Comparison of the effects of the time of home-based cardiac rehabilitation program on the changes in cardiometabolic risk factors in patients with phase-IV myocardial infarction: A randomized controlled trial.

BACKGROUND: It seems that the time of performing cardiac rehabilitation is important in determining the risk of cardiac complications in patients with myocardial infarction (MI). The present study aimed to investigate the effects of a home-based cardiac rehabilitation program (HCRP) conducted in either the morning or evening on cardiometabolic risk factors in phase IV (maintenance) MI patients. METHODS: In this randomized controlled clinical trial, 80 patients with MI were divided into 2 groups of intervention and control (40 individuals per group). Patients in each group were categorized into morning and evening subgroups (20 individuals per subgroup). The therapeutic regimen in the intervention group included HCRP, routine medications, and exercise and walking programs for 8 weeks. Patients in the control group received routine treatments for 8 weeks. Cardiovascular risk factors comprising of cardiac troponin I (cTnI), mean platelet volume (MPV), C-reactive protein (CRP), and cardiometabolic indicators including cholesterol (Cho), high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglyceride (TG), and the maximum rate of oxygen consumption (VO2 max) were measured for all patients before and after the intervention. RESULTS: Our results showed significant reductions in Cho, TG, HDL, LDL, VO2 max, CRP, and MPV (P < 0.05) in the group performing HCRP in the evening compared with the morning group. CONCLUSION: Performing HCRP in the evening, compared with morning, can be significantly more effective in improving the levels of cardiometabolic risk factors in patients with MI. Therefore, it is recommended that rehabilitation programs be implemented in these patients in evening shifts.

Evaluation of shape factor impact on discharge coefficient of side orifices using boost simulation model with extreme learning machine data-driven.

In this paper, for the first time, the impact of the shape factor on the discharge coefficient of side orifices is evaluated using the novel Extreme Learning Machine (ELM) model. In addition, the Monte Carlo simulations (MCs) are applied to assess the accuracy of the modelling. Furthermore, the validation is conducted by means of the k-fold cross-validation approach (with k = 5). In other words, the most optimized number of hidden neurons is chosen to be equal to 30 and the results of all activation functions of the extreme learning machine are examined and the sigmoid activation function is selected for simulating the discharge coefficient. Subsequently, two modelling combinati0ons are introduced using the input parameters and five different extreme learning machine models are also developed. The analysis of the modelling results exhibits that the model with the shape factor is more accurate. The superior model is a function of all input parameters reasonably estimating the discharge coefficient. For example, the values of R and MAPE for this model are estimated to be 0.990 and 0.223, respectively. The results of the superior model are also compared with the empirical equations and it was shown that this model has higher accuracy.

The effect of combined functional training on BDNF, IGF-1, and their association with health-related fitness in the multiple sclerosis women.

OBJECTIVE: Exercise-induced changes in the neurotrophic factors and the physical function are essential for the rehabilitation of the multiple sclerosis (MS) persons. The aim of this study was investigating of effectiveness of the combined functional training (CFT) on brain-derived neurotrophic factor (BDNF), insulin-like growth factor-1 (IGF-1), and their association with health-related fitness in the MS women. DESIGN: Twenty women with relapsing-remitting MS randomly assigned to CFT and control (CON) groups. The CFT consisted of 8 weeks (3 days per week) rhythmic aerobic exercise, TRX suspension training, elastic band training, and bodyweight training. BDNF, IGF-1, and health-related fitness components were assessed before and after the intervention. RESULTS: There was no significant difference in BDNF level between the CFT and the CON group. In contrast, IGF-1, walking speed, and strength of the right- and left-hand was significantly increased in the CFT compared with the CON group. Furthermore, there was a significant and positive correlation between IGF-1 and some fitness components. CONCLUSIONS: The findings indicated that CFT might a useful training mode in the rehabilitation of the MS women. CFT improved IGF-1 level that is a neuroprotective agent in MS. Positive and significant association between IGF-1 and some health-related fitness components indicates of the importance of IGF-1 in the rehabilitation of the MS persons than BDNF.

A mini-review on the most important effective medicinal plants to treat hypertension in ethnobotanical evidence of Iran.

Nowadays, cardiovascular diseases are highly prevalent in human communities. Hypertension is a multifactorial disease which causes a mortality twice higher than general population. Given the fact that medicinal plants have long been used to treat hypertension and are currently being administered for this disease, we sought to report the mostly effective and important medicinal plants on hypertension therapy in ethno-botanical evidence of Iran. In this study, hypertension, Iran, ethno-botany, medicinal plants, and traditional medicine were used as key words to search in Web of Science, PubMed, Scopus, EBSCO and EMBASE to select relevant articles. The findings of this study indicated that in Iran 40 plants in various provinces are used to treat hypertension. Because medicinal plants in this study contain effective compounds and have long been used to treat and reduce hypertension, they could provide suitable research arrangements for controlling hypertension, while effective natural drugs could be developed to control hypertension if their properties are confirmed in pharmacological studies.

