and family support questionnaires were re-completed for the two groups. Finally, the data was entered into SPSS software (version 16). Descriptive statistics including frequency, mean, standard deviation for description and description of data and analytical statistics including: Chi-square, paired T-test and independent T-test were used for data analysis. The significance level was considered as (P

Objective: The present study was designed to investigate the effects of atorvastatin on serum high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), total antioxidant capacity (TAC), and alpha-1 antitrypsin (AAT) in patients with chronic obstructive pulmonary disease (COPD). Methods: A clinical trial study conducted on 42 cases of COPD (Vali-Asr Hospital, Birjand, East of Iran, years 2014–16). Patients were randomly assigned to 21 controls and 21 cases who treated with atorvastatin (40 mg/day for 6 months). Inhaled corticosteroid and long-acting β-agonist were administrated in both groups. The trial was registered at the Iranian Registry of Clinical Trials (registration number: IRCT2016042527594N1). TAC was measured by ferric reducing/antioxidant power assay. An enzyme-linked immunosorbent assay was used to determine IL-6, AAT, and hs-CRP. Spearman's rho test and Wilcoxon, Mann–Whitney, paired, and independent t-tests were used for data analysis in SPSS 23. P < 0.05 was considered significant. Findings: A number of patients completed the study were 16 in atorvastatin and 18 in control group. Mean increments (μmol/L) of TAC (mean ± standard deviation [SD]) were 12.81 ± 605.25 (P = 0.68) in atorvastatin and 160.26 ± 280.54 (P = 0.14) in control group. Mean decrements of IL-6, CRP, and AAT (mean ± SD) were 1.41 ± 5.51 (P = 0.71), 0.98 ± 5.68 (P = 0.72), and 10.94 ± 46.83 (P = 0.21) in atorvastatin and 0.91 ± 11.70 (P = 0.75), 3.23 ± 7.00 (P = 0.19), and 18.77 ± 55.90 (P = 0.21) in control group. Conclusion: Atorvastatin did not succeed in maintaining TAC and CRP reduction. However, less reduction in AAT and more reduction in IL-6 in the atorvastatin group would be likely a beneficial effect in COPD.

Background and Objectives: Hypertension is one of most common clinical disorder and there is a positive relationship among prevalence risk of cardiovascular diseases, overweight, and hypertension. This research aimed to investigate the effects of ginger supplement and high intensity interval training (HIIT) on blood pressure, VO2max, and body fat percentage in overweight women. Methods: In this randomized placebo-controlled quasi-experimental study, according to research team facilities, 24 healthy overweight women (age range, 20-30 years), were divided into 3 groups of ginger (n=8), training+ginger (n=8), and training+placebo (n=8) and performed 10 weeks of HIIT (40m-maximal shuttle run) and daily consumed 3 g of ginger or placebo tablets. To test the hypothesis of the research, paired t-test, one-way ANOVA, and Tukey post-hoc tests, were used at the significance level of p

Clinical education can be taken as a facilitating activity for learning in the clinical settings in which students gain experiences from patients’ bedside and apply their previously learned concepts through their interactions with their teachers and routine works. Clinical education provides an opportunity for students to transform their theoretical knowledge into diverse intellectual and psychomotor skills essential to patient care. The evaluation process of teaching and learning is one of the noticeable activities in educational institutions because the training of skilled and competent manpower, to a large extent, is dependent on this process. The use of modern educational techniques, increasing productivity, and ultimately enhancing the effectiveness of educational centers is the goal followed all over the world but, this is more emphasized in the field of medical sciences that are directly connected with maintaining and improving the health of people and society. This is why for more effectiveness of medical education applying new methods is necessitated. One of the evaluated and structured methods focusing on learning experiences in education is “logbook”. Logbook is a simple means for learners, a framework for organizing various educational activities and recording them. One of the unique characteristics of a logbook is that it requires students acquire a certain number of skills. This causes the students to do their tasks as planned and objectively too; and thanks to repetition and practice they would prevent probable errors. At present, a lot of clinical education aspects are different than in the past. Technology development, changes in the pattern of people’s lifestyle and higher exposure to environmental risk factors (Such as the development of chemical industry, natural or synthetic chemicals, biological agents including viruses and other microorganisms, behavioral factors including psychological stress and drug addiction) cause changes in the pattern of diseases in general and particularly in the domain of communicable and non-communicable diseases. Therefore, in accord with these changes, the graduates and scholars are expected to promote their skills and abilities. Since, identification and analysis of the effectiveness of educational needs are prerequisite for a successful educational system, revision and continuous reviewing of educational programs based on the possibilities, conditions, and new needs are inevitable. Thus, the results of a study on 233 medical students passing their clinical stage (externs or interns) in Birjand University of Medical Sciences in the academic year 2016-2017 showed that 24.5% of them knew high or very high helpful completion of their log books activities in attaining of clinical wards skills and 74.5% expressed the necessity of reviewing available log books in clinical wards. According to the obtained results the necessity of reviewing log books used in clinical wards of BUMS considering the latest clinical issues, diseases- including emerging and reemerging ones- and diagnostic -therapeutic methods in accordance with changes in diagnostic - therapeutic guidelines using the newest resources is critically felt. Furthermore, due to the pervasive use of electronic log books in recent years in medical universities across the country that are in line with developments and innovations in medical education, it is recommended that the log books at this university too, should be presented and evaluated electronically. Electronic log books with ongoing record of activities and clinical techniques based on educational objectives, in addition to learning consolidation, determine unavailable measures to achieve clinical objectives and, thus, cause regular monitoring and evaluation on the part of students.

