Canon Journal of Medicine
Volume:3 Issue: 1, Winter 2022

On 26 November 2021, the World Health Organization (WHO) announced variant B.1.1.529, a variant of concern named Omicron. In this study, we used a susceptible, exposure, infection, and compartmental recovery model (SEIR) to estimate the future status of the omicron virus in Iran.   We showed that the epidemic could last for about 3 to 4 months in Iran. It seems that by increasing the effectiveness of interventions, the Omicron wave could be under control with more minor casualties. The response strategy in Iran should be implemented to gain time for the roll-out of the third vaccine dose and complete those who just received the first shot. Besides, the effectiveness of interventions in the real world almost occurs more slowly than the simulated data.

Coronary artery disease (CAD) is one of the most common causes of death worldwide. Twenty-five percent of people suffering the disease eventually die from sudden death or acute myocardial infarction. This study was established to determine the correlation between CAD and abnormal exercise electrocardiogram (ECG) testing, hypertension, and other associated risk factors. This cross-sectional study was performed on 384 hypertensive patients referred to Isfahan Shariati Hospital Exercise ECG Testing Center in 2011 and 2012. Patients who had irregularities in exercise ECG tests and also had a history of hypertension were selected. Patients with abnormal angiography findings were considered as patients with CAD. Sensitivity and false Positivity of exercise testing compared to angiography were calculated and the data were analyzed using SPSS software. In this study of 384 hypertensive patients, angiography was suggestive of CAD in 310 patients. Among these patients who underwent exercise testing and angiography in order to diagnose ischemic heart disease or CAD, the most common risk factors were family history (56%), diabetes (54.2%), dyslipidemia (41.7%), smoking (40.9%), obesity (38.3%), alcohol (13%), addiction (13%), and anxiety (10.9%). The sensitivity and specificity of ECG exercise testing compared to angiography were calculated as 79% and 64%. According to the results obtained; a detailed history taking and assessing the known risks can assist clinicians to establish the most proper approach to CAD. Also depending on the assessed risk, patients with CAD can benefit from ECG exercise testing much more than strategies using cardiac computed tomography angiography primarily in order to minimize the costs and radiation exposure.

Hypertension is one of the main causes of morbidity and illness in the world. Until now, although the exact casualty of hypertension is not well established but Personality type can be considered as one of the effective factors in hypertension development as effects various aspects of the patient’s life style. In the current study, the relationship between hypertension and temperament has been investigated. This case-control study was performed on 65 patients with hypertension and 65 people with normal blood pressure. Temperament patterns were examined by the TCI standardized questionnaire with 125 questions that examines temperament and character dimensions. Collected data were analyzed by SPSS 20 software using statistical tests. In this study, there was no significant difference in average age and level of education between two groups include hypertensive and non-hypertensive (P-Value=0.22). However hypertensive group the prevalence of diabetes (P<0.001), hyperlipidemia (P<0.001), and cardiac disease (P=0.001) were significantly higher than non- hypertensive group. High blood pressure had a significant relation with harm avoidance temperament but there was not this relation with other temperament models such as average number for novelty seeking, reward dependent and persistence temperament. Evaluation temperament with the questionnaire can provide important information to predict the risk of hypertension in primary care. Regarding the temperament side effects on the health issue, new educational programs for medical students in this field are suggested.

Type 2 diabetes is a chronic disease with an increase in microvascular risks such as retinopathy and neuropathy. According to cardiac neuropathy in diabetic patients and the high prevalence of diabetes, the current study is designed to evaluate heart rate recovery and exercise capacity in diabetic versus healthy individuals. . This clinical study was performed on 228 patients. The age, sex, weight, BMI, educational level, duration of disease, history of other medical disease and smoking, TG, LDL, CHOL, HDL, FBS, SBP, and DBP were listed in the checklist and were evaluated later. The SPSS software was used to analyze data statistically using t-test, Mann-Whitney, and Chi-Square tests. P>0.05 was considered significant.   Mean Heart Rate Recovery, in the first mean, was 16.35 ± 10.56 in the study group and was 25.9 ± 13 in the control group (P=0.001). The mean heart rate during rest in the study group was 84.39 ± 13.5 and in the control group was 81.44 ± 14.27 beat/min (P=0.110). The mean Heart Rate Reserve in the study group was 48.43 ± 18.87 and in the control group was 57.8 ± 24.17 (P=0.001). Negative Chronotropic Incompetence was seen in 10 patients and 19 healthy individuals (P=0.048).   According to our results and previous studies, heart rate recovery in diabetic patients is significantly less than in healthy individuals. The risk of cardiovascular disease in these patients is higher versus healthy individuals, and according to this fact, they need periodic visits.

