Background and Aim: Hypertension is the most common risk factor for cardiovascular diseases in elderly with high cost of treatment and care modalities. This study examines the effect of slow-stroke back massages on hypertension in elderly hypertensive clients.Materials and Methods: This study was carried out in Kahrizak charity foundation for elderly, in 2007. A quasi-experimental quantitative design conducted the study in which blood pressure of two groups of patients before and immediately after the intervention was compared. One hundred and two patients were randomly assigned to either massage or control group. The intervention consisted of slow-stroke back massage (SSBM) with five minutes duration for five consecutive days at time interval 3-7 the afternoon. Data were collected by demographic characteristics form, blood pressure recording form, calibrated mercury sphygmomanometer, and stethoscope.Results: The findings showed that there was no statistically significant difference between groups in average systolic and diastolic blood pressure before implementation of SSBM (P>0.05), but were observed statistically significant difference between two groups after intervention (P<0.05). Friedman test and repeated measures analysis of variance indicated there was statistically significant difference in blood pressure measures day by day. Conclusion: The authors suggest SSBM as an effective nursing intervention for reducing systolic and diastolic blood pressure in elderly hypertensive patients; therefore, it can be used as a component of current and complementary treatment of hypertension.

Background: Heart failure (HF) is a global pandemic and a serious health issue in elderly population. It is among the leading causes of mortality, which imposes immense economic burden and premature deaths. In the present study we evaluate the value of E velocity of mitral inflow/E’ wave of mitral annular velocity/stroke volume (E/e'/SV) index in relation to in-hospital outcomes in patients with acute decompensation of systolic HF. Methods: In this descriptive-cross sectional study, 59 patient admitted with the diagnosis of decompensated HF were selected, and echocardiography was done before initiation of treatment. E/e′ /SV ratio calculated for them before initiation of treatment, and then this index compared with duration of admission, treatment type, in-hospital mortality, and other echocardiographic finding including tricuspid regurgitation gradient (TRG), right ventricle (RV) size, RV function, and left atrium (LA) size. Pro-brain natriuretic peptide (Pro-BNP) and cardiac troponin-I (cTN-I) levels were also recorded. Findings: There was a significant statistical relationship between E/e’ /SV index with LV and RV function, ejection fraction (EF), and functional class (FC) factor, as well as prior hospital admissions rate. Conclusion: According to the results of present study, E/e’ /SV index is not related to the severity of disease, but has a significant relationship with FC and the number of previous admissions.

Background: The hospital-based stroke registry is useful for understanding diverse clinical characteristics of stroke related to geographical, racial, or environmental differences. Methods: The Khorasan Stroke Registry was established for evaluation of incidence, clinical manifestations, risk factors, topography, and etiology of ischemic stroke in Southern Khorasan, Iran, during 2001 – 2005. Consecutive stroke patients underwent a standard battery of diagnostic investigations by a stroke neurologist. Topography and etiology of brain infarction was determined based on the Practical Iranian Criteria classification. Results: The incidence of ischemic stroke in Khorasan population is 43.17 cases per 100,000 people per year. During a 5-year period 1,392 ishemic stroke patients (738 females, 654 males) were evaluated in the Khorasan Stroke Registry. Atherosclerosis constituted 53.6% of etiologies followed by uncertain causes (19.9%), cardioembolism (11.8%), and miscellaneous etiologies (2.9%). Eleven point seven percent of our patients had both atherosclerosis and cardioembolic mechanisms. Rheumatic valvular disease was present in 44.8% of cardioembolic strokes and caused 4.31 preventable stroke cases per 100,000 Iranian population per year. Hypertension and history of ischemic cerebrovascular events were the most frequent risk factors, 53.1% and 22.3% respectively. In-hospital mortality of our ischemic stroke patients was 7.3%. Conclusion: High frequency of atherosclerotic etiology in the Khorasan Stroke Registry is because of its classification criteria, which does not separate small vessel territory infarcts as a different etiologic subtype. Rheumatic valvular disease is an important cause of stroke in Khorasan population.

Introduction: Brain stroke is the most common neurologic disorder and also the most common cause of mortality and morbidity in neurtologic patients. Thanks to new methods of radiography such as MRI, brain vascular lesions including silent stroke are demonstrated more carefully. This study considers the frequency of silent stroke in patients with acute thrombotic stroke in Rafsanjan by using MRI.Methods: This was a descriptive cross-sectional study with convenience sampling on 106 patients with acute thrombotic stroke. For all patients (without history of stroke) MRI was done and suspicious cases of hemorrhage were eliminated. For the remainder EKG, echocardiography, EKG-Monitoring and cardiovascular consultation was performed and cases with emboli and previous stroke were eliminated too. Then a questionnaire consisting of demographic data and risk factors was accomplished and statistically analysed with SPSS 11.5 software. Results: 65.1% of patients with acute thrombotic stroke were female and 34.9% of them were male. The following data were obtained: 31 patients (29.2%) with silent stroke, 55.7% with history of hypertension, 35.8% with diabetes, 17% with history of hyperlipidemia, 12.3% with history of cigarette smoking, 4.7% with history of using OCP, 19.8% with history of addiction and 31.1% with history of heart disease. The most common area of acute thrombotic stroke was parietal lobe with the frequency of 27.4%. The most common area of silent stroke were parietal lobe and cerebellum, both of them with the frequency of 22.6%.Conclusion: High frequency of acute thrombotic stroke and silent stroke shows that silent stroke can be a risk factor for acute thrombotic stroke.