Comparison of the Effects of Special Care Enhanced Recovery and Conventional Recovery Methods after Mini Omega Gastric Bypass.

Background: Bariatric surgery is a surgical procedure for patients with extreme obesity. Enhanced Recovery after Surgery (ERAS) is a method that provides special peri- and post-operation care. Here, we aimed to compare the effects of ERAS and standard recovery cares. Materials and Methods: This is a randomized clinical trial that was performed in 2020-2021 in Isfahan on 108 candidates for mini gastric bypass. Patients were then randomly divided into two equal groups receiving ERAS and standard recovery protocols. Patients were examined and visited after one month regarding the average number of hospitalization days, the average days required to return to normal activity or work, occurrence of pulmonary thromboemboli (PTE) and the rate of readmission. Results: Patients that received ERAS had significantly lower frequencies of nausea and vomiting (P = 0.032). Patients that received ERAS had significantly lower hospitalization duration (P < 0.001) compared to controls. No other significant differences were observed between two groups regarding surgery complication, re-admission rate and occurrence of PTE (P > 0.99 for all). Conclusion: Patients that received ERAS protocol after gastric bypass had significantly lower hospitalization duration and lower incidence of nausea and vomiting. They also had similar post-operative outcomes compared to the standard protocol.

The association between metabolic syndrome and erosive esophagitis: A systematic review and meta-analysis.

Although several studies have shown that each of the metabolic syndrome (MetS) components can be a risk factor for erosive esophagitis (EE), the association between MetS and EE is still a challenging subject, as studies about this association have shown inconsistent results. Therefore, this study was conducted to evaluate the association between MetS and EE. In this study, we followed the MOOSE protocol and the PRISMA guidelines for reporting the results. Web of Science (ISI), Cochrane Library (Cochrane Database of Systematic Reviews - CDSR), EMBASE, Scopus, Science Direct, PubMed/Medline, EBSCO, CINAHL, and Google Scholar search engine were searched for articles published until January 2021. Heterogeneity between studies was estimated by I2 index and Q test. All analyses were performed using Comprehensive Meta-Analysis Software. Finally, 12 studies entered the meta-analysis process after qualitative assessment. MetS was significantly associated with increased risk of EE (OR=1.488 [95 % CI: 1.352-1.638], P<0.001; Heterogeneity: I2= 55.57, P<0.001) in 12 studies with a sample size of 45285 (12825 cases and 29377 controls). In subgroup analysis based on types of studies (P=0.832), MetS diagnostic criteria (P=0.083) and quality of studies (P=0.612), no significant association was found. Sensitivity analysis showed that the overall estimation of effect size is still robust after omission of individual studies from the meta-analysis. Publication bias based on the Begg's test (P=0.945) and Egger's test (P=0.753) were not significant. MetS increases the risk of EE compared to control groups. Future studies should examine if MetS treatment reduces the risk of EE.

Prevalence of Dyspepsia in Iran: A Systematic Review and Meta-analysis.

BACKGROUND: Dyspepsia is a highly prevalent gastrointestinal problem. The present study was carried out to assess the prevalence of dyspepsia in Iran. METHODS: The present study was registered at PROSPERO with the code CRD42019148610. It was carried out based on MOOSE and reporting was performed according to the PRISMA protocol. Systematic search of the literature was performed in July 2019 on international databases of PubMed/Medline, Web of Science (ISI), Cochrane Library, EBSCO, CINAHL, EMBASE, Scopus, Science Direct, and local databases as well as the Google Scholar search engine. Heterogeneity was evaluated using I2 and Chi-square tests. All analyses were done using Comprehensive Meta-Analysis software. RESULTS: Overall, 14 studies with a sample size of 54,118 subjects entered in this meta-analysis. The prevalence of dyspepsia in Iran was 14.6% (95% CI: 9.6-21.7). Large heterogeneity was detected among studies (I2=99.62%, P<0.001). The prevalence of dysmotility-like, ulcer-like, and unspecified dyspepsia was estimated to be 9.7% (95% CI: 4.9-18.4), 12.1% (95% CI: 5.2-25.7) and 17.0% (95% CI: 7.8-33.4), respectively. The prevalence of dyspepsia in Iranian men and women was found at 11.1% (95% CI: 6.3-18.8) and 17.8% (95% CI: 10.0-29.7), respectively. CONCLUSION: The prevalence of dyspepsia in Iran is relatively high. However, it is lower than global estimates.

Epidemiology of gastroesophageal reflux disease in Iran: a systematic review and meta-analysis.

