Muslim women having abortions in Canada: attitudes, beliefs, and experiences.

OBJECTIVE: To improve understanding of the attitudes, beliefs, and experiences of Muslim patients presenting for abortion. DESIGN: Exploratory study in which participants completed questionnaires about their attitudes, beliefs, and experiences. SETTING: Two urban, free-standing abortion clinics. PARTICIPANTS: Fifty-three self-identified Muslim patients presenting for abortion. MAIN OUTCOME MEASURES: Women's background, beliefs, and attitudes toward their religion and toward abortion; levels of anxiety, depression, and guilt, scored on a scale of 0 to 10; and degree of pro-choice or antichoice attitude toward abortion, assessed by having respondents identify under which circumstances a woman should be able to have an abortion. RESULTS: The 53 women in this study were a diverse group, aged 17 to 47 years, born in 17 different countries, with a range of beliefs and attitudes toward abortion. As found in previous studies, women who were less pro-choice (identified fewer acceptable reasons to have an abortion) had higher anxiety and guilt scores than more pro-choice women did: 6.9 versus 4.9 (P = .01) and 6.9 versus 3.6 (P = .004), respectively. Women who said they strongly agreed that abortion was against Islamic principles also had higher anxiety and guilt scores: 9.3 versus 5.9 (P = .03) and 9.5 versus 5.3 (P = .03), respectively. CONCLUSION: Canadian Muslim women presenting for abortion come from many countries and schools of Islam. The group of Muslim women that we surveyed was so diverse that no generalizations can be made about them. Their attitudes toward abortion ranged from being completely prochoice to believing abortion is wrong unless it is done to save a woman's life. Many said they found their religion to be a source of comfort as well as a source of guilt, turning to prayer and meditation to cope with their feelings about the abortion. It is important that physicians caring for Muslim women understand that their patients come from a variety of backgrounds and can have widely differing beliefs. It might be helpful to be aware that patients who hold more anti-choice beliefs are likely to experience more anxiety and guilt related to their abortion than prochoice patients do.

Main clinical determinants of the presence of coronary artery disease in patients with left bundle branch block.

BACKGROUND: Considering clinical parameters as main predictors for coronary artery dis-ease (CAD)in patients with left bundle branch block (LBBB) can be very helpful to explain high likelihood of ischemic events in LBBB conditions. In the present study, we attempted to identify major clinical determinants to predict CAD occurrence in patients with LBBB. METHODS: A retrospective chart review of 229 consecutive patients with the diagnosis of complete LBBB pattern on electrocardiograms was conducted. The final diagnosis of LBBB was based on the Criteria Committee of the New York Heart Association. The participants were also classified based on coronary angiography evidences into two groups including CAD patients (n =99) and non-CAD patients (n =130). RESULTS: Among 99 patients with CAD, 27 (27.3%) had single vessel disease, 30 (30.3%) had two-vessel disease and 42 (42.4%) had three-vessel disease. Also, only two of them had left main lesions. The number of diseased coronary vessels was significantly higher in men than in women so that three vessels disease in men was revealed in 28% and in women was observed in 10.9% (p = 0.002). Using a multivariable logistic regression analysis, male gender (2.445, 95% CI: 1.372-4.367, p = 0.002), advanced age (1.063, 95% CI: 1.032-1.095, p < 0.001), and cigarette smoking (4.112, 95% CI: 1.145-8.635, p = 0.012) were main predictors of CAD in LBBB patients. CONCLUSION: A notable number of patients with LBBB suffered concomitantly from CAD that the presence and severity of this ischemic event could be predicted by male gender, advanced age, and history of smoking in these patients.

Clinical determinants of left ventricular ejection fraction deterioration in patients suffered from complete left bundle branch block.