An ethnobotanical study of medicinal plants administered for the treatment of hypertension.

INTRODUCTION: The incidence of cardiovascular diseases (CVDs) is very high in human societies and their prevention and treatment are the most important priority in many countries. Hypertension makes an important contribution to the development of CVDs. OBJECTIVES: This study aimed to collect the ethno-medicinal knowledge of the traditional healers of Shiraz on medicinal plants used in the treatment of hypertension. MATERIALS AND METHODS: Ethno-medicinal data were collected from September 2012 to July 2013 through direct interview. Twenty-five healers were interviewed using semi-structured questionnaires and their traditional ethno-medicinal knowledge was recorded. Questionnaires were included apothecary personal information, plant local name, plant parts used, method of preparation, season of harvest and traditional use. Data collected from surveys and interviews were transferred to Microsoft Excel 2007 and analyzed. RESULTS: Analysis of data showed that, 27 medicinal plants from 22 families are used for the treatment of hypertension. The families with most antihypertensive species were Apiaceae (8%), Rosaceae (8%) and Papaveraceae (8%). The most frequently used plant parts were leaves (36%) followed by fruits (30%), aerial part (17%) and branches (7%). The most frequently used preparation method was decoction (95%). Borago officinalis (51.85%), Berberis vulgaris (51.58%) had the highest frequency of mention. CONCLUSION: The ethno-medicinal survey of medicinal plants recommended by traditional healers for the treatment of hypertension provides new areas of research on the antihypertensive effect of medicinal plants. In the case of safety and effectiveness, they can be refined and processed to produce natural drugs.

Identification of medicinal plants for the treatment of kidney and urinary stones.

INTRODUCTION: Kidney stones are the third most common urinary tract problems after urinary tract infections and prostate pathology. Kidney stones may cause extreme pain and blockage of urine flow. They are usually treated with medications that may cause a number of side-effects. Medicinal herbs are used in different cultures as a reliable source of natural remedies. OBJECTIVES: This study aimed to determine native medicinal plants used by traditional healers of Shiraz for the treatment of kidney stones. MATERIALS AND METHODS: The ethno-medicinal data were collected between July and September 2012 through face-to-face interview with local herbalist. RESULTS: A total of 18 species belonging to 19 botanical families were recorded in study area. Species with the highest frequency of mentions were Alhagi maurorum (51.58%), Tribulus terrestris (51.58%), and Nigella sativa (48.14). The most frequently used plant parts were aerial parts (38%), leaf (33%) and fruits (17%). Decoction (68%) was the most frequently prescribed method of preparation. Most of the medicinal plants recommended by Shirazian herbalists have not been investigated in animal and humane models of renal stone which provides a new area of research. CONCLUSION: In the case of safety and effectiveness, they can be refined and processed to produce natural drugs.

An ethno-medicinal study of medicinal plants used for the treatment of diabetes.

BACKGROUND: Diabetes is the greatest public health problem and is considered as the silent epidemic of the 21st century. In Iran, there are approximately 1.5 million diabetic patients. Before the discovery of insulin, medicinal plants were widely used for the treatment of diabetes in Iran. OBJECTIVES: This study aimed to determine the indigenous plants used for the treatment of diabetes in Shiraz, southwest of Iran. MATERIALS AND METHODS: Semi-structured direct interviews were conducted with 25 herbalists to identify medicinal plants used to treat diabetes. Questionnaires were included herbalist personal information, plant local name, growth season, plant parts used, preparation methods, and traditional therapies. RESULTS: The interview data indicated that, 24 medicinal plants from 19 families are used for the treatment of diabetes in Shiraz. The families with most antidiabetic species were Compositae (13%), Rosaceae (13%) and Cucurbitaceae (8%). The most frequently used plant parts were fruits (38%) and the most common preparation method was decoction (62%). For 45% of reported plants, pharmaceutical studies approved antidiabetic effects in animal or humane model of diabetes. RESULTS of this study showed that the plants recommended by Shirazian herbalists have potential antidiabetic effects. CONCLUSIONS: It is suggested that the ingredients of indigenous plants be studied to determine therapeutic effects and mechanism of action. If they were safe and effective, they can be refined and processed to produce natural drugs.

Prevalence of non-alcoholic fatty liver disease in patients with coronary artery disease.

BACKGROUND: Several common metabolic risk factors contribute to development of both non-alcoholic fatty liver disease (NAFLD) and coronary artery disease (CAD). The aim was to determine prevalence of NAFLD in patients with CAD. METHODS: This prospective study was carried out from December 2011 to June 2012. All patients with documented diagnosis of CAD with stenosis of one of the main coronary arteries or their branches were included in the study. Ultrasound examination of liver was performed in all patients to diagnose hepatic steatosis. Accordingly, the severity of steatosis was graded from 0 (absence of steatosis) to 3 (severe steatosis). Finally, prevalence of NAFLD was determined in the studied patients. RESULTS: Among 170 patients with CAD included in the study, 63 and 17 had grade 1 and 2 hepatic steatosis in ultrasound examination, respectively, providing prevalence of 47% in studied population. There was no significant difference between patients with NAFLD and those without NAFLD regarding gender (P = 0.120), presence of diabetes mellitus (P = 0.270), hyperlipidemia (P = 0.210) and hypertension (P = 0.870). There was no association between involvement of left anterior descending artery and hepatic steatosis (P = 0.870). CONCLUSION: The present study indicated a high prevalence of NAFLD in patients with documented CAD.

