Effect of saffron oral capsule on anxiety and quality of sleep of diabetic patients in a tertiary healthcare facility in southeastern Iran: A quasi-experimental study

Purpose: To determine the effect of oral capsule of saffron (a herbal medicine) on anxiety and quality of sleep of diabetic patients of a tertiary healthcare facility in Zabol, Iran in 2016.Methods: This was a quasi-experimental study on 50 diabetics of Zabol who met the inclusion criteria. Participants were randomly split into two groups (control and test). Anxiety and quality of sleep were evaluated by Spielberger Anxiety Inventory and Pittsburgh Sleep Quality Index (PSQI). Participants in the intervention group received a daily (between 12 noon and 2 pm) intake of 300 mg saffron capsule after lunch while those in the control group received a placebo daily for a similar duration. After a week, anxiety and sleep quality were assessed.Results: A significant difference in anxiety and quality of sleep prior to and after saffron oral capsule intake (p = 0.001) was observed. In the control group, anxiety and quality of sleep did not show any significant difference before and after intervention (p = 0.001).Conclusion: The results show that saffron capsule intake is effective in reducing anxiety and improving the quality of sleep among diabetic patients. Further studies are required to enhance saffron capsule formulation.Keywords: Anxiety, Blood glucose, Sleep, Diabetes mellitu

Knowledge, attitude and use of complementary and alternative medicine among nurses: A systematic review

Copyright © 2016 Journal of Integrative Medicine Editorial Office. E-edition published by Elsevier (Singapore) Pte Ltd. All rights reserved. This manuscript version is made available under the CC-BY-NC-ND 4.0 license: http://creativecommons.org/licenses/by-nc-nd/4.0/ This author accepted manuscript is made available following 12 month embargo from date of publication (February 2018) in accordance with the publisher’s archiving policyObjectives The purpose of this study was to systematically review the literature to describe the knowledge, attitude and practice of CAM by nurses. Methods Three databases were searched for relevant studies from launch through September of 2017 and included MEDLINE, Scopus and Web of science. Results The average knowledge of CAM therapies by nurses was 62.2% with attitude about use averaging 65.7%. Close to two-thirds (65.9%) reported use of CAM therapies with patients. The primary reasons nurses suggested use of CAM were for stress and anxiety reduction and health improvement. Conclusion Current evidence demonstrates the need for nurse education programs to integrate and strengthen CAM content into existing curricula. Similarly, documentation of the nature and extent of nurse use of CAM therapies in the clinical setting, as well as patient-reported use and preferences for CAM therapies, would provide valuable prospective data

The safety, health, and well-being of healthcare workers during COVID-19: A scoping review

The outbreak of the COVID-19 pandemic has affected the safety and well-being of healthcare workers. A scoping review was conducted to highlight the impact of COVID-19 on the safety, health, and well-being of healthcare workers and to shed light on the concerns about their perceived safety and support systems. A literature search was conducted in three different databases from December 1, 2019, through July 20, 2022, to find publications that meet the aim of this review. Using search engines, 3087 articles were identified, and after a rigorous assessment by two reviewers, 30 articles were chosen for further analysis. Two themes emerged during the analysis: safety and health and well-being. The primary safety concern of the staff was mostly about contracting COVID-19, infecting family members, and caring for patients with COVID-19. During the pandemic, the health care workers appeared to have anxiety, stress, uncertainty, burnout, and a lack of sleep. Additionally, the review focused on the suggestions of health care providers to improve the safety and well-being of workers through fair organizational policies and practices and timely, individualized mental health care

Global, regional, and national burden of chronic kidney disease, 1990–2017 : a systematic analysis for the Global Burden of Disease Study 2017

