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The maternal factors associated with infant low birth weight: an umbrella review. BMC Pregnancy Childbirth 2024; 24:316. [PMID: 38664680 PMCID: PMC11044292 DOI: 10.1186/s12884-024-06487-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 04/05/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND In this umbrella review, we systematically evaluated the evidence from meta-analyses and systematic reviews of maternal factors associated with low birth weight. METHODS PubMed, Scopus, and Web of Science were searched to identify all relevant published studies up to August 2023. We included all meta-analysis studies (based on cohort, case-control, cross-sectional studies) that examined the association between maternal factors (15 risk factors) and risk of LBW, regardless of publication date. A random-effects meta-analysis was conducted to estimate the summary effect size along with the 95% confidence interval (CI), 95% prediction interval, and heterogeneity (I2) in all meta-analyses. Hedges' g was used as the effect size metric. The effects of small studies and excess significance biases were assessed using funnel plots and the Egger's test, respectively. The methodological quality of the included studies was assessed using the AMSTAR 2 tool. RESULTS We included 13 systematic Review with 15 meta-analysis studies in our study based on the inclusion criteria. The following 13 maternal factors were identified as risk factors for low birth weight: crack/cocaine (odds ratio [OR] 2.82, 95% confidence interval [CI] 2.26-3.52), infertility (OR 1.34, 95% CI 1.2-1.48), smoking (OR 2.00, 95% CI 1.76-2.28), periodontal disease (OR 2.41, 95% CI 1.67-3.47), depression (OR 1.84, 95% CI 1.34-2.53), anemia (OR 1.32, 95% CI 1.13-1.55), caffeine/coffee (OR 1.34, 95% CI 1.14-1.57), heavy physical workload (OR 1.87, 95% CI 1.00-3.47), lifting ≥ 11 kg (OR 1.59, 95% CI 1.02-2.48), underweight (OR 1.79, 95% CI 1.20-2.67), alcohol (OR 1.23, 95% CI 1.04-1.46), hypertension (OR 3.90, 95% CI 2.73-5.58), and hypothyroidism (OR 1.40, 95% CI 1.01-1.94). A significant negative association was also reported between antenatal care and low birth weight. CONCLUSIONS This umbrella review identified drug use (such as crack/cocaine), infertility, smoking, periodontal disease, depression, caffeine and anemia as risk factors for low birth weight in pregnant women. These findings suggest that pregnant women can reduce the risk of low birth weight by maintaining good oral health, eating a healthy diet, managing stress and mental health, and avoiding smoking and drug use.
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Comparing the Efficacy and Adverse Events of Available COVID-19 Vaccines Through Randomized Controlled Trials: Updated Systematic Review and Network Meta-analysis. J Res Health Sci 2023; 23:e00593. [PMID: 38315908 PMCID: PMC10843317 DOI: 10.34172/jrhs.2023.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 11/05/2023] [Accepted: 12/03/2023] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Different vaccines have so far been developed and approved to cope with COVID-19 in the world. The aim of this updated network meta-analysis (NMA) was to compare and rank all available vaccines in terms of efficacy and complications simultaneously. Study Design: A systematic review. METHODS Three major international databases, including Web of Science, Medline via PubMed, and Scopus, were searched through September 2023. The transitivity assumption was evaluated qualitatively in terms of epidemiologic effect modifiers. The exposure of interest in this study was receiving any available COVID-19 vaccine, and the primary outcome of interest was the incidence of symptomatic COVID-19. In this NMA, the relative risk of symptomatic COVID-19 was used to summarize the efficacy of vaccines in preventing COVID-19. The data were analyzed using the frequentist-based approach, and the results were reported using a random-effects model. Finally, the vaccines were ranked using a P-score. RESULTS In total, 34 randomized controlled trials (RCTs) met the eligibility criteria for this systematic review and NMA out of 3682 retrieved references. Based on the results of the NMA, mRNA-1273 was the most effective vaccine in preventing COVID-19 and demonstrated the highest P-score (0.93). The relative risk (RR) for mRNA-1273 versus placebo was 0.07 (95% confidence interval [CI]: 0.03, 0.17). The second and third-ranked vaccines were BNT-162b2 (RR=0.08; 95% CI: 0.04, 0.15; P-score=0.93) and Gam-COVID-Vac (0.09; 95% CI: 0.03, 0.25; 0.88). CONCLUSION Based on the results of this NMA, it seems that all available vaccines were effective in COVID-19 prevention. However, the top three ranked vaccines were mRNA-1273, BNT-162b2, and Gam-COVID-Vac, respectively.
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Comparison of corticosteroids types, dexamethasone, and methylprednisolone in patients hospitalized with COVID-19: A systematic review and network meta-analysis. GLOBAL EPIDEMIOLOGY 2023; 6:100116. [PMID: 37637717 PMCID: PMC10445991 DOI: 10.1016/j.gloepi.2023.100116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 07/10/2023] [Accepted: 07/27/2023] [Indexed: 08/29/2023] Open
Abstract
Background COVID-19 is associated with severe pneumonia lung damage, acute respiratory distress syndrome (ARDS), and mortality. In this study, we aimed to compare corticosteroids' effect on the mortality risk in patients hospitalized with COVID-19. Methods PubMed, Web of Science, Scopus, Cochrane Library, and Embase, were searched using a predesigned search strategy. Randomized controlled trials (RCTs) that had compared the corticosteroid drugs were included. The hazard ratio (HR) with a 95% confidence interval (CI) was used to summarize the effect size from the network meta-analysis (NMA). Results Out of 329 retrieved references, 12 RCTs with 11,455 participants met the eligibility criteria in this review. The included RCTs formed one network with six treatments. In addition, five treatments in two RCTs were not connected to the network. Methylprednisolone + usual care (UC) versus UC decreased the risk of death by 0.65 (95% CI: 0.47, 0.90). Among treatments in the network the highest P-score (0.89) was related to Methylprednisolone + UC. Conclusion Based on the results of this NMA it seems Methylprednisolone + UC to be the best treatment option in patients with COVID-ARDS and COVID pneumonia.
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Effect of Low-Level Laser Therapy on Differentiation and Proliferation of Human Dental Pulp Stem Cells: A Systematic Review. J Lasers Med Sci 2023; 14:e47. [PMID: 38028866 PMCID: PMC10658116 DOI: 10.34172/jlms.2023.47] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 09/02/2023] [Indexed: 12/01/2023]
Abstract
Introduction: Considering the positive impact of laser treatment on the proliferation of certain cell types, we opted to perform a systematic review aimed at evaluating the effects of laser therapy and photobiomodulation on the proliferation and differentiation of human dental pulp stem cells (hDPSCs). Methods: We included all research studies examining the impact of laser therapy on hDPSCs, without limitations on publication dates or article languages. The major international databases, including PubMed, ISI Web of Science, and Scopus, were searched from inception to April 2022 by the relevant keywords. Results: In total, 1886 studies were identified in the initial search from the mentioned databases and other sources. Finally, 17 relevant studies were included in the present systematic review after removing duplicates and non-relevant articles. The results indicated the useful effect of low-level laser therapy (LLLT) on the hDPSCs. Conclusion: The findings of this systematic review indicate the useful role of LLLT in cell therapy, proliferation, and differentiation associated with hDPSCs.
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The association of arsenic exposure with mortality due to cancer, diabetes, Alzheimer's and congenital anomalies using Poisson regression. Sci Rep 2023; 13:15456. [PMID: 37726351 PMCID: PMC10509156 DOI: 10.1038/s41598-023-42744-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 09/14/2023] [Indexed: 09/21/2023] Open
Abstract
The present study aims to determine the relationship between the concentration of arsenic in the groundwater of Hamadan province and the mortality rate due to various types of malignancies, congenital anomalies, diabetes mellitus and Alzheimer's. Mortality data due to various causes of death in Hamadan province were collected for five years (2016-2020). Sampling of drinking water was determined in the reference laboratory using polarography method. Poisson regression was used to investigate the relationship between arsenic level and the death rate due to various types of disease, at a significant level (p value < 0.05). According to the results of Poisson regression, among the various causes of death (N = 8042), Alzheimer's 5.94 (3.67-9.61), diabetes mellitus 4.05 (3.5-5.37), congenital malformations 2.98 (1.88-4.72), breast cancer 2.72 (1.56-4.71), leukemia 1.90 (1.24-2.92), stomach cancer 1.64 (1.28-2.10), Liver cancer 1.58 (1.58-2.30), other digestive organs 5.86 (3.38-10.16), meninges and brain cancer 1.57 (1.02-2.41) showed the highest relationship with arsenic contamination. The results of this study could be evidence for a positive and significant relationship between arsenic concentrations and mortality rates due to cancers, diabetes mellitus, Alzheimer disease, and congenital malformations. Therefore, it's necessary to use appropriate water treatment methods to remove arsenic at the source in contaminated areas.
