فهرست مطالب

Archives of Iranian Medicine - Volume:22 Issue: 4, 2019
  • Volume:22 Issue: 4, 2019
  • تاریخ انتشار: 1398/02/14
  • تعداد عناوین: 12
|
  • Bahram Mohebbi , Azar Tol , Roya Sadeghi *, Seideh Fatemeh Mohtarami , Ahmadreza Shamshiri Pages 168-173
    Background
    The Health Belief Model (HBM) as a conceptual framework in health behavior research was applied to improve self-management. This study aimed to determine the effect of theory-based intervention program among women with gestational diabetes mellitus (GDM).
    Methods
    This quazi-experimental study was conducted on 110 women 17–41 years old which were divided randomly into intervention (n = 55) and control (n = 55) groups. The intervention group received a self-management education for four sessions lasting 35–40 minutes accompanied with a phone call as a booster. Both intervention and control groups attended a routine GDM education program at outpatient health centers. A multi-section instrument included demographics, 28 items in HBM (CVI and CVR were 0.83, 0.87, respectively) and self-management sections. All participants were invited to complete the questionnaire at baseline and at three and six months after intervention. SPSS version 21 was performed for data analysis using repeated measure ANOVA and paired t-test. P less than 0.05 was considered statistically significant.
    Results
    At baseline, demographics and HBM constructs revealed no significant differences between two groups (P>0.05). After intervention, perceived susceptibility, severity, barriers, benefits and self-efficacy revealed significant differences in the intervention group compared with controls (P<0.001). Self-management and HbA1c indicated significant differences in the intervention group before and after three and six months (P<0.001) whereas in the control group no significant differences were revealed (P>0.05).
    Conclusion
    Implementing the HBM educational intervention program with focus on benefits of self-management has positive impact on pregnant women.
    Keywords: Gestational Diabetes Mellitus, Heath Belief Model, Intervention, Self-management
  • Yaser Sharif, Omid Sadeghi, Ahmadreza Dorosty, Fereydoun Siassi, Mahmood Jalali, Abolghasem Djazayery, Kazem Mohammad, Mahboobeh Parsaeian, Zahra Abdollahi, Ramin Heshmat, Amirhusein Yarparvar, Hamed Pouraram*, Ahmad Esmaillzadeh* Pages 174-181
    Background
    Some studies have examined the association between micronutrient deficiencies and overweight in children, but data in this regard are conflicting. This study was done to investigate the association between serum levels of vitamin D, A and zinc with overweight in a large sample of Iranian toddlers.
    Methods
    A total of 4261 toddlers, aged 15-23 months, who had an Iranian birth certificate and attended primary health care, were included in the current cross-sectional study. Weight and height were measured by experts based on standard protocols and body mass index (BMI) was calculated. Based on WHO criteria, overweight was defined as BMI-z-score of ≥1SD. Serum levels of 25(OH)D3 , retinol and zinc were measured for each toddler. Binary logistic regression was applied to assess the association of 25(OH)D3 , retinol and zinc levels with overweight.
    Results
    Mean age of study participants was 19.2 ± 8.4 months. After controlling for potential confounders, children in the highest quartile of serum 25(OH)D3 levels had lower odds of overweight compared with those in the lowest quartile (OR: 0.79, 95% CI: 0.63–0.99). Furthermore, a marginally significant inverse association was found between serum levels of 25(OH)D3 and overweight among urban toddlers (OR: 0.75, 95%CI: 0.56–1.00). Such a relationship was not seen for rural children. No other significant association was seen between serum levels of retinol and zinc and overweight either before or after controlling for covariates.
    Conclusion
    In conclusion, we found a significant inverse association between serum levels of vitamin D and overweight among toddlers. Further studies, particularly of prospective nature, are required to confirm our findings.
    Keywords: BMI, Cholecalciferol, Micronutrient deficiency, Overweight, Retinol
  • Parvin Mirmiran, Farshad Teymoori, Golaleh Asghari*, Fereidoun Azizi Pages 182-188
    Background
    Dietary amino acids have been associated with blood pressure (BP) in previous studies; we conducted this study to examine the association between dietary branched chain amino acids (BCAAs) and the incidence of hypertension among participants of the Tehran Lipid and Glucose Study (TLGS).
    Methods
    Analyses were conducted on 4,288 participants aged 20–70 years, who were free of hypertension at baseline (2008– 2011) and were followed for 3 years (2011–2014) to ascertain incident hypertension. Dietary intakes of BCAAs including, valine, leucine, and isoleucine were collected at baseline using the food frequency questionnaire (FFQ). Odds ratio (OR) of hypertension were determined by logistic regression across quartiles of BCAAs, adjusted for sex, age, smoking status, physical activity, body mass index (BMI), diabetes, and some dietary factors.
