Dear Editor, Coronavirus 2019 (COVID-19) was first developed in Wuhan, China in December 2019 and spread rapidly around the world. 1, 2 In late January 2020, the disease was recognized as the sixth international public health emergency. 3 The infection is transmitted from person to person through respiratory secretions and contact with surfaces or people. 4 In general, infectious diseases constantly threaten human health,especially if they are new, because they are always a potential challenge for the healthcare system around the world. 5 Health personnel, like other infectious diseases, are at the forefront of the fight against coronavirus. A high percentage of these personnel work night shifts with high workload. 6 Work-related stress, lack of sleep, and shift work in health care personnel cause sleep disorders and poor sleep quality. 7 Sleep is a specific behavior and each person is aware of its importance and its appropriate duration, and is rotated by waking up. Also, one of the most important parameters in assessing the quality of life and health status of each person is the quality of sleep. 8 Sleep is a key factor in a person’, s physical health and related disorders including poor sleep quality, difficulty sleeping at night, waking up early, circadian rhythm disorders, parasomnia, sleep-related movement disorders, and sleep-related respiratory disorders. 9 Sleep disorders are physical and mental conditions that cause adverse effects due to poor sleep quality. 10 Sleep disorders have many negative effects on people’, s lives and lead to physical complications such as increased risk of obesity, diabetes, high blood pressure, increased heart rate, heart attack, and stroke. 11 Therefore, during the COVID-19 epidemic and with the increase of work pressure in health care workers, there is a possibility of increasing sleep disorders and consequently increasing physical diseases. Healthcare personnel are the most important group in dealing with the COVID-19 epidemic,therefore, increasing the number of medical staff and reducing the number of work shifts can relieve fatigue and maintain energy levels in them and reduce physical complications in them. Among the treatment methods for insomnia, we can mention medication,however, because sedatives have side effects such as drowsiness and decreased accuracy, they are not recommended for people such as nurses who always need full alertness during their shift,instead, non-pharmacological therapies such as relaxation techniques can be used. Because relaxation is a relative state of relief from the mental and physical effects of stress which can improve the sleep quality by regulating the hypothalamus and reducing sympathetic and parasympathetic functions. 12 The progressive muscle relaxation technique introduced and used by Jacobsen is an easy, cost-effective method without the need for special equipment,it is one of the best complementary therapies to reduce the effects of mental illness such as anxiety because people in this method, by contracting and relaxing a specific muscle, cause relaxation in different target muscles and increase concentration and pleasant emotions. 13 In order to improve working conditions, it is also suggested that the chronobiological characteristics of individuals should be considered when planning work shifts and classifying individuals accordingly. This type of chronotype classification is a simple method and takes into account issues such as individual circadian differences, sleep habits and performance on a particular day, and ultimately helps to plan work shifts based on these chronobiological characteristics. 14 Another suggestion that can be made in this regard is physical activity because physical activity promotes physical and mental health with the biological and biochemical changes that follow. As a result, they improve the quality of sleep. In addition, physical activity, if repeated frequently, reduces the risk of physical illnesses such as cardiovascular disease, cancer, diabetes, and hypertension by boosting the immune response in the body. 15

Introduction: The aim of this study was to determine incidence of cardiovascular disease (CVD) risk factors [hypertension (HTN), obesity, Dyslipidemia (DLP), diabetes mellitus (DM) and smoking] in Oskoo.Methods: This study was planned according to WHO pro-tocol “WHO CVD-risk management package for low and medium-resource settings” and named “East Azerbaijan healthy heart program”. The pilot study of this program was done in Oskoo in 2007-2009. In this study, demographic data and CVD risk factors of 37,329 adults aged³30 years old living in Oskoo were collected. In addition, blood samples of 17,388 adults³40 years old were taken (free of charge) for assessment of serum glucose and lipid profile.Results: The study covered 93.52% of Oskoo town population aged³30 years old. We studied 18637 male (M) (91.50% coverage) and 18692 female (F) (95.52% coverage) participants. The incidence of HTN [SBP³140 & DBP³90 mmHg] was 16.25% (M:15.08%, F:17.29%), pre-hypertension [SBP=120-139 & DBP=80-89 mmHg] =37.78% (M:41.38%, F:34.18%), DM [fast blood glucose (FBS) ³126mg/dl] was 7.45% (M:6.35%, F:8.54%), smoking was 9.40% (M:17.00%, F:1.57%), hypercholesterolemia (>200mg/dl) was 47.64% (M:42.46%, F:52.81%) and obesity [body mass index (BMI) ³27] was 50.47% (M:38.79%, F:62.09%).Conclusion: Considering high incidence of CVD risk factors (except smoking) in Oskoo adults ³30 years, it is recommended that this pilot study expanded to all of East Azerbaijan. Free of charge taking blood samples from people³40 years to evaluate lipid profile and glucose levels is worthy to early detecting the prevalent DM or DLP in this target population.

