Assessment of retinal nerve fiber layer thickness in migraine patients measured with optical coherence tomography

Background: Headache is one of the most disturbing symptoms with common neurological signs. Variations in optic nerve perfusion quality or retinal microcirculation may end up in peripapillary retinal nerve fiber layer (RNFL) thickness in patients with migraine. The aim of this study was to investigate the retinal nerve fiber layer (RNFL) thickness in patients with migraine.Methods: This cross-sectional study was conducted by including thirty patients diagnosed with migraine and thirty normal individuals. Patients were evaluated in groups including migraine with and without aura and controls. Retinal nerve fiber layer (RNFL) thickness was measured using stratus optical coherence tomography (OCT) and then was compared in case and control groups. All data were analyzed using SPSS software version 16.Results: RNFL thickness was significantly thinner in migraine patients compared to the control group. Symmetricity of RNFL showed significantly reduction in patients with migraine compared to standard value (95% vs 68%). Comparison of NRR area between patients and standard value showed significantly reduced values (P=0.0001). Mean value of optic disc area showed significantly reduced value compared to standard value about 2.35 m2 (P=0.0001).Conclusions: This study suggests that migraine leads to a reduction in the peripapillary RNFL thickness and to thinning in choroidal structures. These findings can be explained by a chronic ischemic insult related to migraine pathogenic mechanisms.

Prevalence, awareness, treatment, control, and risk factors of hypertension among adults: a cross-sectional study in Iran / 한국역학회지

OBJECTIVES@#Hypertension (HTN) is an important risk factor for cardiovascular disease. Considering the importance of this disease for public health, this study was designed in order to determine the prevalence, awareness, treatment, control, and risk factors of HTN in the Iranian adult population.@*METHODS@#This cross-sectional study was conducted among 2,107 residents of Isfahan, Iran. Samples were selected through multi-stage random cluster sampling in 2015-2016. The outcome variable was HTN, determined by measuring blood pressure in the right arm via a digital arm blood pressure monitor. Awareness, treatment, and control of HTN were assessed by a validated and reliable researcher-developed questionnaire. Other demographic and clinical variables were assessed via a demographic questionnaire.@*RESULTS@#The overall prevalence of HTN was 17.3% (18.9 and 15.5% in men and women, respectively). The prevalence of HTN increased in both genders with age. The prevalence of awareness of HTN among people with HTN was 69.2%, of whom 92.4 and 59.9% were taking medication for HTN and had controlled HTN, respectively. Logistic regression identified age, body mass index, having diabetes and hyperlipidemia, and a positive family history of HTN as determinants of awareness of HTN.@*CONCLUSIONS@#The results showed that HTN was highly prevalent in the community, especially in men and in middle-aged and older adults. Approximately 30.8% of patients were unaware of their disease, and there was less awareness among younger adults. Despite the high frequency of taking medication to treat HTN, it was uncontrolled in more than 40.1% of patients. Health policy-makers should therefore consider appropriate preventive and therapeutic strategies for these high-risk groups.

Prevalence, awareness, treatment, control, and risk factors of hypertension among adults: a cross-sectional study in Iran / 한국역학회지

OBJECTIVES: Hypertension (HTN) is an important risk factor for cardiovascular disease. Considering the importance of this disease for public health, this study was designed in order to determine the prevalence, awareness, treatment, control, and risk factors of HTN in the Iranian adult population. METHODS: This cross-sectional study was conducted among 2,107 residents of Isfahan, Iran. Samples were selected through multi-stage random cluster sampling in 2015-2016. The outcome variable was HTN, determined by measuring blood pressure in the right arm via a digital arm blood pressure monitor. Awareness, treatment, and control of HTN were assessed by a validated and reliable researcher-developed questionnaire. Other demographic and clinical variables were assessed via a demographic questionnaire. RESULTS: The overall prevalence of HTN was 17.3% (18.9 and 15.5% in men and women, respectively). The prevalence of HTN increased in both genders with age. The prevalence of awareness of HTN among people with HTN was 69.2%, of whom 92.4 and 59.9% were taking medication for HTN and had controlled HTN, respectively. Logistic regression identified age, body mass index, having diabetes and hyperlipidemia, and a positive family history of HTN as determinants of awareness of HTN. CONCLUSIONS: The results showed that HTN was highly prevalent in the community, especially in men and in middle-aged and older adults. Approximately 30.8% of patients were unaware of their disease, and there was less awareness among younger adults. Despite the high frequency of taking medication to treat HTN, it was uncontrolled in more than 40.1% of patients. Health policy-makers should therefore consider appropriate preventive and therapeutic strategies for these high-risk groups.

