Prevalence of stress, anxiety, depression among the general population during the COVID-19 pandemic: a systematic review and meta-analysis

BACKGROUND

The COVID-19 pandemic has had a significant impact on public mental health. Therefore, monitoring and oversight of the population mental health during crises such as a panedmic is an immediate priority. The aim of this study is to analyze the existing research works and findings in relation to the prevalence of stress, anxiety and depression in the general population during the COVID-19 pandemic.

METHOD

In this systematic review and meta-analysis, articles that have focused on stress and anxiety prevalence among the general population during the COVID-19 pandemic were searched in the Science Direct, Embase, Scopus, PubMed, Web of Science (ISI) and Google Scholar databases, without a lower time limit and until May 2020. In order to perform a meta-analysis of the collected studies, the random effects model was used, and the heterogeneity of studies was investigated using the I2 index. Moreover. data analysis was conducted using the Comprehensive Meta-Analysis (CMA) software.

RESULTS

The prevalence of stress in 5 studies with a total sample size of 9074 is obtained as 29.6% (95% confidence limit: 24.3-35.4), the prevalence of anxiety in 17 studies with a sample size of 63,439 as 31.9% (95% confidence interval: 27.5-36.7), and the prevalence of depression in 14 studies with a sample size of 44,531 people as 33.7% (95% confidence interval: 27.5-40.6).

CONCLUSION

COVID-19 not only causes physical health concerns but also results in a number of psychological disorders. The spread of the new coronavirus can impact the mental health of people in different communities. Thus, it is essential to preserve the mental health of individuals and to develop psychological interventions that can improve the mental health of vulnerable groups during the COVID-19 pandemic.

Dental caries in primary and permanent teeth in children's worldwide, 1995 to 2019: a systematic review and meta-analysis

Background

Early childhood caries (ECC) is a type of dental caries in the teeth of infants and children that is represented as one of the most prevalent dental problems in this period. Various studies have reported different types of prevalence of dental caries in primary and permanent teeth in children worldwide. However, there has been no comprehensive study to summarize the results of these studies in general, so this study aimed to determine the prevalence of dental caries in primary and permanent teeth in children in different continents of the world during a systematic review and meta-analysis.

Methods

In this review study, articles were extracted by searching in the national and international databases of SID, MagIran, IranMedex, IranDoc, Cochrane, Embase, ScienceDirect, Scopus, PubMed, and Web of Science (ISI) between 1995 and December 2019. Random effects model was used for analysis and heterogeneity of studies was evaluated by using the I² index. Data were analyzed by using the Comprehensive Meta-Analysis (Version 2) software.

Findings

In this study, a total of 164 articles (81 articles on the prevalence of dental caries in primary teeth and 83 articles on the prevalence of dental caries in permanent teeth) were entered the meta-analysis. The prevalence of dental caries in primary teeth in children in the world with a sample size of 80,405 was 46.2% (95% CI: 41.6–50.8%), and the prevalence of dental caries in permanent teeth in children in the world with a sample size of 1,454,871 was 53.8% (95% CI: 50–57.5%). Regarding the heterogeneity on the basis of meta-regression analysis, there was a significant difference in the prevalence of dental caries in primary and permanent teeth in children in different continents of the world. With increasing the sample size and the year of study, dental caries in primary teeth increased and in permanent teeth decreased.

Conclusion

The results of this study showed that the prevalence of primary and permanent dental caries in children in the world was found to be high. Therefore, appropriate strategies should be implemented to improve the aforementioned situation and to troubleshoot and monitor at all levels by providing feedback to hospitals.

The impact of physical exercise on the fatigue symptoms in patients with multiple sclerosis: a systematic review and meta-analysis

BACKGROUND

Despite many benefits of the physical activity on physical and mental health of patients with Multiple Sclerosis (MS), the activity level in these patients is still very limited, and they continue to suffer from impairment in functioning ability. The main aim of this study is thus to closely examine exercise's effect on fatigue of patients with MS worldwide, with particular interest on Iran based on a comprehensive systematic review and meta-analysis.

METHODS

The studies used in this systematic review were selected from the articles published from 1996 to 2019, in national and international databases including SID, Magiran, Iranmedex, Irandoc, Google Scholar, Cochrane, Embase, ScienceDirect, Scopus, PubMed and Web of Science (ISI). These databases were thoroughly searched, and the relevant ones were selected based on some plausible keywords to the aim of this study. Heterogeneity index between studies was determined using Cochran's test and I2. Due to heterogeneity in studies, the random effects model was used to estimate standardized mean difference.