Background: Logbook is raised as one of the valuable clinical evaluation tools to monitor the achievement of educational goals. This study was done to determine the efficacy of present logbooks in clinical wards from medical students' viewpoint in Birjand University of Medical Sciences, Iran. Methods: This analytical-descriptive study was conducted on 233 medical students in clerkship and internship stages in fall 2016. Data collection instrument was a researcher-made questionnaire including 4 demographic questions, 10 viewpoint questions with a 4-point Likert scale and 2 practice questions; validity and reliability of the questionnaire were confirmed. Questionnaires were completed by all the students in clinical wards using self-administered method. Data was analyzed via SPSS using descriptive and analytical tests. Findings: Mean age of the students was 24.02 ± 1.45 years. Their mean knowledge score was 0.70 ± 0.69 from 2, mean viewpoint score was 22.62 ± 7.60 from 40, and mean practice score was 2.61 ± 0.92 from 4. Only 24.5 percent said that logbook complement in learning of clinical skills is highly and very highly useful. 70.8 percent expressed that existing logbooks need to be revised. Pearson's test showed significant correlation between mean knowledge score and viewpoint (P = 0.010) and practice (P = 0.030). Kruskal-Wallis test indicated significant difference in mean practice score based on different clinical wards (P = 0.030). Conclusion: Findings showed that existing logbooks in clinical wards was not efficacious in learning clinical wards skills. Therefore, regarding to logbook role in students learning process, it seems essential to conduct educational workshops for faculty members and students to enhance the knowledge and necessary skills, to design careful implementation, and to revise content of logbooks.

Introduction: Metabolic Syndrome (MS) in children and adolescents is becoming a global public health concern. MS tracks into adulthood increasing the risk for type 2 diabetes mellitus and cardiovascular diseases. This study was designed to verify the rate of MS in elementary school students of Birjand, as a representative sample of Iranian children to verify the best preventive measures in this age group. Methods: This descriptive-analytical, cross-sectional study was performed on 1425 elementary school children through multiple-cluster sampling in 2013. Height, weight, waist circumference and blood pressure of children were measured by standard methods. Blood glucose, triglycerides, cholesterol, High-density lipoprotein-cholesterol (HDL-C) and low-density lipoprotein-cholesterol (LDL-C) levels were also measured after 12 hours fasting. MS was defined according to the Adult Treatment Panel III (ATP-III) based on the National Cholesterol Education Program. Data were analyzed by SPSS using t test and chi-square test. Significance level was set at P

Background: Oxidative stress and alteration of lipid profile due to obesity and overweight is a major risk factor for atherosclerotic plaque or coronary artery disease. Because of antioxidant and lipid lowering potential of saffron, this study investigated weight alteration, lipid profiles, and insulin resistance index in high-calorie diet rats treated with aqueous extract of saffron stigma and petal. Methods: Forty Sprague-Dawley male rats were randomly divided into 8 groups including healthy control, high-fat diet control, nicotinic acid treated, Anethum graveolens treated, and saffron stigma and petal treated groups. Rats received a high-calorie diet for 16 weeks. For treatment, aqueous extract of saffron stigma (40 and 80 mg/kg) and petal (50 and 100 mg/kg) was used once daily for 4 weeks. Afterward, lipid profile, oxidative stress status, and insulin and adiponectin levels were measured using desired kits. Results: There was a significant decrease in the mean weight of the groups receiving saffron stigma and petal compared to control group (P < 0.05). The increased level of insulin hormone in obese group was improved in treated groups especially in the case of saffron stigma. Also, the decreased level of adiponectin was recovered in treated groups. An improvement was seen in oxidative stress markers and lipid profiles in treated groups compared to obesity pair. Conclusions: In this study, a remarkable antioxidant and lipid lowering potential was detected for saffron stigma, which could improve insulin resistance in obese rats. Therapeutic and protective effect of saffron is mainly related to its richness in phenolic compounds. Saffron stigma compared with petal had more notable effect, which could and should be mentioned in pharmaceutical studies.