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Pharmaceutical Therapies for the Treatment of Obesity: A Network Meta-analysis. Clin Ther 2023; 45:671-678. [PMID: 37400324 DOI: 10.1016/j.clinthera.2023.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 05/29/2023] [Accepted: 06/02/2023] [Indexed: 07/05/2023]
Abstract
PURPOSE Despite the introduction of various pharmaceutical therapies for treating obesity, selecting the optimal treatment remains challenging for both patients and physicians. Therefore, in this network meta-analysis (NMA), we aim to simultaneously compare the available drugs for treating obesity to determine the most effective treatment options. METHODS International databases, including PubMed, Web of Science, Scopus, Cochrane Library, and Embase, were searched for studies published from database inception to April 2023. The consistency assumption was evaluated using by the loop-specific and design × treatment interaction approaches. The effects of treatment in the NMA were summarized using mean differences based on a change score analysis. The random-effects model was used to report the results. Results were reported with 95% CIs. FINDINGS Of 9519 retrieved references, 96 randomized controlled trials, including 68 with both men and women, 23 with women only, and 5 with men only, met the eligibility criteria for this study. There were 4 treatment networks in the trials of both men and women, 4 in the trials of women only, and 1 in the trials of men only. The best-ranked treatments in the network in the trials of both men and women were (1) semaglutide, 2.4 mg (P-score = 0.99); (2) hydroxycitric acid, 4667 mg 3 times daily, supervised walking, and 2000-kcal/d diet (P-score = 0.92); (3) phentermine hydrochloride and behavioral therapy (P-score = 0.92); and (4) liraglutide plus advice to diet and exercise (P-score = 1.00). In women, the best-ranked treatments were beloranib (P-score = 0.98) and sibutramine, metformin, and hypocaloric diet (P-score = 0.90). In men, there was no significant difference among treatments. IMPLICATIONS According to the results of this NMA, semaglutide seems to be an effective treatment option for both men and women, whereas beloranib appears to be particularly effective for women with obesity and overweight, but its production has been stopped since 2016 and is not available.
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Arsenic level in drinking water, its correlation with water quality parameters, and associated health risks. ENVIRONMENTAL MONITORING AND ASSESSMENT 2023; 195:899. [PMID: 37380884 DOI: 10.1007/s10661-023-11486-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 06/08/2023] [Indexed: 06/30/2023]
Abstract
This study aimed to evaluate the occurrence and likelihood of health risks related to arsenic in drinking water of all counties of the Hamadan province in the northwest of Iran. In this work, 370 samples were collected from all of the water resources of urban and rural regions, during 5 years (2017 to 2021). Oracle Crystal Ball software was used to perform the Monte Carlo simulation and investigate the potential health risks. According to the results, the average values of arsenic in the nine counties were in the order Kabudarahang (40.1 ppb), Malayer (13.1 ppb), Nahavand (6.1 ppb), Bahar (2.05 ppb), Famenin (0.41 ppb), Asadabad (0.36 ppb), Tuyserkan (0.28 ppb), Razan (0.14 ppb), and Hamadan (< 0.1 ppb). The highest concentration of arsenic occurred in Kabudarahang with a maximum value of 185 ppb. In the spring season, the average concentration of the cations, including calcium, magnesium, sodium, lead, cadmium, and chromium, obtained 109.51 mg/l, 44.67 mg/l, 20.50 mg/l, 88.76 ppb, 0.31 ppb, and 0.02 ppb, respectively. Based on the Delphi classification, the P 90% of oral lifetime cancer risk, in Hamadan province, were within level II (low risk) to VII (extremely high risk). The risk analysis revealed there was a possible carcinogenic risk to humans from oral exposure to As-contaminated groundwater, especially in Kabudarahang county. Therefore, there is an urgent need for management and precise measures in contaminated areas to reduce and prevent the adverse health effects of arsenic.
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The prevalence of uncontrolled diabetes mellitus in patients with type 2 diabetes: a multicenter cross-sectional study. J Diabetes Metab Disord 2023; 22:787-792. [PMID: 37255779 PMCID: PMC10225438 DOI: 10.1007/s40200-023-01201-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 02/17/2023] [Indexed: 03/19/2023]
Abstract
Purpose The prevalence of diabetes is increasing worldwide. Studies have shown that poor blood sugar control is associated with the complications of diabetes, we aimed to determine the prevalence of uncontrolled diabetes mellitus (UDM) and its related factors. Methods This multicenter cross-sectional study was conducted in 2021 on type 2 diabetic patients in three cities; Rasht (in Gillan province), Borujerd (in Lorestan province), and Khodabandeh (in Zanjan province). A predesigned checklist was used to extract the basic characteristics of participants, their hemoglobin A1C, and other required data from their medical records. The prevalence of uncontrolled diabetes was reported with a 95% Confidence Interval. Results In this study, the medical records of 460 patients with type 2 diabetes were included. The mean and standard deviation (SD) of the age of participants was 59.17 (11.59), and 73.2% (337) of participants were female. The prevalence of UDM in Rasht, Borujerd, and Khodabandeh was 58.27%, 69.38%, and 45.65% respectively. The prevalence of UDM in obese patients was 64.78% (57.03, 71.82). Based on the results of the adjusted model, an increase in diastolic blood pressure was significantly associated with UDM, meaning each unit increase in diastolic blood pressure was associated with a 3% increase in UDM (95% CI: 1.01, 1.06), adjusted for age, gender and education. Conclusion According to these results, the prevalence of UDM among patients with diabetes is high. Diastolic blood pressure and low level of education were associated with UDM in diabetic patients.
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Efficacy of Stereotactic Radiosurgery as Single or Combined Therapy for Brain Metastasis: A Systematic Review and Meta-Analysis. Crit Rev Oncol Hematol 2023; 186:104015. [PMID: 37146702 DOI: 10.1016/j.critrevonc.2023.104015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 03/22/2023] [Accepted: 05/01/2023] [Indexed: 05/07/2023] Open
Abstract
To determine the efficacy of stereotactic radiosurgery (SRS) in treating patients with brain metastases (BMs), a network meta-analysis (NMA) of randomized controlled trials (RCTs) and a direct comparison of cohort studies were performed. Relevant literature regarding the effectiveness of SRS alone and in combination with whole-brain radiotherapy (WBRT) and surgery was retrieved using systematic database searches up to April 2019. The patterns of overall survival (OS), one-year OS, progression-free survival (PFS), one-year local brain control (LBC), one-year distant brain control (DBC), neurological death (ND), and complication rate were analyzed. A total of 18 RCTs and 37 cohorts were included in the meta-analysis. Our data revealed that SRS carried a better OS than SRS+WBRT (p= 0.048) and WBRT (p= 0.041). Also, SRS+WBRT demonstrated a significantly improved PFS, LBC, and DBC compared to WBRT alone and SRS alone. Finally, SRS achieved the same LBC as high as surgery, but intracranial relapse occurred considerably more frequently in the absence of WBRT. However, there were not any significant differences in ND and toxicities between SRS and other groups. Therefore, SRS alone may be a better alternative since increased patient survival may outweigh the increased risk of brain tumor recurrence associated with it.
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Development and Psychometric Properties of an Extended Theory of Planned Behavior Questionnaire for Childbearing Intentions and Behaviors in Iran. Korean J Fam Med 2023; 44:109-116. [PMID: 36966741 PMCID: PMC10040272 DOI: 10.4082/kjfm.22.0066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 06/03/2022] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND Childbearing is the most important determinant of population fluctuations, and its study is more important than other population phenomena. Owing to the lack of a valid questionnaire based on the extended theory of planned behavior, this mixed-method study was conducted to determine the validity and reliability of a questionnaire designed to examine related belief-based factors on the intention to bear children in Iranian society. METHODS This study was conducted in two phases in Hamadan city, western Iran, in 2021. Phase 1 consisted of an extensive literature review and a qualitative study using a directed content analysis approach to generate an item pool. Psychometrics were measured in phase 2, including content, face, and construct validity. Reliability was assessed based on internal consistency and stability. The collected data were analyzed using IBM SPSS and AMOS ver. 24.0. RESULTS Mean content validity ratio and content validity index were 0.7 and 0.85, respectively. Exploratory factor analysis of the 32 items identified an eight-factor solution. These factors jointly accounted for 79.1% of the observed variance in the outcome variables. Confirmatory factor analysis indicated a good fit for the data. The internal consistency based on Cronbach's α was 0.85 (0.71-0.93). In addition, stability was confirmed using the test-retest method and intraclass correlation coefficient (0.74-0.94). CONCLUSION The designed questionnaire is a valid and reliable instrument for evaluating related belief-based factors on the intention and behavior of childbearing among married men and women in Iran.
