Evaluation of antibiotic residues in honey: a systematic review and meta-analysis.

Nowadays, incorrect apply of antibiotics to treat infections in honey has led to health risks for humans and antibiotic resistance. Current systematic review and meta-analysis conducted to study antibiotic residues in honey. Data were obtained through searching the databases, including Scopus, Web of Science, PubMed, and other internal databases. The pooled concentration of antibiotic residues was 5.032 (µg/kg) that ranged from 4.72 to 5.33 (µg/kg). The ranking of antibiotics concentration was found in order of fluoroquinolone (8.59 µg/kg) > tetracycline (5.68 µg/kg) > sulfonamides (5.54 µg/kg) > macrolides (4.19µg/kg), respectively. Liquid chromatography-mass spectrometry (LC-MS) method (37.9.7%), high-performance liquid chromatography (HPLC) method (34.4%), and enzyme-linked immunosorbent assay (ELISA) method (27.5.8%) were the most used methods in various studies. In order to avoid contamination, proper use of antibiotics, placement of hives at a suitable distance from agricultural environment, and regular control of antibiotic residues in honey seems to be necessary.

Trend of Conflict Rate in Iran from 2014 to 2020: An Ecological Study.

BACKGROUND: Detecting the correlation of conflict rate within provinces over time provides a better understanding for health policymakers in identifying potential causes. The purpose of this study was to assess the trend of conflict rate in 31 provinces of Iran using the growth mixture model (GMM). METHODS: This ecologic study was conducted based on the data obtained from the Iranian Legal Medicine Organization (ILMO) by gender and provinces between March 21, 2014 and March 21, 2020. First, the 7-year cumulative incidence rates were described; second, the trend of conflict rate was modeled by a linear mixed-effects model according to gender and overall; finally, distinct classes of provinces with similar conflict trends in seven years were identified using the GMM. The significance level was considered less than 0.05. RESULTS: Among provinces, Ardebil and Sistan Baluchistan had the highest and the lowest 7-year conflict incidence rates (95% CI) with 66.6 (52.38, 84.67) and 20.79 (13.53, 31.95) per 100000, respectively. The results of the linear mixed-effects model showed that the annual rate of conflict in Iran decreased by 0.37% from 2014 to 2017 and then slightly increased by 0.07% after 2017. In addition, the GMM results indicated that the trends for Iranian provinces can be clustered into four distinct classes. CONCLUSION: Our study showed the increasing growth of conflict in the last years in most provinces of Iran. Necessary interventions are important to prevent the rising conflict rate due to the various effects of conflict on psychological, social, and health factors.

Evaluation of Vitamin D Serum Levels in Pregnant Women with COVID-19 Compared with the Control Group in Pregnant Women: A Case-Control Study.

The findings of studies on serum 25-hydroxy-vitamin D [25(OH) D] levels in pregnant women with or without coronavirus disease 2019 (COVID-19) were found to be controversial and inadequate. The present study was thus carried out at to fill the gap felt in this regard. In this case-control study, 63 pregnant women with singleton pregnancy who were infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and 62 pregnant women who were matched for gestational age and not infected by COVID-19 were examined. Based on clinical symptoms, the patients with COVID-19 were divided into three groups: mild, moderate, and severe. ELISA method was adopted to measure [25(OH) D] level. The [25(OH) D] means of 23.4 ± 9.2 ng/ml and 31.2 ± 0.15 ng/ml were noted in the case and control groups, respectively (p < 0.001). The [25(OH) D] level of lower than 30 ng/ml was observed in 43.5% of the control group (n = 27) and 71.4% of the case group (n = 45; p = 0.002). Multivariate linear regression analysis to match age, gestational age, [25(OH) D] supplement use, and number of pregnancies showed that [25(OH) D] mean in the case group is 8.2 units lower, compared to the control group (p < 0.001). The [25(OH) D] level in pregnant women with COVID-19 is lower, compared to non-infected pregnant women. However, there is no significant relationship between [25(OH) D] level and disease severity. A sufficient level of [25(OH) D] may protect pregnant women against COVID-19.

A comparative study of 20% azelaic acid cream versus 5% tranexamic acid solution for the treatment of postinflammatory hyperpigmentation in patients with acne vulgaris: A single-blinded randomized clinical trial.

