Publications by authors named "Mohammad Gholami Fesharaki"

46 Publications

Cross-cultural adaptation and psychometric validation of the Persian version of the central sensitization inventory.

Musculoskelet Sci Pract 2021 02 10;51:102314. Epub 2020 Dec 10.

Mechanical Engineering Department, Sharif University of Technology, Tehran, Iran; Mowafaghian Research Centre of Intelligent Neuro-Rehabilitation Technologies, Sharif University of Technology, Tehran, Iran.

Background: The Central Sensitization Inventory (CSI) is a patient-reported tool to assess symptoms associated with central sensitization (CS). It consists of two parts: Part A assesses 25 somatic and emotional CS-related health symptoms, and part B asks if one has previously been diagnosed with a list of 10 Central Sensitivity Syndromes and related conditions.

Objectives: The aim of this study was to translate and cross-culturally adapt the CSI into Persian and to evaluate its psychometric properties.

Design: Cross-sectional study.

Method: After completing the Persian translation, the psychometric properties of the Persian CSI (CSI-Per) were evaluated in 256 patients with chronic pain and 46 healthy subjects.

Results: A confirmatory factor analysis confirmed a 1-factor model suggested in a large recent comprehensive multicountry study. Test-retest reliability (ICC = 0.934; P < 0.001) and the internal consistency (Cronbach's α = 0.87) were both good. After dividing the patient subjects into severity level subgroups, based on CSI-Per total scores, significant associations were found with the Persian version of the pain catastrophizing scale, pain duration, current pain intensity, maximum, minimum and average pain intensity in the past week and average pain intensity in the past month. In addition, total CSI-Per scores differentiated between patients and healthy subjects.

Conclusion: The CSI-Per demonstrated good validity and reliability to assess symptoms associated with CS in Persian-speaking patients with chronic pain.
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http://dx.doi.org/10.1016/j.msksp.2020.102314DOI Listing
February 2021

Real Clinical Practice and Therapeutic Management Following COVID-19 Crisis in two Hospitals in Iran: A Statistical and Conceptual View.

Tanaffos 2020 Nov;19(2):112-121

Student Research Committee, Baqiyatallah University of Medical Sciences, Tehran, Iran.

Background: The Coronavirus disease 2019 (COVID-19) outbreak quickly has spread and became a pandemic. However, no approved therapeutics or effective treatment is available for the treatment of these patients. The present study was done to retrospectively assess the treatment strategies (e.g., pharmaceutical care services) for COVID-19 patients in selected hospitals and highlight the importance of such services in the management of a pandemic.

Materials And Methods: Data from a series of COVID-19 patients (978 patients; 658 males [66.9%] and 324 females [33.1%]) admitted to the selected hospitals in Tehran from 20 February to 19 March 2020 were retrieved retrospectively from the Health Information System (HIS) of the hospitals. The statistical tests were used for analyzing the effect and correlation of the variables (drugs) with the average length of stay (ALOS) in the hospital.

Results: Diverse medication classes and old drugs with or without strong evidence of therapeutic effects against the novel coronavirus, some previously tried as a treatment for SARS-CoV and MERS-CoV, were mostly used for the treatment of patients in the hospitals. Many medications (broad-spectrum antibiotics and antivirals) or combination therapies are used without evidence of their therapeutic effects during pandemics.

Conclusion: Therefore, guidelines should be provided for the off-label use of these drugs by policymakers and stakeholders during a pandemic emergency due to high demands. Also, monitoring of the HIS data can play an important role in improving public health response to emerging diseases.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7680514PMC
November 2020

The effect of ˮ on memory improvement in university students: A randomized open-label clinical trial.

Avicenna J Phytomed 2020 Jul-Aug;10(4):352-364

Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University , Tehran, Iran.

Objective: Numerous studies demonstrated the effect of grape on memory improvement. According to Iranian traditional medicine, "mavizˮ as a specific type of dried grapes can effectively improve memory. However, there is no reported clinical trial on the effect of "mavizˮ on memory improvement in humans. Hence, this study was conducted to investigate "mavizˮ effect on memory in university students.

Materials And Methods: This randomized open-label clinical trial was conducted on a total number of 53 students of Shahed University, Tehran, Iran, from November 2017 to February 2018. The participants were randomly allocated into an intervention group (receiving "mavizˮ, 25 g in the morning for 4 weeks) or a control group (who did not take "mavizˮ). The Digit Span Task and the N-Back Task were used for the measurement of working memory at the pre- and post-intervention stages.

Results: According to the results, no significant differences were found between the two groups regarding age, gender, marital status, and initial working memory test scores. "mavizˮ consumption produced a highly significant improvement in total working memory score in the Digit Span Task (5.18 vs. 2.35, p<0.001) and Acoustic Memory Span (1.29 vs. 0.62, p=0.021). Moreover, "mavizˮ consumption significantly increased the percentage of true responses in the N-Back Task and reduced the mean reaction time in the first level of the task.

Conclusion: "mavizˮ consumption was improved working memory in young healthy adults.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7430964PMC
August 2020

Effects of as an Add-On Therapy on Insomnia in Patients with Obsession or Depression: A Pilot Randomized Double-Blind Placebo-Controlled Trial.

J Altern Complement Med 2020 May 19;26(5):398-408. Epub 2020 Feb 19.

Immunoregulation Research Center, Shahed University, Tehran, Iran.

The present study was conducted to investigate the effect of extracted syrup on the quality and patterns of sleep in patients with depression or obsessive-compulsive disorder (OCD) as add-on therapy. A pilot double-blind randomized placebo-controlled trial. Psychiatric Clinic of Imam Hossein Hospital, Tehran, Iran. Participants were 16-15 years of age with mild and moderate depression or OCD having insomnia. This pilot study was conducted on patients with insomnia divided into two groups with depression (40 patients) or OCD (43 patients). Each group randomly assigned into two arms with the same conditions at baseline. The intervention arm daily received 5 mL syrup every 12 h for 4 weeks, and the control arm received 5 mL placebo syrup every 12 h for 4 weeks. None of the participants was deprived of their routine treatment for depression or OCD. The scores of insomnia symptoms were evaluated using total score of the Pittsburgh Sleep Quality Index (PSQI) and the scores of its components, the depression score using the final Beck depression inventory-II (BDI-II) score, and OCD score using the Yale-Brown Obsessive-Compulsive Scale (YBOCS). The total PSQI score was found to be improved significantly in the intervention arms with depression or OCD ( < 0.001) compared with the corresponding control arms. Significant improvements were also observed in the final mean difference of BDI-II ( = 0.009) and YBOCS ( = 0.001) scores in the intervention arms. syrup significantly improved insomnia symptoms and the scores of depression and OCD.
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http://dx.doi.org/10.1089/acm.2019.0254DOI Listing
May 2020

The relationship between personality traits and psychosomatic complaints in a sample of Iranian adults.

