Ranking Factors Affecting the Attraction of Foreign Medical Tourists in Hospitals Affiliated to Mashhad University of Medical Sciences Based on Marketing Mix Model.

BACKGROUND: This study was designed to rank factors affecting attraction of foreign medical tourists based on marketing mix model. METHODS: In this descriptive study, data were collected through a questionnaire. Foreign patients, hospitalized from Jan 2015 to Sep 2016 in all hospitals of Mashhad were chosen as the study population (13 hospitals). Data analysis was conducted using Friedman test and Wilcoxon test in SPSS 21 at a significance level of 0. 05. RESULTS: Factors of staff, service and process gained the highest score from the perspective of patients; while price, facilities and promotion scored the lowest among parameters affecting the attraction of medical tourists to hospitals of Mashhad. In this context, factors of staff (96%) and price (66%) had the highest and lowest effect on absorption of tourists, respectively. CONCLUSION: To promote medical tourism, important factors such as staff, service, and process should be further stressed and variables of price, facilities and promotion demand for a revision by the authorities in this industry.

Glucokinase gene promoter -30G>A polymorphism: a cross-sectional association study with obesity, diabetes Mellitus, hyperlipidemia, hypertension and metabolic syndrome in an Iranian hospital / Polimorfismo -30G

OBJECTIVE: A -30G>A single nucleotide polymorphism in the promoter region of the glucokinase gene has been previously associated with obesity, insulin resistance and diabetes. The present study aimed to evaluate the association of this polymorphism with obesity and its comorbidities in a population from Northeast Iran. METHODS: Five hundred and forty-two subjects aged 18 to 65 years were included in the study and divided into normal (BMI<25, n=220), overweight (2530, n=187) groups. All subjects were genotyped for the -30G>A polymorphism using the polymerase chain reaction-restriction fragment length polymorphism technique. RESULTS: The genotypes and allele frequencies of the three groups did not differ significantly (p>0.05). When the study population was categorized according to diabetes mellitus, hyperlipidemia, hypertension and metabolic syndrome status, no significant difference in -30G>A genotypes and alleles was found between the subgroups with and without these disorders (p>0.05), apart from a significantly higher frequency of the G allele in the hyperlipidemic vs. non-hyperlipidemic subgroup (p<0.05). CONCLUSION: The findings of the present study do not support an association between the -30G>A polymorphism and high body mass index in the Iranian population.

OBJETIVO: O polimorfismo de nucleotídeo único -30G>A, na região promotora do gene da glucoquinase, já foi associado à obesidade, resistência insulínica e diabete. O objetivo deste estudo foi avaliar a associação deste polimorfismo com a obesidade e suas comorbidades em uma população do nordeste iraniano. MÉTODOS: Quinhentos e quarenta e dois indivíduos com idades entre 18 e 65 anos foram divididos em três grupos: normal (BMI<25, n=220), sobrepeso (2530, n=187). Todos os indivíduos foram genotipados para o polimorfismo -30G>A através da técnica da reação em cadeia da polimerase - polimorfismo do comprimento do fragmento de restrição. RESULTADOS: As frequências dos genótipos e alelos dos 3 grupos não diferiram entre si (p>0,05). Quando a população de estudo foi categorizada de acordo com a presença de diabete, hiperlipidemia, hipertensão arterial e síndrome metabólica, os genótipos e alelos -30G>A dos subgrupos com e sem essas doenças não diferiram entre si (p>0,05), exceto por uma frequência maior do alelo G no grupo de hiperlipidêmicos quando comparados aos não hiperlipidêmicos (p<0,05). CONCLUSÃO: Os achados do presente estudo não confirmam uma associação entre o polimorfismo -30G>A e excesso de peso na população iraniana.

Safety evaluation of saffron (Crocus sativus) tablets in healthy volunteers.

Saffron (Crocus sativus) stigma tablets were evaluated for short-term safety and tolerability in healthy adult volunteers. The study was a double-blind, placebo-controlled design consisting of a 1 week treatment of saffron tablets. Volunteers were divided into 3 groups of 10 each (5 males and 5 females). Group I received placebo; groups 2 and 3 received 200 and 400mg saffron tablets, respectively, for 7 days. General measures of health were recorded during the study such as hematological, biochemical and electrocardiographic parameters done in pre- and post-treatment periods. Clinical examination showed no gross changes in all volunteers after intervention. Saffron with higher dose (400mg) decreased standing systolic blood pressure and mean arterial pressures significantly. Saffron decreased slightly some hematological parameters such as red blood cells, hemoglobin, hematocrit and platelets. Saffron increased sodium, blood urea nitrogen and creatinine. This study showed that saffron tablets may change some hematological and biochemical parameters. However, these alterations were in normal ranges and they were not important clinically.

Antibody titres to heat shock protein 27 are elevated in patients with acute coronary syndrome.