RESULTS

From the systematic review, a meta-analysis was performed on 31 articles which were fulfilled the inclusion criteria. The sample including of 714 subjects was selected from the intervention group, and almost the same sample size of 720 individuals were selected in the control group. Based on the results derived from this meta-analysis, the standardized mean difference between the intervention group before and after the intervention was respectively estimated to be 23.8 ± 6.2 and 16.9 ± 3.2, which indicates that the physical exercise reduces fatigue in patients with MS.

CONCLUSION

The results of this study extracted from a detailed meta-analysis reveal and confirm that physical exercise significantly reduces fatigue in patients with MS. As a results, a regular exercise program is strongly recommended to be part of a rehabilitation program for these patients.

Prevalence and factors related to urinary incontinence in older adults women worldwide: a comprehensive systematic review and meta-analysis of observational studies

BACKGROUND

Urinary incontinence is a common condition in the general population and, in particular, the older adults population, which reduces the quality of life of these people, so this study aims to systematically examine and meta-analyse the overall prevalence of urinary incontinence in older women around the world and the related and influential factors.

METHODS

This report is a comprehensive systematic review and meta-analysis of the findings of research on urinary incontinence in older adults people across the world through looking for MEDLINE, Cochrane Library Sciencedirect, Embase, Scopus, ProQuest and Persian databases, namely iranmedex, magiran, and SID from January 2000 to April 2020, the heterogeneity of the experiments was measured using the I2 index and the data processing was done in the Systematic Meta-Analysis programme.

RESULTS

In 29 studies and the sample size of 518,465 people in the age range of 55-106 years, urinary incontinence in older adults' women in the world based on a meta-analysis of 37.1% (95% CI: 29.6-45.4%) was obtained. The highest prevalence of urinary incontinence was reported in older adults' women in Asia with 45.1% (95% CI: 36.9-53.5%). Meta-regression also showed that with increasing the sample size and year of the study, the overall prevalence of urinary incontinence in the older adults women of the world decreased and increased, respectively, which were statistically significant differences (P <  0.05). According to studies, the most important factors influencing the incidence of urinary incontinence in older women are women's age (p <  0.001), obesity (p <  0.001), diabetes (p <  0.001), women's education (p <  0.001), delivery rank (p <  0.001), hypertension (p <  0.001), smoking (p <  0.001). They also have urinary tract infections (p <  0.001).

CONCLUSION

Given the high prevalence of urinary incontinence in older women around the world, health policy makers must consider control and diagnostic measures in older women and prioritize treatment and rehabilitation activities.

Evaluation of sexual dysfunction and female sexual dysfunction indicators in women with type 2 diabetes: a systematic review and meta-analysis

Type 2 diabetes is one of the most common chronic diseases worldwide, and one of the long-term complications of this disease is sexual dysfunction in women with type 2 diabetes, which has been studied in fewer studies. The aim of this study is to determine the overall prevalence of sexual dysfunction in women with type 2 diabetes and its indicators with systematic and meta-analysis approach. The present meta-analysis study reviewed articles published foreign journals by searching the MEDLINE, Cochrane Library, Science direct, Embase, Proquest and Persian databases, including Iranmedex, Magiran, and SID between January 2000 to December 2018. The heterogeneity of studies was studied using the I2 index and data analysis was carried out in Comprehensive Meta-Analysis software. The Meta-analysis review of 25 studies and 3892 individuals aged 70-18 years showed that the overall prevalence of sexual dysfunction in women with type 2 diabetes was 68.6% (95% CI 61.1-75.3%). The highest and lowest prevalence of sexual dysfunction was 94.4% in Iranian women with type 2 diabetes (95% CI 91.9%-96.3%) in 2014 and 17% in Italian women with diabetes Type 2 (95% CI 6.4-36.9%) in 2015. Results of meta-regression showed that with the increase in sample size and year of study, the overall prevalence of sexual dysfunction decreased and increased, respectively and the differences were statistically significant (P < 0.05). Regarding the high prevalence of sexual dysfunction in women with type 2 diabetes, health policymakers need to take appropriate measures to address this disorder in patients with type 2 diabetes.

Predicting pressure ulcer risk: comparing the predictive validity of 4 scales

OBJECTIVE

To compare the predictive validity of 4 pressure ulcer risk assessment tools.