J Affect Disord 2020 01 12;261:253-258. Epub 2019 Oct 12.

Section of Gastroenterology and Hepatology, School of Medicine, Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran. Electronic address:

Background: It has been suggested that personality traits may be related to the psychological conditions of people. The current study aimed to explore the relationship between personality traits and psychosomatic complaints.

Methods: This study was carried out on a sample of Iranian adults living in Isfahan province. The NEO Five- Factor Inventory questionnaire was used to assess personality traits. A 30-item comprehensive questionnaire was used to assess somatoform symptoms and factor analysis was performed to construct psychosomatic complaints profiles. Data was analyzed by Multiple Indicators Multiple Causes (MIMIC) model, using R software.

Results: In total, 4763 participants were recruited 44.2% males and 55.8% females, with a mean age of 36.54 ± 8.04 years. The results of the MIMIC model showed that there is a significant association between the dimensions of personality (neuroticism, extroversion, openness, agreeableness and conscientiousness) and dimensions of psychosomatic complaints profiles (gastrointestinal, neuro-skeletal, pharyngeal-respiratory and psychological) (P < 0.05). In addition, we found that characteristics such as age, sex, marital status, education, physical activity, and body mass index are related to psychosomatic complaints (P < 0.05) and can affect the association between personality traits and psychosomatic complaints.

Conclusions: Given the relationship between personality traits and psychosomatic complaints, it is possible to provide preventive and therapeutic interventions for psychosomatic complaints based on personality traits specific to each individual.
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http://dx.doi.org/10.1016/j.jad.2019.10.020DOI Listing
January 2020

Million Visual Analogue Scale Questionnaire: Validation of the Persian Version.

Asian Spine J 2019 Apr 29;13(2):242-247. Epub 2018 Nov 29.

Health Research Center, Lifestyle Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.

Study Design: Descriptive cross-sectional study.

Purpose: To validate the Persian version of the Million Visual Analogue Scale Questionnaire (MVAS), a self-administered low back pain (LBP) questionnaire.

Overview Of Literature: The majority of LBP questionnaires translated into Persian evaluate the impact of LBP on daily living. The MVAS is one of the most commonly used self-administered LBP questionnaires, and was developed to assess a different direction and effect of activities of daily living on LBP intensity.

Methods: The questionnaire was translated into Persian with the forward-backward method and was administered to 150 patients randomly sampled from an occupational medicine clinic in Tehran in 2017.

Results: Cronbach's alpha for all subscales ranged between 0.670 and 0.799. Confirmatory factor analysis showed adequate construct validity of the Persian version of the MVAS, with root mean square error of approximation 0.046, goodness of fit index 0.902, and comparative fit index 0.969. Other indexes were satisfactory.

Conclusions: The Persian MVAS is a valid and reliable instrument that can assess the effect of various daily activities on the intensity of LBP.
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http://dx.doi.org/10.31616/asj.2018.0223DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6454270PMC
April 2019

Lamivudine's efficacy and safety in preventing mother-to-child transmission of hepatitis B: A meta-analysis.

Turk J Gastroenterol 2019 01;30(1):66-74

Tehran University of Medical Sciences School of Medicine, Tehran, Iran.

Background/aims: Mother-to-child transmission (MTCT) is a common transmission mode of hepatitis B virus (HBV). It has been shown that the infection may occur in some infants despite the use of immunoprophylaxis, and many studies have demonstrated the efficacy of antivirals such as lamivudine to reduce such events.

Materials And Methods: A meta-analysis was conducted concerning the efficacy and safety of lamivudine during pregnancy, in the prevention of vertical transmission of HBV infection. Studies were identified by searching various databases up to January 2016 for variations of the following phrase: "lamivudine AND (pregnancy or pregnant) AND (HBV or hepatitis)." Subjects who had received lamivudine were included in the case group, and those who had not were included in the control group.

Results: Our search identified a total number of 881 citations, of which 25 studies (with a total number of 2,667 pregnant women) were included in the meta-analysis. The analysis showed a significant difference between the seropositive HBsAg infants from the case and control groups (RR= 16.97, 95% confidence interval 8.36-34.45), which is the most critical factor in determining the MTCT of HBV. No significant difference was reported between the prevalence of side effects in the case and control groups.

Conclusion: This meta-analysis strongly suggests the use of lamivudine in the prevention of HBV vertical transmission in carrier pregnant women with the HBV DNA levels greater than 106 copies/mL. And for women with the HBV viral loads lower than 106 copies/mL, we suggest clinicians to examine the use of lamivudine on a case-to-case basis, noting that lamivudine seems to be a safe drug for the mother and the fetus.
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http://dx.doi.org/10.5152/tjg.2018.18148DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6389296PMC
January 2019

The Psychometric Properties of the Persian Version of the Contamination Cognition Scale (CCS).

Iran J Psychiatry 2018 Jul;13(3):168-174

Tarbiat Modares University, Tehran, Iran.