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National trends and projection of chronic kidney disease incidence according to etiology from 1990 to 2030 in Iran: a Bayesian age-period-cohort modeling study. Epidemiol Health 2023; 45:e2023027. [PMID: 36822190 PMCID: PMC10482568 DOI: 10.4178/epih.e2023027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 01/16/2023] [Indexed: 02/25/2023] Open
Abstract
OBJECTIVES Chronic kidney disease (CKD) is a major public health problem worldwide. Predicting CKD incidence rates and case numbers at the national and global levels is vital for planning CKD prevention programs. METHODS Data on CKD incidence rates and case numbers in Iran from 1990 to 2019 were extracted from the Global Burden of Disease online database. The average annual percentage change was computed to determine the temporal trends in CKD age-standardized incidence rates from 1990 to 2019. A Bayesian age-period-cohort model was used to predict the CKD incidence rate and case numbers through 2030. RESULTS Nationally, CKD cases increased from 97,300 in 1990 to 315,500 in 2019. The age-specific CKD incidence rate increased from 168.52 per 100,000 to 382.98 per 100,000 during the same period. Between 2020 and 2030, the number of CKD cases is projected to rise to 423,300. The age-specific CKD incidence rate is projected to increase to 469.04 in 2030 (95% credible interval, 399.20 to 538.87). In all age groups and etiological categories, the CKD incidence rate is forecasted to increase by 2030. CONCLUSIONS CKD case numbers and incidence rates are anticipated to increase in Iran through 2030. The high level of CKD incidence in people with diabetes mellitus, hypertension, and glomerulonephritis, as well as in older people, suggests a deficiency of attention to these populations in current prevention plans and highlights their importance in future programs for the national control of CKD.
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Coinfection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and influenza virus during the COVID-19 pandemic. Arch Virol 2023; 168:53. [PMID: 36609722 PMCID: PMC9825093 DOI: 10.1007/s00705-022-05628-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 09/08/2022] [Indexed: 01/09/2023]
Abstract
The prevalence of coinfection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and influenza virus among referred patients in Hamadan province, Iran, from November 2, 2021, to January 30, 2022, was evaluated. Samples were obtained from 14,116 individuals with COVID-19 symptoms and screened for SARS-CoV-2 and influenza viruses using a multiplex real-time PCR panel assay. Of these patients, 14.19%, 17.11%, and 1.35% were infected with influenza virus, SARS-CoV-2, and both viruses, respectively. The majority of the coinfected patients were female outpatients aged 19-60 years.
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The Immediate Effects of Aerobic Exercise with and Without External Loads on Blood Glucose, Cardiovascular, Respiratory, and Body Temperature Indices in Type II Diabetic Patients. J Tehran Heart Cent 2023; 18:39-45. [PMID: 37252218 PMCID: PMC10225034 DOI: 10.18502/jthc.v18i1.12580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 12/09/2022] [Indexed: 05/31/2023] Open
Abstract
Background The long-term effects of aerobic exercise on the cardiorespiratory system have been studied extensively. This study aimed to evaluate the effects of aerobic exercise with and without external loads on blood glucose, cardiovascular, respiratory, and body temperature indices in patients with type II diabetes. Methods The present randomized control trial recruited participants from the Diabetes Center of Hamadan University through advertisement. Thirty individuals were selected and divided into an aerobic exercise group and a weighted vest group via block randomization. The intervention protocol included aerobic exercise on the treadmill (0 slopes) with an intensity of 50% to 70% of the maximum heart rate. The exercise program for the weighted vest group was identical to that of the aerobic group, except that the subjects wore a weighted vest. Results The mean age of the study population was 46.77±5.11 years in the aerobic group and 48±5.95 years in the weighted vest group. After the intervention, blood glucose in the aerobic group (167.07±72.48 mg/dL; P<0.001) and the weighted vest group (167.75±61.53 mg/dL; P<0.001) was decreased. Additionally, resting heart rate (aerobic: 96.83±11.86 bpm and vest: 94.92±13.65 bpm) and body temperature (aerobic: 36.20±0.83 °C and vest: 35.48±0.46 °C) were increased (P<0.001). Decreased systolic (aerobic: 117.92±19.27 mmHg and vest: 120.91±12.04 mmHg) and diastolic (aerobic: 77.38±7.54 mmHg and vest: 82.5±11.32 mmHg) blood pressure and increased respiration rate (aerobic: 23.07±5.45 breath/min and vest: 22±3.19 breath/min) were seen in both groups but were not statistically significant. Conclusion One aerobic exercise session with and without external loads reduced blood glucose levels and systolic and diastolic blood pressure in our 2 study groups.
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Interventions to prevent road traffic injuries among pedestrians: a systematic review. Int J Inj Contr Saf Promot 2022; 29:533-549. [PMID: 35776527 DOI: 10.1080/17457300.2022.2089685] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Road traffic injuries (RTIs) are a serious public health problem and are an important cause of disability and death worldwide. A significant proportion of traffic injuries and fatalities are among pedestrians. Reviewing and evaluating related interventions can be a practical step to implementing appropriate methods to prevent RTIs among pedestrians, a highly vulnerable group of road users. The search of articles was conducted in the electronic databases of Scopus, PubMed, ISI, Safety Lit, and CDC. Other papers were also reviewed using forward citation and backward citation. The search strategy was for studies examined from the first years of database creation until January 10, 2021, in all languages in journals with matched judgment according to the type of population, type of interventions, comparators, and results. Joanna Briggs Institute (JBI) checklists were used to determine articles' quality and assess possible biases depending on the type of study. The initial search resulted in finding 16,272 abstracts. Finally, 25 studies, including 17 randomized clinical trials (RCTs) studies, seven studies pretest/post-test interventions (PPI), and one study controlled pretest/post-test interventions (cPPI) met the inclusion criteria. Among these preventive interventional studies, 20 studies were conducted in high-income countries, three were in lower middle-income countries, one study was in upper middle-income country, and only one study was conducted in a low-income country. Most interventional studies in the field of prevention of RTIs (15 studies) had an educational/behavioral approach, designed to change pedestrian behavior and the use of this approach was also effective in improving pedestrian behavior. The legislation/law enforcement approach was used in one study and two studies used an engineering/technology approach. In studies with an engineering approach after engineering reforms, pedestrian injuries in children decreased by 37.5%. In seven studies, multifaceted interventions were used. The interventional studies that used this approach were able to improve pedestrian safe behavior. The majority of studies were based on educational/behavioral approaches and pedestrians' behavior improved notably. In addition, the majority of interventional studies were conducted in countries with high income levels. Therefore, programming for preventive interventions to attenuate RTIs is highly important in low/middle-income countries to reduce the risk of injury to vulnerable road users. These findings can be applied by policy-makers to develop educational, engineering, environmental, and law enforcement interventions and attenuate injuries sustained by pedestrians.
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The prevalence of Q fever in the Eastern Mediterranean region: a systematic review and meta-analysis. Epidemiol Health 2022; 44:e2022097. [PMID: 36317399 PMCID: PMC10396516 DOI: 10.4178/epih.e2022097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 10/28/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES Q fever, caused by the bacterium, is a major zoonotic disease around the world. This disease is common in the Eastern Mediterranean region; therefore, we conducted the first systematic review and meta-analysis on its prevalence in humans, animals, and ticks in the Eastern Mediterranean region. METHODS Major Iranian and international databases were searched from 2000 to 2021. We extracted the prevalence of Q fever in blood samples from animals and milk samples from animals, ticks, and humans as the main outcome. We reported the prevalence of seropositivity and molecular positivity as point estimates and 95% confidence intervals (CIs). RESULTS In this review, 112 papers were identified. The overall seroprevalence of Q fever was 22.4% (95% CI, 19.8 to 25.1). The pooled prevalence of Q fever in ticks was 17.5% (95% CI, -1.3 to 36.4). The prevalence was 25.5% (95% CI, 16.1 to 34.9) in humans. The prevalence of Q fever in animal blood samples from goats, sheep, camels, cattle, cats, dogs, horses, and buffalo were 28.1%, 25.1%, 25.0%, 20.1%, 9.8%, 8.4%, 6.5%, and 6.3%, respectively. Furthermore, the prevalence of Q fever in milk samples of animals was higher in cattle (20.3%) than in sheep (20.0%), goats (16.4%), and camels (3.3%). CONCLUSIONS Coxiella burnetii infections are common in humans and in a wide range of animal species, but they are still not recognized in many countries in the Eastern Mediterranean region, thus presenting a significant threat to human and animal health in the region.