    Results
    The mean ± standard deviation for age and BMI of participants (41.9% men) were 39.7 ± 12.8 years and 26.9 ± 4.6 kg/ m2 , respectively. The median intakes of total BCAAs, valine, leucine, and isoleucine was 17.9, 5.5, 7.8, and 4.5 percentage of total amino acids intake, respectively. We documented 429 (10%) hypertension incident cases. The multivariable adjusted OR for the highest vs lowest quartiles of BCAAs was 1.54 (95% confidence interval (CI):1.03–2.32; P for trend = 0.05); furthermore, the OR (95% CI) of hypertension for the highest vs the lowest quartile of valine was 1.61 (1.10–2.36; P for trend = 0.009) in the fully adjusted model. However, we found no significant association between leucine and isoleucine with incidence of hypertension.
    Conclusion
    Findings indicated that higher BCAA intake, in particular valine, is associated with higher risk of incident hypertension.
    Keywords: Branched chain amino acids, Hypertension, Isoleucine, Leucine, Valine
  • Hoda Mehregan, Marzieh Mohseni, Mojdeh Akbari, Khadijeh Jalalvand, Sanaz Arzhangi, Nooshin Nikzat, Kimia Kahrizi, Hossein Najmabadi* Pages 189-197
    Background
    Hearing loss (HL) is the most common sensory deficit in humans, and genetic factors contribute to about half of the cases. With 112 causative genes identified so far and a disproportionate share of the genes within different ethnic groups, HL has proven to be quite heterogeneous.
    Methods
    Twenty Iranian families having at least 2 children with hereditary HL were initially verified to be GJB2-negative and were then subjected to whole exome sequencing (WES). Sanger sequencing was used to confirm segregation of the variant identified in each family.
    Results
    In 3 families, WES revealed 3 novel variants in KCNQ4, LHFPL5 and COCH genes. The KCNQ4 gene (DFNA2A) encodes a potassium channel (KV7.4) and the heterozygous variant identified (c.1647C>G, p.F549L) resulted in the substitution of Phe549 residing in the KV7.4 cytoplasmic region. The homozygous variant (c.34A>T, p.K12X) was identified in the LHFPL5 gene (DFNB67) which encodes a transmembrane protein, and another variant in a homozygous state (c.116T>A, p.L39X) was identified in the COCH gene which encodes a secretory protein. Pathogenic variants in the COCH gene are associated with late onset autosomal dominant hearing loss (DFNA9) but the affected individuals displayed early onset HL with a recessive mode of inheritance.
    Conclusions
    The 16% contribution of GJB2 to HL in the Iranian population necessitates the discovery of the remaining causal factors. This study is the first to report KCNQ4 and COCH related HL in the Iranian population and the second study, globally, to report HL due to biallelic inactivation of the COCH gene.
    Keywords: COCH, Hearing loss, Iran, KCNQ4, LHFPL5, Whole exome sequencing
  • Younes Nozari, Maziar Parsa, Arash Jalali, Hamid Ariannejad, Akbar Shafiee* Pages 198-203
    Background
    Mean platelet volume (MPV) has been introduced as a simple and accurate method for assessing platelet function, which can be used as a prognostic marker for cardiovascular events. We investigated whether pre-procedural MPV could predict major adverse cardiac events (MACE) in candidates for elective percutaneous coronary intervention (PCI).
    Methods
    In this large retrospective cohort, we reviewed the clinical and follow-up data of 4199 candidates (mean age = 59.9 ± 10.3 years; female patients = 1440 [34.3%]) for elective PCI due to unstable angina (UA) or non-ST segment elevation myocardial infarction (NSTEMI). The primary endpoint of the study was the incidence of MACE defined as in-hospital mortality, cardiac death, nonfatal MI, target lesion revascularization (TLR) or target vessel revascularization (TVR). Based on the MPV level tertiles, patients were categorized into three groups for further comparison.
    Results
    Higher MPV was significantly associated with older age (P<0.001), hypertension (P<0.001), diabetes mellitus (P=0.003), history of previous CABG (P<0.001) and lower levels of serum triglyceride (P<0.001). The frequency of 1-year MACE was 176 (4.1%) with no significant difference between the MPV tertile groups. The highest MPV tertile could significantly predict MACE in the univariable model (hazard ratio = 1.51, 95% confidence interval: 1.05–2.17; P=0.026). In the adjusted model, the highest MPV tertile was a borderline predictor for MACE (hazard ratio = 1.62, 95% CI: 0.98–2.68; P=0.057).