In recent years, many researchers have been searching for effective cognitive factors in the development of obsessive-compulsive disorder (OCD). One of the scales designed to measure this characteristic is the contamination cognition scale (CCS) that evaluates 2 dimensions: overestimating the likelihood and severity of contamination. The aim of the present study was to evaluate the psychometric properties of the Persian version of CCS. The study population of this descriptive psychometric study included students of Shahed University. A total of 490 students were selected via cluster sampling and completed the CCS. CCS was translated and back- translated before given to the students. The Obsessive Beliefs Questionnaire (OBQ) and the Padua Inventory (PI) were used. To assess the evidence for the validity of the scale, the exploratory and confirmatory factor analyses were used. The gathered data were analyzed by SPSS-22 and Amos-22 software. The results of the confirmatory factor analysis (CFA) showed that one-factor model did not have adequate fitness (RMSEA>.05). Therefore, to explore the factors of this scale, exploratory factor analysis (EFA) was used, and it revealed 3 factors (public equipment, food, and restroom) for each of the dimensions (likelihood and severity). CFA by AMOS-22 confirmed the three-factor model (GFI, CFI, and NFI>.95; RMSEA<.05). Furthermore, the results supported criteria validity of CCS with the PI total score (0.56- 0.47, p<0.001) and PI-contamination subscale (0.71-0.75, p<0.001). Also, the correlation between CCS and responsibility/threat subscale of the OBQ was significant (0.47- 0.49, p<0.001) The Cronbach's alpha for likelihood dimensions total was 0.93 and it was 0.94 for severity dimension total. The composite reliability was 0.95 for the likelihood dimension and 0.96 for severity dimension of CCS. Also, the test-retest reliability after a 4-week interval was confirmed (likelihood: r = 0.78; severity: r = 0.81, p<.001). The results indicated that one-factor model of CCS did not have adequate fitness, but three-factor model was confirmed in both dimensions (likelihood and severity). According to the results of the present study, the reliability and validity of the Persian version of CCS were acceptable.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6178325PMC
July 2018

Comparative evaluation of the safety and efficacy of recombinant FVIII in severe hemophilia A patients.

J Pharmacopuncture 2018 Jun 30;21(2):76-81. Epub 2018 Jun 30.

Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.

Objective: This study compared the safety and efficacy of Safacto versus xyntha in patients with severe hemophilia A.

Methods: Thirty-three male patients with severe hemophilia A were randomly divided into two groups. Seventeen patients received Safacto and 16 patients received Xyntha for four consecutive times. The dosage of FVIII was 40-50 IU/kg for each injection. Plasma level of FVIII activity was evaluated before every injection, 15 minutes after the injection and one month after the start of the trial. The rate of factor VIII activity, pain and joint motion were also assessed before and after the treatment.

Results: Plasma level of FVIII clotting activity in Safacto and Xyntha were 1.96±0.5 IU/dl and 1.63±0.5 IU/dl and increased to 88.84±25.2 IU/dl and 100.09±17.8 IU/dl, respectively (P<0.001). Pain score and range of motion improvement were 9.3±0.9 and 8.7±0.1 in Safacto (P=0.17); and 9.4±0.8 and 8.8±0.3 in Xyntha (P=0.35), respectively. No allergic or other unfavorable reactions was observed with either of the preparations.

Conclusion: This study showed that Safacto has a favorable efficacy and safety profile.
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http://dx.doi.org/10.3831/KPI.2018.21.009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6054092PMC
June 2018

Identification of candidate microRNA biomarkers in diabetic nephropathy: a meta-analysis of profiling studies.

J Nephrol 2018 Dec 17;31(6):813-831. Epub 2018 Jul 17.

Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.

Aims: The aim was to perform a meta-analysis on the miRNA expression profiling studies in diabetic nephropathy (DN) to identify candidate diagnostic biomarkers.

Methods: A comprehensive literature search was done in several databases and 53 DN miRNA expression studies were selected. To identify significant DN-miR meta-signatures, two meta-analysis methods were employed: vote-counting strategy and the robust rank aggregation method. The targets of DN-miRs were obtained and a gene set enrichment analysis was carried out to identify the pathways most strongly affected by dysregulation of these miRNAs.

Results: We identified a significant miRNA meta-signature common to both meta-analysis approaches of three up-regulated (miR-21-5p, miR-146a-5p, miR-10a-5p) and two down-regulated (miR-25-3p and miR-26a-5p) miRNAs. Besides that, subgroup analyses divided and compared the differentially expressed miRNAs according to species (human and animal), types of diabetes (T1DN and T2DN) and tissue types (kidney, blood and urine). Enrichment analysis confirmed that DN-miRs supportively target functionally related genes in signaling and community pathways in DN.

Conclusion: Five highly significant and consistently dysregulated miRNAs were identified, and future studies should focus on discovering their potential effect on DN and their clinical value as DN biomarkers and therapeutic mediators.
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http://dx.doi.org/10.1007/s40620-018-0511-5DOI Listing
December 2018

Assessment of length of stay in a general surgical unit using a zero-inflated generalized Poisson regression.

Med J Islam Repub Iran 2017 17;31:91. Epub 2017 Dec 17.

Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.

The effective use of limited health care resources is of prime importance. Assessing the length of stay (LOS) is especially important in organizing hospital services and health system. This study was conducted to identify predictors of LOS among patients who were admitted to a general surgical unit. In this cross-sectional study, the sample included all patients who were admitted to the general surgical unit of Shariati hospital in 2013 (n= 334). To determine the factors affecting LOS, Zero-inflated Poisson (ZIP), zero-inflated negative binomial (ZINB), and zero-inflated generalized Poisson (ZIGP) regression models were fitted using R software, and then the best model was selected. Among all 334 patients, the mean (±SD) age of the patients was 45.2 (±16.47) years and 220 (65.9%) of them were male. The results revealed that based on ZIGP model, type of surgery (appendicitis, abdomen and its contents, hemorrhoids, lung, and skin), type of insurance, comorbid diseases (hypertension, heart disease, and hyperlipidemia), place of residence (local and non-local), age, and number of tests had significant effects on the LOS of GS patients. According to the Akaike information criterion (AIC) in each fitted model, it was found that ZIGP regression model is more appropriate than ZIP and ZINB regression models in assessing LOS in GS patients, especially due to the presence of excess zeros and overdispersion in count data.
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http://dx.doi.org/10.14196/mjiri.31.91DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6014792PMC
December 2017

Identification of candidate microRNA biomarkers in renal fibrosis: a meta-analysis of profiling studies.

Biomarkers 2018 Dec 16;23(8):713-724. Epub 2018 Oct 16.

b Department of Biostatistics, Faculty of Medical Sciences , Tarbiat Modares University , Tehran , Iran.

