Outcomes of a comprehensive healthy lifestyle program on cardiometabolic risk factors in a developing country: the Isfahan healthy heart program

This study evaluated the outcome of a comprehensive, community-based healthy lifestyle program on cardiometabolic risk factors. The Isfahan Healthy Heart Program [IHHP] was a comprehensive action-oriented, multi-component intervention with a quasi-experimental design and reference area. IHHP targeted the population-at-large [n = 2,180,000] in three districts in central Iran. Data from independent sample surveys before [2000 - 2001] and after [2007] this program were used to compare differences in the intervention area and reference area over time after controlling for age, education level and income. The samples in 2000 - 2001 and 2007 included 6175 and 4719 participants in intervention area, and 6339 and 4853 in reference area, respectively. Multiple interventional activities were performed based on the four main strategies of healthy nutrition, increased physical activity, tobacco control and coping with stress. The prevalence of abdominal obesity, hypertension, hypercholesterolemia, hypertriglyceridemia and high LDL-C decreased significantly in the intervention area versus the reference area in both sexes. However the reduction in overweight and obesity was significant only in females [P < 0.05 for all]. There were no significant changes in the prevalence of diabetes mellitus. In the intervention area, the prevalence of hypercholesterolemia decreased from 23.5% to 12.5% among females without any changes in females in the reference area [p < 0.0001]. In males, hypercholesterolemia decreased significantly in both intervention area [18.5% to 9.6%] and reference area [14.4% to 9.8%; p = 0.005]. Mean triglyceride levels had a significant decrease in the intervention area and a non-significant decrease in the reference area [p < 0.0001]. A comprehensive healthy lifestyle program comprising preventive and promotional activities that considers both population and high risk approaches can be effective in controlling cardiometabolic risk factors in a middle-income country

Role of Benzodiazepines in the management of agitation due to inappropriate use of naltrexone

Agitation is an early symptom of the acute opioid withdrawal syndrome in addicts that may start by inappropriate use of naltrexone. The current drug interventions are not efficient or need critical care as well. This study compares the clinical role of midazolam and diazepam for the management of agitation due to inappropriate use of naltrexone. In this double-blind randomized controlled clinical trial, 44 agitated addicts, who did not use any type of benzodiazepine, not on systematic central nervous system depressant drugs, without any known hypersensitivity to diazepam, midazolam, or any other component of their formulation and had no evidence for the need of critical care, were enrolled. An i.v. stat dose of 0.1 mg/kg diazepam and 0.1 mg/kg stat dose of midazolam and a 0.1 mg/kg/h infusion of these drugs were administered for different groups of patients, respectively. Agitation scores were recorded at 30, 60, 120 min after the start of drug administration using Richmond Agitation Sedation Scale score. A significant difference between the mean onset of agitation control in midazolam group [at 67 min] and diazepam group [at 81 min] was recorded. The difference of mean agitation score in the midazolam and diazepam group was only significant at 120 min. There was a negative correlation between agitation score and time elapsed from naltrexone administration to admission. Midazolam and diazepam may not be considered suitable and perfect pharmacologic agents for the initial controlling of agitation induced by naltrexone.

Diabetes and associated cardiovascular risk factors in Iran: the Isfahan Healthy Heart Programme

<p><b>INTRODUCTION</b>Diabetes mellitus (DM) is one of the major health problems worldwide. The aim of this study was to detect the prevalence of DM and its associated risk factors in Iran.</p><p><b>MATERIALS AND METHODS</b>This cross-sectional study was performed in 3 cities in the central part of Iran on participants over the age of 19 years. Sampling was conducted by multi-stage randomised cluster method. Initially, a questionnaire consisting of demographic information, drug intake and smoking status was filled out. Later, a physical examination was performed, including the measurement of systolic blood pressure (SBP) and diastolic blood pressure (DBP), body mass index (BMI) and waist-to-hip ratio (WHR). Fasting blood sample was drawn and analysed for sugar, total cholesterol (TC), triglyceride (TG) and 2-hour postprandial glucose. A fasting blood sugar (FBS) of >126 mg/dL or a 2-hour plasma glucose of over 200 mg/dL was considered an indication of diabetes. The impaired glucose tolerance test (IGTT) was defined with 2-hour plasma glucose of 140 to 200 mg/dL and FBS <126 mg/dL. The collected data were analysed with Student's t-test, chi-square test and multiple logistic regression analysis.</p><p><b>RESULTS</b>This study was performed on 12,514 subjects (48.9% males and 51.1% females). The total prevalence of DM was 6.7% and 5.3% in urban and rural areas and 5.4% and 7.1% in males and females, respectively. The mean blood glucose rose with age in both sexes, and blood glucose was higher in females and in urban areas. IGTT, known and new DM heightens as age increased and more than half of the diabetes cases in all age groups were newly diagnosed. The mean blood pressure, age, BMI, waist circumference and serum lipids were higher in people with DM and IGTT especially in females. Obesity, a family history of DM, high blood pressure, high WHR and ageing were associated with a higher probability of DM, but sex had no effect on this probability.</p><p><b>DISCUSSION AND CONCLUSION</b>Considering the high prevalence of DM in the central regions of Iran, providing vast educational programme to prevent this disease is essential and screening FBS tests, especially for obese subjects and those with a family history of DM, should be taken into account.</p>

Prevalence of the common cold symptoms and associated risk factors in a large population study

Common cold is the most frequent illness managed in general practice. Data regarding prevalence of the common cold in communities is confounded by the close similarity between allergy and/or asthma related symptoms and common cold. The purpose of this study was to elucidate possible correlations between self-reported common cold episodes and asthma/allergy related symptoms and some evident risk factors. As a part of an ISSAC study in Isfahan, Iran, a randomly selected population of 11666 students aged 6 to 18 years[mean +/- SD =12.96 +/- 2.99] were studied. The children or parents completed in a questionnaire with both ISSAC, and other supplementary questions regarding the common cold and allergy.11666 pupils [88.9%] completed the study. Those pupils reporting more than 3 to five episodes of the common cold exhibited a significantly more asthma and/or allergy related symptoms. Persian people with more than 3 to 5 episodes of cold like symptoms per year should be evaluated for allergic conditions

[ effect of cyproheptadine on prevention of Vomiting and Nausea induced by contrast agent during coronary angiography and ventriculography of left ventricle]

Background and aim: coronary artery disease is one of the most common problems in medicine. The correct diagnosis of the affected artery and its treatment can prevent further development of atherosclerosis. Coronary angiography is the gold diagnostic standard of coronary atherosclerosis disease, but causes some dangers for the patients, such as adverse reaction to contrast agent media. Vomiting and nausea are the most common problems during angiography that increase the length of angiography and cause unstrile condition. Nausea and vomiting are related to the serotonin receptors in the brain. The purpose of this study was to investigate the effect of cyproheptadine [a serotonin blocker] on vomiting and nausea during angiography and ventriculography

Methods: in this study, 400 patients were divided into two equal groups. One group received a placebo and the other received 8 mg of cyproheptadine one hour before the angiography. The patients were visited during 12 hours after the angiography and a questionnaire was filled. The data was analyzed using x[2] and t tests by SPSS

Results: minor adverse reaction rate, which was 78 cases, reduced to 27 cases by using cyproheptadine tablet. In the patient, who received placebo the rate of nausea was 27%, vomiting 5.5% and retching 3%. But in those who received cyproheptadine the rate of nausea was 8%, vomiting 2% and retching 1%. The adverse reactions were not correlated to sex, ejection fraction and coronary artery obstruction

Conclusion: cyproheptadine had an important role in decreasing nausea and vomiting during angiography