Journal of Analytical Research in Clinical Medicine
Volume:3 Issue: 4, Autumn 2015

Cardiovascular diseases (CVD) are of the main causes of mortality in the world and impose a heavy economic, social, and health burden on society. Therefore, the objective of this study was to determine the barriers and strategies for identifying and managing risk factors of CVD in levels of preventing, screening, and treating.
During present qualitative study with phenomenological approach, 60 subjects of cardiologists, nurses, patients, and their relatives were selected based on purposive sampling from educational-medical cardiothoracic subspecialty centers. Data were collected using an open-ended questionnaire and was extracted and analyzed with content analysis method.
Barriers were divided into three groups of individual barriers (low awareness, delay in referring for treatment and screening, incorrect beliefs, and not caring about health), socio-economic barriers (high costs, lack of resources, mental and psychological pressures), and health care barriers (non-alignment of doctors, being therapy-oriented, managerial and planning weaknesses, and lack of health care facilities). The most important presenting strategies are: providing public educations, improving family physician program, reduction of costs, cooperation of patients, and using functional indices to evaluate and improve the quality of services.
Low awareness of people, high costs of services, lack of health care facilities, socio-cultural problems of people, and delay in referring of people, for treatment and screening are of the most important barriers of proper identifying and managing risk factors of CVD. Strategies provided in this study to overcome these barriers could be used.

The intention of this study was to identifying and prioritizing challenges in research in Tabriz University of Medical Sciences (TUMS), Iran, and giving exact solutions to remove those challenges from the perspective of stakeholders (the members of faculty board, students, administrators, and research staff of the university).
This mix-method study (quantitative-qualitative) conducted in summer-2014 in TUMS. The participants of this study included 139 of the members of faculty board, 349 of the students, and 39 of administrators and research staff (in total, 525 individuals). The data collection tool in the qualitative section was an open-ended questionnaires (3 questions), and in the quantitative section it consists close question questionnaires (26 questions). For prioritizing these challenges, it was used by prioritization matrix that it had four criteria: Importance, the ability to solve, cost-effectiveness and immediacy.
The important challenges from the perspective of participant included: Lack of co-operations of administrative centers with researchers, the existence of cumbersome rules, lack of motivation in researchers from authorities, being non-economic of doing a research to the professors and students, The lack of research result in decision-making, the low capacity and ability of members of faculty board, students, and staff on issues related to research procedures, and lack of attention to the quality of research.
Lack of attention to the quality of research, and the existence of cumbersome rules in research area have the most priority in challenging research in TUMS, which they need more attention and planning to resolve these challenges of the authorities and managers of this university.

Iron deficiency (ID) is a common nutritional problem lead to many unintended consequences such as decrease energy, immune system problems, and neurological dysfunction. The most common psychological disorder is depression. A patient with ID anemia (IDA) show signs and symptoms of behavioral and mood disorders like depression.
In this study, 100 female patients with diagnosed major depression in years 2010 and 2011 were studied. In all patients standard Hamilton depression rating scale (HDRS) was used to evaluate depression severity. Blood samples were taken for complete blood count difference analysis and evaluating anemia and in those with hemoglobin (Hb) Patients mean age was 36.34 ± 10.43 years old. Mean HDRS score was 32.20 ± 4.07. 19 had anemia, and among them 8% had IDA. Mean HDRS score in patients with IDA (33.37 ± 1.90) was higher than those without (32.09 ± 4.19), but the difference was not significant (P = 0.39). There was no difference between patients with and without anemia in HDRS score. The negative relation was observed between Hb levels, and HDRS score (Pearson correlation = -0.21, P = 0.03).
We observed that the negative correlation between Hb levels and HDRS score. It demonstrates the effect of Hb decrease and anemia occurrence on depression severity; however, it needs more studies.

The electrical impedance spectroscopy technique can be used to measure the electrical impedance of the human bladder tissue, for differentiating pathological changes in the urothelium.
In this study, the electrical impedance spectroscopy technique and then, a numerical technique, finite element analysis (FEA) were used to model the electrical properties of this tissue to predict the impedance spectrum of the normal and malignant areas of this organ.
After determining and comparing the modeled data with the experimental results, it is believed that there are some factors that may affect the measurement results. Thus, the effect of inflammation, edema, changes in the applied pressure over the probe and the distensible property of the bladder tissue were considered. Furthermore, the current distribution inside the human bladder tissue was modeled in normal and malignant cases using the FEA. This model results showed that very little of the current actually flows through the urothelium and much of the injected current flows through the connective tissue beneath the urothelium.
The results of the models do not explain the measurements results. In conclusion, there are many factors, which may account for discrepancies between the measured and modeled data.

Failure to thrive (FTT) is relatively common among cleft patients, most commonly attributed to feeding problems during the first months of life. Close association between midline clefts and pituitary gland abnormalities prompted us to determine the frequency of growth hormone deficiency in cleft patients, which is easily treated.
Any cleft patient with FTT was studied and when the patient’s height was under the 3rd percentile of normal, growth hormone was checked after clonidine administration. Growth hormone was checked before and 30, 60 and 90 minutes after clonidine use.
Of 670 patients with cleft lip or palate, 31 patients (4%) had some kind of growth retardation according to weight, height or head circumstance. Eighteen patients were under the 3rd percentile of normal height. Growth hormone deficiency was detected in 8 patients out of 18 patients and overall frequency of growth hormone deficiency among cleft patients with growth retardation was 25.8% (8 out of 31). Seven patients of 8 were male whereas one was female and half of the patients were syndromic.
Cleft patients have many problems with normal feeding and all kind of support should be provided to achieve near-normal feeding and they should be monitored for normal growth. Any patient with growth retardation, especially height decrease, should be assessed for growth hormone deficiency.

