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Rashidi Fakari F, Hajian S, Darvish S, Alavi Majd H. Predictors of help-seeking behaviors in women with urinary incontinence: Based on Iranian women's lens. PLoS One 2023; 18:e0289785. [PMID: 37540696 PMCID: PMC10403081 DOI: 10.1371/journal.pone.0289785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 07/26/2023] [Indexed: 08/06/2023] Open
Abstract
Urinary incontinence has an undeniable impact on the quality of life of affected women; however, talking about incontinence is not comfortable for many women, and they often hide it and do not seek treatment. Predictors affecting women's decisions to seek treatment in communities can be different. This study was designed to identify predictors of help-seeking behaviors among Iranian women with urinary incontinence. METHODS This cross-sectional, analytical study was conducted on 199 women with urinary incontinence who met the inclusion criteria by convenience sampling from the beginning of 2020 to the middle of 2021. The Incontinence Severity Index, Bradley's Questionnaire for Urinary Incontinence Diagnosis, Medical Embarrassment Questionnaires, Brief-Illness Perception Questionnaire, Incontinence Quality of Life Questionnaire, Barrier to Incontinence Care Seeking Questionnaire, Medical Help Seeking Scale, and Medical Outcomes Study Social Support Survey were all self-administered data collection tools used in this study. Multiple linear regression was used to investigate the relationship and prediction of help-seeking behaviors by other variables. To analyze the data, SPSS software version 20 was used. RESULTS The variables of shame, barriers to care, social support, quality of life, and age were found to be predictors of help-seeking behavior in the research population of women with urinary incontinence. Help-seeking had a direct relationship with quality of life and an inverse relationship with other factors. Among these factors, shame has the greatest impact (P = 0/001, β = - 0/37). CONCLUSIONS The extracted predictors, especially the variable of "shame" as the most important negative factor related to the treatment decisions of women with urinary incontinence, will help to health service providers to take into account these factors in the regular service provision programs that promote women's health, which are effective in facilitating the help-seeking of sufferers and correct guidance towards treatment or rehabilitation.
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Affiliation(s)
- Fahimeh Rashidi Fakari
- Department of Midwifery, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sepideh Hajian
- Department of Midwifery, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soodabeh Darvish
- Department of Obstetrics & Gynaecology, Fellowship of Female Pelvic Floor Medicine and Reconstructive Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Alavi Majd
- Department of Biostatistics, School of Paramedicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Aghaei Z, Hajian S, Darvish S. Maternal Plasma Lipid Profile and Risk of Spontaneous Preterm Labor Study in a Sample of Iranian Women in 2019. Iran J Nurs Midwifery Res 2023; 28:468-473. [PMID: 37694214 PMCID: PMC10484381 DOI: 10.4103/ijnmr.ijnmr_326_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 01/03/2023] [Accepted: 01/08/2023] [Indexed: 09/12/2023]
Abstract
Background Neonatal problems and adverse outcomes may be minimized by up to 90-75% when preterm delivery is diagnosed early and managed properly. This study aimed to determine the association of maternal plasma lipid indices with the occurrence of spontaneous preterm labor. Material and Methods This matched pair case-control study was performed on 80 pregnant women referred to a teaching hospital in Tehran for childbirth in 2019. The lipid profile was assessed in women with spontaneous preterm labor and term birth. According to age, Body Mass Index (BMI), pregnancy number, employment status, and educational level, the women in each group were paired. Data were analyzed using an independent-samples t-test, Mann-Whitney U-test, Chi-square, linear regression, and conditional logistic regression. Results Mean serum levels of total cholesterol, triglycerides, and low-density lipoprotein were all significantly higher in the case group compared with the control group (p < 0.05). The conditional logistic regression test confirmed that this association remained significant even after adjusting the effect of potentially confounding factors such as maternal age and body mass index. In addition, in linear regression the increased levels of triglyceride, total cholesterol, and low-density lipoprotein were found to be associated with 3.33-fold (1.32.-5.32 95% CI, p < 0.001), 2.94-fold (1.60-3.14 95% CI, p = 0.002), and 2.46-fold (1.31.-2.91 95% CI, p = 0.006) increased risk of preterm labor, respectively. Conclusions High triglyceride, total cholesterol, and low-density lipoprotein serum levels may be linked to an increased chance of spontaneous preterm labor, which might be considered a risk factor for this pregnancy problem.
