seyedeh mahdieh namayandeh

 Pulmonary embolism (PE) is a significant public health concern. This retrospective cohort study examines the clinical profiles and outcomes of patients diagnosed with PE at a medical center in central Iran, aiming to identify mortality predictors during hospitalization and follow-up.

 Data from 109 patients diagnosed with PE were analyzed, with a median follow-up of 23 months. The collected information included demographic and clinical characteristics, laboratory findings, treatment protocols, and outcomes. Logistic regression and Kaplan-Meier survival analysis were used to identify independent mortality predictors and assess survival impact.

 The mean age was 59.2 years (±19.7), with 51.4% male. Common symptoms included dyspnea (86%) and chest pain (53%), with non-massive PE being the most prevalent (63%). Independent mortality predictors identified were age (odds ratio [OR] 1.065 per year, P<0.001), female sex (OR 4.421, P=0.009), and PE severity (OR 0.262, P=0.023). Kaplan-Meier analysis showed reduced survival probabilities in females (P=0.009), those with provoked PE (P=0.002), patients over 65 (P=0.016), and individuals with comorbidities (P=0.018). In-hospital mortality was 10.1%, linked to provoked massive PE, absence of thrombolytic therapy, and reduced left ventricular ejection fraction (LVEF).

 In this cohort, age, sex, and PE severity were significant mortality predictors, while provoked PE, advanced age, and comorbidities were associated with lower mid-term survival probabilities.

Percutaneous Trans-Mitral Commissurotomy (PTMC) is an effective non-surgical treatment in patients with severe rheumatic mitral valve stenosis. This study aimed to evaluate the mid-term results of this procedure in central Iran.  This retrospective study was performed on 101 patients with severe mitral valve stenosis who underwent successful PTMC from March 2011 to September 2018 in Afshar Hospital in Yazd. At follow-up, all patients underwent clinical examination, two-dimensional and color Doppler echocardiography, and events were recorded. Data were analyzed using SPSS software version 19.  The mean age of the patients was 44.79± 11.72 years, and 83.3% were female. The mean follow-up time was 38.98 23.33 months (6-94 months).25.8% had AF rhythm, and 12% had previous PTMC or OMVC or CMVC. After percutaneous Trans-Mitral Commissurotomy, 97% of patients were in NYHA functional class I, II and the mitral valve area (MVA) increased from 0.92 ± 0.18 to 1.66± 0.29 cm2 (p<0.0001). Pulmonary artery systolic pressure decreased from 46.96± 18.56 mmHg to 38.43±14.02 mmHg (p<0.0001). The Mean mitral valve gradient decreased from 12.37± 3.99 mmHg to 4.79± 2.38 mmHg (p<0.0001). Restenosis rate and severe mitral regurgitation resulting in mitral valve replacement (MVR) were 10.9% and 2%, respectively. Two patients died because of intracranial hemorrhage (ICH). During the follow-up event, free survival was 82.2%. Multivariable analysis revealed that the predictors of shorter event-free survival were AF rhythm (HR; 4.5, 95%CI;1.59-12.9, P=0.005) and post PTMC higher NYHA functional class (HR;2.2, CI;1-4.8,p=0.049).  Mid-term results of percutaneous transmitral commissurotomy (PTMC) in central Iran are the same as in other parts of the world. This procedure is an effective and low-risk treatment for severe mitral valve stenosis.

The coronary angiography results in a group of patients with myocardial infarction (MI) are normal or near-normal; which is diagnosed as myocardial infarction with non-obstructive coronary arteries (MINOCA). This study aimed to compare the mortality rate and risk factors between MINOCA and myocardial infarction with obstructive coronary artery (MI-CAD).

This retrospective cohort study was conducted from January 1, 2018, to December 31, 2019. A total of 679 patients admitted to Afshar Hospital in Yazd with a diagnosis of ST-elevation myocardial infarction (STEMI) from 2018-2019 who underwent primary Percutaneous Coronary Intervention (PCI) were enrolled in the study. Demographic, and clinical variables, ECG finding and one-year mortality, were extracted using MI registry data from the Yazd Cardiac Research Center.