Background: There is a lack of evidence on the therapeutic efficacy of topical tranexamic acid (TA) for the treatment of acne-related postinflammatory hyperpigmentation (PIH). The current study aimed to assess the efficacy of twice-daily administration of 20% azelaic acid (AZA) cream versus 5% TA solution for the treatment of PIH in patients with acne vulgaris. Materials and Methods: Patients in the present single-blinded randomized clinical trial were randomized into AZA or TA groups for 12 weeks. The rate of healing was assessed by scoring recorded photographs based on postacne hyperpigmentation index (PAHI) at baseline, 4th, 8th, and 12th weeks. The frequency of side effects was examined and recorded at each study time point. Results: Thirty volunteers in each treatment group completed the intervention. PAHI score in both AZA and TA groups improved during the study course (Ptime < 0.001, for both groups). However, mean PAHI scores were comparable in the two groups (Pgroup = 0.05). No significant interaction was also found between time and treatments in terms of PAHI score (Ptime × group = 0.66). The frequency of treatment-related side effects was significantly higher in the AZA group compared to the TA group at week 4 of treatment (P < 0.05). However, no significant difference was observed in the frequency of reported side effects at weeks 8 and 12 of the treatment (P > 0.05). Conclusion: Topical administration of 20% AZA cream and 5% TA solution was comparably efficient in the treatment of acne-related PIH with a significantly better safety profile of TA in the 1st month of the treatment.

Content of potentially toxic elements (PTEs) in coffee and coffee-based products: a meta-analysis study, Systematic review, and health risk assessment.

Coffee is the most popular beverage after water in the world, which has an important role in health as a result of various minerals and vitamins but it may be pollution source of potentially toxic elements (PTEs) that can threate the health. Thus, the current study intended to detect the level of PTEs such as Cadmium (Cd), Copper (Cu), Lead (Pb), Nickel (Ni), Znc (Zn) and Iron (Fe), in various coffee and coffee-based products (powder, ground, processed, infusion and bean). Considering the databases of Scopus, Google scholar, PubMed, and Web of Science, the concentration of PTEs in coffee and coffee-based products was retrieved and meta-analyzed. Additionally, the non-carcinogenic risks in terms of total hazard quotient (TTHQ) were assessed using Monte Carlo simulated (MCS) model. According to the findings of 23 articles, the ranking of metal concentration in different coffees was Fe > Zn > Cu> Ni > Pb > Cd in powder, Fe > Cu > Zn> Ni in ground, Fe > Zn > Ni> Cu> Pb > Cd in processed and infusion and Fe > Zn > Ni> Cs > Pb in bean. Moreover, based on WHO regions, the highest concentrations of Cd and Pb (0.742 mg/kg) were related to the South-East Asia Region (SEARO) and European region (EURO) respectively. However, the highest concentrations of Fe (81.161 mg/kg), Zn (33.392 mg/kg), Cu (9.408 mg/kg), and Ni (18.064 mg/kg) were related to Pan American health organization (PAHO), PAHO, PAHO and Eastern Mediterranean Region (EMRO), respectively. On the other hand, the risk pattern was different in different countries. Moreover, consumers in some countries were not at significant non-carcinogenic risks because of ingestion of PTEs via coffee and consumption of coffee-based products.

Effect of 50-Hz magnetic fields on the expression of activation-induced deaminase, B-cell lymphoma 6 and serum levels of interleukin-6, interleukin-21.

BACKGROUND: Investigations showed different effects of magnetic fields (MFs) on the immune system. During humoral immune responses, genes of activation-induced deaminase (AID) and B-cell lymphoma-6 (Bcl-6) are expressed and interleukin (IL)-6 and IL-21 are produced. These factors play significant roles in class switching, affinity maturation of antibodies and activations of B cells germinal centers (GCs). Therefore, this study investigated the effect of 50-Hz MFs exposure with different densities on these factors. MATERIALS AND METHODS: Eighty rats were divided into four exposures and control groups. The treatment groups were exposed to magnetic flux densities of 1, 100, 500, and 2000 µT (50 Hz, 2 h/d for 60 d). To activation of the immune system, all the animals were immunized with human serum albumin on days 31, 44, and 58 of exposure. Reverse transcription-quantitative polymerase chain reaction was used to assay the expression levels of AID and Bcl-6 genes in the spleen. The serum levels of IL-6 and IL-21 were also detected by enzyme-linked immunosorbent assay at the pre-and post-immunization phases. RESULTS: AID expression was significantly declined at 1µT magnetic flux density, while no change was observed in the expression of Bcl-6. Serum IL-6 was increased only in the 500 µT group at the post-immunization phase. CONCLUSIONS: It seems exposure to 50-Hz MFs at 1 µT density, suppresses AID and may cause a decline in class switching and affinity maturation of Abs. On the other hand, exposure to 500 µT, may activate them. These findings demonstrate the various potential effects of MFs on the humoral immune system.

