Epidemiology of multiple sclerosis in Iran: A systematic review and meta-analysis

BACKGROUND

Multiple sclerosis (MS) is one of the most common neurological disorders and is one of the main causes of disability. The prevalence and incidence of MS in Iran is reported to range from 5.3 to 89/ 100,000and 7 to 148.1/ 100,000, respectively. There are no systematic and meta-analysis studies on MS in Iran. Therefore, this study was conducted to investigate the prevalence and incidence of MS in Iran using meta-analysis.

METHOD

A systematic review of the present study focused on MS epidemiology in Iran based on PRISMA guidelines for systematic review and meta-analysis. We searched eight international databases including Scopus, PubMed, Science Direct, Cochrane Library, Web of Science, EMBASE, PsycINFO, Google Scholar search engine and six Persian databases for peer-reviewed studies published without time limit until May 2018. Data were analyzed using Comprehensive meta-analysis ver. 2 software. The review protocol has been registered in PROSPERO with ID: CRD42018114491.

RESULTS

According to searching on different databases, 39 (15%) articles finalized. The prevalence of MS in Iran was estimated 29.3/ 100,000 (95%CI: 25.6-33.5) based on random effects model. The prevalence of MS in men and women was estimated to be 16.5/ 100,000 (95%CI: 13.7-23.4) and 44.8/ 100,000 (95%CI: 36.3-61.6), respectively. The incidence of MS in Iran was estimated to be 3.4/ 100,000 (95%CI: 1.8-6.2) based on random effects model. The incidence of MS in men was estimated to be 16.5/ 100,000 (95%CI: 13.7-23.4) and the incidence of MS in women was 44.8/ 100,000 (95%CI: 36.3-61.6). The meta-regression model for prevalence and incidence of MS was significantly higher in terms of year of study (p<0.001).

CONCLUSIONS

The results of this study can provide a general picture of MS epidemiology in Iran. The current meta-analysis showed that the prevalence and incidence of MS in Iran is high and is rising over time.

Toxoplasma oocysts in the soil of public places worldwide: a systematic review and meta-analysis

Toxoplasmosis is a zoonotic and cosmopolitan infection. Although a few studies have evaluated the prevalence of Toxoplasma oocysts in the soil of public places, the present study was conducted to provide insights into environmental contamination levels and its potential transmission to humans on a global scale. A systematic search was conducted using bibliographic databases through 30 August 2020. A random effects model was utilized to estimate pooled prevalence with 95% confidence intervals (CIs). Subgroup analysis and meta-regressions were also performed on the geographical and environmental parameters. Finally, 22 articles, wherein 15 420 soil samples were examined, met the systematic review and meta-analysis requirements. The mean pooled prevalence of Toxoplasma oocysts was estimated at 16% (95% CI 10 to 26) in public places. The estimated prevalences in Europe, South America, Asia and North America were 23% (95% CI 4 to 65), 22% (95% CI 18 to 26), 15% (95% CI 0.06 to 33) and 8% (95% CI 0.00 to 97), respectively. An increasing trend was observed in the prevalence of Toxoplasma oocysts with increasing latitude (41-56°), decreasing longitude (0-40°) and increasing relative humidity (≥76%). Loop-mediated isothermal amplification and polymerase chain reaction methods revealed the highest and lowest prevalence rates, respectively, in the detection of Toxoplasma oocysts. Awareness of the health authorities and people about Toxoplasma prevalence in the soil of public places and its risk factors is of great importance to developing effective strategies to prevent infection.

