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1.  Circadian rhythm sleep disorders in patients with multiple sclerosis and its association with fatigue: A case-control study 
Background:
Circadian rhythm sleep disorders are a presentation of sleep disorders in patients with multiple sclerosis (MS). This study aims to compare this problem in MS patients with healthy people and to determine its association with chronic fatigue in MS patients.
Materials and Methods:
A case-control study was performed on 120 MS patients and 60 healthy subjects matched for age and sex, in 2009 in MS Clinic Alzahra Hospital. Sleep quality, rhythm and fatigue severity were assessed using PSQI (Pittsburgh sleep quality index) and FSS (Fatigue severity Scale) questionnaires, respectively. Its reliability and validity has been confirmed in several studies (Cronbach's alpha = 0.83). This index has seven sections including patient's assessment of his/her sleep, sleep duration, efficacy of routine sleep, sleep disorders, use of hypnotic medication, and dysfunction in daily activities.
Results:
Circadian rhythm sleep disorder was more frequent in MS patients relative to healthy subjects (P: 0.002). It was higher in MS patients with severe fatigue relative to MS patients with mild fatigue (P: 0.05). Fatigue severity was 49.9 ± 8.2 and 22.5 ± 7.4 in the first and second group, respectively. PSQI index was 7.9 ± 4.5 in patients with severe fatigue and 5.9 ± 4.5 in patients with mild fatigue and 4.5 ± 2.4 in the control group (P: 0.0001).
Conclusion:
Circadian rhythm sleep disorders are more frequent in MS patients and those with fatigue. Recognition and management of circadian rhythm sleep disorders in MS patients, especially those with fatigue may be helpful in improving care of these patients.
PMCID: PMC3743326  PMID: 23961292
Chronic fatigue; circadian rhythm sleep disorder; fatigue severity scale; multiple sclerosis; Pittsburg sleep quality index
2.  Improvement of dietary oil consumption following a community trial in a developing country: The role of translational research in health promotion 
ARYA Atherosclerosis  2013;9(1):29-37.
BACKGROUND
This study aimed to determine the effects of the interventions of Isfahan Healthy Heart Program (IHHP) on the type of oil consumed at the population level. It also tried to assess how this strategy has been effective as a health policy.
METHODS
The IHHP, a six-year community intervention program (2001-07), aimed at health promotion through the modification of cardiovascular disease risk factors. It was performed in Isfahan and Najafabad counties (intervention area) and Arak county (reference area), all in central Iran. This study targeted the whole population of over 2,000,000 in the intervention area. The findings of annual independent sample surveys were compared with the reference area. Dietary interventions were performed as educational, environmental, and/or legislative strategies.
RESULTS
From 2001 to 2007, the mean of changes for hydrogenated oil consumption was -3.2 and -3.6, and for liquid oil it was 3.6 and 2.8 times per week in the intervention and reference areas, respectively (P < 0.001). According to Commerce office record, the increase in liquid oil distribution during 2000-2007 was significantly higher in Isfahan than Arak (34% vs. 25%).
CONCLUSION
The effects of the simple, comprehensive, and integrated action-oriented interventions of our program could influence policy making and its results at the community level. It can be adopted by other developing countries.
PMCID: PMC3653266  PMID: 23696757
Oil Consumption; Hydrogenated Oil; Liquid Oil; Community Trial
3.  Neurological manifestations in patients with antiphospholipid syndrome 
Iranian Journal of Neurology  2013;12(4):172-175.
Background
Anti-phospholipids syndrome (APS) is considered a non inflammatory auto-immune disease with a significant thrombophilic risk with varied clinical manifestations. The purpose of the current study was to investigate the frequency of thrombotic and non-thrombotic events in patients with APS.
Methods
In this retrospective study, 102 definite APS subjects were recruited (2007-2011) at Alzahra Hospital, Isfahan, Iran. The patients were referred to Multiple Sclerosis Clinic with the diagnosis of definite APS according to 2006 Sydney's criteria. Disorders associated with APS such as pregnancy complication, vascular thrombosis and livedo reticularis (LR) were assessed. Neurological signs and symptoms such as cognitive dysfunction were recorded. Data analyses were performed using SPSS software and P < 0.05 were considered to be statistically significant.
Results
Our findings showed that majority of female gender, higher rate of ischemic thrombotic stroke and high miscarriage lied in a large number of APS patients.
Conclusion
Overall recurrent miscarriage is a common complication among (antiphospholidpid antibody) aPL patients. Furthermore, ischemic stroke is the second common neurological manifestations of APS patients.
PMCID: PMC3829301  PMID: 24250929
Antiphospholipid Syndrome; Miscarriage; Neurological Manifestation
4.  Smoking cessation support in Iran: Availability, sources & predictors 
Background & objectives:
Smoking cessation advice is known as an important factor in motivating smokers to quit smoking. We investigated the extent, sources and predictors of receiving unsolicited advice and seeking active advice for smoking cessation in Iran.
