فهرست مطالب maryam saberi-karimian

It has been shown that angioplasty and endovascular stent deployment, used after coronary revascularization, are associated with an inflammatory response. Inflammation has a key role in the complications of atherosclerotic plaque, coronary artery disease (CAD) and in-stent restenosis (ISR). The objectives of the present study was to investigate serum levels of 12 pro/anti-cytokines and growth factors and their relationship with restenosis.

A total of 244 subjects were recruited in current study including unrelated patients who previously underwent coronary stent implantation (between 2014 and 2017) and were subsequently indicated for coronary angiography. According to angiography results patients were allocated into two groups: cases with stenosis more than 50% within the stent (N=79) and controls with stenosis less than 50% within the stent (N=165). Serum was separated by centrifuging the blood for 15 min at 1000 rpm.  Serum cytokines levels including IL-1α, IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10, TNF-α, IFN-γ, MCP-1, EGF, and VEGF were measured using an EV 3513 cytokine biochip array (Randox Laboratories, Crumlin, UK).

The mean age of the NISR and ISR groups were 62.47±9.2 and 59.49±8.48 years, respectively. The diabetes frequency was significantly higher in the ISR group (55.1%) compared with NISR group (30.9%) (p<0.001). There was no significant difference in levels of cytokines between the two groups (p>0.05).

The results showed that serum levels of pro/anti-inflammatory cytokines and growth factors did not have a significant difference between NISR and ISR study groups.

The Coronavirus Disease 2019 (COVID-19) outbreak is still an ongoing problem affecting people’s well-being globally. It is known that malnutrition is an important determinant of immune function, leading to an increased risk of infection and severity of diseases. The aim of this study was to characterize the relationship between macronutrients and micronutrients and this viral infection.

This study was a historical cohort including 6539 subjects (57.2% females, 42.8% males) from the Mashhad stroke and heart atherosclerotic disorder (MASHAD) cohort study. Dietary intakes were assessed using a 65-item validated food frequency questionnaire (FFQ). Data on COVID-19 diagnosis was collected from online health records of patients available in the Sina health information system from the onset of the disease to the end of July 2020. COVID-19 diagnosis has been confirmed using a lung spiral CT scan or PCR laboratory test. SPSS software (Version 20) was usedfor the analysis of data. .

A total of 154 subjects including 85 men (55.2%) and women (44.8%) were infected with COVID-19. Body mass index (p=0.03) and waist circumference (p=0.01) of the patients along with the protein (p=0.02), total N2 (p=0.02), calcium (p=0.02) and thiamin (p=0.04) content of their diet was significantly associated with COVID-19. After multivariate analysis, dietary calcium remained the only dietary factor that predicted COVID-19 infection (OR=0.94, 95%CI [0.87-0.99], p value=0.04).

Our findings indicated that prevalence of COVID-19 may be affected by dietary macronutrients and micronutrients. According to our data, increased calcium intake can reduce the prevalence of COVID-19.

"Health for All by 2000" was launched by WHO in 1978 and is based on primary healthcare availability worldwide. During the month of Safar, many people from neighboring cities and countries travel to Mashhad. Since the qualitative approach can lead to a better understanding of access to healthcare from the perception of consumers, this study aimed to assess the perception of Pilgrims and healthcare providers of healthcare services and gain more profound knowledge about healthcare consumers’ experiences.  This qualitative study was conducted in Mashhad during Safar based on conventional content analysis from September 20-27, 2022. This study used a semi-structured in-depth interview on 36 participants, including pilgrims (n=27) and healthcare providers (n=9) such as medical doctors, nurses, and health experts selected through purposeful sampling. The interviews were transcribed word for word. The MAXqda software and Graneheim and Lundman’s qualitative content analysis were used for data analysis.  Data analysis revealed three categories, including 1. Understanding the challenges of the treatment services in terms of three subcategories: A. Lack of medical doctors, drug shortages, and higher prices of medicines, B. Experiencing the diseases (skin, cardiovascular diseases, poisoning, and digestive problems, musculoskeletal pain and asthma), and C. Lack of an appropriate place for patient examination and serum injection. 2. Understanding the challenges of health services, including three subcategories: A. Time and place insufficiency of services, B. Lack of access to sanitary detergents, C. Improper cleaning of resting spaces and places, and finally, 3. Understanding the challenges of welfare services, including two subcategories: A. Inadequacy and lack of access to the appropriate rest place, and B. poor quality and sortage of food.  The results indicated that access to healthcare, treatment, and welfare is more than just these services. Health policymakers’ commitment to improving healthcare equity, hopefully, leads to positive changes in the healthcare system. Therefore, enhancing social participation in the healthcare system and providing comprehensive education on the optimal use of healthcare services is necessary to empower pilgrims to access better healthcare.