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Evaluation of Lactocare® Synbiotic Administration on the Serum Electrolytes and Trace Elements Levels in Psoriasis Patients: a Randomized, Double-Blind, Placebo-Controlled Clinical Trial Study. Biol Trace Elem Res 2022; 200:4230-4237. [PMID: 34845600 PMCID: PMC8629602 DOI: 10.1007/s12011-021-03020-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 11/04/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Despite the exact etiopathogenesis of psoriasis remains unknown, the increasing or decreasing of some trace elements and oxidative stress status are considered to play a role. In this study, the effect of Lactocare® synbiotic on the serum levels of trace elements including Zn, Cu, Mg, Na, Fe, P, Ca, and K in the patients with mild to moderate psoriasis was investigated. METHODS Sixty-four patients with mild to moderate psoriasis were included. Patients were randomly divided into treatment (n═32) and control (n═32) groups. The treatment group received Lactocare® and the control group received a placebo (two times daily for 12 weeks). Eight patients from the intervention group and 18 patients from the control group discontinued the study because of the recent COVID-19 condition. For routine trace element analysis, the blood samples were collected from all patients at the baseline as well as week 12 post-treatment. The serum was then isolated and the serum levels of trace elements including Fe, K, Ca, Mg, P, Zn, Na, and Cu were measured using an automatic electrolyte analyzer. For confirmation of the effect of Lactocare® on the alteration of serum levels of trace elements, intra-group analysis was performed at two interval times: baseline and week 12 post-treatment. RESULTS The serum levels of K, P, and Ca in the placebo group were significantly higher than that of the treatment group at baseline. Serum levels of Zn and Ca were significantly higher in the treatment group compared to the placebo group at week 12 post-treatment. Moreover, a significantly lower serum level of K, P, and Ca in the treatment group at the baseline compared to the placebo group was compensated on week 12 post-treatment. Intra-group analysis in the treatment group showed that the serum levels of Fe, Ca, Mg, P, Zn, and Na was significantly increased at week 12 post-treatment compared to baseline levels. Whereas, intra-group analysis in the control group showed only Ca has a significant difference between baseline and week 12 post-treatment. CONCLUSION The serum levels of Fe, Zn, P, Mg, Ca, and Na are increased significantly 12 weeks after oral administration of Lactocare® in psoriatic patients. The serum level of Fe and Cu is affected by sex at pre- and post-treatment. This study supports the concept that Lactocare® exerts beneficial effects in the gastrointestinal tract to improve mineral absorption in psoriatic patients.
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The performance of HEAR score for identification of low-risk chest pain: a systematic review and meta-analysis. Eur J Emerg Med 2022; 29:173-187. [PMID: 35446265 DOI: 10.1097/mej.0000000000000921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Chest pain is one of the most common presentations to the emergency department (ED) and HEART score (history, ECG, age, risk factors, and cardiac troponin) is recommended for risk stratification. It has been proposed that the sum of four items with no troponin (HEAR score) below 2 can be used safely to lower testing and reduce length of stay. To assess the performance of the HEAR score in hospital and prehospital settings, we performed a systematic review and meta-analysis. English studies on the performance of the HEAR score in patients with acute chest pain were included. They were excluded if data are inaccessible. MEDLINE, Embase, Evidence-Based Medicine Reviews, Scopus, and web of science were searched from 1946 to July 2021. The quality of studies was assessed using Quality Assessment of Diagnostic Accuracy Studies version 2. Acute coronary syndrome or major adverse cardiac events prediction were outcomes of interest. The performance indices with 95% confidence intervals (CIs) were extracted. Inverse variance and the random-effects model were used to report the results. Of the 692 articles on the HEAR score, 10 studies were included in the analysis with 33 843 patients. Studies were at low to moderate risk of bias. Three studies were in prehospital and three were retrospective. The pooling of data on the HEAR score showed that the sensitivity at the HEAR<2, <3, and <4 cutoffs in the ED were 99.03% (95% CI, 98.29-99.77), 97.54% (95% CI, 94.50-100), and 91.80% (95% CI, 84.62-98.98), respectively. The negative predictive values (NPVs) for the above cutoffs were 99.84% (95% CI, 99.72-99.95), 99.75% (95% CI, 99.65-99.85), and 99.57% (95% CI, 99.11-100), respectively. Of note, for the HEAR<2, negative likelihood ratio was 0.07 (95% CI, 0.02-0.12). In the prehospital, at the HEAR<4 cutoff, the pooled sensitivity and NPV were 85.01% (95% CI, 80.56-89.47) and 91.48% (95% CI, 87.10-95.87), respectively. This study showed that in the ED, the HEAR score<2 can be used for an early discharge strategy. Currently, this score cannot be recommended in prehospital setting. Prospero (CRD42021273710).
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High-Risk Behaviors and Associated Factors among Iranian Adult Population: A National Survey. IRANIAN JOURNAL OF PUBLIC HEALTH 2022; 51:1107-1117. [PMID: 36407734 PMCID: PMC9643248 DOI: 10.18502/ijph.v51i5.9426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 04/18/2021] [Indexed: 06/16/2023]
Abstract
BACKGROUND There is no official and representative information on certain health-risk behaviors in Iran. This national survey was performed to determine the prevalence of five high-risk behaviors among the adult population and underlying factors. METHODS This cross-sectional study was performed in 23 provinces of Iran in 2019 involving 10,957 participants. The following five risky behaviors were evaluated: (a) using illicit drugs in the past month, (b) drinking alcohol in the past month, (c) having extramarital sex in the past year, (d) having suicidal thoughts in the past month, (e) and attempting suicide in the past year. The logistic regression model was used for analyses and associations were reported using odds ratio (OR) with its 95% confidence interval (CI). RESULTS The prevalence of health-risk behaviors was as follows: illicit drug use 10.4%, drinking alcohol 16.8%, extramarital sex 9.9%, suicidal thoughts 8.8%, and suicide attempt 5.4%. Almost 27.6% of the participants were involved in at least one risky behavior. There was a strong association between illicit drugs use and male gender 2.51 (2.11-2.98) and using psychiatric medications 2.96 (2.46-3.55); between drinking alcohol and male gender 2.23 (1.93-2.58); between extramarital sex and divorced/widowed status 2.43 (1.72-3.44) and having an intimate friend of the opposite sex 3.75 (3.13-4.51); between suicidal thoughts and using psychiatric medications 2.23 (1.83-2.72); between suicide attempt and a history of running away from home 2.10 (1.64-2.68). CONCLUSION More than one-fourth Iranian adult population is involved in at least one risky behavior. Engaging in any risky behavior may increase the possibility of engaging in other high-risk behaviors.
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Understanding the rationales behind childbearing: A qualitative study based on extended theory of planned behavior. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:119. [PMID: 35677275 PMCID: PMC9170212 DOI: 10.4103/jehp.jehp_849_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 07/26/2021] [Indexed: 06/15/2023]
Abstract
BACKGROUND Childbearing is the most important determinant of population fluctuations and its studies are more important than other population phenomena. Many factors are associated with childbearing, but individual factors associated with it have been less studied in a specific framework. The present study aimed to explore and identify the factors related to childbearing based on extended theory of planned behavior (ETPB). MATERIALS AND METHODS This qualitative study was conducted among married women <35 years of age and married men whose spouses were under 35 years of age and lived in the City of Hamadan, Iran, in 2019. The data were collected by semistructured and face-to-face in-depth interviews and continued until the data saturation was reached. Overall, 15 interviews were conducted with 17 people. The data were analyzed, using a directed content analysis approach. RESULTS The data analysis resulted in the extraction of 28 main codes, 9 subcategories, and 4 themes, which were correspond to constructs of the theory, consisting of attitudes, subjective norms, perceived behavioral control, and social support in the field of childbearing. The main predictors were attitude toward childbearing and perceived control. CONCLUSION The findings of this study showed that ETPB has a potential to explain the intention and behavior of childbearing. The ETPB makes it possible to understand many of the factors associated with childbearing. The results of this study could be the basis for designing appropriate data collection instrument in quantitative studies and vast surveys.
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The contribution of avoidable factors in doubling or halving the odds of hypertension. PLoS One 2022; 17:e0266689. [PMID: 35390081 PMCID: PMC8989301 DOI: 10.1371/journal.pone.0266689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 03/24/2022] [Indexed: 11/19/2022] Open
Abstract
Background Despite the well-known impact of fruit/vegetable consumption, physical activity, body mass index, waist-hip ratio, fasting blood glucose, and total cholesterol on blood pressure, the amount of exposure to these factors is required to halve or double the odds of hypertension is unknown, but it was investigated in this research. Methods The data used in this study are derived from results of the seventh Iranian national STEPS survey involving 30,542 adults aged 18 years or older. The questionnaire measured non-communicable disease risk factors covered three different levels including behavioral characteristics, physical and biochemical measurements. The level of exposure to factors necessary to reach the odds ratio of 0.5 or odds ratio of 2.0 was obtained from the coefficients of the multiple logistic regression model. Results An OR of 0.5 corresponds to 7 servings of fruit and vegetable consumption daily and burning of 7175 kcal through physical activity at work or recreation daily. An OR of 2.0 corresponds to an increase in body mass index of about 11 kg/m2, an increase in the waist-hip ratio of about 18%, an increase in fasting blood glucose of about 77 mg/dl, and an increase in total cholesterol of about 134 mg/dl. Conclusion The results of this study indicate how much fruit and vegetable and physical activity halve the odds of hypertension and how much increase in body mass index, the waist-hip ratio, fasting blood glucose, and total cholesterol can double the odds of hypertension. Such information may be useful for developing guidelines by policymakers.
