A systematic review of the effectiveness of self-management interventions in people with multiple sclerosis at improving depression, anxiety and quality of life.

BACKGROUND: Self-management interventions have become increasingly popular in the management of long-term health conditions; however, little is known about their impact on psychological well-being in people with Multiple Sclerosis (MS). PURPOSE: To examine the effectiveness of self-management interventions on improving depression, anxiety and health related quality of life in people with MS. METHOD: A structured literature search was conducted for the years 2000 to 2016. The review process followed the PRISMA guidelines, and is registered with PROSPERO (no. CRD42016033925). RESULTS: The review identified 10 RCT trials that fulfilled selection criteria and quality appraisal. Self-management interventions improved health-related quality of life in 6 out of 7 studies, with some evidence of improvement in depression and anxiety symptoms. CONCLUSION: Although the results are promising more robust evaluation is required in order to determine the effectiveness of self-management interventions on depression, anxiety and quality of life in people with MS. Evaluation of the data was impeded by a number of methodological issues including incomplete content and delivery information for the intervention and the exclusion of participants representing the disease spectrum. Recommendations are made for service development and research quality improvement

Comparison of effects of Enalapril, Ramipril and Amlodipine on blood sugar levels in ill-controlled type 2 Diabetes mellitus patients

Introduction: Insulin resistance, dyslipidemia and hypertension may co-exist in 15-25 % of individuals in industrialized countries. Vasodilator amodipine, ramipril and enalapril being commonly used drugs, were selected to see their beneficial effect in type 2 diabetics with fasting blood sugar >150 mg%.Materials and methods: This was a prospective, open labeled study in which 45 patients of type 2 diabetes mellitus with fasting blood glucose more than 150 mg% were allocated to 3 groups (n=15) each of Amlodipine 2.5mg/day, enalapril 2.5mg/day and ramipril 2.5mg/day for a follow up observation period of 8 weeks and blood glucose was estimated at the baseline and every 15 days.Results: In all the three study groups, statistically significant (p<0.05) reduction in the fasting blood glucose was found when compared to the ‘baseline’ and also ‘within group’ analysis. Add on therapy with vasodilator in such patients of diabetes mellitus was found to be associated with improved glycemic control at the end of 8 weeks.Conclusion: By addition of vasodilators to their current anti-diabetic treatment we tried to probe better control of type 2 Diabetes Mellitus patients with improved insulin responsiveness and decreased dose requirement of antidiabetic drugs