The prognostic, diagnostic and therapeutic value of microRNA (miRNA) expression aberrations in renal fibrosis has been studied in recent years. However, the miRNA expression profiling efforts have led to inconsistent results between the studies. The aim of this study was to perform a meta-analysis on the renal fibrosis miRNA expression profiling studies to identify candidate diagnostic biomarkers. We performed comprehensive literature searches in several databases to identify miRNA expression studies of renal fibrosis in animal models and humans. The miRNAs expression data were extracted from 20 included studies, and both miRNA vote-counting strategy and Robust Rank Aggregation method were utilized to identify significant miRNA meta-signatures. The predicted and validated targets of miRNA meta-signature were obtained by using MultiMiR package in 11 databases. Then a gene set enrichment analysis (KEGG, PANTHER pathways and GO processes) were carried out with GeneCodis web tool to recognize pathways that are most strongly influenced by modified expressions of these miRNAs. We recognized in both meta-analysis approaches a significant miRNA meta-signature of five up-regulated (miR-142-3p, miR-223-3p, miR-21-5p, miR-142-5p and miR-214-3p) and two down-regulated (miR-29c-3p and miR-200a-3p) miRNAs. Enrichment analysis confirmed that miRNA meta-signature cooperatively target functionally related genes in signalling and developmental pathways in renal fibrosis. This meta-analysis identified seven highly significant and consistently dysregulated miRNAs from 20 datasets, as the focus of future investigations to discover their potential influence to renal fibrosis and their clinical utility as biomarkers and/or as therapeutic mediators against chronic kidney disease..
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http://dx.doi.org/10.1080/1354750X.2018.1488275DOI Listing
December 2018

Developing a model for hospital inherent safety assessment: Conceptualization and validation.

Int J Risk Saf Med 2018 ;29(3-4):163-174

Health Research Center, Lifestyle Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.

Background: Paying attention to the safety of hospitals, as the most crucial institute for providing medical and health services wherein a bundle of facilities, equipment, and human resource exist, is of significant importance.

Objective: The present research aims at developing a model for assessing hospitals' safety based on principles of inherent safety design.

Methods: Face validity (30 experts), content validity (20 experts), construct validity (268 examples), convergent validity, and divergent validity have been employed to validate the prepared questionnaire; and the items analysis, the Cronbach's alpha test, ICC test (to measure reliability of the test), composite reliability coefficient have been used to measure primary reliability. The relationship between variables and factors has been confirmed at 0.05 significance level by conducting confirmatory factor analysis (CFA) and structural equations modeling (SEM) technique with the use of Smart-PLS.

Results: R-square and load factors values, which were higher than 0.67 and 0.300 respectively, indicated the strong fit. Moderation (0.970), simplification (0.959), substitution (0.943), and minimization (0.5008) have had the most weights in determining the inherent safety of hospital respectively.

Conclusions: Moderation, simplification, and substitution, among the other dimensions, have more weight on the inherent safety, while minimization has the less weight, which could be due do its definition as to minimize the risk.
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http://dx.doi.org/10.3233/JRS-180006DOI Listing
November 2018

The relationship between shift work and Framingham risk score: A five-year prospective cohort study.

ARYA Atheroscler 2017 Nov;13(6):288-294

Physician of Search Disease, Worksite Follow-Up Unit, Occupational Health Center, Mobarakeh Steel Company, Isfahan, Iran.

Background: There is a small number of studies that considered the relationship between shift work (SW) and Framingham risk score (FRS). This study prospectively examined the association between SW and FRS among man workers based on the multilevel modeling approach.

Methods: This five-year prospective cohort study was done among workers (using stratified random sampling) who work in Esfahan's Mobarakeh Steel Company (EMSC), Iran, from March 2011 to February 2015.

Results: The study sample included 1626 man workers (mean age = 40.0 ± 6.2). Among these subjects, 652 (40.01%), 183 (11.3%) and 791 (48.6%) were day workers, weekly rotating shift workers and routinely rotating, respectively. After controlling unbalanced variables, there was no any significant association between SW and FRS.

Conclusion: The results of this prospective cohort study did not show a relationship between SW and FRS.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5889920PMC
November 2017

Inactive Hepatitis B Carrier and Pregnancy Outcomes: A Systematic Review and Meta-analysis.

Iran J Public Health 2017 Apr;46(4):468-474

Dept. of Reproductive Health, Student Research Committee, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran.

Background: We aimed to explore whether maternal asymptomatic hepatitis B (HB) infection effects on pre-term rupture of membranous (PROM), stillbirth, preeclampsia, eclampsia, gestational hypertension, or antepartum hemorrhage.

Methods: We searched the PubMed, Scopus, and ISI web of science from 1990 to Feb 2015. In addition, electronic literature searches supplemented by searching the gray literature (e.g., conference abstracts thesis and the result of technical reports) and scanning the reference lists of included studies and relevant systematic reviews. We explored statistical heterogeneity using the, I2 and tau-squared (Tau2) statistical tests.

Results: Eighteen studies were included. Preterm rupture of membranous (PROM), stillbirth, preeclampsia, eclampsia, gestational hypertension and antepartum hemorrhage were considerable outcomes in this survey. The results showed no significant association between inactive HB and these complications in pregnancy. The small amounts of -value and chi-square and large amount of I2 suggested the probable heterogeneity in this part, which we tried to modify with statistical methods such as subgroup analysis.

Conclusion: Inactive HB infection did not increase the risk of adversely mentioned outcomes in this study. Further, well-designed studies should be performed to confirm the results.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5439035PMC
April 2017

Combination of sofosbuvir, pegylated-interferon and ribavirin for treatment of hepatitis C virus genotype 1 infection: a systematic review and meta-analysis.

Daru 2017 Apr 20;25(1):11. Epub 2017 Apr 20.

Meta-analysis Study Group, Iran Hepatitis Network, Tehran, Iran.

Background: Hepatitis C virus (HCV) infection is an important cause of chronic liver disease which has been affected 3% of world's population. Some studies have shown that adding Sofosbuvir (SOF), an HCV polymerase inhibitor to the conventional therapy of Pegylated-interferon (PegIFN) plus Ribavirin (RBV) can increase the rate of sustained virologic response (SVR) among HCV-infected patients. This study was conducted to determine the effect of combination therapy with PegIFN and RBV plus SOF for chronic hepatitis C genotype 1 infection using systematic review with meta-analysis.

Methods: In this study, electronic databases including PubMed, Scopus, Science Direct, and Web of Science were comprehensively searched using appropriate strategies containing all related keywords of "hepatitis C", "PegIFN", "RBV" and "SOF". Studies assessed the efficacy of combination therapy with PegIFN and RBV plus SOF for chronic hepatitis C genotype 1 infection were included in the meta-analysis.

