Acute pulmonary embolism due to rupture of pulmonary valve hydatid cyst

Cardiac hydatid cyst is rare comprising 0.5-2% of all cases. A 20-year-old man was admitted for acute pulmonary embolism. Echocardiography and magnetic resonance imaging revealed hydatid cyst of pulmonary valve annulus. The cyst was drained surgically, and the patient was discharged with oral albendazole. For fatal complications of cardiac hydatid cyst, surgery is recommended in all patients

Antihypertensive drugs used by hypertensive patients in the provincial cities of Isfahan, Najaf Abad and Arek

Hypertension is the most prevalent chronic disease encountered by physicians. Its prevalence has been reported at 18% in Isfahan province. Hypertension control decreases the risk of stroke and coronary events by 50% and 15%, respectively. According to the World Health Organization [WHO], the rate of blood pressure control stands at 12.5%. Effective hypertension control requires measures such as screening, diagnosis, lifestyle improvement, and drug therapy. The type of drug regimen prescribed to the hypertensive patient is of key importance in achieving optimal control. The present study was performed to determine the type of drugs used by hypertensive patients in urban and rural areas of the provincial cities of Isfahan, Najaf-Abad and Arak. This descriptive cross-sectional study was performed in the provincial cities of Isfahan, Najaf-Abad and Arak in 2000-2001, as part of Isfahan Healthy Heart Program [IHHP]. Cluster sampling method was used to select 10674 individuals from the urban and rural areas of the said provincial cities. The patients had systolic or diastolic blood pressure readings of >/= 140 and >/= 90, respectively, or received antihypertensive medications. Data were entered into the EPI5 software and analyzed with t-test using SPSS. A total of 2015 hypertensive individuals [18.9%] were identified. Awareness of being hypertensive and rate of treatment and control of hypertension measured 47%, 23% and 9% respectively. Of 670 patients under treatment, 527 had been treated with one drug type, 133 with two drug types with 35 different combinations, and 30 used three drug types with 25 different combinations. Among single-drug regimens, beta-blockers were the most common choice [23%] and atenolol and methyldopa were the most frequently prescribed drugs, respectively. The frequency of diuretics use was 0.9%. Inappropriate combinations such as atenolol and propranolol were seen among two- and three-drug regimens [nine patients]. Drug regimens used by many hypertensive patients are not consistent with standard protocols; these regimens are ineffective in blood pressure control and lead to increased side-effects and subsequently patient noncompliance. Thus, education of physicians and other healthcare providers on hypertension and antihypertensive treatment is essential

[Relationship between hematological factors and metabolic syndrome in an iranian population isfahan healthy heart program]

Metabolic syndrome is considered as one of the risk factor for Cardio Vascular Disease [CVD]. Correlation between this syndrom and white and red blood cell counts is unknown whereas the relationship between insulin resistance and hamatologic factors is indicated in some published articles. The purpose of this study was to assess the correlation between hematologic parameters and metabolic syndrome. In a descriptive study 11974 over 19 years old participants in Isfahan, Najaf-Abad and Arak in rural and urban areas was evaluated as part of Isfahan Healthy Heart Program [IHHP] study . At first these participants' demographic data [age, sex, past history and drug consumption] were collected then trained physicians measured their blood pressure and waist circumference. Blood pressure in two separate occasions was recorded and mean of these measures was used in this study. In all participants, laboratory examinations [RBC, WBC, HDL-C, FBS, TG] were done after a 12 hour fasting. Participants were evaluated for metabolic syndrome according to ATP-III criteria. Data were entered in to SPSS-11 and analyzed by t-test and Spearmen correlation. Overall 6132[51%] females and 5842[49%] males with mean age of 35.6 +/- 3.8 and 35.9 +/- 32 year were studied respectively. The prevalence of metabolic syndrome in male and female participants were 10.6% and 35% respectively and 23/1% in overall. WBC and RBC counts were higher in patients with metabolic syndrome compared to those of normal subjects. Correlation between metabolic syndrome and RBC and WBC counts was significant excluding the case of hypertension. The most powerful correlation was obsereved between count RBC and HDL-C [r: -0.245, p<0.001], WBC and TG [r: 0.195, p<0.001]. We observed increased RBC and WBC counts in patients with metabolic syndrome. In this regard a widespread study may help us use these hematologic parameters even in normal values as indicators for evaluation of high risk patients

