Smoking and Hypertension: A Study in Subjects Admitted to Hospital for Cardiovascular Diseases.

Aims: There is a general consensus in considering cigarette smoking as a major risk factor for cardiovascular diseases: a direct causal association between smoking and hypertension however is questioned. The present paper reports a study on the effect of cigarette smoking and of other clinical parameters on hypertension in a sample of subjects admitted to Hospital for Cardiovascular Diseases (CVD). Study Design: Observational study. Place and Duration of Study: Department of Cardiology Valmontone Hospital and Department of Biomedicine and Prevention, University of Rome Tor Vergata, between April 2007- December 2013. Methodology: We have studied 335 subjects admitted to the Hospital for Cardiovascular Diseases. Statistical analyses were in the study that was approved by the Ethical Committee. We have considered hypertension in relation to smoking, diabetes, age and sex. Results: Multivariate statistical analyses have shown a high significant effect of age (P<.001) and diabetes (P<.01) on hypertension and a border line effect of smoke (P=.05). No effect of sex has been detected (P=.47). The proportion of subjects with hypertension is positively correlated with the number of risk factors examined. Conclusion: Our data indicate that an independent effect of smoking on blood pressure is relatively small and suggest an additive effect of the variables considered on the risk of hypertension.

Cerebrovascular Diseases and Associated Risk Factors in WHO Eastern Mediterranean Countries.

Background: In the WHO Eastern Mediterranean region, nearly one million deaths are caused by cardio-vascular diseases every year. During the last decade, the number of deaths caused by stroke increased by 23%. Most cardiovascular diseases can be prevented by addressing behavioural risk factors such as tobacco use, alcohol, unhealthy diet, physical inactivity, and metabolic risk factors like obesity, high blood pressure, diabetes and raised lipids. Methods: This is a systematic review on cerebrovascular diseases and associated risk factors in WHO Eastern Mediterranean countries. Medline, Science Direct, and other sources were used to get peer reviewed papers dealing with the review theme. The search was limited to publications between 1990 and 2013 (30th June). Results and Discussion: According to the inclusion criteria, 45 papers were included in the present review. The prevalence was found greater than 50% in 38 studies for hypertension, greater than 25% in 36 studies for diabetes, greater than 15% in 26 studies for smoking and greater than 25% in 19 studies for dyslipidemia. It was also indicated that incidence of stroke increases with ageing. The majority of studies found a prevalence of stroke higher in men than in women with a ratio male: female reaching 3.55:1 in one study. Conclusion: Although at different levels of importance, all the studies reveal that hypertension, diabetes, dyslipidemia and smoking are crucial risk factors for stroke. This review also indicates a lack or scarcity of studies in many countries with an uneven contribution by country since 33% of studies are from Pakistan whereas North Africa (Egypt, Morocco, Libya, Tunisia) contributed with only 2 papers.

Epidemiological Study of Male Infertility.

Advanced male age has been associated with signicant reductions in pregnancy rates, increased time-to-pregnancy and increased subfecundity.The present study was aimed at analyzing the male factor causing infertility and epidemiological factors in the rural institute situated in the eastern part of Maharashtra. Aims and Objectives: Study the profile of male infertility in this rural area over a period of 20 years and correlate the various factors responsible for male infertility. Materials and Methods: The present study comprised of retrospective as well as prospective analysis of infertility cases over a period of 20 years. Analysis of the records was done for male factors thoroughly in relation to age, duration and type of infertility, age at marriage, addiction. Statistical Evaluation: Statistical analysis was done in EPI-6 software. Chi square test and variance analysis was used for analyzing the data. Observations:The incidence of primary infertility (62.00%) was higher as compared to secondary infertility (38.00%) in all the five blocks.The semen analysis reports revealed that the most affected age group was 31-40 years. The abnormalities of semen were 35.49%, 86.49% and 53.75% in smokers, alcoholics and in cases having more than one addictions respectively. Cases with no addictions were having the maximum of (82.96%) normozoospermic males. Conclusions:The relationship between smoking and alcoholism was evident. Both of these addictions were found to impair the reproductive functions in male.

Pharmacologic bronchodilation response to salbutamol in COPD patients.

