Background:The Immense cost of cancer treatment is one of the main challenges of health care systems all over the world including Iran. The aim of this study was to analyze the direct treatment costs of colorectal cancer patients in Isfahan, Iran.Methods:In this cross sectional study, the medical records of colorectal cancer (CRC) patients admitted to the Seyyed-al-Shohada Hospital “SSH” from 2005-2010 were reviewed. The profiles of 452 patients were examined. However based on inclusion, exclusion criteria a total number of 432 profiles were analyzed. All records including age, sex, treatment processes and treatment costs were extracted from the patients’ profiles and analyzed using Kruskal-Wallis test.Findings:The results showed that 56.1% of CRC patients were male. The mean age of patients suffering from CRC was 56 ± 13.4. More than Thirty-six percent of the patients were in stages 1-3 of CRC and more than half of them (64.4%) were in the 4th stage. The higher the stage of the cancer the higher the percentage of treatments used. 5-Fluorouracil and Leucovorin (5FU/LV) was the most common used chemical treatment protocol. The mean treatment cost for stage one was 10715 (±4927), for stage two 15920 (±3440), stage three 16452 (±2828) and for stage four was 16723 (±2555) US Dollars. The cost of drug treatment was the first cost driven between the medical services.Conclusion:CRC in Iranian population starts in younger age than people in western countries. This imposed considerable direct and indirect economic cost to the society. The direct medical cost of colorectal cancer in Iran is very higher than 38 million $. Screening programs could reduce the economic cost of CRC significantly.

BACKGROUND:Prehypertension is one of the cardiovascular disease predicators. Management of prehypertension is an appropriate objective for clinicians in a wide range of medical centers. Massage therapy is primarily nonpharmacological treatment that is used to control blood pressure (BP). This study intends to investigate the long-term effect of massage therapy on BP in prehypertensive women.METHODS:This was a single-blind clinical trial study conducted on 50 prehypertensive women who referred to Sedigheh Tahereh Cardiovascular Center, during 6 months in 2009. Participants were selected by simple random sampling and were divided into control and intervention groups. The test group (25 patients) received massage for 10–15 min, three times a week for 10 sessions, and the control group (25 patients) was relaxed in the same environment but with no massage. Their BP was measured before and after each session and 72 h and 2 weeks after finishing the massage therapy. Analyzing the data was done using descriptive and inferential statistical methods (Chi-square, Mann–Whitney, paired t-test, and Student's t-test) through SPSS software version 18 and a significant level was considered as P < 0.05.RESULTS:The results indicated that the mean systolic BP (SBP) and diastolic BP (DBP) in the massage group were significantly lower in comparison with the control group (P < 0.001). Evaluation of durability of the massage effects on BP also indicated that 72 h after finishing the study, still there was a significant difference between the test and control groups in SBP and DBP (P < 0.001), but after 2 weeks, there was not a significant difference in SBP and DBP (P > 0.05) between the two groups.CONCLUSIONS:Although massage therapy seems to be a safe, effective, applicable, and cost-effective intervention to control BP of prehypertensive women, its effects do not persist for a long time.

Background and purpose Performing a proper causative workup for ischemic stroke patients is essential as it guides the direction of primary and secondary preventions. We aim to investigate the etiological evaluation of these patients in university and nonuniversity hospitals. Method We enrolled subjects from the Persian Registry of Cardiovascular Disease–stroke. Stroke patients were categorized base on an etiological-based classification (Trial of Org 10172 in Acute Stroke Treatment or TOAST) into five groups. We also separated patients with ischemic stroke of undetermined etiology due to incomplete standard evaluation from ischemic stroke of undetermined etiology due to negative standard evaluation. The etiological subtypes and diagnostic evaluations were compared between the two hospital groups. Result Ischemic stroke of undetermined etiology was the most common subtype overall (43%). The prevalence of ischemic stroke of undetermined etiology (incomplete standard evaluation) was significantly higher in patients evaluated in nonuniversity hospitals versus university hospital (46.2% vs. 22.3%). Patients with ischemic stroke of undetermined etiology (negative standard evaluation) and large-artery atherosclerosis were significantly more prevalent in university hospitals (10.3% vs. 4.6% and 13.9% vs. 4.4%, respectively). All diagnostic workups were performed more significantly for university hospital patients. Patients with Ischemic stroke of undetermined etiology (negative standard evaluation). Patients were significantly younger (64.91 ± 14.44 vs. 71.42 ± 12.93) and had lower prevalence of risk factors such as hypertension (48.5% vs. 65.4%) and diabetes (19.4% vs. 33.1%) than patients in ischemic stroke of undetermined etiology (incomplete standard evaluation) subgroup. University hospital patients had better clinical outcomes in terms of mortality and degree of disability during one-year follow-up. Conclusion The high clinical burden of ischemic stroke of undetermined etiology especially in nonuniversity hospitals shows the rational for promoting ischemic stroke evaluation and providing specialized stroke centers for these hospitals in a developing country like Iran.

Introduction:The Persian Registry Of cardioVascular diseasE (PROVE) aimed to study the demographic, clinical, diagnosis and treatment of patients with cardiovascular disease (CVD) and to follow them for 1 to 3 years, looking for short-and long-term outcomes. PROVE started in Isfahan in 2014 to test the feasibility of its implementation for later national dissemination. Therefore, we aimed to explain its design, methodology, development, validity of protocols and questionnaires of each CVD and its quality control (QC) design Methods: PROVE feasibility study is an observational (descriptive and analytical) open-label registry that collects patient's data in hospitals or at population level, and follows them for between 1 to 3 years. Patients with acute coronary syndrome (ACS), ST Elevation Myocardial Infarction (STEMI), stroke, atrial fibrillation (AF), heart failure(HF); congenital heart disease (CHD), percutaneous coronary intervention (PCI) and recently, chronic ischemic cardiovascular disease (CICD) were enrolled. Four types of registered CVD (AF, STEMI, HF, CICD) had joined the European observational Research Programme (EORP). ACS and stroke registry started back in 1999 in the surveillance unit of Isfahan Cardiovascular Research Institute (ICRI) using the WHO MONICA (Multinational MONItoring of trends and determinants in CArdiovascular disease) protocol. Physicians and nurses who worked in each registry, received multiple training sessions based on the design of the registry. The development and validity of questionnaires, protocols, data collection, entry and management, and its analysis are supervised by a well-established QC protocol. Results: PROVE subtypes followed different approaches. ACS, STEMI, stroke, HF and CICD are hospital based while AF and CHD are population based. The validity of questionnaires was performed by a QC committee before starting registry. More than 900 questionnaires of HF and 800 of STEMI, 350 of AF, 800 of stroke, more than 1000 of CHD and PCI and 9 of CICD were registered and all its data were managed by mid-September 2016. Using the WHO MONICA method for ACS and stroke since the year 1999, there were more than 150,000 and 37,000 patients registered and followed respectively. The follow up frequency, duration and method was different according to type of disease registry. The case report forms (CRFs) of AF, STEMI, HF, and CICD were sent to the EORP site. Conclusion: PROVE implementation is feasible and can be considered as a valuable source of valid data to improving the management, treatment, prevention and control of patients with CVD. The data can be later used by policy makers and for future research

We found a high mortality rate (31.7%). As NYHA class IV and tachycardia were significant predictors of mortality after adjustment, an effective measure can be treatment of underlying diseases, which deteriorate patients' conditions. Monitoring of medications for at-risk group, especially BB that predicts life, is important.