Association between apo lipoprotein b levels at admission of patientsand short-term morbidity and mortality after myocardial infarction

Dyslipidemia is an important risk factor in cardiovascular diseases. Different studies have shown that Apolipoprotein B [Apo B] is one of the best predictors in determining cardiovascular diseases and patients follow up after cardiovascular events. We hypothesized that there is a relation between Apo B levels and cardiovascular events in patients who have myocardial infarction [MI]. In addition, Apo B may be an appropriate marker for following these patients after MI. In this study, 220 patients with acute myocardial infarction were allocated at their admission to the hospital. They were followed for three months after MI and their morbidity and mortality rates were evaluated. Apo B levels were measured immunoturbidimetrically. Apo B levels were significantly higher in patients with the events including coronary artery bypass grafting [CABG], percutaneous coronary intervention [PCI] and malignant arrhythmias [P = 0.001]. Apo B levels can be an appropriate indicator of cardiovascular events in patients after MI.

Homocysteine level according to some cardiac risk factors and extent of coronary disease

Hyperhomocysteinemia is accompanied by many cardiovascular risk factors. However it's relation with other cardiac risk factors and with extent of coronary artery disease [CAD] is still a controversial issue. This study was designed to investigate the relationship between total plasma homocysteine [tHcy] levels and other cardiovascular risk factors and the severity of CAD. Fasting plasma tHcy levels were measured in 60 patients with angiographically documented CAD and compared to 56 control subjects matched for age, sex, and smoking habits. Also patients were classified into two groups of low risk [with two or few risk factor] and high risk [with three and more risk factor] according to their major risk factors. Mean of tHcy levels were significantly higher in high risk patients compared to low risk patients [p=0.013]. Also hyperhomocysteinemia rate was higher in the high risk patients compared to low risk patients, OR=5 [CI 95%=1.6-16].There was relationship between coronary risk factors and severe coronary artery disease [three vessels disease] but this relationship was statistically significant only in smokers [P=0.012] and diabetic patients [P=0.035]. Plasma tHcy level was an independent risk factor for high risk patients.

association between serum Lipoprotein [a] and other cardiac risk factors with the severity of coronary artery disease

Several meta-analyses have provided support for an association between lipoprotein [a] [Lp [a]] and coronary disease, but the correlation of Lp [a] and other coronary risk factors with severity of coronary artery disease [CAD] are ambiguous. In this case control study, plasma Lp [a] concentration, lipid profile, diabetes, hypertension, smoking were evaluated in 108 patients with and without CAD [Case: 55 and Control: 53] who were admitted at heart center in Shahid Beheshti hospital of Zanjan in 2009. Also patients were classified into two risk groups according to their major risk factors; low risk [with two or few risk factors] and high risk [with three and more risk factors]. The collected data was analyzed with using chi square, independent sample t-test, fisher's exact test, Mann-Whitney test, Kruskal Wallis test and Pearson's correlation coefficient. The mean concentration of Lp [a] in the case and control groups were 60 +/- 11 mg/dL and 32 +/- 3 mg/dL, respectively [P=0.054]. 41.8% of the case group and 22.6% of the control group have abnormal level of Lp [a] [=30 mg/dL] [P=0.03]. Mean lipoprotein [a] was also higher in three vessels disease compared control group [46 +/- 41 vs. 31 +/- 23] and maximum level of lipoprotein [a] in control group was 92 mg/dL and in three vessels disease was 520 mg/dL. Between other cardiac risk factors, diabetes was more frequent in case than control groups [29.1% vs 5.7%] and had a significant relationship with severity of coronary disease [P=0.001]. The main findings of this study were that mean Lp[a] levels were higher in the three vessels group compared to control and diabetes had significant relationship with the severity of coronary disease

Thyroid function and anti-thyroid antibodies in Iranian patients with type 1 diabetes mellitus: influences of age and sex

Type 1 diabetes mellitus is frequently associated with autoimmune thyroid disease [ATD].Genetic susceptibility for autoantibody formation in association with ATD and type 1 diabetes mellitus has been described with varying frequencies, but there is still debate about its prevailing situation in Iran. We have therefore investigated the prevalence of anti-thyroid peroxidase [anti-TPO] and anti thyroglubolin [Anti TG] antibodies in type 1 diabetic patients, and compared the effect of age and sex on the thyroid autoimmunity in patients with type 1 diabetes mellitus in Iran. Ninety one subjects with type 1 diabetes mellitus and one hundred and sixty three unrelated normal controls under the age of thirty years were recruited for the detection of anti-TPO and anti-TG. Radio Immuno Assay and chemiluminescence methods were used for anti-TPO and anti-TG detection respectively. Among 91 type 1 diabetic patients, 36 [39.6%] were positive for anti-TPO and 27[30%] were positive for antiTG. Anti-TPO antibodies were detected only in 6.7% of control group. Comparing with those without thyroid autoimmunity, there was a female preponderance for the type 1 diabetic patients with thyroid autoimmunity [female: male, 28:14 vs. 28:20 respectively]. Among the type 1 diabetic patients those with thyroid autoimmunity, tended to be older [p: 0.04] and to have higher TSH concentration [p: 0.03]. Patients with high anti-TPO levels had longer duration of diabetes [P: 0.02]. The presence of anti-TPO in 39.6% of our type 1 diabetic patients comparing with 8.5% of normal subjects confirmed the strong association of ATD and type 1 diabetes mellitus

[Attitudes of medical students and teachers towards education in community- oriented medical education [COME] center, Zanjan university of medical sciences 2004]

Practical training of medical students is not limited to only hospitals. Outpatient departments and ambulatory care centers attending a greater number of patients can provide students with more exposure to a variety of medical cases. Moreover, community-oriented medical education center, where more patients come for consultation is a suitable center for training medical students. Although awareness toward the importance of community-oriented medical education is increasing, and medical faculties have already adopted this approach for their training, this idea does not appear to be accepted fully in all of schools. To find the attitude of Zanjan Medical students and teachers towards education and facilities in COME center in 2004-2005. In this descriptive study two separate questionnaires for teachers and students were designed to assess their attitudes towards the method of education, number of patients, situation of center and the quality of education in the Community-oriented Medical Education centers. The questionnaires were filled out by 136 interns and externs' who had been trained in COME center and 14 teachers in Zanjan Medical University. Validity of questionnaires had been confirmed and internal consistency reliability had been determined by Cronbach's alpha coefficient [0.79]. In whole, 66.9% of the students and 53.8% of the teachers were interested in attending COME program and most of them believed that COME is necessary for medical education. The percentage of interns who agreed with this center was more than externs. In regard to the teachers' educational method the highest satisfaction rate [83.2%] was obtained for teachers in the pediatrics ward [p=0.0005]. In regard to the number and variety of patients, pediatrics ward [with respectively 71.7% and 65.6%] was the best and internal ward [with respectively 20.7% and 21.5%] was the worst ward according to the students. The overall satisfaction rate was 51.9 +/- 12.5 in students and interns had a more positive attitude comparing to others. It seems that using more experienced teachers, continuous supervision and evaluation of educational activities, establishing proper research facilities and financial support of COME centers are necessary for improving community-oriented medical education