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Affiliation(s)
- Zohreh Aghaei
- Student Research Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sepideh Hajian
- Midwifery and Reproductive Health, Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Soodabeh Darvish
- Department of Obstetrics and, Gynecology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Eftekhar T, Ghanbari Z, Pourali L, Deldar Pesikhani M, Darvish S, Ayati E, Haj Hashemi M, Lotfi Z. Changes of Pelvic Organ Prolapse Symptoms and Quality of Life One Year After Pessary Fitting. ACTA 2021. [DOI: 10.18502/acta.v59i6.6890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Pelvic organ prolapse (POP) is the descend of pelvic organs, including the uterus, bladder, and rectum, to the vaginal wall. Patients with POP may present with symptoms such as vaginal bulging with other symptoms like urinary, defecatory, or sexual dysfunction. This study was conducted to evaluate the changes of POP symptoms one year after pessary fitting. Patients with symptomatic pelvic organ prolapse who presented to the pelvic floor clinic of an academic hospital between August 2016 and April 2019 were considered. Pelvic organ prolapse symptoms, including urinary, defecatory, sexual, and bulging symptoms, were recorded before and one year after pessary fitting. Pelvic floor distress inventory (PFDI)-20 and pelvic floor impact questionnaire-7 (PFIQ-7) were evaluated before and after treatment for all subjects. We analyzed the characteristics of 110 patients who used the pessary for 12 months. At the baseline, the most common prolapse symptoms were vaginal bulging and pelvic pressure. All urinary, defecatory, and sexual symptoms significantly improved one year after regular pessary use (P<0.001). Changes in PFDI-20 and PFIQ-7 before and after pessary use showed a significant improvement in both frequency and satisfaction of sexual function (P<0.001). The study showed significant improvement in bulging, urinary, and defecatory symptoms. Although the majority of patients were not sexually active, a significant proportion of sexually active patients reported an increase in sexual satisfaction.
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Rashidi Fakari F, Hajian S, Darvish S, Alavi Majd H. Explaining factors affecting help-seeking behaviors in women with urinary incontinence: a qualitative study. BMC Health Serv Res 2021; 21:60. [PMID: 33435931 PMCID: PMC7805109 DOI: 10.1186/s12913-020-06047-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 12/26/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Urinary incontinence is widely accepted to be among the most important issues in the global health system. However, only a limited number of women are referred for treatment because different factors complicate help-seeking behaviors. The aim of this study was to explain the factors affecting help-seeking behaviors in women suffering from urinary incontinence. METHODS This study was a qualitative study using the conventional content analysis approach. The study was conducted from December 2018 and August 2019 in Tehran, Iran. The participants were 34 women with urinary incontinence selected using a purposive sampling method. The content analysis approach was based on the Graneheim and Lundman method, and qualitative data management software was used for analysis. RESULTS Data analysis illustrates two themes; " facilitator " and " inhibitor "; the categories "not perceiving disease", "shame", " negative support of important others", and "non-optimal health care system" were among the inhibitors and the categories " reduced quality of life " and " positive support of important others" were found to be facilitators of help-seeking behaviors. CONCLUSIONS The findings of the present study highlight the need for understanding the underlying facilitators and inhibitors of help-seeking behaviors in women with urinary incontinence. We suggest that healthcare providers consider an open dialogue with patients and consider their subjective beliefs and life context during routine visits to facilitate early diagnosis of the disease and ultimately lead to an improvement in the woman's quality of life.
