BackgroundTreatment of patients with acute myocardial infarction (AMI) is time related, so delay in treatment could affect prognosis. Recognizing pre-hospital or in-hospital delays in initiating treatment and reducing these factors is very efficacious in treatment of these patients.ObjectivesThe aim of this study is evaluate the causes of pre-hospital delay just as other studies on effect of different variables such as socioeconomic and personal factors on pre-hospital delay in with patients with AMI.Materials and MethodsA cross sectional study was carried out on 227 patients with acute myocardial infarction and demographic data, educational level, marital status, type of transfer to hospital and delay in arrival to hospital were recorded.Results35.7% patients arrived during one hour of symptom onset, and 7.9% arrived after 24 hours. Patients having high level education (P = 0.0492) and with a family history of coronary artery disease (P = 0.01) had significantly less delay in arriving to hospital. Age, marital status, gender, and route of transfer to hospital were not related with pre-hospital delay (P > 0.05). Patients thought most common cause of delay in arrival was unawareness of coronary artery disease (38.8%) and self-medication (34.3%).ConclusionsIncreasing awareness of patients about cardiovascular symptoms and their risk factors could be helpful in patient's decision in seeking medical help. So general education via media and primary and middle schools could be helpful.

BackgroundPercutaneous coronary intervention (PCI) is the most common revascularization procedure, with over 1 million performed each year, worldwide. Over the past 20 years, the increasing experience of operators coupled with the advent of newer technologies, including coronary stents and a variety of adjuvant drug therapies, have permitted more successful procedures and decreased the morbidity associated with PCIs.ObjectiveTo identify the incidence, predictors, and clinical implications of Major Adverse Cardiovascular Events (MACE) after PCIs.MethodsThis descriptive cross-sectional study was done in Bandar Abbas in Iran in 2015. All patients which treated with PCI in Shahid Mohammadi Hospital during a one-year period were employed. A total of 192 patients were included. At one-year follow-up in this study, incidence and predictors of MACE were evaluated in a prospective study. The data were analyzed by SPSS 19.0 and descriptive tests included frequency and percentage and mean and standard deviation. Also, Chi-square test was used for data analysis. A p value <0.05 was determined as significant.ResultOf the 192 patients, 126 (65.6%) were men and 66 patients were female. Stent had been implemented in 93.8% of patients. Sixty two percent of patients were treated with only one stent, two stents were deployed in 29.7% of patients and 3.6% of patients were treated with three or more stents. Of these patients, 46.9% were treated with Drug Eluted Stent (DES) and 40.1% were treated with Bare Metal Stent (BMS). Both types of stents were used in 8.3% of patients. Also, 4.7% of the patients were treated with balloon angioplasty (POBA). Angioplasty success rate was 95.3% and procedural success rate defined as achieving TIMI III flow with residual coronary stenosis under 30%. No in-hospital mortality or emergency CABG was reported. Re-admission in first year after PCI was required in 34 (17.7%) patients of which, 20 of them (10.4%) needed target vessel revascularization (TVR). Readmission was significantly higher (p=0.034) in the group with BMS compared to those who had DES. MI occurred in 8 patients.ConclusionOur study showed the superiority of DES in comparison with BMS in decreasing readmission and less TVR, but no effect on long term mortality. We recommend more studies in this setting because patients in special groups may benefit more from DES or BMS.

Background Vaccination against Covid 19 disease was based on rational practice theory. One of the most effective methods to control the COVID-19 pandemic is extensive vaccination coverage in the shortest time. The relevant beliefs and predictors of COVID-19 vaccine and the barriers to and facilitators of receiving COVID-19 vaccine should be identified. Individuals’ intention to receive COVID-19 and the effective factors are of an utmost importance. This study aimed to predict intention to receive COVID-19 vaccine in the South of Iran. Methods This cross-sectional study was performed over a period of 2 months (May 2021 to July 2021) in 4 southern provinces in Iran. The study population of this study included people over 18 years of age who did not receive the COVID-19 vaccine. The online questionnaire was used to collect data. We recruited participants through a self-selection sampling method and posted the online survey link. The questionnaire had two parts: demographic information and Theory of Reasoned Action (TRA) questions. All statistical calculations and hypotheses tests were performed using SPSS21 and Amos21 software and the significance level was considered 0.05. Results A total number of 2556 people participated in this study with a mean age of 37.76 (10.7) of years (Age Range = 18–75). The findings showed that attitudes and subjective norms and the use of social media predict the intention to receive COVID-19 vaccine. SEM showed that attitude (β = 0.596, P < 0.001), subjective norms (β = 0.265, P < 0.001) were significant predictors of vaccination intention. In this study, 78% of people were willing to receive the vaccine when they were officially allowed to. Conclusion According to the results of the study, it is suggested to strengthen positive attitudes and subjective norms about the importance of COVID-19 vaccination as well as using social media to inform the community in order increase the intention to vaccinate COVID-19 and increase vaccine coverage.

Acute coronary syndrome (ACS) is closely associated with an increased risk of death. Nrg4, a novel adipocytokine, has negative correlations with indicators of metabolic syndrome. Here, we investigated whether circulating Nrg4 associates with the prevalence of ACS. In this case-control study, a total of 257 subjects (144 patients with ACS and 56 patients diagnosed with stable angina pectoris (SAP)) compared to 57 healthy controls. Serum Nrg4 and hs-CRP concentrations were determined by ELISA. The associations of circulating Nrg4 with other clinical parameters were also analyzed. Serum levels of Nrg4 were lower in patients compared to the control subjects (0.7 ± 0.53 ng/mL versus 1.1 ± 0.9 ng/mL, p = 0.018). There was a significant association between higher Nrg4 level and lower risk of ACS (OR = 0.15; 95%CI = 0.02-0.9; P = 0.046), but not with SAP. This association was independent of potential confounders including traditional cardiovascular risk factors. The distribution of patients with no, 1, 2 and 3 vessel stenosis was significantly different in Nrg4 quartiles. Patients in the lower quartile of Nrg4 were more likely to experience 3 vessel diseases. Serum levels of Nrg4 correlated negatively with HDL-cholesterol in ACS patients. Decreased serum levels of Nrg4 might be an independent risk factor for ACS.

Objective: Diabetes mellitus is a chronic illness and adherence to medications is vital to manage the illness. The purpose of this study was to examine the prediction of medication adherence based on personality factors in a group of individuals with type 2 diabetes in Yasuj. Materials and Methods: One hundred twenty individuals with type 2 diabetes who visited health centers were selected for this study through convenience sampling. The participants completed the NEO-Five Factor Inventory and Medication Adherence Rating Scale (MARS). The data were analyzed by mean, standard deviation, and multiple regression analysis using SPSS software. Results: The results showed that among the big-five personality factors, only neuroticisms significantly predicted adherence to medications (β= -0.31, P-value< 0.003). Furthermore, the model explained only 19% of the variance in medication adherence (R2= 0.19, P-value< 0.01). Conclusion: This study indicated that a large proportion of patients with type 2 diabetes did not adhere to their medications. This study highlighted that the personality trait of neuroticism was important in predicting medication adherence in patients with type 2 diabetes.