Background: Airway hyperresponsiveness (AHR) is the most characteristic feature of asthma, which is reported in COPD patients and smokers. Increased airway responsiveness to ί-agonists is also demonstrated in asthmatics as well as smokers. However, there is no report regarding AHR to ί-agonist drugs in COPD patients. Therefore, in this study pharmacologic bronchodilation response to salbutamol in COPD patients was examined. Materials and Methods: The threshold concentrations of inhaled salbutamol required for a 20% change in forced expiratory flow in 1 sec (FEV 1 ) as PC 20 , or a 35% change in specific airway conductance (sGaw) as PC 35 was measured in 14 COPD patients and 14 normal subjects. Results: Airway responsiveness to salbutamol in COPD patients (PC 20 = 14.14 ± 1.62 and PC 35 = 9.70 ± 1.48 mg/l) was significantly lower than normal subjects (PC 20 = 224.57 ± 16.62 and PC 35 = 81.87 ± 8.16 mg/l, P < 0.001 for both cases). The values of FEV 1 and sGaw in COPD patients (56.43 ± 14.45 and 0.081 ± 0.120 respectively) were significantly lower than those of normal subjects (104.07 ± 5.72 and 0.194 ± 0.041 respectively), (P < 0.001 for FEV 1 and P < 0.005 for sGaw). There was a significant correlation between FEV 1 with PC 20 salbutamol (r = 0.862, P < 0.001). The correlations between PC 20 and PC 35 was also statistically significant (r = 0.862, P < 0.001). Conclusion: These results showed increased airway responsiveness of most COPD patients to salbutamol which was highly correlated to airway caliber.

Water-pipe [narguile] smokers in Lebanon: a pilot study

We carried out a comparative study to assess the demographic and social characteristics of water pipe [WP] smokers, the association with cigarette smoking and chronic respiratory diseases and the dependence profile on 4 groups: exclusive WP smokers, exclusive cigarette smokers, mixed smokers and absolute non-smokers. Cigarette smoking was statistically significantly higher in WP smokers than non-WP smokers; 36.5% of exclusive WP smokers smoked >/= 7 WPs/week. Chronic respiratory disease and chronic bronchitis were reported more frequently in exclusive WP smokers than absolute non-smokers. WP smoking seems to be as great a risk factor as cigarette smoking for chronic respiratory disease

Do smokers benefit from dental hygiene oral prophylaxis? A Nigerian pilot study

Smoking is a major, preventable risk factor for periodontitis. This pilot study in Nigeria evaluated the effect of dental oral prophylaxis on oral hygiene and periodontal indices among 13 systemically healthy smokers and 8 non-smokers. All participants received full-mouth scaling and root planing, tooth polishing, demonstration of correct brushing technique and a new toothbrush and toothpaste. After 6 months, debris index, calculus index, oral hygiene index and community periodontal index of treatment needs status code 0 scores showed no improvement in smokers. There was a 50% improvement of all indices among non-smokers. Smokers showed no benefit from dental oral prophylaxis in this study

pattern of carcinoma of lung as seen in a tertiary care hospital

This cross sectional descriptive study was conducted to assess clinicopathological characteristics of lung cancer in 142 patients, 116 males and 26 females, from various regions of Punjab presenting with clinical features consistent with the diagnosis of lung carcinoma. They were admitted to Gulab Devi Chest Hospital [GDCH], Lahore, Pakistan from January 2005 to January 2007. Our observations revealed that the most prevalent malignancy among these patients was non small cell lung carcinoma including squamous cell carcinoma and adenocarcinoma in males and females respectively. Most common affected age groups were between 41-60 years [n=82] and 51-70 years [n=15] in males and females respectively. Squamous cell carcinoma followed by small cell lung carcinoma were commonly associated with smoking in both genders. Immunohistochemistry was employed for the confirmation of diagnoses in some [n=35] cases. We observed that 4 of 10 [40%] large cell lung carcinomas were strongly positive with HDC. The remaining 06 [60%] large cell lung carcinomas though negative for HDC, were strongly positive with Cyfra 21-1. All small cell lung carcinomas, atypical and typical carcinoids were also strongly reactive to HDC immunostaining. Antimucin antibody was also strongly positive and negative in each 02 of the 04 [50%] poorly differentiated adenocarcinomas where all of them were strongly reactive to Cyfra 21-1. It is concluded that lung cancer is more common in males and is strongly associated with smoking. Hence, interventional measures for prevention and early but correct diagnosis of bronchogenic carcinoma is needed. The role of tumour markers can be very useful in finalizing cases which are difficult to be differentiated