IgG antibody titres to heat shock protein 27 (anti-Hsp27) were measured to determine whether these titres were affected in patients admitted with acute coronary syndrome. Blood samples were taken from 94 patients admitted with acute coronary syndrome. Anti-Hsp27 IgG titres were determined using an in-house enzyme-linked immunosorbent assay (ELISA) in the first and second 12 h after the onset of symptoms and compared with values for 81 age- and sex-matched control subjects. Median antibody titres to Hsp27 in the first sample from patients whose diagnosis was a myocardial infarction (n = 42) was 0.41 absorbancy units (range 0.28-0.57) and for those with unstable angina (n = 52) was 0.31 (range 0.20-0.42), both being significantly higher than for controls (n = 81), which was 0.08 (range 0.05-0.15) (P < 0.05). However, titres fell in the second samples collected in the coronary syndrome patients and were then no longer significantly different from controls (P > 0.05). Myocardial infarction patients also had significantly higher anti-Hsp27 titres in the first 12 h than patients with unstable angina (P < 0.05), but again the difference in the second sample did not reach statistical significance (P > 0.05). Serum antibody titres to Hsp27 rise and fall rapidly after the onset of acute coronary syndrome, and may be an early marker of myocardial ischaemia as patients with myocardial infarction or unstable angina both had high titres.

C-reactive protein associated with coronary artery disease in Iranian patients with angiographically defined coronary artery disease.

INTRODUCTION: Several cross-sectional and cohort studies have reported an association between serum markers of inflammation such as C-reactive protein, and coronary heart disease in Caucasian populations. We aimed to investigate the relationship between levels of serum C-reactive protein (hs-CRP) and the presence of coronary artery disease (CAD) in Iranian patients undergoing coronary angiography. METHODS: Serum hs-CRP, fasting lipid profile and blood glucose levels were measured in 110 patients (61 males and 49 females) undergoing routine coronary angiography. Anthropometric features including blood pressure were determined using standard procedures. Demographic characteristics, including post-menopausal status and smoking habit were assessed by questionnaire. RESULTS: Of the 110 subjects undergoing angiography, 74 (67.28%) had significant CAD (CAD+) and 36 (32.72%) were classified as having insignificant CAD (CAD-). Mean age (p<0.01), waist circumference (p<0.01) and LDL (p<0.05) and median values of hs-CRP (p<0.01) and triglycerides (p<0.05) were higher in the patients CAD+ than in the subjects CAD-. The proportion of women who were postmenopausal was also significantly higher in the CAD+ group. Age (p<0.01), waist circumference (p<0.05) and hs-CRP (p<0.05) were significant CAD predictive factors from logistic regression analysis. Serum hs-CRP concentrations were significantly higher in smokers compared to non-smokers (p<0.05), low density lipoprotein (LDL) (r=0.31, p<0.001), and serum triglycerides (r=0.191, p<0.05) correlated with serum hs-CRP. The median value of serum hs-CRP increased with the severity of the disease, but failed to reach statistical significance. CONCLUSION: Serum hs-CRP is an independent predictor of angiographically defined CAD in an Iranian population. Measurement of the serum hs-CRP level may improve risk stratification among patients suspected of having CAD. The strong correlations between serum hs-CRP with LDL and smoking may be due to the putative pro-inflammatory effects of these two parameters. The association with serum triglycerides may be indirect and related to insulin resistance and adiposity.

Serum copper and zinc concentrations are lower in Iranian patients with angiographically defined coronary artery disease than in subjects with a normal angiogram.

BACKGROUND: An imbalance between zinc and copper metabolism has been reported to predispose to coronary artery disease (CAD) in Western populations, but there are little data for other racial groups. We have therefore investigated the association between serum copper and zinc, and CAD in Iranian subjects undergoing coronary angiography. METHODS: Serum copper, zinc, fasting lipid profile, and blood glucose levels were measured in 114 patients (67 male and 47 female) undergoing routine coronary angiogram. Anthropometric features including blood pressure were determined using standard procedures. Demographic characteristics, including menopausal status and smoking habit, were assessed by questionnaire. RESULTS: Male patients had lower serum copper (p<0.05), lower serum zinc (p<0.05), and higher serum zinc/copper ratio (p<0.05) than females. Serum copper and zinc concentrations were significantly lower in the subjects with angiographically defined CAD than those patients with a normal angiogram, although the zinc/copper ratio was higher in these patients (p<0.001). Serum copper (r=-0.303, p<0.001) and zinc (r=-0.250, p<0.01) concentrations were both inversely related to age, and copper was positively associated with fasting serum triglycerides (r=0.188, p<0.05). CONCLUSION: Serum copper and zinc concentrations were significantly lower in Iranian patients with abnormal versus those with a normal angiogram. However, the zinc/copper ratio was higher in patients with CAD compared to subjects without CAD. Serum zinc and copper concentrations appear to be influenced by several physiological factors including age and gender.