Results: After screening of 757 records, we included five articles with total sample size of 411 to the meta-analysis. Based on the fixed-effect model (χ  = 5.29, P = 0.26 and I = 24.4%), pooled SVR rate for treatment regimen of PegIFN and RBV plus SOF was calculated as 88.54% (95% CI = 85.77%-91.32%).

Conclusions: Combination therapy with PegIFN and RBV plus SOF results in high treatment response in patients with HCV genotype 1 infection.
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http://dx.doi.org/10.1186/s40199-017-0177-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5397824PMC
April 2017

Simultaneous effect of shift work on blood pressure and lipid profile: a path analysis.

Int J Occup Saf Ergon 2018 Mar 8;24(1):68-72. Epub 2017 Aug 8.

b Occupational Health Center , Mobarakeh Steel Company , Iran.

The aim of this study was to assess the direct and indirect effects of shift work (SW) on the systolic blood pressure (SBP) and lipid profile of male workers. For this purpose, a cross-sectional study was conducted involving 6539 male workers of Esfahan Mobarakeh Steel Company. From all of the participants, 3065 (46.8%) were day workers and the remainder were shift workers. The results of path analysis revealed that the most effective variables on SBP were body mass index, fasting blood sugar, triglycerides and SW with a total effect of 0.241, 0.095, 0.064 and 0.056, respectively.
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http://dx.doi.org/10.1080/10803548.2017.1314139DOI Listing
March 2018

Expression of Folliculogenesis-Related Genes in Vitrified Human Ovarian Tissue after Two Weeks Culture.

Cell J 2017 Apr-Jun;19(1):18-26. Epub 2016 Dec 21.

Department of Biostatistics, Faculty of Medicine, Tarbiat Modares University, Tehran, Iran.

Objective: This study was designed to evaluate the effects of vitrification and culture of human ovarian tissue on the expression of oocytic and follicular cell-related genes.

Materials And Methods: In this experimental study, ovarian tissue samples were obtained from eight transsexual women. Samples were cut into small fragments and were then assigned to vitrified and non-vitrified groups. In each group, some tissue fragments were divided into un-cultured and cultured (in α-MEM medium for 2 weeks) subgroups. The normality of follicles was assessed by morphological observation under a light microscope using hematoxylin and eosin (H&E) staining. Expression levels of factor in the germ line alpha (), KIT ligand (), growth differentiation factor 9 () and follicle stimulating hormone receptor () genes were quantified in both groups by real-time reverse transcriptase polymerase chain reaction (RT-PCR) at the beginning and the end of culture.

Results: The percentage of normal follicles was similar between non-cultured vitrified and non-vitrified groups (P>0.05), however, cultured tissues had significantly fewer normal follicles than non-cultured tissues in both vitrified and non-vitrified groups (P<0.05). In both cultured groups the rate of primary and secondary follicles was significantly higher than non-cultured tissues (P<0.05). The expression of all examined genes was not significantly altered in both non-cultured groups. Whiles, in comparison with cultured tissues non-cultured tissues, the expression of gene was significantly decreased, gene was not changed, and genes was significantly increased (P<0.05).

Conclusion: Human ovarian vitrification following culture has no impairing effects on follicle normality and development and expression of related-genes. However, culture condition has deleterious effects on normality of follicles.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5241514PMC
http://dx.doi.org/10.22074/cellj.2016.4890DOI Listing
December 2016

Two Triacylglycerol Pathway Genes, CTDNEP1 and LPIN1, are Down-Regulated by hsa-miR-122-5p in Hepatocytes.

Arch Iran Med 2017 Mar;20(3):165-171

Department of Hematology, Tarbiat Modares University, Tehran, Iran.

Background: Expression of miR-122 is highly specific to hepatocytes of the liver.  This miRNA is involved in lipid hemostasis of the tissue; however, there is no comprehensive understanding of its function in lipid hemostasis.

Materials And Methods: Since hepatocytes are responsible for part of Triacylglycerol (TAG) synthesis in the body, we hypothesized that miR-122, as the most abundant miRNA in the tissue, might regulate TAG metabolism by targeting key enzymes that are involved in its production pathway. A systematic computational analysis of putative targets of miR-122 identified CTDNEP1 and LPIN1 genes in the TAG pathway. We used dual-luciferase reporter assay, quantitative RT-PCR as well as western blot to confirm the repressive effect of miR-122 on CTDNEP1 and LPIN1 in TAG pathway.

Results: Real time PCR on liver needle biopsies with hepatosteatosis showed that miR-122 is up-regulated in hepatosteatosis. Surprisingly, the protein and RNA level of identified targets of miR-122 are also up-regulated in clinical samples, probably as a disproportionate feedback response to the high level of miR-122.

Conclusion: Our findings suggest that up-regulation of miR-122 can trigger the compensatory response of LPIN1 and CTDNEP1 in hepatosteatosis.
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http://dx.doi.org/0172003/AIM.009DOI Listing
March 2017

Combination of Ledipasvir and Sofosbuvir for Treatment of Hepatitis C Virus Genotype 1 Infection: Systematic Review and Meta-Analysis.

Ann Hepatol 2017 March-April;16(2):188-197

Baqiyatallah Research Center for Gastroenterology and Liver Diseases (BRCGL), Baqiyatallah University of Medical Sciences, Tehran, IR Iran.

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http://dx.doi.org/10.5604/16652681.1231562DOI Listing
July 2018

Efficacy of HBM-Based Dietary Education Intervention on Knowledge, Attitude, and Behavior in Medical Students.

Iran Red Crescent Med J 2016 Nov 18;18(11):e23584. Epub 2016 Jul 18.

Biostatistics Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IR Iran.

Background: Using various models of behavior change, a number of studies in the area of nutrition education have confirmed that nutrition habits and behaviors can be improved.

Objectives: This study sought to determine the effects of education on patterns of dietary consumption among medical students at the military university of Tehran, with a view to correcting those patterns.

Methods: In this quasi-experimental study, 242 medical students from the Military University of Tehran were chosen by convenience sampling and then divided into control (n = 107) and intervention groups (n = 135) by block randomization. The self-administered questionnaire involving six categories of item (knowledge, perceived benefits, perceived barriers, perceived threats, self-efficacy and behavior) has been validated (Cronbach alpha > 0.7 for each).

