chronic diseases

Metabolic syndrome is characterized by a cluster of metabolic abnormalities, including insulin resistance, hypertension, dyslipidemia, and abdominal obesity, which significantly increase the risk of cardiovascular disease and type 2 diabetes. Emerging evidence suggests that metabolic syndrome may play a critical role in the cancer progressionand contribute to higher mortality rates. Emerging researches highlight the essential role of the gut microbiota in maintaining health, with dysbiosis being linked to various chronic diseases. This review focused on the potential therapeutic roles of prebiotics, probiotics, and synbiotics in the management and prevention of metabolic syndrome and its associated conditions. Prebiotics support the growth of beneficial gut bacteria, while probiotics are live microorganisms that confer health benefits. Synbiotics, combinations of prebiotics and probiotics, have demonstrated promise in improving gut health and managing metabolic disorders. The article synthesizes clinical and preclinical evidences regarding the effects of these supplements on obesity, diabetes, cancer, inflammatory bowel disease, cardiovascular diseases, and diarrhea. It reviews the efficacy of specific prebiotics (such as inulin and fructooligosaccharides), probiotics (like Lactobacillus and Bifidobacterium), and synbiotics, highlighting their mechanisms of action and clinical outcomes. Additionally, the review emphasized the need for more rigorous clinical trials to establish the safety, efficacy, and optimal use of these supplements in the management of metabolic and chronic diseases.In conclusion, prebiotics, probiotics, and synbiotics hold significant potential for improving metabolic health and managing chronic diseases. Future researches should prioritize well-designed clinical trials to fully explore their therapeutic potential and refine treatment strategies.

 The high prevalence of chronic diseases such as diabetes mellitus, hypertension, and dyslipidemia is a concern for pharmacists. Pharmacists are expected to participate in these efforts by implementing Home Medication Review (HMR). HMR is a community-based collaborative service outside of health facilities that involves physicians and pharmacists to improve the effectiveness of therapy. This study aimed to determine the incidence of drug-related problems (DRPs), the level of patient satisfaction, and the effect of improving the quality of life of patients with chronic diseases who received Home Medication Review services at the Banjarbaru Utara Primary Health Care.    

 This study used a quasi-experimental method with a single group pre-test and post-test design. Data were obtained prospectively, from January to May 2024. DRPs were measured by the Pharmaceutical Care Network Europe (PCNE) form. Patient satisfaction was measured using the five-dimensional service quality questionnaire. Quality of life was measured using the EQ-5D-5L questionnaire with the EQ-5D-5L Index and EQ Visual Analog Scale (VAS) parameters.  

 The study showed that DRPs in patients with chronic diseases before undergoing HMR were 92.50%. Patient satisfaction with HMR services reached 91.33%. Quality of life in chronic disease patients increased, based on the EQ-5D-5L Index, from 0.802 + 0.199 before to 0.854 + 0.189 after HMR (p-value 0.002), and based on the EQ VAS from 72.25 + 12.80 before to 78.12 + 14.19 after HMR (p-value 0.001).     

 This study concludes that HMR services can identify DRPs, and improve satisfaction, knowledge, and quality of life of patients with chronic disease.

 Sleep quality is affected by a plethora of different factors, although its relationship with chronic diseases is still unclear. This study explored perceived sleep quality and its associated determinants among the adult population of Malta.

Study Design:

 A cross-sectional study.

 An anonymous online survey was distributed through social media targeting adults residing in Malta. Data pertaining to socio-demographic, medical history, lifestyle, well-being, sleep, and daytime sleepiness were gathered, and descriptive, univariant, and multiple binary logistic regression modelling analyses were performed.

 A total of 855 adults responded, out of whom 35.09% (95% confidence interval [CI]: 31.90, 38.41) reported sleep difficulties, especially females (81.33%; 95% CI: 76.36, 85.49), while 65.33% (95% CI: 59.61, 70.65) reported suffering from chronic disease(s). Sleep problems were positively associated with multimorbidity (odds ratio [OR]: 2.17; 95% CI: 1.38, 3.40; P=0.001), sleeping<6 hours (OR: 3.79; 95% CI: 1.54, 9.30; P=0.040), and the presence of moderate anxiety symptoms (OR: 1.99; 95% CI: 1.10, 3.59; P=0.020). They were also related to the presence of mild (OR: 2.25; 95% CI: 1.46, 3.45; P=0.001), moderate (OR: 2.40; 95% CI: 1.24, 4.64; P=0.010), and moderately severe (OR: 15.35; 95% CI: 4.54, 31.86; P=0.001) depressive symptoms after adjusting for confounders.

 Chronic conditions, including anxiety and depression, along with short sleep duration, appear to contribute to poor sleep quality in Malta. A multifaceted approach is required to deal with the issue holistically and safeguard the health of current and future generations.

We aimed to study the rate and trends of the incidence of chronic cardiovascular diseases in urban and rural areas of the northern regions of the Republic of Kazakhstan (RK) from 2015 to 2020.

