Introduction: Dyslipidemia may be defined as increased levels of serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), or a decreased serum high-density lipoprotein cholesterol (HDL-C) concentration. Dyslipidemia is an established risk factor for cardiovascular disease (CVD). We aimed to investigate the association of dyslipidemia and CVD events among a population sample from Mashhad, in northeastern Iran. Material and methods: This prospective cohort study comprised a population of 8698 men and women aged 35-65 years who were recruited from the Mashhad Stroke and Heart Atherosclerotic Disorder (MASHAD) study. Socioeconomic and demographic status, anthropometric parameters, laboratory evaluations, lifestyle factors, and medical history were gathered through a comprehensive questionnaire and laboratory and clinical assessment for all participants. Cox regression model and 95% confidence interval (CI) were used to evaluate the association of dyslipidemia and its components with CVD incidence. Results: After 6 years of follow-up, 233 cases of CVD (including 119 cases of unstable angina [US], 74 cases of stable angina [SA], and 40 cases of myocardial infarction [MI]) were identified in the study population. Unadjusted baseline serum LDL-C, TC, and TG levels were positively associated with the risk of total CVD events among the entire population (HR: 1.54, 95% CI: 1.19-2; P-value< 0.01; HR: 1.53; 95% CI: 1.18-1.98; P < 0.01; HR: 1.57; 95% CI: 1.27-2.03; P < 0.01, respectively). However, after adjusting for confounding factors (age, body mass index [BMI], family history of CVD, smoking status [non-smoker, ex-smoker and current smoker], lipid lowering drug treatment, antihypertensive drug treatment, hypertension, healthy eating index [HEI], total energy intake, and presence of diabetes mellitus), a significant direct association only remained between TC and MI risk in men (HR: 2.71; 95%CI: 1.12-6.57; P-value< 0.05). Conclusion:In the present study, TC baseline level was significantly associated with the risk of MI among men.

Background: Coronavirus disease 2019 (COVID-19) pandemic imposes serious problems to health systems around the world and its rapid expansion makes it difficult to serve patients with certain health conditions such as cancer patients which might be at high risk for mortality if they are infected by the severe acute respiratory syndrome coronavirus 2.Aim: To compare the outcomes of cancer patients admitted due to COVID-19 and compare them with data of COVID-19 infected patients without a history of cancer.Methods: In this case-controlled study, 93 healthy people and 92 patients with malignancy admitted for COVID-19 were enrolled. The clinical features and laboratory indicators were assessed at the presentation and both groups were followed-up for treatment options and outcomes prospectively and compared at the level of P ≤ .05.Results: COVID-19 related mortality rate in malignant patients was significantly higher than patients without malignancy (41.3% vs 17.2%, P = .0001). The risk of death increased significantly in patients with malignancy (OR = 8.4, P = .007) and mechanical ventilation (OR = 3.3, P = .034) independent of other variables. Fever (64.5% vs 43.5%, P = .004), chill (35.5% vs 14.1%, P = .001), malaise (49.5% and 30.4%, P = .008), dry cough (51.6% vs 26.1%, P = .0001), and vomiting (17.2% vs 5.4%, P = .012) were reported significantly lower in cancer patients. Conclusion:The results suggest that cancer patients who were infected by COVID-19 may present with atypical symptoms are at higher risk of mortality independent of the demographic data, comorbidities, and treatments.

The dietary inflammatory index (DII) is a novel way of describing diet that has been studied in relation to various health conditions, including cardiovascular disease (CVD) in several populations. We aimed to investigate the association between DII and CVD events among a representative population sample in northeastern Iran. This prospective cohort study was a subsample of 4,672 adults aged 35–65 years, and recruited as part of Mashhad stroke and heart atherosclerotic disorder cohort study population. The DII was computed at baseline according to a 65‐item validated food frequency questionnaire. Cox regression was used to determine the association of DII with incident CVD. One hundred twenty‐four participants developed CVD (including 24 cases of myocardial infarction [MI], 34 cases of stable angina [SA], and 66 cases of unstable angina [UA]). After adjusting for potential confounding factors, a hazard ratios of 1.06 (95% confidence interval: 0.70–1.60), 1.36 (95% confidence interval: 0.52–3.52), 1.33 (95% confidence interval: 0.60–2.94), and 0.86 (95% confidence interval: 0.48–1.53) were found for total CVD, MI, SA, and UA events, respectively, among the participants with proinflammatory diet (DII ≥ 0) versus those with anti‐inflammatory diet (DII < 0). There was no statistically significant association between the DII and total CVD, MI, SA, or UA in this population of middle‐aged Iranian men and women.

Patients with heart failure experience system imbalance and have multiple symptoms. A nurse-led care program based on Johnson’s behavioral system model was used to improve the balance of the behavioral system of heart failure patients. One hundred and fifty patients were randomly assigned into two groups. In the experimental group, the patient’s status was evaluated by a behavioral subsystem assessment tool related to the level of imbalance. The patients in the intervention group received care individually based on their worst subsystem scores over a period of 2 weeks. The results showed significant improvement in restorative, ingestive, eliminative, aggressive/protective, dependency, and achievement ( p < .05) subsystems in the experimental group. However, no significant difference was seen in sexual and affiliative ( p > .05) subsystems.

