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Showing 14 results for Systematic Review
Hussein Kheirandish, Ehsan Shojaeeefar , Alipasha Meysamie ,
Volume 74, Issue 12 (3-2017)
Volume 74, Issue 12 (3-2017)
Abstract
Background: Cupping is one of the most common traditional medical procedures in Iran, which is widely used and prescribed from long time ago. Putting a cup on the skin with induction of negative pressure, causes an artificial inflammation with collection of some body fluids under the skin which can be extracted by scarification. Different mechanisms and effects are attributable to cupping based on several assumptions and theories. Regarding to the vast use of this traditional therapeutic method and relatively different point of views about the effects of cupping, this study was performed to systematically assess published studies in this field and also to find probable indications of cupping.
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Methods: In this systematic review, according to search via Google Scholar, PubMed, Scopus databases and Iranian databases (IranMedex and SID), 99 different scientific articles about cupping and it`s positive and negative effects were assessed. Different diseases categorized in 19 groups according to the pathophysiology and organ similarities for better presentation Results: More than 50 different disorders have been studied in randomized or nonrandomized clinical trials. 84.9% of reviewed papers have reported significant positive effects of cupping. The most common disorders studied in the reviewed papers were musculoskeletal, pain and skin disorders, especially low back pain has been studied more with positive results of cupping. |
Conclusion: In Iran the prevalence of cupping performance is really high. The reported positive effects and also complications especially infection were also dramatic. It seems performing systematic studies on cupping effects in different disorders and designing and implementing an active surveillance system for cupping in our country is essential. According to the type of studies, authors concluded that cupping have been reported as an effective intervention for some diseases such as musculoskeletal and skin disorders, but further methodologically elaborated studies with larger sample sizes should be considered for recommending this intervention scientifically.
Ali Mohammad Mosadeghrad , Parvaneh Isfahani ,
Volume 77, Issue 6 (9-2019)
Volume 77, Issue 6 (9-2019)
Abstract
Background: Unnecessary patient admission to a hospital refers to the hospitalization of a patient without clinical indications and criteria. Various factors related to the patient (e.g., age, disease severity, payment method, and admission route and time), the physician and the hospital and its facilities and diagnostic technologies affect a patient unnecessary admission in a hospital. Unnecessary patient hospitalization increases nosocomial infections, morbidity and mortality, and decreases patient satisfaction and hospital productivity. This study aimed to measure unnecessary patient admissions in hospitals in Iran.
Methods: This study was conducted using a systematic review and meta-analysis at Tehran University of Medical Science in August 2019. Seven electronic databases were searched and evaluated for original research papers published between March 2006 and 2018 on patients’ unnecessary admission to a hospital. Finally, 12 articles were selected and analyzed using comprehensive meta-analysis software.
Results: All studies used the appropriateness evaluation protocol (AEP) for assessing patients’ unnecessary hospitalization in the hospitals. Overall, 2.7% of hospital admissions were rated as inappropriate and unnecessary (CI 95%: 1.5-4.9%). The highest unnecessary patients’ admissions were 11.8% in a teaching hospital in Meshginshahr city in 2016, (CI 95%: 8.8%-15.8%) and the lowest unnecessary patients’ admissions was 0.3% in a teaching hospital in Yasuj city in 2016 (CI 95%: 0%-3.6%). Unnecessary patient admission in public hospitals was higher than private hospitals. A significant statistical correlation was observed between unnecessary patient admission, and sample size (P<0.05).
Conclusion: The rate of unnecessary hospital admission in Iran is low. However, hospital resources are wasted due to unnecessary admissions. Expanding the primary health care network, reducing hospital beds, introducing an effective and efficient patient referral system, using a fixed provider payment method, and promoting residential and social services care at macro level, and establishing utilization management committee, using the appropriateness evaluation protocol, establishing short-stay units, and implementing quality management strategies at the hospital level are useful strategies for reducing avoidable hospital admissions.
Methods: This study was conducted using a systematic review and meta-analysis at Tehran University of Medical Science in August 2019. Seven electronic databases were searched and evaluated for original research papers published between March 2006 and 2018 on patients’ unnecessary admission to a hospital. Finally, 12 articles were selected and analyzed using comprehensive meta-analysis software.
Results: All studies used the appropriateness evaluation protocol (AEP) for assessing patients’ unnecessary hospitalization in the hospitals. Overall, 2.7% of hospital admissions were rated as inappropriate and unnecessary (CI 95%: 1.5-4.9%). The highest unnecessary patients’ admissions were 11.8% in a teaching hospital in Meshginshahr city in 2016, (CI 95%: 8.8%-15.8%) and the lowest unnecessary patients’ admissions was 0.3% in a teaching hospital in Yasuj city in 2016 (CI 95%: 0%-3.6%). Unnecessary patient admission in public hospitals was higher than private hospitals. A significant statistical correlation was observed between unnecessary patient admission, and sample size (P<0.05).
