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Background: Besides the traditional cardiovascular risk factor, some novel risk factors like occupation and career can play an important role in cardiovascular disease (CVDs) incidence. Objective: To assess the association between occupational categories and their positions with cardiovascular events (CVEs) in an Iranian male population. Methods: We followed 2134 men aged 35–65 years for 14 years during the Isfahan Cohort Study (2001–2015) for CVEs including ischemic heart disease and stroke. Firstly, Occupations were classified into 10 categories of International Standard Classification of Occupation (ISCO). Each category was then classified into one of the 4 pre-specified categories, namely high/low skilled white collars and high/low skilled blue collars. White-collar workers referred to managerial and professional workers in contrast with blue collar workers, whose job requires manual labor. Results: The mean age of studied participants was 46.9 (SD 8.3) years. 286 CVE incidents were recorded; unstable angina had the highest rate (46%); fatal stroke, the lowest (3%). There were no significant difference was observed between white and blue collars in terms of CVE incidence, as well as their high and low skilled subgroups. Hazard ratio analysis indicated a significantly higher risk of CVEs only for low-skilled white-collar workers (crude HR 1.47, 95% CI 1.01 to 2.13); this was not significant after adjustment for confounding variables. Conclusion: There is no association between occupational categories and incidence of cardiovascular events among Iranian male population.

Aims The European Society of Cardiology (ESC) EURObservational Research Programme (EORP) Chronic Ischaemic Cardiovascular Disease Long Term (CICD LT) registry aims to study the clinical profile, treatment modalities, and outcomes of patients diagnosed with CICD in a contemporary environment in order to assess whether these patients at high cardiovascular (CV) risk are treated according to ESC guidelines on prevention or on stable coronary disease and to determine mid- and long-term outcomes and their determinants in this population. Methods and results Nine thousand one hundred and seventy-four patients over 18 years with documented CICD defined by a history acute coronary syndrome with/without ST elevation, previous coronary revascularization, or stable coronary artery disease were enrolled between 1 May 2015 and 31 July 2018. Individual patient data on clinical profile, biology, and treatment modalities were collected across 154 centres from 20 ESC countries. Two years of follow-up is scheduled in order to determine the following clinical outcomes: all-cause and CV death, all-cause and CV hospitalizations, changes in medications, and quality of life using the EuroQol5D-5L score. Conclusion The CICD LT is an international registry of care and outcomes of patients hospitalized with CICD which will provide insights into the contemporary profile and management of patients with this common disease.

The Severe acute respiratory syndrome coronavirus-2 (SARS-COV-2) created a global pandemic that continues to this day. In addition to pulmonary symptoms, the virus can have destructive effects on other organs, especially the heart. For example, large pericardial effusion has been observed as a critical and life-threatening finding in Coronavirus disease of 2019 (COVID-19) patients. In this case report based systematic review, we review the reports of moderate to severe pericardial effusion associated with tamponade physiology. Direct cardiomyocyte and pericardium invasion, inflammation and cytokine storms and oxidative stress due to acute respiratory distress syndrome, are the pathogenesis of this phenomenon. The results showed that the manifestations of this finding are variable. Pericardial effusion can be seen as a delayed complication, accompanied by myocarditis or pericarditis, isolated, or with acute respiratory distress syndrome. In most patients, emergency percutaneous pericardiocentesis was performed, and fluid analysis was often exudative in 3 pattern of hemorrhagic, serous, and serosanguinous. Medical treatment and follow-up are recommended, especially in cases of pericarditis.

