The effect of life skills training on self-esteem in students of Shahrekord University of Medical Sciences

زمینه و هدف: بالا رفتن عزت نفس و تغییر نگرش در دانشجویان می تواند آنان را از آسیب های روانی مصون دارد. این پژوهش با هدف بررسی تاثیر آموزش مهارت های زندگی بر افزایش عزت نفس دانشجویان دانشگاه علوم پزشکی شهرکرد انجام شد. مواد و روش ها: در این مطالعه کارآزمایی بالینی که به صورت نیمه تجربی بر روی 60 نفر از دانشجویان دانشگاه علوم پزشکی شهرکرد انجام گرفت، بعد از اطمینان از همگن بودن جامعه، دانشجویان به طور تصادفی به دو گروه مورد و شاهد (30 نفر) تقسیم شدند. یک پیش آزمون عزت نفس از طریق پرسشنامه ها ی کوپر اسمیت از آنها گرفته شد و سپس برای گروه مورد، برنامه آموزشی که شامل کارگاه آموزش مهارت های زندگی بود، ارائه شد. سپس از هر دو گروه پس آزمون عزت نفس براساس همان پرسشنامه گرفته شد و نتایج با یکدیگر مقایسه گردید. یافته ها: میانگین نمره گروه شاهد در پیش آزمون 6/8±3/30 و در پس آزمون 4/8±7/30 بود که تفاوت آماری معنی داری را نشان نداد (P>0.05). میانگین نمره عزت نفس گروه مورد قبل از آموزش 4/7±6/31 و بعد از آموزش 7/6±1/47 بود که نسبت به قبل از آزمون و هم چنین نسبت به گروه شاهد تفاوت معناداری نشان داد (

Comparison of Lumbopelvic and Hip Movement Patterns During Passive Hip External Rotation in Two Groups of Low Back Pain Patients with and without Rotational Demand Activities.

BACKGROUND Because different groups of people with low back pain (LBP) engage in different tasks, their lumbopelvic-hip complex may move in different ways in those groups. The purpose of this study was to quantify the differences in lumbopelvic movement pattern during the passive hip external rotation (PHER) test in LBP patients with and without rotational demand activities (RDA). MATERIAL AND METHODS A total of 30 subjects with LBP, including 15 patients with-RDA and 15 patients without-RDA were enrolled. A passive hip external rotation test was performed. Pelvic and hip rotation over the full range of the test, timing of hip and pelvic motion, and pelvic rotation in the first half of the movement were measured using a 3-D motion analysis system. RESULTS Passive pelvic rotation during the test in the group with RDA was significantly greater than in the other group. However, there was no significant difference between the groups in other kinematic variables, including hip external rotation, timing of hip and pelvic motion and pelvic rotation in the first half of the movement (p > 0.05). CONCLUSIONS 1. A greater lumbopelvic rotation ROM during the PHER existed in LBP patients who regularly participated in RDA. 2. Different groups of patients with LBP who engage in different specific activities may have a specific lumbopelvic movement pattern impairment. Therefore, each group of LBP patients in regard to their specific activities may need a different, specific plan of treatment

Mitochondrial mutation in Iranian patients with multiple sclerosis, correlation between haplogroups H, A and clinical manifestations

As multiple sclerosis (MS) has long been known to be associated with Leber, hereditary optic neuropathy (LHON), a disease caused by mitochondrial (mtDNA) mutations, in this study we assessed possible involvement of mtDNA point mutation in MS patients. Fifty-two MS patients whose disease was confirmed with revised McDonald criteria and referred to Iranian Center of Neurological Research of Imam Khomeini hospital during 2006–2007 entered the study. Secondary mtDNA mutations, age, gender, clinical disability according to expanded disability status scale (EDSS), course of the disease, and presenting symptoms were the variables investigated in this study. DNA purification was performed by Diatom DNA Extraction Kit. Analysis of data was done by SPSS V11.5. The prevalent mutations with frequency of 19.2% were J, L, and T haplogroups. Haplotype A was more prevalent in patients with younger age of onset (P-value = 0.012) and high proportion of haplogroup H was associated with optic nerve involvement (P-value = 0.015). No motor symptoms were seen in haplogroup H patients. There is no significant relationship between duration of the disease and EDSS in different mutation of mtDNA

The comprehensive study of possibility ecological control Mnemiopsis leidyi in Caspian Sea activity: The study and recognization parasitic fauna and Bacterial flore in ctenophore (Mnemiopsis leidyi and Bereo ovata)