Prevalence, awareness, treatment, control, and risk factors of hypertension among adults: a cross-sectional study in Iran / 한국역학회지

OBJECTIVES: Hypertension (HTN) is an important risk factor for cardiovascular disease. Considering the importance of this disease for public health, this study was designed in order to determine the prevalence, awareness, treatment, control, and risk factors of HTN in the Iranian adult population.METHODS: This cross-sectional study was conducted among 2,107 residents of Isfahan, Iran. Samples were selected through multi-stage random cluster sampling in 2015-2016. The outcome variable was HTN, determined by measuring blood pressure in the right arm via a digital arm blood pressure monitor. Awareness, treatment, and control of HTN were assessed by a validated and reliable researcher-developed questionnaire. Other demographic and clinical variables were assessed via a demographic questionnaire.RESULTS: The overall prevalence of HTN was 17.3% (18.9 and 15.5% in men and women, respectively). The prevalence of HTN increased in both genders with age. The prevalence of awareness of HTN among people with HTN was 69.2%, of whom 92.4 and 59.9% were taking medication for HTN and had controlled HTN, respectively. Logistic regression identified age, body mass index, having diabetes and hyperlipidemia, and a positive family history of HTN as determinants of awareness of HTN.CONCLUSIONS: The results showed that HTN was highly prevalent in the community, especially in men and in middle-aged and older adults. Approximately 30.8% of patients were unaware of their disease, and there was less awareness among younger adults. Despite the high frequency of taking medication to treat HTN, it was uncontrolled in more than 40.1% of patients. Health policy-makers should therefore consider appropriate preventive and therapeutic strategies for these high-risk groups.

Detection of Abnormal behaviors in patients with dementia and preliminary symptoms in smart home

Introduction: The number of elderly people who need help in their daily routines is increasing rapidly. Dementia is one of the most important causes of disability in elderly people and its outbreak has been a major burden on human societies. The purpose of this research was using intelligent home technology to monitor elderly behaviors, identify abnormal behaviors, and discover the initial signs of dementia before the onset of the disease. Early diagnosis of dementia at an early stage can lead to a high improvement in its treatment and delay the disease

Method: In this applied, descriptive-analytic study, the abnormal behavior and early symptoms of dementia were identified using machine learning techniques.The kmedoide algorithm was used to analyze abnormal behaviors and to assess the quality of sleep as the primary symptoms of dementia, the valid PSQI questionnaire was used. Matlab 2012 was used for implementation

Results: The results in the abnormal behavioral section indicated that clustering algorithms have high efficacy in detecting abnormal behavior in smart home, and also results in early symptom examinations led to poor sleep recognition in the PSQI as a primary symptom of dementia

Conclusion: The behavior of the elderly, their abnormal behavior and early signs of diseases such as dementia can be recognized using the technology of the system under the supervision of the smart home

Effects of a lifestyle modification program on knowledge, attitude and practice of hypertensive patients with angioplasty: a randomized controlled clinical trial

Background: lack of knowledge, attitude and practice are some of the barriers of having a healthy lifestyle and controlling high blood pressure. This study aimed to determine the effectiveness of a lifestyle modification program on knowledge, attitude and practice of hypertensive patients with angioplasty

Methods: this study was a randomized controlled clinical trial conducted from November to April 2014 on 60 hypertensive patients with angioplasty in Shahid Chamran hospital of Isfahan, Iran. The samples were randomly assigned to two equal groups. Data collection was performed in three stages by a researcher-made questionnaire. The intervention plan was 6 education sessions and then follow up were done by phone call. The gathered data were analyzed via SPSS [V.20], using t-test, Chi-square, repeated measurement, and post hoc LSD test and ANOVA statistics

Results: the mean score of knowledge, attitude and practice in the experimental group immediately after the intervention was 77.8+/-7.2, 88.3+/-6.4 and 86.2+/-6.5, respectively and one month after the intervention was 80.8+/-7.4, 91.1+/-3.5 and 92.5+/-2.2, respectively. But in the control group, the mean score of knowledge, attitude and practice immediately after the intervention [34.90+/-11.23, 61.11+/-6.28, and 38.64+/-7.15] and one month after the intervention was [38.64+/-7.15, 59.56+/-6.31 and 37.27+/-7.26

