فهرست مطالب

  • Volume:15 Issue: 6, 2020
  • تاریخ انتشار: 1398/12/20
  • تعداد عناوین: 7
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  • Nafise Moein, Mohammad Garakyaraghi, Davood Shafie*, Katayoun Rabiei, Sayed Mohsen Hosseini, Tohid Jafari Koshki, Mojtaba Rahimi, Babak Sadeghian, Mahshid Givi, Nizal Sarrafzadegan Pages 253-259
    BACKGROUND

    Considering the high concentrations of pollutants in large cities of Iran and the high prevalence of heart failure (HF) among Iranians, especially with increasing life expectancy, this study investigated the relationship between airborne contaminants with a diameter < 2.5 µm or particulate matter 2.5 (PM2.5) and hospitalization and mortality in patients with HF in Isfahan, Iran, during 2011.

    METHODS

    This ecological study was carried out on a part of data from the CAPACITY study. A total of 275 patients with HF were randomly selected from 840 subjects with International Statistical Classification of Diseases, 10th Revision (ICD-10) diagnosis code I50 in the CAPACITY study. Patients’ records were evaluated and their clinical characteristics, disease history, and laboratory and echocardiographic findings were extracted. Air pollution and climatic data were extracted from the CAPACITY study. Poisson regression was used in crude and adjusted models to evaluate the association between PM2.5 and study outcomes. All analyses were performed using crude models and models adjusted for temperature, dew point, and wind speed.

    RESULTS

    54.9% (n = 151) were men with mean age of 70.4 ± 13.7 years. While most patients (85.8%) were discharged after recovery, 14.2% of the patients died in the hospital. Blood glucose, heart rate, and ejection fraction (EF) were significantly higher on unhealthy days than normal days. Regression analysis revealed no significant relationships between hospitalization and mortality rates and PM2.5 concentrations on healthy days, unhealthy days for sensitive people, and unhealthy days.

    CONCLUSION

    The model used in our study revealed no significant relationships between PM2.5 concentrations and hospital admission on healthy days, unhealthy days for sensitive people, and unhealthy days.

    Keywords: Hospitalization, Mortality, Particulate Matter
  • *Majid Davari, Mohammad Reza Maracy, Elahe Khorasani Pages 260-266
    BACKGROUND

    Socioeconomic inequality is one of the important issues in cardiovasculardiseases (CVDs). The aim of this study was to investigate the distribution,relation betweenselected cardiac risk factors,type of CVD,and the socioeconomic status (SES) in the hospitalizedpatients with heart disease in Isfahan,Iran.

    METHODS

    This analytical,cross-sectional study was conducted in Isfahan in 2013. Thepopulation consisted of all patients with CVD admitted to the public,private hospitals. Thesample size was 721. Data collection was conducted through one researcher-made questionnairewith three sections: demographic,disease,and SES questionnaires. To determine the SES of thepatients,the indicators of income,housing status,occupation,family size,and education wereused. Data analysis was conducted in two statistical levels of descriptive,inferential.

    RESULTS

    69.1% of the patients were placed in the poor status,and there was no wealthy statuswithin the subjects. The five most frequent CVDs were chronic ischemia,unstable angina,arrhythmia,congestive heart failure (CHF),and acute myocardial infarction (MI),respectively.The three highest frequent risk factors in the patients were hypertension (HTN) (47.2%),diabetes (33.6%),and hyperlipidemia (32.6%). Regression analysis of the risk factors,thetype of heart disease on the SES revealed that there were statistically significant differencesbetween patients who were smokers (P,0.030),those who had valve disease (P,0.010),adjusted for age,gender,and marital status.

    CONCLUSION

    Our findings showed that the frequency of CVD risk factors were higher in lowerSES groups,thus SES can be a strong predictor for the occurrence of the CVD risk factors aswell as the CVDs.

    Keywords: Risk Factors, Cardiovascular Diseases, Socioeconomic Factors
  • Azam Alsadat Mirniam, Zahra Habibi, Alireza Khosravi, Masoumeh Sadeghi, Maryam Eghbali Babadi* Pages 267-274
    BACKGROUND

    Hypertension (HTN) is the key risk factor for cardiovascular diseases (CVDs). The purpose of this study was to determine the effect of a multifaceted intervention on blood pressure (BP) control and medication adherence (MA) among patients with uncontrolled HTN.

    METHODS

    A randomized controlled clinical trial study was conducted on 72 patients in the emergency ward who were selected through convenience sampling method. They were randomly divided into intervention and control groups. The studied multifaceted intervention includes motivational interviews and 90 minutes of training sessions, use of a drug reminder box, family support, and 4 phone call follow-ups. ehT8-Item Morisky Medication Adherence Scale (MMAS-8) was used before and after the intervention. BP was measured in both groups before and after the intervention and compared between them.