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The Dynamic Effective Reproductive Number of COVID-19 during the Epidemic in Iran. IRANIAN JOURNAL OF PUBLIC HEALTH 2022; 51:886-894. [PMID: 35936541 PMCID: PMC9288400 DOI: 10.18502/ijph.v51i4.9250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 07/19/2021] [Indexed: 06/15/2023]
Abstract
BACKGROUND We aimed to determine the generation time, the best model for estimating reproduction number (R), and to estimate the basic reproduction number (R0) and effective reproduction number (Rt) for COVID-19 in Iran. METHODS We used the daily incidence cases of COVID-19, hospitalized due to a probable diagnosis of COVID-19 from 19 February 2020 to 17 November 2020 in Iran. Four models, including maximum likelihood (ML), exponential growth (EG), time-dependent (TD), sequential Bayesian (SB) were evaluated. The weekly reproduction number with a 95% confidence interval (CI) was calculated. RESULTS TD model shows the best fit compared to other models for estimating reproduction number in Iran. The R0 in Iran in the first week of the epidemic, leading up to 21 February 2020 was 7.19, 95% CI: 5.56, 9.00. The lowest value for the Rt was equal to 0.77 between 3 to 10 March 2020 and 4 to 11 December 2020. From 11 June 2020 up to13 August 2020, the Rt was more than one but after then to 24 September 2021 was less than one. CONCLUSION TD model was the best fit for estimating the R in Iran. The worst situation of the epidemic in Iran was related to the weeks leading up to 26 February 2020 and 28 October 2020, and better status was related to the weeks leading up to 10 March 2020 and 11 December 2020.
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Global prevalence of unmet need for mental health care among adolescents: A systematic review and meta-analysis. Arch Psychiatr Nurs 2022; 36:1-6. [PMID: 35094819 DOI: 10.1016/j.apnu.2021.10.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 07/07/2021] [Accepted: 10/18/2021] [Indexed: 11/02/2022]
Abstract
PURPOSE Globally mental disorders affect a large number of adolescents. The unmet need for health care of mental health problems is common among adolescents. The aim of this systematic review and meta-analysis was to estimate the global prevalence of unmet needs of mental health care among adolescents. METHODS PubMed, Web of Sciences and Scopus, were searched by June 2018 using a pre-designed search strategy. The summary measure was the prevalence of unmet need for mental health care. The inverse variance method was used in meta-analysis, and the results were reported using the random-effects model at a 95% confidence interval (CI). RESULTS Out of 30,154 retrieved studies, 15 cross-sectional studies met the eligibility criteria and included in the meta-analysis. The included studies involved 51,309 participants, which 34,476 of them required the mental health care services. The overall pooled prevalence of unmet need for mental health care was 54.0% (95% CI: 41.0, 67.0; I2 = 99.9%). Prevalence among adolescents with any mental disorder, general population of adolescents, and high-risk adolescents were 58.1 (46.8, 69.5), 51.4 (30.2, 72.7), and 31.0 (29.0, 33.0) respectively. CONCLUSION Based on the results of this systematic review a considerable proportion of adolescents with mental health problems, have not received the required mental health care.
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Diet Therapeutics Interventions for Obesity: A Systematic Review and Network Meta-Analysis. J Res Health Sci 2021; 21:e00521. [PMID: 34698655 PMCID: PMC8957686 DOI: 10.34172/jrhs.2021.63] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 08/29/2021] [Indexed: 11/09/2022] Open
Abstract
Background: Up to now, different diet therapeutics interventions have been introduced for the treatment of obesity. The present study aimed to compare the diet therapeutics interventions for obesity simultaneously.
Study design: Systematic review and network meta-analysis
Methods: The major international databases, including Medline (via PubMed), Web of Science, Scopus, Cochrane Library, and Embase, were searched using a predesigned search strategy. Randomized controlled trials (RCTs) that had compared the diet therapy interventions were included. The mean difference with a 95% confidence interval was used to summarize the effect size in the network meta-analysis. The frequentist approach was used for data analysis.
Results: In total, 36 RCTs out of 9335 retrieved references met the inclusion criteria in this review. The included RCTs formed nine independent networks. Based on the results, Hypocaloricdiet+Monoselect Camellia (MonCam, P=0.99), energy restriction, behavior modification+exercise (LED) (P=0.99), sweetener at 20% of total calories (HFCS20)+Ex (P=0.67), catechin-richgreentea(650)+inulin (P=0.68), very low calorie diet (VLCD) (P=1.00), normal protein diet+resistance exercise (NPD+RT) (P=0.80), low-calorie diets+exercise (Hyc+Ex) (P=0.85), high-soy-protein low-fat diet (SD) (P=0.75), calorie restriction+behavioral weight loss (Hyc+BWL) (P=0.99) were the better treatments for weight loss in the networks one to nine, respectively.
Conclusion: Based on the results of network meta-analysis, it seems that Hypocaloricdiet+MonCam, LED, HFCS20+Ex, catechin-rich green tea +inulin, VLCD, NPD+RT, Hyc+Ex, SD, Hyc+BWL, are the better treatments for weight loss in patients with overweight and obesity.
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Using Machine Learning Techniques to Predict Factors Contributing to the Incidence of Metabolic Syndrome in Tehran: Cohort Study. JMIR Public Health Surveill 2021; 7:e27304. [PMID: 34473070 PMCID: PMC8446845 DOI: 10.2196/27304] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 04/23/2021] [Accepted: 05/17/2021] [Indexed: 11/25/2022] Open
Abstract
Background Metabolic syndrome (MetS), a major contributor to cardiovascular disease and diabetes, is considered to be among the most common public health problems worldwide. Objective We aimed to identify and rank the most important nutritional and nonnutritional factors contributing to the development of MetS using a data-mining method. Methods This prospective study was performed on 3048 adults (aged ≥20 years) who participated in the fifth follow-up examination of the Tehran Lipid and Glucose Study, who were followed for 3 years. MetS was defined according to the modified definition of the National Cholesterol Education Program/Adult Treatment Panel III. The importance of variables was obtained by the training set using the random forest model for determining factors with the greatest contribution to developing MetS. Results Among the 3048 participants, 701 (22.9%) developed MetS during the study period. The mean age of the participants was 44.3 years (SD 11.8). The total incidence rate of MetS was 229.9 (95% CI 278.6-322.9) per 1000 person-years and the mean follow-up time was 40.5 months (SD 7.3). The incidence of MetS was significantly (P<.001) higher in men than in women (27% vs 20%). Those affected by MetS were older, married, had diabetes, with lower levels of education, and had a higher BMI (P<.001). The percentage of hospitalized patients was higher among those with MetS than among healthy people, although this difference was only statistically significant in women (P=.02). Based on the variable importance and multiple logistic regression analyses, the most important determinants of MetS were identified as history of diabetes (odds ratio [OR] 6.3, 95% CI 3.9-10.2, P<.001), BMI (OR 1.2, 95% CI 1.0-1.2, P<.001), age (OR 1.0, 95% CI 1.0-1.03, P<.001), female gender (OR 0.5, 95% CI 0.38-0.63, P<.001), and dietary monounsaturated fatty acid (OR 0.97, 95% CI 0.94-0.99, P=.04). Conclusions Based on our findings, the incidence rate of MetS was significantly higher in men than in women in Tehran. The most important determinants of MetS were history of diabetes, high BMI, older age, male gender, and low dietary monounsaturated fatty acid intake.
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Transmission of COVID-19 and its Determinants among Close Contacts of COVID-19 Patients Running title. J Res Health Sci 2021; 21:e00514. [PMID: 34465637 PMCID: PMC8957671 DOI: 10.34172/jrhs.2021.48] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 03/30/2021] [Accepted: 04/06/2021] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND This study aimed to determine the secondary attack rate (SAR) and its determinants to describe the clinical features and epidemiological aspects of patients and determine the risk factors of COVID-19 among household contacts in Hamadan Province, west of Iran. STUDY DESIGN A cohort study. METHODS In this cohort study, a total of 323 index cases and 989 related close contacts ages more than 15 years old (family members, relatives, and co-workers) were enrolled using a manual contact tracing approach, and all participants were tested by reverse transcription polymerase chain reaction test. In this research, the frequency of symptoms was assessed, the SAR among contacts of index cases was calculated, and the risk factors of COVID-19 were evaluated by the logistic regression model. RESULTS The secondary attack rate for total household members of index cases was estimated at 31.7% (95% CI: 28.8-34.7). It was found that among household contacts, the highest SARs were related to spouses 47.1% (95% CI: 38.7-55.7) and grandparents/parents 39.3% (95% CI: 29.4, 49.9) of index cases, who had also higher risks to become secondary cases (adjusted odds ratio [OR]=2.98, 95% CI: 1.31-6.75 and adjusted OR=2.76, 95% CI: 1.18-6.44, respectively). Considering the occupation of contacts, unemployed and retired people and housewives were most susceptible for transmission of COVID-19. It was revealed that cough was the most prevalent symptom among index and secondary cases. CONCLUSION Our findings indicated that spouses and grandparents/parents of index cases were the most susceptible individuals for COVID-19 transmission. Prolonged exposure with index case before COVID-19 diagnosis raised the chance of infection among secondary cases.
