آموزش و پرورش جديد شهرستان...

باسمه تعالی

بیماریهاي از مفتخریم که اولین کنگره خاورمیانه پیشگیري هاي اکوکاردیوگرافی، دومین ‌تازهکنگره عروق کرونر قلب، دومین

هاي قلب و عروق و چهارمین ‌المللی دانشجوئی بیماري‌همایش بیندوره آمادگی امتحانات بورد تخصصی را در شهر زیباي شیراز

.برگزار نمائیمترین و ‌پرهزینه به رغم اینکه از ،هاي عروق کرنر قلب‌بیماري

ریزي صحیح و ‌توان با یک برنامه‌، قابل پیشگیري است و میباشد‌می مهمترین بیماري این دههه و در این راه غربالگري جمعیت ب ،اصولی، نظام سالمت کشور را به سمت پیشگیري هدایت نمود

هاي ‌افتد، بطور موثري از سکته‌چه در خانه قلب سالم شیراز اتفاق میتواند همانند آن‌ظاهر سالم، می. شدت کاهش دهده هاي گزاف درمانی را ب‌قلبی پیشگیري، و هزینه

تالش گردیده است که اهمیت پیشگیري در این کنگره براي پزشکان، پرستاران، دستیاران، . یین گرددهاي وابسته قلب و عروق به زبان ساده تب‌دانشجویان و رشته

به منظور امیدوارم برگزاري این کنگره بتواند در یک فضاي صمیمی و دوستانه، شروعی باشد هاي درازمدت ما جهت معرفی شهر زیباي شیراز به عنوان الگوي شهر سالمت در بین کالن ‌برنامه

. شهرهاي خاورمیانهیراز و معاونین دانشگاه، با استفاده از فرصت به عمل آمده از ریاست دانشگاه علوم پزشکی شهاي ‌گیري از بیماري‌استانداري فارس، شهرداري و شوراي شهر شیراز و همچنین مرکز پیش

غیرواگیر وزارت بهداشت، درمان و آموزش پزشکی و شرکتهاي تجهیزات پزشکی و داروئی که ما را . نمائیم‌میدر برپائی این کنگره یاري رساندند تشکر و قدردانی

مدجواد زیبائی نژاد دکتر مح

رئیس مرکز تحقیقات قلب و عروق دانشگاه علوم پزشکی شیراز و رئیس کنگره قلب و عروق خاورمیانه

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Congress organization 1st MIDDLE EAST CONGRESS OF PREVENTIVE CARDIOLOGY &…

ارکان اولین کنگره خاورمیانه پیشگیري از بیماري هاي

عروق کرونر قلب 2013ژانویه 29-31شیراز برابر 1391بهمن ماه 13-10

دکتر محمد جواد زیبایی نژاد: رئیس کنگره •

دکتر فیروزه ابطحی: دبیر علمی کنگره •

دکتر محمد علی بابایی بیگی: دبیر اجرایی •

دکتر جواد کجوري: Board Reviewدبیر بخش •

رمان زرگرانآدکتر : دبیر بخش دانشجویی •

هاي کرونر قلب ‌هاي پیشگیري از بیماري‌گري جدیدترین گایدالینبازن •هاي عروق قلبی ‌بازنگري ریسک فاکتورهاي بیماري •هاي قلبی و بررسی ‌کاربرد اکوکاردیوگرافی از نقطه نظر پیشگیري از بیماري •

افراد با ریسک باالي بیماري عروق قلبی هاي قلب و عروق در بخش دانشجویی ‌تازه •براي رزیدنتهاي قلب Board Reviewت برگزاري جلسا •

محورهاي همایش

Appendix Articles

Program

1st Middle East Congress Of Preventive Cardiology & …

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1st Middle East Congress of Preventive Cardiology 2nd Updates in Echocardiography

2nd International Student Congress on Cardiovascular Reasearch 4th Board Review Course

29 January – 1 February 2013

Day One: Afternoon Tuesday: 29 January 2013 (Main Hall)

Subject Time Holly Quran – International Song Islamic Republic - Shiraz Clip The Congress Opening Ceremony Lecturers are: Dr. Abtahi: Scientific Secretary of the Congress Dr. Ashkani: Scientific Secretary of the Student Congress Dr. Imanie: The President of Shiraz University of Medical Sciences Mr. Sadegh Abedin: Governor – General of Fars Province Dr. Etemad: The advisor of deputy minister of health & head of no communicable diseases Dr. Zibaee Nezhad: Chairman of the Congress

16:30 – 17:30

Pray – Coffee Break 17:30 – 18:00 Session 1 & 2: Preventive Cardiology Chairmen: Dr. Babaee – Dr. Shehab – Dr. Tabandeh – Dr. Malek zadeh – Dr. Zibaee nezhad

Dr. Etemad Prevention and control of Cardiovascular disease 18:00 – 18:15

Dr. Zamirian Burden of Cardiovascular disease in the Middle East 18:15 – 18:35

Dr. Shehab Coronary artery disease in Emirates 18:35 – 18:50 Dr. Shehab Atherosclerosis Risk factors in Emirates 18:50 – 19:05

Dr. Sovaid The metabolic syndrome, definition and risk assessment 19:05 – 19:20

Dr. Malekzadeh

Importance of fatty liver (Hepatic component of metabolic SX.) 19:20 – 19:40

Dr. Ozer Cardiovascular Prevention in Turkish Women 19:40 – 20:00

Mr. Safdari Role of culture and society in prevention of CAD 20:00 – 20:15

Panelist: Dr. Zibaeenezhad – Dr. Malek zadeh – Dr. Tabandeh – Dr. Zamirian Panel: On Preventive Cardiology

20:15 – 21:00

Dinner Sponsor: Governor – General of Fars Province 21:00 – 22:00

Appendix Articles

Day Two: Morning Wednesday: 30 January 2013 (Main Hall) Session 3: Echocardiography 1

Chairman: Dr. Moshkani – Dr. Moaref – Dr. Amin – Dr. Fazli nezhad

Speakers Subject Time

Dr. Abtahi Echocardiography in evaluation of heart failure with normal EF 8:30 – 8:45

Dr. Ghaderi Echocardiography assessment of Hypertensive heart disease 8:45 – 9:00

Dr. Kottke Organizing ambulatory practice to optimize vascular care outcomes 9:00 – 9:15

Session 4: Hypertension Chairman: Dr. Heidary – Dr. Zibaee nezhad – Dr. Aghasadeghi – Dr. Kojori

Speakers Subject Time Dr. Heidary Review of hypertension guidelines 9:15 – 9:30 Dr. Ahmadi Role of diet therapy in HTN control 9:30 – 9:45 Dr. Alasti Cardiovascular hazards of uncontrolled HTN 9:45 – 10:00

Dr. Kojori What is the best Medical Therapy for Hypertension? 10:00 – 10:15

Panelist: Dr. Zibaeenezhad – Dr. Tabandeh – Dr. Kojori – Mrs. Besharati Panel: On HTN

10:15 – 10:30

Coffee Break – Exhibition 10:30 – 11:00

Session 5: Exercise and Prevention Chairman: Dr. Babaee – Dr. Oreii – Dr. Khosropanah – Dr. Rosta


Dr. Jorat Role of exercise in prevention of atherosclerosis heart disease 11:00 – 11:20

Dr. Babaee Role of leisure time exercise in risk factor modification 11:20 – 11:40

Dr. Tufekcioglu Role of echocardiography in sport medicine 11:40 – 12:00

Question & Answer 12:00 – 12:15 Pray 12:15 – 12:30 Panelist: Dr. Babaee – Dr. Mojab – Dr. Radmanesh – Dr. Aslani Panel: On Exercise Prevention

12:30 – 13:00

Lunch– Exhibition 13:00 – 14:00


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Session 6: Echocardiography 2 Chairman: Dr. Romi – Dr. Tufekcioglu – Dr. Toofan – Dr. Mirdamad


Dr. Moshkani Echocardiography in decision making for asymptomatic AS 14:00 – 14:15

Dr. Ozer Echo in risk stratification of patient with HCM and family screening 14:15 – 14:30

Dr. Romi Echocardiography in Bicuspid Aortic valve 14:30 – 14:45 Question & Answer 14:45 – 15:00 Coffee Break - Exhibition 15:00 – 15:30

Session 7: Echocardiography 3 Chairman: Dr. Moaref – Dr.Zamirian – Dr. Poorzand – Dr. Toofan

Speakers Subject Time Moderator: Dr. Salehi Case Presentation 15:30 – 17:00

Dinner Sponsor: Municipality of Shiraz 20:00 – 21:00

Day Three: Morning Thursday: 31 January 2013 (Main Hall) Session 8: Echocardiography 4 Chairman: Dr. Aghasadeghi – Dr. Abtahi – Dr. Alizadeh sani – Dr. Ghaderi


Dr. Tufekcioglu Echocardiographic Diagnosis In Noncompaction Cardiomyopathy: Anatomic or Functional Diagnosis?