BACKGROUND: Recently, the deleterious effects of left bundle branch block (LBBB) on left ventricular systolic function have been taken into consideration. OBJECTIVES: The present study aimed to identify underlying factors that predict left ventricular ejection fraction (LVEF) deterioration in patients suffered from complete LBBB. PATIENTS AND METHODS: In a retrospective case-control study, the data of 220 consecutive patients diagnosed with LBBB on their electrocardiograms were assessed. They were referred to Isfahan Heart Center in Isfahan Province, Iran in 2013. LVEF deterioration was defined as a decrease in LVEF at least 10% between the baseline and follow-up echocardiography study. Thus, achieving the LVEF values ≤ 40% in patients with an initial EF of > 50% was considered LVEF deterioration. RESULTS: Among 220 patients, 40% of LBBB patients suffered LVEF deterioration within 3 months of initial assessment. The group with LVEF deterioration had higher male to female ratio, had higher NYHA score, and suffered more from systolic hypertension than another group. Those with coronary artery disease (CAD) had also significantly lower LVEF than non-CAD ones. Adverse associations were revealed between systolic blood pressure and LVEF measurement (r = -0.193, P = 0.006) as well as between NYHA score and LVEF (r = -0.215, P = 0.002). A multivariable logistic regression model showed that among baseline variables, male gender (OR = 3.218, P < 0.001), history of systolic hypertension (OR = 2.012, P = 0.029), higher NYHA score (OR = 1.623, P = 0.005), and the presence of coronary artery disease (OR = 2.475, P = 0.028) could effectively predict LVEF deterioration in patients with LBBB. CONCLUSIONS: Male gender, history of hypertension, high NYHA score, and the presence of CAD predict LVEF deterioration in patients with LBBB.

Metabolic syndrome and its association with left ventricular dysfunction in patients with left bundle branch block.

BACKGROUND: The present study and for the first time hypothesizes that the patients with left bundle branch block (LBBB) suffer considerably from metabolic syndrome (MetS) and this metabolic phenomenon can be associated with cardiac dysfunction status such as ventricular dilation and reduced left ventricular ejection fraction (LVEF) in these patients. METHODS: A retrospective study was conducted on 220 consecutive patients with diagnosed LBBB. MetS status was diagnosed using the Adult Treatment Panel III of the National Cholesterol Education Program criteria. Systolic function state was assessed using two-dimensional echocardiography. RESULTS: The overall prevalence of MetS among studied LBBB patients was 16.8%. Regarding left ventricular functional status in the two groups, the mean LVEF in the groups with and without MetS was 37.03 ± 9.09% and 43.43 ± 15.62% with a significant difference (p = 0.017). However, left ventricular dilation was similarly detected in both groups with and without MetS (21.6% versus 30.6%, p = 0.273). Multivariable linear regression model showed subjects with MetS had lower LVEF in the presence of confounders (Beta = 6.915, p = 0.039). CONCLUSION: A notable number of LBBB patients suffered from MetS and this metabolic phenomenon is significantly associated with lowering left ventricular function in LBBB patients.

Development of a rapid capture-cum-detection method for Escherichia coli O157 from apple juice comprising nano-immunomagnetic separation in tandem with surface enhanced Raman scattering.

A combined capture and detection method comprising of nano-immunomagnetic separation (NIMS) and surface enhanced Raman spectroscopy (SERS) was developed to detect Escherichia coli O157 from liquid media including apple juice. The capture antibodies (cAbs) were immobilized on magnetite-gold (Fe3O4/Au) magnetic nanoparticles (MNPs) which were used for separation and concentration of the E. coli O157 cells from model liquid food matrix. The capture efficiency (CE) for E. coli O157 using MNP was found to be approximately 84-94%. No cross reactivity was observed with background non-target organisms. There was a significant difference in the mean CE of bacteria captured by MNP and commercially sourced immunomagnetic microbeads (p<0.05). For the detection of target pathogen, SERS labels were prepared by conjugating gold nanoparticles with Raman reporter molecules and the detector antibody (dAb). Au-Raman label-dAb was interacted with gold coated MNP-cAb-E. coli O157 complex. The ability of this immunoassay to detect E. coli O157 in apple juice was investigated. We have successfully applied the synthesized Fe3O4/Au nanoclusters to E. coli O157 detection in apple juice using the SERS method. The lowest detectable bacterial cell concentration in apple juice was 10(2)CFU/mL with a total analysis time of less than an hour. This method presents a convenient way of preconcentration, separation, and detection of low levels of target pathogen from liquid food matrix.