In-vitro effect of hydro-alcoholic extract of Tanacetum parthenium extract on Trichomonas vaginalis

Background: Trichomonas vaginalisis a flagellate parasite causing vaginosis as a common sexual transmitted disease. Metronidazole is the drug of choice for this disease; but due to its side effects it is necessary to search for an alternative drug. In this study, the effect of Tanacetum parthenium on Trichomonas vaginalis was investigated. Methods: Using percolation method, hydro-alcoholic extracts of Tanacetum parthenium was prepared. The extract was dried using vacuum rotary evaporator. Different doses of the extract were added to 8 tubes containing culture medium of Trichomonas vaginalis; metronidazole was added to 1 tube. Finally, 104 Trichomonas vaginalis was added to each tube. Every 24 hours for 3 days, the tubes were seen for count and motion of the parasite under the microscope. Findings: In concentrations of 4, 5, 8 and 10 mg/ml of Tanacetum parthenium, the parasite did not grow. The effect of the extract on Trichomonas vaginalis was similar to the effect of metronidazole. Conclusion: Tanacetum parthenium has efficient effect against Trichomonas vaginalis growth in culture medium; so, this herb can be considered as alternative drug for methronidazole

The effect of low level laser therapy on Pemphigus vulgaris lesions: A Pilot Study

Background: Pemphigus vulgaris is a chronic blistering skin disease. Management of recalcitrant pemphigus ulcers is a great problem. Low Level Laser Therapy (LLLT) is known to supply direct biostimulative light energy to body cells. Objective: This study evaluates the efficacy of low power laser in the healing of pemphigus lesions.Methods: Ten patients with pemphigus vulgaris were enrolled in the trial. The LED-LLLT system used was the Thor LED clusters (109, 69 or 19 diode) (ENGLAND) with 660 nm wave length in continuous wave (CW) and 30 MW energy. Both sides of the patients’ lesion were photographed prior to the study and in each laser therapy sessions.Results: The pattern of changes in QWS patterns differed significantly over time between the two therapies (treatment × time interactions, p<.0001). When compared to the routine therapy, the laser therapy showed more decreases in mean QWS in all sessions in comparison with baseline.Limitations: This is a pilot study.Conclusion: Application of Low Level Laser simultaneously with conventional therapy could result in sensational healing of ulcers especially in patients who do not respond to conventional treatment or suffering from recalcitrant lesions

How to test normality distribution for a variable: a real example and a simulation study

Many commonly used statistical methods require that the population distribution be nearly normal. Unfortunately, in some papers the one-sample Kolmogorov-Smirnov test has been used for testing normality while the assumptions of applying this test are not satisfied. To conduct this test, it is assumed that the population distribution is fully specified. In practical situation where the mean and SD of population distribution is not specified in advance, one can use a modification of the K-S test for checking the normality assumption which is called, Lilliefors test. In this paper, we explain the method of computing this test with some common statistical softwares such as SPSS, S-PLUS, R and StatXact and utilize a dermatology dataset from Skin Research Center of Shohada-e-Tajrish hospital to illustrate how the use of the one-sample K-S (with the mean and SD estimated from the sample) instead of its modification can be misleading in practice. We also use Monte Carlo simulation to compare the approximate power of the one-sample K-S test (with the estimated population mean and SD) with Lilliefors test in some common specified continuous distributions. The result indicates that one should not use the one-sample K-S test for assessing the normality assumption in practical situation.

Immunological cross reaction between cancer cells and hydatid cyst

Background and aims: Hydatid cyst is the larval stage of the tape worm Echinococcu granulosus. Anticancer effects of some parasites have been shown. Moreover, existence of common antigens between some parasites especially hydatid cyst and cancers have been reported. So, immunological cross reaction between hydatid cyst and cancer cell antigens has been investigated in this study. Methods: In this laboratory descriptive study, different hydatid cyst antigens were prepared and antibody raised against them in rabbits. In dot immunoblotting, those antigens were probed with sera of patients with cancers (collected from Imam Hossein Hospital in Isfahan). Also, cross reaction among excretory secretory products of cancer cells and antisera raised against different hydatid cyst antigen was investigated. In order to remove carbohydrate bands of antigens, sodium periodate buffer was used. Results: Antisera raised against laminated & germinal layers of hydatid cyst reacted with excretory secretory products of cancer cells. Also, antigens of hydatid cysts reacted with cancer patients sera. Carbohydrate bands of antigens were involved in some immunological cross reactions. Conclusion: Results of this work emphasis existence of common antigens between hydatid cyst and cancers. Therefore, more study about these common antigens is recommende