Conclusion: The rate of unnecessary hospital admission in Iran is low. However, hospital resources are wasted due to unnecessary admissions. Expanding the primary health care network, reducing hospital beds, introducing an effective and efficient patient referral system, using a fixed provider payment method, and promoting residential and social services care at macro level, and establishing utilization management committee, using the appropriateness evaluation protocol, establishing short-stay units, and implementing quality management strategies at the hospital level are useful strategies for reducing avoidable hospital admissions.
Alireza Khatony , Samiramis Qavam , Hamed Tavan ,
Volume 77, Issue 7 (10-2019)
Volume 77, Issue 7 (10-2019)
Abstract
Background: Coronary artery disease today is a major contributor to mortality and morbidity from cardiovascular disease. The drug, interventional and surgical methods are used to treat coronary artery stenosis. Statins are the most commonly used drugs for stenosis and coronary artery disease. Low-density lipoprotein (LDL) The purpose of this study was to evaluate the effect of atorvastatin on LDL and C-reactive protein (CRP) reduction in patients.
Methods: This study was a systematic review and meta-analysis. Articles were selected using the keywords of atorvastatin, LDL, C-reactive protein (CRP) and reduction, and searches in Scopus, Google Scholar and PubMed databases from March 2003 to February 2018. For this purpose, all analytical, clinical trials, cross-sectional, and case-control studies were searched and collected in association with the efficacy of atorvastatin on low density lipoprotein and CRP.
Results: In the initial search, 90 papers were found and evaluated. Finally, 20 papers were analyzed. The studies were published. The total sample size was 21609 persons with an average sample size of 1080 in each study. Twenty studies were entered into the final analysis. The LDL-lowering rate was 51 mg/dl with atorvastatin (I2=98.48, P<0.001). Also, CRP reduction before and after administration of atorvastatin was 1.99 (0.96-3.03) and 0.76 (0.08-1.43), respectively. The results of meta-regression of age-related studies showed that LDL levels were low in studies with lower age, and LDL levels were low in studies with higher age. The results of a meta-regression study of atorvastatin in terms of body mass and the association of low-density lipoprotein with atorvastatin showed that in those with a higher body mass, low-density lipoprotein decreased.
Conclusion: According to the results, the use of atorvastatin reduces the amount of C-reactive protein (CRP). The rate of low density lipoprotein (LDL) reduction was better and faster in young and obese people. It is recommended that people have a proper diet and regular exercise in their daily schedule.
Methods: This study was a systematic review and meta-analysis. Articles were selected using the keywords of atorvastatin, LDL, C-reactive protein (CRP) and reduction, and searches in Scopus, Google Scholar and PubMed databases from March 2003 to February 2018. For this purpose, all analytical, clinical trials, cross-sectional, and case-control studies were searched and collected in association with the efficacy of atorvastatin on low density lipoprotein and CRP.
Results: In the initial search, 90 papers were found and evaluated. Finally, 20 papers were analyzed. The studies were published. The total sample size was 21609 persons with an average sample size of 1080 in each study. Twenty studies were entered into the final analysis. The LDL-lowering rate was 51 mg/dl with atorvastatin (I2=98.48, P<0.001). Also, CRP reduction before and after administration of atorvastatin was 1.99 (0.96-3.03) and 0.76 (0.08-1.43), respectively. The results of meta-regression of age-related studies showed that LDL levels were low in studies with lower age, and LDL levels were low in studies with higher age. The results of a meta-regression study of atorvastatin in terms of body mass and the association of low-density lipoprotein with atorvastatin showed that in those with a higher body mass, low-density lipoprotein decreased.
Conclusion: According to the results, the use of atorvastatin reduces the amount of C-reactive protein (CRP). The rate of low density lipoprotein (LDL) reduction was better and faster in young and obese people. It is recommended that people have a proper diet and regular exercise in their daily schedule.
