behrouz pourheidar

Acute coronary syndrome is the most common cardiovascular disorder. Hope and optimism lead to adaptation to and moderation of the damaging effects of depressed mood on the outcome of this disorder. The aim of this study was to determine the effect of positive psychology-based audio messages on hope and optimism among patients with acute coronary syndrome.

Methods & Materials:

 In this randomized controlled clinical trial, 84 patients with acute coronary syndrome were assigned to either intervention or control groups in Shahrekord educational hospitals in 2017-2018. The intervention group received audio messages based on positive psychology and cardiovascular self-care, and control group only received self-care messages in two hospital admissions and six weeks after discharge. The Life Orientation Test-Revised and the Snyderchr('39')s Hope Scale were completed before the intervention, at the discharge time, one week and six weeks after the intervention. Data were analyzed by c² and Fisher exact tests and analysis of variance using the SPSS software version 20.

No significant difference is observed in the mean score of hope before the intervention and at the discharge time. However, the mean score of hope was significantly different between the two groups, one week and six weeks after the intervention (P<0.001). There was no significant difference in the mean score of optimism between the two groups before the intervention. Nevertheless, difference in the mean score of optimism was significant at the discharge time (P=0.027), one week and six weeks after the intervention (P<0.001).

Positive psychology-based messages improve hope and optimism in patients with acute coronary syndrome. Therefore, this intervention is recommended along with other treatments.

Congenital anomalies are common causes of medical interventions, long-term illness and death. The aim of this study was to determine the risk factors of congenital anomalies in disabled patients under 15 years old registered in Welfare Organization of Shahrekord.

The present study was a case–control study. 350 disabled patients registered in the Welfare Organization of Shahrekord and 350 matched healthy children were included in study. Demographic information and probable risk factors were recorded in the checklist through the patient's file and interviews with parents.

The most common anomalies were cardiac disorders (31.1%), cerebral palsy (18.3%) and Down syndrome (14.9%). The body weight, length and head circumference at birth, mean father's and mother's age at the time of pregnancy , Father's and  mother's ethnicity, economic status , education, type of delivery, birth season, maternal body mass index during pregnancy, maternal diabetes mellitus, hypothyroidism, hypertension  and infectious disease during pregnancy, parental addiction, parents' smoking, folic acid and iron intake during pregnancy, drug use during pregnancy ,hypoxia, consanguinity and family history of congenital anomaly were significantly different in two groups (p <0.05). Based on the results of logistic regression Type of delivery (caesarean section) , low socioeconomic status, father’s age, family history of congenital anomalies, father’s smoking and infant hypoxia had a significant correlation with the congenital anomalies.

Since early identification of congenital anomalies is essential for preventive interventions, considering the risk factors of this study will be helpful for primary prevention.
Women at risk especially from poor socioeconomic should be mentioned and screened for more support and prenatal care.

Contrast induced nephropathy (CIN) is one of the most common complications after radiographic procedures using intravascular radiocontrast media. The aim of the current study was to assess the effect of atorvastatin on prevention of CIN in patients undergoing coronary angiography. In a clinical trial study, 200 patients referred for angiography were randomly divided into two groups of using 80 mg atorvastatin and placebo before the procedure. Furthermore, 100 patients who were under chronic treatment of statins were included as the third group. Serum creatinine (Scr) levels before and after the procedure were evaluated and incidence of CIN (post-procedural Scr of >0.5 mg/dl or 25% from baseline) was assessed. Mean age of the participants was 60.06 ± 0.69 years and 276 (92%) were male. There were no significant differences between group with respect to age and gender. In pre-operation atorvastatin, placebo and long term statin groups, the incidence of CIN was 1%, 2% and 1%, and mean changes of Glomerular filtration rate (GFR) was 3.68 ± 1.32, −0.77 ± 1.21 and 1.37 ± 0.86; and mean changes of creatinine (Cr) was −0.05 ± 0.02, 0.02 ± 0.02 and −0.01 ± 0.01 respectively. respectively (P = 0.776, 0.026 and 0.041 respectively). In pre-operation atorvastatin group, Cr decreased, and GFR increased significantly (P = 0.019 and 0.007 respectively). pre-operation short term high dose atorvastatin use was associated with a significant decrease in serum Cr level and increase in GFR after angiography.

Statins are shown effective by some studies in preventing contrast-induced nephropathy (CIN). We evaluated the effectiveness of atorvastatin in the prevention of CIN in computed tomography angiography (CTA) candidates. This study was conducted on patients referring for elective CTA with normal renal function. Patients received atorvastatin (80 mg/day) or placebo from 24 h before to 48 h after administration of the contrast material. Serum creatinine was measured before and 48 h after contrast material injection. CIN was defined as an increase in serum creatinine level of ≥ 0.5 mg/dl or ≥ 25% of the baseline creatinine. A total of 236 patients completed the study; 115 atorvastatin, 121 placebo, mean age = 58.40 ± 9.80 year, 68.6% male. Serum creatinine increased after contrast material injection in both the atorvastatin (1.00 ± 0.16-1.02 ± 0.15 mg/dl, P = 0.017) and placebo groups (1.03 ± 0.17-1.08 ± 0.18 mg/dl, P < 0.001). Controlling for age, gender, comorbidities, drug history, and baseline serum creatinine level, patients who received atorvastatin experienced less increase in serum creatinine after contrast material injection (beta = 0.127, P = 0.034). However, there was no difference between the atorvastatin and placebo groups in the incidence of CIN (4.3 vs. 5.0%, P = 0.535). In patients undergoing CTA, a short-term treatment with high dose atorvastatin is effective in preventing contrast-induced renal dysfunction, in terms of less increase in serum creatinine level after contrast material injection. Further trials including larger sample of patients and longer follow-ups are warranted.

Hepatitis B virus is one of the important viral causes of liver inflammation with high worldwide prevalence and important hepatic and extra hepatic complications.. The aim of this study was to investigate the prevalence and risk factors of hepatitis B in Chaharmahal and Bakhtiari province, Iran..Patients and For this descriptive, analytical, population-based study, 3000 participants older than 15 years were enrolled according to the clustering method. After obtaining written informed consent and taking required blood samples, we gathered data on demographic status and probable transmission routes of disease using questionnaire between 2012 and 2013. The data was analyzed using SPSS software (descriptive parameters and chi-square). P value below 0.05 was considered as statistically significant.. The mean age of participants was 38.4 ± 16.3. The seroprevalence rate of hepatitis B was found to be 1.3% (95% CI, 0.95%-1.81%). Prevalence of HBeAg among HBsAg positive participants was 2.5% (only 1 of 40). Seroprevalence was higher in male group (2.5 times higher than women), age group of over 55 years, farmers, and non-public occupations. Positive seroprevalence was associated with a history of renal disease, familial transmission, transfusion, surgery in hospital, circumcision, contact with hepatitis B infected individuals, imprisonment, intravenous (IV) drug abuse, and smoking (P < 0.05). Nevertheless, the highest odds ratio (OR) was obtained for history of renal disease (OR = 7.64: 3.01-18.4), followed by imprisonment (OR = 5.4: 1.86 -15.7) and IV drug abuse (OR = 5.68: 1.3-24.7).. Chaharmahal and Bakhtiari province could be categorized as a low endemic region for hepatitis B infection, with a seroprevalence similar to that in other provinces of western Iran. Vaccination seems to influence its decrease, especially in adolescents and youth. More surveillance and attention to risk factors are suggested to identify high-risk groups and to implement vaccination..