The estimated frequency of MINOCA was 4.6%. Patients with MINOCA (
47.14±6.2) were younger than patients with MI-CAD (57.61±9.1) (P <0.0001). MINOCA patients (47.4±9.47) had a considerably greater left ventricular ejection fraction (LVEF) than MI-CAD patients (43.5±6.8) (P =0.018). The majority site of MI in MINOCA patients was located in the non-anterior wall (p <0.0001). A comparison of MINOCA and MI-CAD patients' one-year mortality revealed no significant difference (P =0.07).  

The prevalence of patients with MINOCA in Yazd was similar to other communities. Although these patients probably do not have a better prognosis, despite being younger and having better LV systolic function and lower CAD risk factors.

Identification of self-care behaviors and barriers in the COVID-19 pandemic can help health policymakers design appropriate and practical plans. This study aimed to investigate the efficacy of self-care behaviors in preventing COVID-19 based on the health belief model (HBM) among families in Yazd City.

The present cross-sectional study was conducted using the convenience sampling method in 2020. The research data were collected via a researcher-made questionnaire based on the HBM. The validity and reliability of the questionnaire were confirmed before its distribution on social networks. A total of 226 questionnaires were collected and analyzed using SPSS software version 22.

The results showed no significant correlations between the mean scores of HBM constructs and participants’ age, gender, and education level (p > 0.05). Also, the linear regression test indicated that perceived self-efficacy (B = 0.88), perceived susceptibility (B = 0.63), and perceived intensity (B = 0.74) were the most predictive constructs, demonstrating statistical significance. (P < 0/05). The HBM constructs could significantly predict preventive behaviors of COVID-19 and accounted for 29.6 % of their changes (Adjusted R2 = 0.296, F = 18.85, p ≤ 0.000).

Implementing effective interventions based on the health belief model, with a particular focus on improving self-efficacy, perceived susceptibility, and perceived

Opium addiction is one of the fundamental public health problems today that could influence cardiovascular disease outcomes. Recent studies have shown that opium addiction may increase the risk of postoperative complications in patients undergoing on-pump coronary artery bypass graft surgery. In this retrospective cross-sectional study, we aimed to assess whether opium addiction may affect the postoperative complications of off-pump coronary artery bypass graft surgery (OPCAB) (1). In this cross-sectional study, we searched the clinical records of all patients who underwent OPCAB surgery from 2017/03/21/ to 2018/03/19/ at Afshar and Seyed Al-Shohada Hospitals in Yazd, Iran. We evaluated the patients for postoperative complications. Complete patient demographic and clinical data collected through a review of patient records. Finally, the collected data were analyzed using SPSS software version 18. A total of 889 patients (667 (76.2%) non-addicted, 127 (14.3%) opium addicts, and 86 (9.6%) smokers and opium addicts) met our criteria and were included in the study. The average age of the participants was 62.09 ± 9.8 years. Frequency distribution of the most postoperative variables such as intubation duration, intensive care unit (ICU) stay, postoperative bleeding volume, pack cell count, need for fresh frozen plasma (FFP), platelet injection volume, need for reoperation, need for intra-aortic balloon pump, as well as Atrial fibrillation (AF) rhythm showed no significant difference between the three groups. However, the only significant difference between the three groups reported the need for postoperative use of inotropic drugs (p=.001). According to the results, the only complication that differed significantly in the three patient groups after OPCAB was the need for inotropic drugs.

Oxidative stress is involved in the pathogenesis of many diseases, including atherosclerosis. Lipid profile conditions, oxidative stress and antioxidant imbalances play a major role in the development of the disease. The purpose of this study was to compare the different time course of concurrent training on lipid profile and total antioxidant capacity of cardiac patients.