Conclusion: lifestyle modification program can be effective in promoting the knowledge, attitude and practice of hypertensive patients with angioplasty. Nurses can use this program in their care provision programs for these patients

T helper 2 cytokine analysis of bronchoalveolar lavage in the murine model of allergic broncho pulmonary aspergillosis

Background and Aims: aspergillus fumigatus is a sporadic fungus that causes different infections and allergies in immunocompromised patients. The allergic disease caused by this fungus is called allergic bronchopulmonary aspergillosis [ABPA]. ABPA is considered important in atopic and immunocompromised individuals, which can result in inflammation and epithelial damage. Therefore, the aim of this study was to evaluate the T helper [Th] 2 responses in a ABPA murine model by measuring the main cytokines involved in Th2

Materials and Methods: twenty male BALB/c mice were divided into two groups of 10 mice each: control and ABPA group. ABPA was induced by inhalation of A. fumigatus conidia intranasally. Total and specific IgE were measured in the mice sera. Levels of cytokines in broncho alveolar lavage [BAL] of under studied groups were measured by Enzyme-linked immunosorbent assay three weeks after the treatment

Results: the obtained results indicated that total and specific IgE increased in the ABPA group [p<0.05]. The levels of Interleukin [IL]-4, IL-5 and IL-13 in brocho alveolar lavage of ABPA group was significantly higher than the control group [p<0.05], whereas interferon-gamma levels did not reveal any significant differences between the studied groups

Conclusions: the findings of the present study confirmed the role of Th2 cytokines in the ABPA reactions. However, more comprehensive studies are necessitated to determine the exact mechanisms of immune responses to ABPA as well as the role of Th1/Th2 responses in control of ABPA reactions. Regulation of Th2 responses could nbe regarded as a potential therapy for ABPA as well

Feasibility study of anti-neurofilament antibodies detection by indirect quenching fluoroimmunoassay

Neurofilaments [NFs] are the main constitutes of intermediate filaments in neurons. They are composed of three subunits with heavey, medium and low molecular weight. Anti-neurofilament antibodies exist in serum of patients with some neurodegenerative diseases. A fluoroimmunoassay has been developed for determining of antibodies against neurofilaments, using an anti-fluorescein serum and fluorescein-labeled NFs. Antibodies raised against bovine spinal cord NFs in rabbit and the labeled NFs are incubated with anti-fluorescein serum at room temperature. At high levels, binding of anti-neurofilaments [anti-NFs] to labeled NFs prevented subsequent binding of the anti-fluorescein to fluorescein groups, resulting in little change in the signals of the label. Conversely, at low level of anti-NFs the free fraction of the labeled NFs is available to be bound by anti-fluorescein, which markedly reduced fluorescence intensity of label. Thus, the fluorescence intensity of assay mixture directly reflects the amount of anti-NFs antibodies in the serum. It is concluded that the availability of fluorescein-labeled NFs and antibody directed against fluorescein group permit measurement of anti-NFs antibodies in serum of neurodegenerative patients

Is the association between salt intake and blood pressure mediated by body mass index and central adiposity?

Objective: to assess the amount of salt intake among normotensive [NT] and prehypertensive [PHT] subjects and to determine whether the association between salt intake and blood pressure is correlated with body weight and waist circumference [WC] or is independent

Methods: a total of 806 NT and PHT subjects from Isfahan Healthy Heart Program [IHHP] were enrolled in the study. A standard questionnaire was used to assess sociodemographic characteristics. The amount of salt intake was measured by the 24-hour urine collection method. Blood pressure, height, weight, and WC were measured based on standard protocols