BACKGROUND: Gastroesophageal reflux disease (GERD), which leads to acid reflux into the esophagus, is a common gastrointestinal disorder. Several studies have shown the prevalence of GERD in Iranian population, but their evidence is contradictory. Therefore, the present study was conducted to investigate the epidemiology of GERD in Iran. METHODS: The entire steps of this systematic review and meta-analysis were based on the MOOSE protocol, and the results were reported accordance with the PRISMA guideline. This review is registered on PROSPERO (registration number: CRD42020142861). To find potentially relevant published articles, comprehensive search was done on international online databases Scopus, Science Direct, EMBASE, PubMed/Medline, CINAHL, EBSCO, Cochrane Library, Web of Science, Iranian online databases and the Google Scholar search engine in June 2019. Cochran test and I2 index were used to assess the heterogeneity of the studies. Data were analyzed using Comprehensive Meta-Analysis software ver. 2. The significance level of the test was considered to be P <  0.05. RESULTS: The daily, weekly, monthly, and overall prevalence of GERD symptoms in Iranian population was 5.64% (95%CI [confidence interval]: 3.77-8.35%; N = 66,398), 12.50% (95%CI: 9.63-16.08%; N = 110,388), 18.62% (95%CI: 12.90-26.12%; N = 70,749) and 43.07% (95%CI: 35.00-51.53%; N = 73,189), respectively. The daily, weekly, monthly, and overall prevalence of heartburn in Iranian population was 2.46% (95%CI: 0.93-6.39%; N = 18,774), 9.52% (95%CI: 6.16-14.41%; N = 54,125), 8.19% (95%CI: 2.42-24.30%; N = 19,363) and 23.20% (95%CI: 13.56-36.79%; N = 26,543), respectively. The daily, weekly, monthly, and overall prevalence of regurgitation in Iranian population was 4.00% (95%CI: 1.88-8.32%; N = 18,774), 9.79% (95%CI: 5.99-15.60%; N = 41,140), 13.76% (95%CI: 6.18-44.31%; N = 19,363) and 36.53% (95%CI: 19.30-58.08%; N = 21,174), respectively. The sensitivity analysis for prevalence of all types GERD, heartburn and regurgitation symptoms by removing a study showed that the overall estimate is still robust. CONCLUSION: The present meta-analysis provides comprehensive and useful information on the epidemiology of GERD in Iran for policy-makers and health care providers. This study showed a high prevalence of GERD in Iran. Therefore, effective measures on GERD-related factors such as lifestyle can be among the health policies of Iran.

The relationship between metabolic syndrome and increased risk of Barrett's esophagus: an updated systematic review and meta-analysis.

BACKGROUND: The relationship between metabolic syndrome (MetS) and Barrett's esophagus (BE) is still a challenging issue, and inconsistent results have been reported in different studies. Therefore, this study was conducted to determine the relationship between MetS and BE. METHODS: In this study, we followed the MOOSE protocol and results were reported according to the PRISMA guidelines. All study steps were performed independently by two authors. If necessary, the dispute was resolved by consultation with a third author. The search strategy is designed to find published studies. Comprehensive search was done in the following databases until July 2019: Cochrane Library, PubMed/Medline, Web of Science, Science Direct, EMBASE, Scopus, CINAHL, EBSCO, and Google Scholar search engine. All analyses were performed using Comprehensive Meta-Analysis Software Ver.2, while p-value lower than 0.05 was considered significant. RESULTS: In 14 studies with a sample size of 108,416, MetS significantly increased the risk of BE (OR = 1.354; 95% CI: 1.145-1.600; P < 0.001; Heterogeneity: I2 = 81.95%; P < 0.001). Sensitivity analysis by omitting one study showed that overall estimates are still robust. Subgroup analysis was significant for continent (P < 0.001) and MetS diagnostic criteria (P = 0.043), but was not significant for variables of study type (P = 0.899), study setting (P = 0.115), control groups (P = 0.671) and quality of studies (P = 0.603). The Begg (P = 0.912) and Egger's (P = 0.094) tests were not significant; therefore, the publication bias did not play a role in the results. CONCLUSION: MetS increases the risk of BE compared to control groups. The results of this study can help health practitioners by identifying a treatable risk factor for the most important risk factor for esophageal carcinoma (ie, BE). Future studies should examine whether treatment for MetS reduces the risk of BE.

The effectiveness of an intervention program -barton intervention program- on reading fluency of Iranian students with dyslexia.

BACKGROUND: Difficulty with reading fluency has been increasingly acknowledged as a significant aspect of reading disabilities which is called dyslexia. To investigate this important issue, this research aims to examine the impact of an intervention program on reading fluency of dyslexic students. MATERIALS AND METHODS: The research is an experimental one. The population of the study included all the second- and third-grade male and female students in the city of Ilam, Iran, among whom 68 students were recognized to be dyslexic using a screening inventory reading test (IRT) developed by Shafiei et al., in 2009, they were selected using purposeful sampling method. The students were equally divided and assigned into a control and an experimental group. The experimental group received the Barton intervention program for 10 weeks. The reading fluency test was administered for the measurement of reading fluency in pre- and post-tests. Data were analyzed using descriptive statistics (mean and standard deviation) and paired t-test. RESULTS: The analysis of the finding through t-test found a statistically significant difference between the control and experimental groups after the intervention program at P < 0.01. CONCLUSIONS: The results revealed that the students who received the intervention program of the experimental group were improved in terms of their reading fluency.