8:30 – 8:45

Dr. Alizadeh sani Role of cardiac imaging in atherosclerotic heart disease 8:45 – 9:00

Dr. Salehi Atherosclerotic changes of cardiac structure and function by echocardiography

9:00 – 9:15

Session 9: Dyslipidemia Chairman: Dr. Khosropanah – Dr. Aslani – Dr. Rosta - Dr. Barzigar

Speakers Subject Time Dr. Sarafzadeghan New guideline of preventive Cardiology 9:15 – 9:30

Dr. Aghasadeghi New guidelines on treatment of dyslipidemia 9:30 – 9:45

Dr. Eftekhari Diet control for treatment of dyslipidemia 9:45 – 10:00 Dr. Nikoo Statin intolerance Alternative strategies 10:00 – 10:15

Panelist: Dr. Aghasadeghi – Dr. Addll – Dr. Noogh – Dr. Zamani 10:15 – 10:30

Appendix Articles

Speakers Subject Time Panel: On Dyslipidemia Coffee Break - Exhibition 10:30 – 11:00

Session 10: Diabetes Chairman: Dr. Aminian – Dr. Kottke – Dr. Tabandeh – Dr. Sarafzadegan

Speakers Subject Time Dr. Aminian Diabetes and atherosclerotic heart disease 11:00 – 11:15

Dr. Kottke The comparative effectiveness of heart disease prevention and treatment strategies 11:15 – 11:35

Dr. Shehab Strategies for risk reduction in diabetic patient 11:35 – 11:55 Dr. Moravej Diabetes in pediatric population 11:55 – 12:10

Pray 12:10 – 12:30 Panelist: Dr. Aminian - Dr. Asare – Dr. Kafi - Dr. Amin Panel: On Diabetes

12:30 – 13:00

Lunch– Exhibition 13:00 – 14:00 Session11: Echocardiography 5 Chairman: Dr. Shojai fard – Dr. Mirdamadi – Dr.Nickparvar – Dr. Abdar Esfehani

Speakers Subject Time Dr. Moaref Speckle tracking and its application 14:00 – 14:15 Dr. Mirdamadi 2D & 3D evaluation of left ventricle 14:15 – 14:30 Dr. Fazli nezhad 3D evaluation of ischemic MR 14:30 – 14:45

Dr. Poorzand Echocardiography assessment of the effect of the RV Pacing 14:45 – 15:00

Coffee Break - Exhibition 15:00 – 15:30

Session 12: Echocardiography 6 Chairman: Dr. Amin – Dr. Zamirian – Dr. Ozer – Dr.Romi


Dr. Nickparvar Atrial dyssynchrony in patients with heart failure 15:30 – 15:45

Dr. Abdaresfehani Role of echo in the Aortic Valve repair 15:45 – 16:00 Dr. Shojai fard Role of echo for CRT optimization 16:00 – 16:15

Question & Answer 16:15 – 16:30 Panelist: Dr. Amirghofran – Dr. Tufekcioglu – Dr. Toofan – Dr. Hoseini Panel: Tricuspid regurgitation and TV Repair

16:30 – 17:30


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Day Four: Morning Friday:: 1 February 2013 (Main Hall) Session 13: Obesity Chairman: Dr. Ziyaolhagh – Dr. Ostovan – Dr. Assare – Dr. Molodi

Speakers Subject Time Dr. Mazlom Obesity and heart in adult population 9:00 – 9:20 Dr. Moravej The problem of obesity in pediatric population 9:20 – 9:40

Dr. Ostovan Uncommon risk factors of atherosclerotic heart disease 9:40 – 10:00

Coffee Break - Exhibition 10:00 – 10:30 Session14: Smoking Chairman: Dr. Nikoo – Dr. Azim zadeh – Dr. Jorat – Dr. Adell


Dr. Khosro panah Smoking and atherosclerotic heart disease 10:30 – 10:50

Dr. Moradi Health theories, stages of change model 10:50 – 11:10

Dr. Azimzadeh Air pollution and heart disease 11:10 – 11:30 Panelist: Dr. Khosropanah – Dr. Aghajani – Mr. Ansari – Mrs. Gharib Panel: On Smoking

11:30 – 12:00

Closing Ceremony

12:00 – 13:00

City Tour

14:00 – 17:00

Appendix Articles

Board Review Course 29 January – 1 February 2013 Day One: Morning Tuesday: 29 January 2013 (EDC Hall) Session 1:

Speakers Sub Heading Subject Time

Dr. Zibaee nezhad How to answer board exam Heart Sound

9:00 – 9:30

Dr. Kojori Heart Sound overview 9:30 – 10:00

Dr. Saneii How to read CXR in board exam CXR 10:00 – 10:30

Dr. Kojori Interesting cases 10:30 – 11:00 Coffee Break - Exhibition 11:00 – 11:30

Dr. Barzigar How to Read ECG in board exam

ECG Introduction

11:30 – 12:00

Dr. Aghasadeghi Interesting ECG Presentation 12:00 – 12:30

Dr. Zamirian Tachy - brady shock! 12:30 – 13:00

Pray – Lunch– Exhibition 13:00 – 14:00 Day Two: Morning Wednesday: 30 January 2013 (EDC Hall) Session 2:


Dr. Molodi How to read an angio in board exam Post bypass, coronary

Angio Study

9:00 – 9:30

Dr. Kojori Interesting case congenital 9:30 – 10:00

Dr. Zand Parsa

Interesting case valvular 10:00 – 10:30


Dr. Ostovan How to read a tracing in board exam

Pressure Recording

11:00 – 11:30

Dr. Adel Interesting cases valvular 11:30 – 12:00

Dr. Asare Interesting case Myocardial pericardial

12:00 – 12:30

Pray – Lunch– Exhibition 12:30 – 13:30


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Day Three: Morning Thursday: 31 January 2013 (EDC Hall) Session 3:


Dr. Oreii How to answer in board exam, AF, Flutter EP

Review

9:00 – 9:30

Dr. Nikoo SVT EP study 9:30 – 10:00 Dr. Aslani VT EP study 10:00 – 10:30


Dr. Salehi How to answer in board exam VHD

Echo Study

11:00 – 11:30

Dr. Moaref Interesting cases Pericardial, myocardial 11:30 – 12:00

Dr. Abtahi Interesting cases MI, congenital 12:00 – 12:30

Pray – Lunch– Exhibition 12:30 – 13:30

Nursing Program Day One: Afternoon Tuesday: 29 January 2013 (Sina Hall) Session 1: Chairpersons: Ms. Negahban – Mr. Safdari – Ms. Ghodsbin

Speakers Subject Time Quran / Welcome 14:00 – 14:15

Ms. Jahanbin Epidemiology of cardiovascular risk factors 14:15 - 14:30

Ms. Rostami The Importance of genetics& gender in cardiovascular diseases 14:30 – 14:45

Ms. Najafi The Secondary Prevention of myocardial Infection 14:45 – 15:00

Coffee Break - Exhibition 15:00 – 15:30 Session 2: Chairpersons: Dr. Moatari – Ms. Gharib – Ms. Hazrati


Mrs. Zare Role of diabetes and metabolic syndrome in cardiovascular disease and preventive strategies

15:30-15:45

Ms. Besharati Role of hypertension in cardiovascular disease and preventive strategies 15:45 – 16:00

Ms. Tanori far Role of hyperlipidemia in cardiovascular disease and preventive strategies 16:00 – 16:15

Appendix Articles


Ms. Gharib Role of smoking in cardiovascular disease and cessation strategies 16:15 – 16:30

Question & Answer 16:30 – 17:00 Day Three: Afternoon Thursday: 31 January 2013 (Sina Hall) Session 1: Chairpersons: Ms. Zarifkar - Ms. Jahanbin – Mr. Ansari

Speakers Subject Time Quran / Welcome 13:30 - 13:45

Ms. Rajeh Role of stress in cardiovascular disease and controlling strategies 13:45 – 14:00

Dr. Rakhshan Role of nutrition in the prevention of cardiovascular disease 14:00 - 14:20

