Cardiovascular diseases (CVD) and cerebrovascular diseases (CeVD) are large and growing problems in low- and middle-income populations. Secondary prevention, which can reduce the risk of recurrent CVD includes changes in lifestyle, pharmacological interventions and revascularization procedures. The aim of the first phase of this project was to perform situation analysis and identify gaps in secondary prevention of major cardiovascular diseases. This study estimated the physicians' awareness and the patients' knowledge and behavior towards CVD and CeVD complications. It also assessed the efficacy of methods for decreasing recurrent events.
A sample of consecutive patients was selected from the outpatient units of the health care facilities selected for the study. Stratified random sampling of primary and secondary private and public health care facilities in cities and villages was performed to select 449 eligible cases. A total of 257 men and 192 women were selected. The inclusion criteria were as follows: Age above 21 years, established diagnosis of CVD and/or CeVD defined as any of the following alone or in combination with others: previous myocardial infarction, stable/unstable angina, percutaneous transluminal coronary angioplasty (PTCA), coronary artery bypass graft (CABG), stroke, transient ischemic attack (TIA), and/or carotid arterectomy. The patients were included if their first event had occurred more than a month, but no earlier than three years before the study.
The prevalence of high systolic and diastolic blood pressure was 40.1% and 26.9% respectively in MI patients, and 70.1% and 51.2% respectively in CeVD patients. In most of the patients, fasting blood sugar and total cholesterol were within the normal range. Among MI patients, 93.9%, 68.5% and 48.2% were already taking aspirin, beta-blockers and statins, respectively. Among CeVD patients, 79.9%, 61.1% and 23.2% were taking aspirin, beta-blockers and statins, respectively. Blood pressure had been managed in 94.9% and 93.7% of MI and CeVD patients, respectively. Among MI patients, 85.8% and 83.2% had correct behavior towards blood sugar and cholesterol control and 68% had adequate knowledge of the risk of recurrent events.
Secondary prevention of vascular diseases should be regarded as a key component of public health strategies to reduce the rising burden of CVD and CeVD in Iran.

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The purpose of this study was to measure leptin concentrations in the blood of smokers and non smokers during ST elevation acute myocardial infarction, and to compare them with values obtained from normal smoker and non smoker subjects. Leptin serum concentrations were measured in 58 patients (34-75 years of age) with acute myocardial infarction and 38 normal subjects (36-69 years of age). Leptin serum concentrations were measured using two-site immunoradiometric assay (IRMA) principle. In normal smokers (N=20) leptin concentration was 5.8 ± 2.5 ng/ml (mean ± SD), while in non smokers (N=18) this value was 5.9 ± 4.1 ng/ml (mean ± SD). Data showed no significant difference in both groups (p > 0.05). While leptin concentration was 7.8 ± 2.9 ng/ml in smoker patients (N=32) which was significantly higher than in normal smoker subjects (p=0.02). Also leptin value was 9.2 ± 3.7 ng/ml in non smoker patients (N=28) which was also significantly higher than in normal non smoker subjects (p=0.001). Our results demonstrated that smoking has no effect on leptin concentrations in normal subjects and in patients with acute myocardial infarction, but leptin concentration increases significantly during ST elevation acute myocardial infarction in smoker and non smoker patients.

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Antineoplastic activity of mercury(II) cystine complex was studied against ehrlich ascites carcinoma (EAC) cells in Swiss Albino mice. Cell growth inhibition, increase of life span, haematological parameters, alkaline phosphatase activity of tumour bearing mice inoculated with EAC cells were studied with the test compound. It was found that this compound significantly inhibited the tumour cell growth, enhanced life span of the tumour bearing mice at dose 6 mg/kg i.p. Such treatment also restored the altered haematological parameters and serum alkaline phosphatase activity very closely towards normal. The compound can be considered as a potent antineoplastic agent.

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Both urinary bilharziasis and urothelial neoplasia are associated with increased production of tissue carcinoembryonic antigen (CEA). Urine and serum CEA were determined in 43 patients with urinary bladder carcinoma including 22 post bilharzial and 21 nonbiharzial cases, in addition to 10 normal control cases. A significant increase was detected in both urine and serum CEA levels with bladder carcinoma compared to control cases. Urinary CEA was significantly elevated in 86% of bilharzial, versus 62% in nonbilharzial bladder carcinoma cases. Only 10.5% of control cases had urinary CEA elevation. The mean urinary CEA in bilharzial patients were higher than that of nonbilharzial carcinoma, but the difference was not statistically significant. There was a definite relationship between urine CEA and the stage of malignancy; the higher the stage, the higher the level of urine CEA. No relationship could be detected between the stage of malignancy and serum CEA, or between the grades of malignancy and urine or serum CEA levels. In conclusion, urinary CEA is more useful than serum CEA in the early detection of urotherlial carcinoma particularly if provoked by bilharziasis. Its level is also correlated with the tumor stage.

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Hypercholesterolemia is a metabolic disorder that ultimately results in arterial sclerosis and complications like hypertension and coronary arterial diseases. Various drugs have been used for treatment of this condition and many studies are underway to be used in the future. Chitosan and Salvadora Persica are two such drugs. Chitosan is produced by deacetylation of chitin which is present mainly in the exoskeleton of crustaceans. The aim of this in vitro study was to study the effects of these two drugs on blood lipid levels.
In this Interventional Laboratory Trial, 30 mature vistar rats weighing 200-250 grams were selected and after a period of two weeks of adaptation to the surroundings, they were allotted randomly to 6 groups. The rats were then fed for a period of 15 days with normal or fatty diet, with or without the drugs. Chitosan in pure powder form and persica in the form of hydro alcoholic, Salvadora persica stem extract were added to the diet of the respective study groups. At the end of this period, blood samples were taken in order to measure cholesterol, triglyceride, and HDL and LDL levels. Data were analyzed statistically using SPSS software program and Scheffe, ANOVA and Descriptive statistical tests.
Both chitosan and persica decreased cholesterol and LDL levels in the groups ingesting fatty diet (P < 0.05) and the mean reduction was not statistically different for the two drugs (P > 0.05). The two drugs had no effect on triglyceride and HDL levels (P > 0.05). Both chitosan and persica had no effect on blood lipid levels of subjects on normal diet whose cholesterol levels were normal (P > 0.05).
Persica and chitosan have similar effects on reduction of cholesterol and LDL levels in cases of hypercholesterolemia, but have no effect on triglyceride and HDL levels.

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In recent years there has been growing awareness regarding the role of religion and spirituality (R/S) in the practice of clinical medicine. We aim to assess the beliefs and practises of physicians regarding the role of R/S in clinical practice. Concomitantly, we aim to assess the beliefs of our patients and whether they like to address such issues. Questionnaire based cross sectional study among hospitalized patients and their treating doctors. The majority of patients were male (62.9%), Malay Muslims (75.4%) and had primary (32.5%) or secondary (48.6%) education. Nearly all patients and doctors believed in the existence of God and life after death. Although significant majority of both patients and physicians agreed that religious involvement is associated with improved health, only half of doctors discussed such issues in clinical situations. Three quarters of patients noticed an increase in faith due to illness and similar proportion wanted a religious counsellor to help them rather than a psychiatrist. Only a quarter of physicians agreed with euthanasia, 68% with use of placebo and just 10% with false hope of cure, while among patients only 6.4% agreed with euthanasia and 92% had a hope of cure.
Religion is important to many patients and doctors, but more than half doctors ignore it in their clinical practice, a discrepancy between beliefs and behaviour. In conclusion, religion deserves greater attention in the practice of medicine.

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We attempted to evaluate the therapeutic effect of local application of trichloroacetic acid (TCA) and hydrogen peroxide (H2O2) for aphthous ulcers minor(AUM).
Fifty four patients with aphthous ulcers minor (AUM ) were enrolled in this study between January 2002 and December 2004. They were divided blindly into3 equal groups, 18 patients managed with local application of 30% trichloroacetic acid (TCA), 18 treated by local 6% hydrogen peroxide (H2O2) and the last group by 0.9% normal saline locally also(control group), all patients were followed up after 3-7 days. Assessments by clinical examination were performed, depending on 3 criteria, tingling and pain, tenderness, and surrounding erythema.
Thirty two patients = 42.5% belong to (20-29) years age group, the male to female ratio was 0.6: 1. Commonest site of aphthous ulcers minor (AUM ) was labial and buccal mucosa (14 patients = 25.9%), 38 patients =70% were non smoker, there were 3 male patients and one female affected when they quitted cigarette smoking, 19 out of 54 patients (35%) treated with the three agents went into remission. Treatment success was observed in 13 out of 18 (72.2%) patients with 30% trichloroacetic acid (TCA), whereas only 5 out of 18(28%) patients treated by local application of 6% hydrogen peroxide (H2O2) went into remission and only one patient improved in control group (5.5%).
Based on our findings, 30% trichloroacetic acid (TCA) was a potential agent with minimal side effects for treatment of AUM.

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