Prevalence of waterpipe smoking among rural pregnant women in Southern Iran

To estimate the prevalence of waterpipe smoking among rural pregnant women in Southern Iran and to identify the impact of maternal waterpipe smoking on baby's birth weight. Subjects and Methods: A population-based survey was conducted in rural areas of Southern Iran in 2004 using existing health records and interviewing all mothers during the 10 days after delivery. Maternal exclusion criteria included cigarette smoking during pregnancy, a history or occurrence of epilepsy, diabetes and hypertension [gestational and/or essential] during pregnancy, factors that have been proved to have detrimental effects on birth weight. Of the 2,808 mothers interviewed, 224 [8%] were waterpipe smokers of which 90 [3.2%] and 134 [4.8%] were occasional [smoking less than once per day] and daily [at least once per day] smokers, respectively. Six hundred and seventy-four [24%] were passively exposed to waterpipe smoke during pregnancy and 322 [11.5%] were exposed to second-hand cigarette smoke. Mothers who started smoking during the first trimester had lower birth weight babies [3,215 +/- 612 g] compared to those who started smoking during the second or third trimesters [3,447 +/- 550 g, p = 0.04]. Waterpipe smoking during pregnancy is prevalent in Southern Iran and appears to be a risk factor for low birth weight babies

Chronic obstructive pulmonary disease in patients with catheter diagnosed coronary artery disease: prevalence and risk factors

Chronic obstructive pulmonary disease [COPD] and coronary artery disease [CAD] co-morbidity exists at different rates. This co-morbidity affects quality of life and increases mortality. In the developing world the prevalence of CAD is increasing but the prevalence of COPD is unknown. This study was designed to estimate the proportion of patients with CAD who have concomitant COPD and identify factors that may increase the likelihood of COPD in CAD patients. A cross sectional study that included consecutive adults with catheter diagnosed CAD recruited from two cardiac centers. Patients completed a COPD diagnosis validated questionnaire and performed spirometry using an electronic spirometer. COPD was diagnosed if patient score placed him/her in the high likelihood zone of having COPD, or if the FEV1 was less than 80% predicted. Results were compared using chi-square test. Fifty nine patients with CAD were studied. The mean age [SD] was 59 [9.7] years. Of these 59 patients; 27 [44%] had COPD diagnosed by either questionnaire or spirometry. COPD was significantly more among patients with single vessel disease compared with multiple vessel disease [p = 0.01]. There was no difference in the number of smokers among patients with CAD and COPD, and CAD alone [p = 0.29]. The prevalence of COPD increased with increasing age [p=0.003]. In this group of patients with CAD more than two in five have concomitant COPD. The prevalence of COPD increases with age and is more in patients with single vessel disease compared with patients who have multiple vessel disease

Incidence of ventricular arrhythmias, brady-arrhythmias and sudden cardiac death in Sudanese patients with acute myocardial infarction

Ventricular arrhythmias [VAS], including ventricular tachycardia [VT], ventricular fibrillation [VF] and Brady-arrhythmias, are life-threatening complications of acute myocardial infarction [MI]. To study the incidence of ventricular arrhythmias, brady-arrhythmias and Sudden Cardiac Death [SCD] in Sudanese patients with acute MI. This is a prospective cross sectional, hospital based study, conducted at Elshaab Teaching Hospital Khartoum Sudan. One Hundred Sudanese patients with acute MI were enrolled in the study in the period between August 2006 and December 2006. A questionnaire was constructed in sections to address the different aspect of the study group. ECG Monitor was used to confirm the complication in every patient. Of the study group forty seven [47%] patients were 55-65 years old, twenty eight [28%] were more than 65 years old and twenty five [25%] were less than 55 years old. Sixty nine [69%] were males. Twenty patients [20%] developed complications [ventricular arrhythmias [VAS], Brady-arrhythmias and SCD]. The incidence of ventricular arrhythmias, brady-arrhythmias and sudden cardiac death following acute myocardial infarction were significantly high in Sudanese patients. The increased incidence is even in all age groups. DM, smoking and past history of IHD are the commonest associated risk factors. Thrombolysis is under used and had no significant impact