Background With the onset and spread of the COVID‐19 pandemic, the hospitalization and treatment of noncovid patients were dramatically affected. The aim of this study is to evaluate the electrophysiology (EP) lab activity in a referral center in Iran during the COVID‐19 era. Methods A cross‐sectional descriptive survey was conducted on EP lab activity in Shahid Chamran Heart Center, Isfahan, Iran. Two periods of COVID‐19 occurrence peaks in Iran were compared with same date in 2019. Information was collected on number of diagnostic and therapeutic electrophysiology studies (EPSs) and implantation of intracardiac devices such as permanent pacemaker (PPM), implantable cardioverter defibrillator (ICD), and cardiac resynchronization therapy (CRT). Results In the first peak of COVID‐19 pandemic, both of EPSs and intracardiac device implantations decreased by 80% compared to the same period in 2019. The most common type of device implanted during this period was PPM (70%); however, at the time of control, the ICD (73%) was the most common. Paroxysmal supraventricular tachyarrhythmia (PSVT) was the best indication for diagnostic and therapeutic EPSs in covid and control periods. In the second peak of prevalence of COVID‐19 virus infection in Iran, 6% and 36% decreases in device implantations and EPSs were seen, respectively. During this period, the number of procedures increased, although it was still lower than in 2019. Conclusion A significant reduction in the EP lab activity has been observed during both the COVID‐19 pandemic peaks., This study is a cross‐sectional descriptive survey conducted on EP lab activity in Shahid Chamran Heart Center, Isfahan, Iran (as largest Heart Center in center of Iran), regarding number of EPS and intracardiac device implantations during the two peaks of COVID‐19 pandemics in Iran. The same date in 2019 was considered as control time. In conclusion, our EP lab activity decreased significantly during the COVID‐19 era.

As the COVID-19 pandemic continues, more information on the non-respiratory effects of the coronavirus is obtained. Cardiovascular complications, especially acute coronary syndromes, are rare. However, they prove to be effective factors in the mortality rate of COVID-19 subjects. Acute ST-elevation myocardial infarction with a special angiographic pattern in the form of extensive and multi-vessel thrombosis, regardless of atherosclerotic plaques, has posed a new therapeutic challenge. This has been associated with an increase in the incidence of stent thrombosis. Hypercoagulation, due to severe inflammation, is the main pathology of this phenomenon. Technically, percutaneous coronary intervention with aspiration thrombectomy and injectable antiplatelet are the mainstay of treatment for these patients. In addition, it is vital that appropriate antiplatelet and ischemia treatment after the intervention be taken into account.

As has been well established, the resting Electrocardiogram (ECG) findings provide valuable diagnostic and prognostic information for the occurrence of Cardiovascular Events...

OBJECTIVE: Distal radial artery access or trans-snuffbox access (TSA) is a novel, safe, and feasible technique for coronary artery interventions wherein its vascular hemostasis is still concerned. So, this study aimed to compare two homeostasis methods comprising manual and mechanical compression approaches in patients undergoing coronary angiography (CAG) via TSA. METHODS: In a prospective nonrandomized clinical trial, a total of 80 patients undergoing diagnostic CAG by TSA were divided into two equal groups: manual compression and mechanical compression (using radial TR band), the main end point of which was primary hemostasis time. Other variables were patient satisfaction, puncture site pain severity, hospitalization time, and local neurovascular complication during the 30-day follow-up. RESULTS: The mean age of the patients was 57.1±8.0 years, with 40 of them (54.1%) being male. The primary hemostasis time was significantly shorter in the manual compression approach [15.0±5.9 minutes with median 15 (9–20)] than in the TR band group [25.7±4.9 minutes with median 25 (20–30)] (p0.050). The neurovascular complication, including hematoma, numbness, and dRA occlusion, rates had also no significant difference between the two groups (p>0.050). CONCLUSION: The manual compression approach on the puncture site reduces hemostasis time in patients undergoing CAG via TSA when compared with the mechanical compression method.