Background Health system planning requires careful assessment of chronic kidney disease (CKD) epidemiology, but data for morbidity and mortality of this disease are scarce or non-existent in many countries. We estimated the global, regional, and national burden of CKD, as well as the burden of cardiovascular disease and gout attributable to impaired kidney function, for the Global Burden of Diseases, Injuries, and Risk Factors Study 2017. We use the term CKD to refer to the morbidity and mortality that can be directly attributed to all stages of CKD, and we use the term impaired kidney function to refer to the additional risk of CKD from cardiovascular disease and gout. Methods The main data sources we used were published literature, vital registration systems, end-stage kidney disease registries, and household surveys. Estimates of CKD burden were produced using a Cause of Death Ensemble model and a Bayesian meta-regression analytical tool, and included incidence, prevalence, years lived with disability, mortality, years of life lost, and disability-adjusted life-years (DALYs). A comparative risk assessment approach was used to estimate the proportion of cardiovascular diseases and gout burden attributable to impaired kidney function. Findings Globally, in 2017, 1·2 million (95% uncertainty interval [UI] 1·2 to 1·3) people died from CKD. The global all-age mortality rate from CKD increased 41·5% (95% UI 35·2 to 46·5) between 1990 and 2017, although there was no significant change in the age-standardised mortality rate (2·8%, −1·5 to 6·3). In 2017, 697·5 million (95% UI 649·2 to 752·0) cases of all-stage CKD were recorded, for a global prevalence of 9·1% (8·5 to 9·8). The global all-age prevalence of CKD increased 29·3% (95% UI 26·4 to 32·6) since 1990, whereas the age-standardised prevalence remained stable (1·2%, −1·1 to 3·5). CKD resulted in 35·8 million (95% UI 33·7 to 38·0) DALYs in 2017, with diabetic nephropathy accounting for almost a third of DALYs. Most of the burden of CKD was concentrated in the three lowest quintiles of Socio-demographic Index (SDI). In several regions, particularly Oceania, sub-Saharan Africa, and Latin America, the burden of CKD was much higher than expected for the level of development, whereas the disease burden in western, eastern, and central sub-Saharan Africa, east Asia, south Asia, central and eastern Europe, Australasia, and western Europe was lower than expected. 1·4 million (95% UI 1·2 to 1·6) cardiovascular disease-related deaths and 25·3 million (22·2 to 28·9) cardiovascular disease DALYs were attributable to impaired kidney function. Interpretation Kidney disease has a major effect on global health, both as a direct cause of global morbidity and mortality and as an important risk factor for cardiovascular disease. CKD is largely preventable and treatable and deserves greater attention in global health policy decision making, particularly in locations with low and middle SDI

Mapping 123 million neonatal, infant and child deaths between 2000 and 2017

Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2—to end preventable child deaths by 2030—we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000–2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations

Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-Adjusted life-years for 29 cancer groups, 1990 to 2017 : A systematic analysis for the global burden of disease study

Importance: Cancer and other noncommunicable diseases (NCDs) are now widely recognized as a threat to global development. The latest United Nations high-level meeting on NCDs reaffirmed this observation and also highlighted the slow progress in meeting the 2011 Political Declaration on the Prevention and Control of Noncommunicable Diseases and the third Sustainable Development Goal. Lack of situational analyses, priority setting, and budgeting have been identified as major obstacles in achieving these goals. All of these have in common that they require information on the local cancer epidemiology. The Global Burden of Disease (GBD) study is uniquely poised to provide these crucial data. Objective: To describe cancer burden for 29 cancer groups in 195 countries from 1990 through 2017 to provide data needed for cancer control planning. Evidence Review: We used the GBD study estimation methods to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-Adjusted life-years (DALYs). Results are presented at the national level as well as by Socio-demographic Index (SDI), a composite indicator of income, educational attainment, and total fertility rate. We also analyzed the influence of the epidemiological vs the demographic transition on cancer incidence. Findings: In 2017, there were 24.5 million incident cancer cases worldwide (16.8 million without nonmelanoma skin cancer [NMSC]) and 9.6 million cancer deaths. The majority of cancer DALYs came from years of life lost (97%), and only 3% came from years lived with disability. The odds of developing cancer were the lowest in the low SDI quintile (1 in 7) and the highest in the high SDI quintile (1 in 2) for both sexes. In 2017, the most common incident cancers in men were NMSC (4.3 million incident cases); tracheal, bronchus, and lung (TBL) cancer (1.5 million incident cases); and prostate cancer (1.3 million incident cases). The most common causes of cancer deaths and DALYs for men were TBL cancer (1.3 million deaths and 28.4 million DALYs), liver cancer (572000 deaths and 15.2 million DALYs), and stomach cancer (542000 deaths and 12.2 million DALYs). For women in 2017, the most common incident cancers were NMSC (3.3 million incident cases), breast cancer (1.9 million incident cases), and colorectal cancer (819000 incident cases). The leading causes of cancer deaths and DALYs for women were breast cancer (601000 deaths and 17.4 million DALYs), TBL cancer (596000 deaths and 12.6 million DALYs), and colorectal cancer (414000 deaths and 8.3 million DALYs). Conclusions and Relevance: The national epidemiological profiles of cancer burden in the GBD study show large heterogeneities, which are a reflection of different exposures to risk factors, economic settings, lifestyles, and access to care and screening. The GBD study can be used by policy makers and other stakeholders to develop and improve national and local cancer control in order to achieve the global targets and improve equity in cancer care. © 2019 American Medical Association. All rights reserved.Peer reviewe

Dialysis Adequacy among Haemodialysis Patients in Eastern Mediterranean Region: A Systematic Review and Meta-Analysis