The oxidative stress has been proposed as an important case of exudative age-related macular degeneration (E-ARMD). The aim of the present study was to investigate homocysteine (Hcy), asymmetric dimethylarginine (ADMA) and oxidized low-density lipoprotein cholesterol (Ox-LDL-C) levels, the factors involved in oxidative stress, in the patients with E-ARMD.
In a cross-sectional study, 45 patients with E-ARMD were compared with 45 sex- and age-matched healthy controls. The levels of biochemical factors, Hcy, ADMA, and of Ox-LDL were estimated by standard methods in both study groups.
The levels of Hcy (15.4 ± 7.2 vs. 10.7 ± 3.7 μM, P = 0.001), Ox-LDL (52.2 ± 13.8 vs. 37.8 ± 10.8 U/l, P = 0.001), and ADMA (0.84 ± 0.23 vs. 0.71 ± 0.26 μM, P = 0.012) were significantly higher in the patients with E-ARMD than those in the controls. In the patient group, there was a positive and significant correlation between serum Ox-LDL and Hcy concentrations (r = 0.719, P = 0.001), but no correlation was found between serum ADMA and Ox-LDL (r = 0.010, P = 0.900) and also between serum Hcy and ADMA levels (r = -0.070, P = 0.600).
The high levels of Hcy as an oxidant agent and ADMA as an endogenous nitric oxide synthase inhibitor can lead to increase Ox-LDL levels, and they may have important roles in oxidative stress, which can be a trigger in E-ARMD.

The present study aimed at investigating the difference between the expression and presence of sexual symptoms and dysfunction in depressed women treated with fluoxetine, and the possibility of sexual dysfunction following consumption of fluoxetine.
This cross-sectional analytic study was conducted on 44 women candidates for receiving fluoxetine after the diagnosis of depression. Patients’ complaints of sexual dysfunction were collected and compared using Arizona Sexual Experiences Scale (ASEX) questionnaire during their first visit and 2 months after receiving fluoxetine. Two-way data were analyzed using chi-square test, and Wilcoxon Signed Ranks test was used to study ordinal variables in SPSS software.
This study indicates that there is a significant difference between the final score of the ASEX questionnaire and that of each question before and after the consumption of fluoxetine. Using ASEX scale, it was indicated that 11 (25.0%) and 27 (61.4%) of participants suffered from sexual dysfunction at their first and second visit, respectively, and that there is a correlation between the expression of sexual dysfunction symptoms and sexual dysfunction disorder.
Results indicate that consumption of fluoxetine causes sexual dysfunction, and there is a correlation between the expression of sexual dysfunction symptoms and sexual dysfunction disorder. Moreover the fewer participants complain about symptoms, the more the chance of sexual dysfunction.

It has been suggested that a cesarean section increases risk of developing asthma due to lack of exposure to maternal microflora during birth. To investigate the association between the mode of delivery and the risk of asthma in children aged 5-14 years in Tabriz, Iran.
A case-control study was performed on 233 (case = 81, control = 152) children aged 5-14 years referred to outpatient clinics of Tabriz Children’s Hospital and Sheikhorrais Clinic in 2014. Clinical asthma diagnosis was done according to Global Initiative for Asthma Criteria. A questionnaire was administered to obtain a demographic, environmental, and clinical history. Age-sex frequency matching with cases was carried out during sampling for controlling of possible cofounding effects of age and sex for asthma.
Of 233 children, 53.6% of them were male (case group = 54.3% and control group = 53.3%). Over half (54.5%), the participants had been delivered by caesarian section. Cases were not significantly more likely to have been delivered by caesarian section as compared to controls [adjusted odds ratio (AOR) = 0.69; 95% confidence interval (CI) = 0.34-1.42]. However, more frequent episodes of common cold [b = 0.094; standard error (SE) (b) = 0.031, P Delivery mode was not associated with risk of developing childhood asthma in our study. Intra-family marriage increased the odds of childhood asthma. Further study on the relationship between maternal education and the odds of asthma is proposed.

This case report of unilateral otitis media in a 19-year-old female secondary to Wegener’s granulomatosis (WG) highlights, for the audiologist, the importance of being aware of some of the less common etiologies of middle ear disease. Unilateral otitis media that resists usual forms of medical treatment may represent one of the earliest signs of WG, a potentially life-threatening disease. Case Report: A female patient, age 19, in previous good health, presented a moderate unilateral conductive hearing loss secondary to the sudden onset of unilateral otitis media, accompanied by painful sinusitis. However, the symptoms continued to worsen. By the conclusion of a 6-month period of illness, she was jointly diagnosed by an immunologist and rheumatologist as possessing WG, and treatment began immediately. With aggressive treatment, the patient has now been in remission for 5 years. It is important that audiologists be aware of the early signs to make an appropriate referral for treatment, particularly since they are usually among first to see these patients. Early diagnosis and referral are critical.