Results: the mean ages [+/- SD] of NT and PHT subjects were 35.9 [+/- 11.9] and 44.7 [+/- 12.5] years, respectively [P < 0.001]. The mean values of body mass index [BMI] and WC were greater among PHT than NT subjects [BMI: 27.9 +/- 3.8 vs. 25.1 +/- 4.3 kg/m2; P < 0.001 and WC: 90.2 +/- 8.6 vs. 81.2 +/- 11.2 cm; P < 0.001, respectively]. PHT subjects had higher amount of salt intake than NT ones [10.3 +/- 6.2 vs. 12.7 +/- 7.1 g/d, respectively; P = 0.003]. Odds ratio [OR] for being PHT increased significantly across the tertils of salt intake in crude model and sociodemographic- adjusted model. Further adjustment for BMI and WC values weakened the OR for being PHT and showed nonsignificant trend [OR [and 95% CI] for BMI across tertiles of salt intake: 1, 1.26 [0.59 – 2.69], 1.89 [0.93 – 3.81]; P = 0.063 and OR [and 95% CI] for WC across tertiles of salt intake: 1, 1.22 [0.58 – 2.57], 1.79[0.89 – 3.56]; P = 0.082]

Conclusion: the findings of this study suggest that the association between salt intake and blood pressure is related to body weight and WC

Body mass index or microalbuminuria, which one is more important for the prediction and prevention of diastolic dysfunction in non diabetic hypertensive patients?

Numerous studies have now demonstrated that heart failure with a normal ejection fraction [HFnlEF] is common. Hypertension is also the most commonly associated cardiac condition in patients with HFnlEF. Despite the observed link between microalbuminuria, obesity, and cardiovascular disorders, this question has remained-Which is more important for the prediction and prevention of diastolic dysfunction in non diabetic hypertensive patients?' The current study was a cross section study conducted on a total of 126 non diabetic hypertensive patients screened to identify those with hypertension. Urine creatinine was measured by the picric acid method and urine albumin content was measured by a sensitive, nephelometric technique. The urinary albumin/creatinine ratio [UACR] was determined as an indicator of microalbuminuria. Complete two dimensional, doppler, and tissue doppler echocardiography was performed and the recording of the diastolic function parameters was carried out. High body mass index and high systolic blood pressure were positively correlated with the appearance of left ventricular hypertrophy, whereas, the UACR index had no significant relationship with hypertrophy. Multivariable analysis also showed that advanced age and systolic blood pressure were significantly associated with the E/E annulus parameter. According to our investigation obesity is more important than microalbuminuria for the prediction and prevention of diastolic dysfunction in non diabetic hypertensive patients

[Comparison of the effectiveness of cognitive behavioral therapy and medication on the quality of life in the patients with essential hypertension]

Essential hypertension is one of the most important factors on quality of life and third casual of death in the world. The purpose of the present study was to determine the effect of cognitive behavioral therapy and drug therapy on drug therapy on improvement of quality of life in the patients with essential hypertension. This clinical trial was performed in Heart center of Medical University of Isfahan [Iran] between April 2007 and April 2008. 40 Patients with essential hypertension were selected randomly and assigned into 2 groups: experimental group that received cognitive behavioral therapy and control group with drug therapy. All of the patients completed the quality of life and a demographic questionnaire before start of interventions as pre test. The post test was completed after the end of interventional and follow up completed after 4 month later. Findings showed that cognitive behavioral therapy was more effective than drug therapy on improvement of quality of life in the patients with essential hypertension in pot test and follow up. Cognitive behavioral therapy was effective on improvement of quality of life in the patients with essential hypertension. According to findings of this work, we suggest that team work approach consist of psychologists and heart professional can be useful for treatment of quality of life in the patients with essential hypertension

[Evaluation of visual evoked potentials' findings in patients with multiple sclerosis]

Multiple Sclerosis is one of the commonest neurological disorders that because of its different clinical presentation, recurrent and progressive attacks, and age spectrum of patients who are usually young, has particular importance. Optic neuritis is common in MS patients and VHP is abnormal in most of the patients with optic neuritis. VHP is also abnormal in most of the MS patients who do not have the history of optic neuritis. The aim of this study was to compare the incidence of VEP in MS patients with and without the history of optic neuritis. This study included 80 patients with definite MS diagnosis who referred to the MS Clinic Ghaem Hospital. A questionnaire used to collect the patients demographic and illness history. Patients were divided into two groups based on the history of optic neuritis. The full neurological examination including VEP carried out for the patients. Collected data analyzed with SPSS and statistical tests. The abnormal VEP found in 92.2% of patients with the history of optic neuritis. The incidence of VEP in patients without the history of optic neuritis was 57.5%. The VEP abnormality recorded 40.5% unilateral and 59.5% bilateral in the first group of patients. In the second group the VEP was 87% unilateral and 13% bilateral. Many MS patients without the history of optic neuritis, had abnormal VEP, therefore VEP can be used for the early diagnosis of MS. Although, patients with the history of optic neuritis will have significant improvement with the time, but many cases with increased PI00 latency is persistence, and can be used as a marker of the pervious optic neuritis attack

