Coronary artery disease risk factors in an urban and peri-urban setting, Kerman, Southeastern Iran [KERCADR study]: methodology and preliminary report

This article was to present the sampling and measurements methods and the main preliminary findings of the KERCADR cohort study [first round] in an urban and peri-urban setting, Kerman, southeastern Iran2009-11. 5900 [3238 female] people aged between 15 to 75 years were recruited in the household survey by non-proportional to size one-stage cluster sampling. Trained internal specialists, general practitioners, clinical psychologists and dentists have assessed the study subjects by person-assisted questionnaires regarding different NCD risk factors including cigarette and opium smoking, physical activity, nutrition habits, anxiety, depression, obesity, hypertension and oral health. Blood samples were also collected for determining FBS, HbA1c, cholesterol and triglyceride. Weighted standardized prevalence estimates were calculated by STATA 10 survey analysis package. The participation rate was more than 95% in all subgroups. Cigarette smoking [18.4% vs. 1.2%], opium use [17.8% vs. 3.0%] and triglyceridemia [16.1% vs. 12.0%] were significantly higher among men than women. In contrast, women were presented with higher level of sever anxiety [29.1% vs. 16.7%], obesity [16.8% vs. 9.2%], low-physical activity [45.1% vs. 39.2%] and uncontrolled diabetes [60.2% vs. 31.0%]. More than 68% of all subjects have presented with moderate to severe gingival index scores. The first round of the KERCADR cohort with sufficient sample size and response rate provided precise estimates for the main clinical and para-clinical NCD risk factors. These evidences need to be translated into public health interventions and monitored in the next rounds of the cohort

[Assessing time between arriving to hospital and administration of streptokinase in patients with acute myocardial infarction in emergency department of Kerman University of medical sciences in 2003-4]

Acute myocardial infarction is one of the major causes of mortality in developing countries such as Iran. One of the most important progresses in acute myocardial infarction is early administration of thrombolytic agents such as streptokinase. This study was performed to determine the time interval from patients' referral to the emergency wards to the introduction of thrombolytic therapy and the factors associated with delay in drug administration. In a period of 8 months, 130 patients with presumed acute myocardial infarction were investigated. In order to determine the causes of delay in streptokinase administration, duration of symptoms onset to drug administration was divided into 4 specified periods and measured in minutes. Results were analyzed using ANOVA and t-test. Findings showed a mean elapsed time of 298 minutes between pain onset and referring to the emergency ward, 73 minutes between patient's arrival and streptokinase administration. Mean time from symptom onset to drug infusion was 370 minutes. There was a delay of 2 hours in drug administration in 18% of patients. The most important causes of delay were long distance and delay of physicians and staff. Considering the findings, increasing people's knowledge about the symptoms of heart problem, providing medical facilities and instruction of medical staff play important role in decreasing delay time in drug administration and increasing streptokinase output

[ cerebrovascular accident and usin oral contraceotive pill for prevention of menstrual bleeding]

Background: over one billion Muslims fast worldwide during the month of Ramadan. Many of Moslem's women continue to using oral contraceptive pill [OCP] to prevent menstrual bleeding because of Ramadan and it's fasting. The object of this study was to investigate whether continues using OCP has any effect on cerebrovascular accident in women fasting in Ramadan

Materials and Methods: this observational case-control study was based on quota sampling of 41 patients with CVA and 123 control patients who refer to Baghyatallah Hospital because of other disease. Both of them using OCP

Results: 73.2% of patients have hemorrhagic cerebrovascular accident. All of patient belong to less than 30 years old use OCP and 58.9% of patients belong to 35-45 years age group use OCP and 50% of patient of over 45 years old group use OCP too. Age mean of patient was more than control group [p=0.015]. In patient group there is more percent of OCP user that continue pill to prevent menstrual bleeding.[p-0.000, OR=45.2]

Conclusion: continuous using of OCP for prevention of menstrual bleeding makes increase in risk of CVA

Therapeutic effects of vitamin D and calcium in patients with polycystic ovary syndrome

Polycystic ovary syndrome [PCOS] is the most important cause of oligoovulation and anovulation in women of reproductive age and in infertile women. Considering insulin resistance and hyperinsulinemia in this syndrome, it is believed that calcium, as well as vitamin D, will have a unique role in correcting the impairment in insulin secretion and help the development of oocytes in mammals. Therefore, this study was carried out with the objectives of evaluating the effects of calcium on human ovulation and on the size of follicles in comparison with the current use of metformin. In this research, all PCOS patients [In accordance with the Rotterdam criteria and diagnosis confirmation by a gynecologist] who attended the infertility unit of Vali-e-Asr Reproductive Health Research Center from 2004 to 2005, after expressing their willingness to participate in the research were assigned to three 20-patient treatment groups as it follows: The cases were treated daily with: 1] Calcium/Vit. D [1000/mg], 2] Calcium/Vit. D [1000 mg] and metformin [1500mg] or 3] Metformin [1500mg] tablets for 3 months and were followed up for 3 more months. After this 6-month period, the size of dominant follicles, regularity of menses and pregnancy were checked for. After data collection and entry, statistical analysis [Kruskal Wallis, t-test, ANOVA and Generalized Estimating Equation [GEE] Regression] on the basis of the hypothesis, with a significance level of p=0.05 was performed by using SPSS software [Version 11]. Considering the response to treatment by the patients [Dominant follicle >/= 12mm in size], GEE showed that the response was significantly higher during the 5[th]-6[th] months in the Calcium/Vit. D and metformin treatment group than the ones from the other groups [p= 0.03]. Considering the effects of metformin in reducing and regulating insulin production, and vitamin-D in regulating and correcting serum insulin levels, simultaneous administration of these two medications is suggested for the treatment of insulin impairment and reduction of androgen levels for better oocyte maturation