Background: The association of dietary patterns and metabolic syndrome with the severity of coronary artery disease (CAD) is little known. Aim: This study aimed to explore the relationship between major dietary patterns and the severity of CAD among newly discovered patients by using structural equation modeling (SEM). Methods: In this cross-sectional study, we included 423 newly diagnosed patients with CAD, aged 35–65 years, who underwent coronary angiography. The severity of CAD was assessed by the Gensini score. All patients were tested by using a semi-quantitative food frequency questionnaire, international physical activity questionnaire, perceived stress scale, lipid profile, fasting blood glucose, and anthropometric and blood pressure measurements. Statistical analysis was performed using SPSS and AMOS version 24. Results: Two dietary patterns (DPs) were identified by principal components analysis and labeled as “unhealthy DP” and “healthy DP”. The results of SEM analysis showed that the unhealthy DP has a significant positive direct association with the severity of CAD (β=0.304, p<0.001), which is indirectly mediated by the presence of metabolic syndrome (β=0.021, p=0.021), adjusted for age and perceived stress scale. However, healthy DP has a significant negative direct association with the Gensini score (β=-0.213, p<0.001), and an indirect association through negative metabolic syndrome (β=-0.019, p=0.022), controlled for gender, physical activity, and perceived stress scale. Conclusions: The severity of CAD was directly associated with the unhealthy DP and indirectly mediated by the presence of the metabolic syndrome, while a healthy DP had a direct inverse association with CAD severity and indirectly mediated by the absence of metabolic syndrome.
Background: It has been recently reported that lipoprotein-associated phospholipase A2 (Lp-PLA2) may predict the risk of cardiovascular disease. The effect of multi-strain probiotics on Lp-PLA2 in patients with type 2 diabetes is still not clear. This study aimed to determine the effect of multi-strain probiotic supplementation on lipoprotein-associated phospholipase A2, and glycemic status, lipid profile, and body composition in patients with type 2 diabetes. Methods: In this randomized double-blind placebo-controlled clinical trial, 68 participants with type 2 diabetes, in the age group of 50-65 years, were recruited and randomly allocated to take either probiotic (n= 34) or placebo (n= 34) for 12 weeks. The primary outcome was lipoprotein-associated phospholipase A2, and secondary outcomes were glycemic parameters, lipid profile, anthropometric characters, and body composition (fat mass and fat-free mass). Results: There was a significant reduction in serum lipoprotein-associated phospholipase A2, in the probiotic group, it dropped by 6.4 units at the end of the study (p <0.001) compared to the placebo group. Probiotic supplementation also resulted in a significant improvements in the hemoglobin A1c and high-density lipoprotein cholesterol 1.5% (p <0.001) and 6 mg/dl (p 0.005). There were no significant changes in other outcomes. Conclusion: We showed that probiotic supplementation was beneficial for reducing Lp-PLA2 and hemoglobin A1c and improving high-density lipoprotein cholesterol which may suggest an improvement in the prognosis in patients with type 2 diabetes.
BACKGROUND፡ The association of dietary patterns (DPs) linked to the severity of coronary artery disease (CAD) is little known. Therefore, this study aims to explore the relationship between major DPs and the severity of CAD.METHODS: This cross-sectional study was conducted among423 newly discovered CAD patients (both genders, aged 35-65 years), who underwent coronary angiography. The severity of CAD was assessed by the Gensini score. All patients were tested using a semi-quantitative food frequency questionnaire and other related data through face-to-face interviews. Factor analysis and logistic regression were applied by using SPSS version-24.RESULTS: By principal component analysis, two major DPs were identified: “Unhealthy” DP that characterized mainly by high intakes of sugar and sweets, soft drinks, salts, cooking oils, and processed meats, and “Healthy” DP that consisting high intakes of fruits, fish, poultry, vegetables, whole grains. After adjustment for confounding variables, the odds of severe CAD was significantly higher in the third (T3) and second (T2) tertile of the unhealthy pattern by 4.79 and 2.48 times more compared to the first tertile (T1) (OR 4.79; 95%CI 2.60, 8.83; P<0.001) and (OR 2.48; 95%CI 1.40, 4.39; P=0.002), respectively. However, the odds of CAD severity in the T3 and T2 of the healthy pattern was lowered by 0.24 and 0.38 times less compared to the T1 (OR 0.24; 95%CI 0.12, 0.47; P=0.002) and (OR 0.38; 95%CI 0.20, 0.73;P=0.006), respectively.CONCLUSION: The severity of CAD was significantly increased by the unhealthy dietary pattern, while decreased by adherence to the healthy pattern.
Background: The association between life-event stressors and low physical activity linked to the severity of coronary artery disease (CAD) is poorly understood. Therefore, this study aimed to determine the perceived stress status and physical activity level associated with the severity of CAD.Methods: The study was conducted among 423 patients with newly discovered CAD (both sexes, aged 35–65 years) confirmed by coronary angiography results. CAD severity was classified according to the Gensini score as severe or non-severe. The fasting blood glucose and lipid profiles were also investigated. Anthropometric and brachial blood pressure measurements were obtained. A structured questionnaire including participants’ characteristics, the Perceived Stress Scale (PSS-14), and the International Physical Activity Questionnaire were used via face-to-face interviews. Multivariable binary logistic regression was used to assess the predictors of CAD severity using IBM SPSS ver. 24.0 (IBM Corp., Armonk, NY, USA).Results: Most participants were classified as having severe CAD (63.8%). Adjusting for age, sex, smoking status, systolic blood pressure, body mass index, and history of hypertension, the severity of CAD increased by 9% for a onescore increase in the PSS (odds ratio [OR], 1.09; 95% confidence interval [CI], 1.01–1.14; P=0.030). Moreover, sufficiently active (600–1,500 metabolic equivalents [METs]/wk) patients had lower odds of severe CAD (OR, 0.43; 95% CI, 0.23–0.72; P=0.027) than those with insufficient activity. However, no significant association was found between physical activity (≥1,500 METs/wk) and CAD severity.Conclusion: The odds of CAD severity significantly increased with increasing perceived stress score but decreased with sufficient physical activity.
Background: In the healthcare setting, occupational hazards are posed a crucial risk for healthcare workers (HCWs). Few studies highlighted the knowledge, attitude, and practices of occupational health and safety (OHS) among HCWs in the Palestinian context. Therefore, this study aims to assess the knowledge, attitude, and practices among HCWs in Gaza Strip. Methods: A cross-sectional study was conducted among 330 HCWs. The self-administered questionnaire was used in this study, including 32 items Likert scale for knowledge, attitude, and practices toward OHS. Data analyses were applied by using SPSS version-24. Frequencies, chi-square, and independent t-test were used to test the categorical and continuous variables. Results: In this study, 330 HCWs were recruited from different departments. The main results showed 54.9% of the nurses were having the highest level of OHS knowledge, while 66.7% of administrative careers were having the lowest percentage. Regarding OHS’ attitude, the results indicated that 47.7% of the nurses were having a positive, while 83.3% of the engineers and technicians were having a negative attitude. Moreover, the data analysis showed that 50.4% of the nurses were having good practice towered OHS, while 62.5% of the radiologist technicians were having poor practice. Furthermore, this study showed that the majority (80.3%) of the HCWs were not receive training courses in OHS. Conclusion: Even though the knowledge, attitude, and practice were sufficient among nurses compared with other HCWs, it was still a gap between them. Therefore, a focus training program in OHS is needed to engage the policy and procedures of OHS in hospital services.
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