The present study was a quasi-experimental study. Twenty male patients, mean age 56  ± 9.75, were voluntarily divided into the control and combination training groups The concurrent training group performed aerobic and resistance training for eight and three days a week. Aerobic exercise was performed for 15-20 minutes at 50-80% of maximal heart rate and resistance training program consisted of three upper extremity movements and two lower extremity movements with three sets and 10 repetitions. Blood samples were taken before and after four and eight weeks, and lipid profile and total antioxidant capacity were measured. Data were analyzed by repeated measures ANOVA using SPSS version 16 software.

Concurrent training has reduced the significant levels in LDL, cholesterol and triglycerides after four and eight weeks, and has also reduced a significant increase level in HDL. Concurrent exercise had a significantly effect on the amount of total antioxidant after eight weeks (P <0.05).

According to the findings of the study, it can be concluded that with eight weeks of concurrent training, there is a significant difference in the levels of lipid profiles and total antioxidant capacity of cardiac patients.

Coronary artery revascularization is the standard treatment for patients with severe left main coronary artery disease (LMCAD). In cases where the patient refuses surgical revascularization or PCI, medical treatment will be the only option. The purpose of this study was to compare the one-year outcomes of patients with (LMCAD) in terms of surgical or medical treatment. This prospective cohort study was conducted on 139 patients (91 men and 48 women) with severe left main coronary artery disease who were diagnosed by coronary angiography from 1st Mar 2014 to 28th Feb 2014. Patients were followed up for one year as to major adverse cardiac and cerebral events (MACCE) including death, non-fatal myocardial infarction, stroke, and hospitalization. From total of 2661 coronary angiographies, 139 patients (5.2%) with a mean age of 63.2±7.2 years had LMCAD. The mortality rate in the medical treatment group and the surgical group appeared to be 16.7% (6 cases) and 8.7% (9 cases) respectively (p =.156). The rate of stroke in the medical group turned out to be 5.6% (n=2) and in the surgery group 2% (n=2) (p =.27). The rehospitalization rate was 19.4% in the medical treatment group but 4.9% in the surgical group (p =.013). During one year, the survival rate was significantly lower in the medical group than the group undergoing coronary artery bypass graft surgery (58.3% vs. 84.5%) (p =.002). In the short term, the optimal medical treatment of patients with LMCAD was not significantly different from that of CABG patients in terms of fatal cardiac and cerebral events. However, rehospitalization was more common due to recurrent angina pectoris.

Heart failure is one of the most common chronic cardiovascular diseases, which often triggers disability or death. Health-related Quality of life (HRQoL) is one of the most critical factors in deciding how to treat these patients. In this study, we want to figure out the effect of different factors on the quality of life in patients.

This cross-sectional study was performed on 129 patients with heart failure referring to the center of Afshar Hospital in Yazd City, Iran 2017-2018. The standard (Shot Form survey) SF-36 questionnaire was used to measure different dimensions of quality of life.

In the present study, 77 men and 52 women with heart failure were included and the relationship between comorbidities, heart failure classification factors, age, sex, and history of hospitalization with quality of life was measured. The result revealed a significantly higher quality of life in patients under 50 years (P = 0.005) as well as in men (p<0.001). And in the total population, the average quality of life appeared to be 45.46.

Quality of life in patients with heart failure is related to gender and age, so in women over 50 years, the quality of life proved lower but not related to factors such as, hospitalization, type of failure and stage of the disease. Among diseases related to heart failure, only people with high blood pressure showed lower quality of life scores. The total quality of life index score among our subjects was reported to be moderate to low.

Obesity and overweight are important public health problems which are rapidly growing throughout the world. This study aims to provide 10-year incidence estimates of obesity and overweight in adults along with their risk factors in an Iranian adult population.

This cohort study was conducted within the framework of the Yazd Healthy Heart Project (YHHP) throughout phases from 2005-2006 to 2015-2016 among urban adult population. The participants comprised of 1000 males and 1000 females aged 20-74 years from urban areas of Yazd. Cox proportional hazards model was used to examine the potential risk factors for obesity and overweight.