    Conclusion
    High MPV was associated with cardiovascular risk factors and older age while high MPV was a borderline independent predictor for 1-year MACE in the candidates for elective PCI
    Keywords: Coronary artery disease, Mean platelet volume, Major adverse cardiac events, Non-ST elevation myocardial infarction, Percutaneous coronary intervention, Platelet count
  • Nizal Sarrafzadegan, Noushin Mohammmadifard* Pages 204-210
    Four decades ago, Iran encountered rapid sociodemographic and economic transitions. This review was carried out to investigate the trend of cardiovascular disease (CVD) prevalence, mortality and morbidity, relevant challenges and suggestions for prevention of CVD. In Iran, the most prevalent causes of death have transited from infectious and diarrheal diseases in 1960 to CVD few decades ago. CVD was the first leading cause of mortality and a million disability adjusted life years (DALYs) led to 46% of all deaths and 20%-23% of the burden of disease in Iran. Ischemic heart disease and stroke are considered the first and second cause of death and DALYs in Iran, respectively. CVD rising epidemic might be related to socioeconomic and cultural changes, nutrition transition, inadequate physical activity, industrialization and urbanization and increasing life expectancy, increasing metabolic and physical risk factors, low accessibility and affordability to primary care and treatment, and low compliance because of economic and psychological problems. Thus, planning and implementing strategies for prevention and control of the disease and its risk factors are on top of the ministry of health agenda in the recent years. Health promotion strategies to prevent and control CVD risk factors, early detection of the disease and treatment of acute and chronic CVD events are essential elements for reducing the burden of CVD in Iran.
    Keywords: Cardiovascular disease, Ischemic heart disease, Prevention, Risk factor, Stroke
  • Amin Talebi Bezmin Abadi*, Jeong Yeh Lee Pages 211-212
  • Ali Kashkooe, Bita Geramizadeh*, Saman Nikeghbalian, Seyed, Ali Malekhosseini Pages 213-216
    Background
    Solid pseudopapillary tumor of pancreas (SPTP) is a rare tumor of the pancreas which mostly occurs in young women. Since its first description in 1969, more than 500 cases have been reported. There have been just 2 case reports and 1 review (7 cases) from Iran. In this study, we reported our experience with 22 patients with SPT from the largest pancreaticobiliary center in Southern Iran.
    Methods
    During 6 years (2012–2017), 22 cases of SPTP were operated on in our center. All of these cases were recruited and after confirmation of the pathological diagnosis, clinical charts were evaluated and all the clinicopathologic findings as well as outcome of the surgery were evaluated.
    Results
    Among the 22 patients, 20 were female and 2 were males. The age range was 15–52 years and the tumor sizes were 3.5 to 17 cm. All of the tumors had preoperative diagnosis by imaging modalities and were operated on with no complication or recurrences. Just one case showed liver metastasis. All of the patients with SPTP in this study were alive and in good condition.
    Conclusion
    SPTP is not very rare in our center. In young patients presenting with pancreatic mass, especially in female patients, one of the most important diagnoses is SPTP. Conservative surgery and tumor excision is satisfactory and patients show excellent prognosis even after liver metastasis
    Keywords: Clinicopathologic findings, Solid pseudopapillary tumor of pancreas
  • Bahman Jalali kondori*, Fatemeh Azemati, Mohammad Hossein Asadi, Hossein Bahadoran Pages 217-219
    Takayasu’s arteritis, formerly known as "pulseless disease", is a chronic inflammatory disease which affects the aorta and its main branches. The prevalence of this disease is higher in Asian countries and among young women. Depending on the progress of the disease, the symptoms and prognosis of the disease is different. Herein, we report the case of a 31-year-old woman with Takayasu’s arteritis in the Iranian population. In this case, the size of the aorta and the main branches increased and the large artery walls were thickened. Narrowing of the right and left subclavian artery, carotid artery and left vertebral artery were obvious in these patients. In addition, an anatomic variation was observed in the aortic arch branches. In this patient, the left vertebral artery was branched directly from the aortic arch instead of the left subclavian artery. Hepatomegaly and splenomegaly, indicating a chronic inflammatory disease, were also observed in this case.
    Keywords: Anatomic variation, Aorta, Computed tomography angiography, Takayasu arteritis
  • Shirin Moossavi * Page 220
  • Davide Giuseppe Ribaldone*, Sharmila Fagoonee Page 221
  • Parastoo Saniee, Farideh Siavoshi*, Reza Malekzadeh, Sara Kadkhodaei Pages 222-224