Hamidreza Mirzaei , Mohammadreza Barzegartahamtan ,
Volume 77, Issue 12 (3-2020)
Volume 77, Issue 12 (3-2020)
Abstract
Background: The rate of recurrence and mortality in high-risk prostate cancer remains high. On the other hand, the use of chemotherapy in metastatic prostate cancer has improved overall survival of patients. The aim of this study was to evaluate the effect of neoadjuvant chemotherapy alone on increasing survival of patients with high risk localized prostate cancer
Methods: This is a systematic review study. Databases including Scopus, Medline, PubMed, Google Scholar, Cochrane, Embase were searched. The terms used include prostate cancer, adenocarcinoma, neoadjuvant, chemotherapy, chemotherapy alone, systemic therapy. Of the various types of articles, only oiginal research studies that specifically focused on neoadjuvant chemotherapy (not chemotherapy with target therapy, immunotherapy, or hormone therapy) were identified. Inclusion criteria included study type (original research studies) and sample type (high-risk localized prostate cancer patients) and outcome type (patient survival).
Results: A total of 17 original research studies were identified. All of these studies were phase one or phase two. Docetaxel was the most commonly used chemotherapy drug. Also, the most common regimen used was the use of docetaxel alone. The rate of decrease in prostate-specific antigen (PSA) (>50%) after neoadjuvant chemotherapy was reported in 24 to 58% of patients. PSA declines of less than 50% after neoadjuvant chemotherapy occurred in 40 to 100% of patients. No studies reported a complete pathologic response following neoadjuvant chemotherapy. However, the relative pathologic response and reduced tumor volume were seen in the majority of patients. All of these studies showed that neoadjuvant chemotherapy alone, in high-risk prostate cancer patients, was almost well tolerated and that the complications were mostly mild (grade 1 and 2). Grade 3 and 4 complications were negligible. A 2-year recurrence-free survival of up to 68.5% and a 5-year recurrence-free survival of up to 49% were reported. The overall 5-year survival also ranged from 35 to 48%.
Conclusion: The use of neoadjuvant chemotherapy alone has not clearly increased the survival of patients with high-risk localized prostate cancer, and there is controversy in studies.
Methods: This is a systematic review study. Databases including Scopus, Medline, PubMed, Google Scholar, Cochrane, Embase were searched. The terms used include prostate cancer, adenocarcinoma, neoadjuvant, chemotherapy, chemotherapy alone, systemic therapy. Of the various types of articles, only oiginal research studies that specifically focused on neoadjuvant chemotherapy (not chemotherapy with target therapy, immunotherapy, or hormone therapy) were identified. Inclusion criteria included study type (original research studies) and sample type (high-risk localized prostate cancer patients) and outcome type (patient survival).
Results: A total of 17 original research studies were identified. All of these studies were phase one or phase two. Docetaxel was the most commonly used chemotherapy drug. Also, the most common regimen used was the use of docetaxel alone. The rate of decrease in prostate-specific antigen (PSA) (>50%) after neoadjuvant chemotherapy was reported in 24 to 58% of patients. PSA declines of less than 50% after neoadjuvant chemotherapy occurred in 40 to 100% of patients. No studies reported a complete pathologic response following neoadjuvant chemotherapy. However, the relative pathologic response and reduced tumor volume were seen in the majority of patients. All of these studies showed that neoadjuvant chemotherapy alone, in high-risk prostate cancer patients, was almost well tolerated and that the complications were mostly mild (grade 1 and 2). Grade 3 and 4 complications were negligible. A 2-year recurrence-free survival of up to 68.5% and a 5-year recurrence-free survival of up to 49% were reported. The overall 5-year survival also ranged from 35 to 48%.
Conclusion: The use of neoadjuvant chemotherapy alone has not clearly increased the survival of patients with high-risk localized prostate cancer, and there is controversy in studies.
Tahereh Yaghoubi , Hamid Sharif Nia , Mobin Mohammadi Nejad , Azar Jafari , Mostafa Hoseinoo , Amir Hossein Goudarzian ,
Volume 78, Issue 2 (5-2020)
Volume 78, Issue 2 (5-2020)
Abstract
Background: Long after the implementation of the “Health System Transformation Project”, no comprehensive assessment of patient and nurse satisfaction rate has been carried out in Iran based on available databases. Thus, this review study was designed and performed to answer this question: “How is the evaluation of the Health System Transformation Project in nurse and patient satisfaction dimensions.”
Methods: A systematic review of related studies based on preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines was performed via keywords such as “Health System Transformation Project”, “Transformation Project”, “health”, “Iran”, “challenges”, “physician”, “nurse”, “patient”, and “satisfaction” to search Iranian (Magiran and Scientific Information Database, SID) and international databases (PubMed, ISI web of knowledge, Scopus, Google Scholar, and ProQuest) with OR and AND operators from March 2014 to April 2019. Also the quality of studies was assessed using STROB checklist (special for cross-sectional studies). Then required information (for example type of studies, sample size, mean age of participants and satisfaction score) were gathered from studies.
