From Pulmonary Embolism to Inflammatory Bowel Disease; Give Tunnel Vision up

Inflammatory bowel disease (IBD) is a multisystem disorder with gastrointestinal tract involvement. These patients have the higher risk for thromboembolic events compared to normal population. This study describes a unique case of pulmonaryembolism as a first manifestation of inflammatory bowel disease

Diabetes mellitus type 1: is it a global challenge?

Type 1 diabetes, a serious and life-threatening disease with many complications, is one of the most common (autoimmune) endocrine and metabolic conditions in childhood, with life-saving treatment and lifelong, but painful and time-consuming in daily life, requiring self-action and a balanced diet, equally distributed among boys and girls

Comparison of two educational methods (slide presentation & using microscope monitoring) in teaching experimental histology

زمینه و هدف: در سال های اخیر استفاده از فناوری های جدید در آموزش بسیار مورد تاکید است. اما تاثیر تغییر روش های آموزشی بر روی فراگیری دانشجویان از دیر باز مورد سوال بوده است. این مطالعه با هدف بررسی تاثیر شیوه آموزشی قدیمی نمایش اسلاید های پروژکتوری و روش نوین استفاده از میکروسکوپ مونیتورینگ بر روی نمره آزمون نهایی درس بافت شناسی عملی دانشجویان رشته پزشکی انجام شده است. روش بررسی: در این مطالعه تجربی تعداد 36 نفر از دانشجویان رشته پزشکی که در کلاس بافت شناسی عملی ثبت نام کرده بودند بطور تصادفی به دو گروه تقسیم شدند. گروه اول با روش سنتی نمایش اسلاید و گروه دوم با استفاده از میکروسکوپ مونیتورینگ مورد آموزش قرار گرفتند. در پایان نیمسال تحصیلی دانشجویان هر دو گروه در آزمون عملی ایستگاهی و یکسان شرکت کردند. سپس نمرات دانشجویان هر دو گروه جمع آوری و با استفاده از آزمون t مستقل آنالیز و مقایسه شدند. یافته ها: میانگین نمره دانشجویان گروه میکروسکوپ مونیتورینگ 39/2±32/14 و نمره گروه نمایش اسلاید 18/2±18/13 بود (05/0P>). نتیجه گیری: داده های حاصل دلالت بر آن دارند که روش های آموزشی پیشرفته تر ممکن است تاثیر زیادی در نمره آزمون نهایی فراگیران نداشته باشد

Genotyping of Hepatitis B Virus in HBsAg Positive Individuals Referred to the Health Centers of Shahrekord, Iran

Background & aim: Hepatitis B Virus is one of the most important viral hepatitis which includes eight genotypes based on genetic variations in the gene encoding virus RNA polymerase. Clinical picture, treatment response and prognosis of HBV infection is genotype dependent. Therefore, this study was aimed to determine the HBV genotypes in HBsAg-positive individuals. . Methods: This experimental study was conducted on one hundred and sixteen HBsAgpositiveindividuals referred to the health centers of Shahrekord, Iran, in 2011. Firstly, the viral nucleic acid was extracted from serum samples and subsequently, the samples were subjected to Polymerase Chain Reaction (PCR). Finally, genotyping was carried out on the positive samples, using Real-time PCR with type specific primers and probes. The data were analyzed using the chisquare test. Results: 23 out of 116 (19.8%) of the HBsAg-positive individuals were positive for HBV DNA. 17 out of 23 (73.9%) and 6 out of 23 (26.1%) of the patients were found to be infected with HBV genotypes of D and C, respectively. Conclusion: Same as other regions of Iran, genotype D, , is the dominate genotype of HBV in Shahrekord, Iran. However, genotype C may be one of the other common genotypes in this region

Evaluating the Effect of Family-Centered Intervention Program on Care Burden and Self-Efficacy of Hemodialysis Patient Caregivers Based on Social Cognitive Theory: A Randomized Clinical Trial Study

Background Caregivers of hemodialysis patients spend a large amount of time providing care to these patients while tolerating fatigue and stress. This study evaluated a family-centered empowerment program on the care burden and self-efficacy of hemodialysis patient caregivers based on social cognitive theory. Methods In this randomized clinical trial, 70 family caregivers of hemodialysis patients in Isfahan, Iran, were selected and randomly allocated to intervention and control groups, in 2015–2016. Two questionnaires were used to collect the family caregivers’ characteristics, care burden, and self-efficacy, and patients’ negative and positive outcomes expectancies. Data were analyzed using SPSS before, immediately after, and 2 months after the intervention. Results There was no significant difference in the mean scores of care burden, positive outcomes expectancies, negative outcomes expectancies, and self-efficacy between the two groups before the intervention. However, there were significant differences in the post-test and follow-up data analyses (P<0.05). Conclusion Given the degenerative nature of chronic kidney disease, it can be considered as a source of long-term and chronic stress for caregivers. Therefore, by implementing an empowerment program, caregiving behaviors can be improved, positive outcomes expectancies can be increased, and negative outcomes expectancies can be reduced. Keywords: Family-Centered Nursing; Illness Burdens; Family Caregivers; Hemodialysis Patien

