Effect of Self-care on Quality of Life of Multiple Sclerosis Patients.

Long term diseases and their psycho-cognitive physiologic defects or signs affect life quality of the patients in different life stages and threaten their health resulting in their disabilities. Multiple sclerosis (MS) as a long-term life threatening disease can make acute disabilities affecting patients’ life trend. Unknown manner of disease, poor prognosis and treatment on one hand and hard prevention on the other hand have all limited the treatment to a supportive one although patients can have almost a normal length of life with appropriate self-care. Self care can well diminish the disease extension and complications provides the patient with a better life quality and his family with a better coping ability against new conditions. So this study was carried out with the above title. This study was quasi-experimental and the method of data gathering was questionnaires which included two sections as follows 26 MS patients referring to private and clinic of Isfahan Alzahra hospital were selected by convenient sampling. After that, the subjects started self-care programs for three weeks and then life quality questionnaire was filled either with the patients or the researcher. The findings were analyzed and compared with former findings through descriptive and inferential statistics. Findings showed a noticeable increase in life quality mean score in domain of physical function (P<0.001), psycho cognitive domain (p<0.001), social function (P<0.001) and general health (p<0.001) after self care program. There was also a sharp increase in total life quality score after self-care program compared with before that. The findings showed that self-care could positively affect life quality items. It is hoped that by formation of educational supportive associations or at least a well equipped rehabilitation center for the patients, the patients can be provided with facilities of self-care as well as a condition in which the patients themselves carry out their self care

Effect of Self-care on Quality of Life of Multiple Sclerosis Patients.

مولتیپل اسکلروزیس به عنوان یک بیماری غیرقابل درمان و دارای معلولیتهای فراوان، تا حدود زیادی زندگی طبیعی مبتلایان را تحت تأثیر قرار می دهد. با آموزش مراقبت از خود می توان از بروز یا پیشرفت بسیاری از عوارض کاست، زندگی مطلوب را افزایش داد و در تحمل بسیاری از مشکلات بوسیله سازگاری با شرایط به وجود آمده، خانواده را یاری داد؛ لذا این پژوهش با هدف بررسی تاثیر خودمراقبتی بر کیفیت زندگی مبتلایان به مولتیپل اسکلروزیس صورت گرفته است. این پژوهش به صورت نیمه تجربی، یک گروهی و دو مرحله ای انجام شده است. تعداد کل نمونه ها 28 بیمارمبتلا به مولتیپل اسکلروزیس مراجعه کننده به یکی ازدرمانگاه های خصوصی ونیز درمـانگاه بیمارستان الزهرا بوده اند که با روش نمونه گیری آسان انتخاب شده اند. اطلاعات مورد نیاز با استفاده از پرسشنامه خود ساخته کیفیت زندگی جمع آوری گردیده است. نتایج حاصل با استفاده از آمار توصیفی و استنباطی با نتایج قبلی مورد مقایسه قرار گرفت. یافته های پژوهش نشان داد که افزایش چشمگیری در میانگین امتیازات کیفیت زندگی در حیطه های عملکردجسمانی، روانشناختی ،حیطه عملکرد اجتماعی و سلامت عمومی بعد از اقدام به خودمراقبتی ایجاد شده است. همچنین یافته های پژوهش نشان داد که میانگین امتیازات کلی کیفیت زندگی بعد از خودمراقبتی افزایش بارزی نسبت به قبل از خودمراقبتی داشته است. نتایج حاصل از پژوهش نشان می دهد که انجام خودمراقبتی تاثیر مثبتی بر روی اجزای کیفیت زندگی دارد. امید است با ایجاد و تقویت انجمن های آموزشی و حمایتی، امکان انجام اقدامات خود مراقبتی برای بیماران مبتلا به مولیتپل اسکلروز فراهم گردد

Efficacy of Calcium Salts on Controlling Phytophthora pistaciae, the Cause of Pistachio (Pistacia vera L.) Gummosis

Research in plant disease management focuses on developing safe methods for humans and the environment in order to prevent the entry of harmful chemicals in food. Simple inorganic salts have low cost and are safe enough to be used as pesticides. Phytophthora genus causes crown and root rot (gummosis) in crops and leads to great losses in some pistachio (Pistacia vera L.) production areas annually. In this study, the potential efficacy of different calcium salts with various concentrations on Phytophthora pistaciae control was examined. This was done to find out a safe way of material usage instead of synthetic pesticides. Samples from the crown of a pistachio tree, with gummosis, were cultured on lima bean agar to isolate and purify the pathogen. P. pistaciae identification was done using the PCR method with ITS4 and ITS6 primers. Pathogenicity of isolate was confirmed through tests on apples, pistachio branches, and pistachio seedlings. Different concentrations of seven calcium salts (chloride, nitrate, sulfate, oxide, hydroxide, phosphate, and carbonate) were applied which reduced mycelial growth and 3000ppm of calcium oxide inhibited it completely. Most of the salts reduced the number of sporangia, zoospores, and cyst germination percentage. Calcium oxide and calcium hydroxide also caused hyphae branching and deformation of some sporangia. The results suggested that some calcium salts, especially calcium oxide, could control the growth of P. pistaciae in vitro. Future in vivo studies are needed to examine whether calcium salts can reduce the disease severity and spread of the pathogen in the environment if those are sprinkled over the soil around the infested crown

Serum IL-18 and hsCRP Correlate with Insulin Resistance without Effect of Calcitriol Treatment on Type 2 Diabetes

