Validity of Self-reported Hypertension and Factors Related to Discordance Between Self-reported and Objectively Measured Hypertension: Evidence From a Cohort Study in Iran / 예방의학회지

OBJECTIVES: Self-reporting can be used to determine the incidence and prevalence of hypertension (HTN). The present study was conducted to determine the validity of self-reported HTN and to identify factors affecting discordance between self-reported and objectively measured HTN in participants in the Ravansar Non-Communicable Diseases (RaNCD) cohort. METHODS: The RaNCD cohort included permanent residents of Ravansar, Iran aged 35-65 years. Self-reported data were collected before clinical examinations were conducted by well-trained staff members. The gold standard for HTN was anti-hypertensive medication use and blood pressure measurements. The sensitivity, specificity, positive and negative predictive values, and overall accuracy of self-reporting were calculated. Univariate and multivariate logistic regression were used to examine the discordance between self-reported HTN and the gold standard. RESULTS: Of the 10 065 participants in the RaNCD, 4755 (47.4%) were male. The prevalence of HTN was 16.8% based on self-reporting and 15.7% based on medical history and HTN measurements. Of the participants with HTN, 297 (18.8%) had no knowledge of their disease, and 313 (19.9%) had not properly controlled their HTN despite receiving treatment. The sensitivity, specificity, and kappa for self-reported HTN were 75.5%, 96.4%, and 73.4%, respectively. False positives became more likely with age, body mass index (BMI), low socioeconomic status, and female sex, whereas false negatives became more likely with age, BMI, high socioeconomic status, smoking, and urban residency. CONCLUSIONS: The sensitivity and specificity of self-reported HTN were acceptable, suggesting that this method can be used for public health initiatives in the absence of countrywide HTN control and detection programs.

Validity of Self-reported Hypertension and Factors Related to Discordance Between Self-reported and Objectively Measured Hypertension: Evidence From a Cohort Study in Iran / 예방의학회지

OBJECTIVES@#Self-reporting can be used to determine the incidence and prevalence of hypertension (HTN). The present study was conducted to determine the validity of self-reported HTN and to identify factors affecting discordance between self-reported and objectively measured HTN in participants in the Ravansar Non-Communicable Diseases (RaNCD) cohort.@*METHODS@#The RaNCD cohort included permanent residents of Ravansar, Iran aged 35-65 years. Self-reported data were collected before clinical examinations were conducted by well-trained staff members. The gold standard for HTN was anti-hypertensive medication use and blood pressure measurements. The sensitivity, specificity, positive and negative predictive values, and overall accuracy of self-reporting were calculated. Univariate and multivariate logistic regression were used to examine the discordance between self-reported HTN and the gold standard.@*RESULTS@#Of the 10 065 participants in the RaNCD, 4755 (47.4%) were male. The prevalence of HTN was 16.8% based on self-reporting and 15.7% based on medical history and HTN measurements. Of the participants with HTN, 297 (18.8%) had no knowledge of their disease, and 313 (19.9%) had not properly controlled their HTN despite receiving treatment. The sensitivity, specificity, and kappa for self-reported HTN were 75.5%, 96.4%, and 73.4%, respectively. False positives became more likely with age, body mass index (BMI), low socioeconomic status, and female sex, whereas false negatives became more likely with age, BMI, high socioeconomic status, smoking, and urban residency.@*CONCLUSIONS@#The sensitivity and specificity of self-reported HTN were acceptable, suggesting that this method can be used for public health initiatives in the absence of countrywide HTN control and detection programs.

Mortality from aluminum phosphide poisoning in Kermanshah Province, Iran: characteristics and predictive factors / 한국역학회지

OBJECTIVES: Aluminum phosphide (ALP), also known in Iran as rice tablets, is one of the most effective rodenticides used to protect stored grain. However, ALP poisoning regularly causes mortality in humans. The aim of this study was to evaluate the characteristics and predictive factors of mortality from ALP poisoning.METHODS: This study evaluated all patients with ALP poisoning referred to Imam Khomeini Hospital in Kermanshah Province, Iran from 2014 to 2015. For each patient, the following information was recorded: age, sex, the number of tablets consumed, the number of suicide attempts, the time elapsed from consumption to treatment, blood pressure, blood pH, HCO3 levels, and PCO2. Differences between the survivors and non-survivors of ALP poisoning were analyzed using univariate logistic regression and multivariate analysis.RESULTS: In this study, 48 patients were male and 29 patients were female (total: 77 patients). The average age of the survivors and non-survivors was 28.7 and 31.3 years, respectively. All cases (100%) of ALP poisoning were intentional, with the goal of committing suicide. The main predictive variables of mortality from ALP poisoning were blood pressure, blood pH, and time elapsed from consumption to treatment.CONCLUSIONS: The likelihood of mortality in patients with ALP poisoning can be predicted using blood pressure, blood pH, and time elapsed from consumption to treatment. These findings may help healthcare providers take more effective measures to treat patients with ALP poisoning.

