Arya Atherosclerosis
Volume:5 Issue: 3, Autumn 2009

Knowledge, attitude and practices of health professionals influence the health awareness of clients presenting to the centers for health and treatment. This project was de-signed and conducted to increase the knowledge and improve the attitudes and practices of health professionals at all levels of the health system, towards prevention and control, as well as diagnosis and treatment of non-communicable diseases, especially cardiovascular diseases. The study consisted of three phases: situation analysis, intervention, and re-evaluation. To perform situation analysis, we applied randomized cluster sampling and selected 2000 health workers from the target population. Identical methods were used in control and intervention communities. We designed a questionnaire and determined its reliability and validity. Essential training on risk factors, healthy nutrition, and ways of coping with stress and maintaining adequate physical activity were taught to the target groups via seminars inte-grated into the health professionals’ in-service continuing education program. The educational materials consisted of books and leaflets. Awareness, attitude and practices of health professionals affect the outcome of efforts towards prevention and control of non-communicable diseases and their risk factors both in the society, and in the health professionals’ community. Multiple educational interventions in this study can help to rein in non-communicable diseases.

Causes of cerebral venous thrombosis (CVT) vary around the world. Oral con-traceptive pills (OCP) are among the most frequent causes of cerebral venous thrombosis. Consecutive patients admitted with cerebral venous thrombosis in Ghaem hospital, Mashhad during 2005-2008 were prospectively investigated. Diagnosis of cerebral venous thrombosis was made by corresponding results of MRI, and MRV or conventional angiography. All of the patients had a complete medical history, physical examination and underwent a standard battery of diagnostic investigations by stroke neurologists. Sixty two patients (51 females, 11 males) with mean age of 32.3, ranged 18-62 years were admitted with cerebral venous thrombosis. Oral contraceptive pills consumption was found as risk factor in 56.8% of females with cerebral venous thrombosis. These females had used LD and HD types of oral contraceptive pills in 97% and 3% respectively. 41% of females with cerebral venous thrombosis; (21/51) were on short term oral contraceptive pills consumption. In this latter group of females, Ramadan and Hadj religious months were the reason of using short term oral contraceptive pills in 86% and 5% respectively. Short term oral contraceptive pills consumption is the most common cause of cerebral venous thrombosis in Iranian women. Programs for public awareness should be con-ducted for reducing use of these pills in short term periods during Ramadan and Hadj months.

Although the relationship between unhealthy lifestyle and development of non-communicable diseases in the youth has been understood but intervention studies to im-prove lifestyle behaviors in this age group are low. Consequently, this study was performed to highlight important intervention activity of a NCD prevention and health promotion program for young people and to present its main results in Iran. The Youth Intervention Project (YIP) as a part of Isfahan Healthy Heart Program (IHHP) was carried out on all the youth aged 19-25 years in Isfahan and Najafabad counties as intervention areas and Arak as control area. The target groups could be reached in Red Crescent Society, universities, and garrisons. Multifactorial interventions included healthy nutrition, physical activity, coping with stress, and tobacco cessation by more emphasis on hookah smoking. Also, enforcing no-smoking regulations in teahouses and coffee shops was considered. After performing multifactorial interventions, the change of fast food consumption frequency was statistically significant in comparison between intervention and control areas (P for trend < 0.05). Percentage of individuals with high stress level were more significant in intervention area compared with control area (P for trend

Coronary angiography allows a direct evaluation of coronary artery. The aim of this investigation was to evaluate the coronary artery stenosis among males and females un-derwent coronary angiography (CAG). This randomized clinical trial was performed on 620 (425 males and 195 females) patients from March 2006 to September 2007 in the coronary angiographic registry of Imam Khomeini Hospital. The patients were selected for CAG according to the clinical criteria. Hypertension, diabetes, current medication, socio-demographic data, smoking, age and sex were recorded according to medical history and laboratory data. Ejection fraction of left ventricle was significantly higher in women in comparison with men (P = 0.01). No significant differences in the extent of coronary artery disease be-tween men and women were observed. Women with coronary artery disease were older than men (P < 0.001). Although our study does not show any gender differences in the number of diseased vessels, it shows higher prevalence of risk factors such as diabetes mellitus and hypertension in women.