Ms. Dehghan rad

Weight controlling in the prevention of cardiovascular disease 14:20 - 14:40

Ms. Pasyar The role of exercise in controlling cardiovascular risk factors 14:40 – 15:00

Coffee Break - Exhibition 15:00 – 15:30 Session 2: Chairpersons: Ms. Ravanshad- Ms. Besharati - Ms. Shojaee


Ms. Soltani Guidelines on CHD prevention in clinical practice 15:30 - 15:50

Ms. Dadgar Role of CAD in women 15:50 - 16:10 Ms. Beheshtipor Prevention of CVD in children 16:10 - 16:30

Mr. Ansari Controlling of risk factors of CVD in Iran 16:30 – 17:00


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Workshop Day One: Afternoon Tuesday: 29 January 2013 (Sina Hall) Workshop 1:

Time Speaker Subject

10:00 – 12:00 Dr. Nekoian Easy Writing Article in Cardiovascular Research

Day Two: Afternoon Wednesday: 30 January 2013 (EDC Hall) Workshop 2:


14:00 – 16:00 Dr. Nejatian Cardiac Rehabilitation

Day Three: Afternoon Thursday: 31 January 2013 (Sina Hall) Workshop 3:


11:00 – 13:00 Dr. Mojab Sports Medicine

Appendix Articles

1st Middle East Congress of Preventive Cardiology and 2nd Updates in Echocardiography

2nd International Student Congress on Cardiovascular Research 29 Jan – 1 Feb 2013

Scientific Programs:

10/11/1391 شنبه سه روزTuesday: 29 Jan 2013

Time Title 17 – 18:30 Opening ceremony 20:30 - 22 Dinner

Session 1:

11/11/1391:چهارشنبه روز Wednesday: 30 Jan 2013

Board Time Titles

Prof. Kord Afshar (Chairman) Dr. Scot R. Jafarian Dr. F. Masoud Kabir Dr. Alireza Shamloo Prof. Hosseini

14 - 14:45 Invited lecturer

Nutrition in cardiovascular patients (By: Dr. Kord Afshar)

14:45 - 15

Protective role of Simvastatin against ventricular fibrillation by modulation of electrical restitution and alternans during β-receptors activation on monophasic action potential of isolated rabbit heart (By: S Aminoshari’a Najafi)

15 - 15:15

Evaluation the effect of testosterone on cardiovascular disease healing factors: Nitric Oxide and Stromal Cell-Derived Factor-1α (By: M Motamer)

15:15 - 15:45 Rest

15:45 – 16:30 Invited lecturer

Points to be mentioned for a cardiovascular specialist (By: Dr. Hosseini)

16:30 – 18 Poster session 1


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12/11/1391 پنجشنبه روز Thursday: 31 Jan 2013

Time Title 9:30 – 11 Poster Session 2

Session 2 13/11/1391 جمعه روز

Friday: 1 Feb 2013 Board Time Title Prof. Babaei (Chairman) Dr. M. Nemovi Dr. M. Sharifian Dr. Tohid Emami Dr. S. R. Jafarian

9 – 9:45 Invited lecturer

The role of cerebral oximetry in prevention of cerebrovascular events following cardiovascular interventions (By Dr Babaei)

9:45 – 10

Stem Cell Therapy for Cardiovascular Diseases: Implication of Nanotechnology in Regenerative Medicine (By: MR Hashemzadeh)

10 – 10:15 Regulators of G-protein signaling (RGS) proteins in cardiovascular system (By: M. Goharinia)

10:15 – 10:45 Rest

10:45 – 11

Changes of inflammatory markers in patients with postoperative AF candidates heart surgery (By: S A H Sayegh)

11 – 11:15

Correlation between high sensitive c-reactive protein (HSCRP) and athermanous plaques in carotid and aortic arch in ischemic stroke patients (By: M Sharifian)

11:15 – 11:30

Stenosis level, Plaque Morphology and Intima-media Thickness of Internal Carotid Artery in Chronic Stable Angina and Acute Coronary Syndrome: a comparative study (By: A Manafi)

11:30 – 11:45

Cloning of Vascular Endothelial Growth Factor111 (VEGF111) recombinant cDNA and treatment of cardiac ischemia (By: F Dehghanian)

Appendix Articles

Appendix Articles


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بر میزان عالیم ) EMDR(تاثیر روش حساسیت زدایی با حرکات چشم و پردازش مجدد افسردگی بیماران مبتال به سکته قلبی

کارشناس ارشد مراقبت هاي ویژه، دکتر رضا ضیغمی، محمد مرادي کارشناس ارشد روان پرستاري، دکتر محمد بهنام مقدم ناس ارشد روانشناسی، مدرس دانشگاهحمید رضا جوادي دانشیار، عزیز بهنام مقدم کارش

email : [email protected] 09175427454دانشگاه علوم پزشکی قزوین تلفن

بروز عالیم افسردگی پس از . افسردگی یک عامل خطر مستقل براي بروز بیماري هاي قلبی می باشد :زمینه

بیماران مبتال به سکته قلبی می باشد که بر پیش آگهی سکته قلبی یک مشکل روانشناختی بسیار شایع در بین با پیشگیري و درمان افسردگی می توان از بروز بیماري هاي قلبی و عوارض .این بیماران تاثیرات منفی دارد

در پیشگیري و درمان افسردگی روش یکی از روش هاي روان درمانی جدید . ناشی از آن جلوگیري کرد .کات چشم و پردازش مجدد می باشدحساسیت زدایی با حر

هدف از انجام این مطالعه بررسی کارایی روش درمانی حساسیت زدایی با حرکات چشم و پردازش مجدد : هدف .بر میزان عالیم افسردگی بیماران مبتال به سکته قلبی می باشد

ته قلبی که به کلنیک بیمار مبتال به سک 60. این پژوهش یک مطالعه کارآزمایی بالینی می باشد :روشمراجعه کرده بودند به روش نمونه گیري در دسترس 1391تخصصی بیمارستان بوعلی سیناي قزوین در سال

براي گردآوري داده ها از دو . انتخاب و آنها را به طور تصادفی به دو گروه کنترل و آزمایش تقسیم شدنددر طی EMDRروش درمانی . بک استفاده گردید پرسشنامه اطالعات جمعیت شناختی و پرسشنامه افسردگی

میزان . دقیقه اي به صورت یک روز در میان براي گروه آزمایش توسط محقق انجام شد 90تا 45دو جلسه . توسط پرسشنامه افسردگی بک اندازه گیري شد EMDRافسردگی بیماران قبل و بعد از اجراي روش درمانی

.تی زوجی، تی مستقل و کاي اسکویر مورد تجزیه و تحلیل قرار گرفتند داده ها بوسیله آزمون هاي آماريبود و بعد EMDR 72/3± 2/19میانگین میزان عالیم افسردگی در گروه آزمایش قبل از روش درمانی :نتایج

P ) .رسید که از نظر آماري تفاوت معناداري را نشان داد 3/6±48/2از اجراي این روش به در حالی(0/001˂ .که در گروه کنترل اختالف آماري معناداري مشاهده نگردید

باعث کاهش قابل توجهی در میزان عالیم افسردگی بیماران EMDRروش روان درمانی : بحث و نتیجه گیريبه عنوان یک روش استاندارد، جدید، و مقرون EMDRمی توان از روش درمانی . مبتال به سکته قلبی می شود

با پیشگیري و درمان افسردگی با این روش . هش یا درمان عالیم افسردگی استفاده نمودبه صرفه براي کا .درمانی جدید می توان از بروز بیماري هاي قلبی و عوارض آنها جلوگیري نمود

روش حساسیت زدایی با حرکات چشم و پردازش مجدد، افسردگی، سکته قلبی :کلمات کلیدي

Appendix Articles

The relationship between heart disease death rates by income level in each of the countries covered by the World Health Organization

* 1Maryam sadat shahshahani, Maryam shirazi, Manije dehi2 1MSc, Instructor, Department of Health &managment Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran *: [email protected] MSc, Instructor, maragheh Department of Health &managment Nursing, School of Nursing and 2Midwifery, tabriz University of Medical Sciences, tabriz, Iran Background: The prevalence of heart disease -, especially coronary heart disease, increase in China, India, Pakistan and the Middle East, including Iran's . The World Health Organization states more than 50 percent of deaths and disability from heart disease and stroke, with a combination of effective national efforts and individual actions and reducing risk factors such as hypertension, high cholesterol, obesity and smoking will be resolved.But another important factor is exist: the economy. Therefore, in this study, relationship between the heart disease mortality rate with level-income in countries have been discussed. Methods: This study reviewed data provided by the World Health Organization in 2011, in connection with the heart disease death rate in countries with different income levels. Conclusion: The results of 194 member states is highest mortality from heart disease, due to Ischemic heart diseases (12.75) and the lowest percent disease is rheumatoid. There is no significant difference in death rates between men and women. Death rate in countries with less than the average income is maximum (men 8.48%, women 7,077%), and low-income countries has the lowest death rate.there is no significant difference Among high-income countries, and more than the average income In Iran 1.42% of the deaths due to heart disease that greater in men (men 0.82%, women 0.6%). Discussion: Previous studies have shown higher risk of heart attack in some developing countries are more than in rich and poor. Moreover, the poor have less access to health services They took the risk factors for undiagnosed and therefore do not receive the treatment. Thus, the early detection, can be greatly reduced the death rate.