The retrospective data were analyzed using modern methods of biomedical statistics. We used the Electronic Register of Dispensary Patients (2015-2020), where we conducted a retrospective study and trend calculations. The study included patients with chronic cardiovascular diseases (CVD) (according to the International Classifier of Diseases-10, the following nosologies were identified: I25 chronic coronary heart disease and its nosological forms (I25.0-I25.9), and patients by age categories, consisting of dispensary registration in polyclinics of the northern region of the RK.

For 2015 - 2020 in the northern region (urban and rural) of RK, 12,315 patients were registered, who were on dispensary records for the chronic CVD. This amounted to 87.3% of urban residents, and 12.7% of rural residents. The share of patients with chronic CVD in the northern region of the republic by age groups had a bimodal growth pattern with the first peak at the age of 60-74 (40.4%) and the second - at the age of 45-59 (37.7%).

This study notes an increase in chronic CVD, both in urban and rural areas of the northern region of the RK. This once again proves the need for the development, implementation and use of modern tools in the provision of medical services to cardiological patients at the outpatient level, taking into account the characteristics of the northern regions of our country.

Today, chronic diseases have spread all over the world. The World Health Organization (WHO) mentions air pollution as the biggest environmental health hazard, attributing 7 million premature deaths every year to this pollution, which includes suspended particles and gases with concentrations that are detrimental to human health. Factors of interest in this field are micrometer diameter particles, tropospheric ozone, sulfur dioxide, nitrogen dioxide, and carbon monoxide. The purpose of this research is to increase public awareness of air pollution and its side effects on different parts of the digestive system.

A narrative review was done using several databases, including PubMed, Magiran, Web of Science, and Google Scholar. Relevant studies published from 1990-2021 were identified.

Globally, ecological studies have demonstrated a relationship between short-term exposure to air pollution and several gastrointestinal diseases.

The results of these studies showed that pollutants have a direct effect on the increased prevalence and number of cases of chronic gastrointestinal diseases. The results of this research can inform policymakers in making comprehensive decisions to solve the problem, individuals who are exposed to pollutants, and the public in raising awareness and promoting the use of protective equipment.

In the current scoping review, nutrition transition and its consequences in Iran have been reviewed, and relevant health improvement policies have been described.

This was an analytical study which concerned demographic, economic and socio-political context, nutrition, dietary patterns and related metabolic syndrome, or their consequences among Iranian population in recent decades.

In the last decades, socio-economic problems increased food insecurity, and unhealthy diet has been common. The prevalence of obesity was higher in urban areas compared with rural areas. There was also a high prevalence of nutritional risk factors; food choices tended to be less healthy; high-fat food choices has been increased, and there was lower physical activity. The prevalence of non-communicable diseases and metabolic syndrome including hypertension and type 2 diabetes mellitus are progressively elevated.

Urgent preventive strategies and policies by the government and healthcare community are essential. These strategies are necessary for promoting national health, increasing life expectancy, and decreasing metabolic syndrome, diet-related and lethal diseases including cardiovascular diseases, and diabetes.

The epidemiological transition and the increase of chronic diseases resulted in the rise of endocrine, nutritional and metabolic (ENM) diseases as causes of death. This study aimed to explore the death rate caused by ENM in Iran 2006-18.

Secondary data analysis was done. The demographic data on death were extracted (age, sex and cause of death) at the provincial level from the death records registered by civil registration. The conditions and trends of ENM death were analyzed from 2006 to 2018. The differences were analyzed in terms of age, sex, place of residence, and over time through indicators of death rate, sex ratio, and years of life lost (YLL).

Out of 1708 pregnant women, 244 (14.3%) had GDM, and 1464 (85.7%) did not. There was a statistically significant difference between these two groups in terms of age (P: <0.001), weight (P: <0.001), number of pregnancies (P: <0.001), delivery (P: <0.001), previous diseases (P: <0.001), and Rh (P: 0.01). While in terms of the ABO blood group system (P= 0.3) and abortion rate (P= 0.067), no statistically significant difference was observed.

6,906 people were died in Iran between 2006- 2018 due to ENM diseases.  The death rate from this disease increased from 3.5 per 100,000 people in 2006 to 8.4 in 2018. More women died, especially in old age, with the peak of death being at the age of 50 and older. ENM death resulted in the loss of 67,041 years of life.

Health-related quality of life (HRQOL) is an important clinical outcome in patients with chronic Heart failure (CHF). The aim of this study was to evaluate HRQOL in patients with CHF and determine its relationship with demographic and clinical variables.

In this cross-sectional descriptivecorrelational study, 200 patients with CHF were selected from clients referring to teaching hospitals affiliated to Tehran University of Medical Sciences. They were interviewed to complete demographic and clinical questionnaires and the Kansas City Cardiomyopathy Questionnaire (KCCQ).  Some clinical variables were extracted from their medical records. KCCQ was used to measure their HRQOL. Descriptive statistics, independent t-test and ANOVA were used for data analysis.

