The Prevalence of Depression and Anxiety in Women with Ovarian Cancer: An Updated Systematic Review and Meta-Analysis of Cross-Sectional Studies.

BACKGROUND: The results of this study included the prevalence of anxiety and depression in women with ovarian cancer. METHODS: A thorough search of numerous databases, including PubMed (Medline), Scopus, Web of Science, Embase, and PsycoInfo, was conducted to identify relevant cross-sectional studies published between July 2013 and October 2021. STATA 16 was used to analyses the data, and a random effects model was used to determine the pooled prevalence and a 95% confidence interval (95%CI). RESULTS: Of the 18 cross-sectional studies reviewed, 17 reported the prevalence of anxiety and 16 reported the prevalence of depression in patients with ovarian cancer. There was a moderate degree of heterogeneity between studies, as the pooled prevalence of depression was 27% (95%CI: 14%-41%; I2=69.44%). Similarly, there was a greater degree of heterogeneity in the pooled prevalence of anxiety, which was found to be 33% (95%CI: 21%-44%; I2=78.55%). CONCLUSION: The findings of this study show that, compared to the overall female population, ovarian cancer patients have much greater rates of sadness and anxiety. These results highlight the necessity for healthcare policymakers to prioritize the provision of resources and support for carrying out additional research, such as longitudinal studies or cohorts, to ascertain the efficacy of various treatments or interventions intended to lessen mental health disorders in women diagnosed with ovarian cancer. Healthcare practitioners can enhance the general wellbeing and quality of life for women with this disease by addressing the psychological components of care.

Systematic Review and Meta-Analysis of Treatment Effects on Survival in Patients with Inflammatory Breast Cancer.

The objective of this study was to determine the survival rate and the effects of different treatments on patients with inflammatory breast cancer (IBC). The study employed a systematic approach that included a search strategy across four databases: Embase, Web of Sciences, PubMed, and Scopus. The results obtained were screened initially by titles and abstracts, followed by full-texts in EndNote 8 software. The next stage involved data extraction and qualitative evaluation, where the Metan command was used to estimate the pooled survival rate. A total of 28 studies with a sample size of 63,796 were finally analyzed. The overall 3- and 5-year survival rates (OS) for IBC patients were found to be 52% (95% CI; 46-58%, I2: 99.42%) and 61% (95% CI; 53-69%, I2: 93.63%), respectively. The 5-year OS rates in patients with non-metastatic and metastatic IBC were 59% (95% CI; 54-63%, I2: 98.31%) and 30% (95% CI; 26-35%, I2: 50.84%), respectively. The 5-year OS rate in non-metastatic patients who underwent BCS surgery was 60% (CI 95%; 26-94%, I2: 95.13%). The overall 5- and 3-year OS rates for patients with IBC were lower than those for all types of breast cancer, and the rates were even lower in patients with metastasis. Therefore, it is recommended that healthcare workers and women at risk should be vigilant of early symptoms of IBC to prevent metastasis by seeking medical attention on time.

Estimating the Survival Rate in Glioblastoma Multiforme Patients who Received a Peptide Vaccine: A Systematic Review and Meta-analysis.

INTRODUCTION: Glioblastoma Multiforme (GBM) has a poor prognosis, with current treatments providing no advantage in terms of survival. Certain new immunotherapy methods, such as peptide vaccines, have been used in clinical trials. In this meta-analysis, the effectiveness of peptide vaccinations on the survival rate of GBM patients was studied. METHODS: A comprehensive search was carried out using three electronic databases: PubMed, Scopus, and ISI. The purpose of this research was to assess Overall Survival (OS). The pooled overall one-year and two-year survival rates in GBM with peptide vaccination were calculated using the general inverse variance technique as random effects hazard ratios (HRs). In the study, subgroups of countries were compared with each other. Japan had the highest one-year survival rate, and the US had the highest two-year survival rate. RESULTS: With 95% Confidence Intervals (CIs), the one-year OS rate in GBM patients treated with peptide vaccination increased significantly, but the two-year survival rate did not increase. As a result, while additional research is needed, it cannot be concluded that it is an effective therapy for GBM. CONCLUSION: Our study found that while peptide vaccination treatment did not increase second-year survival, it improved first-year survival. More research needs to be done to find effective vaccinebased treatments for GBM that can help patients survive longer.

The association between the multiple birth and breast cancer incidence: an update of a systematic review and meta-analysis from 1983 to 2022.

