Introduction: Dream, as a kind of mental activity, includes various functions such as mood regulation, adjustment and integration of new information with the available memory system. The study was done for assessing the relationship between physiological and psychological components of cardiac diseases with emotionally negative dreams in cardiac rehabilitation. Methods: At the baseline of this cross-sectional study, 156 patients from Western Iran participated during April–November 2016. People 20 years–80 years able to recall the emotional content of dreams after cardiac surgery entered the study. The Beck depression inventory (BDI), Beck anxiety inventory (BAI), Buss and Perry’s aggression questionnaire (BPAQ) and Schredl’s dream emotions manual were used for collecting data. A binary logistic regression analysis used for the study of the relationship between risk factors and emotionally negative dreams. Results: The mean age of participants was 59 (SD = 9) years (men: 64.1%). The results showed that 25% of patients have negative emotional content. After adjustment for demographic variables, the results showed that increased anxiety [adjusted odds ratio (adj OR) = 1.08 [1.01– 1.16], P = 0.020] and anger (adj OR = 1.03 [1.00–1.06], P = 0.024) and hypertension (adj OR = 2.71 [1.10–6.68], P = 0.030) can predict the dreams with negative content significantly. Conclusion: The increasing rates of anxiety and anger and history of hypertension are related to increasing dreams with the negative emotional load. The control of risk factors of dreams with negative emotional load can be the target of future interventions.

BACKGROUND: Health care services effort to provide alternative cardiac rehabilitation (CR) models to serve patients according to their preferences and needs. So, the present study aimed to assess and compare the effects of hospital-based and hybrid CR programs on chest pain intensity and discomfort in cardiac surgery patients. METHODS: In this prospective study, 110 cardiac surgery patients were invited to the CR department of a hospital in the western part of Iran between March and July 2016. Patients were divided into two groups: hospital-based and hybrid CR. The hospital-based program included 26 sessions, and the hybrid program included 10 training sessions and exercise. The Brief Pain Inventory and Pain Discomfort Scale were used as research instrument, and data were analyzed using the paired t-test and ANCOVA. RESULTS: The results indicated that both hospital-based and hybrid CR are effective in reducing the chest pain intensity and discomfort of cardiac surgery patients (P < 0.05). In addition, the comparison of scores before and after treatment using ANCOVA shows that no significant differences were observed between the two programs (P > 0.05). CONCLUSIONS: Traditional hospital-based CR delivery is still the first choice for treatment in developing countries. However, hybrid CR is as effective as a hospital-based program in reducing pain components and it includes only 38% of the total cost in comparison to hospital-based delivery. So, we recommend using hybrid CR according with the recommendations of American Heart Association about using CR for the management of angina symptoms.
American Heart Association ; Cardiovascular Diseases ; Chest Pain* ; Cost-Benefit Analysis ; Delivery of Health Care ; Developing Countries ; Home Care Services ; Humans ; Iran ; Prospective Studies ; Rehabilitation* ; Thoracic Surgery ; Thorax*

OBJECTIVE: To investigate predictors of depressive symptom aggravation at the end of a cardiac rehabilitation (CR) program. METHODS: The design of the study was retrospective. The administrative data were obtained from the database of the CR department of a heart hospital in Iran. The demographic and clinical information of 615 CR patients between January 2000 and January 2010 was analyzed using binary logistic regression analysis. RESULTS: The results showed that 10.7% of the patients completed the CR program with aggravated depressive symptoms. After adjustment for gender, age, and pre-intervention depression score, lower education level (p<0.05) and smoking (p<0.01) were significant predictors of increased depressive symptoms at the end of the program. Our model variables could explain 6% to 13% of the dependent variable variance. CONCLUSION: The results suggest that targeting patients who are less literate or who smoke could allow for taking the required measures to prevent or control depression at the end of a CR program. It is suggested that future studies consider other variables.
Demography ; Depression* ; Education ; Heart ; Heart Diseases ; Humans ; Iran ; Logistic Models ; Rehabilitation* ; Retrospective Studies ; Smoke ; Smoking

No abstract available.
Chest Pain* ; Humans ; Thorax*

OBJECTIVE: To investigate the role of sociodemographic factors in failure to complete outpatient cardiac rehabilitation (CR). METHODS: This was a retrospective study that used information obtained from the database of the cardiac rehabilitation department of a cardiac hospital in Iran. Data from 1,050 CR patients treated at the hospital between January 2001 and January 2013 was analyzed using binary logistic regression analysis. RESULTS: Only 49% of the patients completed the CR program. After adjustment for baseline variables, it was found that the following were significantly associated with failure to complete the CR program: illiteracy (p<0.001), old age (p<0.001), being an employee or retired (p<0.05), having a low capacity for exercise (p<0.001), depression (p<0.001), low anxiety (p<0.001), and not currently being a smoker (p<0.001). CONCLUSION: Paying more attention to older patients with low literacy levels and limited exercise capacity, who are employed or retired, and who are not current smokers, and taking therapeutic measures to control psychological complications such as depression, may be effective in ensuring that patients complete outpatient cardiac rehabilitation.
Anxiety ; Demography ; Depression ; Literacy ; Heart Diseases ; Humans ; Iran ; Logistic Models ; Outpatients* ; Patient Dropouts ; Rehabilitation* ; Retrospective Studies ; Sociology