Workplace Violence Against Iranian Nurses: A Systematic Review and Meta-Analysis

Nurses are exposed to workplace violence more than other healthcare professionals. This study aims to examine the prevalence of different types of workplace violence against Iranian nurses. A systematic review and meta-analysis were designed according to the PRISMA statement. To avoid bias, all stages of the research were done independently by two researchers. Eligible studies were retrieved from comprehensive search of several electronic databases included Magiran, Barakat Knowledge Network System, IranDoc, Regional Information Center for Science and Technology (RICST), Scientific Information Database (SID), Iranian National Library, PubMed/Medline, Cochrane Library, Scopus, Science Direct, ISI Web of Knowledge, CINAHL, and Google Scholar until April 2017. A random effects model was applied to combine studies. Data were analyzed using Comprehensive Meta-Analysis software version 2. In 26 studies, 10,858 nurses entered the meta-analysis process. The mean age and work experience of the nurses were 33.5 ± 7.5 and 10.85 ± 10.1 years, respectively. The prevalence of workplace verbal, physical, sexist, and racist violence and threat against Iranian nurses was 80.8% (95% confidence interval [CI] [74.2, 86.0]), 24.8% (95% CI [17.4, 34.0]), 6.7% (95% CI [4.9, 9.2]), 14.6% (95% CI [10.1, 20.7]), and 44% (95% CI [30.1, 58.8]), respectively. The prevalence of verbal and physical violence against the emergency department nurses was 89.7% (95% CI [69.4, 97.1]) and 21.0% (95% CI [12.6, 32.9]), respectively. The highest prevalence of verbal, physical, sexist, and racist violence was from patient's relative (42.3%, 95% CI [30.7, 54.7]), patients (12.6%, 95% CI [5.9, 25.0]), healthcare workers (5.1%, 95% CI [2.4, 10.4]), and patients (2.3%, 95% CI [0.9, 5.4]), respectively. Given the high prevalence of violence against the nurses in Iran, it is highly necessary to take certain intervention measures and design new policies.

The association between metabolic syndrome and polycystic ovary syndrome: A systematic review and meta-analysis

BACKGROUND

One of the most frequently encountered endocrinopathy in women of reproductive age is polycystic ovary syndrome (PCOS). Recent studies have reported varied prevalence of metabolic syndrome (MetS) in women with PCOS. The aim of this study is to determine if the women with PCOS are at a higher risk of MetS.

METHOD

The present systematic review and meta-analysis was conducted according to the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines. To collect articles, we searched online databases of PubMed/Medline, Scopus, Web of Science, Science Direct, Embase, CINAHL, Cochrane Library, EBSCO and Google scholar search engine and the reference list of the retrieved articles using MeSH keywords of "metabolic syndrome", "woman" and "polycystic ovary syndrome" without time limit until October 2018. Cochran's Q test and I² Index were used to evaluate the heterogeneity among studies and the random effects model was used for combining the results. Data analysis was performed in STATA software version 11.1.

RESULT

Finally, 72 studies involving 10075 PCOS patients with an average age of 26.2 ± 5.01 years were included in the meta-analysis. The heterogeneity rate was high (I² = 76.5%; p < 0.001) and the pooled estimate of the association between MetS and PCOS was significant (OR = 2.57, 95% CI: 2.18-3.02; P < 0.001).

CONCLUSION

According to the results, there is higher risk of MetS in women with PCOS. Therefore, diagnosis and treatment of MetS in women with PCOS may have a significant impact on this patients health and reduce the rate of mortality and morbidity.

The prevalence of metabolic syndrome in patients with polycystic ovary syndrome: A systematic review and meta-analysis

INTRODUCTION

Polycystic ovary syndrome (PCOS) is an endocrinopathy with unknown pathophysiology among women of reproductive age. Several studies have been conducted to determine the prevalence of metabolic syndrome (MetS) among PCOS patients. However, the results were contradictory. The present study was conducted to evaluate the prevalence of MetS in PCOS patients using the related published data.

METHOD

The present systematic review was perfumed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The search was done using MeSH keywords in databases of PubMed, Scopus, Embase, CINAHL, Web of Science, Cochrane Library, EBSCO, and Google scholar search engine as well as the reference list of the retrieved papers without time limit until October 2018. We used Cochran's Q test and I² Index to evaluate the heterogeneity among the studies and the random effects model was used to combine the results. Data analysis was performed using Stata ver. 11.1.

RESULTS

Forty six studies including 8946 patients with PCOS were included in the final analysis. Total heterogeneity was high (I²: 91.43%, P < 0.001). The prevalence of MetS in PCOS patients was estimated to be 30% (95%CI: 27-33). Subgroup analysis based on MetS diagnostic criteria showed an estimated prevalence of 0.27% (95%CI: 0.18-0.37), 0.30% (95%CI: 0.27-0.34), 0.32 (95%CI: 0.25-0.39), 0.32 (95%CI: 0.27-0.37) and 0.24 (95%CI: 0.14-0.34) for IDF, NECP-ATPIII, AHA NHLBI, CDS, and unknown criteria, respectively.