BACKGROUND: It has been assumed that perinatal factors such as multiple pregnancies may affect subsequent breast cancer risk in the mother. Considering the inconsistencies in the results of case-control and cohort studies published in the world, this meta-analysis was conducted in order to determine the exact association between multiple pregnancies (twins or more) and the breast cancer incidence. METHODS: This study was performed as a meta-analysis based on PRISMA guidelines by searching the international databases of PubMed (Medline), Scopus, and Web of Science as well as by screening selected articles based on their subject, abstract and full text. The search time was from January 1983 to November 2022. Then the NOS checklist was used to evaluate the quality of the final selected articles. The indicators considered for the meta-analysis included the odds ratio (OR) and the risk ratio (RR) along with the confidence interval reported in the selected primary studies. The desired analyzes were performed with STATA software version 17 to be reported. RESULTS: In this meta-analysis, 19 studies were finally selected for analysis, which fully met the inclusion criteria. Of these, 11 were case-control studies and 8 were cohort ones. Their sample size was 263,956 women (48,696 with breast cancer and 215,260 healthy) and 1,658,378 (63,328 twin or multiple pregnancies and 1,595,050 singleton pregnancies), respectively. After combining the results of cohort and case-control studies, the effect of multiple pregnancies on the breast cancer incidence was equal to 1.01 (95% CI: 0.89-1.14; I2: 44.88%, P: 0.06) and 0.89 (95% CI: 0.83-0.95; I2: 41.73%, P: 0.07), respectively. CONCLUSION: The present meta-analysis results showed, in general, multiple pregnancies were one of the preventive factors of breast cancer.

HIV prevalence and associated factors among female sex workers in Iran: a bio-behavioral survey in 2020.

Despite the overall decline in human immunodeficiency virus (HIV) prevalence, it remains unacceptably high in key populations. This study aimed to estimate prevalence of HIV infection and high-risk behaviors among female sex workers (FSWs). This study was a cross-sectional survey of FSWs conducted between December 2019 and August 2020 in eight geographically diverse cities in Iran. After providing informed consent, participants completed a bio-behavioral questionnaire and after completion of the interview, rapid diagnostic tests (RDT) and dried blood spots (DBS) were collected to determine HIV and syphilis status as per national guidelines, if the women consented. All analyzes were based on RDS adjustment. Weighting was done according to Giles'SS estimator. Among the 1515 FSWs, the overall prevalence of HIV and syphilis were 1.6% (95% CI: 0.8-2.3) and zero, respectively. The highest HIV prevalence was observed in Shiraz (5.1%) and Khorramabad city (1.6%). In addition, HIV-positive FSWs had a higher mean age at first sexual contact than HIV-negative FSWs (21.4 ± 5.6 vs. 17.2 ± 4.2 years). Injection drug use and a history of arrest or incarceration were associated with an increased odds of HIV infection (OR = 6.25; 95% CI: 1.90-20.55 and OR = 4.57; 95% CI: 1.64-12.72, respectively). Based on the results, strategies to improve early HIV diagnosis, harm reduction, and use of testing and treatment strategies are needed to reduce and control HIV infections.

Colorectal Cancer Screening Program Results in Iran.

Background: Colorectal cancer (CRC) accounts for a large proportion of the global burden of cancer and is the fourth leading cause of cancer-related mortality worldwide. Fecal Immunochemical Testing (FIT) can be used for CRC screening programs due to its high accuracy and compliance. The present study reports the preliminary results of the CRC screening program in Iran among all people aged 50 to 69 years. Methods: This cross-sectional study was carried out on 2,669,625 participants referred to health centers in Iran for CRC screening programs in 2018 and 2019. The data required for this study was taken from the CRC screening program. Relevant information for all individuals aged 50 to 69 referred to the health system that was called for colorectal cancer screening was extracted from the Integrated Electronic Health Records (SIB) database. Finally, the standards indices were calculated for all provinces. Gender, history of inflammatory bowel disease (IBD) (Crohn's disease or ulcerative colitis), history of colon cancer or adenoma in a first-degree family (father, mother, siblings or children), history of colon cancer in a second-degree family if occurred under the age of fifty (aunt, uncle, grandparents), lower gastrointestinal bleeding in a prior month, constipation in the prior month (with or without diarrhea, abdominal pain and feeling of fullness in the colon after defecation), more than ten percent weight loss in the last six months and FIT were assessed. Results: Among a total number of over 2.6 million, 56.3% were female, and the number of people evaluated by health care providers for CRC screening programs in 2018 and 2019 were 1,365,248 (14.23%) and 1,304,377 (12.89%), respectively. The number of people with positive FIT evaluated for the CRC screening program in 2018 and 2019 was 33,299 (3.09%) and 33,583 (2.57%), respectively. Bushehr province (0.59%) and Isfahan province (7.35%) had the lowest and highest positive FIT rate in 2018, respectively. Also, the correlation between the above-mentioned variables and the number of people with a positive FIT across gender was statistically significant (p<0.05). The study of the relationship between the number of positive FIT cases and the variables examined by Behvarz and community health worker showed that the number of people with a family history of colon cancer in second-degree relatives under the age of 50 and also the number of people with an individual history of inflammatory bowel disease had a significant association with the number of positive FIT cases (p<0.05) (ß=-0.718, 95% CI; -2.557-14.992, ß=0.388, 95% CI; 0.322-16.737, respectively). The relationship between the number of positive FIT cases and effective variables was not statistically significant (p>0.05). Conclusion: Positive cases should be referred for further evaluation and colonoscopy. Before performing a screening program, the conditions for performing colonoscopy for these people must be assessed and prepared. The FIT for CRC screening program can be easily promoted in Iran.