METHODS

Prospective clinical design in which 230 subjects free of pressure ulceration on admission were assessed using the Braden, Gosnell, Norton, and Waterlow scales within 48 hours of admission. Subjects' skin condition was assessed once every 24 hours for a minimum of 14 days to identify any skin breakdown.

RESULTS

Based on Youden's index, the Gosnell Scale had better predictive validity in identifying patients at risk for pressure ulcer development (J = 68%). The other scales did not predict individuals at risk with high accuracy, despite having high sensitivity and specificity.

CONCLUSION

Numerous pressure ulcer risk assessment tools have been developed, but sufficient evidence for using one tool over another does not exist. In this study, the Gosnell Scale was found to be more appropriate for application in patients with neurologic and orthopedic conditions.

CLINICAL RELEVANCE

Being able to predict which patients are at risk for pressure ulcers can assist practitioners in tailoring care to prevent unnecessary complications and suffering, as well as reduce costs.

The prevalence of obesity in older adults in Iran: a systematic review and meta-analysis

Background

one of the most important age-dependent physiologic alterations in the body composition of older adult people is obesity and overweight, increasing the risk of cardiovascular disease and mortality rate.

Objective

The aim of the present study is to determine the prevalence of obesity in older adults in Iran.

Methods

The present study was conducted via meta-analysis and systematic review method, from March 2000 to October 2018. Subject-related literature was obtained via searches in ScienceDirect, Medline (PubMed), SID, Magiran, Scopus, and Google Scholar databases. Heterogeneity of studies was assessed using the I² index, and data were analyzed by Comprehensive-Meta analysis software.

Results

In the assessment of 18 studies and 29,943 persons aged over 50 years, the prevalence of obesity in older adults of Iran was 21.4% (95%CI: 26.6–16.9%) based on the meta-analysis. The highest obesity prevalence was obtained in older adults of Babol (Amir Shahr) which was 44.2% (95%CI: 41.1–47.2%) in 2007, while the minimum obesity prevalence was found in older adults of Razavi Khorasan which was 11.3% (95%CI, 10–12.8%) in 2007. Further, as the sample size and the study year increased, the obesity prevalence diminished in older Iranian adults (p < 0.05).

Conclusion

This study suggests that the prevalence of obesity in the older adults of Iran is high. Accordingly, healthcare planners and politicians should consider effective and practical policies to reduce obesity in older adults.

A systematic review and meta-analysis of prevalence of insomnia in the third trimester of pregnancy

Background

Sleep disorders, which are among the foremost important medical care issues, are prevalent in pregnancy. The present study is a meta-analysis of the prevalence of insomnia in the third trimester of pregnancy. This study aims to systematically review the overall prevalence of insomnia in the third trimester of pregnancy through conducting a meta-analysis.

Method

The literature used in this meta-analysis for the topic discussed above were obtained through searching several databases, including SID, MagIran, IranDoc, Scopus, Embase, Web of Science (WoS), PubMed Science Direct and Google Scholar databases without time limitation until December 2020. Articles developed based on cross-sectional studies were included in the study. The heterogeneity of studies was investigated using the I² index. Also, the possible effects of heterogeneity in the studied studies are investigated using meta-regression analysis.

Result

In 10 articles and 8798 participants aged between11–40, the overall prevalence of insomnia in the third trimester of pregnancy based on meta-analysis was 42.4% (95% CI: 32.9–52.5%). It was reported that as the sample size increases, the prevalence of insomnia in the third trimester of pregnancy increases. Conversely, as the year of research increases, the prevalence of insomnia in the third trimester of pregnancy decreases. Both of these differences were statistically significant (P < 0.05).

Conclusion

Insomnia was highly prevalent in the last trimester of pregnancy. Sleep disorders are neglected among pregnant women, and they are considered natural. While sleep disturbances can cause mental and physical problems in pregnant women, they can consequently cause problems for the fetus. As a result, maintaining the physical and mental health of pregnant mothers is very important. It is thus recommended that in addition to having regular visits during pregnancy, pregnant women should also be continuously monitored for sleep-related disorders.

The Effect of Exercise on the Older Adult's Blood Pressure Suffering Hypertension: Systematic Review and Meta-Analysis on Clinical Trial Studies

Background

Senescence refers to spontaneous and progressive irreversible degenerative changes in which both the physical and psychological power diminish significantly. Hypertension is the most common cardiovascular disease in the elderly. Several studies have been conducted regarding the effect of exercise on reducing the blood pressure of the elderly, which have found contradictory results. One of the uses of meta-analysis study is responding to these assumptions and resolving the discrepancies. Accordingly, the aim of the present study is to determine the impact of exercise on the blood pressure of older adults.