Results: Following the educational intervention, the mean score of knowledge, health belief model (HBM) structure, and behavior of students in relation to healthy patterns of food intake increased significantly (P < 0.05). The mean pre-intervention knowledge score was 6.76 (1.452), referring to threats to HBM constructs including perceived threat 2.93 (1.147), perceived benefits 7.28 (1.07), perceived barriers 5.44 (1.831), self- efficacy 4.28 (1.479), and behavior 8.84 (2.527). The post-intervention scores all improved as follows: knowledge 8.3 (1.503), perceived threats 3.29 (1.196), perceived benefits 7.71 (0.762), perceived barriers 5.9 (1.719), self- efficacy 4.6 (1.472), and behavior 9.45 (2.324). This difference in mean scores for knowledge, health belief structures and employee behavior before and after educational intervention was significant (P ≤ 0.05).

Conclusions: The significant improvement in the experimental group's mean knowledge, HBM structures , and behavior scores indicates the positive effect of the intervention.
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http://dx.doi.org/10.5812/ircmj.23584DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5301994PMC
November 2016

Predictors of Oral Health Behaviors in Female Students: An Application of the Health Belief Model.

Iran Red Crescent Med J 2016 Nov 20;18(11):e24747. Epub 2016 Feb 20.

Young Researchers and Elite Club, Karaj Branch, Islamic Azad University, Karaj, IR Iran; Baqiyatallah University of Medical Sciences, Tehran, IR Iran.

Background: Oral and dental health diseases can affect the general health of students.

Objectives: The aim of this study was to identify the predictors of oral and dental health behavior using the health belief model (HBM) in female students in Teheran, Iran.

Patients And Methods: This was a cross-sectional study framed by the HBM, including 400 female students living in district 5 of Tehran, Iran. The sampling technique used in this study was multi-stage stratified random sampling. The data on the HBM constructs (perceived severity, perceived susceptibility, perceived benefits, perceived barriers, cues to action, and self-efficacy) and demographic characteristics were collected using a self-administered questionnaire. Descriptive statistics, bivariate correlations, and linear regression were performed to analyze the data, using the SPSS software, version 18.

Results: The results showed that there were relationships between the knowledge, perceived barriers, cues to action, and mother's education with oral health behaviors. A multivariate hierarchical regression analysis was conducted with the barrier entered at step one, knowledge at step two, and cues to action at step three. Finally, the three variables accounted for 17% of the total variance in the oral and dental health behavior.

Conclusions: The current study provided evidence for the utility of the belief-based model in the prediction of oral health behaviors. It could be suggested that oral health behavior can be promoted by reducing the perceived barriers and enhancing the students' knowledge of oral and dental hygiene.
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http://dx.doi.org/10.5812/ircmj.24747DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5292392PMC
November 2016

Alexander Technique Training Coupled With an Integrative Model of Behavioral Prediction in Teachers With Low Back Pain.

Iran Red Crescent Med J 2016 Sep 9;18(9):e31218. Epub 2016 Aug 9.

Rehabilitation Faculty, Tehran University of Medical Sciences, Tehran, IR Iran.

Background: Individuals suffering from chronic low back pain (CLBP) experience major physical, social, and occupational disruptions. Strong evidence confirms the effectiveness of Alexander technique (AT) training for CLBP.

Objectives: The present study applied an integrative model (IM) of behavioral prediction for improvement of AT training.

Methods: This was a quasi-experimental study of female teachers with nonspecific LBP in southern Tehran in 2014. Group A contained 42 subjects and group B had 35 subjects. In group A, AT lessons were designed based on IM constructs, while in group B, AT lessons only were taught. The validity and reliability of the AT questionnaire were confirmed using content validity (CVR 0.91, CVI 0.96) and Cronbach's α (0.80). The IM constructs of both groups were measured after the completion of training. Statistical analysis used independent and paired samples t-tests and the univariate generalized linear model (GLM).

Results: Significant differences were recorded before and after intervention (P < 0.001) for the model constructs of intention, perceived risk, direct attitude, behavioral beliefs, and knowledge in both groups. Direct attitude and behavioral beliefs in group A were higher than in group B after the intervention (P < 0.03).

Conclusions: The educational framework provided by IM for AT training improved attitude and behavioral beliefs that can facilitate the adoption of AT behavior and decreased CLBP.
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http://dx.doi.org/10.5812/ircmj.31218DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5253206PMC
September 2016

Assessment of transient elastography (FibroScan) for diagnosis of fibrosis in non-alcoholic fatty liver disease: A systematic review and meta-analysis.

Caspian J Intern Med 2016 ;7(4):242-252

Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.

Background: Transient elastography (TE) is a new modality for the diagnosis of liver fibrosis caused by various etiologies. This study was conducted to determine the accuracy of TE in detecting the different stages of liver fibrosis in non-alcoholic fatty liver disease (NAFLD) patients.

Methods: MEDLINE/PubMed, Embase, Ovid, Cochrane Library, American College of Physicians (ACP) Journal Club, Google Scholar, Database of Abstracts of Reviews of Effects, and Web of Science that evaluated the liver stiffness by means of TE and liver biopsy were enrolled in this systematic review and meta-analysis. Published articles were extracted from 2002 to March 2015.

Results: A total of 7 articles from 114 papers were included which consisted of 698 patients. The results indicated that when F ≥3, the outcomes were 93.7% (95% confidence interval (CI): 92-95.5), 91.1% (95% CI: 89-93.2), 82.4% (95% CI: 79.9-84.9), and 95.9% (95% CI: 94.4-97.4) for sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV), respectively. With fibrosis stage ≥4, it has reached the sensitivity of 96.2 % (95% CI: 94.5-97.8), a specificity of 92.2% (95% CI: 89.9-94.6), a PPV of 5.5% (95% CI: 51.2-59.8) and NPV of 98.5% (95% CI: 97.4-99.5).

Conclusion: We concluded that as the pathological fibrosis increases, the sensitivity, specificity and NPV of TE in the diagnosis of fibrosis improves in NAFLD patients. TE can be considered as a unique alternative instead of liver biopsy in NAFLD patients and it has an important role in the exclusion of liver cirrhosis. More studies are required to confirm the results.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5153515PMC
January 2016

The Distribution of Hepatitis C Virus Genotypes in Middle Eastern Countries: A Systematic Review and Meta-Analysis.