Erectile dysfunction as a predictor of early stage of coronary artery disease.

BACKGROUND: Diagnosis of coronary artery disease (CAD) in early stages is vital in decreasing mortality by reducing the risk factors. The aim of this study was to investigate the association between erectile dysfunction (ED) and CAD. METHODS: A total of 200 patients were divided into four groups according to their angiography results: Group 1 (G1, n = 59): patients with one-vessel disease (1-VD); Group 2 (G2, n = 40): patients with two-vessel disease (2-VD); Group 3 (G3, n = 50): patients with three-vessel disease (3-VD); and controls (C, n = 51) without any coronary disease. The International Index of Erectile Function (IIEF) was completed for all the patients to assess their sexual function and ED in the last 6 months. RESULTS: Mean age of the participants was 57.69 ± 12.466 years. The prevalence of ED in the CAD patients was significantly higher than that of the controls (75.16% vs. 60.8%; p value = 0.041). There was a significant direct correlation between the number of involved vessels in the CAD patients and ED severity (r: 0.183; p value = 0.010), and the ED rate increased with age. CONCLUSION: In conclusion, ED severity correlated with the number of involved vessels documented by coronary angiography. Consequently, ED may be considered a possible marker for the development of atherosclerosis and CAD.

Lipid profile in cerebrovascular accidents.

BACKGROUND: Changes in the lipid profile have been suggested as a risk factor for developing ischemic stroke. Their role in intra-cerebral hemorrhage, however, is not clear. The present study was designed to evaluate the lipid profile levels of patients who had experienced an acute stroke during the first 24-hour and to compare these levels in different patients suffering from the stroke, either hemorrhagic or ischemic, and healthy individuals. METHODS: In this cross-sectional study, 258 consecutive patients with acute stroke admitted to the neurology department of our center during September 2006 and September 2007 were studied. As for the control group, 187 apparently healthy subjects living in the same community and matched for age and sex were selected. Lipid profile was measured and compared between the three groups. RESULTS: In the patients' group, 65 suffered from hemorrhagic stroke (group 1) and the other 193 had ischemic stroke (group 2). Except for TG values, there was no significant difference among the ischemic and hemorrhagic lipid profile. Age, cholesterol, and LDL influenced the risk of developing an ischemic stroke; TG was not reported as a risk factor or a protective one. While the comparison of data retrieved from patients suffering from hemorrhagic strokes with the controls, revealed LDL as the risk factor contributing to the development of ICH whereas TG was reported as a protective factor. CONCLUSION: It could be concluded that LDL level can be considered as a risk factor for both ischemic and hemorrhagic cerebral events.

Allopurinol as adjunctive therapy in intractable epilepsy: a double-blind and placebo-controlled trial.

BACKGROUND: Adenosine has been proposed to be an endogenous anticonvulsant agent. It inhibits glutamate release from excitatory neurons and neuronal firing. Therefore, adenosine agonists have potential clinical application as antiepileptics. In this double-blind randomized, placebo-controlled trial, we assessed the antiepileptic effect of allopurinol as an adjuvant agent in 38 patients with refractory epilepsy. METHODS: Thirty eight patients were randomly allocated equally to allopurinol+preexisting antiepileptic (Group A) or placebo+preexisting antiepileptic (Group B) for a 6-month, double-blind, placebo-controlled study. The dose of allopurinol was titrated up to 300 mg/day (100 mg TDS). The dose of preexisting medications was maintained without change over the trial. The effect of allopurinol was evaluated by a reduction in the total number of seizures per month and duration of seizure attacks. RESULTS: Of 38 participants, 32 patients completed the study. There were significant differences between the two groups in terms of reduction in the total number of seizure over the trial. Seizures reduction of >30% in 66%, >50% in 55%, and >60% in 44% of cases in the allopurinol group was achieved after 2 months and persisted during the study. Nevertheless, only during month 4 was there a significant difference between the two groups regarding reduction in seizure duration. In the allopurinol group, two patients had transient rashes, two patients had mild nausea, and two experienced dizziness, but only one patient discontinued the drug due to dizziness. In the placebo group, one patient had rash and one patient had nausea. In addition, no significant hematological or hepatic changes were found during the trial in both groups. CONCLUSIONS: The results suggest allopurinol as a safe and effective adjuvant agent in refractory epilepsy. Based on this study, we suggest that purine metabolism pathways and the specific use of allopurinol should be further investigated with regards to neurobiology and treatment of refractory epilepsy.