Background and Objective: Type 2 diabetes is one of the most important public health challenges. Self-efficacy and health literacy play a key role in self-care for diabetic patients. The aim of this study was to determine the effect of training based on self-efficacy theory on health literacy, self-care behaviors and self-efficacy in patients with type 2 diabetes.

Obesity is an important feature of the metabolic syndrome and is associated with an increased risk of type 2 diabetes mellitus, cardiovascular disease, and some cancers. The aim of this study was to determine the relationship between body fat percentage and an imbalance of the prooxidant/antioxidant balance (PAB), serum superoxide dismutase (SOD1) and inflammation (serum hs‐CRP) and increase risk of metabolic syndrome and diabetes mellitus. In this study, 9154 individuals were recruited as part of the Mashhad Stroke and Heart Association Disorder (MASHAD) study. Subjects were categorized into two groups according to body fat percentage as defined >25% in male and > 30% in female, according to gender. Biochemical factors, including serum PAB, SOD1, and hs‐CRP were measured in all subjects. SPSS version 18 was used for statistical analyses for all. GraphPad Prism 6 for figures was used. Of total number of subjects (9154), 6748 (73.7%) were found to have a high body fat (BF) percentage. Serum hs‐CRP and PAB were significantly higher in individuals with a high BF percentage (P < 0.05) but SOD1 was not significantly different between the two groups (P > 0.05). BF percentage, serum PAB and serum hs‐CRP were significantly higher in individuals with metabolic syndrome and diabetes versus those without metabolic syndrome and diabetes mellitus (P < 0.05), however serum SOD1 was significantly lower in individuals with metabolic syndrome (P < 0.005). Oxidative stress and inflammation are two factors that may link the presence of high BF percentage with the development of metabolic syndrome, diabetes, and cardiovascular disease. © 2018 BioFactors, 45(1):35–42, 2019

Background:Risk for anxiety and depression is increased in women with high-risk pregnancy. The aim of this study was to evaluate anxiety and depression in women with mild and severe preeclampsia at admission and 6 weeks postpartum.Materials and Methods:In this cohort study, 122 preeclamptic women who were admitted to the Public hospital and Tamin Ejtemaee hospital of Mashhad were included. Selection was done by convenience sampling method. Beck Depression Inventory II (BDI-II) and Spielberger State-Trait Anxiety Inventory (STAI) were completed at admission and 6 weeks after delivery. Data were analyzed by SPSS 16 using Chi-square, Fisher's exact test, Mann-Whitney U test, and Repeated measurement.Results:The mean depression score was 4.81 ± 4.09 at admission and 11.17 ± 5.5 at 6 weeks postpartum. The mean of trait anxiety was 42.5 ± 10.5 at admission and 32.3 ± 6.5 at 6 weeks postpartum, and the mean of state anxiety score at admission was 43.09 ± 9.5 and at 6 weeks postpartum was 31.99 ± 5.9. There was a significant difference between the scores of depression (F = 3.8, P < 0.001), state anxiety (F = 1.52, P < 0.001), and trait anxiety (F = 1.5, P < 0.001) at admission and 6 weeks postpartum. No significant differences were found between severity of preeclampsia and the scores of depression, state anxiety, and trait anxiety at admission and 6 weeks postpartum.Conclusions:The mean score of state and trait anxiety decreased significantly in preeclamptic women from admission to 6 weeks postpartum, but the mean score of depression increased. Severity of preeclampsia was not an independent risk factor of depression and anxiety.

Reference intervals (RIs) are important tools for improving medical decision-making. Hematology reference values can be influenced by important covariates such as genetic and environmental factors, rendering it essential to define RIs for specific populations. Therefore, we aimed to establish accurate and robust RIs for hematological markers in a healthy adult male Iranian population. This cross-sectional study was conducted in a population of 723 males aged 20-60 years old. Hematological parameters were routinely measured using a Sysmex auto analyser system (KX-21 N). The quality of assays was monitored using commercial quality control samples. The nonparametric rank method, as recommended by the Clinical and Laboratory Standards Institute (CLSI) guidelines, was used to calculate the 2.5th and 97.5th percentiles as the lower and upper reference limits, respectively. Of the 12 hematological parameters assessed, only mean platelet volume (MPV) demonstrated significant age-specific differences, requiring two partitions from 20 to 35 years (8.7-12.2 fL) and 35 to 65 years (8.5-11.5 fL). The remaining hematological parameters (e.g. leukocyte, erythrocyte, and platelet parameters) could be defined by one age range. This study established RIs for 12 routinely used hematological parameters in a healthy male population living in the northeastern region of Iran. Established RIs differed from those previously reported by other cohorts, highlighting the importance of population-specific RIs.