Content of potentially toxic elements (PTEs) in various animal meats: a meta-analysis study, systematic review, and health risk assessment.

Meat comprises the main part of the diet in many countries around the world. The present study aimed to assess potentially toxic elements (PTEs) lead (Pb), arsenic (As), cadmium (Cd), copper (Cu), nickel (Ni), zinc (Zn), and iron (Fe) in various meats (camel, chicken, cow, pork, birds, seafood (fish and crab), and sheep). The present study was performed on the concentration of PTEs in various meats by different databases including Scopus, PubMed, and Web of Science along with a meta-analysis. Additionally, the non-carcinogenic risk was assessed by calculating the total hazard quotient (TTHQ). According to findings, the highest concentration of Cd was related to sea (0.460 mg/kg). The highest concentrations of Cd and As were reported in camel meat (1.965 and 1.503 mg/kg, respectively). Regarding trace elements, the highest concentrations of Zn, Fe, Cu, and Ni were observed in seafood (fish and crab), cow meat, and bird's meat (71.159 mg/kg, 36.608 mg/kg, 8.680 mg/kg, and 1.592 mg/kg, respectively). Moreover, considering the type of continents based on the concentration of PTEs in various meats, the highest concentrations of As (0.792 mg/kg), Cd (0.315 mg/kg), Pb (1.049 mg/kg), Fe (44.088 mg/kg), and Ni (1.113 mg/kg) were related to Eastern Mediterranean region (EMRO), African Region (AFRO), EMRO, the Pan American Health Organization (PAHO), and EMRO, respectively. However, the highest concentrations of Cu (4.846 mg/kg) and Zn (60.742 mg/kg) were related to European Region (EURO) and AFRO, respectively. On the other hand, the result of the risk assessment indicated that the risk pattern was different among countries.

The Level of Heavy Metal in Fresh and Processed Fruits: A Study Meta-analysis, Systematic Review, and Health Risk Assessment.

Intake of fruits is important for health. However, it can be a contamination source of potentially toxic elements (PTEs). The present study aimed to investigate the concentration of PTEs such as arsenic (As), lead (Pb), cadmium (Cd), copper (Cu), nickel (Ni), and Iron (Fe) in various fresh and processed fruits. All the studies related to the concentration of PTEs in fresh and processed fruits by international databases including were included and non-carcinogenic risks assessment was evaluated based on the total hazard quotient (TTHQ). According to findings highest concentrations of As, Cd and Pb were observed in pineapple, mango, and cherry, while the lowest concentrations of these metals were found in berries, pineapple, and berries. Regarding trace elements, peach and cucumber represented the highest and lowest concentrations of Fe, respectively. Moreover, the highest and lowest concentrations of Cu were related to plum and banana, respectively. Considering the type of continents, the highest concentrations of As, Cd, Pb, Fe, Ni, and Cu among fresh and processed fruits belonged to Pan American Health Organization (EMRO), EMRO, African Region (AFRO), European Region (EURO), AFRO, and Western Pacific Region (SEARO). Eventually, the non-carcinogenic risk assessment of the heavy metal in fresh and processed fruits indicated that the risk pattern was different in various countries and the calculated TTHQ level in infants was below 1. Overall, the consumption of fresh and processed fruits is safe and does not pose a risk to the health of consumers.

The value of ovarian hyperstimulation syndrome in predicting pregnancy outcome in women with polycystic ovarian syndrome and candidate for in vitro fertilization: A case-control study.