CONCLUSION

Considering the prevalence of MetS in PCOS patients, diagnosis of MetS in PCOS patients is necessary to reduce the mortality and morbidity rates.

A comparison of faculty led, mentorship program and peer mentoring on nursing students wound dressing clinical skills

BACKGROUND

The promotion of clinical nursing education requires using modern educational methods to develop students' knowledge and skills. There are however many different models by which education can be delivered with a wealth of literature supporting varying approaches. This is of particular relevance to clinical education where to date no singular approach has been identified as being the most appropriate.

OBJECTIVES

This study aimed to compare and investigate the effect of a peer education method, a mentor-led education method versus a traditional faculty-led method for instruction regarding surgical wound care skills among nursing students.

DESIGN

This study used an experimental three-group pre- and post-test design.

SETTINGS

The research was conducted within two surgical wards of a university-affiliated hospital in the west of Iran.

PARTICIPANTS

A total of 102 nursing students (first and second year) were assigned to three groups; peer-led learning group (n = 34), mentorship-led group (n = 34) or a faculty-led control group (n = 34).

METHODS

To ascertain performance in surgical dressing skill, data was collected in each group before and after the respective educational intervention. Data was collected using a surgical dressing skills checklist made by the research team which was piloted prior to the study. All statistical analysis was performed using SPSS v.22.0 (SPSS Inc., Chicago, IL).

RESULTS

Based on findings, after the intervention, the mean (SD) scores of surgical dressing and wound care skills were 28.24 (4.63), 31.76 (4.89), and 29.12 (5.33) for the peer-led, mentor-led and faculty-led groups, respectively. There was no significant difference between mentor group and faculty group or between peer group and faculty group (P > 0.05). However, the findings did demonstrate statistical difference in performance in surgical dressings and wound care techniques in the mentorship group method compared to the peer method (P = 0.006).

CONCLUSIONS

Although participants in the mentor group performed best of all groups, our findings demonstrate that those in the peer method group performed as well as those in the faculty-led group in surgical dressing performance. Therefore, it is recommended that peer and mentor learning methods are given consideration by curriculum planners in for use in the development of student nurse clinical skill and competence in surgical wound care.

Appraisal of new density coefficient on integrated-nanoparticles concrete in nuclear protection

The most important material for shielding is concrete in nuclear facilities which performance can be improved by addition some Nanoparticles (NP) at the various concentrations. Nanoparticles, which have a distinctive potential for bio-radiation and shielding of nuclear reactors, are used in many areas due to their special characteristics, which lead to an improvement in the mechanical properties and the pore structure of the concrete shield. The aim of this research was to initiate a novel coefficient (n), experiment to theory density ratio for integrated NP at different nanoparticle concentrations (xnano), established upon purely mathematical viewpoints and some appropriate physical objectives.

Temporal Patterns of Road Traffic Injuries in Iran

BACKGROUND

Road traffic injuries (RTIs) are the main causes of death and disability in Iran. However, very few studies about the temporal variations of RTIs have been published to date.

OBJECTIVES

This study was conducted to investigate the temporal pattern of RTIs in Iran in 2012.

MATERIALS AND METHODS

All road traffic accidents (RTAs) reported to traffic police during a one-year period (March 21, 2012 through March 21, 2013) were investigated after obtaining permission from the law enforcement force of the Islamic Republic of Iran. Distributions of RTAs were obtained for season, month, week, and hour scales, and for long holidays (more than one day) and the day prior to long holidays (DPLH). The final analysis was carried out using the Poisson regression model to calculate incidence rate ratios for RTIs. All analyses were conducted using STATA 13.1 and Excel software; statistical significance was set at P < 0.05.

RESULTS

A total of 452,192 RTAs were examined. The estimated rate of all accidents was 219 per 10,000 registered vehicles, or 595 per 100,000 people. About 28% of all RTAs, and more than one third of fatal RTAs, occurred during the summer months. The incidence rate for all traffic accidents on DPLH was 1.20, compared to workdays as a reference category, and it was 1.40 for fatal crashes. The rate of fatal road traffic accidents in outer cities was 3.2 times higher than in inner ones.