A total of 2000 participants aged 47.09 ± 16.97 years and body mass index (BMI) of 21.99 ± 2.21 kg/m2 were entered in this study at baseline. After 10 years of follow-up, the cumulative incidence of overweight for the entire population was 38.6% (41.6% in women and 36.8% in men). Furthermore, the 10-year cumulative incidence of obesity was 14.8% in the population (20.8% for women and 10.5% for men). Female participants showed a significantly higher incidence rate compared to males either for obesity or overweight. Regarding risk factors, there was a significant association between non-smoking (HR= 1.54, 95% CI: 1.06-2.25), socio-economic status (HR= 1.82, 95% CI: 1.13-2.94), and education (HR= 1.56, 95% CI: 1.14-2.13) with overweight (P < 0.05).

This study revealed the incidence rate of obesity and overweight is significantly high in adult population of Yazd, Iran especially in women. The most important predictors of overweight seem to be smoking, lower socio-economic status, and education.

Congenital cardiovascular malformation is the most common group of birth defects. Fetal echocardiography is highly sensitive and specific in the diagnosis of congenital heart disease in low- and high-risk populations.

This study aimed to assess abnormal findings in fetal echocardiography and maternal disease.

This cross-sectional study was performed on 114 pregnant women referred to Afshar hospital, Yazd, Iran from October 2016 to March 2017. All pregnant women underwent fetal echocardiography through fetal heart screening protocol, which is administered by the international society of ultrasound in obstetrics and gynecology guidelines. Data collected included referral cause, gestational age, maternal age, gravida, and final diagnosis after an accurate fetal echocardiography.

The mean gestational age was 20 wk. The most common referral cause of pregnant women included diabetes (36.8%), fetal arrhythmia (14%), high maternal age (7%), and echogenic focus on ultrasound (6.1%). The most common postpartum findings were normal (68.4%), cardiac abnormalities (17.6%), and arrhythmias (14%). In postnatal echocardiography, the results were consistent with fetal echocardiography except in 2 women.

This study showed that fetal echocardiography can be used in the early diagnosis and treatment of congenital heart diseases.

Breast cancer is an uncontrolled and unnatural proliferation of cells in different breast tissues. The first measure to diagnose breast cancer is an examination by a surgeon followed by mammography, sonography, sampling, and other diagnosing methods. Given that there are several methods to diagnose breast cancer, and most of them are quite expensive, the present systematic review compares the expenses and effectiveness of different methods to diagnose breast cancer.

The study was carried out as a systematic review through searching databases, i.e., PubMed, Web of Science, Magiran, Scopus, and Embase for articles published from March 1999 to May 31, 2017. The research articles regarding health technology assessment and economic assessment (n = 8) were examined.

Generally, conducting MRI screening and digital mammography every six months after the age of 30 are proved to be the most efficient and economical methods to screen carriers of BRCA (BReast CAncer) mutated genes. Besides, implementing both the techniques simultaneously was more cost-efficient with BRCA1 compared to BRCA2. Some studies have revealed that genetic tests and Oncotype tests, in particular, were the most cost-efficient methods to diagnose the disease, especially in its early stages.

Consequently, indexing gene expression in individuals with BRCA gene mutation is revealed to more cost-efficient.

The current study aimed to determine the optimal cut-off of obesity indices for detecting coronary heart disease (CHD) in 10-year study of Yazd Healthy Heart Cohort (YHHC) in Iran.

A total of 2000 individuals aged 20-74 years were enrolled. All participants without cardiovascular disease (CVD) had a full medical check-up at the start of the study. At the start of the study, a variety of obesity indices were assessed and calculated, including body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHpR), waist-to-height ratio (WHtR), A Body Shape Index (ABSI), abdominal volume index (AVI), body adiposity index (BAI), and body roundness index (BRI). Coronary artery bypass graft (CABG), percutaneous coronary intervention (PCI), myocardial infarction (MI), Rose Angina Questionnaire (RAQ) (chest pain) greater than 3, and electrocardiographic (ECG) changes in favour of the coronary artery disease (CAD) were considered as the CVD risks. A time-dependent receiver operating characteristic (ROC) curve with right-censored data and naive estimator was used to estimate the time-dependent sensitivity and specificity and the best cut-off of the anthropometric indices for CHD risk.

