mahsa rafiee alhossaini

Various extracardiac disorders are associated with congenital heart defect (CHD) at varying prevalence rates (7%–50%). Over the years, numerous studies worldwide have investigated these associations. This study aimed to examine the prevalence of extracardiac anomalies in children with CHD in Isfahan, one of Iran’s largest cities. 

This cross-sectional study was conducted in Isfahan, Iran, from 2020 through 2022, involving 750 infants under 1 year old diagnosed with CHD. Pediatric cardiologists performed echocardiography to evaluate the cardiovascular system and detect CHD. Most participants were referred for cardiac examinations due to abnormalities detected during physical examinations of skin, cerebral, spinal cord, abdominal, and urinary tract regions. Patients exhibiting signs of a syndromic disorder were also referred for CHD evaluation. 

Out of 750 infants with confirmed CHD, 241 (32.13%) presented at least 1 extracardiac malformation. Ninety (37.7%) had craniofacial malformations, with 66.7% having cleft palate with or without cleft lip. Forty-eight patients (19.9%) had genetic syndromes, most commonly Down syndrome (56.5%), and 46 (19.8%) had gastrointestinal abnormalities, including intestinal or esophageal atresia. 

The prevalence of extracardiac anomalies in patients with CHD is significant, and these patients are at an increased risk of mortality and morbidity throughout their lives. Implementing a screening program could effectively prevent further complications associated with the late diagnosis of these anomalies. (Iranian Heart Journal 2024; 25(3): 6-12)

Syncope is a temporary loss of consciousness with a loss of postural tone. Medicinal treatment of reflex syncope has shown to have no significant effect in reducing the recurrence of syncope. A 36-month follow-up of our pilot cohort showed that non-pharmacological treatments alone were effective in reducing relapse rates. The purpose of this study is to investigate long-term results and 8-year follow-up of previous patients.

The current study is a continuation of a prospective pilot cohort which was done between August 2013 and 2014 in two academic hospitals in Isfahan (Dr. Chamran heart center and Imam Hossein children hospitals). This current study examines the 8-year follow-up results of children with reflex syncope who were treated with non-pharmacological treatments alone or with drugs. Therefore, the patients who participated in the pilot study were enrolled (30 patients in the pharmacologic group and 40 patients non-pharmacological group). Finally, on 26 patients in the pharmacologic group and 31 patients in the non-pharmacological group (after applying the exclusion criteria), the incidence of syncope and pre-syncope attacks was compared between these two groups of patients using the Chi-square test.

Our study showed that within 5 years after the last follow-up, the incidence of syncope and pre-syncope in patients with a history of vasovagal syncope who did not continue the diet or tilt exercises was different between the two groups of patients (without medication and drug recipient) was not significantly different, even the incidence of presyncope increased significantly again in both groups. The incidence of syncope in the period of 5 years after the last follow-up from the previous study was slightly increased in the group of patients without medication compared to the previous periods, but in the group of patients receiving medication, this incidence decreased slightly.

In order to prevent recurrence, the use of non-pharmacological methods is effective, but for the stability of this recovery, follow-up and continuation of these methods is necessary.

The risk of obesity commonly changes with age, which is a longitudinal (aging) effect. Moreover, the individuals who enter the study at the same age have similar living conditions that may influence their obesity risk in a particular way; this is a cross-sectional effect. Both cross-sectional and longitudinal effects of age should be considered for a better understanding of the effect of age on obesity and the related factors.

The present study aimed to (i) assess both the cross-sectional and longitudinal effects of age on obesity and (ii) determine how obesity changes with age in the target population using a Marginal Logistic Regression (MLR) model.

The current study made use of the information of individuals who had participated in the Isfahan Cohort Study. Participants were a large group of Iranian adults over 35 years of age who lived in the central region of Iran in 2001. Repeated measurements were obtained in 2001, 2007, and 2013.

From 2001 to 2013, the percentage of obesity in men and women raised from 13% and 31% to 18% and 44%, respectively. Both cross-sectional and longitudinal effects of age were significantly associated with the odds ratio of obesity. There was a rise in the probability of obesity for individuals aged 35-60 years at baseline and a decline for the older ones. The odds of obesity had about a 2% increase (on average) per year, regardless of the baseline age.

The obtained results pointed to a difference between the cross-sectional and longitudinal effects of age on the probability of obesity in the target population. The high and rising prevalence of obesity was a serious public health issue among participants, especially women, aged 35-60 years. The assessment of changes in obesity in a population-based study provides opportunities to target subpopulations that need more care and attention in public health interventions.

Cardiovascular diseases (CVD) are the second leading cause of death, after accidents, in Iran. This study was performed to assess the change in levels of knowledge about 8 risk factors of CVD and its associated determinants the Iranian general population.
The current repeated cross-sectional study included 3014 people in 2004, 3012 in 2005, and 4719 in 2007, aged older than 19 years. Knowledge about 8 risk factors (high blood pressure, nutrition, physical inactivity, smoking, diabetes, heredity, stress, and obesity) as the major causes of CVD was evaluated using latent transition analysis (LTA).
The most widely known CVD risk factors were nutrition and physical inactivity followed by stress. In addition, old age, low level of education, male gender and low socioeconomic status (SES) level were the significant determinants of low knowledge levels of CVD risk factors. Besides, individuals’ knowledge of CVD risk factors increased across the time.
Public knowledge of CVD risk factors has increased; however significant gaps continue to exist, particularly among the elderly, less-educated people, people in low socioeconomic status level and men. Future intensified educational efforts by policymakers are necessary for improving knowledge of CVD, particularly among high-risk groups.