Association between chlamydia pneumoniae infection and carotid atherosclerotic plaques

Several studies have suggested an association between Chlamydia pneumonia infection and atherosclerosis. This study was designed to investigate the association between this organism and atherosclerotic plaque formation in right and left common carotid arteries [CCAs] and extracranial portions of internal carotid arteries [ICAs]. Antibodies to Chlamydia pneumoniae [IgA and IgG] were measured and compared in 42 patients who had plaque in at least one CCA or ICA [detected by duplex ultrasound] and 82 patients without any plaque in these arteries. Cp.IgG and Cp.IgA titers over 1.10 ISR were defined to be positive. We found that 6.1% of control subjects and 16.7% of cases were Cp.IgA seropositive. The difference between these two groups was prominent but was not statistically significant [P = 0.104]. 4.2% of females without atherosclerotic plaque and 31.6% of females with plaque were Cp.IgA seropositive. This difference is statistically significant [P = 0.005]. There was no significant difference in seropositivity of Cp.IgG between case and control subjects or in male and female groups with or without plaque. Cp.IgA is a predictor of atherosclerosis in women, but Cp.IgG has no predictive value for plaque formation in either gender

influence of chlamydia pneumoniae infection on intima-media-thickness [IMT] in common carotid artery

Atherosclerosis is a multifactorial disease and the identification and diagnosis of its risk factors can help prevent its complications. Among the recently introduced risk factors is infection with Chlamydia pneumoniae. Atherosclerosis is initially characterized by increased intima-media-thickness [IMT], which can be measured by duplex ultrasonography. This study was designed to assess the role of Chlamydia pneumoniae infection in increasing IMT. Extracranial carotid duplex ultrasound was done in 83 individuals and IMT was measured 1 centimeter proximal to bifurcation of the common carotid arteries. IMT more than 0.9 mm was considered as increased. Forty-four individuals had increased IMT and were included in the case group; 39 individuals with normal IMT were considered as the control group. These two groups were matched for age, sex, smoking, and underlying diseases. Chlamydia pneumoniae IgG [Cp.IgG] and Chlamydia pneumoniae IgA [Cp.IgA] were measured in these 2 groups by using the ELISA method and titers more than 1.10 ISR [Immune Status Ratio] were defined as positive, 0.9-1.09 ISR as borderline, and less than 0.9 ISR as negative. We compared the prevalence of Cp.IgG and Cp.IgA seropositivity and the means of antibody titers in these 2 groups. There was no significant difference in the prevalence of Cp.IgG and Cp.IgA seropositivity and in the mean titers of these antibodies between the case and control groups. Cp.IgG and Cp.IgA do are not valuable predictors of increased IMT

Evaluation of autoantibody against modified LDL levels in patients with cardioovascular diseases

Atherosclrosis is a process that initiated with hypercholestrolemia and fatty streak formation. Previous studies showed oxidative modification of LDL render immunogenic and autoantibodies to epitopes of oxidized LDL. Oxidized LDL [OX-LDL], has antigenic properties. Antibodies against oxidized LDL have been proposed to be independent predictors of atherosclerosis development. The main aims of the current study were to compare antibody titers to different types of oxidized LDL [Cu+2-LDL, Malondialdehyde-LDL] and Native-LDL between angiographically documented coronary patients, non-documented patients and healthy subjects. Correlation between autoantibodies against oxidized LDL and increased risks of cardiovascular diseases has been shown. As a case-control study, we evaluated angiographically documented coronary patients, non-documented patients and healthy subjects to measure anti-OX-LDL autoantibody levels. Enzyme-linked immunosorbent assay was used to measure anti-OX-LDL autoantibodies. ANOVA test used for statistical analysis. Titers of anti-Malondialdehydo-LDL autoantibodies were 3.55 +/- 0.415, 0.361 +/- 0.20, 0.093 +/- 0.078 respectively in each group [P<0.005]. There was not statistically meaningful difference, between native-LDL and Cu+2-LDL antibodies. It seems the titre of autoantibodies against OX-LDL considered as a predictor of progression of atherosclerosis. Our data provide further support for a role of oxidatively modified LDL in atherogenesis