Results: From 43 articles that were gathered from primary stages, 18 articles were selected after passing different screening levels. On average, the level of patiaent satisfaction with the Health System Transformation Project was acceptable. Ghazvin province was seems more successful in satisfaction of patients against of other provinces. However, various positive and negative reports were found about the satisfaction of nursing groups. Generally, it seems that Tehran province (at the center of Iran) was more successful in performing the Health System Transformation Project (from the aspect of satisfaction of different groups).
Conclusion: Based on obtained results, patient’s satisfaction was appropriate in most of studies and also in nursing group was under average level.
Methods: A systematic review of related studies based on preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines was performed via keywords such as “Health System Transformation Project”, “Transformation Project”, “health”, “Iran”, “challenges”, “physician”, “nurse”, “patient”, and “satisfaction” to search Iranian (Magiran and Scientific Information Database, SID) and international databases (PubMed, ISI web of knowledge, Scopus, Google Scholar, and ProQuest) with OR and AND operators from March 2014 to April 2019. Also the quality of studies was assessed using STROB checklist (special for cross-sectional studies). Then required information (for example type of studies, sample size, mean age of participants and satisfaction score) were gathered from studies.
Results: From 43 articles that were gathered from primary stages, 18 articles were selected after passing different screening levels. On average, the level of patiaent satisfaction with the Health System Transformation Project was acceptable. Ghazvin province was seems more successful in satisfaction of patients against of other provinces. However, various positive and negative reports were found about the satisfaction of nursing groups. Generally, it seems that Tehran province (at the center of Iran) was more successful in performing the Health System Transformation Project (from the aspect of satisfaction of different groups).
Conclusion: Based on obtained results, patient’s satisfaction was appropriate in most of studies and also in nursing group was under average level.
Awat Feizi, Mojgan Mortazavi , Shirinsadat Badri, Mohammad Javad Norouzi ,
Volume 78, Issue 4 (7-2020)
Volume 78, Issue 4 (7-2020)
Abstract
Background: Pentoxifylline, a valuable medication with promising clinical characteristics and considerable profile of safety is used in many conditions namely chronic kidney diseases (CKD). However, the decision to prescribe pentoxifylline for anemia in CKD should be based on evidence accrued from randomized controlled trials (RCTs). Yet, substantial heterogeneity exists in studies performed to evaluate pentoxifylline therapy, particularly in relation to classification of patients, the different quality and research design, sample size, baseline parameters, clinical outcome measures, and definition of endpoints and clinically meaningful improvements. As a result, assessment of pentoxifylline in treating anemia of CKD by conducting a systematic review and meta-analysis of the published relevant clinical studies seems rational and promising.
Methods: The present systematic review was done in accordance with the PRISMA guideline for systematic reviews and meta-analysis. Peer-reviewed RCTs with at least four weeks of follow-up were including in the meta-analysis. Online databases (PubMed/Medline, ISI Web of Science, Embase, and Scopus) were searched to December 2017 using selected MeSH terms related to the studied topic. Data was extracted independently by two reviewers using a standard form and then cross-checked. Statistical analyses were carrying out with Stata Software, version 7.0 (Stata Corp., College Station, TX, USA). P value of less than 0.05 was considered statistically significant. Data are presented as standard mean difference (SMD) and confidence interval (CI) 95%.
Methods: The present systematic review was done in accordance with the PRISMA guideline for systematic reviews and meta-analysis. Peer-reviewed RCTs with at least four weeks of follow-up were including in the meta-analysis. Online databases (PubMed/Medline, ISI Web of Science, Embase, and Scopus) were searched to December 2017 using selected MeSH terms related to the studied topic. Data was extracted independently by two reviewers using a standard form and then cross-checked. Statistical analyses were carrying out with Stata Software, version 7.0 (Stata Corp., College Station, TX, USA). P value of less than 0.05 was considered statistically significant. Data are presented as standard mean difference (SMD) and confidence interval (CI) 95%.
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Results: According to the predefined criteria, a total of ten studies (parallel group or cross-over trials, and case-control studies) were included and screened for data extraction by two reviewers, separately. The preliminary results extracted from meta-analysis have shown that pentoxifylline can significantly increase transferrin saturation (SMD: 0.348; CI95%: 0.008, 0.688), but there were no conclusive effects of pentoxifylline on hemoglobin (SMD: 0.171; CI95%: -0.390, 0.732), hematocrit (SMD: 0.466; CI95%: -1.426, 2.357), ferritin (SMD: -0.010; CI95%: -0.346, 0.326), and administered dose of erythropoietin (SMD: 0.114; CI95%: -0.232, 0.460), in pooled analyses.