1 MSc, Instructor, Department of Health &managment Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran *: [email protected] 2 MSc, Instructor, maragheh Department of Health &managment Nursing, School of Nursing and Midwifery, tabriz University of Medical Sciences, tabriz, Iran


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The Effects of Whey Protein Isolate Supplementation and Resistance Training on Cardiovascular Risk Factors in Overweight Young Men

Shiva Irani1 & Farhad Ahmadi Kani Golzar 2 1. PhD Student in Medical, Kurdistan University of Medical Sciences, Sanandaj, Iran. E-mail: [email protected] 2. *Corresponding author: M.Sc in Exercise Physiology, Faculty of Physical Education & Sport Sciences, University of Isfahan, Iran. E-mail: [email protected]. Phone: 09188704927 Background: Most of those who expose to oxidative stress and cardiovascular diseases, before resorting to drug treatment, can reduce such risk factors throughout diet and exercise. Limited studies have been performed regarding the effects of resistant training and protein supplementation combination on cardiovascular risk factors. The purpose of this study was to investigate the effects of whey protein supplementation accompanied with resistance training on cardiovascular risk factors in overweight young men. Methods: A total number of 30 individuals with body mass index of 25-30 kg/m2 were randomly divided into three groups of supplement plus 6 weeks of resistance training (W), placebo plus 6 weeks of resistance training (D), and control (C). C group were only assessed in pre-test and post-test and they consumed no materials, and were not given any training programs. Whey protein supplement (30 grams of solution per day) and placebo (the same amount of starch solution) were consumed by the subjects. Lipid profile, fibrinogen, fasting blood sugar, resting systolic and diastolic blood pressure and waist to hip ratio were measured. Data was analyzed by repeated measures analysis of variance (ANOVA) and Bonferroni post-hoc test. Findings: After supplementation, cholesterol and high-density lipoprotein cholesterol levels increased (P < 0.05). Levels of low-density lipoprotein cholesterol and triglyceride showed favorable decreases in both supplement and placebo groups (P < 0.05). No changes were observed in fibrinogen levels, fasting glucose, resting systolic and diastolic blood pressure, and waist to hip ratio. Conclusion: Whey supplementation combined with 6 weeks of resistance training in overweight individuals created favorable changes in some cardiovascular risk factors which can lead to prevention of heart disease. Collectively, whey protein has the potential to be used as an added component in dietary plans and in functional foods aimed at the management of chronic diseases in overweight individuals. Keywords: Whey proteins Isolate, Resistance training, Cardiovascular risk factors, Overweight young men

Appendix Articles

The effect of Non-amendable risk factors of coronary artery stenosis in early and late onset coronary artery disease patients in South Iranian

population Sara Senemar1, Seyyed Mohammad Bagher Tabei2 , Babak Saffari 1 , Samaneh toosi1, Zeynab Ahmadi 1 1 Human Genetic Research Group, Iranian Academic Center for Education, Culture & Research (ACECR), Fars Province Branch, Shiraz, Iran 2 Department of genetic, Shiraz University of Medical Sciences, Shiraz, Iran Premature coronary heart disease (PCAD) is under the influence of environmental and genetic factors. Some risk factors of coronary heart diseases are not modifiable such as sex, age, family history and Consanguinity marriage. The Aims of this study are to find association among between consanguinity, family history, age and gender with PCAD (early) & CAD (late coronary) artery disease. Material and methods: In total, 800 patients with symptoms of chest pain and diagnosed with angiography were include in this study. The patients were divide into two groups, depending on their age at inclusion; group 1 had patients (N=400) were males aged ≤ 5o years and females aged ≤ 55 years which 200 of them had positive angiography and the others with negative angiography were define as the controls, group 2 patients (N=400) were males aged ≤5o years and females aged ≤55 years that 200 of them had negative angiography as the control group. Positive angiography defined as the present of greater than 50% coronary diameter cut. Result: The average age of men in PCAD patients are 60.5 and controls are 59.3. The average age of men in CAD patients is 46.5 and control is 44 years. Percentage of age in PCAD patients male are 44.95 and in PCAD patients female are 48 but in control groups of PCAD are 40.7 in male and 47.2 in female. Percentage of age in CAD patients male are 59.9 and in CAD patients female are 62.3 but in control groups of PCAD are 53.3 in male and 61.5 in female. Correlation between gender in-patients who have PCAD is not significant but CAD is significant (P value =0.045). Correlation between gender in-patients and controls in PCAD and CAD are significant (p=0.000). Family history of MI was not significant in CAD group but history of MI was significant in PCAD group. Correlation between consanguinity degrees for the parents in CAD and PCAD groups was not also significant. Discussion: This research can be confirming that theory of ageing is increase risk of heart disease. These findings indicate the risk of coronary heart disease in


32

women less than men of the same age because of an environmental factors and effects of sex hormones. Family history of myocardial infarction in –patients and control group with PCAD are more than in-patients and control group with CAD. As well as we know that genetics which has a high percent in family history of MI; is a large impact in the young people with a history of MI and we should be need a medical care. The last result has shown that in both groups (PCAD and CAD) didn’t relationship between consanguinity marriage and coronary heart disease in Iranian population. Keywords: early onset, late onset, coronary artery disease, Family history, Myocardial infraction, Consanguinity marriage

Appendix Articles

Effect of MTHFR variant (C677T) and plasma homocysteine levels in premature Coronary Atherosclerotic Disease in South Iran.

Sara Senemar1, Babak Saffari1, Mehran Karimi2, Marzieh Bahari1, Najmeh Jooyan1, Mohammad Bager Sharifkazemi3, Majid Yavarian 2

1 Human Genetic Research Group, Iranian Academic Center for Education, Culture & Research (ACECR), Fars Province Branch, Shiraz, Iran 2 Hematology Research Center, School of Medicine, Shiraz University of Medical Sciences, Shiraz 71937, Iran 3 Department of Internal Medicine, Cardiovascular Unit, Shiraz University of Medical Sciences, Shiraz, Iran

Abstract Hyperhomocysteinaemia (HHcy) has been shown to be a strong and independent risk factor for coronary artery disease (CAD). An alanine/valine (Ala/Val) gene polymorphism at 222nd amino acid of 5,10-methylenetetrahydrofolate reductase (MTHFR) renders the enzyme thermolabile and less active which in turn may yield a subsequent increase in plasma total homocysteine (tHcy) levels. Using PCR-RFLP analysis, a total of 403 individuals including 243 patients with angiographically documented multi-vessel CAD and 160 healthy subjects with normal angiography documents were studied to assess whether this polymorphism is associated with increased risk of CAD and plasma levels of tHcy. Nevertheless our results failed to admit a significant difference between CAD and CAD-free subjects for Ala/Val polymorphism. On the other hand plasma Hcy concentrations were significantly higher in individuals with Val/Val genotype than subjects with Ala/Ala genotype. In low folate levels, the influence of mutation was more apparent indeed, so that the homozygous mutant genotype (Val/Val) showed significant differences in average tHcy concentration not only in comparison to the homozygote wild types (Ala/Ala) but also in comparison to the heterozygotes (Ala/Val) (P<0.01 and P<0.05 respectively). Conversely, the mutation remained neutral concerning tHcy levels in participants with sufficient folic acid levels. Moreover, as the logistic regression analysis with backward likelihood ratio method indicated, in addition to the MTHFR polymorphism, smoking habit and familial history of heart defects were also among the major predictors of HHcy in the current investigation. In conclusion, the association study achieved here indicated that the MTHFR mutation though associated with homocysteine levels seemed not related to atherosclerosis per se in our population. Keywords: Coronary Artery Disease, MTHFR, C677T polymorphism, Homocysteine


