Quality of care of peptic ulcer disease worldwide: A systematic analysis for the global burden of disease study 1990-2019.

BACKGROUND: Peptic ulcer disease (PUD) affects four million people worldwide annually and has an estimated lifetime prevalence of 5-10% in the general population. Worldwide, there are significant heterogeneities in coping approaches of healthcare systems with PUD in prevention, diagnosis, treatment, and follow-up. Quantifying and benchmarking health systems' performance is crucial yet challenging to provide a clearer picture of the potential global inequities in the quality of care. OBJECTIVE: The objective of this study was to compare the health-system quality-of-care and inequities for PUD among age groups and sexes worldwide. METHODS: Data were derived from the Global Burden of Disease Study 1990-2019. Principal-Component-Analysis was used to combine age-standardized mortality-to-incidence-ratio, disability-adjusted-life-years-to-prevalence-ratio, prevalence-to-incidence-ratio, and years-of-life-lost-to-years-lived-with-disability-into a single proxy named Quality-of-Care-Index (QCI). QCI was used to compare the quality of care among countries. QCI's validity was investigated via correlation with the cause-specific Healthcare-Access-and-Quality-index, which was acceptable. Inequities were presented among age groups and sexes. Gender Disparity Ratio was obtained by dividing the score of women by that of men. RESULTS: Global QCI was 72.6 in 1990, which increased by 14.6% to 83.2 in 2019. High-income-Asia-pacific had the highest QCI, while Central Latin America had the lowest. QCI of high-SDI countries was 82.9 in 1990, which increased to 92.9 in 2019. The QCI of low-SDI countries was 65.0 in 1990, which increased to 76.9 in 2019. There was heterogeneity among the QCI-level of countries with the same SDI level. QCI typically decreased as people aged; however, this gap was more significant among low-SDI countries. The global Gender Disparity Ratio was close to one and ranged from 0.97 to 1.03 in 100 of 204 countries. CONCLUSION: QCI of PUD improved dramatically during 1990-2019 worldwide. There are still significant heterogeneities among countries on different and similar SDI levels.

Anti-Inflammatory and Immunomodulatory Effects of Barberry (Berberis vulgaris) and Its Main Compounds.

Berberis vulgaris is a well-known herb in Iran that is widely used as a medicinal plant and a food additive. The aim of this study was to investigate the anti-inflammatory and immunomodulatory effects of Barberry and its main compounds. This narrative review was conducted by searching keywords such as B. vulgaris, Barberry, immunomodulatory, anti-inflammatory, medicinal herbs, plants, and extract, separately or combined in various databases, such as Web of Sciences, PubMed, and Scopus. According to the inclusion and exclusion criteria, just English language articles, which reported effective whole plants or herbal compounds, were included. 21 articles were reviewed in this study. In the in vivo models (mice, rats, and human cells) and in the in vitro models (some organ cells such as the spleen, kidney, blood, and brain), B. vulgaris and its main components showed anti-inflammatory effects in both models. The main mechanisms were the shift of cell immune response to Th2, T reg induction, inhibition of inflammatory cytokines (IL-1, TNF, and IFN-γ), and stimulation of IL-4 and IL-10. The induction of apoptosis in APCs and other effector cells was another important mechanism.

Epidemiologic study of type 2 diabetes mellitus and metabolic syndrome in rural population of kurdistan province, Iran, in 2011-2017.

BACKGROUND: Metabolic syndrome is a serious health problem and is associated with an increased risk of type 2 diabetes and cardiovascular disease. The aim of this study was to determine the status of these two diseases in the rural population of Kurdistan province, west of Iran. METHODS: In this cross sectional study, 10,496 villagers of Kurdistan province during the period from March 2011 to February 2017 were selected through randomized systematic sampling. Required information was collected using pre-made check list and the examinations were performed. The data were analyzed with SPSS v22 software using chi-square test. RESULTS: In the present study, the mean age of the population was 46.0 ±â€¯14.13 y/o and 49.2% people were male and 50.8% were female. The prevalence of metabolic syndrome was 22.1% and for type 2 diabetes the prevalence was 19.6%. Hypertension was significantly higher in women (p < 0.001). There was a significant difference between the two sexes in terms of waist circumference, type 2 diabetes and metabolic syndrome. There was a significant difference between age groups with hypertension, waist circumference, type 2 diabetes and metabolic syndrome (p < 0.001) and a significant relationship between educational status with hypertention, waist circumference, type 2 diabetes and metabolic syndrome (p < 0.001). The results also showed that the relationships between age group and gender with BMI was significant (P < 0.001). CONCLUSION: The prevalence of diabetes in the rural population of Kordestan province is moderate but it has a high prevalence in metabolic syndrome. Educational and healthcare interventions seem to be necessary to reduce these prevalences, especially among women and in older ages.