Background and Objectives: Metabolic syndrome (MS) is associated with increased risk of cardiovascular disorders. MS is increasing among adolescents. This study was conducted to determine the prevalence of MS in 11-18 years old Birjandi school children in 2012. Materials and Methods: This cross–sectional study was conducted on 2394 eleven-eighteen years old school children in Birjand (1304 girls and 1090 boys) through Multiple-Cluster Sampling. Height, weight, waist circumference and blood pressure were measured by standard methods. Blood glucose, triglycerides, cholesterol, HDL-C and LDL-C were measured after a 12-hour fasting. MS was defined according to the modified Adult Treatment Panel III criteria. Data were analyzed by the SPSS software (ver. 16) using statistical T test, logistic regression and Chi square at P

Background and Aim: Nonalcoholic fatty liver disease is the most common cause of abnormal liver enzymes. We aimed to investigate the effects of of resistance and combined exercise on levels of liver enzymes in women with fatty liver disease Materials and Methods: In this study, 37 women were assigned into three groups including control, resistance and combined exercise groups. Resistance exercise protocol included 8 movements, 3 sets, 8-10 repetitions which performed at %60-75 of one repetition maximum، 3 times per week for 8 weeks. Combined exercise included 4 resistance movement in the first half of training session and the aerobic exercise at intensity of %60-75 maximum heart rate in the other half. The AST, ALT and ALP were measured using biochemical methods. Paired t-test results for the extraction of one-way ANOVA , at a significant level of 0/05 were analysed. Results: The level of ALP only in the resistance exercise group significantly decreased (p=0.03), but AST and ALT levels did not significantly change in any groups (p>0.05). The mean of ALT/AST ratio significantly increased in the resistance exercise group (p =0.04), but no significant changes were observed in the combination and control groups. The mean of flexibility (p=0.001), maximal oxygen consumption (p=0.02), muscle strength (p=0.003) and grip strength (p=0.001), significantly increased after resistance exercise. Conclusion: None of the resistance and combined exercises had significant effect on the levels of AST and ALT, but the resistance exercise improved ALP and fitness indicators.Therefore, resistance exercise may be more favorite for fatty liver patients.

Introduction: Being competent in performing clinical skills is necessary in medical profession. Acquiring essential competencies requires for time, patience, and practice in an appropriate context. Logbook is an instructional notebook in which there is a list of skills students must learn. These skills have been organized according to the opinion of faculty members of each ward and the international objectives set by ministry. The educational process could be evaluated continuously by means of these logbooks. This study was performed to evaluate the effect of using log books on clinical skills learning in cardiology ward. Methods: This quasi-experimental study was performed on 60 clerkship and internship students of cardiology ward in 2007-2008. In the first phase, students entering cardiology ward were selected as the control group. They received the usual instructions on clinical skills of the ward. In the second phase, logbooks were distributed among the next group of students as the experiment group and necessary explanations were provided for them. Students were asked to fill the required parts in the logbook and confirm them by their teacher. The educational content for both groups was the same. At the end of the course, students of each group were evaluated by their teachers using checklists for every single competency. Scores achieved for each competency were added up separately. The Mean scores of competencies achieved by students of both groups were compared using t-test. Results: The mean scores of all competencies achieved by the experiment group were significantly higher compared to those of the control group (α

Background: Recent evidence suggests that skeletonization of the left internal mammary artery (LIMA) can improve the flow and length of the flow, reduce deep sternal infections and postoperative pain. Objectives: The present study aimed to investigate the effect of two LIMA harvesting techniques (skeletonization and pedicled) on postoperative pain and bleeding. Methods: This randomized double blind clinical trial study on patients undergoing LIMA harvest in Birjand was conducted dur- ing years 2012 to 2014. The patients were divided to two (skeletonization N: 30 and pedicled N: 30) groups according to the LIMA harvesting method. Their demographic information and other relevant data were collected by means of a questionnaire. Results: In total, 60 cases, who were candidates for coronary artery bypass grafting (CABG) at the cardiac surgery department of Valiasr hospital in Birjand, were studied. In the skeletonized group, the conduit length was significantly longer (17.96 vs. 17.27, P < 0.001), yet there was no significant difference between early and mid-term pain scores (P values: 0.32 and 1.0, respectively) and early postoperative bleeding (782.26 vs. 903.16, P = 0.657). Conclusions: The IMA skeletonized collection resulted in the reduction of postoperative pain and increased conduit length. Skele- tonization could not decrease postoperative bleeding.