Mortality from aluminum phosphide poisoning in Kermanshah Province, Iran: characteristics and predictive factors / 한국역학회지

OBJECTIVES: Aluminum phosphide (ALP), also known in Iran as rice tablets, is one of the most effective rodenticides used to protect stored grain. However, ALP poisoning regularly causes mortality in humans. The aim of this study was to evaluate the characteristics and predictive factors of mortality from ALP poisoning. METHODS: This study evaluated all patients with ALP poisoning referred to Imam Khomeini Hospital in Kermanshah Province, Iran from 2014 to 2015. For each patient, the following information was recorded: age, sex, the number of tablets consumed, the number of suicide attempts, the time elapsed from consumption to treatment, blood pressure, blood pH, HCO3 levels, and PCO2. Differences between the survivors and non-survivors of ALP poisoning were analyzed using univariate logistic regression and multivariate analysis. RESULTS: In this study, 48 patients were male and 29 patients were female (total: 77 patients). The average age of the survivors and non-survivors was 28.7 and 31.3 years, respectively. All cases (100%) of ALP poisoning were intentional, with the goal of committing suicide. The main predictive variables of mortality from ALP poisoning were blood pressure, blood pH, and time elapsed from consumption to treatment. CONCLUSIONS: The likelihood of mortality in patients with ALP poisoning can be predicted using blood pressure, blood pH, and time elapsed from consumption to treatment. These findings may help healthcare providers take more effective measures to treat patients with ALP poisoning.

Mortality from aluminum phosphide poisoning in Kermanshah Province, Iran: characteristics and predictive factors / 한국역학회지

OBJECTIVES@#Aluminum phosphide (ALP), also known in Iran as rice tablets, is one of the most effective rodenticides used to protect stored grain. However, ALP poisoning regularly causes mortality in humans. The aim of this study was to evaluate the characteristics and predictive factors of mortality from ALP poisoning.@*METHODS@#This study evaluated all patients with ALP poisoning referred to Imam Khomeini Hospital in Kermanshah Province, Iran from 2014 to 2015. For each patient, the following information was recorded: age, sex, the number of tablets consumed, the number of suicide attempts, the time elapsed from consumption to treatment, blood pressure, blood pH, HCO3 levels, and PCO2. Differences between the survivors and non-survivors of ALP poisoning were analyzed using univariate logistic regression and multivariate analysis.@*RESULTS@#In this study, 48 patients were male and 29 patients were female (total: 77 patients). The average age of the survivors and non-survivors was 28.7 and 31.3 years, respectively. All cases (100%) of ALP poisoning were intentional, with the goal of committing suicide. The main predictive variables of mortality from ALP poisoning were blood pressure, blood pH, and time elapsed from consumption to treatment.@*CONCLUSIONS@#The likelihood of mortality in patients with ALP poisoning can be predicted using blood pressure, blood pH, and time elapsed from consumption to treatment. These findings may help healthcare providers take more effective measures to treat patients with ALP poisoning.

Fasting consequences during Ramadan on lipid profile and dietary patterns

The aim was to assess the effects on lifestyle and lipid profile while fasting during holy month of Ramadan. An interventional cohort study designed with 160 subjects who were fasting during Ramadan recruited from different mosques in Kermanshah. Data were collected in three stages at the beginning and at the end of Ramadan as well as one month following Ramadan using demographic and FFQ questionnaires. Blood pressure was measured and a 5 ml blood sample was collected in order to measure BUN, Creatinine, and lipid profile analysis. Significant increases was observed in total cholesterol [P=0.02], LDL-C [P=0.001], HDL-C [P=0.001], and BUN [P=0.002] following Ramadan compared with earlier measurements. Triglyceride [TG] level decreased following Ramadan [P=0.04] but returned to the same level one month later. Systolic blood pressure increased and diastolic blood pressure decreased during fasting period. There was a significant decrease in cereals, dairy products, and meat consumption while consumption of fruits and vegetables have been increased during Ramadan [P=0.003]. Our results revealed increased levels of T-Chol and LDL-C in fasting as well as HDL-C. Increased HDL-C may prevent the side effects of T-Chol and LDL-C in healthy subjects. Given the metabolic changes that occurred during Ramadan, healthy eating and intake of low fat and low sugar diet during Ramadan are highly recommended

[ effect of omeprazol and ranitidine on gastric acidity in ICU patients]

ICU patients especially those under mechanical ventilation or with a history of coagulation disorders are at the risk of stress ulcer development and related GI bleeding. Typically H2 blockers administration showed prophylactic role to control gastric acidity. Preliminary studies have shown that administration of intravenous omeperazol is effective. The object of this study was to compare the effect of oral rout administration of omerprazol with intravenous ranitidine on gastric pH. In this experimental study 40 ICU patients under mechanical ventilation allocated into same conditions and matched ranitidine and omeprazol groups [20 subjects in each group]. First group received 50 mg intravenous ranitidine twice per day and the second group received 40 mg oral omeperazol once a day. The gastric acidity was monitored using Chroning method. Gastric pH was determined before administration and three times per day after drugs administration then followed for three consequent days. Data was analyzed using T-test and SPSS software. The mean gastric pH in the Ranitidine group was 2.07 +/- 0.79 before and 2.80 +/- 0.85 after drug administration. In the Omperazol group gastric pH was 2.01 +/- 1.52 before and 3.90 +/- 1.52 after drug administration. The oral Omeperazol administration was significantly effective than intravenous Ranitidine administration [p<0.005]. Our data suggest that in critically ill patients oral rout administration of Omeparazol is more effective than intravenous H2 blocker [Ranitidine] to decrease gastric acidity and may prevent from stress ulcer