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Effect of interventions based on regular physical activity on weight management in adolescents: a systematic review and a meta-analysis. Syst Rev 2021; 10:52. [PMID: 33557946 PMCID: PMC7871535 DOI: 10.1186/s13643-021-01602-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 01/27/2021] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Physical inactivity is one of the major risk factors for non-communicable diseases. This systematic review and meta-analysis aimed to assess the effects of educational interventions on promoting regular physical activity in adolescent weight management programs. METHODS The relevant studies indexed in Embase, Web of Science, Scopus, and ProQuest databases were searched using keywords namely "Physical Activity, Adolescent, Weight Management, Body Mass Index (BMI), Randomized Controlled Trials, and Clinical Trial." Up to the end of March 2020, two authors independently screened the papers, extracted data, and assessed the methodological quality of the studies using Effective Public Health Practice Project (EPHPP) tool. RESULTS Out of 12,944 initial studies, 14 met the inclusion criteria after screening the titles, abstracts, and full texts of the papers. The participants in these studies were aged between 6 and 18 years, and 13 studies included participants from both sexes. Moreover, eight of them were performed as a controlled clinical trial. The overall estimate of the difference showed that the interventions improved weight loss which is a statistically significant finding. The participants in the intervention group had a weight loss of 1.02 kg compared to the control group at a 95% confidence interval (- 4.794-0.222). CONCLUSION Published longitudinal data indicated that physical activity declines over the transition from adolescence to adulthood. Using the results of the study, policy-makers can design educational interventions using educational models and patterns. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration number: CRD42020173869.
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The effect of peer support approach on communication skills of nursing students in pediatric clinical setting. Nurse Educ Pract 2021; 52:102984. [PMID: 33677430 DOI: 10.1016/j.nepr.2021.102984] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 01/04/2021] [Accepted: 01/31/2021] [Indexed: 12/16/2022]
Abstract
Peer support is a valuable teaching-learning approach to enhance deep learning in the clinical environment. The purpose of the present study was to investigate the effect of peer support on the communication skills of undergraduate nursing students when interacting with hospitalized children and their parents. This was a pre-and post-test quasi-experimental study with two groups. Through the cluster random sampling method, six practical groups of students who undertook a 3-week pediatric practicum were selected. Three groups were allocated to the experimental (n = 51) and control groups (n = 52). Two volunteer post-graduate students in pediatric nursing formed the peer group. First, the peers participated in three 45-min sessions using different scenarios about communication skills. They then tutored the intervention group to improve their communication skills. The communication skills with 5 children and 5 parents were observed for each undergraduate student via the checklist. The experimental group demonstrated significantly higher mean scores of the communication skills than the control groups in post-test (P < 0.001). Moreover, the mean scores of communication skills was significantly higher in post-test than pre-test in both the experimental and control groups (p < 0.001). Peer support approach promoted the communication skills of undergraduate nursing students in pediatric clinical setting.
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Correction to: Epidemiology of animal bite in Iran during a 20-year period (1993-2013): a meta-analysis. Trop Med Health 2021; 49:7. [PMID: 33499928 PMCID: PMC7836587 DOI: 10.1186/s41182-020-00294-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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The Role of Media on the Intention of Adolescents Smoking: A Systematic Review and Meta-Analysis. JOURNAL OF EDUCATION AND COMMUNITY HEALTH 2020. [DOI: 10.29252/jech.7.4.311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
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Associated Factors with Developmental Delay of under 5 Year Old Children in Hamadan, Iran: A Case-Control Study. JOURNAL OF EDUCATION AND COMMUNITY HEALTH 2020. [DOI: 10.29252/jech.7.4.263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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The Epidemiology of Aggression and Associated Factors among Iranian Adult Population: A National Survey. J Res Health Sci 2020; 20:e00499. [PMID: 33424008 PMCID: PMC8695783 DOI: 10.34172/jrhs.2020.34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Accepted: 11/22/2020] [Indexed: 12/01/2022] Open
Abstract
Background: This survey was conducted to determine the level of aggression among the Iranian adult population and underlying predisposing factors.
Study design: A cross-sectional study.
Methods: This cross-sectional study included 10,957 participants, involving 23 out of the 31 provinces of Iran in 2019. The outcome of interest was aggression, evaluated by the Buss & Perry aggression questionnaire. The association between aggression and 34 demographic, behavioral, social, and cultural characteristics was assessed using simple and multiple linear regression.
Results: The overall mean (SD) score of aggression was 77.10 (22.53). Based on the severity of aggression, the participants were categorized into four groups as follows: 2,464 (23.1%) nonaggressive, 4,692 (43.9%) mild, 3,071 (28.8%) moderate, and 454 (4.2%) severe aggressive. Aggression was more likely to occur in people with the following characteristics: younger ages, having several siblings, lower ranks of birth, having an intimate friend of the opposite sex, having an aggressive father/mother, history of parental divorce, interest in watching action/porn movies, listening to music, history of escape from home/school, using neuropsychiatric drugs, using illicit drugs, history of suicidal thoughts/attempt, and family conflict and hostility. Aggression was less likely to occur with the following characteristics: reading, regular physical exercise, the ability to control anger, regular prayer, adherence to avoid lying, respect to other people's rights, sexual satisfaction, and attachment to parents.
Conclusions: A majority of the population has some degree of aggression. Aggression is a multifactorial behavior corresponding with several demographical, social, cultural, and religious factors, some of which back to early childhood events.
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How Can the Epidemic Curve of COVID-19 in Iran Be Interpreted? J Res Health Sci 2020; 20:e00491. [PMID: 33169723 PMCID: PMC7585769 DOI: 10.34172/jrhs.2020.27] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 09/29/2020] [Indexed: 02/01/2023] Open
Abstract
Background: Iran is one of the countries most affected by COVID-19. This review provides possible interpretations of the observed trend of COVID-19 in Iran.
Study design: A rapid review
Methods: We reviewed the daily new cases of COVID-19 based on hospitalized and outpatients, reported deaths, and diagnostic testing in Iran.
Results: Iran reported its first peak in the number of cases in late March, 2020. From the 1 April to 3 May 2020, the downward trend in the number of cases was started. The death trend also showed a peak in early April as well as a downward trend in late April. During May, the number of death cases showed a stable trend with a daily number of deaths ranging between 50 and 75 cases. Then the number of deaths gradually increased.
Conclusion: The epidemic curve in Iran is a function of different factors such number of total tests, change in mitigation policies, and heterogeneities among different provinces in the country. Therefore it should be interpreted under the light of the effect of such factors.
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Challenges for management of the COVID-19 epidemic in Iran. GLOBAL EPIDEMIOLOGY 2020; 2:100035. [PMID: 33015615 PMCID: PMC7525261 DOI: 10.1016/j.gloepi.2020.100035] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 09/25/2020] [Accepted: 09/25/2020] [Indexed: 12/27/2022] Open
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What are network meta-analyses (NMAs)? A primer with four tips for clinicians who read NMAs and who perform them (methods matter series). Br J Sports Med 2020; 55:bjsports-2020-102872. [PMID: 32948517 DOI: 10.1136/bjsports-2020-102872] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2020] [Indexed: 12/17/2022]
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Prevalence and severity of carpal tunnel syndrome symptoms among Iranian butchers and their association with occupational risk factors: Implications for ergonomic interventions. Work 2020; 66:817-825. [PMID: 32925141 DOI: 10.3233/wor-203227] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Carpal tunnel syndrome (CTS) is a common disorder among occupations where upper extremities are actively involved in. Many occupational and non-occupational risk factors may contribute to this disorder. Knowledge regarding occupational risk factors can guide us to implement interventional programs. OBJECTIVE The aim of the present study was to assess the prevalence and severity of CTS symptoms among butchers and their association with several occupational and non-occupational risk factors. METHODS In this study, 152 butchers in Hamadan, Iran, were examined. The Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) was used to investigate the severity of CTS symptoms among the individuals. Several risk factors such as body mass index (BMI), wrist ratio, active working hours per day, working experience, and the ergonomic quality of hand tools used by butchers were also investigated. Statistical tests such as the crude and robust regression were used to analyze the data. RESULTS The prevalence of moderate and mild symptoms of CTS were 7% and 54%, respectively. Moreover, 39% of the butchers were free of CTS symptoms. Crude regression analyses showed that the severity of CTS symptoms had a significant relationship with age, work experience, active working hours per day, working hours per week, and ergonomic quality of the hand tools (p value <0.05). There was no significant relationship between the severity of CTS symptoms and wrist ratio and BMI. Results of the robust regression analysis showed a significant relationship between the severity of CTS symptoms with experience, active working hours, and quality of the hand tools. CONCLUSION Occupational risk factors such as working experience, active working hours per day, and the ergonomic quality of hand tools are significant risk factors of CTS symptoms among butchers. Slippery handle is the main non-ergonomic feature of knives and cleavers used by butchers. There was no association between BMI and wrist ratio with CTS symptoms.