Routine use of cerebral protection [filter wire] during carotid artery stenting: results of a single center registry of 37 patients

To evaluate the short-term outcome of patients who underwent carotid stenting with the routine use of cerebral protection devices. In our center, 36 successful carotid stenting procedures [of 38 at tempted] were performed in 37 patients [23 men; aged 66 +/- 7 years]. Cerebral protection involved distal filter devices [n = 36] of which 12 were Accunet and 24 were EZ filter wires. The protection devices were positioned successfully in 36 of the 38 attempted vessels. The 30-day incidence of stroke and neurological death was three. Neurological complications included one major stroke, and one minor stroke. There was also one [sudden cardiac death on the first day]. The proportion of stroke or death was two for symptomatic lesions and one for asymptomatic lesions, and two in patients aged < 80 years and one in those aged >/= 80 years. Protection device-related vascular complications included mild spasm, which occurred after three procedures [8%], none of which led to neurological symptoms. There were another four cardiogenic deaths in 30-day follow-up. In this uncontrolled study, routine cerebral protection during carotid artery stenting was technically feasible and clinically safe. The incidence of major neurological complications in this study was lower than in previous reports of carotid artery stenting without cerebral protection

Preoperative carotid artery valuation in 1045 patients undergoing coronary artery bypass graft surgery

To evaluate the prevalence of significant carotid artery stenosis and its determining factors in candidates of coronary artery bypass graft [CABG] surgery. 1045 consecutive CABG candidates underwent carotid artery Doppler examination in a cross sectional study. The relation of age, gender, history of smoking and diabetes, as well as lipid profile to significant carotid stenosis was evaluated. In study subjects, mean age of 60.57 +/- 9.3 years, the prevalence of significant carotid stenosis [>60%] was 6.9%. In subjects older than 65 years the significant stenosis tolled to 12.5%. Over 50 years of age, female gender, hypercholesterolemia and diabetes were independent determining factors for significant carotid stenosis. Significant carotid stenosis has significantly higher prevalence among patients over 50 years of age. Cost benefit studies are recommended to revise the current evaluation protocols

causes of failure to control hypertension in population aged over 65

Hypertension is a major cause of cardiovascular disease and the prevalence of hypertension shows a linear increase with aging so that it increases by 10 percent for every 10 years. To investigate the causes of failure to control blood pressure in people aged over 65 years. This research was a descriptive case-control study on 200 cases aged over 65 years, who were diagnosed with hypertension through a routine travel check-up for pilgrimage to Mecca, carried out at Isfahan Amine Hospital in 2003. Following the medical examinations and measuring blood pressure according to WHO standards, the subjects were divided into two groups marked as controlled blood pressure [case group] and uncontrolled blood pressure [control group]. A questionnaire was filled in for each subject and the data were analyzed with X[2] and t-student test. The age mean values were 70.7 +/- 5.2 and 69.5 +/- 4.9 in case and control groups, respectively. In case group, less than half of the subjects were taking their anti hypertensive drugs regularly and 12.5% followed their own way of self-therapy. 55% of people in case group expressed a lack of motivation as the cause of discontinuation of their therapy. Also, their knowledge and practice were found to be significantly lower than control group [p<0.05]. In comparison with other studies, it was observed that the most common causes of failure to control blood pressure are poor knowledge, inappropriate practice in avoiding risk factors and the discontinuation of the complete pharmaceutical antihypertensive therapy