Method

In this research, in order to find electronic published papers from 1992 to 2019, the papers published in both domestic and foreign databases including SID, MagIran, IranMedex, IranDox, Gogole Scholar, Cohrane, Embase, Science Direct, Scopus, PubMed, and Web of Science (ISI) were used. Heterogeneity index between the studies was determined based on Cochran test Q(c) and I². Considering existence of heterogeneity, random effects model was employed to estimate the standardized subtraction of the mean exercise test score for reduction of blood pressure in the older adults across the intervention group before and after the test.

Results

In this meta-analysis and systematic review, eventually 69 papers met the inclusion criteria. The total number of participants was 2272 in the pre- and postintervention groups when examining the systolic changes and 2252 subjects in the pre- and postintervention groups when inspecting the diastolic changes. The standardized mean difference in examining the systolic changes before the intervention was 137.1 ± 8.09 and 132.98 ± 0.96 after the intervention; when exploring the diastolic changes, the pre- and postintervention values were 80.3 ± 0.85 and 76.0 ± 6.56, respectively, where these differences were statistically significant (P < 0.01).

Conclusion

The results of this study indicated that exercise leads to significant reduction in both systolic and diastolic blood pressure. Accordingly, regular exercise can be part of the treatment plan for hypertensive elderly.

The Effect of Sleep Quality on Students' Academic Achievement

BACKGROUND

Sleep is an inseparable part of human health and life, which is crucial in learning, practice, as well as physical and mental health. It affects the capacity of individual learning, academic performance, and neural-behavioral functions. This study aimed to determine the relationship between sleep quality and students' academic achievement among students at Kermanshah University of Medical Sciences.

METHODS

In this cross-sectional study, 102 medical students from different fields, with maximum variation sampling, completed Pittsburgh Sleep Quality Index (PSQI). For data analysis, SPSS 19 was used through which Pearson correlation test, Spearman test, and t-test were employed.

RESULTS

Based on the quality of sleep questionnaire scores, the results indicated no significant difference between students with high grades and those with low grades. However, there were moderate and sometimes severe sleep disturbances in both groups.

CONCLUSION

The results showed no significant difference between sleep quality and academic achievement. Nevertheless, longitudinal study should be performed to control for confounding factors.

The effect of exercise on anxiety in the elderly worldwide: a systematic review and meta-analysis

Background

Physical activity and exercise are among the most important, simplest, and cheapest approaches to anxiety treatment, especially for the elderly. Their positive effects on improvement of mental disorders in the elderly have attracted a considerable level of attention. Therefore, the present study was conducted to determine the effect of sport on reducing anxiety in the elderly using meta-analysis.

Methods

In this study, national and international databases of SID, MagIran, IranMedex, IranDoc, Cochrane, Embase, ScienceDirect, Scopus, PubMed, and Web of Science were searched to find studies published electronically from 1999 to 2019. Heterogeneity between the collected studies was determined using the Cochran's test (Q) and I². Due to presence of heterogeneity, the random effects model was used to estimate the standardized mean difference of sport test scores obtained from the measurement of anxiety reduction among the elderly, between the intervention group before and after the test.

Results

In this meta-analysis and systematic review, 19 papers finally met the inclusion criteria. The overall sample size of all collected studies for the meta-analysis was 841 s. Mean anxiety score before and after intervention were 38.7 ± 5.6 33.7 ± 3.4 respectively, denoting a decrease in anxiety score after intervention.

Conclusion

Results of this study indicates that Sport significantly reduces Anxiety in the Elderly. Therefore, a regular exercise program can be considered as a part of the elderly care program.

The effect of polymorphisms (174G> C and 572C> G) on the Interleukin-6 gene in coronary artery disease: a systematic review and meta-analysis

Background

Coronary Artery Disease (CAD) is caused by the blockage of the coronary arteries. it is argued that there has an association between the Interleukin-6 gene and the occurrence of atherosclerosis, coronary artery disease, Due to the short half-life and high variability of Interleukin-6 (IL-6), limited studies have been performed on the association of serum levels of interleukin-6 with coronary artery disease. The aim of this study is to investigate the relationship between IL-6 gene polymorphisms and coronary artery disease.

Methods

This study was conducted as a meta-analysis of selected articles with no lower time limit and upto March 2020. Articles related to the subject were obtained by searching several data sources,such as the SID, IranDoc, Scopus, Embase, Web of Science (ISI), PubMed, Science Direct, and Google Scholar databases. The heterogeneity of the studies was assessed using the I² index in the Comprehensive Meta-Analysis software.