The obesity prevalence is growing worldwide. There is strong evidence indicating that a disturbance of zinc, copper and magnesium concentrations is associated with the development of obesity and its related diseases. Our aim was to determine the effect of curcumin supplementation on serum zinc, magnesium and copper in obese individuals.

In this randomized crossover trial study, thirty obese patients with an age range of 18 to 65 years were randomized to treatment with curcumin 1 g/day or placebo for 30 days. There was then a two-week wash-out period, after which, subjects crossed to the alternate regimen. Serum levels of zinc, copper and magnesium were determined at baseline and at the end of the study.

The study groups were similar to each other in base line characteristics. We did not observe significant impacts (p>0.05) of curcumin on Cu, Zn, Mg serum concentrations.

Curcumin administration at a dose of 1 g/day for 30 days did not affect serum Cu, Zn, Mg levels in obese subjects.

Ramadan is the ninth lunar month. During this month, Muslims fast from sunrise to sunset. This study aimed to describe the Persian cohort participants’ basic information and nutritional habits regarding Ramadan fasting. 

This cross-sectional study was conducted on Mashhad study population who completed the validated Ramadan fasting questionnaire. 

Total number of 8769 individuals (59.2% females, mean age of 57.44±8 years) participated in this study. There was a significant difference in fasting between men and women in society; 97% of women and 90.2% of men have fasted during their lifetime (P <0.001). In total, 63.2% of those who did not fast suffered from chronic diseases, 7.5% from acute conditions, 14.9% from weakness, and 14.5% from personal reasons. Almost 94% of the studied population did not experience any medical problems during fasting. Among these, severe hypoglycemia was the most reported during fasting (1.9%) followed by loss of consciousness in 1.5% of subjects, which was statistically different based on gender (1% of men and 1.7% of women, P=0/008). 

Based on the results, 94.3% of the studied population had a history of fasting, and women have fasted sooner and significantly higher than men during their lifetime. The main reasons for non-fasting were chronic disease in women and personal reasons in men. Almost 94% of the fasted population reported no medical problems during fasting. The most commonly reported problem during fasting was severe hypoglycemia.

The association between the serum antibody titer of several heat shock proteins (HSPs) and cardiovascular disease (CVD) risk factors so far has been the subject of several previous studies. To evaluate the association of adiposity indices and HSP-27 antibody titers in healthy individuals. Overall 4823 individuals were recruited from Mashhad Stroke and Heart Atherosclerotic Disorders Study (MASHAD study), that included 1496 individuals with normal-weight (body mass index (BMI) <25 kg/m2), 1975 individuals with over-weight (BMI 25-30 kg/m2), and 1352 individuals with obesity (BMI≥ 30 kg/m2). The serum anti-HSP-27 antibody titers were not significantly different among obese individuals [0.21 (0.11 – 0.34) absorbency unit (AU)], over-weight individuals [0.19 (0.10 – 0.33) AU] and normal-weight individuals [0.19 (0.10 – 0.33) AU]. we have found no significant relationship among anti-HSP-27 antibody concentration and degrees of adiposity among Iranian adults.