The Effect of Mesenchymal Stem Cells Derived-Conditioned Media in Combination with Oral Anti-Androgenic Drugs on Male Pattern Baldness: An Animal Study

Objective: Androgenetic alopecia (AGA) is a prevalent form of hair loss, mainly caused by follicular sensitivity toandrogens. Despite developing different anti-androgen treatment options, the success rate of these treatments hasbeen limited. Using animal models, this study evaluated the therapeutic effects of umbilical cord (UC) stem cellconditioned media (CM) combined with oral anti-androgens for hair regeneration.Materials and Methods: In this experimental study, Poloxamer 407 (P407) was used as a drug carrier forsubcutaneous testosterone injection. AGA models were treated with oral finasteride, oral flutamide, and CMinjections. Samples were thoroughly evaluated and compared using histological, stereological, and molecularanalyses.Results: Injecting CM-loaded hydrogel alone or combined with oral intake of anti-androgens improved hair regeneration.These treatments could promote hair growth by inducing hair follicles in the anagen stage and shortening the telogenand catagen phases. Furthermore, the combination treatment led to an upregulation of hair induction gene expressionwith a downregulation of inflammation genes.Conclusion: Through a reduction in inflammation, injection of CM-loaded hydrogel alone or combined with oral intakeof anti-androgens induces the hair cell cycle with regeneration in damaged follicles. Hence, this could be a promisingtherapeutic method for AGA patients

Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Background: Understanding the health consequences associated with exposure to risk factors is necessary to inform public health policy and practice. To systematically quantify the contributions of risk factor exposures to specific health outcomes, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 aims to provide comprehensive estimates of exposure levels, relative health risks, and attributable burden of disease for 88 risk factors in 204 countries and territories and 811 subnational locations, from 1990 to 2021. Methods: The GBD 2021 risk factor analysis used data from 54 561 total distinct sources to produce epidemiological estimates for 88 risk factors and their associated health outcomes for a total of 631 risk–outcome pairs. Pairs were included on the basis of data-driven determination of a risk–outcome association. Age-sex-location-year-specific estimates were generated at global, regional, and national levels. Our approach followed the comparative risk assessment framework predicated on a causal web of hierarchically organised, potentially combinative, modifiable risks. Relative risks (RRs) of a given outcome occurring as a function of risk factor exposure were estimated separately for each risk–outcome pair, and summary exposure values (SEVs), representing risk-weighted exposure prevalence, and theoretical minimum risk exposure levels (TMRELs) were estimated for each risk factor. These estimates were used to calculate the population attributable fraction (PAF; ie, the proportional change in health risk that would occur if exposure to a risk factor were reduced to the TMREL). The product of PAFs and disease burden associated with a given outcome, measured in disability-adjusted life-years (DALYs), yielded measures of attributable burden (ie, the proportion of total disease burden attributable to a particular risk factor or combination of risk factors). Adjustments for mediation were applied to account for relationships involving risk factors that act indirectly on outcomes via intermediate risks. Attributable burden estimates were stratified by Socio-demographic Index (SDI) quintile and presented as counts, age-standardised rates, and rankings. To complement estimates of RR and attributable burden, newly developed burden of proof risk function (BPRF) methods were applied to yield supplementary, conservative interpretations of risk–outcome associations based on the consistency of underlying evidence, accounting for unexplained heterogeneity between input data from different studies. Estimates reported represent the mean value across 500 draws from the estimate's distribution, with 95% uncertainty intervals (UIs) calculated as the 2·5th and 97·5th percentile values across the draws. Findings: Among the specific risk factors analysed for this study, particulate matter air pollution was the leading contributor to the global disease burden in 2021, contributing 8·0% (95% UI 6·7–9·4) of total DALYs, followed by high systolic blood pressure (SBP; 7·8% [6·4–9·2]), smoking (5·7% [4·7–6·8]), low birthweight and short gestation (5·6% [4·8–6·3]), and high fasting plasma glucose (FPG; 5·4% [4·8–6·0]). For younger demographics (ie, those aged 0–4 years and 5–14 years), risks such as low birthweight and short gestation and unsafe water, sanitation, and handwashing (WaSH) were among the leading risk factors, while for older age groups, metabolic risks such as high SBP, high body-mass index (BMI), high FPG, and high LDL cholesterol had a greater impact. From 2000 to 2021, there was an observable shift in global health challenges, marked by a decline in the number of all-age DALYs broadly attributable to behavioural risks (decrease of 20·7% [13·9–27·7]) and environmental and occupational risks (decrease of 22·0% [15·5–28·8]), coupled with a 49·4% (42·3–56·9) increase in DALYs attributable to metabolic risks, all reflecting ageing populations and changing lifestyles on a global scale. Age-standardised global DALY rates attributable to high BMI and high FPG rose considerably (15·7% [9·9–21·7] for high BMI and 7·9% [3·3–12·9] for high FPG) over this period, with exposure to these risks increasing annually at rates of 1·8% (1·6–1·9) for high BMI and 1·3% (1·1–1·5) for high FPG. By contrast, the global risk-attributable burden and exposure to many other risk factors declined, notably for risks such as child growth failure and unsafe water source, with age-standardised attributable DALYs decreasing by 71·5% (64·4–78·8) for child growth failure and 66·3% (60·2–72·0) for unsafe water source. We separated risk factors into three groups according to trajectory over time: those with a decreasing attributable burden, due largely to declining risk exposure (eg, diet high in trans-fat and household air pollution) but also to proportionally smaller child and youth populations (eg, child and maternal malnutrition); those for which the burden increased moderately in spite of declining risk exposure, due largely to population ageing (eg, smoking); and those for which the burden increased considerably due to both increasing risk exposure and population ageing (eg, ambient particulate matter air pollution, high BMI, high FPG, and high SBP). Interpretation: Substantial progress has been made in reducing the global disease burden attributable to a range of risk factors, particularly those related to maternal and child health, WaSH, and household air pollution. Maintaining efforts to minimise the impact of these risk factors, especially in low SDI locations, is necessary to sustain progress. Successes in moderating the smoking-related burden by reducing risk exposure highlight the need to advance policies that reduce exposure to other leading risk factors such as ambient particulate matter air pollution and high SBP. Troubling increases in high FPG, high BMI, and other risk factors related to obesity and metabolic syndrome indicate an urgent need to identify and implement interventions