Results

The GG genotype of the IL-6174 G> C polymorphism with a 0.8 odds ratio tended to reduce the risk of CAD by 20%. The odds ratio of CAD in CG and GG genotypes were found to be 1.16 and 1.48 times respectively, indicating the increasing effect of these two genotypes. In the IL-6-572 C>G polymorphism, CG and GG genotypes increased the risk of CAD by 1.21 and 1.27 times respectively, and the CC genotype tended to reduce the risk of CAD by 15%, considering the odds ratio of 0.85.

Conclusion

This study showed a relationship between IL-6174G> C and Interleukin-6 (IL-6) 572 C>G genes and coronary artery disease. Moreover, the protective effects of GG genotype in IL-6 gene 174 G> C and CC genotype in IL-6 gene 572 C>G gene were reported. The study also confirmed that the CG and CC genotypes of the G>C IL-6174 gene have an increasing effect on coronary artery disease. Moreover, CG and GG genotypes in the IL-6 gene 572 C>G increased the risk of developing CAD. It should be noted that the increased risk of developing CAD was limited to meta-analytic studies in reported literatures.

The prevalence of severe depression in Iranian older adult: a meta-analysis and meta-regression

Background

Depression is one of the most common psychiatric disorders in the older adult and one of the most common risk factors for suicide in the older adult. Studies show different and inconsistent prevalence rates in Iran. This study aims to determine the prevalence of severe depression in Iranian older adult through a meta-analysis approach.

Methods

The present meta-analysis was conducted between January 2000–August 2019. Articles related to the subject matter were obtained by searching Scopus, Sciencedirect, SID, magiran, Barakat Knowledge Network System, Medline (PubMed), and Google Scholar databases. The heterogeneity of the studies was evaluated using I² index and the data were analyzed in Comprehensive Meta-Analysis software.

Results

In a study of 3948 individuals aged 50–90 years, the overall prevalence of severe depression in Iranian older adult was 8.2% (95% CI, 4.14–6.3%) based on meta-analysis. Also, in order to investigate the effects of potential factors (sample size and year of study) on the heterogeneity of severe depression in Iranian older adult, meta-regression was used. It was reported that the prevalence of severe depression in Iranian older adult decreased with increasing sample size and increasing years of the study, which is significantly different (P < 0.05).

Conclusion

Considering the high prevalence of severe depression in Iranian older adult, it is necessary for health policy makers to take effective control measures and periodic care for the older adult.

A comparison of the glasgow coma scale score with full outline of unresponsiveness scale to predict patients' traumatic brain injury outcomes in intensive care units

Background. Neurological assessment is an essential element of early warning scores used to recognize critically ill patients. We compared the performance of the Glasgow Coma Scale (GCS) with Full Outline of Unresponsiveness (FOUR) scale as an alternative method in the identification of clinically relevant outcomes in traumatic brain injury. Objective. The purpose of this study was to compare the performance of GCS with FOUR scale. Methods. For this study 104 patients with brain injury were recruited from the ICU of Taleghani Hospital, a major teaching hospital in Kermanshah in the western part of Iran. Data was collected concurrently from the ICU admissions by three well-educated nurses and then checked for accuracy by the researcher. Patients were followed up until two weeks or hospital discharge to record their survival status. As a final point expected risk of mortality was calculated using the original formulas for each scale. Results. The mean age of 104 participants was 41.38 ± 18.22 (rang 17 to 86 years) mostly (81 patients 77.9%) males. The FOUR scale has a better prediction for death than GCS. Conclusion. It appears that FOUR scale had better predictive power for mortality and may be a suitable alternative or complementary tool for GCS.

The prevalence of retinopathy among type 2 diabetic patients in Iran: A systematic review and meta-analysis