Measurement of the serum levels of serum troponins I and T, albumin and C-Reactive protein in chronic hemodialysis patients and their relationship with left ventricular hypertrophy and heart failure.

BACKGROUND: Hemodialysis patients are at high risk for cardiovascular diseases. The prognostic value of cardiac troponins, albumin and CRP in hemodialysis patients and their association with cardiac diseases has been proven. The aim of this study was to investigate the relationship between these factors and heart failure and left ventricular hypertrophy in hemodialysis patients in Sanandaj city. METHODS: A total of 90 hemodialysis patients referred to hemodialysis ward of Tohid Medical Center of Sanandaj were enrolled in the study. After receiving the required information from patients and recording them in questionnaire, blood samples were taken from them and were sen to Lab for Measurement. Finally, the data were analyzed using SPSS software and Spearman correlation coefficient for independent variables and Chi square test and correlation coefficient of Choprovert's for independent qualitative variable. RESULTS: In the case of LVH, 23.3% of patients were with normal thickness, 38.9% had mild LVH, 30% had moderate LVH and 7.8% had severe LVH. The mean serum albumin level in patients was 3.8 g/dl, CRP 9.4 mg/dL, and troponins I and T were 0.4 and 685.06 ng/dL, respectively. There was a statistically significant relationship between cardiac I and T troponins levels and CRP levels in patients with chronic hemodialysis (P < 0.05. There was a significant relationship between serum albumin level, troponins I, T and CRP with left ventricular hypertrophy in chronic hemodialysis patients (P < 0.05). CONCLUSION: Serum levels of I and T troponins, albumin, as well as CRP, are related to heart failure and left ventricular hypertrophy in hemodialysis patients, and this can be used by physicians to determine the patient's ability and risk of disease Cardiovascular diseases.

Cardiovascular events in patients with over 10 years history of type 2 diabetes mellitus.

BACKGROUND: Diabetes is one of the concerns of today's public health and patients with type 2 diabetes are at increased risk of death due to cardiovascular diseases. The aim of this study was to evaluate the prevalence of cardiovascular diseases in patients with over 10 years history of type 2 diabetes mellitus referred to the Sanandaj Diabetes Clinic. METHODS: In this study, 400 patients with type 2 diabetes who had over 10 years history of diabetes were selected and the required information was prepared based on taking their history and files. Finally data were analyzed using T-test, Chi-square and Fisher test methods. RESULTS: In this the mean duration of diabetes was 14.59 ±â€¯4.07 years. 95.25% of patients had dyslipidemia. The frequency of history of cardiovascular events was 78.25%. 12.25% of patients had a history of ischemic heart disease and 82.75% had a history of high blood pressure. There was a significant relationship between the incidence of cardiovascular events with hypertension, HDL level and family history of early cardiovascular disease (p < 0.05). CONCLUSION: The high risk of cardiovascular events in diabetic patients it strongly emphasizes the need for quick and serious approaches to prevent cardiovascular events in diabetic patients.

Evaluation of serum levels in T3, T4 and TSH in beta-thalassemic patients referred to the Abuzar hospital in Ahwaz.

INTRODUCTION: Regarding the functioning of the endocrine system, and especially in the thyroid of patients with thalassemia, multiple studies in different parts of the world have reported conflicting results. The aim of this study was to assess the levels of thyroid hormones and TSH in beta-thalassemic patients in the city of Ahwaz. METHODS: In this matched case-control study, 105 patients in the case group and 105 subjects as controls were randomly selected from clients referred to the Abuzar hospital in 2015-2016. Serum levels of T3, T4, and TSH hormones were measured using ELISA. Data was processed with the SPSS15 software and tested by using independent t-tests and logistic regression. RESULTS: The study results showed that the serum level of T3 hormone did not significantly differ between the two groups (p> 0.05). Whereas the serum level of T4 was lower in the case group, compared to the controls, which was statistically significant (p <0.05). The serum level of thyroid stimulating hormone (TSH) in the case group was higher than the control group, and this difference was statistically significant (p <0.05). Logistic regression analysis showed significant differences in serum levels of T4 (OR: 0.58) and TSH (OR: 1.57) between the case and control groups (p<0.05). CONCLUSION: Hypothyroidism is clear in patients with beta thalassemia. With regard to the possible effect of iron on the disorder, a blood transfusion schedule should be performed at intervals, and the desferal injection program should be done regularly to prevent hemochromatosis in patients with thalassemia major due to the effect of accumulation of iron on thyroid function and detection of hypothyroidism. This course of action will prevent incidence of this complication in patients with thalassemia major.