Background: Ovarian hyperstimulation syndrome (OHSS) as a known complication in women with polycystic ovarian syndrome (PCOS) may occur following inducible fertility treatments such as in vitro fertilization (IVF) and can affect the sequels of these treatments. Objective: This study aimed to assess the effects of OHSS on pregnancy outcomes through IVF in women with PCOS. Also, we assessed the value of baseline sexual hormones to predict the pregnancy's success. Materials and Methods: This case-control study was conducted on 180 consecutive women suffering from PCOS who were candidates for IVF at Fatemieh hospital in Hamadan, Iran, from May-July 2022. The women were assigned to the case group (with OHSS, n = 129) and the control group (without OHSS, n = 51). Measuring the sexual hormones was performed using the enzyme-linked immunosorbent technique. Results: In the multivariable logistic regression model, OHSS could not predict the likelihood of clinical or chemical pregnancy following IVF. None of the baseline sexual hormones could predict the successful chemical or clinical pregnancy in PCOS women following IVF. Conclusion: OHSS may not influence IVF-related outcomes in PCOS women. The values of sexual hormones may not also determine the pointed outcome.

Evaluation of polycyclic aromatic hydrocarbons (PAHs) in processed cereals: A meta-analysis study, systematic review, and health risk assessment.

Background: The present study investigated the contamination of processed cereals such as bread, spaghetti, flour, and bran, with polycyclic aromatic hydrocarbons (PAHs). Scope and approach: The databases such as PubMed, Scopus, and Science Direct were searched from 14/December/1972 to 25/May/2021. Key findings: We identified 639 articles and selected 18. The highest PAH concentrations found in bread, spaghetti, flour, and bran were related to anthracene, chrysene, fluorene, and naphthalene, respectively. On the other hand, the lowest PAH concentrations found in bread, spaghetti, flour, and bran were related to benzo[k]fluoranthene, benzo[a]pyrene, dibenz[a,h]anthracene, anthracene and dibenz[a,h]anthracene, respectively. Moreover, carcinogenetic and mutagenic risk assessment of the PAHs revealed a country-to-country variation. As a result, evaluation and control of PAHs in cereals should be done.

Which patients bring the most costs for hospital? A study on the cost determinants among COVID-19 patients in Iran.

BACKGROUND: Accurate information on the cost determinants in the COVID-19 patients could provide policymakers a valuable planning tool for dealing with the future COVID-19 crises especially in the health systems with limited resources. OBJECTIVES: This study aimed to determine the factors affecting direct medical cost of COVID-19 patients in Hamadan, the west of Iran. METHODS: This study considered 909 confirmed COVID-19 patients with positive real-time reverse-transcriptase polymerase-chain-reaction test which were hospitalized from 1 March to 31 January 2021 in Farshchian (Sina) hospital in Hamadan, Iran. A checklist was utilized to assess the relationship of demographic characteristics, clinical presentation, medical laboratory findings and the length of hospitalization to the direct hospitalization costs in two groups of patients (patients with hospitalization ≤ 9 days and > 9 days). Statistical analysis was performed using chi-square, median test and multivariable quantile regression model at 0.05 significance levels with Stata 14 software program. RESULTS: The median cost of hospitalization in patients was totally 134.48 dollars (Range: 19.19-2397.54) and respectively 95.87 (Range: 19.19-856.63) and 507.30 dollars (Range: 68.94-2397.54) in patients with hospitalization ≤ 9 days and > 9 days. The adjusted estimates presented that in patients with 9 or less hospitalization days history of cardiovascular disease, wheezing pulmonary lung, SPO2 lower than 90%, positive CRP, LDH higher than 942 U/L, NA lower than 136 mEq/L, lymphosite lower than 20% and patients with ICU experience had significantly positive relationship to the median of cost. Moreover, in patients with more than 9 hospitalization days, history of cardiovascular disease and ICU experience was statistically positive association and age older than 60 years and WBC lower than 4.5 mg/dL had statistically negative relationship to the median of hospitalization cost. CONCLUSION: As the length of hospital stay, which can be associated with the severity of the disease, increases, health systems become more vulnerable in terms of resource utilization, which in turn can challenge their responsiveness and readiness to meet the specialized treatment needs of individuals.

Comparative efficacy of silibinin and nano-silibinin on lead poisoning in Male Wistar rats.