Overall, 1623 participants (818 men and 805 women) with mean and standard deviation (SD) of weight of 71.21 ± 12.94 kg were included. In a 10-year follow-up, 101 [59 (58.42%) men and 42 (41.58%) women] developed CVD event. WHpR demonstrated the largest area under the time-dependent ROC curve (AUC) of 0.65 and 0.63 as well as 95% confidence interval (CI) of 58.64-72.66 and 50.74-75.55 for men and women, respectively, in predicting CVD. Optimal WHpR cut-off was 0.93 and 0.92, respectively, for men and women.

WHpR index was superior to other obesity indices in predicting CHD.

Almost 90% of people with diabetes have type 2 diabetes and the upward trend of this chronic disease is still ongoing, so that after about four decades, this disease is still one of the top 10 causes of death, while half of these deaths occur in people under 60 years of age. Therefore, prevention is essential and the implementation of the most effective intervention approach is required after recognizing at-risk individuals. This study aimed to evaluate the effect of lifestyle modification interventions and metformin on the prevention of type 2 diabetes and improvement in four risk factors related to diabetes.

The study was conducted by searching PubMed, Scopus, Web of science, and Google Scholar without time and language restrictions. Randomized controlled trials which examined the effect of both lifestyle modification interventions and metformin in a population over the age of 18 years with no history of any type of diabetes were included. After the withdrawal of poor quality studies and those withfollow-up time of less than 6 months, structured review and meta-analysis will be performed to calculate the relative risk of type 2 diabetes incidence and mean difference in weight, body mass index, plasma fasting glucose, and hemoglobin A1c. Data analysis was performed using comprehensive meta-analysis software version 2.2.064.

This study will make it possible to choose between two conventional therapeutic approaches (lifestyle modification and metformin) to prevent type 2 diabetes and its impact on four risk factors.

The results of this study can be used as a guide to provide valid evidence for the decision of senior managers of the Ministry of Health and large hospitals to use common technologies used in distance care for patients with CHF and other chronic diseases. This study will also provide a new understanding of the various studies that have been conducted to help patients with chronic failure by different types of remote care technologies in terms of effectiveness, safety, technology, and economic costs.

Diabetes mellitus is one of the major risk factors for cardiovascular disease, and increases the risk of postoperative mortality. HbA1c is a measure of glycemic control. This study aimed to determine the effect of glycemic status on the complications of coronary artery bypass graf (CABG) surgery in diabetic patients. This cross-sectional study was performed on 300 diabetic patients including 186 (62%) men and 114 (38%) women who underwent CABG from March 2010 to August 2011 and selected via census method. Preoperative blood glucose control status was determined using HbA1c levels, and the patients were evaluated for postoperative in-hospital complications. The mean age of the patients was 62.3 ± 6.9 years. In-hospital mortality was 1.0% (3/300). New-onset atrial fibrillation was the most common complication (35%). HbA1c level above 7.5% was a predictor of in-hospital mortality after CABG (unadjusted odds ratio 1.9, 95٪ CI: 1.1-3.2, p = 0.006). After stratifying analysis with Chi-sqaure test we found that gender history of myocardial infarction had no significant relationship with HbA1c level in two groups with or without complication. Long-term uncontrolled blood glucose before CABG is associated with increased postoperative complications. Preoperative HbA1c measurement can be a predictor of high-risk patients.

Congenital heart disease is the most common congenital anomaly. About 50% of Neonates with congenital heart disease are asymptomatic in the first few days of life and are not diagnosed on initial examination. Pulse oximetry is a non-invasive method that can show the percentage of oxygen saturation in the blood and congenital heart disease.