34

The association between Coronary artery disease and Lifestyle habits (Smoking, Tea consumption and Oral Contraceptive Drug use), Hypertension and Menopause age among Fars province population. Zeinab Ahmadi1, Majid Yavarian, Sara Senemar

Corresponding Author, Zeinab Ahmadi, MSc. Human genetics research group. Iranian academic center for Education, Culture & Research (ACECR), Fars Branch, Zand Ave. P.O. Box 71345-1463, Shiraz, Iran. Tel: 711-233-7851, Fax: 711-230-3662, E-mail: [email protected]

Introduction and aim: Coronary artery disease is a leading cause of mortality, morbidity, and disability in Iranian population. The objective of this study is looking on the impact of coronary artery disease risk factors in two groups of CAD and PCAD in the region. These risk factors are smoking, hypertension, tea consumption and oral contraceptive drug and menopause age. This is the first study of its kind in the Fars province. Methods: The present case-control study consisted of 618 patients and 451 healthy individuals, recruited from 3 hospitals of Shiraz, Fars province in 2009-2012. All patients underwent angiography. The questionnaires were completed in order to collect data. Results: Smoking increased the risk of coronary artery disease in men (CAD: OR= 2.186, 95% CI= 1.374- 3.478; P= 0.001 & PCAD: OR= 3.026; 95% CI= 1.745- 5.243; P= 0.000). However, there was no significant association between smoking and coronary artery disease in women (P> 0.05). Drinking tea depends on the amount of consumption. Consumption of 1-3 cups of medium colored tea and more than 3 cups of medium colored tea per day decreased the risk of coronary artery disease (OR= 0.453; 95% CI= 0.239- 0.860; P= 0.015 & OR= 0.505; 95% CI= 0.260- 0.982; P= 0.044), although consumption of more than 3 cups of strong tea per day increased the risk of coronary artery disease (OR= 2.517; 95% CI= 1.454- 4.358; P=0.001). Hypertension increased the risk of coronary artery disease in both genders (OR= 2.538; 95% CI= 1.740- 3.702; P= 0.000). Increasing menopause age had a protective effect on coronary artery disease (OR= 0.925; 95%CI= 0.876- 0.978; P=0.006), while becoming menopausal increased the risk of coronary artery disease (OR= 2.800; 95% CI= 1.735- 4.518; P= 0.000). Regarding the last risk factor, there was no significant association between oral contraceptive drug use and coronary artery disease (P > 0.05). Conclusion: Our findings suggest that smoking, hypertension, consumption of more than 3 cups of strong tea per day and early menopause age increased the risk of coronary artery disease in Fars province. Hypertension agent was stronger than smoking. Hypertension and smoking had more influence on PCAD group. Tea consumption had more influence on the CAD group. Moreover, consumption of medium colored tea had a protective effect on coronary artery disease. Keyword: Coronary artery disease, Smoking, Hypertension, Tea consumption, Sexual hormones

mailto:[email protected]

Appendix Articles

Coronary Risk Factors in Patients With Coronary Artery Ectasia: A Case-Control Study From Iran

Mahmoud M. Shabestari*, Farahzad Jabbari, Ghazal Ghasemi, Hoda Azizi, Toktam Moghiman, Saeed Ibrahimzadeh, Yousef Garivani, Javad Mahmoudi, Fahimeh Shabestari,

#Dr. Mahmoud Shabestari, Preventive Cardiovascular Care Research Center, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad , Iran Tel: +985 118 544504, Fax: +985 118 544504, Email: [email protected] Background: Coronary artery ectasia is a rare finding in angiography. We investigated the prevalence of coronary artery ectasia and assessed cardiovascular risk factors as probable influencing factors in this disease in our region. Methods: This study was conducted from October 2007 to March 2010 on 2500 patients visiting Imam Reza and Razavi hospitals, Mashhad, Iran who had chest pain and were selected for angiographic studies. The study was based on reviewing angiographic films besides filling in questionnaires. 103 coronary artery ectasia cases showing 4% prevalence for this kind of coronary involvement were selected as the study group and compared with 62 patients with atherosclerosis and no ectasia as the control group. Results: Mean age of the study and control group was 57.6 and 54.1yrs, respectively indicating a statistically significant difference (p=0.032). The study and control groups showed no significant difference based on sex, smoking history and mean Body Mass Index (BMI). However, a BMI above 25 had a significantly higher prevalence in the study group (p=0.036). Mean hs-CRP and homocystein levels were 3.4 and 11.8 in the study group and 2.3 and 8.3 in the control group, respectively, both revealing a significant difference (p=0.002, p<0.001). Hyperlipidemia in ectasia patients in comparison to controls was significantly more prevalent (p=0.001). Conclusion: The prevalence of coronary artery ectasia was 4% and cardiovascular risk factors in ectasia cases included: hyperlipidemia, high hs-CRP, and homocystein. Key words: Dilatation, Pathologic, Angiography, Coronary Artery Disease, risk factors


36

پیشگیري از بیماریهاي قلبی در طب سنتی ایران *محمد ابراهیم زحلی نژاد

ایران شیراز- دانشگاه علوم پزشکی شیراز- کمیته تحقیقات دانشجویی

[email protected] ایران -شیراز -دانشگاه علوم پزشکی شیراز -مرکز تحقیقات طب سنتی و تاریخ طب

آن در اکثر امروزه بیماریهاي قلبی یکی از دغدغه هاي بهداشتی کشورهاي جهان است و شیوع :مقدمه

با وجو پیشرفتهاي قابل توجه در درمانهاي دارویی . کشورهاي خاورمیانه و بخصوص ایران در حال افزایش استو جراحی، براي پیشگیري از مرگ و میر ناشی از این بیماریها بخشی از منابع بهداشتی کشورها صرف آموزشهاي

.الزم در این زمینه شده استاعضاي اصلی و در واقع اصلی ترین عضو بدن از دیر باز مورد توجه بوده است و در نتیجه قلب به عنوان یکی از

در طول تاریخ پزشکی نیز توجه ویژه اي به آن می شده است به نحوي که بخش عمده اي از منابع طی سنتی .هدارندایران در زمینه پیشگیري و درمان بیماریهاي آن بوده است تا آن را از امراض مختلف دور نگ

، منابع طب سنتی ایران "گوگل اسکوالر "و "پاب مد"در این مقاله پس از بررسی پایگاههاي دادها :روش کارمانند قانون ابن سینا، ذخیره خوارزمشاهی جرجانی، الحاوي رازي، اکسیر اعظم ، کامل الصناعۀ علی بن عباس

.اهوازي بررسی شدندز بیماریهاي قلب شامل کاهش وزن، مصرف نمک، اسیدهاي چرب آخرین دستورات غذایی حفاظت ا :نتایج

اشباع و مشروبات الکلی است در حالی که توصیه به مصرف رژیم غذایی غنی از سبزیجات و لبنیاتی که میزان فعالیت فیزیکی متعادل نیز از جمله توصیه هاي امروزي کنترل بیماریهاي . کمی از چربیهاي اشباع دارند، است

در منابع طب سنتی ایران جداي از توصیه هاي درمانی به بیماران قلبی بر حسب نوع بیماریشان، .قلبی استیکسري توصیه هاي عمومی حفاظت از قلب نیز دیده می شود که بر اساس اهمیت زیاد قلب در طب سنتی

م و شادي دستورات طب سنتی ایران شامل پرهیزات غذایی و غیر غذایی است که شامل پرهیز از خش.استمفرط، وسواس، ورزش و نزدیکی زیاد و استنشاق بوهاي کریه است در این گروه ازدستورات پرهیز از غذاهایی که

در کنار این پرهیزات، توصیه هایی نیز براي مصرف مواد غذایی و فعالیتهایی . ایجاد نفخ می کنند نیز وجود داردمل مصرف بوي خوش، گالب، به، سیب، انار و گوشتهاي که باعث تقویت قلب می شوند نیز وجود دارد که شا

به نظر می رسد که با توجه به رژیم غذایی و فرهنگ جامعه ایران .است... لطیف که هضم راحتی داشته باشند و می توان با استفاده از توصیه ها و پرهیزات طب سنتی ایران و تلفیق آن با دستورات انجمنهاي قلب و عروق

. کا شرایط بهتري را براي محافظت افراد جامعه کشورمان فراهم کنیماروپا و آمري قلب، پیشگیري، طب سنتی، دستورات غذایی :کلمات کلیدي