CONCLUSIONS

Our findings reveal that there are temporal variations in traffic accidents, and long holidays significantly influence accident rates. Traffic injuries have different patterns on outer/inner city roads, based on weekday and holiday status. Thus, these findings could be used to create effective initiatives aimed at traffic management.

A time series analysis of environmental and metrological factors impact on cutaneous leishmaniasis incidence in an endemic area of Dehloran, Iran

The aim of this study was to investigate the relationship between the environmental and metrological variables and cutaneous leishmaniasis (CL) transmission and its prediction in a region susceptible to this disease prevalence using a time series model. The accurate locations of 4437 CL diagnosed from 2011 to 2015 were obtained to be used in the time series model. Temperature, number of days with temperature over 30 °C, and number of earthquake were related to CL incidence using the Seasonal Auto-correlated Integrated Moving Average (SARIMA) model according to the Box-Jenkins method. In addition, the relationship between land use and surface soil type in 500- and 1000-m radius around the CL patients were investigated. The SARIMA models showed significant associations between environmental and meteorological variables and CL incidence adjusted for seasonality and auto-correlation. The result indicated that there are need more robust preventive programs in earthquake-prone areas with high temperature and inceptisol soil type than other areas. In addition, the region with these characteristics should be considered as high-risk areas for CL prevalence.

Environmental Related Risk Factors to Road Traffic Accidents in Ilam, Iran

Introduction:

Road traffic injuries (RTIs) are the most serious health issue in the world and the main cause of death after the first year of birth. Environmental factors are among the most important and effective aspects of RTIs occurrences and their human consequences.

Aim:

This study aimed to identify the environmental factors associated with road traffic accidents (RTAs) in Ilam province.

Methods:

All crash data in Ilam province in 2012 were investigated. RTI’s data was collected using COM 114 form which included some human, environmental and vehicle related factors. Through Chi-Square test and logistic regression model, the association between environmental factors and RTIs was examined. For all statistical analyses we used the package Stata 13.1.

Results:

A total of 2314 traffic accidents were investigated. The highest 1659 (72.3%) and lowest 19 (0.83%) frequency of RTAs occurred during day and sunrise respectively. The majority of RTAs took place in July and September. The maximum number of RTAs was when the day was clear (91.7%) 2103 and the minimum when it was cloudy (3.5%) 81. A significant relationship was found between fatal RTAs and factors such as; the sort of the road, the hindered visibility, the location of the accident, the accidents’ place, the climate, and lighting of the day (P<0.05). The adjusted chance of traffic accidents causing death or injuries in main streets was 9.7 times more than in highways; in sidetracks it was 3.54 times more. And when it was cloudy, the chance was 2.60 times more than when was clear (P<0.05).

Conclusion:

Regarding the standards of road construction, development of the roads, and educating drivers how to adjust their driving behavior to the environment and road conditions could have a great role in decreasing RTAs causing death or injury.

Parasitic Infections of Wild Boars (Sus scrofa) in Iran: A Literature Review

BACKGROUND

Swine species are an important source of meat production worldwide, except in Islamic countries where pig breeding and pork consumption are forbidden. Hence, they are often neglected in these regions. A considerable number of wild boars (Sus scrofa) inhabit Iranian territories, particularly in dense forests of north, west and southwest of the country, but our knowledge regarding their parasites is very limited.

OBJECTIVE

The lack of a comprehensive record in this connection encouraged us to review the whole works of literature in the country.

METHODS

The current review presents all the information about the parasitic diseases of wild boar in Iran extracted from articles available in both Persian and English databases until June 2017.

RESULTS

So far, 8 genera of protozoa (Toxoplasma, Balanthidium, Tritrichomonas, Blastocystis, Entamoeba, Iodamoeba, Chilomastix and Sarcocystis) and 20 helminth species, including four cestode species, two trematode species, thirteen nematode species as well as a single species of Acanthocephala have been described in Iranian wild boars.