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Affiliation(s)
- Fahimeh Rashidi Fakari
- School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sepideh Hajian
- Midwifery & Reproductive Health research centre, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Soodabeh Darvish
- Department of Obstetrics & Gynaecology, Fellowship of Female Pelvic Floor Medicine and Reconstructive Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamid Alavi Majd
- Department of Biostatistics,School of Paramedicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Ghanbari Z, Sohbati S, Eftekhar T, Sahebi L, Darvish S, Alasiri S, Deldar Pasikhani M. Fractional CO2 Laser for Treatment of Vulvovaginal Atrophy: A Short Time Follow-up. J Family Reprod Health 2020; 14:68-73. [PMID: 33603796 PMCID: PMC7865202 DOI: 10.18502/jfrh.v14i2.4347] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objective: The aim of this study was to evaluate the safety and efficacy of fractional CO2 laser for treatment of vulvovaginal atrophy. Materials and methods: In this clinical trial study, we evaluated the laser effect on vulvovaginal atrophy in 47 women aged 43-80 years. Each woman was treated with fractional CO2 laser, SmartXide2V2LR, DEKA, Monalisa Touch, vaginal 360o probe and cosmetic probe. The severity of vulvovaginal atrophy symptoms was evaluated before first session of laser and every 4 weeks after laser treatment until 12 weeks. Adverse effects including pain and itching were assessed at all visits. The statistical analysis was performed using SPSS version 23. Results: The response to laser therapy for vaginal dryness was significantly (p <0.001) improved. Also, the response to laser therapy for each symptom include dyspareunia, vaginal discharge, itching and urge urinary incontinence was statistically significant (p <0.001) based on visual analogue scale (VAS). Conclusion: It seems vaginal fractional CO2 laser can be applied as an effective and safe treatment method in genitourinary syndrome of menopause (GSM). It is necessary to conduct studies with long-term follow-up.
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Affiliation(s)
- Zinat Ghanbari
- Department of Obstetrics & Gynecology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Samira Sohbati
- Department of Obstetrics & Gynecology, Kerman University of Medical Sciences, Kerman, Iran
| | - Tahereh Eftekhar
- Department of Obstetrics & Gynecology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Leyla Sahebi
- Maternal Fetal and Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Soodabeh Darvish
- Department of Obstetrics & Gynecology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Safa Alasiri
- Department of Obstetrics & Gynecology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Marayam Deldar Pasikhani
- Department of Obstetrics & Gynecology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
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Abasian Kasegari F, Pazandeh F, Darvish S, Huss R, Nasiri M. Admitting women in active labour: A randomised controlled trial about the effects of protocol use on childbirth method and interventions. Women Birth 2019; 33:e543-e548. [PMID: 31892475 DOI: 10.1016/j.wombi.2019.12.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Revised: 12/07/2019] [Accepted: 12/09/2019] [Indexed: 10/25/2022]
Abstract
AIM To determine the effects of protocol of admitting women in active labour on childbirth method and interventions during labour and childbirth. METHODS This single-blind randomised clinical trial was conducted in a public hospital in Mazandaran province (Iran) in 2017. Two hundred nulliparous low-risk women were randomly assigned into intervention and control groups. The participant women were admitted in the intervention group using the admission protocol and to the group control by staff midwives and doctors. The admission criteria of the protocol were: the presence of regular, painful contractions, the cervix at least four cm dilated and at least one of the following cues: cervix effaced, and spontaneous rupture of membranes, or "show". The primary outcome measure was childbirth method. Data were analyzed in SPSS-22 using Mann-Whitney and Chi-square tests. The level of statistical significance was set as p<0.05. FINDING There were significant differences between the intervention and control groups in the number of caesarian section (CS) (p<0.001). Two groups had a statistically significant difference in amniotomy (p=0.003), augmentation by oxytocin (p<0.001), number of vaginal examinations (p<0.001) and fundal pressure (p<0.001). CONCLUSIONS Using a protocol for admission of low risk nulliparous women in active labour contributed to reduction of the primary caesarean section rate and interventions during childbirth. A risk assessment and using evidence informed guidelines in admission can contribute to reduce unsafe and harmful practices and support normalisation of birth. This is essential for demedicalisation and a useful strategy for reducing primary CS.