Prevalence and predictors of non-fatal myocardial infarction in Jordan

This study in May 2002, part of the Jordan Department of Statistics national crosssectional, multistage employment and unemployment survey, measured the prevalence of selfreported myocardial infarction [MI] and the association with modifiable risk factors among Jordanians aged 40+ years. Of 3083 participants, 183 [5.9%] had ever been told by a doctor that they had had a MI. The prevalence varied by age and sex; 128 [69.9%] of the cases were in men. Among males and females, self-reported hypertension and hypercholesterolaemia were significantly associated with MI and diabetes was a significant risk factor for women. There was a significant relationship between current smoking and MI but not with previous smoking. Exercise and body mass index were not statistically significant predictors of MI in both males and females

Environmental noise in Beirut, smoking and age are combined risk factors for hearing impairment

Effect of smoking and environmental noise on hearing impairment was investigated in 440 people aged 21-50 years living in Beirut. Participants were divided into 4 groups: nonsmokers and smokers living in noisy areas [70-90 dBA] and non-smokers and smokers living in quiet areas [45-55 dBA]. Smoking was associated with hearing loss at 8000 Hz, in both bivariate and multivariate analysis. An additive interaction at high frequencies [mostly at 8000 Hz] between smoking and noise appeared after age 40 years. At age 21-39 years, neither smoking nor environmental noise had a significant adverse effect on hearing capacity at low frequencies

[Analysing the regression of cancer cases in Iraq during the period 1990-2005]

The research aimed to determine the effect of negative factors of the health status in Iraq The simple analysis regression of some cancer cases during the period from 1990 -2005 through the data of cases of cancer [larynx, chest and brain] selected hospitals in Baghdad province [Medical city, Al-yarmook hospital, Al-Karama hospital and Al-khadhmia hospital]. SPSS.10 statistical analysis was employed to get the t-test, F-test, person correlation [r] and R2. The result showed positive correlation [r =0.79] between the factors of the health status and age with the cases of cancer [the larynx and chest] and r =0.78 for brain cancers. There was a significant difference between that factor and age. Also the results showed increase of the cases of cancer in males in comparison with that of the females due to many reasons including smoking and contamination

Smoking cessation programs in Middle Eastern dental schools

This study aimed to explore current policies and practices concerning smoking cessation programs adopted by dental schools across the Middle East and to determine the extent of smoking cessation teaching in dental schools. A survey questionnaire was e-mailed to the deans of twenty-five dental schools that were identified from the Arab Association of Dental Faculties website. The response rate was 80%. Fifty-five percent had written tobacco policies, 85% banned smoking in non-clinical teaching facilities, 90% banned smoking in clinical areas and 55% in public access areas. Fifty-five percent taught students appropriate patient smoking cessation techniques. All schools taught the role of tobacco in oral cancer and periodontal disease aetiology and 75% in osseointegrated implant failure. With respect to barriers limiting the teaching of smoking cessation, 35% had not encountered any obstacles. However, 20% cited social, peer pressure, overloaded curriculum and lack of training and interest. Forty- five percent of respondents stated that there were no planned initiatives to develop smoking cessation techniques within their curricula. It is concluded that Middle Eastern dental schools have identified the role of education in the anti-smoking campaign. However, much still needs to be done on improved approach to policy implementation

relative impact of smoking or Hypertension on severity of premature coronary artery disease

Not much information is available about the effect of smoking and hypertension on the number and severity of vessel involvement and left ventricular ejection fraction [LVEF] at coronary angiography of young patients with coronary artery disease. The present study describes the relative importance and comparative effect of smoking and hypertension on severity of premature coronary artery disease. The study comprised 240 consecutive patients under the age of 45 years, with a diagnosis of acute myocardial infarction [AMI], unstable angina or stable angina, who underwent coronary angiography. Other aspects investigated included evaluation of smoking profile and HTN in each patient, LVEF, the number and type of vessel involvement as well as the severity of stenosis. Of 216 patients, 142 [approximately 60%] were smoker and 74 [31%] were hypertensive. Left anterior descending coronary artery [LAD] involvement was more common in smoker young patients who had more severe stenosis of LAD vessel and lower LVEF than hypertensive young subjects. Higher frequency of right coronary artery [RCA] involvement and more severe stenosis of this vessel were found in hypertensive young individuals compared to smoker young patients. Our study indicated that smoking was more prevalent and also a more important risk factor in coronary artery disease of young adults. Smoker young patients tended to have more LAD involvement, more severe stenosis of this vessel and also lower LVEF, compared to hypertensive young patients