Appendix Articles

بررسی دیدگاه هاي حکماي طب سنتی ایران در پیشگیري از بیماري هاي قلبی و نقش تغذیه در سالمت قلب

2سودابه بیوس، *1فاطمه نجات بخش

[email protected]، طب سنتی، دانشگاه علوم پزشکی تهران ‌انشکدهمتخصص طب سنتی، د. 1طب سنتی، دانشگاه علوم پزشکی تهران ‌، دانشکدهکارشناس مامائی. 2

هدف از این مطالعه، بررسی دیدگاه هاي حکماي طب سنتی ایران درباره راههاي پیشگیري از بیماري :اهداف. سالمت قلب بوده استهاي قلب و به خصوص نقش تغذیه در

این مطالعه مروري سیستماتیک بوده و با بررسی کتب معتبر و اصلی طب سنتی ایران در بخش هاي :روش کارحفظ سالمتی قلب و مشخص کردن اشتراکات، اختالفات و افتراقات و سپس تجزیه و تحلیل محتوایی این

. مطالب انجام گرفته استن به سالمت قلب به عنوان یکی از اعضاي رئیسه بدن توجه ویژه اي شده در مکتب طب سنتی ایرا :ها‌یافتهدر این زمینه دستورات مختلفی وجود دارند که در دو دسته کلی دستورات مرتبط با تغذیه و دستورات . است

. غیر غذائی قرار می گیرندکتب طب سنتی ایران دستورات حفظ سالمتی قلب، شامل دستورات غذائی و غیر غذائی در م :گیري‌نتیجه

بسیار گسترده و داراي نکات ارزنده و مفیدي است که خوشبختانه این دستورات چندان پیچیده نبوده و استفاده و به کارگیري آن ها، در صورت اثباتشان با تحقیقات و مطالعات کافی، نیاز به تسلط به مبانی طب سنتی ایران

. ده می باشندندارد؛ لذا براي تمامی پزشکان قابل استفا

قلب، حفظ سالمتی، پیشگیري، تغذیه، طب سنتی ایران :کلمات کلیدي


38

بررسی تاثیر دیابت مزمن بر روي بیماران مبتال به اختالالت قلبی عروقی

امیر طباطبایی کارشناسی ارشد پرستاري ، دانشگاه آزاد اسالمی ، واحد قوچان ، گروه پرستاري، قوچان ، ایران

[email protected] 09153135849

اختالالت عروق کرونر در بیماران مبتال . دیابت تاثیرات جدي و سریع بر روي سیستم قلبی عروقی دارد :مقدمهاز حمالت حاد آنفارکتوس میوکارد ارتباط درصد 25دیابت با . برابر شایعتر از سایر افراد است 3تا 2به دیابت

بیماري هاي قلب و عروق، علت اصلی مرگ و میر و از عوامل مهم ناتوانی هاي افراد دیابتی به شمار می . دارددرصد مبتالیان به دیابت به دلیل بیماري هاي قلبی و عروقی، جان 65رود، برخی آمارها حاکی از آن است که

در یک فرد مغز و اندام ها شایع ترین علت بروز بیماري قلبی و اختالالت عروقی .خود را از دست می دهنددر رگ هایی است که مسوول رساندن غذا و کلسترول که این امر ناشی از تجمع است، دیابتی ، آترواسکلروزیس

.هستند اکسیژن به قلب، مغز و نواحی دیگر بیمار مبتال به دیابت مراجعه کننده به مرکز 90 روي رب توصیفی تحلیلیپژوهش حاضر ، مطالعه :روش کار

الزم در اطالعات دموگرافیک و مشخصات دو بخششامل ( پرسشنامه با استفاده از مشهد بیمارستان مشاورهنرم به دست آمده توسط اطالعات سپس .مصاحبه توسط پژوهشگر می باشد و )مزمن و تاخیري اثرات زمینه .گرفت قرار تحلیل و هتجزي مورد SPSS افزار

به طور متوسط گروه سنی %). 97(بودند 2بیشتر بیماران شرکت کننده در پژوهش مبتال به دیابت نوع :نتایج BMIافراد % 75.5. سال از ابتالیشان به بیماري دیابت می گذشت 4آنها بیشتر از % 71سال داشتند و 42

ناشی از دیابت بر روي سیستم قلبی عروقی افراد شامل بیشترین عوارض شایع . داشتند kg/m220بیشتر از هیچکدام از عوارض دیابت . آنفارکتوس میوکارد% 11هیپر لیپیدمیا، % 36.5افراد داراي فشار خون باال، % 41

با دیابت و عالئم اختالالت قلبیآزمون کاي اسکوئر نشان داد بین .افراد دیده نشده بود% 15مزمن بر روي فرزند ارتباط معنی دار وجود 2سال ، تحصیالت زیر دیپلم و داراي بیش از 30-45درآمد کم، سن ، مونثجنس

. )> 05/0p(داردهدف از این مطالعه ابزاري جهت نشان دادن اهمیت ارتباط بین دیابت و اختالالت سیستم : بحث و بررسی

و کاهش شیوع بیماري و انجام قلبی عروقی توسط ترسیم مداخالت جهت پیشگیري و درمان عوارض دیابت، کنترل قند خون، مسواك زدن، )مانند سبزي ها(تغذیه سالم، مصرف کافی فیبرهاي غذایی .مداخالت است

مصرف آسپرین درصورت نداشتن مشکل خاص و واکسیناسیون هاي ساالنه آنفلوانزا می تواند از عوارض قلبی و .عروقی بیماري دیابت جلوگیري کند

تاثیر، دیابت، اختالالت قلبی عروقی :لیديواژگان ك


Appendix Articles

و مراقبتهاي پرستاري) AD(کاربرد وسایل مکانیکی جهت حمایت گردش خون

راحله واردي شیراز) ع(بیمارستان تخصصی وفوق تخصصی حضرت علی اصغر سوپروایزور بالینی -

[email protected] 09173101347

نارسایی قلب عبارت است از شرایط فیزوپاتولوژي که قلب قادر نیست متناسب با احتیاجات متابولیکی : مقدمه

اعضاء خون را پمپ نموده ویا فقط با افزایش حفرات قادر به انجام این کار میباشد که اغلب با نارسایی عملکرد .میوکارد همراه است

اختالالت متابولیکی وبا استفاده از داروهاي اینوتروپ نتوان از بروز سیکل معیوب در صورتیکه با اصالح حجم و .اندیکاسیون دارد) AD(بکارگیري وسایل مکانیکی جهت حمایت از خون . جلوگیري نمود

: ADهدف از بکارگیري افزایش بازده قلب و جلوگیري از آسیب اعضاء حیاتی -1 یزیولوژي ناشی از ایسکمیکاهش ایسکمی میوکارد پاتوف -2

: ADاندیکاسیون استفاده از در بیمارانیکه انتظار میرود عملکرد عضله قلب برگرددمثال شوك کاردیوژنیک بعد از عمل جراحی قلب -1

ومیوکاردیت حاد .در بیمارانی که منتظر پیوند قلب هستند در صورتیکه نارسایی قلب شدیدتر گردند -2 .دچار نارسایی قلبی پیشرفته بوده ولی کاندید مناسب پیوند قلب نیستند در بیمارانی که -3

: ADع انوا : از نظر کلی به دو دسته تقسیم میشوند

وسایل مکانیکی در حمایت کوتاه مدت ازگردش خون -1 وسایل مکانیکی در حمایت طوالنی مدت از گردش خون -2

:اهداف درمان هاي محیطی ومرکزيبهبود گردش خون کافی در بافت

بهبود وضعیت همودینامیک

حفظ خون رسانی عروق کرونر

حفظ برون ده ادراري مناسب

: پارامترهاي بررسی پرستاري



40

ارزیابی اهداف درمان

ثبات همودینامیک ،کنترل آریتمی ،پرفیوژن سیستمیک ،اعتماد ازعدم وجود ایسکیمی ،مشاهده وتشخیص فوري عالئم عوارض جانبی

ص وطبقه بندي شرایط هشدار دهندهتشخی

عملکرد صحیح دستگاه

ثبات همودینامیک

، مانیتور مداوم وهر ساعته همودینامیک،برون ده قلبی ، برون ده ادراري ،ضربان قلب ، فشار خون وضعیت نورولوژیک