Bacterial flora and parasitic fauna of M. leidyi an exotic invader jelly fish to Caspian Sea ecosystem and B. ovata to Black sea an alternative biological control agent was studied. During summer 1382 to spring 1383, using routine Bacteriological work. 72 sample of sea water Caspian Sea obtained from depth 20 and 50 meters, 36 sample of M. leidyi from depth 20 meters, 10 sample of B. ovata and 3 sample of sea water (Black sea) were collected and according to Bacteriological was studied. 216 sample of M. leidyi from depth 10 to 50 meters of Caspian Sea and 47 sample of B. ovata from Black and Marmarreh Sea (Turkey) were collected and was studied. In this study no parasite from was identified in M. leidyi (Caspian sea) but 64 percentage and 73 percentage of B. ovata (Marmarreh and Black sea respectively) contaminated to Trichodina ctenophore at varians concentration B. ovata of Black sea (130 min 1050 max) and B. ovata Marmarre sea (420 min 2100 max). While B. ovata kept at high salinity of 21 ppt was more contaminated with this pretrichial protozoan (Trichodina) than in low salinity (12/5 ppt). in comparision of bacterial flore in two cetenophore (M. leidyi and B. ovata) was observed that some of bacteria such as micrococcus sp, Aeromonas sp. Bacillus coagulans in both ctenophore and some other bacteria such as Agromobacterium and chromobacterium only observed in B. ovata but other researcher have reported fram Caspin sea and some of bacteria to specific Shewanella , Vibrio harveiy and bacillus linens was observed in B. ovata . Of course specific bacteria cannot transfer to Caspian Sea (different of salinity black sea (2/1%) to Caspian Sea (1/25 %)). Therefore if B. ovata to introduce to south Caspian Sea for biological control population M. leidyi. it is necessary at first some of viral pathogen in aquatic animal (fish) such as VNN, IPN,IHN,VHS,SVC was studied and then with confidence 95% non-infestation B. ovata to viruses and pass from bath anti parasite and anti-bacterial must be introduce to south Caspian sea

Epidemiology of familial multiple sclerosis in Iran: a national registry-based study

Background Admittedly, little is known about the epidemiological signatures of familial multiple sclerosis (FMS) in different geographical regions of Iran. Objective To determine the epidemiology and the risk of FMS incidence in several provinces of Iran with a different ethnic population including, Fars, Tehran, Isfahan (Persians), and Mazandaran (Mazanis), Kermanshah (Kurds), and Chaharmahal and Bakhtiari (Lors). Methods This cross-sectional registry-based study was performed on nationwide MS registry of Iran (NMSRI) data collected from 2018 to 2021. This system, registers baseline characteristics, clinical presentations and symptoms, diagnostic and treatments at regional and national levels. Results A total of 9200 patients including, 7003 (76.1%) female and 2197 (23.9%) male, were participated. About 19% of patients reported a family history of MS; the order from highest to lowest FMS prevalence was as follows: Fars (26.5%), Chaharmahal and Bakhtiari (21.1%), Tehran (20.5%), Isfahan (20.3%), Mazandaran (18.0%), and Kermanshah (12.5%). Of all FMS cases, 74.7% (1308 cases) were female and 25.3% (442 cases) were male. FMS occurrence was much more common in females than males (P-value = 0.001). Further, the mean age at onset was 30 years among FMS cases. A substantially higher probability of relapsing-remitting MS and secondary-progressive MS was found among FMS cases than sporadic MS (SMS) (P_value = 0.001). There was no significant difference in Expanded Disability Status Scale (EDSS) scores between FMS and SMS. The majority of FMS cases were observed among first-degree relatives, with the highest rate in siblings. There was a significant association between MS risk and positive familial history in both maternal and paternal aunt/uncle (P_value = 0.043 and P_value = 0.019, respectively). Multiple sclerosis occurrence among offspring of females was higher than males (P_value = 0.027). Conclusions In summary, our findings imply a noteworthy upward trend of FMS in Iran, even more than the global prevalence, which suggests a unique Atlas of FMS prevalence in this multi-ethnic population. Despite the highest rate of FMS within Persian and Lor ethnicities, no statistically significant difference was observed among the provinces

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

SummaryBackground Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatoryactions. We aimed to evaluate the safety and efficacy of azithromycin in patients admitted to hospital with COVID-19.Methods In this randomised, controlled, open-label, adaptive platform trial (Randomised Evaluation of COVID-19Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospitalwith COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients wererandomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once perday by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatmentgroups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment andwere twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants andlocal study staff were not masked to the allocated treatment, but all others involved in the trial were masked to theoutcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treatpopulation. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936.Findings Between April 7 and Nov 27, 2020, of 16 442 patients enrolled in the RECOVERY trial, 9433 (57%) wereeligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomlyallocated to receive azithromycin and 5181 patients were randomly allocated to usual care alone. Overall,561 (22%) patients allocated to azithromycin and 1162 (22%) patients allocated to usual care died within 28 days(rate ratio 0·97, 95% CI 0·87–1·07; p=0·50). No significant difference was seen in duration of hospital stay (median10 days [IQR 5 to >28] vs 11 days [5 to >28]) or the proportion of patients discharged from hospital alive within 28 days(rate ratio 1·04, 95% CI 0·98–1·10; p=0·19). Among those not on invasive mechanical ventilation at baseline, nosignificant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilationor death (risk ratio 0·95, 95% CI 0·87–1·03; p=0·24).Interpretation In patients admitted to hospital with COVID-19, azithromycin did not improve survival or otherprespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restrictedto patients in whom there is a clear antimicrobial indication