ABSTRACT Background: Chronic low-grade systemic inflammation presented in Type 2 diabetes mellitus plays a major role in disease progression as well as development of micro-and macro-vascular complications of diabetes. Therefore, reducing inflammation can be beneficial in prevention of diabetes complications. Objectives: To investigate the association between insulin resistance and inflammatory markers, and assessing the effects of oral Calcitriol on inflammatory cytokines in type 2 diabetic patients. Methods: In this double-blind randomized placebo-controlled trial, 70 participants with type-2 diabetes were randomly divided to two groups. One group received two capsules of Calcitriol (0.25 μg 1,25-dihydroxy cholecalciferol per each capsule) per day. The second group received placebo tablets. At the beginning of the study, we assessed insulin resistance and its relation to inflammatory profile. Serum high sensitive Creactive protein (hs CRP), interleukin-6 and interleukin-18 were also measured at the beginning and the end of the 12-week supplementation trial. Results: Mean calcium, phosphorus and vitamin D concentrations in the study participants were 8.98 ± 0.79 mg/dl, 3.86 ± 0.50 mg/dl and 40.91 ± 30.9 ng/ml, respectively. IL-18 and hsCRP had significant positive associations with insulin resistance markers and negative associations with insulin sensitivity markers. At the end of the 12-week supplementation trial, no significant difference was seen in serum levels of hsCRP, IL-6 and IL-18 between the two groups, while these values were adjusted for baseline values. Conclusion: Inflammation was associated with insulin resistance in diabetic patients. No anti-inflammatory effect of Calcitriol in terms of decreasing hsCRP, IL-6 and IL-18 detected

The role of T helper 9(Th9) against Infectious Diseases

Background and aims: Infectious diseases are disorders caused by organisms such as bacteria, viruses, fungi or parasites .The Th9 subset develops in response to combined signals from TGF-b and IL-4 among a cacophony of other cytokines in an extracellular milieu. T helper 9 (Th9) cells, as a novel CD4 T cell subset, seem to play a complex role in the outcome of specific immune responses. In this article, we aimed to review the role of these cells in infectious disease. Methods: In this mini-review study, we study 25 novel articles since 2009 to 2014 about the role of T helper 9 in some Infectious Diseases. Results: Pleural mesothelial cells promoted Th9 cell differentiation by presenting antigen. It significantly differentiated Th17, but not Th9 cells in the development of CVB3-induced VMC. The microenvironment of VMC seemed to contribute to the differentiation and proliferation of Th17 rather than to differentiation of Th9 cells. Having reviewed the limited number of articles considering this relevance, we came to this result that Lymphatic Filariasis and mycobacterium tuberculosis infections confirmed the existence of such relationship. In addition, Rapamycin resistant murine Th9 cells have a stable in vivo phenotype and inhibit graft-versus-host reactivity but concerning Viral Myocarditis, Th9 cells could not protect against it. Conclusion: The accurate molecular mechanisms underlying the generation and differentiation of human Th9 cells are not elucidated completely. Th9 cells exhibit Ag specific expansion in a chronic helminth infection (lymphatic filariasis), but in relevance to viral myocarditis, Th9 cells did not play an efficient role against it. However; knowing that whether Th9 cells participate in the protection against infections needs further research

The global, regional, and national burden of stomach cancer in 195 countries, 1990-2017 : a systematic analysis for the Global Burden of Disease study 2017

Background: Stomach cancer is a major health problem in many countries. Understanding the current burden of stomach cancer and the differential trends across various locations is essential for formulating effective preventive strategies. We report on the incidence, mortality, and disability-adjusted life-years (DALYs) due to stomach cancer in 195 countries and territories from 21 regions between 1990 and 2017. Methods: Estimates from GBD 2017 were used to analyse the incidence, mortality, and DALYs due to stomach cancer at the global, regional, and national levels. The rates were standardised to the GBD world population and reported per 100 000 population as age-standardised incidence rates, age-standardised death rates, and age-standardised DALY rates. All estimates were generated with 95% uncertainty intervals (UIs). Findings: In 2017, more than 1·22 million (95% UI 1·19–1·25) incident cases of stomach cancer occurred worldwide, and nearly 865 000 people (848 000–885 000) died of stomach cancer, contributing to 19·1 million (18·7–19·6) DALYs. The highest age-standardised incidence rates in 2017 were seen in the high-income Asia Pacific (29·5, 28·2–31·0 per 100 000 population) and east Asia (28·6, 27·3–30·0 per 100 000 population) regions, with nearly half of the global incident cases occurring in China. Compared with 1990, in 2017 more than 356 000 more incident cases of stomach cancer were estimated, leading to nearly 96 000 more deaths. Despite the increase in absolute numbers, the worldwide age-standardised rates of stomach cancer (incidence, deaths, and DALYs) have declined since 1990. The drop in the disease burden was associated with improved Socio-demographic Index. Globally, 38·2% (21·1–57·8) of the age-standardised DALYs were attributable to high-sodium diet in both sexes combined, and 24·5% (20·0–28·9) of the age-standardised DALYs were attributable to smoking in males. Interpretation: Our findings provide insight into the changing burden of stomach cancer, which is useful in planning local strategies and monitoring their progress. To this end, specific local strategies should be tailored to each country's risk factor profile. Beyond the current decline in age-standardised incidence and death rates, a decrease in the absolute number of cases and deaths will be possible if the burden in east Asia, where currently almost half of the incident cases and deaths occur, is further reduced. Funding: Bill & Melinda Gates Foundation

Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017

A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1–70.8) million) to 6.4% (58.3 (47.6–70.7) million), but is predicted to remain above the World Health Organization’s Global Nutrition Target of <5% in over half of LMICs by 2025. Prevalence of overweight increased from 5.2% (30 (22.8–38.5) million) in 2000 to 6.0% (55.5 (44.8–67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic

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

Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background: In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods: GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings: Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990–2010 time period, with the greatest annualised rate of decline occurring in the 0–9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10–24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10–24 years were also in the top ten in the 25–49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50–74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation: As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and developm nt investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens