The Possible Role of COVID-19 in the Triggering of Underlying Mitochondrial Dysfunction in MELAS Syndrome, A Brief Report of three cases.

BACKGROUND: During corona virus pandemic, various neurological complications of COVID-19 have been reported. Recent studies demonstrated different pathophysiology for neurological manifestations of COVID-19 such as mitochondrial dysfunction and damage to cerebral vasculature. In addition, mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) syndrome is a mitochondrial disorder with a variety of neurological symptoms. In this study, we aim to assess a potential predisposition in mitochondrial dysfunction of COVID-19, leading to MELAS presentation. METHODS: We studied three previously healthy patients with the first presentation of acute stroke-like symptoms, following COVID-19 infection. We analyzed the patients' clinical data and brain magnetic resonance imaging (MRI) lesions that presented to the neurological center of a university-affiliated hospital in Tehran, Iran, from September 2020 to August 2021. RESULTS: All cases are characterized by a temporoparietal abnormality in imaging studies and electroencephalogram (EEG). Based on electrodiagnostic tests, three patients were diagnosed with myopathy. In two brothers with relatively the same symptoms, one performed muscle biopsy finding myopathic process, and genetic testing confirmed a 3243A>G point mutation in a heteroplasmic state in one of our patients. CONCLUSION: Although MELAS is not a prevalent condition, the recent increase in the number of these patients in our center might indicate the potential role of COVID-19 in triggering the silent pre- existing mitochondrial dysfunction in these patients.

Quality of life in Iranian elderly population using the SF-36 questionnaire: systematic review and meta-analysis.

BACKGROUND: Ageing is a major known risk factor that is a threat to human health. To date, many studies have investigated quality of life (QOL) among the elderly population in the Islamic Republic of Iran. However, their results were inconsistent. AIMS: We designed this systematic review and meta-analysis to estimate the overall mean score of QOL based on the Short Form 36 Health Survey Questionnaire (SF-36) among the Iranian elderly population. METHODS: We searched international databases (Medline, Scopus and Science Direct) and national databases (Science In-formation Database, MagIran, IranMedex and Irandoc) up to February 2015. We included all cross-sectional studies that evaluated QOL among the Iranian elderly population using SF-36. RESULTS: Of 2150 studies identified, 15 were included in the meta-analysis. The mean scores for QOL in the 8 scales were: 47.58, 51.75, 55.42, 55.78, 59.55, 51.54, 47.85 and 51.31 for physical-role, physical function, mental health, bodily pain, social functioning, emotional-role, general health, and vitality, respectively. CONCLUSIONS: Our results indicated that health-related QOL decreased with increasing age. QOL was worse in women than in men, especially in physical-role and general health scales. Elderly people who lived in a nursing home had lower QOL than those who lived in their own home. So, health policy-makers should design comprehensive programmes to improve health-related QOL for the Iranian elderly population.

The Prevalence and risk factors of osteoporosis among the elderly in Hamadan province: A cross sectional study.

Background: Osteoporosis is the most common metabolic bone disease and is a public health issue, particularly among the elderly, across the world. Given the significance of the disease in causing disability and, in particular, its dangers in old age, we aimed to examine osteoporosis and its determinant factors among the elderly. Methods: We conducted a cross sectional study in the province of Hamadan from September 2015 to March 2016 on all the elderly men and women covered by 'Integrated and Comprehensive Elderly Care Program'. The data required for this study was collected through an aging health care checklist. To estimate the adjusted association of potential risk factors and other confounding variables of osteoporosis, multiple logistic regression was used at a significance level of 5%. Results: In this cross sectional study, 1779 elderly men and women aged 6o years and over were studied. The prevalence of osteoporosis was 7.99% (95%CI:7.79-8.18), which was higher among women than in men (8.08% vs. 7.83%). The factors that raised the probability of osteoporosis were as follow: aging (OR= 1.05, 95% CI: 1.02-1.07, p<0.001), low education (OR=1.96, 95% CI:1.02-3.84, p=0.04), living in urban areas (OR=2.82, 95% CI:1.93-4.11, p<0.001), smoking (OR=2.39, 95% CI:1.42-4.04, p<0.001), and family history of osteoporosis (OR=1.95, 95% CI:1.07-3.54, p=0.03). Conclusion: Based on our results, aging, low education level, living in urban areas, being a cigarette smoker, and having a family history of osteoporosis were all predicting factors for osteoporosis among the elderly.

The association between nutritional exposures and metabolic syndrome in the Tehran Lipid and Glucose Study (TLGS): a cohort study.

OBJECTIVES: This study was conducted with the goal of investigating the effect of various food consumption on the incidence of metabolic syndrome (MetS). STUDY DESIGN: Prospective cohort study. METHODS: This study conducted on 3616 healthy adults aged ≥20 years, who were not affected with MetS. Nutritional intake was determined at the beginning of the study (2008-2011) by the Food Frequency Questionnaire (FFQ), and the incidence of MetS was investigated after a median of 24.6 months follow-up. Data were analyzed by multiple logistic regression, with 95% confidence interval. RESULTS: After adjusting the effect of other variables in the model many foods in the whole grains group such as Sangak bread (OR = 0.35, 95% CI: 0.11-1.56), multiple types of vegetables and fruits - such as peach (OR = 0.11, 95% CI: 0.01-0.75), and mushroom (OR = 0.28, 95% CI: 0.11-0.71) had protective effects against MetS. From the dairy group yoghurt (OR = 0.43, 95% CI: 0.18-1.01) and ice cream (OR = 0.35, 95% CI: 0.12-1.06) had similar such effects. CONCLUSION: Based on our findings, there was a significant rise in the incidence of MetS in Iran. The daily consumption of foods from the whole grains, dairy, vegetable and fruit groups can help reduce the odds of MetS.

Prevalence of osteoporosis in Iran: A meta-analysis.

BACKGROUND: Several studies have investigated the prevalence of osteoporosis among general population in several parts of Iran. However, the results have been inconsistent. This meta-analysis was conducted to estimate the overall prevalence of osteoporosis. MATERIALS AND METHODS: International and national electronic databases were searched until April 2012, including Web of Knowledge, Medline, Scopus, Ovid, ScienceDirect, Science Information Database, IranMedex, MagIran, as well the relevant conference databases. The reference lists of included studies were screened as well. The cross-sectional studies addressing the prevalence of osteoporosis among Iranian general population were retrieved irrespective of age and sex. Bone mineral density (BMD) based on T-score was classified as follows: (a) normal (T-score ≥-1); (b) osteopenia (-2.5SD < T-score <-1SD); (c) osteoporosis (T-score ≤-2.5). Study quality was assessed using the recommended checklist of STROBE. RESULTS: Of 2598 retrieved studies, 31 studies comprising 34,814 people was used for meta-analysis. The overall prevalence of osteoporosis in lumbar spine was 0.17 (95% CI: 0.13, 0.20) and that of osteopenia was 0.35 (95% CI: 0.30, 0.39). The prevalence was higher in older age groups, in women, and in the northern regions of the country, with an increasing trend in recent years. CONCLUSION: This meta-analysis indicated that osteoporosis and osteopenia are common problems among Iranian population older than 30 years. Furthermore, increasing trend of the diseases in recent years is promising a critical public health problem in Iran in the near future. However, due to the heterogeneity between the studies' results, further evidence based on a national survey is needed to estimate the exact prevalence of the diseases in the country.

Effectiveness of using platelet-rich fibrin to increase keratinized tissue around the tooth in the modified apical reposition flap method: A split-mouth, randomized controlled trial.

OBJECTIVES: One of the simplest methods to increase keratinized gingiva is the modified apically repositioned flap (MARF) technique. In this method, the periosteum remains exposed, which may lead to postoperative pain and discomfort. In the presence of bone dehiscence, bone resorption and gingival recession may occur. Hence, this study aims to use platelet-rich fibrin (PRF) to promote wound healing in the MARF technique and overcome its disadvantages. MATERIAL AND METHODS: In this randomized controlled trial study, 10 patients (six males and four females with a mean age of 33.9 ± 11.13) with less than 2 mm of attached gingiva bilaterally were treated by the MARF + PRF membrane (test group), on the one hand, whereas, on the other hand, it was treated only by MARF (control group). Clinical parameters of keratinized gingiva include thickness, width, and vestibule depth before and 8 weeks after the intervention were measured. RESULTS: The attached gingival width increased significantly in both groups (1.7 mm in the MARF and 2.3 mm in the PRF) and this was greater in the PRF group (p < .05). Gingival thickness in the PRF method was significantly higher than in the control group (p < .05). Probe depth, vestibular depth, and postoperative pain were not different in both groups. Wound shrinkage in the MARF group (51%) was significantly higher than in the PRF group (30%) (p < .05). CONCLUSION: Using PRF with the MARF method significantly increased the width and thickness of the gingiva and reduced shrinkage compared to MARF only. Postoperative pain and vestibular depth changes were similar in both groups.

Investigating salivary concentration of calcium ion in hypothyroidism.

Background and Aims: Hypothyroidism is the most common disease of the thyroid gland. Thyroid hormone plays a crucial role in regulating tissue growth and metabolism. Additionally, patients with thyroid dysfunction have a higher incidence of caries and periodontal problems. The presence of calcium and phosphate ions seems to be effective in remineralizing teeth and reducing caries. The aim of this study was to evaluate the salivary level of calcium in patients with hypothyroidism. Results: The results of this study showed that saliva calcium concentration in patients with hypothyroidism is significantly lower than healthy subjects. Also, no significant association was found between salivary calcium levels and TSH and T4 hormones level of blood. Conclusion: The increased prevalence of dental caries in patients with hypothyroidism may be related to a decrease in their calcium levels.

The Boosting Effects of Melatonin on the In Vitro Fertilization (IVF) of Women with Polycystic Ovary Syndrome.

Polycystic ovary syndrome (PCOS) is one of the most critical disorders, which affects approximately 20% of women of childbearing age and melatonin supplementation in these women can be effective. However, human studies in this area are particularly limited to IVF candidates. The aim of this clinical trial study was to evaluate the effect of melatonin on the in vitro fertilization (IVF) in PCOS involved women. In this clinical trial study, a total of 320 women with PCOS were randomly assigned to the intervention and control groups. Patients in the intervention group (n=160) received a combination of melatonin and metformin (3 mg and 500 mg, respectively) three times a day. The control group (n=160) received metformin 500 mg from the luteal phase of the cycle before the start of gonadotropin. Oocyte and embryo quality, number of oocytes, and pregnancy outcomes were compared in both groups. Our study revealed that the frequency of Metaphase II oocytes (69.9% vs. 57.9%, p<0.001) and the number of embryos of the top-quality (grade A) were higher in the group treated with melatonin (40.3% vs. 29.9%, p=0.001). The rate of clinical pregnancy and implantation were also higher in the intervention group. The odds of clinical pregnancy in the intervention group was 1.8 times (p=0.039). Moreover, oral melatonin supplementation was effective in patients with PCOS, who were candidates for IVF because of the increased quality of mature oocytes, top-quality embryos, and increased odds of clinical pregnancy.

Comparing the Efficacy and Adverse Events of Available COVID-19 Vaccines Through Randomized Controlled Trials: Updated Systematic Review and Network Meta-analysis.

BACKGROUND: Different vaccines have so far been developed and approved to cope with COVID-19 in the world. The aim of this updated network meta-analysis (NMA) was to compare and rank all available vaccines in terms of efficacy and complications simultaneously. Study Design: A systematic review. METHODS: Three major international databases, including Web of Science, Medline via PubMed, and Scopus, were searched through September 2023. The transitivity assumption was evaluated qualitatively in terms of epidemiologic effect modifiers. The exposure of interest in this study was receiving any available COVID-19 vaccine, and the primary outcome of interest was the incidence of symptomatic COVID-19. In this NMA, the relative risk of symptomatic COVID-19 was used to summarize the efficacy of vaccines in preventing COVID-19. The data were analyzed using the frequentist-based approach, and the results were reported using a random-effects model. Finally, the vaccines were ranked using a P-score. RESULTS: In total, 34 randomized controlled trials (RCTs) met the eligibility criteria for this systematic review and NMA out of 3682 retrieved references. Based on the results of the NMA, mRNA-1273 was the most effective vaccine in preventing COVID-19 and demonstrated the highest P-score (0.93). The relative risk (RR) for mRNA-1273 versus placebo was 0.07 (95% confidence interval [CI]: 0.03, 0.17). The second and third-ranked vaccines were BNT-162b2 (RR=0.08; 95% CI: 0.04, 0.15; P-score=0.93) and Gam-COVID-Vac (0.09; 95% CI: 0.03, 0.25; 0.88). CONCLUSION: Based on the results of this NMA, it seems that all available vaccines were effective in COVID-19 prevention. However, the top three ranked vaccines were mRNA-1273, BNT-162b2, and Gam-COVID-Vac, respectively.

The effect of intervention programs on road traffic injury prevention among adolescents and young people: a systematic review.

Road traffic injuries (RTIs) are a significant cause of death and disability among young people worldwide. Programs that use injury prevention strategies have been shown to effectively reduce the number of injuries. This systematic review aims to present the available evidence on the effectiveness of intervention programs in preventing RTIs among adolescents and young adults. Articles were identified and retrieved from databases including PubMed, Embase, Web of Science, Scopus, Science Direct, Magiran, SID, and Iran Medex. Two reviewers independently screened the articles. Articles published from the first year of publication until January 2018 that met the eligibility criteria were included in the review. These articles covered randomized controlled trials, pretest/post-test interventions, and controlled pretest/post-test interventions aimed at reducing RTIs among adolescents and young people aged 12-26 years. The framework, provided by Murphy and Haddon, were used to categorize the interventions. According to this framework, the interventions were categorized into five groups including education/behavior change, incentive, engineering/technology, legislation/enforcement, and multifaceted programs. The methodological quality of the studies was assessed using the Effective Public Health Practice Project. Of the initial 3165 findings, 13 studies met the inclusion criteria. Eleven of these studies used educational/behavioral approaches, while two employed multifaceted programs. In the educational/behavioral approach, participants' behaviors were considered as outcome variables. Only one of these studies was not successful. Multifaceted interventions were successful in changing behaviors. No studies were found on the effectiveness of other interventions. Eight studies were assessed as having moderate quality. The systematic review shows that educational/behavioral strategies and multifaceted programs are effective in reducing RTIs among young adults and adolescents. However, there is a lack of studies on other potential interventions. The quality of the included studies was moderate, suggesting a need for more rigorous research.

The Relationship between Health Literacy and Hypertension Control: A Cross-Sectional Study.

Background: Uncontrolled hypertension is a major public health problem among patients in developed and developing countries. The present study was conducted to investigate the prevalence and causes of uncontrolled hypertension to facilitate the design of more effective methods of hypertension control. Methods: This cross-sectional study was conducted on 303 adults with hypertension. The Standard Health Literacy Questionnaire was used to collect data. Uncontrolled hypertension was ascertained based on the WHO definition. A multiple logistic regression model was used at a 95% confidence level. Variables considered were confounders including age, sex, marital status, family size, income (monthly mean), smoking (past or current), education level, and physical activity (times in a week). Results: The mean (SD) age of the participants (n=303) was 59.3(12.7) years, and 57.4% were men. The prevalence of uncontrolled hypertension was 50.5%. The mean score of health literacy among patients with controlled hypertension was higher than that among patients with uncontrolled hypertension (64.83±23.72 vs 46.28±22.19; P<0.001). The odds of uncontrolled hypertension decreased by 3% in the patients (OR: 0.97; P=0.06). Adherence to treatment (OR: 0.13; P<0.001), salt consumption per package purchased per month (OR: 4.40; P=0.001), increased physical activity per hour per week (OR: 0.56; P<0.001), current or passive cigarette smoking (OR: 4.59; P=0.010), a positive history of chronic diseases (OR: 2.62; P=0.027), and increased family size (per 1 child) (OR: 0.57; P<0.001) were associated with uncontrolled hypertension. Conclusion: The results showed a borderline association between increased health literacy and hypertension control. Additionally, increased salt consumption, reduced physical activity, small family size, and underlying diseases (eg, diabetes, chronic heart disease, and renal disease) could increase the odds of uncontrolled hypertension in Iranian society.

Comparative Effects of Kemphor and Chlorhexidine Mouthwashes on Tooth Staining and Gingivitis: A Randomized Controlled Crossover Clinical Trial.

Objectives: Considering the side effects of chlorhexidine (CHX), which is currently the gold-standard antimicrobial mouthwash, this study aimed to compare the effects of Green Kemphor and CHX mouthwashes on tooth staining and gingivitis. Materials and Methods: This randomized controlled crossover clinical trial evaluated 38 patients requiring CHX mouthwash following oral surgery and periodontal therapy. The patients were randomly assigned to CHX and Kemphor groups (n=19). In CHX group, patients used CHX mouthwash in the first 2 weeks, and after a 4-day washout period, they used Kemphor mouthwash for 2 weeks. This order was reverse in the Kemphor group. Gingivitis was evaluated using the Silness and Loe gingival index (GI), and tooth staining was evaluated by the Lobene index at 0 (baseline), 2 and 4 weeks. Data were analyzed by paired t-test. Results: CHX mouthwash significantly decreased the GI and increased tooth staining (gingival stains, body stains, and stain extent) at 2 weeks (P<0.05). Kemphor mouthwash significantly decreased the GI and increased tooth staining after 2 weeks (P<0.05). The GI in Kemphor group was significantly lower than that in CHX group at 4 weeks (P<0.05). Also, the tooth staining parameters in the Kemphor group were significantly lower than the corresponding values in the CHX group at 2 and 4 weeks (P<0.05). Conclusion: Kemphor had higher efficacy for reduction of GI and caused less tooth staining than CHX; thus, it may be recommended for use as an alternative to CHX.

Assessment of Met and Unmet Care Needs in Older Adults without Mental Disorders using the Camberwell Assessment of Need for the Elderly: A Systematic Review and Meta-analysis.

BACKGROUND: Physical, psychological, and social changes in the aging lead to new needs in the care of the elderly. The Camberwell Assessment of Need for the Elderly (CANE) evaluates older adults' care needs. This study aimed to assess the types of needs of the elderly using the CANE questionnaire. STUDY DESIGN: A systematic review. METHODS: This systematic review included all cross-sectional studies. International databases, including Web of Sciences, Medline, Scopus, and ProQuest were searched up to June 2021. Such keywords as aged OR ageing OR "older adults" OR "older people" OR "older person" OR elderly, AND need OR "needs assessment" OR "met needs" OR "unmet needs" were used to design the search strategy. A 95% CI was calculated using the exact method, and the meta-analysis of proportion (metaprob) module was used for data analysis. RESULTS: In total, 769 studies were retrieved in this review. At the following stages, 760 articles were excluded upon checking the duplicates; moreover, the titles and abstracts did not meet the eligibility criteria. Finally, nine studies remained. The mean±SD age of 2200 participants was obtained at 78.4±5.9 years. The highest and lowest met needs were related to the physical (45%) and social (21%) dimensions, respectively. Furthermore, the highest unmet needs were observed in the physical and social dimensions (0.07%), and the lowest unmet needs were related to the psychological and environmental dimensions (0.04%). CONCLUSIONS: The CANE is sensitive enough to identify unmet needs in different samples and settings. Therefore, a new care model and appropriate interventions for the elderly can be designed based on the CANE results.

Predicting the incidence of brucellosis in Western Iran using Markov switching model.

OBJECTIVE: Brucellosis is a zoonosis almost chronic disease. Brucellosis bacteria can remain in the environment for a long time. Thus, climate irregularities could pave the way for the survival of the bacterium brucellosis. Brucellosis is more common in men 25 to 29 years of age, in the western provinces, and in the spring months. The aim of this study is to investigate the effect of climatic factors as well as predicting the incidence of brucellosis in Qazvin province using the Markov switching model (MSM). This study is a secondary study of data collected from 2010 to 2019 in Qazvin province. The data include brucellosis cases and climatic parameters. Two state MSM with time lags of 0, 1 and 2 was fitted to the data. The Bayesian information criterion (BIC) was used to evaluate the models. RESULTS: According to the BIC, the two-state MSM with a 1-month lag is a suitable model. The month, the average-wind-speed, the minimum-temperature have a positive effect on the number of brucellosis, the age and rainfall have a negative effect. The results show that the probability of an outbreak for the third month of 2019 is 0.30%.

Network meta-analysis of palliative treatments in patients with esophageal cancer.

We aimed to compare available palliative treatments in terms of survival and to rank these treatments for esophageal cancer. Web of Science, Medline, Scopus, Cochrane Library and Embase were searched. The risk of bias was judged using Cochrane's tools. Statistical heterogeneity was assessed using the Chi2 test and was quantified by I2. The results were summarized using the hazard ratio (HR). The rank probability for each treatment was calculated using the p-score. Nineteen RCTs met the eligibility criteria for this study. Treatments formed three networks including networks A, B, and C. The Ultraflex stent (p-score = 0.93), irradiation stent (p-score = 0.89), and thermal ablative therapy (p-score = 0.85) were the first ranking treatments in networks A, B, and C, respectively. Based on the results of this network meta-analysis, it appears that the ultraflex stent, the irradiation stent, and thermal ablative therapy are the better treatments among the networks.

Factors for the Primary Prevention of Breast Cancer: A Meta-Analysis of Prospective Cohort Studies.

BACKGROUND: This report provided the effect of 15 preventable factors on the risk of breast cancer incidence. STUDY DESIGN: A systematic review and meta-analysis. METHODS: A detailed research was conducted on PubMed, Web of Science, and Scopus databases in January 2020. Reference lists were also screened. Prospective cohort studies addressing the associations between breast cancer and 15 factors were analyzed. Between-study heterogeneity was investigated using the χ2, τ2, and I2 statistics. The probability of publication bias was explored using the Begg and Egger tests and trim-and-fill analysis. Effect sizes were expressed as risk ratios (RRs) with 95% confidence intervals (CIs) using a random-effects model. RESULTS: Based on the results, out of 147,083 identified studies, 197 were eligible, including 19,413,702 participants. The RRs (95% CI) of factors associated with breast cancer were as follows: cigarette smoking 1.07 (1.05, 1.09); alcohol drinking 1.10 (1.07, 1.12); sufficient physical activity 0.90 (0.86, 0.95); overweight/obesity in premenopausal 0.92 (0.82, 1.03) and postmenopausal 1.18 (1.13, 1.24); nulliparity 1.16 (1.03, 1.31); late pregnancy 1.37 (1.25, 1.50); breastfeeding 0.87 (0.81, 0.93); ever using oral contraceptive 1.00 (0.96, 1.05); ever using estrogen 1.13 (1.04, 1.23); ever using progesterone 1.02 (0.84, 1.24); ever using estrogen/progesterone 1.60 (1.42, 1.80); ever taking hormone replacement therapy 1.26 (1.20, 1.32); red meat consumption 1.05 (1.00, 1.11); fruit/vegetable consumption 0.87 (0.83, 0.90); and history of radiation therapy, based on single study 1.31 (0.87, 1.98). CONCLUSION: This meta-analysis provided a clear picture of several factors associated with the development of breast cancer. Moreover, the useful information in this study may be utilized for ranking and prioritizing preventable risk factors to implement effective prevention programs.

Using Machine Learning Techniques to Predict Factors Contributing to the Incidence of Metabolic Syndrome in Tehran: Cohort Study.

BACKGROUND: Metabolic syndrome (MetS), a major contributor to cardiovascular disease and diabetes, is considered to be among the most common public health problems worldwide. OBJECTIVE: We aimed to identify and rank the most important nutritional and nonnutritional factors contributing to the development of MetS using a data-mining method. METHODS: This prospective study was performed on 3048 adults (aged ≥20 years) who participated in the fifth follow-up examination of the Tehran Lipid and Glucose Study, who were followed for 3 years. MetS was defined according to the modified definition of the National Cholesterol Education Program/Adult Treatment Panel III. The importance of variables was obtained by the training set using the random forest model for determining factors with the greatest contribution to developing MetS. RESULTS: Among the 3048 participants, 701 (22.9%) developed MetS during the study period. The mean age of the participants was 44.3 years (SD 11.8). The total incidence rate of MetS was 229.9 (95% CI 278.6-322.9) per 1000 person-years and the mean follow-up time was 40.5 months (SD 7.3). The incidence of MetS was significantly (P<.001) higher in men than in women (27% vs 20%). Those affected by MetS were older, married, had diabetes, with lower levels of education, and had a higher BMI (P<.001). The percentage of hospitalized patients was higher among those with MetS than among healthy people, although this difference was only statistically significant in women (P=.02). Based on the variable importance and multiple logistic regression analyses, the most important determinants of MetS were identified as history of diabetes (odds ratio [OR] 6.3, 95% CI 3.9-10.2, P<.001), BMI (OR 1.2, 95% CI 1.0-1.2, P<.001), age (OR 1.0, 95% CI 1.0-1.03, P<.001), female gender (OR 0.5, 95% CI 0.38-0.63, P<.001), and dietary monounsaturated fatty acid (OR 0.97, 95% CI 0.94-0.99, P=.04). CONCLUSIONS: Based on our findings, the incidence rate of MetS was significantly higher in men than in women in Tehran. The most important determinants of MetS were history of diabetes, high BMI, older age, male gender, and low dietary monounsaturated fatty acid intake.

Prevalence and Incidence of Metabolic Syndrome in Iran: A Systematic Review and Meta-Analysis.

Metabolic syndrome (MetS) is a predictor of several diseases such as cardiovascular diseases, diabetes, dyslipidemia, stroke, osteoarthritis, certain cancers, and death leading to public health concern in most societies. We aimed to estimate the pooled prevalence and incidence of MetS in Iranian population through a meta-analysis study. We included cross-sectional and cohort studies to estimate the overall prevalence and incidence rates of MetS in Iran National databases including MagIran, Science Information Database, IranMedex, and international databases including Medline, Web of Sciences, and Scopus were searched up to October 2017. Finally, 125 studies were included. The total sample size was 472,401 with a mean age of 38 ± 7.8 years. The overall pooled prevalence and incidence rate among the general population of Iran was 0.26 (95% CI: 0.26, 0.29) and 97.96 (95% CI: 75.98, 131.48), respectively. The pooled prevalence of MetS was higher in females and in urban areas. The highest and lowest prevalence of MetS was obtained by the Iranian definition criteria (0.43) and the NHANES III (0.12). The highest and lowest incidence rates of MetS were obtained by IDF (144.07 per 1000) and the JIS (89.73 per 1000). The prevalence of MetS was higher in women and those living in urban areas. Furthermore, the prevalence of MetS increased with increasing age in both genders.

Forecasting the monthly incidence rate of brucellosis in west of Iran using time series and data mining from 2010 to 2019.

BACKGROUND: The identification of statistical models for the accurate forecast and timely determination of the outbreak of infectious diseases is very important for the healthcare system. Thus, this study was conducted to assess and compare the performance of four machine-learning methods in modeling and forecasting brucellosis time series data based on climatic parameters. METHODS: In this cohort study, human brucellosis cases and climatic parameters were analyzed on a monthly basis for the Qazvin province-located in northwestern Iran- over a period of 9 years (2010-2018). The data were classified into two subsets of education (80%) and testing (20%). Artificial neural network methods (radial basis function and multilayer perceptron), support vector machine and random forest were fitted to each set. Performance analysis of the models were done using the Root Mean Square Error (RMSE), Mean Absolute Error (MAE), Mean Absolute Root Error (MARE), and R2 criteria. RESULTS: The incidence rate of the brucellosis in Qazvin province was 27.43 per 100,000 during 2010-2019. Based on our results, the values of the RMSE (0.22), MAE (0.175), MARE (0.007) criteria were smaller for the multilayer perceptron neural network than their values in the other three models. Moreover, the R2 (0.99) value was bigger in this model. Therefore, the multilayer perceptron neural network exhibited better performance in forecasting the studied data. The average wind speed and mean temperature were the most effective climatic parameters in the incidence of this disease. CONCLUSIONS: The multilayer perceptron neural network can be used as an effective method in detecting the behavioral trend of brucellosis over time. Nevertheless, further studies focusing on the application and comparison of these methods are needed to detect the most appropriate forecast method for this disease.