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

Background: Many patients with COVID-19 have been treated with plasma containing anti-SARS-CoV-2 antibodies. We aimed to evaluate the safety and efficacy of convalescent plasma therapy in patients admitted to hospital with COVID-19. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]) is assessing several possible treatments in patients hospitalised with COVID-19 in the UK. The trial is underway at 177 NHS hospitals from across the UK. Eligible and consenting patients were randomly assigned (1:1) to receive either usual care alone (usual care group) or usual care plus high-titre convalescent plasma (convalescent plasma group). The primary outcome was 28-day mortality, analysed on an intention-to-treat basis. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936. Findings: Between May 28, 2020, and Jan 15, 2021, 11558 (71%) of 16287 patients enrolled in RECOVERY were eligible to receive convalescent plasma and were assigned to either the convalescent plasma group or the usual care group. There was no significant difference in 28-day mortality between the two groups: 1399 (24%) of 5795 patients in the convalescent plasma group and 1408 (24%) of 5763 patients in the usual care group died within 28 days (rate ratio 1·00, 95% CI 0·93–1·07; p=0·95). The 28-day mortality rate ratio was similar in all prespecified subgroups of patients, including in those patients without detectable SARS-CoV-2 antibodies at randomisation. Allocation to convalescent plasma had no significant effect on the proportion of patients discharged from hospital within 28 days (3832 [66%] patients in the convalescent plasma group vs 3822 [66%] patients in the usual care group; rate ratio 0·99, 95% CI 0·94–1·03; p=0·57). Among those not on invasive mechanical ventilation at randomisation, there was no significant difference in the proportion of patients meeting the composite endpoint of progression to invasive mechanical ventilation or death (1568 [29%] of 5493 patients in the convalescent plasma group vs 1568 [29%] of 5448 patients in the usual care group; rate ratio 0·99, 95% CI 0·93–1·05; p=0·79). Interpretation: In patients hospitalised with COVID-19, high-titre convalescent plasma did not improve survival or other prespecified clinical outcomes. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research

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

Evaluating Prevalence of Postural Changes in Freestyle and Greco-Roman Wrestlers: A Review of Literature

Objective: Intense training and competition lead to fatigue and muscular imbalance in wrestlers that cause postural abnormalities. Thus, it is essential to identify these changes and the related mechanisms to prevent musculoskeletal and sports injuries among wrestlers. The present study is a comprehensive review of the literature on postural changes in freestyle and Greco-Roman wrestlers. Methods: This paper offers a thorough review of the literature on changes in freestyle and Greco-Roman wrestlers. It encompasses a series of search queries from inception to Mar 2020 from existing databases including PubMed/MEDLINE, EBSCO Web of Science, Science Direct, Cochrane Central Register of Controlled Clinical Trials, Google Scholar, and Scopus. A host of other publications were also reviewed manually. Once candidate papers were extracted, the title and abstract were studied, those meeting the inclusion criteria were selected for further analysis, and the others were discarded.  Results: A total number of 11 articles were selected. Overall, 4 articles studied postural changes in wrestlers, 2 studied Q angle and flat foot, and 5 compared the two wrestling styles. Conclusion: Results show that estimated changes in kyphosis, lordosis, forward shoulder, forward head, Q angle, and flat foot were more significant among wrestlers. However, the kyphosis angle was higher among freestyle wrestlers, while a higher lordosis angle was observed for Greco-Roman wrestlers. Moreover, a higher degree of flat foot and Q angle was observed in the dominant leg of experienced freestyle wrestlers. Results of forwarding shoulder and forward head were contradictory, and more studies need to be done

Human glutathione s-transferase enzyme gene variations and risk of multiple sclerosis in Iranian population cohort

Multiple sclerosis (MS) is an inflammatory disease with unknown etiology. Oxidative stress has been demonstrated to play a role in pathological and inflammatory mechanisms of MS. Cells activate antioxidant processes in response to oxidative stress. Glutathione is one of the antioxidant agents in the brain and serves as a cofactor for glutathione s-transferase (GST) enzymes for detoxifying nerve cells. Among different classes of GST, GSTM1 and GSTT1 are associated with the loss of function due to structural homozygous deletion. The aim of this study is to investigate GSTM1 and GSTT1 null genotypes in an Iranian population. In this study, 270 patients and 250 healthy controls were investigated. Patient's disabilities were assessed by Kurtzke Expanded Disability Status Scale (EDSS) and genotypes were determined by multiplex PCR. Association between genotype and MS, type of MS, gender, and inability level were surveyed. The findings demonstrated a highly significant association between the null genotypes and MS (OR = 6.89 for M1/T1). The combination of two genotypes increased the risk of MS by 6.8 times. The null genotypes were found to be more frequent in women than in men. Moreover, a significant association was observed between the null genotype and EDSS 6–10 (OR = 3.199). No significant association was noticed between MS type and the studied genotypes. According to this study, it can be proposed that people with GSTM1 and GSTT1 deletions are at a higher risk for developing MS, which can be due to a decrease in enzymatic activity and their levels in nerve cells and the brain