Conclusion: There is uncertainty about therapeutic effects of pentoxifylline on anemia of CKD patients. Since these patients has many diverse complications and receive multiple drug therapy, the results of such meta-analysis regarding outcomes of pentoxifylline therapy may have beneficial effects on rational drug prescription. |
Ali Mohammad Mosadeghrad , Parvaneh Isfahani, Taraneh Yousefinezhadi,
Volume 78, Issue 4 (7-2020)
Volume 78, Issue 4 (7-2020)
Abstract
Background: Medical errors are those errors or mistakes committed by healthcare professionals due to errors of omission, errors in planning, and errors of execution of a planned healthcare action whether or not it is harmful to the patient. Medical error in hospitals increases morbidity and mortality and decreases patient satisfaction and hospital productivity. This study aimed to determine the prevalence of medical errors in Iranian hospitals.
Methods: This study was conducted using systematic review and meta-analysis approaches. All articles written in English and Persian on the prevalence of medical errors in Iranian hospitals up to March 2019 were searched in Web of Science, PubMed, Elsevier, Scopus, Magiran, IranMedex and Scientific Information Database (SID) databases, and Google and Google Scholar search engines. In addition, reference lists of the retrieved papers were hand-searched. A total of 9 studies matching the inclusion criteria were identified, reviewed, and analyzed using comprehensive meta-analysis software.
Methods: This study was conducted using systematic review and meta-analysis approaches. All articles written in English and Persian on the prevalence of medical errors in Iranian hospitals up to March 2019 were searched in Web of Science, PubMed, Elsevier, Scopus, Magiran, IranMedex and Scientific Information Database (SID) databases, and Google and Google Scholar search engines. In addition, reference lists of the retrieved papers were hand-searched. A total of 9 studies matching the inclusion criteria were identified, reviewed, and analyzed using comprehensive meta-analysis software.
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Results: The prevalence of medical errors was reported in 9 studies and prevalence rate ranged from 0.06% to 42%. Most studies used reporting forms completed by hospital employees for determining the prevalence of medical errors (67%). Only three studies collected data by reviewing patients’ medical records. Accordingly, the overall prevalence of medical error in Iran's hospitals based on the nine published articles was 0.01% (95% Cl 0%-0.01%) during 2008 to 2017. The highest medical error was recorded in a hospital in Shiraz, 2.1% (95% Cl: 1.4%-2.7%) in 2012. A significant statistical correlation was observed between medical errors and sample size (P<0.05).
Conclusion: The prevalence rate of medical error in Iran is low. It is strongly recommended to use more advanced and valid methods such as occurrence reporting, screening, and the global trigger tool for examining medical errors in Iranian hospitals. Proving adequate education and training to patients and employees, simplifying and standardizing hospital processes, enhancing hospital information systems, improving communication, promoting a safety culture, improving employees’ welfare and satisfaction, and implementing quality management strategies are useful for reducing medical errors. |
Mostafa Bahremand, Ehsan Zereshki, Behzad Karami Matin, Samira Mohammadi,
Volume 78, Issue 5 (8-2020)
Volume 78, Issue 5 (8-2020)
Abstract
Background: Coronary artery ectasia (CAE) is dilatation of an arterial segment to a diameter at least 1.5 times that of the adjacent normal coronary artery. The incidence of coronary artery ectasia is distinct in different countries that can be found in 1.2% to 5% of angiographic examinations.
Methods: This is a retrospective study that was conducted from September 2019 to February 2020 in Kermanshah University of Medical Sciences and the results were reported briefly. To obtain the desired articles, electronic searches were conducted in databases including the Scopus, PubMed, and Science Direct databases without time limited until October 2019. The keywords used were Coronary Artery Ectasia AND (Diabetes OR "Diabetes Mellitus"). This was done by two individuals separately and the final results were confirmed by a third person. Mixed method appraisal tool (MMAT) was used to evaluate the quality of studies. The structure of writing and the process of performing and reporting the study are based on the PRISMA checklist.
Methods: This is a retrospective study that was conducted from September 2019 to February 2020 in Kermanshah University of Medical Sciences and the results were reported briefly. To obtain the desired articles, electronic searches were conducted in databases including the Scopus, PubMed, and Science Direct databases without time limited until October 2019. The keywords used were Coronary Artery Ectasia AND (Diabetes OR "Diabetes Mellitus"). This was done by two individuals separately and the final results were confirmed by a third person. Mixed method appraisal tool (MMAT) was used to evaluate the quality of studies. The structure of writing and the process of performing and reporting the study are based on the PRISMA checklist.