High blood Pressure control in a rural area of Iran

Hypertension is an important risk factor for cardiovascular diseases. One of the cornerstones of Primary prevention of cardiovascular diseases is screening high blood pressure and antihypertensive drug therapy. Unfortunately little has been known about controlling of hypertension in rural areas of Iran. This research was performed to assess the control of high blood pressure in rural areas of Charmahal and Bakhtyari Province. In a cross- sectional study, 376 patients were selected by a random cluster sampling from 19 rural healthcare centers. Their Blood pressure were measured and recorded. Systolic Blood Pressure [SBP] lower than 140 mmHg and Diastolic Blood Pressure [DBP] lower than 90 mmHg were defined as successful control of high blood pressure. The percentage of successful control of high blood pressure was calculated and its relation with gender, Body Mass Index [BMI], and type of drug therapy was evaluated. Blood pressure was successfully controlled in 125 of 376 patients [33%]. We found that male patients, and patients who were on multi-drug therapy had better blood pressure control [P-Value < 0.05]. There was not any significant relationship between BMI of patients with level of blood pressure control. It seems that insufficient blood pressure control still, remains major public health problem. These results underscore the urgent need to develop national strategy to improve treatment of hypertension

Obesity and its association with other cardiovascular risk factors in women's in central Iran - women healthy heart project

Cardiovascular diseases [CVD] are considered the most important cause of death worldwide. Obesity is a major CVD risk factor. This study was conducted to evaluate the prevalence of obesity and its association with other CVD risk factors in Iranian women. This cross-sectional study was conducted in 2001 as part of Isfahan Healthy Heart Program [IHHP] in three Central Iranian cities of Isfahan, Najaf-Abad and Arak. Being over 19 years of age, absence of pregnancy, absence of mental retardation and Iranian nationality were the criteria for inclusion in the study. A questionnaire on demographics characteristics, drug consumption, smoking status, and physical activity were filled out for every subject. Height, weight and blood pressure of all subjects were measured and fasting blood samples were taken to measure blood glucose and lipids. The data were analyzed with T-test, X[2] and multiple linear regression, using SPSS11. Of 6391 women aged 38.8 +/- 14.5 years participating in the study, 79% lived in the urban areas and 21% in the rural areas. The prevalence of a higher BMI was greater in urban areas in all ages. Hypertension, diabetes, total cholesterol-triglyceride and LDL-C disorders and inadequate physical activity were more prevalent in obese women than normal ones, but no significant difference was seen in HDL-C disorder and smoking between the two groups [P<0.05]. There was a significant positive relationship between BMI and age, blood glucose and urban residence, and a negative relationship was observed between BMI and inadequate physical activity [P<0.05]. The high prevalence of obesity and the major risk factors of cardiovascular diseases in urban areas is testament to unhealthy lifestyle and insufficient physical activity of women in areas studied

Causes of uncontrolled blood pressure in the over-65 population

Hypertension is a major cause of cardiovascular disease and the prevalence of hypertension shows a linear increase with aging so that it increases by 10 percent every 10 years. This study was conducted to investigate the causes of uncontrolled blood pressure in people aged over 65 years. This descriptive case-control study was conducted at Isfahan Amin Hospital in 2003 on two-hundred over-65 subjects diagnosed with hypertension through a routine travel check-up for Mecca pilgrimage. After medical examinations and blood pressure measurement according to WHO standards, the subjects were divided into a case group [controlled blood pressure] and a control group [uncontrolled blood pressure], respectively. A questionnaire was filled in for each subject and the data were analyzed with X[2] and t-student test. The case and control groups had mean ages of 70.7 +/- 5.2 and 69.5 +/- 4.9 years, respectively. In the case group, less than half of the subjects were taking their antihypertensive medications regularly and 12.5% engaged in self-therapy. Fifty-five percent of subjects in the case group expressed a lack of motivation as the reason for discontinuing therapy. Their knowledge and practice were also found to be significantly lower than the control group [P<0.05]. In comparison with other studies, it was observed that the most common causes of uncontrolled blood pressure are poor knowledge, inappropriate practice in avoiding risk factors, and the discontinuation of pharmaceutical antihypertensive therapy