CONCLUSION

This review sheds light on the veterinary and public health aspects of the parasitic diseases of wild boars in the country and alerts authorities for future preventive measures.

The association between Borna Disease Virus and schizophrenia: A systematic review and meta-analysis

INTRODUCTION

Schizophrenia is a disabling psychiatric disorder. The role of Borna Disease Virus (BDV) in the etiology of schizophrenia has been suggested by several studies. However, the existence of such association remained controversial. The present meta-analysis was conducted to evaluate this association.

METHOD

This systematic review and meta-analysis was conducted using preferred reporting items for systematic reviews and meta-analysis (PRISMA). Online databases including Scopus, PubMed, Science direct, Embase, PsycINFO, Web of Science and Google scholar search engine were searched until January 15, 2017. The heterogeneity of the studies was evaluated using Cochran's Q test and I² statistic. Finally, random effects model was used for combining the results using Stata software version 11.1.

RESULT

Overall, 30 studies containing 2533 cases and 4004 controls were included in the meta-analysis. The combined odds ratio (OR) for the relationship between BDV and schizophrenia was estimated to be 2.72 (95%CI: 1.75-4.20). This association based on RT-PCR, WB, IFA, EIA, RLA, ECLIA methods was estimated to be 3.83 (95%CI: 1.59-9.20), 4.99 (95%CI: 1.80-13.85), 1.27 (95%CI: 0.23-7.12), 2.26 (95%CI: 0.48-10.64), 1.67 (95%CI: 0.50-5.56) and 2.88 (95%CI: 1.38-6.01), respectively. Subgroup analysis according to WBC, serum and plasma samples was estimated to be 3.31 (95%CI: 1.19-9.25), 2.21 (95% CI: 1.17-4.17), 2.21 (95%CI: 1.03-4.73) and 7.89 (95%CI: 1.75-35.53), respectively.

CONCLUSION

The results indicated the role of BDV in the etiology of schizophrenia.

Comparing the effects of face-to-face and telenursing education on the quality of family caregivers caring in patients with cancer

BACKGROUND

Taking care of patients with cancer is often done at home and by family caregivers. However, these groups do not receive the necessary education regarding care at home.

OBJECTIVES

The present study aimed to compare the effects of face-to-face and telenursing training methods on the quality of services provided by the family caregiver for patients with cancer.

MATERIALS AND METHODS

A total of 103 family caregivers of patients with cancer were randomly divided into 3 groups: control (N = 35), face to face (N = 34), and telenursing (N = 34). The control group only received the routine training, and the face-to-face and telenursing groups were trained for 12 weeks. Quality of care was measured using a questionnaire before and after intervention. Chi-square, Fisher's exact, and analysis of variance tests were used for data analysis.

RESULTS

After intervention, the average total quality score for the care of patients in face-to-face (166.13 ± 13.91) and telenursing (157.76 ± 17.24) groups was significantly higher than the control group (82.51 ± 16.84) (P < 0.001). In addition, the average psychosocial care score for face-to-face group (49.06 ± 6.05) was significantly higher than telenursing group (43.83 ± 6.15) (P < 0.001).

CONCLUSION

The results of the study showed that the two methods of training were effective on the quality of care among family caregivers of patients with cancer to a similar extent.

The effectiveness of cognitive training on improving cognitive function and sleep quality in community-dwelling elderly in Iran

Background and aim

Given the ever-increasing of the older adults population and in order to achieve healthy and active ageing goals and improvement in the cognitive function and sleep quality in older adult, this study aimed to evaluate the effect of cognitive training program on improving cognitive function and ageing-related sleep quality in community-dwelling elderly in Iran, in 2018.

Methods

This was an experimental study. The sample comprised 420 older adults who were a member of the comprehensive health center in one of the southern cities of Iran. 164 had a cognitive problem and sleep disorder, of whom 108 were selected by the available method and based on inclusion criteria. Participants were randomly allocated to an experimental group (n=54) and a control group (n=54). Experimental group samples were undergoing the intervention for two months. Data were collected using MMSE questionnaire, Pittsburgh sleep quality, insomnia severity index and Clinical Dementia Rating Scale (CDR). Data were collected one month before-and-after the intervention. Data were analyzed using SPSS software.

