Some of these steroid sparing drugs can take several months to demonstrate an effect.To minimize side effects, patients on corticosteroids should follow a strict high-protein, low-carbohydrate, low-salt diet; and with long-term corticosteroid use a daily calcium supplement and weekly vitamin D supplement (and a weekly dose of Fosamax for postmenopausal women) should be considered.For patients not responding to this approach there is weak evidence supporting the use of intravenous immunoglobulin, ciclosporin, tacrolimus, mycophenolate mofetil and other agents; and trials of rituximab have indicated a potential therapeutic effect. Inclusion-body myositis
Despite its very similar clinical presentation to PM, IBM does not respond to the drugs that effectively treat PM, and there is no proven effective therapy for IBM. Alemtuzumab is being studied but as of May 2013 it had not demonstrated clinical effectiveness in IBM. Dysphagia (difficulty swallowing) may be improved by intravenous immunoglobulin, though more trials are needed. Non-fatiguing, systematic strength-building exercise has demonstrated benefit. Occupational and rehabilitation therapists can offer good advice on walking without falling and performing fine motor tasks, and can provide appropriate canes, braces and wheelchairs. Speech pathologists can provide advice on preventing choking episodes and reducing the anxiety of an immanent aspiration for both patients and carers. Epidemiology
Every year between 2.18 and 7.7 people per million receive a diagnosis of PM or DM. Around 3.2 children per million per year are diagnosed with DM (termed juvenile dermatomyositis), with an average age of onset of seven years. Diagnosis of adult DM commonly occurs between 30 and 50 years of age.
Growing seedlings: For this technique pre-germinated seeds are sown between mid-/end-February and beginning of April and grown in nurseries. Seedlings are grown in tuffs with 3–5 plants/tuff and a seed density of 1.2–1.6 kg/1000 tuffs. A fastened germination is achieved by alternating high temperature during daytime (30 °C for 8 h) and lower temperature during nighttime (20 °C for 16 h). Before transplanting, the seedlings should be fertilized and acclimated to cold temperatures. Transplantation should start around Mid-April with row spacing of 42–50 cm (17–20 in) and plant spacing within rows of 25–30 cm. Vegetative propagation: Stolons (with several buds) of 10 cm should be planted from mid-April in a depth of 5–7 cm (2–2+3⁄4 in). Head cuttings are grown in nurseries starting between mid-May and mid-June. Growing tips with two leaf pairs are cut from the mother plant and treated with root-growth inducing hormones. Transplantation can be delayed in comparison to the growing seedling technique. Greenhouse
The stinging nettle can also be grown in controlled-environment agriculture systems, such as soil-less medium cultivations or aeroponics, which may achieve higher yields, standardize quality, and reduce harvesting costs and contamination. Sting and treatment
Urtica dioica produces its inflammatory effect on skin (stinging, burning sensation often called "contact urticaria") both by impaling the skin via spicules – causing mechanical irritation – and by biochemical irritants, such as histamine, serotonin, and acetylcholine, among other chemicals. Anti-itch drugs, usually in the form of creams containing antihistamines or hydrocortisone, may provide relief from nettle dermatitis.