The levels of physical activity (PA) is an important  for the health of children and environmental factors play a vital role in shaping children's attitudes, behavior and physical-mental development. Hence the identification of the environmental factors that may contribute to children`s health is important. The relevant literature between 2015-2020 was reviewed, and the factors classified according to three principal environments of home, neighborhood and school. Findings highlight the need for more studies, especially into contextual factors and design-related characteristics of the environments. Increasing child`s PA opportunities including active play and commute vs. sedentary behavior (SB) in all of the three environments were suggested through: 1) proper presence and availability of PA supportive places (either indoors or outdoors), routes (sidewalks, cycling routes) and equipment, 2) consideration of practical threshold for walking/cycling time and distance to schools and neighborhood destinations, 3) provision of neighborhood with more traffic/social safety, 4) limitation of child`s sedentary time (ST), SB supportive devices number and accessibility, 5) emphasizing the importance of teachers, child care providers and family role (role modeling, support, attitude, rules, socioeconomic status (SES), perceptions, concerns, priorities and physical-mental health). Implementation of policies and measures targeted at enhancement of the environments PA supportive qualities simultaneous with promotion of knowledge of planners, designers, teachers, child care providers and families about children`s PA importance is needed.

Previous studies have shown that the health burden associated with vitamin D deficiency is increasing globally. Vitamin D supplementation appears to be a feasible strategy for improving vitamin D status within populations. Little information is available on the perception and barriers to the widespread application of vitamin D supplements in Iran. Therefore, this study was conducted to explore the perception of health care providers regarding the implementation of vitamin D supplementation program in the Iranian cities of Mashhad, Qom and Zahedan.This qualitative conventional content analysis study was conducted at 3 medical universities in Iran: Mashhad (MUMS), Qom (QUMS) and Zahedan (ZAUMS) University of Medical Sciences. These universities, are within regions with differing prevalence of vitamin D deficiency, and were selected based on the results of National Integrated Micronutrient Survey 2012 (NIMS-II study). Individual semi-structured in-depth interviews were performed with 103 participants (consisting of health professionals and health providers) to understand the perceptions of health professionals and health care providers’. The data were collected from December 2018 to July 2019. Guba and Lincoln’s criteria were used to ensure the trustworthiness of the data. Data were analyzed using conventional content analysis based on the approach of Graneheim and Lundman's.There were three categories of barriers to distribution and use of individual supplements,  and the funding to implement the program; there were ten subcategories. Supplement distribution were affected by three subcategories of inadequate distribution of the supplement, irregular distribution of the supplement, and   insufficient space to store the supplements. Individual barriers to the use of supplement comprised five subcategories: forgetting to take them, lack of knowledge about their benefits, accessing a health care center providing them, negative advertising for supplement use, and not taking them because of cost. Funding to implement the program contained the two subcategories of financial limitation in urban and rural area and financial limitation for all target groups.The findings showed that health care providers reported a variety of barriers to supplement use. Applying a multiple strategy requires: training, conducting advertising campaigns, financial support, sufficient and regular distribution of the supplement and perhaps the use of alternative methods of supplement delivery, such as food fortification can be helpful.

Vitamin D deficiency (VDD) affects more than one billion individuals globally. We aimed to review all the published papers on vitamin D deficiency in  in the country. 

PubMed, Google Scholar, Web of Science, Scopus, Science direct and scientific information databases were searched for papers related to the prevalence of vitamin D insufficiency for all age groups in Iran from 2000 to 2018. The Joanna Briggs Institute prevalence critical appraisal tool was applied for the assessment of the methodological quality of these studies. The Meta-analysis is based on the random effect model using Comprehensive Meta-analysis data analysis.

Eighty-seven original articles reported on participants with vitamin D insufficiency in Iran. According to the meta-analysis of the prevalence of moderately deficient of vitamin D in men and women as well as younger and older individuals (>18 years) using a cut-off point of 25(OH) D3<20 ng/mL was 39% and 51%, respectively. Vitamin D concentrations <30 ng/mL among Iranian populations in the cities of Tehran, Shiraz, Mashhad, and Zahedan were reported to be higher than 90%. The prevalence of vitamin D insufficiency in Iranian women was higher than in men in various age groups. The highest prevalence of vitamin D insufficiency in neonates, children, adults and pregnant women was observed in the Middle East. Most countries had a high prevalence of VDD in elderly people.