درجه باالتر ازپاها باشد 40سر بیمار

چک پالس اکسیمتري هر دو ساعت

Appendix Articles

Broken heart syndrome

Vizeshfar,Fatemeh department of nursing, school of nursing and midwifery, Shiraz university of medical sciences Shiraz, Iran [email protected] Takotsubo cardiomyopathy is also known as broken heart syndrome also known as transient apical ballooning syndrome apical ballooning cardiomyopathy, stress-induced cardiomyopathy, Gebrochenes-Herz-Syndrome, and stress cardiomyopathy is a type of non-ischaemic cardiomyopathy in which there is a sudden temporary weakening of the myocardium. Patients with stress cardiomyopathy can have similar symptoms to patients with a heart attack Typically these symptoms begin just minutes to hours after the person has been exposed to a severe, and usually unexpected, stress. “Stress” refers to the body’s response to things it perceives as abnormal. These abnormalities can be physical such as high body temperature, dehydration, or low blood sugar, or can be emotional, such as receiving news that a loved one has passed away. Most of the patients we have seen with it do not have a previous history of heart disease. It is quite clear from the available medical literature so far, however, that stress cardiomyopathy affects primarily women. In addition, it tends to occur most frequently in middle aged or elderly women (average age about 60). The treatment of takotsubo cardiomyopathy is generally supportive in nature. There's a chance that broken heart syndrome can happen again after a first episode. There's no proven therapy to prevent additional episodes; however, many doctors recommend long-term treatment with beta blockers or similar medications that block the potentially damaging effects of stress hormones on the heart. Managing stress in your life is also important. Keyword: Takotsubo cardiomyopathy, Broken heart syndrome cardiomyopathy


http://en.wikipedia.org/wiki/Ischemia

http://en.wikipedia.org/wiki/Cardiomyopathy

http://en.wikipedia.org/wiki/Myocardium


42

Identification of the most important modifiable risk factors among patients with coronary artery disease in Fars province

Toosi S*¹. MSc., Senemar S¹. MSc. Human Genetic Research Group, Iranian Academic Center for Education, Culture & Research (ACECR), Fars Branch, Shiraz, Iran. *Correspondence: Samane Toosi, MSc., Human Genetic Research Group, Iranian Academic Center for Education, Culture & Research (ACECR), Fars Branch, Shiraz, Iran, Tell: +987112337851, Fax: +987112303662, email: [email protected]

BACKGROUND: The prevalence of coronary artery disease (CAD) is high in Iran and in Fars province. A case control study was performed to determine the prevalence of five modifiable risk factors of CAD (hypertension, diabetes mellitus, hypercholesteroleamia, BMI>25 (overweight/obesity) and smoking), and identification of the most important risk factors in patients confirmed CAD and in both men and women separately in a population from Fars province. METHODS: A total of 550 patients (275 males and 275 Females) with angiographically confirmed CAD, along with 450 Controls (225 Males and 225 Females) were selected. All patients were evaluated for conventional risk factors for coronary artery disease like diabetes mellitus, hypertension, smoking, hypercholesteroleamia. Data was analyzed by SPSS Statistical Program (Version 15.0). RESULTS: The prevalence of various risk factors for coronary artery disease In cases versus controls was found to be : hypertension (64.4 vs. 34.4%), diabetes mellitus (45.1 vs. 24.5%), history of current smoking (57 vs. 31.3%), hypercholesterolemia (44 vs. 35.3%) and BMI > 25 kg/m2 (69.7 vs. 44%). Our findings showed that hypertension (p=0.000), BMI>25 (p=0.000) and smoking (p=0.000) were statistically associated with CAD, while diabetes mellitus and hypercholesteroleamia were not statistically significant (p<0.05). Binary Logistic Regression analysis revealed that hypertension was the most important risk factor (OR=2.35,95%CI=1/8-3) followed by BMI>25 (OR=1.78, 95%CI=1.3-2.3), and smoking (OR=1.6, 95%CI=1.2-2.1). Also smoking (OR=2.93, 95%CI=1.1-4.3 p=0.000) was strongly associated with CAD in men while hypertension (OR=2.5, 95%CI=1.7-3.6, p=0.000) were more important in women. CONCLUSION: The results of the present study showed that coronary artery disease in our study was related mainly to hypertension, smoking and BMI>25. In conclusion, the importance of coronary artery disease risk factors may differ between individuals, different communities, different ethnic groups and by sex and age and In a certain population one or more risk factors may contribute to the pathogenesis of CAD. Therefore prevention strategies like identification all important modifiable risk factors and risk management (modifying life style and medication treatment) are needed. Keywords: coronary artery disease, risk factor

Appendix Articles

بر فشار خون و استعداد بروز آریتمی هاي بطنی مرگبار در REMاثر محرومیت از خواب مدل حیوانی

4، دکتر نوشین نقش1، دکتر وحید حاجعلی1، دکتر وحید شیبانی4، سودابه قربانی3و2و1دکتر سیاوش جوکار

عروقی متعاقب کم خوابی، دث قلبی-با توجه به کاهش ساعات خواب در جوامع امروزي و گزارشاتی مبنی بر افزایش حوادر مرگباربر فشار خون و استعداد بروز آریتمی هاي بطنی REMمطالعه حاضر به منظور بررسی اثر محرومیت از خواب

در شرایط عادي ): CTL(گروه شانزده تایی که شامل گروه کنترل 5حیوانات به . موش بزرگ آزمایشگاهی طراحی گردیدساعت در درون 72و 48که به ترتیب به مدت : 72و شم 48ن محرومیت از خواب، گروههاي شم حیوان خانه و بدو

ساعت که به 72و تست 48تست هاي، گروهREMبدون محرومیت از خواب ) Larg platform(دستگاه سوي چندگانه REMمحرومیت از خواب همراه با) Small platform(ساعت در درون دستگاه سوي چندگانه 72و 48ترتیب به مدت حیوان 8در . اندازه گیري شدحیوان از هر گروه 8 يکورتیکواسترون پالسماسطح در پایان دوره آزمایش . نگهداري شدند

پس از ثبت فشار خون و نوار قلب پایه حیوانات، داروي . بررسی شدآریتمی هاي قلبی استعداد به و شریانی دیگر فشار خوندقیقه جهت القاء آریتمی 10میلی لیتر در دقیقه و به مدت / 1میکروگرم در 5/1رید دمی و به میزانآکونیتین از طریق و

. تزریق شدساعته از خواب موجب افزایش معنی دار فشار سیستولی، فشار شریانی 72نتایج نشان داد که محرومیت

بر ضربان قلب، شاخص مصرف اکسیژن داري معنیگردید اما تاثیر (p<0.01)نوارقلب QTو فاصله (p<0.05)میانگینهمراه بود اما PVCاگر چه در این مطالعه بی خوابی با افزایش تعداد . میوکارد و سطح کورتیکواسترون پالسما نداشت

ناشی از انفوزیون داروي آکونیتین را ) VT/VFتاکی کاردي و فیبریالسیون بطنی(آریتمی هاي قلبی مرگبار تعداد و مدت . معنی دار بود VTو PVCریتمی ها شد که در مورد آ وقوعتاخیر در افزایش زمان بعالوه بی خوابی موجب . ش ندادافزاي

. معنی داري را نشان نداد تفاوت حیوانیمقایسه نمرات شدت آریتمی در گروههاي یش ریسک پرفشاري در موش صحرایی با افزا REMساعت محرومیت از خواب 72این یافته ها پیشنهاد می کند که

بعالوه این میزان از بیخوابی . نمی باشد ناشی از افزایش استرس احتماال نوارقلب همراه بوده که QTخون، و افزایش فاصلهخطر افزایش در شرایط استرس شدید با اینحال. هدنمی درا در موش صحرایی افزایش آریتمی هاي مرگبار قلبی بروز

فشارخون و اگر این مطالعه قابل تعمیم به انسان باشد با مانیتورینگ. محتمل استالنی طو QTآریتمی در حضور فاصله . را در افراد شیفت کار کاهش داد حوادث قلبی عروقیمی توان ریسک محیط کار نوار قلب و کاهش استرس QTفاصله

فیبریالسیون بطنی ، کورتیکواسترون، فشار خون، تاکیکاردي بطنی،REMمحرومیت از خواب :کلمات کلیدي


44

روز اول بعد از 30و 15رفتارهاي مراقبت از خود در بیماران مبتال به سکته قلبی در طی سکته قلبی

، فرزانه شیخ االسالمی، دکتر احسان کاظم نژاد لیلی1مریم نیاکان، عزت پاریاد

جراحی قلب بیمارستان شهید فقیهی ICUخش مریم نیاکان، کارشناس ارشد آموزش پرستاري، سرپرستار ب: نویسنده مسئول[email protected]