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Results: Based on the search strategy carried out at PubMed, Scopus and Science Direct databases, 106 studies were found, which resulted in 24 articles being analyzed based on inclusion and exclusion criteria of which three were conducted in China, 18 in Turkey and one in Sweden, Egypt, and France. Finally, 24 articles were analyzed and the results showed a direct and effective relationship between diabetes mellitus and CAE (OR=1.19, CI: 0.94, 1.51).
Conclusion: Based on these results, the risk of CAE in subjects with diabetes mellitus was 19% higher than in subjects without diabetes mellitus. |
Seyed Vahid Jasemi, Maryam Janatolmakan, Masoud Mohammadi, Alireza Khatony,
Volume 79, Issue 6 (9-2021)
Volume 79, Issue 6 (9-2021)
Abstract
Background: Asthma is the most prevalent chronic disease in childhood and has been growing globally over the last three decades. Studies in this regard indicate different and irrelevant results in Iran. Different prevalence of asthma has been reported in industrialized countries, prevalence of 25.9% in the United Kingdom, 12.8% in Spain and 31% in Australia. This study aimed to evaluate asthma in Iranian children through systematic review and meta-analysis.
Methods: This study was performed as a systematic review and meta-analysis from January 2001 to December 2018. Related articles to the reviewed subject were obtained through searches of Scopus, ScienceDirect, Magiran, SID, Medline (PubMed), and Google Scholar databases. Cross-sectional studies were selected for inclusion in the study and observational studies as well as review studies were excluded from the study. Searches on Google search engine and the inspection of sites related to the topic were also incorporated to examine the grays literature. Duplicate articles and articles that were similar and obtained from the same source were removed through the EndNote software. The total number of articles was 896. Subsequently, the number of articles and studies that met the requirements of the first stage was 274. Ultimately after the elimination of 236 irrelevant articles and the elimination of 5 articles in the secondary examination, eventually 33 articles were added to the final stage. By the I2 index, the heterogeneity of the studies was investigated and reported.
Methods: This study was performed as a systematic review and meta-analysis from January 2001 to December 2018. Related articles to the reviewed subject were obtained through searches of Scopus, ScienceDirect, Magiran, SID, Medline (PubMed), and Google Scholar databases. Cross-sectional studies were selected for inclusion in the study and observational studies as well as review studies were excluded from the study. Searches on Google search engine and the inspection of sites related to the topic were also incorporated to examine the grays literature. Duplicate articles and articles that were similar and obtained from the same source were removed through the EndNote software. The total number of articles was 896. Subsequently, the number of articles and studies that met the requirements of the first stage was 274. Ultimately after the elimination of 236 irrelevant articles and the elimination of 5 articles in the secondary examination, eventually 33 articles were added to the final stage. By the I2 index, the heterogeneity of the studies was investigated and reported.
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Results: In a survey of 33 studies and 97205 participants in the age range of (3-18) years, the general prevalence of asthma in this study based on meta-analysis was 5.1% (CI95%: 4-6.5%). The highest prevalence of asthma was among children from Babol which was 19% (CI95%: 17.8% -20.3%) in 2014 and the lowest prevalence of asthma was among children from Isfahan with 0.7% of prevalence (CI95%: 0.5-1.1) in 2001. Also, with the increase of research years and overall sample size in each study, asthma in children shows increasing and decreasing levels, respectively; and the differences were statistically significant.
Conclusion: Based on what was reported in this study, the prevalence of asthma among Iranian children is lower compared to children of developed countries. |
Association between alcohol consumption and pancreatic
cancer: a systematic review of cohort studies
Zohreh Ghoreishi, Ali Esfahani, Shima Asgarzad, Laleh Payahoo, Fatemeh Hajizadeh-Sharafabad ,
Volume 79, Issue 10 (1-2022)
Volume 79, Issue 10 (1-2022)
Abstract
Background: Among all types of cancers, pancreatic cancer has poor prognosis with 5-year survival below 10%. In theory, alcohol intake may be a modifiable risk factor for pancreatic cancer due to its role in multiple carcinogenic and metabolic signaling pathways. In addition, alcohol consumption may lead to chronic pancreatitis which is underlying cause of pancreatic cancer. However, little is known about whether this factor is associated with pancreatic cancer. This study aimed to systematically review the cohort studies investigating the possible link between alcohol consumption and the morbidity or mortality of pancreatic cancer.