Vitamin D insufficiency is common in the Iranian population and is an important public health problem that should be considered seriously.

Air leak is one of the post-surgical complications following thoracic surgeries. Studies have shown that patients with more intraoperative air leaks are at higher risk of developing prolonged postoperative air leak. Various adjuncts have been used in attempts to reduce alveolar air leaks (AAL). One of these, is the topical application of Glubran-2. This study examines the role of Glubran-2 in management of air leak in patients with chronic empyema.

This was a randomized clinical trial that included 44 patients with chronic pulmonary empyema who underwent decortication and pleurectomy. They were divided into 2 equal groups. In the first group, Glubran-2 was used for management of air leak and in another group other routine methods were used for this purpose. Patients in each group were assessed according to their age, sex, location of the lesion, cause of the lesion, air leak and duration of hospitalization. The data were analyzed using the software Statistical Package for the Social Sciences (SPSS Inc, Chicago, IL) software.

All data of the clinical features showed no significant difference among case and control group in patients with chronic empyema at baseline (P>0.05). Alveolar air leak duration and duration of hospitalization were significantly lower in the sealant group compared to the no-sealant group (P< 0.001 and P< 0.01, respectively). Prolonged AAL (PALL) was found in 5 (50.0 %) patients in the case group and 15 (83.3 %) patients in the control group for a total of 20 (50 %) patients. There was no significant difference between the two groups regarding PAAL (P= 0.77).

Our results support the use of Glubran-2 glue for decreasing alveolar air leak and then decreasing duration of hospitalization in the patients who underwent the thoracic surgeries.

Chronic kidney disease is an ailing condition that in the final stages can lead the patient to renal replacement therapies such as dialysis. An arteriovenous fistula (AVF) with proper function and maturation is needed with this regard. The aim of this study was to evaluate the effect of blood pressure on the function and maturation of AVF and AVG.

This retrospective cross-sectional study was performed between September 2016 and March 2019 on all patients with chronic renal failure, who referred to the Alavi Vascular Surgery Hospital as candidates for hemodialysis and underwent AVF implementation by the researchers. Using a predesigned checklist, the hospital records of all patients were reviewed and data including the demographic information of patients (age and sex), previous medical history (diabetes, hypertension), smoking status and blood pressure of the patient before and after surgery were extracted. In order to follow the patients and evaluate the function and maturation of the fistula, the dialysis centers in Mashhad were contacted and information about the successful dialysis of the patients was recorded. Data were extracted from the forms and entered into SPSS software and at the end, patients' blood pressure was compared between functional and unfunctional groups and also in terms of access type.

Totally, 298 cases were enrolled in the study and classified into two groups including 242 (81.2%) functional AVFs and 56 (18.8%) unfunctional AVFs. The mean age of the patients was 55.15±17.93 years and the median was 58.5 (67.0-43.0) years old. Moreover, 152 patients (51.0%) were male and 146 patients (49.0%) were female. There was no significant difference regarding age (p=0.057) and gender (p=0.290) between the two study groups. Furthermore, underlying diseases (diabetes and hypertension) showed significant difference between the two study groups (p<0.001). Only, diabetes relative frequency showed significant difference between fistula and graft groups (p=0.022). The median systolic (SBP) and diastolic blood pressure (DBP) was significantly higher in functional group compared to the unfunctional (p<0.05). However. There was no significant difference regarding the median SBP and DBP between the two types of access including fistula and graft (p>0.05).

Our study revealed that probably blood pressure paly and important role in the function and maturation of AVF.

Previous studies have suggested that diabetes mellitus and obesity are associated with an increased risk of severe complications with COVID. We aimed to investigate whether individuals with obesity and diabetes mellitus are more likely to be infected with COVID19. The information related to COVID-19 was extracted from the Sina Health system information of Mashhad Health Deputy among participants in Mashhad cohort study (n=9704 people). Information regarding the cardiac risk factors of the individuals was previously recorded during the recruitment phase of the Mashhad cohort study. The relationship between COVID infection and several CVD risk factors was investigated. The results showed that obesity (P= 0.001) and diabetes mellitus (DM), (P= 0.01) were positively related to COVID-19. Furthermore, DM augmented the risk of COVID-19 by 1.79 folds (P-value= 0.004; OR: 1.79; CI:1.21-2.67). The incidence of COVID-19 until 2020.07.19 was 2.36% in Mashhad Study Cohort population. Moreover, DM has increased the risk of COVID-19 by 1.79 folds in the population.