Lead (Pb) is an environmental neurotoxin that can lead to toxicity. It has shown that tissues can be exposed to oxidative stress in lead poisoning. Since silymarin is a natural agent with antioxidant effects, this study aimed to investigate the antioxidant and chelation effects of silibinin and nano-silibinin on the oxidative stress status in lead-poisoned rats. Sixty male Wistar rats randomly divided into ten groups (n = 6). Control and Pb groups treated with or without silibinin and nano-silibinin for six days. Following measuring of weight and blood lead levels, biochemical antioxidant parameters evaluated. Finally, a histopathological examination of the liver performed. In this experiment, silibinin and more efficiently nano-silibinin prevented weight loss and blood lead level elevation induced by lead. Also, they increased the attenuated levels of superoxide dismutase (SOD) activity, catalase (CAT), total thiol molecules (TTM), glutathione (GSH), and total antioxidant capacity (TAC). Lead-induced elevation of lipid peroxidation products (MDA) and nitric oxide (NO) normalized to the standard level in silibinin and especially nano-silibinin groups. These data suggested that silibinin and especially nano-silibinin can decrease blood lead levels and prevent weight loss and oxidative stress in the lead-poisoned rat's model.

The concentration of polycyclic aromatic hydrocarbons (PAHs) in mother milk: A global systematic review, meta-analysis and health risk assessment of infants.

BACKGROUND: Bio-monitoring of polycyclic aromatic hydrocarbons (PAHs) contaminants in mother milk is essential to keep mothers and infants healthy against potential risks. The current study assesses the concentration of PAHs in mother milk through a meta-analytic and systematic review approach. METHODS: All the published studies up to December 2020 regarding the concentrations of various PAHs in mother milk were searched throughout major international databases such as PubMed, Scopus, and Web of Science. Moreover, the possible carcinogenic and mutagenic risks to infants were evaluated based on the BaP (benzo[a]pyrenee) equivalent dose. RESULTS: According to the results of 13 articles included among 936 retrieved studies, the lowest and highest concentration of PAHs was (0.125 ng/g) and (76.36 ng/g) related to benz(a)anthracenem and 1-methylnaphthalene, respectively. The highest (9.830 ng/g) and lowest (0.009 ng/g) concentration of PAHs was related to Mexico and Japan, respectively. Besides, carcinogenetic and mutagenic risk assessment of the PAHs indicated that risk pattern was different across countries. It can be concluded that the consumption of mother milk is safe and does not pose a risk due to the ingestion of PAHs to the health of infant consumers.

Joint frailty model for recurrent events and death in presence of cure fraction: Application to breast cancer data.

In many biomedical cohort studies, recurrent or repeated events for individuals can be terminated by a dependent terminal event like death. In this context, the time of death may be associated with the underlying recurrent process and there often exists the dependence between the occurrences of recurrent events. Moreover, there are some situations in which a portion of patients could be cured. In the present study, the term "cured" means that some patients may neither experience any recurrent events nor death induced by the disease under study. We proposed a joint frailty model in the presence of cure fraction for analysis of the recurrent and terminal events and estimated the effect of covariates on the cure rate and both aforementioned events concurrently. The use of two independent gamma distributed frailties in this model enabled us to consider both the dependence between the recurrences and the survival times and the interrecurrences dependence. The model parameters were estimated employing the maximum likelihood method for a piecewise constant and a parametric baseline hazard function. Our proposed model was evaluated by a simulation study and illustrated using a real data set on patients with breast cancer who had undergone surgery.

Multiple Sclerosis Associated Risk Factors: A Case-Control Study.

BACKGROUND: Hamadan Province is one of the high-risk regions in Iran for Multiple sclerosis (MS). A majority of the epidemiological studies conducted in Iran addressing MS are descriptive. This study was conducted to assess MS and its associated risk factors in Hamadan Province, the west of Iran. METHODS: This case-control study compared 100 patients with MS (case group) and 100 patients with acute infectious diseases (control group) from September 2013 to March 2014. A checklist was used to assess the demographic, medical, and family history of the patients. The Friedman-Rosenman questionnaire was also used to assess personality type. Statistical analysis was performed using logistic regression model with Stata 11 software program. RESULTS: The adjusted odds ratio (OR) estimate of MS was 4.37 (95% CI: 2.33, 8.20) for females compared to males; 0.15 (95% CI: 0.06, 0.43) for people aged above 50 years compared to aged 14 to 29 years; 0.44 (95% CI: 0.21, 0.91) for overweight or obese people compared to normal weights. Crude OR indicated a significant association between the occurrence of MS and exclusive breast feeding, season of birth, and smoking. However, the association was not statistically significant after adjustment for other covariates. CONCLUSION: The risk of MS is significantly lower in male gender, obese/overweight, and old people. Furthermore, non-smoking, non-exclusive breast-feeding, and born in autumn may increase the risk of MS but need further investigation. However, long-term large prospective cohort studies are needed to investigate the true effect of the potential risk factors on MS.