Investigating the prevalence of hypertension and its associated risk factors in a population-based study: Fasa PERSIAN COHORT data.

BACKGROUND: A high prevalence rate of hypertension (HTN) and its subsequent serious complications made this disease a major health-treatment concern in many societies. The current study aimed to investigate the prevalence of hypertension and its associated risk factors in Fasa PERSIAN COHORT in south of Iran in 2019. METHODS: This was an analytical-cross sectional study. The study population were the individuals covered by Fasa cohort. Information of the first phase of Fasa Persian cohort in south of Iran was used in this study. Independent t test, chi-square test, analysis of variances, Pearson correlation coefficient, and multiple stepwise regression were used to analyze the obtained data. Thereafter, the data was analyzed using SPSS software version 22, and P value < 0.05 was considered as statistically significant. RESULTS: Out of 10,111 individuals included in the study, 5546 (54.86%) subjects were women and 4565 (45.16%) other were men. The overall prevalence rate of hypertension was estimated as 46.6%. In the present study, (16/1%) of the participants were with HTN stage 1, and (17/9%) of them were with HTN stage 2. The results show that there were significant positive correlations among HTN and age, BMI, HDL, TG, BUN, ALP, smoking, physical activity, cardiovascular diseases, diabetes, and renal failure (P < 0.5). CONCLUSIONS: Prevalence of HTN in this study population is considerable. Therefore, it is suggested that health system should program some plans to prevent hypertension's prevalence and eliminate its risk factors.

Correlation of resting heart rate with anthropometric factors and serum biomarkers in a population-based study: Fasa PERSIAN cohort study.

BACKGROUND: There is a positive association between raised resting heart rate (RHR), and all causes of mortality and shorter life expectancy. Several serum biomarkers and some anthropometric factors can affect the resting heart rate. This study aimed to investigate the determinants of resting heart rate in a large random sample of the Iranian population. MATERIAL AND METHODS: It is a standardized, retrospective study and the subjects were chosen from the baseline survey of the Prospective Epidemiological Research Study in IrAN (PERSIAN) Fasa non-communicable disease cohort study. It was conducted from winter 2014 to summer 2019 and after obtaining informed consent from a random sample, all the eligible subjects were enrolled. All anthropometric factors and biologic laboratory factors were collected and analyzed by implement smoothly clipped absolute deviation (SCAD) linear regression and SCAD quantile regression. The comparisons between males and females were done via independent T-test. RESULTS & CONCLUSION: A total number of 9975 persons from 35 to 90 years old were included. The overall median resting heart rate was 74 (interquartile range:66-80). Mean age has no important difference between males and females (P = 0.79) but, resting heart rate was significantly higher in females (76.6 versus 71.4, P < 0.001). All anthropometric factors except wrist circumference were higher in females (P < 0.05). Age has an adverse effect on resting heart rate and also, there was a direct association between resting heart rate and systolic blood pressure and blood glucose. Alpha-blockers (coefficient = 5.2) and Beta1-blockers (coefficient = - 2.2) were the most effective drugs with positive and negative effects on resting heart rate respectively. Lower hemoglobin, obesity, and more body mass index, and more low-density lipoprotein were associated with more resting heart rate. Continuing the monitoring of this sample via our cohort study and put to action multinational prospective researches with large sample sizes and long follow-ups can lead to more precise results and better scientific judgments.

A Traditional Mouthwash (Punica granatum var pleniflora) for Controlling Gingivitis of Diabetic Patients: A Double-Blind Randomized Controlled Clinical Trial.

This study evaluates the safety and efficacy of Punica granatum var pleniflora mouthwash in treatment of diabetic gingivitis. In a double-blind randomized clinical trial 80 patients with diabetes mellitus and gingivitis were assigned to Golnaar and chlorhexidine 0.2% groups. After using mouthwashes for 2 weeks; participants underwent tooth scaling and the last visit was 2 weeks after scaling. The primary outcome measures were plaque, modified gingival and gingival bleeding indices, and pocket depth. Both interventions had significant improvement on all of the gingival and plaque indices (P < .001 for all indices). There were no significant differences between Golnaar and chlorhexidine in primary outcome measures except for modified gingival index for which Golnaar mouthwash had a superiority after 2 weeks when comparing with chlorhexidine (P = .039). Meanwhile, Golnaar mouthwash had no staining effect. Golnaar mouthwash is safe and effective in treatment of gingivitis in diabetic patients although further studies are recommended.

Gingivitis from the Viewpoint of Traditional Persian Medicine.