This was a descriptive cross-sectional study and the sampling method was census. Echocardiography was performed for all neonates with spo2 less than 95% and also neonates who were diagnosed with a problem by a cardiologist. After collecting the samples, the results obtained from pulse oximetry, physical examination and echocardiography were analyzed using SPSS software version 16 and statistical tests of Kolmogorov-Smirnov normality and Spearman correlation. Was investigated.

In pulse oximetry evaluation, 1.9% of neonates had spo2 (arterial oxygen saturation) less than 95%. 1.7% of neonates had heart problems in physical examination and 2.12% of neonates had heart problems in echocardiography. The highest correlation between pulse oximetry and echocardiography was 0.917.

Considering the diagnostic importance of congenital heart diseases and their impact on a personchr('39')s life, it is recommended that pulse oximetry be added to physical examinations at birth as a screening method for heart disease.

Coronary artery disease (CAD) is a major problem in Iran as well as throughout the globe, and coronary artery bypass grafting (CABG) surgery is an appropriate option for many patients with symptomatic and severe CAD. The main purpose of this study was assessment of the short and long-term outcomes of patients undergoing CABG in Yazd Province, Iran.

This historical cohort study examined the mortality rates of patients who had undergone CABG in Afshar Hospital in Yazd from 2011 to 2013. During this period, 2510 patients undergoing CABG were entered into the study and then followed for in-hospital and long-term mortality.

Mean age of the patients was 61.37 ± 10.50 years and 34.1% were women. In-hospital mortality turned out to be 3.7% and age over 70, left ventricular (LV) dysfunction, female gender, and left main (LM) involvement induced significant higher in-hospital mortality. Of all the patients, 84.1% were followed for a period of 41 ± 20 months. The survival rate proved to be 92.4% in one year and 82.9% in five years. The patients with age over 70, diabetes mellitus (DM), and LV systolic dysfunction (LVSD) showed significant lower survival rate, whereas the patients with utilization of left internal mammary artery (LIMA) demonstrated significant higher survival rate.

In-hospital and long-term mortality rate of patients undergoing CABG surgery is acceptable in comparison with other studies and more effort is needed into making this event a success.

The purpose of this study is to investigate the amount of salt consumed by the people of Yazd and the related factors based on other studies. 

A general search was performed on electronic databases of Daneshgostar Barakat system, Magiran, SID, and English databases such as Scopus PubMed, Web of sciences, Science direct and Google scholar searching engine using keywords: salt intake" OR "sodium intake" OR "salt reduction" OR "salt content" OR "sodium reduction" OR "Diet, Reducing"  regardless of the time interval. A total of 273 articles were obtained from the mentioned website. This review covers the period from June 3 to September 30, 2019. A total of 15 related articles were analyzed, and the study on the amount of salt consumed was evaluated.

The amount of salt received by the people of Yazd is higher than the standard of the World Organization and has an increasing trend.

A population-based approach can lower blood pressure levels and presumably significantly reduce mortality and start of high blood pressure. Therefore, the implementation of a comprehensive plan and intervention in salt consumption is necessary for society.

SARS-COV 19 is a new coronavirus that was reported first time in 30 December 2019 in Wuhan, China. The first case of coronary heart disease in Iran was reported with a definitive test on February 18 in Qom province and the first case in Yazd province on 24 February. The World Health Organization (WHO) declared a Covid infection on March 11 a pandemic. The aim of this study was to investigate the seroepidemiology of COVID 19 in Yazd province.

The present study was a cross-sectional population-based study of seroepidemiological type that was conducted to investigate the serological prevalence of Covid-19 in the period of 3 to 20 May 2020 in Yazd Province. Sampling was clustered and it was without age and sex restrictions. Information was collected including demographic information, adherence to health protocols, and history of clinical symptoms of COVID 19. "Pishtaz ELISA Kit" was used to evaluate the IgG and IgM antibody titers against Covid 19. Chi-square, analysis of variance and T tests were used via SPSS.version.16 software

Mean age of the participants was 34.3± 17.5. Among the study participants, 507 (54.5%) were women. The serological prevalence of definite cases was 14.91% (95% CI: 12.91-16.91%) and suspicious cases were 2.85% (95% CI:1.85-3.85%). Ardakan City with 32% had the highest and Taft, Mehriz, Khatam with 7% had the lowest prevalence of COVID 19 (P <0.05).