Methods: This study was carried out based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). All of cohort studies that assessed the association between alcohol intake and the risk of pancreatic cancer or death were included in this systematic review without a language restriction. Electronic databases including PubMed, Web of science, Scopus, and Google scholar were searched using the keywords "pancreatic cancer" and "alcohol" and similar words from 1990 to April 2021 to find the cohort studies.
| Results: 858 articles were identified, of which 806 were excluded and the full-text of 52 papers were evaluated for the eligibility. Eventually, 22 articles were eligible and were included in this study. Many of the articles assessed the impacts of low to moderate alcohol intake. A comprehensive review of these studies showed that low to moderate alcohol consumption had a non-significant correlation with pancreatic cancer, while high alcohol consumption was significantly associated with the risk of pancreatic cancer or death. The results also revealed that high liquor consumption was associated with higher risk of pancreatic cancer. Nevertheless, the follow-up durations in most of these studies were shorter than that to lead to pancreatic cancer. Conclusion: Long-term heavy alcohol drinking can increase the morbidity or mortality of pancreatic cancer. Regarding that several genetic and environmental variations involve in the pathogenesis of this cancer, simultaneous control of these differences should be addressed to determine the net effect of alcohol drinking on pancreatic cancer. |
Negar Heidari , Paria Heidari, Nader Salari, Hakimeh Akbari, Masoud Mohammadi,
Volume 79, Issue 12 (3-2022)
Volume 79, Issue 12 (3-2022)
Abstract
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Background: Parkinson's disease is one of the chronic neurological diseases. It is the second most common neurodegenerative disease after Alzheimer's, affecting 7.5 million people worldwide and its rate is expected to increase by 20% by 2020. three symptoms of tremor, muscle stiffness and movement disorders are among the main diagnostic symptoms of the disease. The prevalence of Parkinson's worldwide varies between 18 and 418 cases per 100,000 people per year. It is generally estimated that the prevalence of this disease in the general population is 0.3%. A systematic review study was performed to determine the factors associated with Parkinson's disease. Methods: This study was a systematic review that was conducted by searching national and international databases until February 2020. Initially, all articles which had mentioned Parkinson-related factors were collected and accepted by researchers based on studies. Entry and exit criteria were met. Exclusion criteria included irrelevant items, duplication of studies, unclear procedure, and lack of access to the full text of the study. To reduce bias, articles were evaluated independently by two researchers, and the quality of articles was assessed using the STROBE checklist. All final articles submitted to the systematic review process were prepared by a template checklist. Checklists included article title, first author’s name, year of publication, place of study, risk factors, protective factors, and ineffective factors or the ones which their effects have not yet been determined, and the average age. Results: In these studies, the following risk factors were reported: family history, agricultural occupation, literacy, stress, well water consumption, aging, environmental factors, genetic factors, pesticide exposure, and alcohol abuse. On the other hand, factors such as smoking and oilseeds, high levels of B-complex vitamins, female estrogen hormones, and selenium have been reported to protect against Parkinson's disease. Conclusion: Considering the results of the present study and although there is no definitive treatment for this disease, protective factors and risk factors should be seriously considered by health policymakers for preventive measures. |
Zahra Asadi-Piri , Ebrahim Jaafaripooyan,
Volume 80, Issue 11 (2-2023)
Volume 80, Issue 11 (2-2023)
Abstract
Background: Access to healthcare is a fundamental right of every individual, regardless of their geographic location or socioeconomic status. In many countries, deprived areas often face a shortage of physicians and other healthcare professionals. This study aimed to investigate the approaches essential to attract and retain physicians in the deprived and rural areas.
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Methods: The present study is a systematic review using appropriate keywords in Persian and English language. The main databases including Google Scholar, Scopus, Web of Science, PubMed, SID, and IranMedex were searched from May 2005 to September 2022 in both languages. Different approaches implemented by countries to attract and retain doctors were classified using thematic analysis.
Results: A total of 18 articles were selected for inclusion in the study. Educational, regulatory, motivational, and personal and professional support drivers have been used to attract and retain physicians. The successful interventions implemented were mainly educational and supportive; such as admitting native medical students, providing relevant curricula on working in the deprived and rural areas, and conducting training courses in these regions. Those studying the topics and courses related to serving in the rural areas during their academic education or internship and residency programs had served more time in these areas. Assimilating the topics related to providing services in rural areas into the curriculum, holding fellowship courses and related graduate studies, awarding scholarships to the physicians working in deprived areas, providing free amenities, reducing working hours, and considering special holidays are considered among the recommended solutions. Conclusion: Various drivers were used for attracting and retaining physicians in the deprived and rural areas. Besides, the challenge to retain doctors in such areas was fairly common. Most countries have put more priority on the use of financial incentives, nevertheless, a combination of interventions was preferred. It is worth mentioning that a range of economic, political, and social factors could play a key role in the success of recommended interventions. |
Mostafa Kazemi , Mohammad Hossain Dadkhah Tehrani , Ali Asghar Khaleghi, Masoud Mohammadi ,
Volume 81, Issue 9 (12-2023)
Volume 81, Issue 9 (12-2023)
Abstract
Background: Prostate cancer is one of the most common cancers in the world, which is associated with a high prevalence, especially in the elderly male population. Treatment options for non-metastatic prostate cancer usually include active surveillance, radiotherapy and surgery, so the aim of the present study is a systematic review of brachytherapy in the treatment of prostate cancer.