Self–efficacy domain had the highest score (mean=61, SD=18.31) and physical symptoms had the lowest (mean=42.92, SD=13.45) in HRQOL. There was a significant relationship between HRQOL and 4 demographic variables: sex, educational level, economic condition, as well as occupational status and also between HRQOL and clinical variables including: duration of illness, number of hospitalizations, non-cardiac diseases, ejection fraction, diuretic consumption and body mass index there was a statistically significant relationship.

Patients with CHF had low HRQOL. Nurses and healthcare providers should plan care and programs to reduce frequency, severity and symptoms of heart failure and help improve HRQOL in these patients.

Chronic diseases are the most common non-communicable diseases worldwide. Today, with the increase in the elderly population, the burden of the disease is gradually increasing, and alternative treatment methods for these diseases are gaining importance. Potential adverse reactions, contraindications, and interactions with prescription drugs and herbals are important to evaluate. Therefore, the use of plants by chronic patients should be under supervision of health professionals. In this study, we aimed to obtain comprehensive data by questioning the plants used by patients using drugs for chronic disease, their usage patterns, and changes seen as a result of plant use. For this purpose, 60 people over the age of 18 (47% female, 53% male) participated in the survey study, and 53.3% of the patients stated that they used plants in the treatment. Twenty-one plants have been identified. Linden and mint-lemon mixture are the most commonly used plants, accounting for 62% and 15% of the total, respectively. The most commonly used preparation method is decoction (60%). 62.5% of the users obtain the plants from herbalists' stores; 59.37% of the patients learned the use of plants through advice (friend, neighbor, relative); 96.87% of the patients stated that they benefited from the use of plants. According to these results, the patients need to be informed about the use of plants as a complementary treatment. Thus, further efforts should be made to raise awareness of the use of herbal medicine and possibility of herb-drug interactions among physicians and other health professionals.

The COVID-19 pandemic has impacted negatively our society and resulted in numerous deaths. It has had an effect on every facet of health care delivery. Rules, regulations, and payment policies were changed to allow extensive use of telecommunications technology in lieu of inperson clinical visits to protect health care personnel and patients throughout the country from the risk of disease transmission. Telerehabilitation (TR) is equally effective in delivering specific health, medical, and rehabilitation expertise from worldclass medical centers to homes and small clinics throughout metropolitan regions.Maintaining social distance and self-isolation during the worldwide coronavirus epidemic requires online courses, films with exercise instructions, or individual online consultations.

Home care service is considered as comprehensive care for children with chronic disease or COVID‑19. This study aimed to investigate the factors affecting the implementation of a home care nursing program for such children in 2019–2020.

A descriptive‑analytical study was conducted with 198 nurses working in pediatric wards of selective hospitals of Isfahan University of Medical Sciences. The data were collected through an author‑administered questionnaire with 44 questions. The questionnaire was designed in two parts. Part one involved gathering the demographic data of the participants. Facilitating and barrier factors of the implementation of the care were prioritized and examined in part two by using the Likert scale in both the individual and the organizational domains. The data were analyzed using the mean frequency and paired t test.

The mean (SD) score of individual and organizational facilitating factors were 65.65 (16.24) and 65.98 (11.29), respectively, and the mean (SD) score of the organizational barriers was 82.04 (14.36), which was significantly higher than the mean score (SD) of the individual barriers of 57.94 (14.82) (t197 = 21.32, p < 0.05). The most important individual facilitating factor (53.82%) was “respectful communication with the family,” and the most important organizational facilitator (80.40%) was “Physicians’ support of the nurses.”

Organizational factors were the most significant barriers. Therefore, the findings of this study will help policymakers in the program implementation.

Nephrotic syndrome (NS), like any other chronic illness, may affect the health-related quality of life (HRQoL) of children, so do the complications related to the disease, and its treatment. A better understanding of the (HRQoL) of people with nephrotic syndrome may help to better guide their treatment.

Sixty children with nephrotic syndrome were assigned as the first case group, besides 81 healthy children as the first control group and 98 children with other chronic illnesses as the second control cohort. The participant and his or her caregiver were asked to fill in the standard HRQoL questionnaire. The patient’s demographic data were also collected and analyzed using SPSS version 26 software.

60 patients with nephrotic syndrome (mean age 9.8±3.7) scored lower grades in physical, social, educational fields as well as total scores than the healthy controls (mean age 9.5 ± 2.7) and higher than the controls with other chronic diseases (mean age 9.7±3.9) (P < 0.05). The emotional QOL score was close to that of the non-healthy control group. No correlation was found between the clinical phenotype of disease regarding the response to steroids and HRQOL (P > 0.05).

The study shows that nephrotic syndrome can affect all aspects of the quality of life of patients. We suggest that comprehensive care of patients with NS be routinely managed in a multidisciplinary clinic with filling HRQOL questionnaires integrated as a common practice.