بیماري عروق کرونر که در مراحل . امروزه جهان پزشکی با رشد ابتال به بیماریهاي مزمن مواجه است :مقدمه

مل یکی از عوا. نهایی می تواند به سکته قلبی منجر گردد نیز یکی از انواع بیماریهاي مزمن محسوب می گرددتعیین کننده و موثر در حفظ سالمتی و پیشگیري از تشدید عالئم و نشانه هاي بیماري بویژه در بیماریهاي

جهت پیشگیري از تشدید عالئم رفتارهاي مراقبت از خود انجام . مزمن انجام رفتارهاي مراقبت از خود می باشدو کاهش هزینه مزمنبیشتر در بیماران و نشانه ها، کاهش دفعات بستري، کاهش مرگ و میر، احساس سالمت

همچنین بیماران می توانند با کسب مهارتهاي مراقبت از خود، بر .ضروري و حیاتی می باشدآنان هاي درمان هدف این مطالعه تعیین .میزان احساس آسایش، تواناییهاي عملکردي و فرایندهاي بیماري خود تأثیرگذار باشند

.روز بعد از ترخیص می باشد 30ماران مبتال به سکته قلبی در طی رفتارهاي مراقبت از خود بیبیمار تعیین گردید و روش 132حجم نمونه این مطالعه . این مطالعه یک مطالعه طولی بوده است :هاروش

داده ها با استفاده از پرسشنامه اطالعات زمینه اي و مداخله . نمونه گیري به صورت تدریجی در نظر گرفته شد. روز بعد از ترخیص تکمیل گردید 30و 15و همچنین پرسشنامه رفتارهاي مراقبت از خود در فواصل زمانی گر

و استفاده از آمار توصیفی و آزمونهاي آماري من 19نسخه spssتجزیه و تحلیل داده ها تحت نرم افزار آماري .ویتنی یو و کروسکالوالیس انجام شد

داراي رفتار مراقبت از خود مطلوب %) 72(بعد از ترخیص اکثریت بیماران 15روز نتایج نشان داد در :هایافتهبعالوه . اندرفتارهاي مراقبت از خود نامطلوب را نشان داده%) 1/84(اکثریت افراد 30اند در حالیکه در روز بوده

هاي در مورد حیطه). p>0001/0(باشدبعد از ترخیص تفاوت آماري معنادار می 30و 15بین این رفتارها در روز آور و عدم رعایت رژیم غذایی، رعایت فعالیت جسمانی، تعدیل اثر متغیرهاي تنیدگی(رفتارهاي مراقبت از خود

اما در مورد مصرف رژیم دارویی تجویز ) p>001/0(مصرف سیگار در این محدوده زمانی تفاوت آماري معنادار .شده این تفاوت معنادار نبوده است

تواند کاهش یافته است که می 15نسبت به روز 30رفتارهاي مراقبت از خود بیماران در روز :گیرينتیجه .بعلت عدم درك کامل بیمار از وضعیت موجود بوده باشد

سکته قلبی، رفتارهاي مراقبت از خود :هاکلید واژه

Appendix Articles

Burnout and Coronary Heart Disease Reiskarimian Farahnaz, Dokohaki Roya Shiraz University Of Medical Science, Nursing and Midwifery Collage Hazarte Fatemeh

Burnout is a long-term affective state consisting of emotional exhaustion, physical fatigue, and cognitive weariness symptoms. It is an outcome of a gradual depletion of energetic resources resulting from prolonged exposure to stress, particularly work-related stress. The prevalence of burnout among workers is high and is considered a stable, long-term phenomenon, regardless of sample makeup, cultural context, or duration of follow-up. Accumulated evidence suggests that, in addition to its negative impact on quality of life and mental health, burnout has a negative impact on physical health and may be considered a risk factor for physical morbidity and bodily disorders. It has been found to be associated with risk of Type 2 diabetes, sleep disturbance, musculoskeletal pain, impaired fertility, and all-cause mortality. Other evidence suggests that burnout is associated with cardiovascular risk factors such as dyslipidemia, other components of metabolic syndrome, and inflammation biomarkers. Based on such evidence, it has been suggested that burnout may be a risk factor for coronary heart disease (CHD). To date, the association between burnout and CHD has been directly tested in little study. In one study (Toker etal) association between burnout and incidence of CHD determined. Conclusions showed burnout is a risk factor for future incidence of CHD. Individuals with high levels of burnout have a significantly higher risk of developing CHD compared with those with low levels of burnout. In another study (Hallman etal) on Swedish women with CHD reported a significantly higher level of burnout than the healthy matched group. Therefore findings reveal that burnout and coronary heart disease can have relation to each other.


46

Forgiving and Cardiovascular Benefits Reiskarimian Farahnaz, Zandi Keramat Allh Shiraz University Of Medical Science, Nursing and Midwifery Collage Hazarte Fatemeh

A variety of emotional experiences, such as hostility and anger, link to ill health and cardiovascular disease through increasing sympathetic nervous system reactivity to stress. When individuals face with interpersonal conflict, or social stress, cope in a variety of ways. One may retaliate directly, such as taking revenge, or one may avoid the situation or offender. However, both the expression and the suppression of aggression may be associated with negative health consequences. A third alternative is forgiveness has long important moral virtue, it also seems to be beneficial for physical health. According to Wade and Worthington (2005), forgiveness is defined as ‘‘a positive method of coping with a hurt or offense that primarily benefits the victim through a reorientation of emotions, thoughts, and/or actions toward the offender’’. Forgiveness is associated with fewer reported physical symptoms, fewer medications taken, a stronger immune system, and reduced cardiovascular mortality with less strain on it. More forgiving people have lower blood pressure at baseline and also show faster cardiovascular recovery after offense, yielding lower overall blood pressure. Several studies have examined state forgiveness by comparing physiological responses to forgiven and unforgiven offenses. In one study people with higher state forgiveness showed reduced cardiovascular reactivity (CVR) during the interview. Another data showed that imagining a hurtful event in a forgiving way leads to smaller increases in blood pressure than imagining the same event from an angry perspective. In other research, forgiveness was associated with reduced diastolic blood pressure (DBP) and quicker DBP recovery from stress. Findings suggest that the pathway by which forgiveness impacts health is not through reactivity but through an overall lowering of blood pressure levels and a quick blood pressure recovery following stress.In addition forgiving implies a reduction of negative emotions including anger, resentment, and hostility, with a simultaneous increase in positive emotions such as empathy, compassion, and affection for the transgressor. Clinical studies have examined the role forgiveness plays in reducing feelings of anxiety, depression and hostility for improving cardiovascular health, and overall it appears that forgiveness may be cardioprotective.

Appendix Articles

The effect of sustained nursing consult by telephone (telenursing) on

adherence to self-care behaviors and blood pressure in hypertensive

patient Seyed Said Najafi*, Seyedeh Mahban Faraji, Marzieh Moattari, Firuzeh Abtahi *Nursing department, Shiraz University of Medical Sciences, Iran, Email: [email protected],

Tel:09161613828 , Fax: 6474252 Background: Despite the high prevalence of high blood pressure but the control rate is low in different communities. Poor control of, hypertension is associated with a number of diseases, such as stroke, heart and renal failure, and high, mortality rates. Studies have shown the inconsistent results of long-distance health interventions including telephone counseling in controlling the disease. The aim of this study was to determine the effect of sustained nursing counseling by telephone in improving blood pressure control and self-care behaviors in patients with hypertension. Methods: This was a quasi-experimental trial. 50 individuals were randomized to usual care or telephone-based intervention group. Each group had 25 patients. All patients received a clinic consultation with training. Then, Patient groups received sustained nursing counseling by telephone during the 8 weeks. BP was measured using a digital monitor and self-care behaviors measured using particular form. Result: There were no significant differences in the baseline measures between the control and study groups. Significant difference was found at 8 weeks after intervention was initiated between groups in, systolic blood pressure (control 16 vs study 22.3, p = 0.03). Other variables including diastolic BP (7.3 vs 13, p = 0.293) and adherence to self-care behaviors were no significant differences after intervention (p> 0.05). Conclusions: This study showed that sustained nursing counseling after clinic nurse have positive effects on systolic blood pressure control. This combined mode of services is worth considering for blood pressure control and other chronic disease, management programs. But this mode of intervention, in short time, does not affect in improve adherence to self-care behaviors and lifestyle modification. Keywords: nursing consult by telephone, telenursing, adherence to self-care behaviors, blood pressure, hypertensive patient

Tel:09161613828

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