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Affiliation(s)
- Freshteh Abasian Kasegari
- School of Nursing and Midwifery Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Biostatistics, Faculty of Paramedical, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzaneh Pazandeh
- Department of Midwifery and Reproductive Health, Midwifery and Reproductive Health Research Centre, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Biostatistics, Faculty of Paramedical, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Soodabeh Darvish
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Biostatistics, Faculty of Paramedical, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reinhard Huss
- Nuffield Centre for International Health and Development, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK; Department of Biostatistics, Faculty of Paramedical, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Malihe Nasiri
- School of Nursing and Midwifery Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Biostatistics, Faculty of Paramedical, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Haghdoost S, Pazandeh F, Darvish S, Khabazkhoob M, Huss R, Lak TB. Association of serum vitamin D levels and urinary tract infection in pregnant women: A case control study. Eur J Obstet Gynecol Reprod Biol 2019; 243:51-56. [PMID: 31671292 DOI: 10.1016/j.ejogrb.2019.10.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 10/03/2019] [Accepted: 10/17/2019] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Urinary tract infection (UTI) is common during pregnancy and can cause serious complications for the mother and fetus. Vitamin D, is known to have an effect on the urothelium, with immunomodulatory capacity against bacterial infection. This study explored the association between serum vitamin D levels and urinary tract infections in pregnant women. STUDY DESIGN In this case control study, 187 participants including, 97 pregnant women diagnosed as a symptomatic UTI (case group) and 90 matched healthy pregnant women (control group) were consecutively enrolled from prenatal care clinic of Imam Reza Hospital in Urmia, North West of Iran. The two groups were matched for trimester and parity, and sexual intercourse. Blood samples were collected from both groups. Chemiluminescent immunoassay (CLIA) was used to evaluate the serum vitamin D levels. We used a binary multivariate unconditional logistic regression approach to evaluate the association between UTI and vitamin D and risk factor of the UTI. RESULTS Vitamin D deficiency (less than 20 ng/mL) was diagnosed in 85.7% of case group and 52.2% of control group. The serum vitamin D levels were significantly lower in pregnant women in the case group compared to the control group (12.7 ± 5.9 ng/ml vs 26.05 ± 10.37; p < 0.001). Pregnant women in case group with acute pyelonephritis had significantly lower serum vitamin D levels than those with Cystitis (p < 0.05). The serum vitamin D level of less than 20 ng/ml was the only factor associated with UTI after adjusting for all the confounders in multiple binary logistic regression modeling (AdjOR = 3.67; 95% of CI: 1.19-6.24; p < 0.001). CONCLUSIONS Women with vitamin D deficiencies are at increased risk of urinary tract infections during pregnancy. However, further studies are essential to confirm these observed results.
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Affiliation(s)
- Simin Haghdoost
- Student Research Committee, Department of Midwifery and Reproductive Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzaneh Pazandeh
- Department of Midwifery and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences Tehran, Iran.
| | - Soodabeh Darvish
- Department of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Khabazkhoob
- Department of Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
| | - Reinhard Huss
- Senior Teaching fellow, Nuffield Centre for International Health and Development, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Tahereh Behroozi Lak
- Reproductive Health Research Center, Department of Infertility, Urmia University of Medical Sciences, Urmia, Iran
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Barooti E, Darvish S, Kariman N, Yazdanpanah G. Comparison of Human Chorionic Gonadotropin Test and Amnisure Test for Diagnosis of Premature Rapture of Membrane. mljgoums 2019. [DOI: 10.29252/mlj.13.1.28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Niroumanesh S, Mehdipour P, Farajpour A, Darvish S, Paprocka-Borowicz M, Busza H, Plewa R, Bułło A, Jagielski J. A cytogenetic study of couples with repeated spontaneous abortions. Ann Saudi Med 2011; 31:77-9. [PMID: 21245604 PMCID: PMC3101730 DOI: 10.4103/0256-4947.75785] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND AND OBJECTIVE The frequency of chromosomal aberrations in Iran is not definitely known. This study determined the frequency of chromosomal aberrations in a series of couples with two or more spontaneous abortions and compared the findings with that reported from other countries. METHODS This was a descriptive study conducted on 100 couples with recurrent abortions. Both partners were karyotyped as part of the primary investigation. Other probable causes of abortion were also investigated. RESULTS Chromosomal aberrations were found in 8 (8%) of the females and 5 (5%) of the males. The prevalence of chromosomal abnormalities was as follows: 4 (30.8%) balanced reciprocal translocations, 3 (23%) Robertsonian translocations, 3 (23%) pericentric inversions, 1 (7.7%) paracentric inversion, 1 (7.7%) chromosomal marker, and 1 (7.7%) polymorphism 9qh+. CONCLUSIONS The pattern of chromosomal aberrations was similar to that reported in other studies, but the prevalence of chromosomal aberrations was higher.