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Case Fatality Rate of COVID-19: Meta-Analysis Approach. ARCHIVES OF IRANIAN MEDICINE 2020; 23:644-646. [PMID: 32979914 DOI: 10.34172/aim.2020.78] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 07/01/2020] [Indexed: 11/09/2022]
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Prevalence of high-risk behaviors in reproductive age women in Alborz province in 2019 using unmatched count technique. BMC WOMENS HEALTH 2020; 20:186. [PMID: 32867777 PMCID: PMC7461357 DOI: 10.1186/s12905-020-01056-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Accepted: 08/25/2020] [Indexed: 11/26/2022]
Abstract
Background Our knowledge on the prevalence of high-risk behaviors among women of Alborz is not reliable due to the sensitivity of the issue. This study aimed to estimate the prevalence of seven risk behaviors among the reproductive age women in Alborz Province, Iran. Method In this cross-sectional study, 2000 women were randomly selected from a registered healthcare system in 2019. A researcher-made questionnaire was used to collect the required data. The prevalence of the risk behaviors including drug abuse, hookah, alcohol drinking, tobacco smoking, extramarital intercourse, and gambling was estimated using the unmatched count technique, and the prevalence rate was reported at a 95% confidence interval. Results The response rate for this study was 95%. The estimated prevalence for drug abuse, hookah, alcohol drinking, tobacco smoking, extramarital intercourse, and gambling were 3% (95%CI: 2.78 to 3.22), 10.5% (95%CI: 10.29 to 10.71), 7% (95%CI: 6.78 to 7.22), 10% (95%CI: 9.78 to 10.22), 8.7% (95%CI, 8.29 to 8.71), and 7.5% (95%CI, 4.71 to 7.28), respectively. Conclusion High risk behaviors are highly prevalent among Iranian women. Enforcing laws, prohibition, marketing restrictions, increasing taxation, expanding treatment, promoting condom distribution and providing community-based service are recommended to reduce the effects of high risk behaviors among women.
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Changes in the distribution of etiologies of cirrhosis among patients referred for liver transplantation over 11 years in Iran. Eur J Gastroenterol Hepatol 2020; 32:844-850. [PMID: 31688307 DOI: 10.1097/meg.0000000000001590] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
BACKGROUND AND AIM Cirrhosis is a major public health problem worldwide. The prevalence of cirrhosis is various in different geographical regions. The aim of the present study was to determine the distribution of the etiologies of cirrhosis and their proportional changes through recent 11 years in Iran. METHODS In this retrospective, observational study, the data of cirrhotic patients who have been listed for liver transplantation in the Namazi Transplant Center (Shiraz, Iran) between January 2006 and December 2016 were analyzed. Demographic and clinical data of the patients including model for end-stage liver disease score, year of registration, and the etiologic diagnosis for each patient were retrieved. RESULTS The ratio of males to females was the highest (2.6:1) in patients with age over 50 years. Of 4891 patients, hepatitis B virus cirrhosis had the highest frequency (23.53%) and alcoholic cirrhosis had the lowest frequency (1.70%). The percentages of waiting list patients with hepatitis B virus (34.48%-17.48%) (P < 0.001), autoimmune hepatitis (12.64%-8.50%) (P = 0.037), and alcoholic cirrhosis (2.30%-1.10%) were decreased (P = 0.008) and the percentages of waiting list patients with cholestatic (12.64%-25.20%) and nonalcoholic steatohepatitis cirrhosis (0.77%-8.82%) were increased over 11 years (both P < 0.001). Hepatitis B virus and autoimmune hepatitis cirrhosis were the most prevalent in male and female patients, respectively. CONCLUSION The results of the present study showed an increase in the frequency of cholestasis and nonalcoholic steatohepatitis cirrhosis and therefore it should be considered in the health policy implementation.
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Prevalence and Incidence of Metabolic Syndrome in Iran: A Systematic Review and Meta-Analysis. Int J Prev Med 2020; 11:64. [PMID: 32577194 PMCID: PMC7297433 DOI: 10.4103/ijpvm.ijpvm_489_18] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 08/08/2019] [Indexed: 12/15/2022] Open
Abstract
Metabolic syndrome (MetS) is a predictor of several diseases such as cardiovascular diseases, diabetes, dyslipidemia, stroke, osteoarthritis, certain cancers, and death leading to public health concern in most societies. We aimed to estimate the pooled prevalence and incidence of MetS in Iranian population through a meta-analysis study. We included cross-sectional and cohort studies to estimate the overall prevalence and incidence rates of MetS in Iran National databases including MagIran, Science Information Database, IranMedex, and international databases including Medline, Web of Sciences, and Scopus were searched up to October 2017. Finally, 125 studies were included. The total sample size was 472,401 with a mean age of 38 ± 7.8 years. The overall pooled prevalence and incidence rate among the general population of Iran was 0.26 (95% CI: 0.26, 0.29) and 97.96 (95% CI: 75.98, 131.48), respectively. The pooled prevalence of MetS was higher in females and in urban areas. The highest and lowest prevalence of MetS was obtained by the Iranian definition criteria (0.43) and the NHANES III (0.12). The highest and lowest incidence rates of MetS were obtained by IDF (144.07 per 1000) and the JIS (89.73 per 1000). The prevalence of MetS was higher in women and those living in urban areas. Furthermore, the prevalence of MetS increased with increasing age in both genders.
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Behavioral factors influencing childhood obesity: a systematic review and meta-analysis. Obes Res Clin Pract 2020; 14:109-118. [DOI: 10.1016/j.orcp.2020.03.002] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 02/21/2020] [Accepted: 03/10/2020] [Indexed: 11/28/2022]
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Epidemiology of animal bite in Iran during a 20-year period (1993-2013): a meta-analysis. Trop Med Health 2019; 47:55. [PMID: 31798312 PMCID: PMC6884825 DOI: 10.1186/s41182-019-0182-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 10/04/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Rabies is a fatal disease that still kills 2-6 people a year in Iran. A meta-analysis was conducted in order to generate accurate data on animal bite exposure, and to estimate the incidence of animal bite across the country. MATERIALS AND METHODS Major national and international electronic databases were searched using the keywords "animal bite," rabies, prevalence, incidence, and Iran. Web of Knowledge, PubMed, Scopus, Ovid, and ScienceDirect were used as international databases, and the national databases included Science Information Database, MagIran, and IranDoc. Descriptive cross-sectional studies addressing the incidence of animal bite were selected and screened by two authors, and pre-specified data were extracted. The population of provinces or cities of studies was extracted from the Statistical Centre of Iran. The overall incidence of animal bite in Iran was estimated using a random-effects model with 95% confidence interval (CI). Study quality was assessed using the STROBE recommended checklist. RESULTS A total of 34 studies were selected for the meta-analysis out of 1215 retrieved studies. The number of animal bites in the studies during 1993-2013 was 230,019 cases. The overall estimated incidence rate of animal bite in Iran was 13.20/1000 (95%, CI 12.10, 14.30) and the mean age of people was 26.23 (SD = 5.02) year. The incidence rate of animal bite among males (14.90/1000) was much higher than females (4.55/1000), and was higher in rural areas (17.45/1000) compared with urban areas (4.35/1000). The incident rate was highest among students compared with other reported occupations. The incidence rate of dogs was 10.40/1000 followed by cats, cows, wolves, jackals, and foxes. Domestic animals had a higher incidence rate than stray and wild animals. The incidence rate of animal bite during spring was 4.90/1000; however, the incidence rate in other seasons had no significant difference. In the retrieved studies, the highest incidence rate of animal bite was found in the West Azerbaijan Province (146.83/1000). CONCLUSION The current study is the first comprehensive analysis of the published animal bite studies in Iran. Accurate data on animal bite incidence may lead to more effective policy-decisions towards more efficient resource allocation to primary health care for reducing rabies case. Such information is a primary and major necessity for rabies control program in the country. Animal bite reduction can significantly minimize the risk of rabies infection, thereby reducing public health costs for the expensive post-exposure treatment.
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The HIV treatment cascade in people living with HIV in Iran in 2014: Mixed-method study to measure losses and reasons. Int J STD AIDS 2019; 30:1257-1264. [PMID: 31558135 PMCID: PMC7008700 DOI: 10.1177/0956462419867573] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The study assessed the HIV treatment cascade of people living with HIV (PLWH) in Iran and the reasons for gaps in HIV services in 2014. We did the cascade analysis using the WHO HIV test-treat-retain cascade analysis tool (2014). To measure the gaps, we check the records for all PLWH reported to the national HIV surveillance till September 2014 to define how many were alive, linked to HIV care, assessed for CD4 count, started antiretroviral therapy (ART), and reported to be alive up to five years after ART. To assess the reasons for gaps in the cascade, we ran desk review, four focus group discussions (FGD) and fifty one in-depth interviews with key informants including PLWH. Spectrum model estimated 75,700 PLWH in Iran, of whom, only 22,647 people (%30) were diagnosed. Of those who were diagnosed with HIV, 16,266 people (%72) enrolled in HIV care. About 13% of all PLWH retained in HIV care and only 9% (6,745 people) had ever tested for CD4 count. Only 8% (6,018 people) of all PLWH received ART by September 2014. We found the biggest gap in the HIV treatment cascade to be HIV diagnosis as only 30% of PLWH have been diagnosed. Innovative strategies to improve HIV testing, particularly those work best for key populations, is critical to reach the 90–90-90 targets.