BACKGROUND: Cancer is one of the main public health issues in the world. Breast cancer is one of the most common types of cancer among women. It is also the second cause of mortality in women. The association between the use of oral contraceptive pills and breast cancer is controversial and a main issue in public health. Some findings have shown that taking these pills does not have a significant effect in increasing the risk of breast cancer, while others have confirmed the carcinogenic effect of these products. These contradictory findings necessitated this meta-analysis, through of all correlated studies in Iran. METHODS: All published studies were considered from June 2000 until June 2015, using reliable Latin databases like PubMed, Google Scholar, Google search, Scopus, and Science Direct, and Persian database like SID, Irandoc, IranMedex, and Magiran. Finally, 26 papers were selected: 24 studies were case control while two were population based studies. A total of 26 papers with 46,260 participants were assessed since 2001. RESULTS: Overall estimate of OR for the effect of oral contraceptive pills on breast cancer is 1.521 (CI = 1.25–1.85), which shows that the intervention group had more chance (52%) compared to the control group (P = 0.001). Using these pills increased the risk of breast cancer up to 1.52 times. CONCLUSIONS: Because of directly increasing levels of estrogen and the role of estrogen in gaining weight indirectly, oral contraceptive pills can stimulate the occurrence of breast cancer. More studies should be conducted for controlling the period of pill use.
Breast Neoplasms* ; Breast* ; Case-Control Studies ; Estrogens ; Female ; Humans ; Iran ; Mortality ; Public Health ; Sudden Infant Death

OBJECTIVETo determine the nature and extent of Iranian casualties by ballistic missile attacks during the eight years of the Iraq-Iran war.

METHODSThe data collected about Iraqi missile strikes on Iranian cities included the following: date and time, number and type of missiles, cities targeted, and injuries and deaths resulting from impacts of missiles in civilian areas. The data were extracted from a database that was constructed by the army staff headquarters based on daily reports of Iranian army units during the war.

RESULTSOver a period of eight years (1980-1988), Iraqi army fired 533 ballistic missiles at Iranian territories. From those, 414 missiles (77.7%) landed on Iranian cities. The impacts of these missiles caused the deaths of 2,312 civilians and injured 11,625 others. Three types of ballistic missiles were used: FROG-7, Scud, and Al-Hussein (a modified version of the Scud missile). Twenty-seven cities in Iran were struck by Iraqi ballistic missiles. The highest mortalities from ballistic missiles were in Dezful and Tehran. Iraqi missile attacks continued for 90 months (2,748 days).

CONCLUSIONOur results point to the necessity of investigating the psychological consequences of Iraqi ballistic missile attacks among survivors in 27 Iranian cities during the eight years of the Iraq-Iran war.

Blast Injuries ; epidemiology ; Humans ; Iran ; Iraq ; epidemiology ; Time Factors ; Warfare ; Wounds and Injuries ; epidemiology ; Wounds, Gunshot ; epidemiology

OBJECTIVEInjury is a major neglected health problem in developing countries. The first step in dealing with injury problem is to identify the injury patterns and characteristics. Therefore, we aimed to demonstrate the current status of trauma admissions to hospitals in Shiraz, as a major city of Iran.

METHODSA hospital-based study was conducted in 2002. All injured patients admitted during 6 months in emergency departments of two general hospitals of Shiraz, Nemazi and Chamran were included.

RESULTSA total of 1,765 injured patients were registered during the study period, with mean age of 33 years. Manual workers were the most vulnerable group among occupational categories. Inner-city roads were the most common place of injury and traffic accident was the major cause of injury. Overally, falling injury was the second common cause of injury in males and the first cause in females (especially at the age of over 60).

CONCLUSIONAs other studies conducted in our society, traffic accidents are the major cause of morbidity and mortality and this can emphasize on the obligation to take legislative action in the field of driving and road safety, directing resources and educating the public and raising the awareness of the community in prevention of this iceberg-like problem.

Accidents, Traffic ; statistics & numerical data ; Adolescent ; Adult ; Female ; Humans ; Iran ; epidemiology ; Male ; Middle Aged ; Wounds and Injuries ; epidemiology

OBJECTIVETo determine the pattern of causalities of Iraqi ballistic missile attacks on Tehran, the capital of Iran, during Iraq-Iran war.

METHODSData were extracted from the Army Staff Headquarters based on daily reports of Iranian army units during the war.

RESULTSDuring 52 days, Tehran was stroked by 118 Al-Hussein missiles (a modified version of Scud missile). Eighty-six missiles landed in populated areas. During Iraqi missile attacks, 422 civilians died and 1 579 injured (4.9 deaths and 18.3 injuries per missile). During 52 days, 8.1 of the civilians died and 30.4 injured daily. Of the cases that died, 101 persons (24%) were excluded due to the lack of information. Among the remainders, 179 (55.8%) were male and 142 (44.2%) were female. The mean age of the victims was 25.3 years+/-19.9 years. Our results show that the high accuracy of modified Scud missiles landed in crowded areas is the major cause of high mortality in Tehran. The presence of suitable warning system and shelters could reduce civilian casualties.

CONCLUSIONThe awareness and readiness of civilian defense forces, rescue services and all medical facilities for dealing with mass casualties caused by ballistic missile attacks are necessary.

Humans ; Iran ; Iraq

Caesarean section without medical indication imposes many problems to families, personnel and medical equipment causing some side effects to pregnant woman and foetus, compared to natural childbirth. The present study aimed to evaluate the interventions in reducing caesarean section in the world. This study was a systematic review using Embase, PubMed, Scopus, Web of Science, Science Direct, Magiran and SID databases and grey literature. All studies conducted during 2000–2018 were reviewed and finally the studies with inclusion and exclusion criteria were selected. A total of 19 studies were selected among 5,559 studies. The interventions conducted for reducing caesarean section included training the specialists and women by using Six Sigma method, changing the guidelines, reviewing the definition of natural childbirth various stages, encouraging the natural childbirth and expanding painless childbirth. All interventions were divided into educational strategy and managerial strategy. The interventions can be implemented to change the behaviour of physicians and attitude of pregnant women in order to reduce caesarean section. In this regard, the authorities are recommended to make more efforts.