BACKGROUND: Gingivitis is among the top general health problems in the world, especially in developing countries. Meanwhile, it may be associated with pulmonary and cardiovascular diseases. In a qualitative study, we tried to identify the corresponding terminology to gingivitis in traditional Persian medicine (TPM) and to explain its potential mechanisms, treatments, and prevention characteristics. METHODS: In a literature review, 4 modern textbooks and 18 related articles, 2 traditional medical dictionaries and 12 traditional medical and 4 traditional pharmaceutical texts were assessed by a specific method. Initially, traditional scripts were searched for signs and symptoms of gingivitis as well as related keywords such as bleeding, swollen and loosen gum, oral or gingival ulcers, teeth, or gingival pain. Then the disease/s or disorder/s, which matched gingivitis in TPM, was appraised in details. Finally, potential mechanisms, prevention and therapeutic protocols presented by TPM were collated and summarized. RESULTS: "Lasse-e-Dâmiyeh" (bleeding gum) or "Khoon-Reezi az Goosht-e Bon-e Dandân" (bleeding from under teeth flesh) was the main disease comparable to gingivitis. Based on TPM, the leading etiologies are insufficient gum feeding mechanism, pouring and gathering of excessive fluid in the gum and accumulation of excessive blood in it or in the whole body. Although there were remarkable similarities in the subjects of different TPM texts over the centuries, particularly in oral and teeth hygiene and overall approach to gingivitis, we faced notable differences in recipes (herbal drugs) that each text proposed. CONCLUSION: While there are overlapping terminologies to gingivitis in TPM, "Lasse-e-Dâmiyeh" is the closest disease that relates to it. Meanwhile, adjusting diet and lifestyle, having appropriate oral hygiene, obtaining a vast variety of herbal medications, cupping, phlebotomy, leech therapy, etc. are the different TPM modalities for the prevention and treatment of gingivitis that can be considered as therapeutic and/or research issues.

Anxiety-depressive disorders among irritable bowel syndrome patients in Guilan, Iran.

BACKGROUND: Psychiatric disorders are common in irritable bowel syndrome (IBS) patients. The prevalence of psychiatric disorders in IBS patients varies in different cultures. We conducted this study to determine the prevalence of psychiatric disorders METHODS: In a cross-sectional study, 256 IBS patients were selected (using the criteria of Rome III) and evaluated for psychiatric disorders. In the first phase, subjects were screened using the General Health Questionnaire 28 (GHQ28). In the second phase, those who had scores ≥ 23 were assessed through semi-structured psychiatric interviews. RESULTS: Thirty out of 256 subjects had no significant psychiatric symptoms after performing GHQ28. In further psychiatric evaluation of the remaining subjects (226) who suffered from some degree of a psychiatric problem, 36 were diagnosed without Anxiety/Depressive disorder. Thus 66 subjects (25.8%) were known as a group without any significant psychiatric problem. A total of 190 subjects (74.2%) with anxiety-depressive problems were diagnosed; 89 were suffering from pure anxiety disorders, 41 were suffering from depressive disorders and 60 had co-morbid anxiety-depressive disorders. When comparing anxiety-depressive patients (n = 190) with normal subjects (n = 66), gender (P = 0.016), occupation (P = 0.002) and intensity of IBS (P < 0.001) showed statistically significant differences. CONCLUSION: The high prevalence of anxiety-depressive disorders in this study indicates the necessity of psychiatric assessment, early diagnosis and treatment of the patients with IBS. It may improve management of the patients suffering from IBS.

A 10-year study of esophageal cancer in Guilan province, Iran: the Guilan Cancer Registry Study (GCRS).

BACKGROUND: Northern Iran counts as one of the highest prevalence regions for esophageal cancer (EC) worldwide. This study was designed to assess the epidemiologic aspects of EC in north central and northwest Iran over a 10 year period. MATERIALS AND METHODS: The Guilan cancer registry study (GCRS) is a population- based cancer registry study featuring retrospective (1996-2003) and prospective (2004-2005) phases. A detailed questionnaire based on WHO standards for cancer registratration was applied to gather the required information. Two trained physicians coded information using ICD-O-3 in close coordination with an expert pathologist. RESULTS: A total of 19,936 cases of malignancy (mean age 55.4±18.0 years, range: 1-98 years) were registered, including 1,147 cases (670 males, 447 female; mean age: 64.0±11.5 years) of EC. In 1996 the male/female ratio among patients with EC was 1.25 which increased to 1.53 in 2005. The lower third of the esophagus still remained the most common site of tumors. The average age-standardized rate (ASR) was 6.9 and 4.1 per 105 men and women, respectively. In 1996, the ASRs were 7.2 and 5.2 per 105 men and women which decreased to 6.9 and 4.1 per 105 in 2004-2005. Squamous cell carcinoma (SCC) was the most prevalent histological subtype of EC accounting over 80% of cases. CONCLUSIONS: However the prevalence of adenocarcinoma (ADC) showed an increase to 18.4%. Guilan province may be considered a relatively low incidence region for EC.

Unexplained infertility as primary presentation of celiac disease, a case report and literature review.