Methods:
A cross-sectional study was performed as a part of Isfahan Healthy Heart Program (IHHP) on 9093 adult individuals (both men and women) in 2004-2005. Demographic characteristics, smoking status, sources and preferences for smoking cessation support were recorded.
Results:
In the studied population, 66.8 and 14.4 per cent had received and asked for cessation support, respectively. Smokers had received advice from family (92.2%), friends (48.9%), physician (27.9%) and other health care providers (16.2%). Smokers had asked for cessation help more frequently from family (64.5%) and friends (42.0%). Women (OR: 0.59, 95% CI: 0.37-0.94) and singles (OR: 0.51, 95% CI: 0.36-0.71) received less advice. Hookah smokers received (OR: 0.23; 95% CI: 0.14-0.38) and asked (OR: 0.21; 95% CI: 0.06-0.68) for cessation help less than cigarette smokers. Receiving advice increased the odds of seeking support (OR: 7.98; 95% CI: 4.37-14.57).
Interpretation & conclusions:
Smokers’ family and friends were more frequent sources for smoking cessation support. Tobacco control programmes can count on smokers’ family and friends as available sources for smoking cessation support in countries where smoking cessation counselling services are less available. However, the role of physicians and health care workers in the smoking cessation counselling needs to be strengthened.
PMCID: PMC3135990  PMID: 21727661
Cigarettes; hookah; Iran; smoking; smoking cessation
5.  Association between sleep duration and metabolic syndrome in a population-based study: Isfahan Healthy Heart Program 
BACKGROUND:
Recent epidemiologic studies have found that self-reported sleep duration is associated with components of metabolic syndrome (MS) such as obesity, diabetes and hypertension. This relation may be under influence of regional factors in different regions of the world. The association of sleep duration and MS in a sample of Iranian people in the central region of Iran was investigated in this study.
METHODS:
This cross-sectional study was conducted as a part of the Isfahan Healthy Heart Program (IHHP). A total of 12492 individuals aged over 19 years, 6110 men and 6382 women entered the study. Definition of National Cholesterol Education Program was used to define MS. Sleep duration was reported by participants. Relation between sleep duration with MS was examined using categorical logistic regression in two models; unadjusted and adjusted for age and sex.
RESULTS:
In our study, 23.5 % of participants had MS. Compared with sleep duration of 7-8 hours per night; sleep duration of less than 5 hours was associated with a higher odds ratio for MS. This association remained significant even after adjustment for age and sex (OR: 1.52; 95%CI: 1.33-1.74). However, sleep duration of 9 hours or more showed a protective association with MS (OR: 0.79; 95%CI: 0.68-0.94).
CONCLUSIONS:
There was a positive relation between sleep deprivation and MS and its components. This relation was slightly affected by sex and age.
PMCID: PMC3214399  PMID: 22091310
Sleep; Metabolic Syndrome; Heart; Population
6.  The impact of obesity on hypertension and diabetes control following healthy Lifestyle Intervention Program in a developing country setting 
BACKGROUND:
The aim of this study was to evaluate the impact of obesity and overweight on diabetes mellitus (DM) and hypertension (HTN) control in a healthy lifestyle intervention program in Iran.
METHODS:
Within the framework of the Isfahan Healthy Heart Program (IHHP), a community trial that was conducted to prevent and control cardiovascular disease and its risk factors, two intervention counties (Isfahan and Najafabad) and one reference county (Arak) were selected. Demographic information, medical history, anti-diabetic and anti-hypertensive medications use were asked by trained interviewers in addition to physical examination and laboratory tests for 12514 adults aged more than 19 years in 2001 and were repeated for 9572 adults in 2007.
RESULTS:
In women, the frequency of HTN control change significantly neither in normal weight nor in those with high body mass index (BMI), waist circumference (WC) or waist to hip ratio (WHR). In men, the frequency of HTN control was only significant among those with high WHR, whereas the interaction between changes in intervention compared to reference area from 2001 to 2007 was significant in men with normal or high WC or WHR. In intervention area, the number of women with high BMI who controlled their DM increased significantly from 2001 to 2007 (p = 0.008), however, this figure decreased in men. In reference area, obesity indices had no significant association with DM control. The percentage of diabetic subjects with high WC who controlled their DM decreased non-significantly in intervention area compared to reference area in 2007. A non-significant increase in controlled DM among men and women with high WHR was observed between intervention and reference areas.
CONCLUSIONS:
Our lifestyle interventions did not show any improving effect on HTN or DM control among obese subjects based on different obesity indices. Other lifestyle intervention strategies are suggested.
PMCID: PMC3252770  PMID: 22247721
Hypertension; Diabetes; Obesity; Control; Prevention; Iran

Results 1-6 (6)