Diabetic retinopathy is one of the most major causes of blindness and disability in diabetic patients and imposes very high cost on Health Care System. Studies conducted in the country showed different and inconsistent prevalence of the disease. The study aims to determine the overall prevalence of retinopathy in patients with type 2 diabetes in Iran through a systematic review and meta-analysis. The present study was conducted via meta-analysis method during March, 2000 to October, 2018. The articles related to the subject under study were obtained from Magiran, SID, Medline (PubMed), Science Direct, Scopus and Google Scholar databases. I2 index was used to examine the heterogeneity of articles studied; and the data was analyzed by Comprehensive Meta-Analysis Software. Through the study of 34 articles and 17,079 individuals with age range of 5-83, the overall prevalence of retinopathy for type 2 diabetic patients in Iran and on the basis of meta-analysis, was obtained that was 37.8% (32.84-43%, 95% confidence interval); the highest prevalence of retinopathy for type 2 diabetic patients was in Tehran province with 78% (68.8-85.1%, 95% confidence interval) in 2006 and the lowest prevalence of retinopathy for type 2 diabetic patients was in Isfahan province with 9% (7.1-11.4, 95% confidence interval) in 2006; furthermore, the prevalence of retinopathy for type 2 diabetic patients in Iran increases with increased sample size that it was statistically significant (P < 0.05). Regarding the high prevalence of retinopathy for type 2 diabetic patients in the country, it is essential that health policy makers take effective measures to reduce the disease incidence in diabetic patients.

Effect of Telenursing and Face-to-Face Training Techniques on Quality of Life in Burn Patients: A Clinical Trial

OBJECTIVE

To compare the effect of telenursing and face-to-face training on the quality of life (QOL) of patients with a burn injury.

DESIGN

This clinical trial with pretest-posttest design on 3 groups was conducted in Kermanshah, Iran, from 2017 to 2018. Convenience sampling was used.

SETTING

A tertiary hospital in Kermanshah, west of Iran.

PARTICIPANTS

A total of 90 patients with burns of grade 2 and 3 after discharge from the hospital were randomly assigned to 3 groups including telenursing (30), face-to-face training (30), and control (30).

INTERVENTIONS

Each intervention group received 1-on-1 telephone training and face-to-face training in 8 sessions (2 sessions of 15 to 20min/wk). The control group received regular care.

MAIN OUTCOME MEASURES

QOL was evaluated by the Burn Specific Health Scale-Brief (BSHS-B).

RESULTS

The mean BSHS-B scores before and after intervention for telenursing, face-to-face, and the control group were 71.43±21.92 and 133.06±11.97; 64.83±26.16 and 124.83±23.05; and 58.63±20.89 and 73.13±33.04, respectively. There was a statistically significant difference among the 3 groups with respect to the training methods after intervention (P<.001). In addition, post hoc test did not show a significant difference between the telenursing and face-to-face groups (P=.244).

CONCLUSIONS

Educational methods in the form of telenursing and face-to-face training were effective and promoted QOL in survivors of burn injuries. Both telenursing and face-to-face training can be used to improve the QOL of survivors of burn injuries during the rehabilitation phase.

The prevalence of Restless Legs Syndrome/Willis-ekbom disease (RLS/WED) in the third trimester of pregnancy: a systematic review

Background

RLS is known as one of the most common movement disorders during pregnancy, which is most aggravated in the third trimester of pregnancy and can affect up to one-third of pregnant women. This study intends to determine the total prevalence of RLS in the third trimester of pregnancy through a systematic review.

Methods

The present study was conducted via meta-analysis method up to 2019. The papers related to the subject of interest were obtained through searching in SID, MagIran, IranDoc, Scopus, Embase, Web of Science (ISI), PubMed, Science Direct, and Google Scholar databases. Heterogeneity of the studies was examined via I² index, and the data were analyzed in Comprehensive meta-analysis software.

Results

In investigating 10 papers capturing 2431 subjects within the age range of 25–39 years, the total prevalence of RLS in the third trimester of pregnancy based on meta-analysis was obtained as 22.9% (95% CI: 14.7–33.8%). Further, as the sample size increased, the RLS prevalence diminished, while with increase in years, this prevalence increased, where this difference was statistically significant (P < 0.05).

Conclusion

Prevalence of RLS in the third trimester of pregnancy is high, healthcare policymakers should organize educational classes to improve the life dimensions among this group of pregnant women.

The effect of self-management education through weblogs on the quality of life of diabetic patients

BACKGROUND

Self-management education of diabetes which is one of the most important noncommunicable diseases worldwide involves facilitating knowledge, skills, and ability required for self-care in these patients. Concerning the progressive growth of use of Internet for educating patients and absence of different studies about education through use of weblogs in patients with diabetes in Iran, the present study was conducted with the aim of determining the effect of self-management education through weblogs on the quality of life of affect the patients.