Objective(s): Angiotensin II type 1 receptor blockers (ARBs) represent one of the widely used antihypertensive agents. In addition to anti‐hypertension effect, some ARBs also show other molecular effects such as activating peroxisome proliferator-activated receptor-g and so on. Here we studied the effects of telmisartan on the rat isolated mesenteric artery rings pre-contracted by phenylephrine (PE).Materials and Methods: Rat mesenteric artery rings were pre-contracted with 10 mM PE, and cumulative concentration-response curves to telmisartan were obtained. The endotheliumdependent mechanisms were investigated by mechanical removal of the endothelium. K+channels were investigated by pretreatment of the artery rings with various K+channel blockers.Results: Telmisartan produced concentration-dependent relaxation of the artery rings precontracted by 10 mM PE. Denudation of the endothelium did not affect the relaxant effect of telmisartan. Pretreatment with BaCl2 nearly inhibited the relaxation induced by the 0.5, 1, 5 and 10 mM telmisartan, but did not affect the relaxation induced by the 50 and 100 mM telmisartan. While the relaxation induced by telmisartan was not affected by pretreatment with TEA, 4-AP and glibenclamide.Conclusion: These findings demonstrated that telmisartan produces concentration dependent vasodilation in isolated rat mesenteric artery rings with or without endothelium pre‐contracted by PE. KIR channel may be involved in such a relaxant effect of telmisartan.

Background: Cardiovascular disease is the most common cause of mortality in patients with end-stage renal disease. Determining the spectrum of echocardiographic abnormalities in these patients can help the prevention of mortality in this group of chronically ill patients.Methods: 123 adult patients with chronic renal failure who underwent hemodialysis and echocardiography during February till November 2006 were enrolled. Complete 2-D, M-mode, Doppler and color Doppler study were performed by a single operator for each patient and the abnormalities were recorded.Results: The mean age was 38.3±13 and 61.5 % were female. The mean cardiac dimensions were right ventricular diastolic dimension: 1.89±0.05 cm, inter-ventricular septal dimension: 1.3±1.23 cm, enddiastolic dimension: 6.1±0.6 cm, endsystolic dimention: 3.84±2.5 cm, ejection fraction: 59.2±11 %, left ventricular mass: 238±90 gr. The prevalence of LV systolic dysfunction (EF < 50 %) was 20.3%, valvular regurgitation > mild, mitral regurgitation: 52.8%, aortic regurgitation: 24.4%, and tricuspid regurgitation: 35.8%. Valvular calcification was seen in 14.5% of the patients but no significant stenosis was noted. The prevalence of pulmonary hypertension (SPAP>30 mm Hg) was 14.7% and that of pericardial effusion (> mild) was 14.7%. Cardiac ejection fraction was lower in patients requiring more hemodialysis sessions (p value <0.036).Conclusion: Echocardiographic abnormalities are very common in patients suffering from end-stage renal disease (ESRD), so periodic echocardiographic examination for diagnosis and treatment of cardiac abnormalities is highly recommended.

Background: We conducted this study to report the demographics and clinical profile of patients with nonarteritic anterior ischemic optic neuropathy referred to a referral neuroophthalmology center in Iran.Methods: During a five-year period, 107 patients with nonarteritic anterior ischemic optic neuropathy were studied. A detailed history of previous or current systemic diseases was obtained and a complete ophthalmic evaluation including best corrected visual acuity, color vision testing, and computerized perimetry was performed.Results: Sixty-six men and 41 women with a mean±SD age of 52.7±10.3 (range: 30 – 80) years were studied. Most (62.2%) of the patients aged more than 50 years. Twenty-two (20.5%) patients had had an episode of nonarteritic anterior ischemic optic neuropathy in the fellow eye. Overall, 51 (47.7%) patients had no evidence of a previous or current systemic disease. Diabetes mellitus and hypertension were reported in 40.1% and 26.1% of the patients, respectively.The best corrected visual acuity was 20/200 or worse in 43 (40.1%) eyes and 20/40 or better in 43 (40.1%) eyes. The best corrected visual acuity was significantly better in nondiabetic patients (0.62±0.69 LogMAR) than diabetics (0.96±0.84, P=0.03). The visual field analysis of reliable fields (76 eyes) revealed that the mean deviation ranged from -32.6 to -1.3 dB with a mean±SD of -19.7±8.08 dB. Diffuse defect was the most prevalent defect detected on 36.8% of visual fields of the study eyes followed by inferior altitudinal defect (26.3%). In the fellow eyes, without any evidence of prior optic nerve problem, inferior and superior arcuate scotoma were found in 30% and 20% of the eyes, respectively.Conclusion: Characteristics of nonarteritic anterior ischemic optic neuropathy patients in a population of Iranian patients were similar to nonarteritic anterior ischemic optic neuropathy as described in previous studies, with the exception of higher proportion of younger patients and a higher propensity for diabetes. Visual field defects were common in clinically normal fellow eyes.