    RESULTS

    No significant difference existed between the two groups in terms of MA and systolic and diastolic BP before the study. The differences between the mean changes in postintervention systolic (-25.75 ± 19.39 vs. -2.88 ± 11.92 mmHG; P < 0.001) and diastolic (-6.18 ± 8.87 vs. -1.06 ± 8.70 mmHg; P = 0.010) BP in the intervention and control groups were statistically significant. The mean changes in post-intervention MA in the intervention and control group was 2.91 ± 1.64 and -0.36 ± 1.15, respectively; this difference was statistically significant (P < 0.001).

    CONCLUSION

    The studied multifaceted intervention promoted MA and reduced systolic and diastolic BP. Thus, the use of this method as a supplementary treatment is recommended after patient discharge.

    Keywords: Blood Pressure, Hypertension, Medication Adherence, Nursing, Iran
  • Fereshte Hossienifar*, Mozhgan Entezari, Shidokht Hosseini Pages 275-280
    BACKGROUND

    Cardiovascular disease (CVD) is one of the common diseases and today, it is considered as not only an important cause of mortality but also a significant aspect of health geography. The evidence presented in the literature indicates that hard water may reduce the cases of sudden death caused by CVDs because drinking water contains significant amounts of calcium and magnesium, which play a crucial role in the electrical activity of heart. Hence, the present study aimed at investigating the relationship between water hardness and CVD mortality rate in Isfahan, Iran.

    METHODS

    In this ecological study, the available data regarding the cardiovascular mortality rate and water hardness have been used. Preparation of zoning map has been conducted using the Geographic Information System (GIS) software considering Inverse Distance Weighting (IDW) interpolation models. Moreover, statistical analysis has been conducted using SPSS software.

    RESULTS

    A reverse relationship was observed between cardiovascular mortality rate and water hardness. However, the observed relationship was not statistically significant (2013: r = -0.066, 2014: r = -0.155, 2015: r = -0.051, P > 0.050).

    CONCLUSION

    The results of mapping with GIS and statistical analysis with SPSS both indicated a non-significant inverse relationship between the water hardness and CVDs. However, lack of a significant relationship highlights the necessity of conducting similar studies involving larger sample sizes and wider areas of investigation to present a definitive and generalizable result

    Keywords: Water, Hardness, Cardiovascular Diseases, Iran
  • Fatemeh Tavakoli, Hamid Kazemi Zahrani, Masoumeh Sadeghi* Pages 281-287
    BACKGROUND

    The aim of this study was to investigate the effectiveness of dialectical behavior therapy (DBT) on adherence to treatment and self-caring behavior in patients with coronary heart disease (CHD).

    METHODS

    This was an experimental study based on control and experimental groups with pretest and post-test. 32 male and female patients with CHD having at least high school diploma, referring to Isfahan cardiovascular research institute, Isfahan, Iran, were selected and placed randomly in two groups of control and experimental. Pre-test stage was done for both two groups by 8-item Morisky Medication Adherence Scale (MMAS-8) and Self-Care of Coronary Heart Disease Inventory (SC-CHDI). The experimental group was placed under the intervention of DBT for 8 sessions of 2 hours (once a week). Afterwards, the post-test was done for both groups.

    RESULTS

    It was shown by analyzing results from t-test that adherence to treatment and selfcare behavior significantly increased in experimental group comparing to control group [(1.81 ± 0.75 vs. 5.19 ± 1.22, P < 0.001) and (72.50 ± 4.38 vs. 55.50 ± 7.42, P < 0.001), respectively]. Also results showed that self-caring and adherence to treatment significantly increased after being adjusted for baseline measurement (P < 0.001). The findings showed that DBT had effect on adherence to treatment and self-caring behavior of patients with CHD.

    CONCLUSION

    On the basis of results, it could be said that DBT intervention can have positive impact on adherence to treatment and self-caring behavior of patients with CHD.

    Keywords: Coronary Disease, Dialectical Behavior Therapy, Treatment Adherence, Self-Care
  • Santosh Kumar Sinha, Mohammad Asif, Vikas Mishra, Mahmodulla Razi, Vinay Krishna Pages 288-291
    BACKGROUND

    Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) are the leading causes of acquired diseases in children and young adults in developing countries carrying considerable morbidity and mortality. Rheumatic fever (RF) commonly affects children between 5-15 years old and is rarely seen in < 5 years old. Mitral stenosis (MS) is the most common sequela, as it bears maximum onslaught. In India, few patients follow an unusually rapid course in developing severe MS because of its fulminant nature following attack of ARF.

    CASE REPORT

    Our patient was a 28-month-old girl who had developed severe MS, mitral regurgitation (MR), and pulmonary hypertension (PH) as the sequelae of ARF which she had suffered at the age of 18 months old.

    CONCLUSION

    To the best of our knowledge, this is the youngest reported case of rheumatic MS following ARF after extensive search in the literature. This case highlights the fact that very young population is not immune to ARF contrary to prior belief and therefore, more stringent preventive measures need to be implemented for it and possibility of ARF should be kept in mind while evaluating carditis in a child.

    Keywords: Acute Rheumatic Fever, Mitral Stenosis, Mitral Regurgitation, Pulmonary Hypertension