The purpose of this study was to determine the impact of acute exposure to air pollution on the hemodynamic parameters and physical fitness components in two groups of healthy men differing in fitness (trained and untrained) and the correlation of parameters be-tween the areas. Thirty four healthy college student males (18 low-fitness, mean age 20.44±2.43 years and 16 high-fitness, age 22.19 ± 2.07 years) who were students of the Isfahan University participated in this study. First, two environments including with high and moderate concentrations of ambient air pollution were determined on the basis of the environmental protection agency. Then, all participants performed a Canadian Aerobic Fitness test (CAFT) to determine maximal oxygen uptake (VO2max) in sport sciences laboratory. Each participant also performed 2 sub-maximal exercise tests in two environments including polluted. The tests consisted of three phases: phase A, in non-polluted air area (laboratory), and phase B, very polluted air area, C, moderate polluted air area. All 3 exercise tests were completed within a 1-week period interval between phases. Maximal oxygen uptake (VO2max), maximal heart rate (MHR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and other anthropometric values were measured at end sub-maximal exercise test. Data were analyzed using one-way analysis of variance (ANOVA) with repeated measures and correlation. At baseline, there were no significant differences between the groups in age, height, weight, DBP, but body mass index(BMI), body fat, resting heart rate(RHR) and SBP was significantly lower in subjects with high fitness (F 1,32 = 10.96, P < 0.002, F 1,32 = 13.91, P < 0.001, F 1,32 = 21.29, P < 0.001, F 1,32 = 13.72, P < 0.001, respectively). Although, baseline MHR and VO2max were higher in subjects with high-fitness than in students with low-fitness (F 1,32 = 10.07, P < 0.01, F 1,32 = 74.23, P

This study aimed to investigate 28-day case fatality rate due to acute myo-cardial infarction (MI) in Isfahan using a standardized surveillance system. A prospective longitudinal study was performed on hospitalized myocardial infarction patients in Isfahan, Iran from 2000 to 2004. All hospitalizations due to myocardial infarction (MI) events were recorded via a system adopted from “World Health Organization Monitoring Trends and Determinants in Cardiovascular Disease” (MONICA) project, with ignoring MONICA age limitation. Patients were followed and their families enquired about their patients survival status at 28th day with phone calls and if not available at home visits. Age-adjusted hospital admission rate showed an increase during the study period, rising from 131.67 to 209.27 per 100000, but slowed toward the end of the study. Patients’ mean age was 62.35±12.64, with one third of events documented among female patients. Young patients (< 45 years old) comprised 8.6% of hospitalizations which remained nearly constant through the study. The corresponding figure was about 28% for patients aged less than 55 years. The 28-day case fatality rate was 23.1% for women and 13.2% for men. For individuals aged 35-64 years, the fatality rate was 13.0% for women and 7.7% for men. This study showed an increase in myocardial infarction hospital admission rate in Isfahan but the rate of increase is decreasing. A multi-centric community-based myocardial infarction incidence study is needed to elucidate myocardial infarction epidemiology in Iran.

No reflow is a phenomenon in which myocardial ischemia and reduced antegrade flow occur despite the absence of proximal stenosis, spasm, dissection, or embolic cut off of major distal branches.1 In another word no reflow phenomenon means failure of restoration of myocardial flow despite removal of epicardial coronary obstruction.2 The incidence is 2% with plain balloon angioplasty (PTCA), 7% in patients undergoing rotational atherectomy, 12% for primary percutaneous coronary intervention (PCI), and much higher at 42% for PCI of degenerated Saphenous Vein Graft (SVG).3 No reflow is a strong predictor of mortality after PCI. The mortality of patients who developed no reflow has been estimated to be 8% Predictors of no reflow include a higher plaque burden, thrombus, lipid pools by intra vascular ultra sonography (IVUS), higher lesion elastic membrane cross sectional area, preinfarction angina and thrombolysis in myocardial infarction (TIMI) flow grade 0 on the initial coronary angiogram.

Coronary artery fistula is an abnormal communication between a coronary ar-tery and a cardiac chamber or major cardiac vessels, mostly congenital but some of them are acquired as a consequence of coronary artery perforation. We report a case of cavity spilling coronary artery perforation during percutaneous coronary intervention 7 years ago. Because of continuing symptoms and risk of developing heart failure and pulmonary hypertension we were ought to treat this iatrogenically formed coronary artery fistula. We used stent graft implantation to treat it with acceptable results. Beside their application as a rescue for acute coronary artery perforations, stent grafts can be used with acceptable results in iatrogenically acquired coronary artery coronary artery fistula