Factors influencing quality of life in patients with myocardial infraction

Background & Aim: Myocardial infarction is a common and dangerous life threatening disease with an impact on quality of life. The present descriptive-analytical study aims to determine quality of life in patients with myocardial infarction referring to Hadjar hospital affiliated to the Shahre-kord University of Medical Sciences. Material & Method: This was a descriptive-analytical study in which 150 patients admitted to cardiac care unit of Hadja hospital within 8 weeks post infarction were selected by non random sampling method. Data were collected through interview, patients’ medical records and patients self report. The tool for collecting data regarding quality of life was SF36 questionnaire. Data were analyzed by descriptive and inferential statistics. Results: Findings showed that the mean value of age was 55.7 ±10.5 and that quality of life in majority of subjects (%53) was fairly favorable. Regarding aspects of quality of life, most patients had fairly favorable general status (physical and psychological health) (%62) and social function (%65). Also, sleep pattern of majority of subjects (%61) was favorable and most of them (62%) had unfavorable physical activity. There was statistically significant correlation between quality of life and variables such as duration of disease (P<0.05), intensity of pain (P<0.05), decline or loss of job function, and the degree of fatigue (P<0.05), but there was no statistically significant relationship between quality of life and other demographics as age, gender, marital status, economic status and occupational status. Conclusion: Because fatigue and pain have some relationship with quality of life in patient with myocardial infarction, health care personnel, spatially nurses should pay attention to dimensions of quality of life when planning care for these patients. Failure to do so may leads to quality of life of patients to be neglected

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

Reversible left bundle branch block should be mentioned in cardiac resynchronization therapy; A clinical case report

BACKGROUND: Cardiac resynchronization therapy (CRT) is a medical device to help cardiac synchronized contractility by electrical impulses. Improvement of symptoms and left ventricular systolic function, reducing hospital admissions and mortality in patients with moderate to severe heart failure are the main benefits of administration of cardiac resynchronization therapy. CASE REPORT: In this article, we describe a case of heart failure and left bundle branch block (LBBB) who was candidate for cardiac resynchronization therapy; but after managing hyperkalemia, left bundle branch block resolved, ejection fraction increased and cardiac resynchronization therapy implantation was canceled. CONCLUSION: Exclusion of treatable causes is the first important step before any interventions. Now there is an important question; is cardiac resynchronization therapy effective in patients with heart failure and transient or intermittent left bundle branch block?&nbsp;</p

The study of soil chitinolytic bacterial strains and their use against fungal pathogen Alternaria alternata in vitro

Introduction: In sustainable agriculture, biological control is an important alternative to control various plant diseases, in particular, pathogenic fungus that causes the most economic damage to agricultural products in the world. Each soil species bacterium has unique specified features and abilities. Alternaria sp has specific herbal poisons that lead to diseases in them. Biological control of fungal diseases in agricultural products across the world has been done in recent years using fungi and soil antagonist bacteria. Some bacterial isolates that produce chitinase enzymes fight with fungal pathogens. Materials and Methods: To achieve an antagonist chitinolytic bacteria against Alternaria alternata fungal, screening soil species bacterium that produce chitinase of some urban and agriculture soil samples of Qazvin were carried out. Results: In this study, five different strain of chitinolytic bacteria were found, two strains of Pseudomonas nitroreducens in vitro and one strain (AHH4), they had the ability to destroying fungal pathogen Alternaria sp in the farm. as the presence of high concentrations (0/05 OD600 and above) of the bacteria, A. alternata fungus growth stopped completely. Discussion and conclusion: However, one of them, P. nitroreducens (AHH4) could control the fungusat in vitro and invivo and inhibit the growth of fungus. So P. nitroreducens (AHH4) chitinolytic bacteria has efficiently effect on inhibit A. alternata fungal growth. As the presence of high concentrations (0/05 OD600 and above) of the bacteria A. alternata fungus growth stopped completely. The isolate AHH4 was submitted to NCBI/DDBJ/EMBL as KR905055 accession number