METHODS

This study was performed as intervention on patients referring to diabetes clinic of Talghani hospital in Kermanshah in winter 2018 and spring 2019. The samples consisted of 98 patients with diabetes chosen through available sampling and randomly assigned into study and control groups. For data collection, diabetes quality of life (DQOL) short form clinical questionnaire, Persian version, was used. The intervention involved training self-management conducted through 60 sessions via a designed weblog. The obtained information was introduced into SPSS 21, and analyzed through Mann-Whitney, t-test, and paired t-test.

RESULTS

According to the results of this study, the mean age of the examined patients was 32.1 ± 4.9 years, where the major participants were male (n = 52 in the test group, 52.5%). The results showed that after the intervention, the test and control groups were different in terms of anthropometric variables and metabolic indicators; the mean waist circumference in the test and control groups was 98.6 ± 9.8 and 101.5 ± 7.8, respectively; the mean FBS following the intervention in the test and control groups was 131.08 ± 16.04 and 238.2 ± 40, respectively; and the mean BMI postintervention in the test and control groups was obtained as 27.3 ± 3.4 and 30.1 ± 3.8 respectively, where these differences were significant according to independent t-test (p < 0.05). The mean score of quality of life postintervention in the test and control groups was obtained as 56.1 and 49.9 respectively; according to Mann-Whitney test, the difference between the two groups was significant (p < 0.05).

CONCLUSION

The results of the present study revealed the positive effect of weblog based self-management on the quality of life of patients with diabetes following the intervention. Further, reduced levels of FBS, BMI, as well as systolic and diastolic blood pressure were also observed, which could be due to increased awareness of patients about their abilities, its risks, as well as the ways to control and treat it.

Aflatoxin M1 in Milk Worldwide from 1988 to 2020: A Systematic Review and Meta-Analysis

Background. Aflatoxins are found in various types of food and animal feed. Food contamination with aflatoxin toxin is of particular importance today. Various studies have reported different prevalence of aflatoxin M1 in animal milk. Therefore, due to the importance of this toxin, its role in health, and lack of general statistics about it worldwide, the present study aimed to determine the prevalence of aflatoxin M1 in milk worldwide with a systematic review and meta-analysis study. Methods. In this review study, national and international databases were extracted from SID, MagIran, IranMedex, IranDoc, Embase, ScienceDirect, Scopus, PubMed, and Web of Science (ISI) between January 1988 and February 2020. A random effects model was used for analysis, and heterogeneity of studies with an I2 index was investigated. Data were analyzed using Comprehensive Meta-Analysis (version 2). Results. The prevalence of aflatoxin M1 in milk worldwide from January 1988 to February 2020 in 122 articles with a sample size of 18921 was 79.1% (95% CI: 75.5–82.3%). Regarding the heterogeneity based on metaregression, there was a significant difference between the effect of the year of study (p≤0.001) and sample size (p≤0.001) with the prevalence of aflatoxin M1 in animal milk. Conclusion. The results of this study show that the prevalence of aflatoxin M1 in milk is high worldwide. Therefore, considering the importance of the milk group and its products, special measures should be taken to protect the ration from aflatoxin molds and milk quality.

Prevalence of nephropathy in patients with type 2 diabetes in Iran: A systematic review and meta-analysis based on geographic information system (GIS)

BACKGROUND AND AIMS

Diabetic nephropathy are one of the most important causes of renal failure and dysfunction in diabetic patients and imposes high costs for the healthcare system. Studies conducted in Iran show different prevalence. This study aims to determine the overall prevalence of nephropathy in patients with type 2 diabetes in Iran with a systematic review and meta-analysis.

METHODS

The present study was carried out by meta-analysis from January 2000 to May 2020. Related articles were obtained through searching in Scopus, Cochrane, Library, ScienceDirect, Embase, SID, Magiran, Barakatkns, Medline (PubMed), and Google Scholar. Heterogeneity of studies was studied using I² index and data were analyzed using Comprehensive Meta-Analysis and Arc map (ArcGIS 10.6) software.

RESULTS

In a review of 18 articles and 6190 subjects aged 20-83 years, the overall prevalence of nephropathy in patients with type 2 diabetes in Iran was 30.6% (95%CI: 24.3-37.7) based on a meta-analysis. The highest prevalence of nephropathy in patients with type 2 diabetes was obtained in Tehran province with 57.3% (95%CI: 51.5-62.9) in 2008 and the lowest prevalence of nephropathy in patients with type 2 diabetes was obtained in Hamedan province with 14.4% (95%CI: 11.3-18.8) in 2016. An increase in sample size and research year reduces the prevalence of nephropathy in patients with type 2 diabetes in Iran, and differences were statistically significant (P < 0.05).