Hepat Mon 2016 Sep 23;16(9):e40357. Epub 2016 Aug 23.

Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Baqiyatallah University of Medical Sciences, Tehran, IR Iran.

Context: The hepatitis C virus (HCV) is classified into seven genotypes and more than 100 subtypes. The treatment regimen, duration and efficacy of HCV therapy may vary according to the HCV genotype. Therefore, the HCV genotype should be determined prior to antiviral therapy. The objective of the current study was to review systematically all studies reporting the distribution of HCV genotypes in the countries that make up the Middle East.

Evidence Acquisition: Articles were identified by searching electronic databases, including Scopus, PubMed and Google scholar, with timeline limits (articles published between 1995 and 2016). We carried out a systematic search regarding the distribution of HCV genotypes in Middle Eastern countries.

Results: A total of 579 studies were identified by the electronic search. Of these, a total of 187 were identified as eligible papers including 60,319 patients who were meta-analyzed for pooled distribution of HCV genotypes. In Turkey, Israel, Cyprus, and Iran, genotype 1 was the most prevalent HCV genotype with rates of 82% (95% CI, 82%-83%), 68% (95% CI, 67%-69%), 68% (95% CI, 59%-77%), and 55% (95% CI, 54%-55%), respectively. In Egypt, Iraq, Saudi Arabia, and Syria, HCV genotype 4 was the most common genotype with rates of 86% (95% CI, 85%-88%), 60% (95% CI, 56%-64%), 56% (95% CI, 54%-55%), and 57% (95% CI, 54%-61%), respectively. On the basis of adjusted data, HCV genotype 4 was the most prevalent genotype in the Middle East region, with a rate of 74.7% (95% CI, 73.4%-76%), followed by genotype 1 at 15.1% (95% CI, 14.1%-16%).

Conclusions: Our results showed that HCV genotype 4 is the most prevalent genotype in the Middle East region. However, HCV genotype 1 is the most prevalent among non-Arab countries in the region including Turkey, Iran, Cyprus, and Israel.
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http://dx.doi.org/10.5812/hepatmon.40357DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5097177PMC
September 2016

Job Stress and Related Factors Among Iranian Male Staff Using a Path Analysis Model.

Iran Red Crescent Med J 2016 Jun 14;18(6):e34314. Epub 2016 May 14.

Biostatistics Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IR Iran.

Background: In recent years, job stress has been cited as a risk factor for some diseases.

Objectives: Given the importance of this subject, we established a new model for classifying job stress among Iranian male staff using path analysis.

Materials And Methods: This cross-sectional study was done on male staff in Tehran, Iran, 2013. The participants in the study were selected using a proportional stratum sampling method. The tools used included nine questionnaires (1- HSE questionnaire; 2- GHQ questionnaire; 3- Beck depression inventory; 4- Framingham personality type; 5- Azad-Fesharaki's physical activity questionnaire; 6- Adult attachment style questionnaire; 7- Azad socioeconomic questionnaire; 8- Job satisfaction survey; and 9- demographic questionnaire).

Results: A total of 575 individuals (all male) were recruited for the study. Their mean (±SD) age was 33.49 (±8.9) and their mean job experience was 12.79 (±8.98) years. The pathway of job stress among Iranian male staff showed an adequate model fit (RMSEA=0.021, GFI=0.99, AGFI=0.97, P=0.136). In addition, the total effect of variables like personality type (β=0.283), job satisfaction (β=0.287), and age (β=0.108) showed a positive relationship with job stress, while variables like general health (β=-0.151) and depression (β=-0.242) showed the reverse effect on job stress.

Conclusions: According to the results of this study, we can conclude that our suggested model is suited to explaining the pathways of stress among Iranian male staff.
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http://dx.doi.org/10.5812/ircmj.34314DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5006310PMC
June 2016

Application of Bayesian Hierarchical Model for Detecting Effective Factors on Growth Failure of Infants Less Than Two Years of Age in a Multicenter Longitudinal Study.

Iran Red Crescent Med J 2016 May 26;18(5):e36732. Epub 2016 May 26.

Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IR Iran.

Background: Nowadays, one of the major public health problems among children is growth failure. It can be characterized in terms of either inadequate growth or the inability to maintain growth.

Objectives: The main objective of this study was to examine the effects of some factors on growth failure among a sample of infants less than two years old.

Materials And Methods: The present longitudinal archival study relied on data gathered from health files from February 2007 to July 2010 for 1,358 children under two years of age, selected from eight health centers in the east and northeast parts of Tehran, Iran. In the present study, growth failure refers to at least a 50 g decrease in an infant's weight as recorded at each attendance in comparison to the previous measurement. The impacts of risk indicators were assessed using the Bayesian hierarchical logistic regression modeling technique.

Results: The highest and lowest percentage of growth failure was 5.8% and 0.1%, respectively, in the eleventh and the first month after birth. The obtained results from the Bayesian hierarchical modeling revealed that diarrhea (95% credible interval (CrI): 0.70 - 3.31), discontinuation of breastfeeding (95% CrI: 0.77 - 5.96), and respiratory infections (95% CrI: 2.07 - 4.61) were significant risk factors for growth failure. The random term at the child level was significant (95% CrI: 0.74 - 7.82), while the variation in centers was extremely small (95% CrI: 0.004 - 4.22).

Conclusions: It was noted that a relatively high prevalence of growth failure was observed in the study sample. For minimizing the impact of significant risk factors on growth failure, the early detection of growth failure and its risk indicators is of great importance. In addition, when the focus of the analysis is on the different nested sources of variability and the data has a hierarchical structure, using a hierarchical modeling approach is recommended to achieve more accurate results.
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http://dx.doi.org/10.5812/ircmj.36732DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4939415PMC
May 2016

Prevalence of Hepatitis C Virus Genotypes Among Patients in Countries of the Eastern Mediterranean Regional Office of WHO (EMRO): A Systematic Review and Meta-Analysis.

Hepat Mon 2016 Apr 19;16(4):e35558. Epub 2016 Apr 19.

Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Baqiyatallah University of Medical Sciences, Tehran, IR Iran.

Context: Hepatitis C virus (HCV) infection is a major global public health issue. The Eastern Mediterranean regional office (EMRO) of the world health organization (WHO) seems to have one of the highest prevalence rates worldwide, with at least 21.3 million HCV-infected patients.