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Inequality in the global incidence and prevalence of tuberculosis (TB) and TB/HIV according to the human development index. Med J Islam Repub Iran 2019. [DOI: 10.47176/mjiri.33.45] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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The global prevalence of dental healthcare needs and unmet dental needs among adolescents: a systematic review and meta-analysis. Epidemiol Health 2019; 41:e2019046. [PMID: 31778605 PMCID: PMC6883027 DOI: 10.4178/epih.e2019046] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 10/27/2019] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES Access to dental healthcare services is a major determinant of dental health in communities. This meta-analysis was conducted to estimate the global prevalence of dental needs and of unmet dental needs in adolescents. METHODS PubMed, Web of Science, and Scopus were searched in June 2018. The summary measures included the prevalence of met and unmet dental needs. A meta-analysis was performed using the inverse variance method to obtain pooled summary measures. Out of 41,661 retrieved articles, 57 were ultimately included. RESULTS The pooled prevalence of orthodontic treatment needs was 46.0% (95% confidence interval [CI], 38.0 to 53.0), that of general treatment needs was 59.0% (95% CI, 42.0 to 75.0), that of periodontal treatment needs was 71.0% (95% CI, 46.0 to 96.0), and that of malocclusion treatment needs was 39.0% (95% CI, 28.0 to 50.0). The pooled prevalence of unmet dental needs was 34.0% (95% CI, 27.0 to 40.0). CONCLUSIONS The highest and lowest prevalence of unmet dental needs were found in Southeast Asia and Europe, respectively. The prevalence of dental needs was higher in the countries of the Americas and Europe than in other World Health Organization (WHO) regions. The prevalence of unmet dental needs was higher in Southeast Asia and Africa than in other WHO regions.
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The effects of vitamin D supplementation on expanded disability status scale in people with multiple sclerosis: A critical, systematic review and metaanalysis of randomized controlled trials. Clin Neurol Neurosurg 2019; 187:105564. [PMID: 31669929 DOI: 10.1016/j.clineuro.2019.105564] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 07/22/2019] [Accepted: 10/13/2019] [Indexed: 02/07/2023]
Abstract
In this meta-analysis of randomized controlled trials (RCTs), the effects of vitamin D supplementation on the scores for the expanded disability status scale (EDSS) in people with multiple sclerosis (MS) are assessed. The following databases were search up to January 2018: MEDLINE, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials. The quality of the relevant extracted data was assessed according to the Cochrane risk of bias tool. Data were pooled by the use of the inverse variance method and expressed as mean difference with 95% Confidence Intervals (95% CI). Six studies were included in this meta-analysis. The findings demonstrated that supplementation with vitamin D alone and vitamin D plus calcium did not affect the EDSS score (WMD -0.11 (-0.33, 0.11); P = 0.32). In addition, subgroup analysis showed that vitamin D supplementation alone, when compared to the use of a placebo, and vitamin D plus calcium supplementation compared with the control did not affect EDSS (WMD -0.13 (-0.30, 0.11); P = 0.29) and (WMD -0.08 (-0.57, 0.41); P = 0.29), respectively. Overall, this meta-analysis indicated that taking vitamin D in people with MS had no significant effect on EDSS.
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Association of postpartum depression and cesarean section: A systematic review and meta-analysis. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2019. [DOI: 10.1016/j.cegh.2019.02.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
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Inequality in the global incidence and prevalence of tuberculosis (TB) and TB/HIV according to the human development index. Med J Islam Repub Iran 2019; 33:45. [PMID: 31456969 PMCID: PMC6708111 DOI: 10.34171/mjiri.33.45] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Indexed: 11/05/2022] Open
Abstract
Background: Tuberculosis (TB) is one of the ten leading causes of death, especially in developing countries. We aimed to assess the inequality in the incidence and prevalence of TB and TB/HIV based on the human development index (HDI) globally.
Methods: In this ecological study, the data on the incidence and prevalence of TB, HIV, and TB/HIV co-infection in 168 countries were obtained from the World Health Organization (WHO). The HDI of these countries in 2000, 2005, 2010, and 2015 was also obtained from the United Nations Development Program (UNDP). The concentration index was used to assess the inequality of the incidence and prevalence of TB and TB/HIV based on the HDI globally.
Results: The concentration index for the incidence of TB according to the HDI was -0.32 (95% CI: -0.46, -0.17), -0.36 (95% CI: -0.49, -0.23), -0.37 (95% CI: -0.52, -0.22), and -0.36 (-0.52, -0.21) in 2000, 2005, 2010, and 2015, respectively. The same pattern was observed for the incidence and prevalence of TB/HIV. The results showed that TB and TB/HIV mainly concentrated in countries with a lower HDI.
Conclusion: According to the results of this study, the incidence of TB and TB/HIV and the prevalence of TB/HIV concentrated in the countries with a lower HDI. In addition, inequality in TB and HIV based on the HDI did not change from 2000 to 2015. Therefore, it seems that public health programs, especially in low-income countries, should be revised and the World Health Organization and the United Nations should provide more technical and financial help for these countries.
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Letter by Doosti-Irani et al Regarding Article, "Associations of Variability in Blood Pressure, Glucose and Cholesterol Concentrations, and Body Mass Index With Mortality and Cardiovascular Outcomes in the General Population". Circulation 2019; 139:e909-e910. [PMID: 31059314 DOI: 10.1161/circulationaha.118.038504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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The effect of alcohol on osteoporosis: A systematic review and meta-analysis. Drug Alcohol Depend 2019; 197:197-202. [PMID: 30844616 DOI: 10.1016/j.drugalcdep.2019.01.025] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 01/08/2019] [Accepted: 01/09/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Osteoporosis is a multifactorial disease hallmarked by the interaction of genetic, nutritional and environmental factors. We aimed to assess the effect of alcohol consumption on the osteoporosis by undertaking a systematic review and meta-analysis. METHODS We searched electronic databases including MEDLINE, Scopus, and Web of Science until June 2018. We identified all pertinent observational studies that examined the risk of OSTEOPOROSIS with alcohol use including cohort, case-control and cross-sectional studies. Relative risks (RR) for cohort studies and odds ratios (ORs) for case-control studies were pooled using the random effects model. Risk of bias was assessed using the Newcastle-Ottawa scale. RESULTS From a pool of 3479 studies identified six met the study inclusion criteria (three case control, two cohorts and one cross-sectional study). Compared with abstainers of alcohol, persons consuming 0.5-1 drinks per day had 1.38 times the risk of developing osteoporosis (adjusted RR = 1.38, 95% CI: 0.90-2.12), persons consuming 1-2 drinks per day had 1.34 times the risk of developing OSTEOPOROSIS (adjusted RR = 1.34, 95% CI: 1.11-1.62), and persons consuming two drinks or more per day had 1.63 times the risk of developing osteoporosis (adjusted RR = 1.63, 95% CI: 1.01-2.65). We found a positive association between alcohol consumption and osteoporosis in the case-control studies (adjusted OR = 2.95, 95% CI: 1.78-4.90). CONCLUSION Our study demonstrates a positive relationship between alcohol consumption and osteoporosis.
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Quality of life in Iranian elderly population using the SF-36 questionnaire: systematic review and meta-analysis. EASTERN MEDITERRANEAN HEALTH JOURNAL 2019; 24:1088-1097. [PMID: 30701524 DOI: 10.26719/2018.24.11.1088] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 08/06/2018] [Indexed: 12/21/2022]
Abstract
Background Ageing is a major known risk factor that is a threat to human health. To date, many studies have investigated quality of life (QOL) among the elderly population in the Islamic Republic of Iran. However, their results were inconsistent. Aims We designed this systematic review and meta-analysis to estimate the overall mean score of QOL based on the Short Form 36 Health Survey Questionnaire (SF-36) among the Iranian elderly population. Methods We searched international databases (Medline, Scopus and Science Direct) and national databases (Science In-formation Database, MagIran, IranMedex and Irandoc) up to February 2015. We included all cross-sectional studies that evaluated QOL among the Iranian elderly population using SF-36. Results Of 2150 studies identified, 15 were included in the meta-analysis. The mean scores for QOL in the 8 scales were: 47.58, 51.75, 55.42, 55.78, 59.55, 51.54, 47.85 and 51.31 for physical-role, physical function, mental health, bodily pain, social functioning, emotional-role, general health, and vitality, respectively. Conclusions Our results indicated that health-related QOL decreased with increasing age. QOL was worse in women than in men, especially in physical-role and general health scales. Elderly people who lived in a nursing home had lower QOL than those who lived in their own home. So, health policy-makers should design comprehensive programmes to improve health-related QOL for the Iranian elderly population.
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