By June 2020, nearly 18% of the population of the province was definitively or suspiciously infected with COVID 19. Unfortunately, up to 25% of the population does not follow the early prevention protocols of COVID 19.

The population attributable risk (PAR) percent has used widely in public health policy. We aimed to calculate the attribute risk of hypertension due to hyperuricemia by Levin's formulas compare to direct PAR calculation method.

This was a sub-study of Yazd Healthy Heart Cohort (YHHC). Overall, 1256 normotensive individuals were enrolled through multistage randomized cluster sampling and followed up for mean 9.8 years, from 2005-2015. The threshold cutoff point of the hyperuricemia was considered equal and more than 75th percentile that equal to 5.5 mg/dl for men and 4.3mg/dl for women. To calculate the attributable risk of hyperuricemia in developing hypertension, two methods were applied. Levin's formulas and direct PAR estimation by population risk calculation via exposure prevalence weighted formula. Multiple logistic regression was used for estimate of odds ratio (OR) of hyperuricemia in developing hypertension. We calculated Relative Risk (RR) from OR. The data were analyzed using SPSS software version 16. A significant level of 0.05 was considered.

Hypertension developed in 44.7% of individuals with uric acid level ≥ 75th percentile vs. 35.6% of other individuals (P=0.024). Attributable risk (AR) of hyperuricemia in hypertension incidence was 9.1%. PAR of hyperuricemia for hypertension incidence by using two methods mentioned before was 6%, 5.8% respectively.

The results of the study confirmed the noticeable contribution of hyperuricemia as an independent other risk factor for the occurrence of hypertension. PAR of hyperuricemia for hypertension incidence by using two methods almost near was 6%, 5.8% respectively.

Current evidence indicates the resurgence of whooping cough despite high coverage of whole-cell (wP) and acellular (aP) pertussis vaccines. To investigate the cytokine response to a genetically inactivated protein containing the S1 subunit of pertussis toxin (PTS1) with and without the Listeriolysin O (LLO-PTS1), in comparison with current wP and aP vaccines in the mice model.  Thirty-six female NMRI mice aged 8 to 12 weeks (25 ± 5 g) were divided into six groups, including control (n=6) and five treated groups (n=6/each). Treated groups received intraperitoneal injection of recombinant PTS1, recombinant fusion LLO-PTS1, aP, wP, and sham (phosphate-buffered saline), whereas the control group did not receive anything. After60 days, the serum levels of IFN-γ, IL-4, and IL-17 cytokines were evaluated by ELISA method. Our findings showed LLO-PTS1 significantly increased IL-17 and IL-4 cytokines compared with wP and aP vaccines. IFN-γ failed to increase substantially in the LLO-PTS1 group compared to others, but it was non-inferior to standard vaccines. Our alum free mono-component monovalent recombinant fusion protein (LLO-PTS1) could bear the capacity to stimulate the release of IFN-γ similar to wP and aP vaccines in the mouse model. Besides, it showed better results in stimulating the release of IL-17 and IL-4 response. This study can be regarded as a platform for further probes in booster pertussis vaccine development.