With the outbreak of the second peak of COVID-19 in many countries of the world, the symptoms and complications of this disease has received a great deal of attention. One of the most important known complications of severe acute respiratory syndrome coronavirus 2 is the occurrence of venous thromboembolic events, especially in critically ill patients who are hospitalized in the intensive care unit. The pathology of this event is complex and multifactorial, but the main problem now is the timely diagnosis of these phenomena, which can reduce the mortality and morbidity of patients. Deterioration of clinical condition in patients with severe acute respiratory syndrome coronavirus 2 infection along with increased coagulation markers can increase clinical suspicion of venous thromboembolic events. Imaging techniques, especially computed tomography pulmonary angiography, can well solve this puzzle and lead to timely treatment of these patients.

Objective The aim of study was to evaluate the impact of health-related quality of life (QoL) on the occurrence of ischaemic heart disease (IHD) and stroke using a validated questionnaire.Methods W...

To determine the effects of transdermal fentanyl patches (TFPs) for postoperative analgesia in patients undergoing total knee arthroplasty (TKA) surgery. A randomized, double-blind, controlled trial study of 40 ASA I–III patients undergoing TKA surgery was performed under general anaesthesia. Patients were randomly divided into two groups. Group I (n = 20) received two 25 μg TFPs placed on the laterals of chest wall approximately 12 h before induction of general anaesthesia. Group II, the control group (n = 20), received placebo patches of identical size. Postoperative pain at rest was assessed with visual analogue scale (VAS) at 0, 30 min and 2, 4, 6, 12, 24, 48 and 72 h. Total rescue consumption of morphine was estimated with patient control analgesia during the first 72 h after operation. The degree of active knee flexion and incidence of side effects were also evaluated. The VAS scores at 2, 4, 6, 12, 24, 48 and 72 h were significantly less in the group I compared to the group II (p

The subacromial syndrome is the most common source of shoulder pain. The mainstays of conservative treatment are non-steroidal anti-inflammatory drugs and exercise therapy. Recently, low-level laser therapy (LLLT) has been popularized in the treatment of various musculoskeletal disorders. The aim of this study is to evaluate the additive effects of LLLT with exercise in comparison with exercise therapy alone in treatment of the subacromial syndrome. We conducted a randomised clinical study of 80 patients who presented to clinic with subacromial syndrome (rotator cuff and biceps tendinitis). Patients were randomly allocated into two groups. In group I (n = 40), patients were given laser treatment (pulsed infrared laser) and exercise therapy for ten sessions during a period of 2 weeks. In group II (n = 40), placebo laser and the same exercise therapy were given for the same period. Patients were evaluated for the pain with visual analogue scale (VAS) and shoulder range of motion (ROM) in an active and passive movement of flexion, abduction and external rotation before and after treatment. In both groups, significant post-treatment improvements were achieved in all parameters (P = 0.00). In comparison between the two groups, a significant improvement was noted in all movements in group I (P = 0.00). Also, there was a substantial difference between the groups in VAS scores (P = 0.00) which showed significant pain reduction in group I. This study indicates that LLLT combined exercise is more effective than exercise therapy alone in relieving pain and in improving the shoulder ROM in patients with subacromial syndrome.

To compare intraarticular morphine–bupivacaine and tramadol–bupivacaine as postoperative analgesics in patients undergoing arthroscopic anterior cruciate ligament (ACL) reconstruction. A randomized, double blind, controlled trial study of 60 ASA I–II patients undergoing arthroscopic ACL reconstruction was performed under general anesthesia. Patients were randomly allocated into three groups. The MB group (n = 20) received 10 mg morphine and 0.5% bupivacaine; the TB group (n = 20) received 100 mg tramadol and 0.5% bupivacaine; and the control group (n = 20) received isotonic saline intraarticularly in a total volume of 20 ml after the operation. Postoperative pain was assessed with visual analogue scale (VAS) at 0, 30, 60, 90 min and 2, 4, 6, 12, 24 h being at rest. Analgesic duration as defined was the time of first request for analgesics, the first 24 h analgesic consumption, time to unassisted ambulation, discharge time and incidence of side effects were also evaluated. The VAS scores at 30, 60, 90 min and 2, 4, 12, 24 h were significantly less in the MB and TB groups in comparison with the control group (P