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

Metadata: a New Word for an Old Concept

Metadata is a relatively new word for a concept with an long history. This article takes a general look at metadata as a means of cataloging electronic resources. Various definitions and types of metadata are presented and interpreted. Terms related to metadata are illustrated and some major metadata projects such as Dublin Core are discussed. Finally, some problems of metadata development are mentioned

Association of autoimmune pancreatitis with Raghib syndrome

Key Clinical Message Autoimmune pancreatitis (AIP) is a form of chronic pancreatitis scarcely found in children. Raghib syndrome is a rare congenital heart defect known as persistent left superior vena cava (LSVC) draining into the left atrium. Total signs of Raghib syndrome in AIP case accompanied by an IgG4‐related disease were described. Abstract Autoimmune pancreatitis (AIP) is a form of chronic pancreatitis scarcely found in children. Raghib syndrome is a rare congenital heart defect known as persistent left superior vena cava (LSVC) draining into the left atrium. Here, we describe Raghib syndrome in AIP case accompanied by an IgG4‐related disease (AIP/IgG4RD). A 13‐year‐old boy presented with a 3‐month history of fever and abdominal pain. The laboratory findings showed SGOT and SGPT, ALP was increased, while amylase and γ‐GT were normal. Immunoglobulins were normal, except for IgG. Endosonography, spiral CT of the abdomen, and cholangiopancreatography showed an enlargement of the pancreas. Contrast echocardiography discovered opacification of the coronary sinus and left atrium. Transesophageal echocardiography for LSVC revealed a dilatation in the coronary sinus, indicating persistent LSVC. Following the injection of agitated saline into the left antecubital vein, bubbles entered both left and right atria in LSVC. It is reasonable to exclude some of these rare disorders as Raghib syndrome, in cases that will be started on medications like corticosteroids, which increases the susceptibility to thromboembolic events