Vitamin D is a fat soluble vitamin with a well-known general metabolism and actions in bone structure and immune system regulation. Vitamin D exhibits direct antimicrobial activities against a spectrum of microbes, including Gram-positive and Gram-negative bacteria, enveloped and non-enveloped viruses, as well as fungi. An observational study showed that concentrations of 38 ng/ml or more were associated with a significant more than twofold reduction in the risk of developing acute respiratory syndrome (17% vs. 45%). Some clinical trials on vitamin D showed a decrease in incidence and severity of the Coronavirus Disease 2019 (COVID-19). To achieve the optimum vitamin D3 levels, approximately half of the population should take at least 2000–5000 iu/d of vitamin D3. Various loading doses were proposed for achieving a 25(OH)D concentration of 30 ng/ml. A study reported that to achieve the concentration of 40–60 ng/ml a weekly or fort nightly dose totaling 100,000–200,000 iu over 8 weeks (1800 or 3600 iu/d) as loading should be prescribed. Approximately about half the people, using 5000 iu/d of vitamin D3 or 30,000–35,000 iu/wk would increase 25(OH)D concentration to 40 ng/ml and 6235–7248 iu/d can ensure that 97.5% of the people have concentrations > 20 ng/ml. Well-designed human clinical studies over the dosage and combination of micronutrients such as vitamin C and D and Zinc in different populations are required to substantiate the benefits of micronutrient supplementation against infection.

The response to ovarian stimulation is different among women referring for assisted reproductive techniques. This difference could be due to different genotypes in genes related to reproduction such as estrogen receptor beta (ERβ or ESR2) gene.

In the present study, we explored the rate of ESR2 gene polymorphism in infertile women undergoing IVF treatment with different ovarian response to ovulation induction.

A cross-sectional study was performed among 91 infertile women. The relationship between genotype distribution of the +1730 G/A polymorphism in the ESR2 gene (rs4986938) and the mean number of follicles and oocytes, their mean ratio, mean number of embryos, mean size of the follicles and pregnancy rates were measured. The ESR2 gene +1730 G/A polymorphism were identified by the amplification-refractory mutation system-polymerase chain reaction.

Genotypes GG, GA, and AA of the ESR2 gene presented frequencies of 27.5%, 67%, and 5.5%, respectively, in the infertile women. The results of the study showed that the mean number of follicles and oocytes, their mean ratio, mean number of embryos, mean size of the follicles, and pregnancy rates are not related to different genotypes.

According to the endocrine and paracrine factors which are involved in the ovulation induction and maturation of oocytes, more studies with higher number of participants are required to confirm the results of the present study; in addition, further studies are required to find out other gene polymorphisms affecting estrogen receptor efficacy in the infertile women.

Stroke is the third most common cause of death in developed countries and is the most common neurological disabling disease. Today, several risk factors are known for stroke including lifestyle and risk factors such as hypertension and diabetes which differ in cultures and countries. The aim of this study was to determine the frequency of ischemic stroke in patients admitted to the Brain Department of Ghaem Hospital in 1395.

In this observational cohort study, 201 cases of ischemic stroke who confirmed by neurologists as well as imaging techniques for diagnosis patients hospitalized to the Neurology Section of Ghaem Hospital, Mashhad, Iran During 1395.  The Patientschr('39') information such as age, sex, and The place of living and also the type of stroke and its main risk factors, including history of stroke in the past, hypertension, diabetes mellitus, high blood sugar cigar and high blood lipids were extracted from their records and completed in the checklist. 1 year follow up performed by telephone calling. Data were analyzed and examined by SPSS 21 and statistical tests.

According to the analysis, except for the cigarette variable (P-value = 0.003) HDL and TG (P-value = 0.001), no significant relationship was found between the other risk factors of disease risk and sex. In this study, 201 patients with ischemic stroke were studied. The mean age of the participants in the study was 50.92 years. In this study, the prevalence of stroke in men were higher than that of women, 104 (51.7%) for males and 97 (48.3%) for women. In the study of the most important clinical risk factors for stroke, the results showed that the highest prevalence was hypertension in women with 68 (70.1%) and the least of them was smoking with 16 (16.5%). The mean annual death rate in this study was 15.9%, which did not have a significant relationship with sex groups.

In this study, hypertension, having diabetes and high blood glucose levels were the most important risk factors for stroke in patients, these results are in accordance with the previous finding studies. Regarding the results, it seems that the control of blood pressure and diabetes is not effectively considered, which requires further investigation.