The disability-adjusted life years (DALY) may provide a better indicator of the burden of disease than mortality. This study provides the estimates of both Years of Life Lost (YLL) and COVID-19 mortality in Mashhad.

This cross-sectional research was carried out in Mashhad, the second-most populous city in Iran. The mortality data in the population served by Mashhad University of Medical Sciences (MUMS) were extracted from the national mortality data system. In this system, all deaths in the whole of the country are recorded based on the International Classification of Diseases, tenth edition (ICD10). The data in the current study comprised all cases of death recorded in the population under the auspices of MUMS from January 21st to April 19th 2019 and 2020 which were transferred to Stata software after sorting. The method recommended by the World Health Organization (WHO) was used for the estimation of YLL.

The YLL per 1000 caused by COVID-19 was 1.2 years and increased with age., and was higher in men (1.6 years) compared to women (0.9 years). The incidence of COVID-19 was higher in the urban area (9.8%) compared to rural areas (4.8%). During the study period, COVID-19 was the fourth most prevalent cause of death in Mashhad after cardiovascular disease (35.4%), cancer (12.9%) and respiratory disease (10.6%).

The YLL per 1000 caused by COVID-19 was 1.2 years, increased with age and was greater in males than in females.

In this case report, we have explained a patient with Hydatid cyst of the lung. He aged 29 years weighted 61 kg. The most common symptom was provocative cough and there was a large cystic lesion on computed tomography (CT) scan that had filled approximately three-quarters of the left hemithorax (Figure 1). The patient had a positive hydatid agglutination test (HAT) test and was diagnosed with a vague hydatid cyst of the left lung and underwent left posterolateral thorachotomy in August 2021. After removing the cyst membrane, the patient's pericyst lesion (10 x 15 cm) was completely excised (Figure 2). Figure 3 shows a pulmonary hydatid cyst in which the congested blood vessels in the pricyst with fibrofatty collagenous tissue have been revealed.

Metabolic syndrome (MetS) is characterised by a clustering of metabolic cardiovascular disease (CVD) risk factors that include: central obesity, impaired glucose metabolism, dyslipidaemia (hypertriglyceridemia, increased low-density lipoprotein [LDL], decreased high-density lipoprotein [HDL]) and hypertension. Paraoxynase-1 (PON1) is a plasma HDL associated protein that inhibits the oxidation of other lipoproteins. There is some evidence of reduced enzyme activity in subjects with metabolic syndrome. Curcumin is a natural polyphenol, it has been reported that curcumin has beneficial effects on several metabolic syndrome associated parameters. The aim of this study was to evaluate the effect of phospholipid complex of curcumin as an antioxidant on the activity of this enzyme in subjects with metabolic syndrome. A double-blind randomised control study was undertaken in 80 patients with metabolic syndrome. Subjects in the intervention (n = 40) were given capsules of phospholipidated curcumin (1 g/day) for a period of 6 weeks. The control subjects (n = 40) received a placebo. Fasting blood samples of each person were obtained during the start and the end of the study. Paraoxonase activity was measured using a PON1 fluorescence Paraoxonase Assay Kit and Arylesterase activity was measured by photometeric method using a UV-Visible spectrophotometer. Serum paraoxonase enzyme activity did not change significantly between the curcumin treated group and the control group before the intervention (0.54 ± 0.18 U/µl versus 0.49 ± 0.14 U/µl; P > 0.05), nor did serum arylesteras activity change significantly between two study groups (152.67 [46.60 to 916.05] U/µl versus 129.77 [55.34 to 344.78] U/µl; P > 0.05). In addition, there was no significant difference in changes at baseline and after the intervention in serum PON1 activity between the curcumin treated group and the control group (-0.03±0.19 U/µl versus -0.04±0.18 U/µl; P > 0.05), nor was there a significant change in arylesteras activity (-12.36 [-88.83 to 110.24] U/µl versus -4.58 [-61.06 to 47.07] U/µl; P > 0.05). Phospholipid fortified curcumin has no significant effect on serum PON1 activity.

