Association between blood pressure and parameters related to sleep disorders in Tabari cohort population.

BACKGROUND: Insomnia and other sleep disorders can cause an increase in blood pressure, thereby resulting in premature death. Regarding this, the present study was conducted to investigate the relationship between hypertension and parameters related to sleep disorders in Tabari cohort population. METHODS: In this cross-sectional study, the data from the enrollment phase of the Tabari cohort study were adopted. Tabari cohort is a part of the PERSIAN (Prospective Epidemiological Research Studies in Iran) cohort study. Data analysis was performed using descriptive and inferential statistics. RESULTS: Out of 10,255 patients enrolled in the Tabari cohort, 2,281 patients (22.2%) had hypertension. According to the results of univariable logistic regression test, the odds ratio of high blood pressure in patients with insomnia and hypersomnia is 1.22 (95% confidence interval [CI], 1.06-1.40) and 1.22 (95% CI, 1.01-1.47) times higher than normal sleep. This odds ratio was not significant after adjusting the effect of sex, age, body mass index, waist circumference, area residence, high-density lipoprotein cholesterol, triglyceride, and total cholesterol variables with multivariable logistic regression. Frequency of routine hypnotic medication usage (14.6% vs. 5.7%, P < 0.001), involuntary napping (25.3% vs. 19%, P < 0.001), and leg restlessness during sleep (14.8% vs. 11.7%, P < 0.001) was higher in hypertensive individuals than in nonhypertensive cases. CONCLUSIONS: This study showed that sleep disorders prevalence are higher in hypertensive patients than nonhypertensive patients. Also, routine use of hypnotics was significantly higher medication in patients with hypertension compared to that in the nonhypertensive patients.

Pyridoxine for treatment of levetiracetam-induced behavioral adverse events: A randomized double-blind placebo-controlled trial.

BACKGROUND: Levetiracetam is a broad-spectrum antiseizure medication with known behavioral side effects. The possible beneficial effect of pyridoxine on improvement of these psychiatric problems has been suggested in few previous studies. This clinical trial aimed to investigate the effect of pyridoxine on behavioral side effects of levetiracetam in adult patients with epilepsy. METHODS: This study was a randomized double-blind placebo-controlled clinical trial on 53 adult patients with epilepsy with behavioral side effects after treatment by levetiracetam. Patients who met the study criteria were randomized to receive 40 mg/day pyridoxine or placebo. Their psychiatric state was surveyed by SCL-90-R questionnaire before and three weeks after initiation of treatment. RESULTS: There were no statistically significant differences in the behavioral adverse effects between the pyridoxine-treated group and the placebo group. CONCLUSION: Although this study showed no statistically significant beneficial effects of pyridoxine on the behavioral adverse effects of levetiracetam, placebo-controlled trials with a larger size and higher doses are needed to determine whether it is effective or not.

Assessment of Nutritional Status and Related Factors of Lactating Women in the Urban and Rural Areas of Southwestern Iran: A Population-Based Cross-Sectional Study.

BACKGROUND: During the lactation period, mothers are at an increased risk of nutritional deficiencies due to improper dietary patterns, physiological changes, and various socio-demographic factors. The present study aimed to examine the nutritional status, dietary intake, and related factors among lactating women in the urban and rural areas of Khorramabad, Lorestan province in the southwest of Iran. METHODS: The present population-based cross-sectional study was conducted in Khorramabad (Iran) during April-July 2012. The study population included 708 lactating mothers who were referred to the health centers in Khorramabad (10 urban health centers and 30 rural health/community centers). A multi-stage sampling method was used to recruit the participants. The nutritional status and food intake of the participants were assessed over three days using the 24-hour dietary recall (24HDR) and dietary record (DR) questionnaires. The data were analyzed using SPSS software (version 16.0) with the Chi-square test, Fisher's exact test, paired t test, independent t test, and Pearson correlation coefficient. P<0.05 was considered statistically significant. RESULTS: The mean age and body mass index (BMI) of the mothers were 29.78±6.24 years and 26.11±3.70 kg/m2, respectively. There was a significant difference in calorie intake between the different categories of age, BMI, education level, job status (P<0.001) and lactation stage (P=0.034). The energy and nutrient intakes, except iron and phosphor, were statistically lower (P<0.05) than the prescribed Recommended Dietary Allowances (RDA). The intake of vitamins K, B1, B2, B3, and C; protein, magnesium, phosphor, zinc, copper, and iodine by mothers in the rural areas was significantly higher (P<0.05) than those in the rural areas. Higher intakes of energy and macronutrients by the lactating mothers had a significant negative correlation with an increase in age and had a significant positive correlation with a higher BMI (P<0.001). CONCLUSION: Lactating women in the urban and rural areas of Khorramabad (Iran) had a poor nutritional status. Nutrition education and a modified dietary pattern during the lactation period are recommended.

The Psychometric Properties of the Center for Epidemiological Studies Depression Scale (CES-D) for Iranian Cancer Patients.

Objectives: The Center for Epidemiologic Studies Depression Scale (CES-D) was specifically created to assess depression in cancer patients. However, to date, the CES-D has not been validated in Farsi. Therefore, this study aimed to assess the psychometric properties of the CES-D in Iranian cancer patients. Methods: During a three-month period (October to December, 2015), a total of 380 cancer patients completed a Farsi version of the CES-D. The construct validity of the scale was evaluated by exploratory factor analysis. Reliability was assessed using Cronbach's alpha and McDonald Omega. All of the statistical procedure were run by SPSS 22 (SPSS Inc., Chicago, IL, USA). Results: The construct validity of the CES-D determined three factors (somatic affect, negative affect, and positive affect), which explained 65.60% of the total variance. The internal consistency was greater than 0.70. Conclusion: Findings revealed that the Farsi version of the CES-D has acceptable validity and reliability, which can be used to measure depression in Iranian cancer patients.

Loperamide Dependency: A Case Report.

BACKGROUND: Loperamide is used as an antidiarrheal drug and is available over-the-counter. It cannot pass the blood-brain barrier and it does not have a considerable abuse potential. It can lead to dangerous cardiac arrhythmia. CASE REPORT: Herein, we report a 35-year-old man with a 13-year history of abusing opioids who had undergone detoxification for four times during this period. He underwent detoxification for using 200 mg loperamide daily with anticholinergic agents, clonidine, non-steroidal analgesics, and diazepam. No evidence of arrhythmia was seen in the patient. CONCLUSION: Tolerating high doses of loperamide could be dangerous and increases the risk of fatal cardiac arrhythmias.