CONCLUSION

Considering the high prevalence of nephropathy in patients with type 2 diabetes in Iran, it is essential that health policymakers take effective measures to reduce this disease in diabetic patients.

Glasgow Coma Scale Versus Full Outline of UnResponsiveness Scale for Prediction of Outcomes in Patients with Traumatic Brain Injury in the Intensive Care Unit

AIM

Glasgow Coma Scale (GCS) is the most applied tool for classifying intensity of coma and predicting patient outcomes with traumatic brain injuries. The present study was conducted with the aim of comparing two criteria of Full Outline of UnResponsiveness (FOUR) scale and GCS in predicting prognosis in patients with traumatic brain injuries.

MATERIAL AND METHODS

In this prospective study, 198 patients with traumatic brain injuries were investigated. FOUR and GCS criteria for each patient were determined by four well-educated nurses. The area under receiver operating characteristic (ROC) curve was determined for in-hospital mortality outcomes.

RESULTS

Of all patients, 65.2% survived and 34.8% died, and FOUR had correctly predicted 82% of them. FOUR had 0.76 sensitivity and GCS had a sensitivity 0.85. Mean scores for mortality and survival rates were 4.59±2.36 and 10.71±2.24 in GCS, and 3.15±3.52 and 12.77±2.43 in FOUR, respectively. The area under ROC curve was 0.961 for FOUR and 0.928 for GCS. The area under the curve was high for FOUR in scores 6 and 7, and for GCS in scores 5 and 6.

CONCLUSION

FOUR score is a valuable, sensitive and specific diagnostic criterion for predicting outcomes in patients with traumatic brain injuries.

Candida albicans skin infection in patients with type 2 diabetes: a systematic review and meta-analysis

Background

Fungal infections including Candida albicans is one of the most important health concerns among type 2 diabetic patients. Therefore, this study aimed to determine the prevalence of C. albicans skin infection in patients with type 2 diabetes in a systematic review and meta-analysis.

Methods

In this review study, data were extracted from national and international databases of SID, MagIran, IranMedex, IranDoc, Google Scholar, Cochrane, Embase, ScienceDirect, Scopus, PubMed, and Web of Science (WoS) with no time limit until January 2021. The random effects model was used for doing analysis and the I² index was used for assessing the heterogeneity of studies. Data were analyzed using Comprehensive Meta-Analysis (Version 2).

Results

The prevalence of C. albicans skin infection in patients with type 2 diabetes was 11.4% (95% CI: 8.9%-14.4%) in 13 reviewed articles with a sample size of 1348. Regarding the heterogeneity based on meta-regression, there was a significant difference between the effect of sample size (P < 0.05) and the prevalence of C. albicans skin infection in patients with type 2 diabetes.

Conclusion

The results of this study showed that C. albicans skin infection was high in type 2 diabetic patients in Iran. Therefore, to improve the aforementioned situation and to troubleshoot and monitor at all levels, appropriate policies should be adopted.

The Effect of Lavender (Lavandula stoechas L.) on Reducing Labor Pain: A Systematic Review and Meta-Analysis

BACKGROUND

Labor pain is one of the most severe pains, which most of women experience. By using novel supportive methods, the labor pain can be reduced, which makes this event pleasant and delightful. Several original studies have been conducted in regard to the effect of lavender on reducing labor pain, whose results are controversial. One of the applications of meta-analysis studies is to respond to these hypotheses and remove controversies; therefore, this study aimed to determine the effect of lavender on labor pain in Iran by using meta-analysis.

METHODS

In this study, to find published articles electronically from 2006 to 2019, the published articles in national and international databases of SID, MagIran, IranMedex, IranDoc, Google Scholar, Cochrane Library, Embase, ScienceDirect, Scopus, PubMed, and Web of Science (ISI) were used. Heterogenic index between studies was determined by Cochrane test (Q)c and I 2. Due to heterogeneity, the random effects model was used to estimate standardize difference of the mean score of lavender test in order to assess the labor pain between intervention and control group.

RESULTS

In this meta-analysis and systematic review, finally 13 eligible articles met the inclusion criteria of the study. The sample size from original studies enrolled in the meta-analysis entered in the intervention group was 794 individuals and in the control group was 795 individuals. Mean score for pain in the control group was 7.2 ± 0.42 and in the intervention group was 5.4 ± 0.58 and this difference was statistically significant (p ≤ 0.001).

CONCLUSION

The results of this study showed that lavender can reduce labor pain, which can be considered by health policy makers and gynecologists.