Introduction: Dialysis adequacy is one of the most important indicators for measuring the quality of care provided in hemodialysis (HD) wards. Despite individual studies, there is still no comprehensive study about dialysis adequacy in the Eastern Mediterranean Region (EMRO). This study was conducted to evaluate the dialysis adequacy in HD patients in the EMRO. Methods: In the present systematic review and meta-analysis international (EMBASE, Scopus, PubMed, Web of Science) and national (SID, MAGIRAN) databases were searched for related articles using keywords “dialysis adequacy” and “EMRO” from 1 January 2000 to April 30, 2020. The quality of studies was studied using Hoy et al instrument. Results: Out of 966 retrieved studies, 63 studies conducted on 15462 HD patients were included. The pooled mean of KT/V and URR were 1.24 (95% CI: 1.19, 1.30) and 63.03% (95% CI: 61.31, 64.75), respectively. The pooled prevalence of Kt/V>1.2 and URR>65.0% were 42.73% (95% CI: 31.58, 53.88) and 42.52% (95% CI: 25.3, 59.7), respectively. Conclusion: The results of the present study indicate the poor dialysis adequacy in the EMRO region and the need to improve the physical infrastructure, workforce, and pieces of equipment in hemodialysis wards

Meticulous observations essential before and after coil embolization of pulmonary arteriovenous malformation; lessons learned from two case

BACKGROUND: Endovascular coil embolization is an approved treatment for pulmonary arteriovenous malformation (AVM) but it brings high rate of thromboembolic complications with subsequent morbidity and mortality.&nbsp;Hereby, we report two cases of AVM coil embolization and management of their compilations. CASE REPORT: The first case was a 57-year-old male with five implanted coils in the lower lobe of right lung in which two of them were migrated soon after implantation. On exploration, a large atrial septal defect was detected and then repaired successfully. The next day, he was transferred for fluoroscopy. Two embolized coils were found at the site of the left iliac artery which was extracted via snare through sheath implanted in the left femoral artery. Coil migration to the left atrium and subsequently to the left iliac artery is reported for the first time. The second case was a 45-year-old male with central cyanosis and clubbing of upper and lower extremities from childhood. On computed tomography angiography (CTA), a vascular lesion was found. The patient underwent coil embolization for closure of AVM. The patient was still symptomatic after successful closure of AVM. On CTA, two feeding arteries were detected. He underwent second coil embolization procedure. CONCLUSION: AVM coil embolization is a temptative procedure, which should be performed on its real indications by an expert centers who can handle complications of this procedure. The performance of CTA seems beneficial in some cases to confirm complete embolization of AVM. &nbsp;&nbsp;</p

A case of Marfan’s syndrome with multi-level aortic dissections

BACKGROUND: Although Marfan&rsquo;s syndrome is a disease with various phenotypes, but the major mechanism of death is cardiovascular complication. Aortic dissection is a major cause of death in Marfan syndrome. CASE REPORT: A 30-year-old man with severe refractory chest and left flank pain and history of previously surgically repaired Type A aortic dissection was referred to the hospital. His typical manifestations of Marfan&rsquo;s syndrome were identified. Cardiovascular imaging showed an acute spiral dissection in the descending aorta extending to the left renal and femoral arteries with no evidence of thrombosis in its huge false lumen (8 cm). By the diagnosis of acute, expanded, spiral, Type B aortic dissection, he underwent the stent grafting of dissected aorta. He discharged without any complication. On follow-up cardiovascular imaging, thrombosed false lumen in stented aorta from descending aorta to the proximal abdominal aorta was seen. CONCLUSION: Endovascular treatment of Type B dissection is an effective treatment in Type B dissection, even in patients with Marfan syndrome.&nbsp;</p

Causes of Chronic Kidney Disease in Iranian Children: A Meta-Analysis and Systematic Review

This study aimed to determine the causes of chronic kidney disease (CKD) in Iranian children. In this systematic review and meta-analysis study, international (PubMed, Web of Science, Scopus, and Google Scholar) and national (SID, Magiran) databases were searched for articles published through December 30, 2017. The quality of the studies was determined using the Hoy instrument. Out of 2,117 initial studies, 13 studies performed on a total of 3,596 children were included in the final stage of the study. Based on the results of the random effects method (95% CI), the main causes of chronic kidney disease in stages 1-4 (CKD) were CAKUT (37%) and glomerulonephritis (19.96%); in stage 5 (ESRD) they were CAKUT (40.82%) and urological disorders (27.44%). Considering the high prevalence of CAKUT, glomerulonephritis and urinary problems, the use of comprehensive approaches can be very effective in enhancing the knowledge of patients about the causes of kidney disease. The results obtained from the present study can assist policymakers in more accurately planning screenings of the causes of CKD in Iranian children