Results

There was no significant difference between the mean score of cognitive function and sleep quality in both the intervention group and the control group before the intervention (p>0.05). At the post-test, the mean (SD) of elderly adults’ cognitive function in the intervention and control groups were 2.7 (1.3) and 3.44 (1.7), respectively (p=0.017). Moreover, the mean (SD) of sleep quality in older adults in the intervention and the control group was 6.76 (2.3) and 9.25 (2.36), respectively (p<0.001).

Conclusion

Given the obtained results in the current study the cognitive training promotes cognitive function and sleep quality in older adults. Therefore, since this program is effective, low-cost and applicable, it can be used to improve cognitive function and sleep disorder in the older adult population.

Prevalence of different pain patterns in patients with COVID-19: A systematic review and meta-analysis

Background and Objectives: Pain assessment is very important in these patients, but no comprehensive systematic reviews / meta-analyses (SRs/MAs) have been performed so far. For this reason, this study was performed to determine the prevalence of pain in patients with Covid-19 in the world by SR/MA method.

The Role of Oxidant-Antioxidant Status in Suicide Behavior in Kurdish Ethnicity

Introduction:

Oxidative stress plays a critical role in the pathogenesis of neurodegenerative and neuropsychiatric disorders. However, its role in suicidal behavior has not been clarified yet. Consequently, we aimed to evaluate the oxidant-antioxidant status in the serum of suicide attempters in Ilam city.

Methods:

Fifty suicide attempters and 40 control subjects (volunteers) aged 18–35 years were studied in the current experiment. To consider the oxidant-antioxidant status, serum levels of Malondialdehyde (MDA), Nitric Oxide (NO), Superoxide Dismutase (SOD), and the Total Antioxidant Capacity (TAC) were measured.

Results:

Serum levels of SOD and TAC were significantly lower in the suicide attempters group compared to the controls. Furthermore, serum NO level was significantly higher in the suicide attempters compared to the control groups. Interestingly, the serum level of MDA was significantly lower in the suicide attempters compared to the control groups.

Conclusion:

The oxidative stress without MDA elevation, detected in suicide attempters, can be considered a biochemical hallmark in suicide behavior.

Epidemiology of road traffic crashes in Ilam Province, Iran, 2009-2013

Objective

Road traffic crashes (RTCs) are major public health challenges of world health systems, and the main leading cause of death in children and young adults aged 5 to 29 years. This study aimed to assess the epidemiology of RTCs in Ilam, Iran.

Results

The total mortality rate due to RTCs has been increasing every year. There was a statistically significant relationship between age/sex and death or injury from RTCs in pedestrians, drivers, and passengers (p < 0.05). There was a significant relationship between the part of body trauma and RTCs in pedestrians (p < 0.001). Furthermore, a significant relationship was found between the type of vehicle and using seat belt with RTCs in drivers and passengers (p = 0.000).

Supply-and-demand projections for the health workforce at a provincial level from 2015 to 2025 in Ilam, Iran

Background:

Human resources are the key component of health systems. It is critical to have the right number of human resources at anytime and anywhere in the health system. This article aims to help local health decision makers to identify potential gaps between the future supply and demand of human resources and to make necessary changes in medical training processes to fill the gap.

Methods:

An eight-stage process was applied to project the supply and demand of health workers in Ilam province in 2025 for the following fields: public health, environmental health, general medicine, dentistry, pharmacy, nursing and midwifery. To estimate the demand for human resources, a mainly population-based model (manpower-to-population ratio) was applied. A modified version of the Australian dynamic stock and flow model was used to predict the supply of new recruits in 2025. The potential surplus or shortfall in the health workforce was calculated by comparing the supply and demand in 2025.

Results:

The demand and supply projections for the chosen fields were estimated respectively as: general medicine 457, 709; pharmacy 131, 86; dentistry 86, 251; nursing 949, 1657; midwifery 24, 247; public health 182, 211; and environmental health 92, 225.

Conclusions:

The current trend of medical graduates will meet the need for human resources in 2025, and there is no need to increase medical student admission. The Education Deputy of Ilam Medical University should take into account the health needs of its catchment area in medical educational processes and training new health-care staff.