In current observational study, we have reported a patient with Iraqi nationality suffering from chondroblastic osteosarcoma of the clavicle (Figure 1). He aged 17 years old having height 1.75 m and weight 60 kg without any family history of malignancy. The signs have been started 1 year ago as a painful swelling. MRI showed a cortical expansion and bone destruction (Figure 2). Diagnosis was made based on fine needle aspiration (FNA) and biopsy. The patient underwent a chemotherapy course but did not respond to the treatment. After chemotherapy, he did not take any medicine and referred to the physician’s office with swelling in right clavicule in 30th January, 2021. 3 months after the end of chemotherapy, the claviculectomy surgery was performed without reconstruction. He underwent the sub-total clavicular resection surgery at Razavi Hospital, Mashhad, Iran. Tumor swelling was 3 x 4 cm and the length of the excised clavicle was about 7 cm (Figure 3). Two months after the surgery, he was followed up and stated no issues. Figure 4 has shown light micrograph with a numerous fusiform osteoblastic cells.

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.

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.

The study groups had similar base line characteristics. We did not find significant effects (p>0.05) of curcumin on serum HDL CUC levels.

Curcumin administration at a dose of 1 g per day for 30 days did not affect HDL CUC in subjects with obesity.

Sleep-duration is related to obesity. Curcumin can affect behavioral changes that arise from sleep deprivation in animal models. In this study, we assessed the effects of curcumin on sleep-duration in metabolic-syndrome (MetS) patients.

This study was a double-blind clinical trial in 120 adults with MetS. All participants received crude curcuminoids in a simple formulation (n=40), phospholipidated curcuminoids (n=40) or placebo (n=40) 1 g/day during 6 weeks. Demographic data, anthropometric indices and serumbiochemical factors were documented forall volunteers at baseline and after the intervention. A standard questionnaire was used for evaluating physical-activity-level (PAL) and patients’ sleep-duration, including night time sleep and daily napping. Based on the time of sleep, sleeping hours were classified into: night time sleep; daily naps and total sleeping hours in 24 hours.

A total of 120 participants aged 38.72±10.05 years old were enrolled into the study. We did not find significant differences in biochemical factors, sleep-duration or PAL at baseline among the 3 groups (p>0·05). Moreover,curcumin did not exert any significant effect on sleep-duration before, or after, adjustment for confounding factors in the overweight and obese individuals, or in total population (p>0.05).

The results showed that curcumin does not have an effect on sleep-duration in subject with MetS.

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality globally, and specifically in Iran. Generally, diabetes mellitus is the result of impaired glucose tolerance which together with dyslipidemia are considered as important risk factors of CVD. The aim of this study was to determine the relationship between fasting serum glucose (FSG), lipid profile and CVD endpoints, and to establish an optimal FSG cut-off in the MASHAD cohort study after nearly 6 years of follow-up.

All the participants of MASHAD study were followed up for 6 years to determine their cardiovascular status. FSG, fasting lipids, and physical examinations were all recorded. To identify the optimal cut- off point of FSG, we carried out receiver operating curve (ROC) analysis

We determined MASHAD cutoff point of blood glucose as 90 mg/dl predicting the CVD outcome. The sensitivity and specificity of the FSG criterion were 54.34% and 71.68%, respectively. The AUC was 0.665 (95% CI 0.656-0.675, P< 0.0001). The adjusted hazard ratio show that FSG is associated with 2.34 increase in CVD risk using MASHAD cutoff point (HR 2.34, 95% 1.73–3.17, P< 0.001).

These findings suggest that not only FSG and lipid profile are related to CVD outcome in the MASHAD study, but also elevated fasting glucose levels is strongly associated with cardiovascular events in this population. Besides, the fasting glucose at a threshold of 90 mg/dl can be used for screening cardiovascular events among the Iranian population.