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Affiliation(s)
- Shirin Niroumanesh
- Mirza Koochak Khan Hospital, Medical Sciences/University of Tehran, Tehran, Iran
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10
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Valadan M, Yarandi F, Eftekhar Z, Darvish S, Fathollahi M, Mirsalehian A. Chlamydia trachomatis and cervical intraepithelial neoplasia in married women in a Middle Eastern community. East Mediterr Health J 2010. [DOI: 10.26719/2010.16.3.304] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Sadeghian S, Graili P, Salarifar M, Karimi AA, Darvish S, Abbasi SH. Opium consumption in men and diabetes mellitus in women are the most important risk factors of premature coronary artery disease in Iran. Int J Cardiol 2009; 141:116-8. [PMID: 19346018 DOI: 10.1016/j.ijcard.2008.11.063] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2008] [Accepted: 11/16/2008] [Indexed: 10/20/2022]
Abstract
We performed this study to compare of CAD risk factors in young male and female in Iran. In an analytic cross-sectional study, two groups of patients were evaluated with and without Coronary artery disease. The result of study suggests that there is a relationship between CAD and diabetes mellitus, increasing level of LDL and lipoprotein A in women, While CAD in men had more relation with smoking and opium use. High prevalence and uncontrolled diabetes mellitus in females and relatively high prevalence of opium consumption in males result in different premature CAD patterns.
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12
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Sadeghian S, Darvish S, Shahbazi S, Mahmoodian M. Two ecstasy-induced myocardial infarctions during a three month period in a young man. Arch Iran Med 2007; 10:409-12. [PMID: 17604486 DOI: 07102/aim.0026] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Ecstasy normally contains 3,4 methylenedioxymethamphetamine (MDMA) that increases the levels of serotonin, dopamine, and epinephrine in the central nervous system with consequent adverse effects on the cardiovascular system. Herein, we presented a case of ecstasy abuse which resulted in two episodes myocardial infarction during a three month period; the second episode led to death due to thrombus formation.
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Affiliation(s)
- Saeed Sadeghian
- Research Department, Tehran Heart Center, Tehran University of Medical Sciences, North Karegar Avenue, Tehran 1411713138, Iran.
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13
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Sadeghian S, Darvish S, Salimi S, Esfehani FA, Fallah N, Mahmoodian M, Salarifar M, Karimi A. Metabolic syndrome: stronger association with coronary artery disease in young men in comparison with higher prevalence in young women. Coron Artery Dis 2007; 18:163-8. [PMID: 17429288 DOI: 10.1097/mca.0b013e328012a94f] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Being overweight, a constituent of the metabolic syndrome, is also an important contributing factor to the development of coronary artery disease in younger patients, compared with the older patient population. Owing to the above-mentioned fact, we sought to assess the association of the metabolic syndrome with premature coronary artery disease. METHODS In an analytic cross-sectional study, 940 patients (553 women<or=55 years and 387 men<or=45 years), 637 with coronary artery disease and 303 without coronary artery disease, were evaluated. The extent of atherosclerosis was assessed with a clinical vessel score. Besides established coronary artery disease risk factors, all patients were evaluated for the presence of metabolic syndrome based on the National Cholesterol Education Program Adult Treatment Panel III criteria. RESULTS The overall prevalences of metabolic syndrome and coronary artery disease were 56 and 67.8%, respectively. Metabolic syndrome prevalence was higher in women than in men (69.6 vs. 36.4%, P<0.001). The odds ratio of metabolic syndrome for premature coronary artery disease was 1.82 (95% confidence interval 1.17-2.82) after adjusting for age and multiple established coronary artery disease risk factors; the strength of this association varied by sex (2.17 in men vs. 1.22 in women). CONCLUSIONS This study revealed a stronger association between metabolic syndrome and coronary artery disease in men<or=45 years than in women<or=55 years. It seems that endogenous estrogens may play a role in reducing the effects of metabolic syndrome-related risk and therefore in spite of higher prevalence of metabolic syndrome in young women, the effect of this syndrome on coronary artery disease is more dominant in young men.
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Affiliation(s)
- Saeed Sadeghian
- Research Department Tehran Heart Center, Tehran University of Medical Sciences, Shahed University, Tehran, Iran.