Objectives: The aim of the present study was to review systematically all epidemiological data related to the prevalence of HCV genotypes in infected patients in EMRO countries.

Data Sources: A systematic search was conducted of peer-reviewed journals indexed in electronic databases (PubMed, Scopus, ISI, PakMediNet, and IMEMR, and Persian-specific databases including SID, Iran Medex, and MagIran).

Study Selection: A systematic search was performed with temporal limits (papers published between January 2000 up to June 2015), regarding the prevalence and distribution of HCV genotypes in EMRO countries.

Data Extraction: The prevalence rates of HCV genotypes were pooled by metan command in Stata 14. Statistical heterogeneity was explored using the I-square at the 5% significance level. Publication bias was assessed, graphically and statistically, by funnel plot and Begg and Egger tests.

Results: A total of 563 records were identified through the electronic search. Of these records, 134 studies comprising 67681 HCV-infected individuals were included in the meta-analysis. In Iran, subtype 1a was the predominant subtype with a rate of 42% (95% CI, 39 - 46), followed by subtype 3a, 35% (95% CI, 31 - 38). In Pakistan, Subtype 3a was the most common subtype with a rate of 56% (95% CI, 49 - 62), followed by subtype 3b, 10% (95% CI, 7 - 12). In Saudi Arabia and Egypt, genotype 4 was the most prevalent genotype with a rate of 65% (95% CI, 59 - 72) and 69% (95% CI, 36 - 100) respectively. In Tunisia and Morocco, subtype 1b was the most common subtype with a rate of 69% (95% CI, 50 - 88) and 32% (95% CI, 7 - 56) respectively.

Conclusions: The genotype distribution of HCV takes diverse patterns in EMRO countries. Genotypes 1 and 3 were predominant in Iran and Pakistan, while genotype 4 and 1 were the most common genotypes in the Middle East Arab countries and North African Arab countries. Understanding the genotypes of HCV can help policy makers in designing good strategies for treatment.
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http://dx.doi.org/10.5812/hepatmon.35558DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4894080PMC
April 2016

Hepatitis B Virus Infection in the General Population of Iran: An Updated Systematic Review and Meta-Analysis.

Hepat Mon 2016 Apr 26;16(4):e35577. Epub 2016 Apr 26.

Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Baqiyatallah University of Medical Sciences Tehran, IR Iran.

Context: The hepatitis B virus (HBV) is a major global public health problem, affecting more than 2 billion people worldwide. Accurate and updated data on HBV prevalence is important for further planning to control the infection. The aim of this study was to update the prevalence estimate of HBV infection in the general population of Iran.

Evidence Acquisition: A systematic review was done for data on the prevalence of HBV infection in the general Iranian population published between Jan. 1, 1990, and Jan. 1, 2016, in both international and national databases, including PubMed, Scopus, Web of Science, Scientific Information Database, IranMedex, and Magiran. All papers with clearly described time and location of the study, proper sampling strategies, and proper analysis methods were included in the present study. Data were extracted by two independent reviewers. Prevalence of HBV infection with a 95% confidence interval (CI) was calculated using Stata software, version 13.

Results: The polled estimated prevalence of HBV infection in the general population of Iran was 2.2 % (95% CI: 1.9% - 2.6%). The highest prevalence of HBV infection (8.9%, 95% CI: 7.6% - 10.2%) was reported from Golestan province, and the lowest prevalence (0.7%, 95% CI: 0.4% - 1.1%) was seen in Kermanshah province. The prevalence of HBV infection was estimated at 3% (95% CI: 2.2% - 3.8%) for Iranian males and 1.7% (95% CI: 1.2% - 2.3%) for Iranian females. The prevalence of HBV infection in the general population of Iran was 2.9% (95% CI: 2.5% - 3.4%) before 2010 and 1.3% (95% CI: 0.9% - 1.7%) after 2010.

Conclusions: In total, Iran was classified within the low-intermediate HBV prevalence areas (2% - 4%), while according to recent data (after 2010), Iran was classified within the low HBV prevalence areas (< 2%), indicating that preventive measures conducted in Iran have been effective.
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http://dx.doi.org/10.5812/hepatmon.35577DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4888501PMC
April 2016

Statin Antiarrhythmic Effect on Atrial Fibrillation in Statin-Naive Patients Undergoing Cardiac Surgery: A Meta-Analysis of Randomized Controlled Trials.

J Cardiovasc Pharmacol Ther 2016 Mar 1;21(2):167-76. Epub 2015 Sep 1.

Seyyed-al-Shohada Heart Center, Urmia University of Medical Science, Urmia, Iran.

Background: Statin therapy has been thought to improve outcomes in cardiac surgeries. We aimed to determine the statin effects on the development of postoperative atrial fibrillation (AF), hospital length of stay (LOS), and inflammatory status in patients undergoing cardiac surgeries.

Methods: A systematic literature search in databases was performed, until January 2015. Randomized clinical trial (RCT) studies evaluating statin effect on statin-naive patients with sinus rhythm undergoing cardiac surgeries were eligible to be analyzed.

Results: Twelve RCTs involving 1116 patients, 559 receiving statin and 557 receiving control regimen, were analyzed. Postoperative AF occurred in 17.9% and 36.1% of patients in the statin and control groups, respectively. The statin therapy was associated with decreases in the postoperative AF (risk ratio [RR] 0.50, 95% confidence interval [CI] 0.41-0.61, P < .000010), hospital LOS (mean difference in days, RR -0.44, 95% CI -0.67 to -0.20, P = .0002), and postoperative C-reactive protein (CRP) compared with control (mean difference in mg/L, RR -12.37, 95% CI -23.87 to -0.87, P = .04). The beneficial effects on AF and CRP were more marked in patients receiving atorvastatin compared to other statins. Decrease in postoperative AF was greater in coronary artery bypass graft surgery compared to that in isolated valvular surgery.

Conclusion: Perioperative statin therapy in statin-naive patients with sinus rhythm undergoing cardiac surgeries was associated with decreases in the development of postoperative AF, the hospital LOS, and the CRP level. However, there were insufficient data to provide evidences regarding statin impacts in patients undergoing isolated valvular surgery.
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http://dx.doi.org/10.1177/1074248415602557DOI Listing
March 2016