BACKGROUND: Celiac sprue (gluten sensitive enteropathy) is an autoimmune disease which is hereditary and its pathology mainly bases on immunologic intolerance to gluten. It has a vast variety of signs and symptoms and its clinical features range from a silent disease to a typical gastrointestinal disorder. In this study we reviewed and summarized some other related issues about this disease and its relation with infertility. CASE: The case is a 26 years old lady who had referred to a gynecologist because of infertility for 2 years and later it revealed that she has celiac sprue. CONCLUSION: Screening for its silent or subtle types especially among suspicious cases such as unexplained infertility seems to be a cost effective action. Meanwhile, in time administration of a gluten-free diet can lead to an almost complete cure.

Huge simultaneous trichobezoars causing gastric and small-bowel obstruction.

Bezoars are concretions of foreign materials that impair gastrointestinal motility or cause intestinal obstruction in the stomach, small intestine or bowel of humans or animals. There are many types of them such as phyto, lacto and trichobezoars. Although bezoars are not rare, multiple giant bezoars which totally fill the stomach lumen and have extension to the small intestine (Rapunzel syndrome) are very rare. This is a case report of a young girl who had a history of trichophagia and presented with partial gastric and intestinal obstructive signs. The patient was healthy, and her physical exam was almost normal and the only positive thing in her past medical history was trichophagia from several years ago. She had a big trapped bobble in her stomach and several air-fluid levels in abdominal radiograph and was investigated with endoscopy which confirmed the diagnosis of a huge gastric trichobezoar.

Astigmatic Outcomes of Temporal versus Nasal Clear Corneal Phacoemulsification.

PURPOSE: To compare the astigmatic outcomes of phacoemulsification cataract surgery using temporal versus nasal clear corneal incisions. METHODS: In a clinical trial, consecutive patients with senile cataracts underwent phacoemulsification and implantation of a hydrophobic acrylic foldable intraocular lens through a horizontal clear corneal incision (temporal in right and nasal in left eyes). Outcome measures included keratometric astigmatism and surgically induced astigmatism (SIA) calculated by the vector analysis method using the Holladay-Cravy- Koch formula. RESULTS: The nasal and temporal groups consisted of 20 eyes each. Mean preoperative keratometric astigmatism was 0.63±0.48 D and 0.38±0.39 D in the temporal and nasal incision groups respectively (P=0.09). Data on 10 eyes in each study group was available for the six-month analysis. Mean keratometric astigmatism was as follows in the temporal and nasal groups respectively: 0.85±0.47 D versus 1.95±0.45 D at 1 week (P<0.001), 0.73±0.46 D versus 1.79±0.55 D at 4 weeks (P<0.001), and 0.63±0.30 D versus 1.05±0.56 D at 6 months (P=0.053) after surgery. SIA at the same follow-up intervals was 0.71±0.20 D versus 1.80±0.22 D (P<0.001), 0.63±0.20 D versus 1.65±0.31 D (P<0.001) and 0.26±0.46 D versus 0.92±0.36 D (P=0.002) in the temporal versus nasal incision groups respectively. CONCLUSION: Temporal clear corneal phacoemulsification induces significantly less astigmatism as compared to similar surgery using the nasal approach.

Peripapillary retinal nerve fiber layer thickness measurement by three-dimensional optical coherence tomography in a normal population.

PURPOSE: To determine peripapillary retinal nerve fiber layer (RNFL) thickness values by three-dimensional optical coherence tomography (3D-OCT) in a normal Iranian population and to evaluate the concordance of these measurements with those obtained by the second generation of optical coherence tomography (OCT II). METHODS: In a cross-sectional observational study, 96 normal Iranian subjects 20-53 years old were enrolled. Peripapillary RNFL thickness in one randomly selected eye of each subject was measured by 3D-OCT and also by OCT II. Standard achromatic perimetry, corneal pachymetry and A-scan ultrasonographic biometry were also performed. Other study variables included age, gender, laterality (right versus left eye), refractive error, corneal diameter and disc area. RESULTS: Mean peripapillary RNFL thickness measured by 3D-OCT (75.50±8.38) µm was significantly less than that measured by OCT II (144.10±33.32 µm) (P<0.001). Using 3DOCT, no significant difference in peripapillary RNFL thickness was observed by gender (P=0.90) or laterality (P=0.17); RNFL thickness had no correlation with age (P=0.95), axial length (P=0.32), spherical equivalent refractive error (P=0.21), central corneal thickness (P=0.66) and disc area (P=0.31). However, a positive correlation was found between peripapillary RNFL thickness and corneal diameter (P=0.03). CONCLUSION: 3D-OCT seems to yield lower RNFL thickness values as compared to OCT II. It seems advisable to obtain separate baseline measurements when using different generations of OCT machines.