ObjectivesDespite enormous efforts in public education, treatment seeking time still remains more than optimal in patients with acute coronary syndrome. This prospective study tries to determine the risk factors of pre-hospital delay in patients with acute coronary syndrome.MethodsDescriptive data of 190 patients with diagnosis of acute coronary syndrome attending in 2 tertiary level teaching hospital emergency departments were analyzed to determine risk factors of delayed pre-hospital treatment seeking. Demographic, social and clinical characteristics of patients were obtained and they were asked to fully describe their symptoms and the actions they had done after their symptoms onset.ResultsThirty nine (20.52%) of patients were arrived in emergency department in <1 h of their symptoms onset, 73 (38.43%) were arrived between 1 and 6 h and 78 (41.05%) were arrived in >6 h. Sex, route of transport, scene-to-hospital distance, attributing the symptoms to non-cardiac causes and outpatient physician consultation and cigarette smoking were the risk factors of delayed treatment seeking in our studied patients with acute coronary syndrome. Patients with previous history of ischemic heart disease and Coronary Care Unit admission and patients with underlying diseases like diabetes mellitus, hypertension and hyperlipidemia showed a trend to have more delayed treatment seeking behavior but not with a statistically significant difference. Patients with positive family history of acute coronary syndrome arrived in emergency department earlier than other patients but again with not a statistically significant difference.ConclusionMost patients with acute coronary syndrome arrived in emergency department in >6 h of their symptoms onset. Sex, route of transport, scene-to-hospital distance, attributing the symptoms to non-cardiac origins, outpatient physician consultation and cigarette smoking were risk factors of delayed treatment seeking in studied patients.

Context: Five species of the genus Ajuga (Lamiaceae) having the common name of "bugle" are found in Iran. In Persian medicine (PM), the genus Ajuga (Kamaphytus) is used for treating jaundice, joint pain, gout, amenorrhea, sciatica, and wound healing. This study aimed to review the ethnobotanical, phytochemical, and biological activities of Ajuga species that grow in Iran to determine their therapeutic potentials and suggest further studies on the healing properties of this genus in Iran. Evidence Acquisition: Electronic databases such as PubMed, Scopus, and Google Scholar were comprehensively searched for studies on Ajuga species in Iran, including "Ajuga austro-iranica," "Ajuga chamaecistus," "Ajuga comata" (Syn.: "Ajuga Chia," "Ajuga chamaepitys subsp. Chia"), "Ajuga orientalis," and "Ajuga reptans." The search period was from 1966 to February 2021. The related articles were selected according to the inclusion and exclusion criteria of the current study. Results: Several ethnobotanical and pharmacologic reports have verified the traditional uses of the genus Ajuga for anti-inflammatory, hypoglycemic, hypolipidemic, analgesic, anabolic, anti-arthritis, antipyretic, and hepatoprotective activities. Numerous phytochemicals have been identified from Ajuga species involving phytoecdysteroids, neo-clerodane-diterpenes, iridoids, flavonoids, withanolides, phenylethyl glycoside, and essential oils. Conclusions: Due to the beneficial therapeutic effects of Ajuga genus, it can be considered in future clinical studies as a source of natural antioxidants, dietary supplements in the pharmaceutical industry, and stabilizing food against oxidative deterioration.