Comparison of clinic visits among children of smoking and non-smoking families

Complications of cigarette smoking are of the major obstacles of a society. Both active and passive smoking cause various forms of diseases in men, women and children. Since almost one third of the world's population are children under 14 years of age, preventing the unwanted health consequences of involuntary smoking can help in improvement of health as well as the health level of the society. In cooperation with the "Iran Statistics Center" and by using PPS method a number of families required for the study were selected among 22 districts of Tehran. After obtaining a consent, a questionnaire was filled out by a physician through interviewing the families randomly. In this study, 214 families were questioned out of which 129 had at least one smoker member in their family [60.2%]. A total number of 825 individuals were studied [including 270 men, 281 women and 274 children under the age of 14], out of which 87 men [32.2%], 42 women [14.9%] and overall 129 subjects [23.4% of the population over the age of 14 and 15.6% of the general population] were smokers. The mean number of visits to the physician by the children of all families was 3.7 +/- 1.8 per year. This number was 2 +/- 0.9 and 4.7 +/- 1.56 in the non-smoking and smoking families respectively [p=0.000]. Mean exhaled CO level of a non-smoker or passive smoker of a smoking family was 20.2 +/- 5.8; whereas this rate was 6.6 +/- 3.5 in a non-smoker member of a non- smoking family [p=0.000]. Comparison of the number of visits does not significantly indicate the disease-inducing role of passive smoking but only that these visits are more in families that smoke

Assessment of factors that contribute of lung cancer

A descriptive study to assess of factors that contributes of lung cancer. The study was carried out in Specialized Surgery teaching hospital, Ibin Al- Beetar hospital and Ibin Al- Nafees hospital for the period From January 2004 to October 2004 .The study aimed to assess the factors that contribute to lung cancer and to identify the relationship between the variables of the study with lung cancer. A purposive [non-probability] sample of [70] patients with lung cancer was selected for the study. An assessment form was employed for the purpose of the study. Test- retest reliability was employed through computation of Pearson correlation coefficient. Content validity of the assessment was determined through a panel of experts. Data were collected through the interview technique. Data were analyzed through descriptive statistical approach [frequency and percentage] and inferential statistical approach [chi -square]. The study showed that the majority of the study sample were [60-69] years old and most of them were male [65.7%] .The level of education was primary graduate [32.9%] and most of them were working in governmental officer. The result of the study showed that smoking is the majors' factors that contribute to lung cancer. The study recommended stopping smoking, established special center to lung cancer in Iraq, regular chest exam to workers in the industry and need specialist nurse in cancer in Iraq

[Effective factors in tendency towards cigarette smoking smoking among Tabrizian high school students]

A large number of youngsters and adolescents smoke in the different countries and they have inappropriate information about the correlation between cigarette smoking and numerous diseases and do not receive appropriate education in this regard. The aim of this study was to determine effective factors in tendency towards cigarette smoking among adolescents in Iran and promoting public health level with providing appropriate education and changing their attitude to cigarette smoking. Totally 1000 students of Tabriz city from different schools were randomly chosen. Data were collected by questionnaire consisting of 11 questions without mentioning the personal characteristics of participants that its reliability validity was confirmed by psychiatrists and social medicine specialists. Data were analyzed by SPSS and Chi square test. The results of this study showed that 16% of students in Azarshahr, Osku, Khosroshahr and 12.6% of students in Tabriz smoke cigarette. The main reason in tendency towards smoking is lack of suitable recreation that included 33% of all cases and other factors were as follows: fun, curiosity, hopelessness and social and family problems. Health behaviors are acquired and also are educable and changeable. One of the best ways in preventing cigarette smoking is to give health education especially to adolescents. They should be educated on how to say no against the pressure of their bad friends