Migraine is an inflammatory condition with high prevalence. Approximately 18% of women and 6% of men suffer from Migraine. It is classified into two groups based on aura manifestations. Aura is characterized by any combination of visual, hemisensory, or language abnormalities. Although not completely elucidated, one possible explanation for its cause may be related to the reduction of blood flow of the brain’s arteries or increased hemoglobin level. In this study, we aim to find out the relationship between migraine and red cell distribution width (RDW). 100 patients with migraine who were referred to specialized clinics Al-Zahra hospital between 2015-2016 and age and sex-matched 100 control subjects enrolled in this study. The disease diagnosis was confirmed by a neurologist. Fasting venous blood samples were taken from subjects for performing CBC, ferritin and, iron, and TIBC tests. HIT6 questionnaire was considered to assess the severity of migraines. There were 100 patients with a median age of 36 years (range 18-50). 22% were male and 78% were female. Data analysis didn’t show any relationship between migraine severity and RDW. Also, RDW didn’t have any relationship with the type of migraine (with aura or without aura).  This study could not reveal any significant association between RDW and migraine. Observing high RDW in both case and control groups brings us to the hypothesis high prevalence of iron deficiency in our country. According to the results, low ferritin levels had a relationship with increased severity of migraine.

Thalassemia can lead to psychological and emotional problems and functional disorders in patients and their families. The present study has investigated the behavioral risk factors and functional state of patients with thalassemia major (TM) and their families. The present cross-sectional study has been conducted on 61 children with TM (case) and 61 healthy children (control) admitted to Amirkabir Hospital, Arak, Iran. In addition to the clinical, behavioral, and demographic information checklist for each person, the behavioral evaluation questionnaire was filled out for their patients and families. The mean age ± standard deviation (SD) of the patients in the case and control groups were 19.86 ± 9.86 (range: 5-54) and 18.50 ± 8.8 (range: 5-50), respectively. According to CBCL in children under 16 years, there were no significant differences in terms of withdrawal/depression (P=0.143), somatic complaints (P=0.07), rule-breaking behaviors (P=0.20), and aggressive behavior (P=0.28), while the attention problems (P=0.03), anxiety and depression (P=0.001) and thought problems (P=0.01) were significantly higher in these patients. In over 16-year-old patients, anxiety and depression were significantly higher than the healthy group (P=0.001). Siblings of patients didn’t show more psychological problems (P>0.05). In contrast, the anxiety and depression in mothers (P<0.0001 - P=0.02) and fathers (P=0.01 - P=0.02) of patients were significantly more than average individual’s parents. Thalassemia major leads to some behavior problems in patients, influencing different aspects of their lives. It is essential to provide more supportive care with psychological intervention in these patients and their parents.

Dermatofibrosarcoma protuberans (DFSP) is a rare tumor and has a slow-growing behavior. Presentation is nonspecific, and diagnosis is made after the operation and pathologic examination. The most common sites of this tumor are the trunk, head and neck, and extremities. We report a 42-year-old woman presenting with a breast mass and positive history of breast cancer in her mother. Pre-operation biopsy showed phyllodes tumor. After wide excision of the mass, the pathology report confirmed the DFSP diagnosis. Apart from surgery, she received no adjuvant treatment (chemotherapy, radiotherapy, or hormone therapy). The patient has not experienced recurrence since then. According to the rarity and high rate of recurrence of breast DFSP, it should not be missed as a differential diagnosis of breast masses. Taking a multidisciplinary approach and using proper diagnosis and treatment methods can improve the outcome.