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14
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Kassaian SE, Alidoosti M, Saleh DK, Zeinali AMH, Salarifar M, Sahraian AM, Shirani S, Kazazi EH, Darvish S, Marzban M, Abbasi SH, Massumi A. Risk factors for major complications due to delay in surgery in staged carotid stenting and coronary bypass graft surgery. EUROINTERVENTION 2007; 3:60-66. [PMID: 19737686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
AIMS To answer the question whether the delay in coronary artery bypass grafting (CABG) after carotid stenting (CAS) results in adverse events, we describe our experience with planned staged CAS followed by CABG. METHODS AND RESULTS We retrospectively surveyed our hospital carotid stenting data base, to identify all patients who were scheduled to undergo staged carotid stenting followed by CABG. A total of 39 patients who underwent CAS were candidates for staged CABG but only 28 (71.7%) of them referred. In the interval between carotid stenting and CABG, 4 deaths occurred (14.2% of cases), all of them were in the first week after CAS and due to cardiac problems. Also, 2 patients (7.1%) had a minor stroke. Increased number of predictors of type C (most important was stenosis of 95%-99%), age > 75 or significant valvular heart disease were associated with increased rate of complications after CAS. CONCLUSION Should carotid intervention be performed in the high risk group of patients with > 4 suggested predictors of type C (most importantly is stenosis of 95%-99%), valvular heart disease or age > 75, physicians should closely observe the patients (perhaps in the hospital) during the waiting period before CABG, particularly in the first week after carotid stenting.
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Affiliation(s)
- Seyed Ebrahim Kassaian
- Interventional Cardiologist, Tehran Heart Center, Medical Sciences, University of Tehran, Tehran, Iran
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15
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Sadeghian S, Fallahi F, Salarifar M, Davoodi G, Mahmoodian M, Fallah N, Darvish S, Karimi A. Homocysteine, vitamin B12 and folate levels in premature coronary artery disease. BMC Cardiovasc Disord 2006; 6:38. [PMID: 17002799 PMCID: PMC1592513 DOI: 10.1186/1471-2261-6-38] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2006] [Accepted: 09/26/2006] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Hyperhomocysteinemia is known as an independent risk factor of atherosclerosis, but the probable role of hyperhomocysteinemia in premature Coronary Artery Disease (CAD) is not well studied. The aim of this study was to assess the role of hyperhomocysteinemia, folate and Vitamin B12 deficiency in the development of premature CAD. METHODS We performed an analytical case-control study on 294 individuals under 45 years (225 males and 69 females) who were admitted for selective coronary angiography to two centers in Tehran. RESULTS After considering the exclusion criteria, a total number of 225 individuals were enrolled of which 43.1% had CAD. The mean age of participants was 39.9 +/- 4.3 years (40.1 +/- 4.2 years in males and 39.4 +/- 4.8 years in females). Compared to the control group, the level of homocysteine measured in the plasma of the male participants was significantly high (14.9 +/- 1.2 versus 20.3 +/- 1.9 micromol/lit, P = 0.01). However there was no significant difference in homocysteine level of females with and without CAD (11.8 +/- 1.3 versus 11.5 +/- 1.1 micromol/lit, P = 0.87). Mean plasma level of folic acid and vitamin B12 in the study group were 6.3 +/- 0.2 and 282.5 +/- 9.1 respectively. Based on these findings, 10.7% of the study group had folate deficiency while 26.6% had Vitamin B12 deficiency. Logistic regression analysis for evaluating independent CAD risk factors showed hyperhomocysteinemia as an independent risk factor for premature CAD in males (OR = 2.54 0.95% CI 1.23 to 5.22, P = 0.01). Study for the underlying causes of hyperhomocysteinemia showed that male gender and Vitamin B12 deficiency had significant influence on incidence of hyperhomocysteinemia. CONCLUSION We may conclude that hyperhomocysteinemia is an independent risk factor for CAD in young patients (below 45 years old)--especially in men--and vitamin B12 deficiency is a preventable cause of hyperhomocysteinemia.
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Affiliation(s)
- Saeed Sadeghian
- Assistant Professor of Cardiology, Research Department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Faramarz Fallahi
- Assistant Professor of Cardiology, Shahed University, Tehran, Iran
| | - Mojtaba Salarifar
- Assistant Professor of Interventional Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Gholamreza Davoodi
- Assistant Professor of Cardiology, Research Department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehran Mahmoodian
- Researcher, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Nader Fallah
- Regular member of board, Department of Biostatistics, Shahed University, Tehran, Iran
| | - Soodabeh Darvish
- Researcher, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbasali Karimi
- Associated Professor of cardiac surgery, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
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