Methods: The study conducted is a systematic review article in which a review of the treatment of prostate cancer with brachytherapy has been done. The information used is taken from articles published in Persian and English in Google scholar, SID and PubMed databases from 2000 to 2022. The selected keywords in this article included Brachy therapy, Prostate cancer, Radio therapy, Prostate neoplasms, High dose rate, Low dose rate and External beam radio therapy. Selection of studies was done according to PRISMA guidelines.
Methods: The study conducted is a systematic review article in which a review of the treatment of prostate cancer with brachytherapy has been done. The information used is taken from articles published in Persian and English in Google scholar, SID and PubMed databases from 2000 to 2022. The selected keywords in this article included Brachy therapy, Prostate cancer, Radio therapy, Prostate neoplasms, High dose rate, Low dose rate and External beam radio therapy. Selection of studies was done according to PRISMA guidelines.
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Results: Brachytherapy can be classified into 2 types of permanent implantation and temporary implantation based on the length of the treatment period. In permanent brachytherapy implants for prostate cancer, iodine (125I) or palladium (103Pd) are used as radioactive sources for low dose rate cases and for high dose rate brachytherapy. Iridium (192Ir) is used. Brachytherapy is usually used in two ways, either as a monotherapy in which LDR and HDR are used to treat some low-risk patients, or as a booster treatment after other treatments such as EBRT, which here may be part of the treatment process before, after, or during treatment. In contrast to brachytherapy alone, brachytherapy plus EBRT is an appropriate approach in patients with intermediate-risk and high-risk disease. In high-risk patients, the combined use of EBRT and HDR-BT can lead to better results than EBRT alone. Brachytherapy treatment is not suitable for every disease.
Conclusion: One of the main advantages of this treatment method is the ability to administer a high dose of radiation while minimizing radiation exposure to adjacent healthy organs. Since optimal dose distribution occurs in the treatment, quality treatment can be ensured. The results obtained from both forms of brachytherapy are generally suitable and comparable to other treatment methods with fewer side effects. |
Hossein Eskandari, Faramarz Sohrabi , Adeleh Rezagholizadeh Shirvan , Mohammad Asgari , Neda Shahvaroughi Farahani ,
Volume 81, Issue 12 (2-2024)
Volume 81, Issue 12 (2-2024)
Abstract
Background: The experience of existential distress, along with other forms of distress, is one of the common experiences in end-of-life patients. Therefore, the purpose of this research is to review related studies and conceptualize existential distress in palliative care of cancer patients.
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Methods: This study was a systematic review, which was conducted from May 1 to July 31, 1402 at Allameh Tabatabai University and search strategy was written and performed in MEDLINE, Web of Science/PubMed and Scopus databases from the beginning of 2003 to the end of 2022. The inclusion criteria included all quantitative, qualitative, mixed and review studies that focused on the experience of adult patients. Lack of access to the full text of the article and studies in non-English language, clinical trial (randomized and non-randomized), letter to the editor, case report and protocol were excluded from the list of studies. After removing duplicate articles, two research authors reviewed the studies independently according to the inclusion and exclusion criteria, and the differences between them were resolved by discussion.
Results: After searching, screening and selecting articles based on inclusion and exclusion criteria, finally 22 articles were included in the study, of which three were review articles, eight were quantitative and 11 were qualitative. Terminally cancer patients experience existential distress, and the data are significant for estimating the prevalence of these symptoms, especially in the severe category. In addition to examining the prevalence of this symptom, patients have described their experience of existential distress in several categories: Feelings of loneliness and isolation (or loss of support system), relationship concerns (concerns about family, changes in relationships, and conflictual relationships), loss of control/autonomy (physical control, cognitive and emotional control), burden on others, loss of sense of continuity (loss of roles, pleasurable activities and sense of self), uncompleted life tasks, hopelessness/helplessness, dissolving of the future, uncertainty and frightening ambiguity, feeling guilt/ regret about the past, lack of meaning, inevitable thoughts of death. Conclusion: It seems that the themes raised beyond cultural differences show the universal human suffering, whose accurate conceptualization can help to develop effective therapeutic interventions to reduce existential distress. |
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