Impact of COVID-19 pandemic on screening and diagnosis of patients with prostate cancer: a systematic review protocol.

INTRODUCTION: With the exponential progress of patients with COVID-19, unexpected restrictions were directed to limit SARS-CoV-2 dissemination and imposed health-system an entire reformation to diminish transmission risk. These changes likely have caused the full range of cancer screenings and diagnosis gaps. Regardless of the recommendations, prostate cancer (PCa) screening/diagnosis programmes were momentarily postponed. Prostate-specific antigen (PSA) testing has been an inexpensive, low-invasive and relatively precise means of detection for PCa screening that would improve the uncovering of any type of PCa. Unfortunately, a decrease in PSA screening would significantly decrease PCa detection, with non-negligible growth in PCa-specific death. This review is designed to improve our understanding of the impact of the COVID-19 pandemic on the screening and diagnosis of patients with PCa. METHODS AND ANALYSIS: This systematic review will be reported in accordant with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance. A comprehensive search has been executed through five main electronic databases: PubMed/MEDLINE, Web of Science, Scopus, Embase and ProQuest until 1 March 2022. Besides, grey literature, preprint studies and references of included studies will be searched. The main keywords have been used to perform the search strategy: COVID-19, prostatic neoplasms. All the relevant studies that met the inclusion criteria will be screened, selected and then extracted data by two independent authors. The quality assessment of the included studies will be performed by the Newcastle-Ottawa Scale. In case of any disagreement between the two authors in selecting, extracting data and assessing the quality of included studies, it will be resolved via consensus and checked by the third author. ETHICS AND DISSEMINATION: As this study will be a systematic review without human participants' involvement, there will be no requirement for ethics approval. Findings will be presented at conferences and in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER: CRD42021291656.

Prevalence of hookah smoking among Iranian pupils and university students: An updated systematic review and meta-analysis.

OBJECTIVE: Today, smoking is considered a pressing global health issue. The present study aimed to estimate the total prevalence of hookah smoking among pupils and university students in Iran. MATERIALS AND METHODS: This systematic review and meta-analysis were conducted via searching in databases such as Scientific Information Database (SID), MagIran, Scopus, PubMed and Web of Sciences from inception to October 2021. We targeted observational studies evaluating the prevalence or frequency of hookah smoking among Iranian pupils and university students. Data analysis was performed using a random-effects model, and the heterogeneity of the articles was assessed using Cochran's Q test and the I2 statistic. RESULTS: In total, 124 studies conducted on 155 115 subjects were reviewed. The lifetime prevalence of hookah smoking among high school students and university students was estimated at 34.4% and 32.3%, respectively. In addition, the frequency of hookah smoking within the past month/week (point prevalence) was estimated at 21.5% and 16.6% in university students and pupils, respectively. The frequency of hookah smoking within the past year (period prevalence) was also reported to be 22.5% and 20.8% in these groups, respectively. No significant correlation was observed between the prevalence of hookah smoking, sample size, year of publication and the mean age of the participants. Region 5 had the highest lifetime prevalence (41.7%) and period prevalence (27.1%). However, Region 1 had the highest point prevalence of hookah smoking (27.2%). CONCLUSIONS: According to the results, hookah smoking is highly prevalent among Iranian pupils and university students. Therefore, proper educational interventions are required in the form of workshops and curricula to raise awareness regarding the hazardous effects of this unhealthy habit on the young generation.

The effect of the polycystic ovary syndrome and hypothyroidism on the risk of fibrocystic breast changes: a meta-analysis.

This meta-analysis aimed to determine the pooled association between polycystic ovary syndrome (PCOS), hypothyroidism, and fibrocystic breast changes. We searched important databases, including PubMed (Medline), Scopus, Web of Science, and Embase to retrieve all relevant studies published from 1990 to April 2021. The bias risk of selected articles was assessed based on the JBI checklist. Our search strategy yielded a total of 487 articles from the international databases. After screening their full-texts, 6 articles met the inclusion criteria and were considered for meta-analysis. The effect of PCOS on the incidence of fibrocystic breast changes was 2.49 (95% CI 1.85-3.34). Also, the effect of hypothyroidism on the incidence of fibrocystic breast changes was 1.90 (95% CI 0.92-3.93). The results showed that women with PCOS were at higher risks to develop fibrocystic breast changes.

Comparing clinical outcomes in patients with diabetes undergoing coronary artery bypass graft and percutaneous coronary intervention in real world practice in Iranian population.

BACKGROUND: Coronary artery bypass graft (CABG) is generally regarded as one the treatment options for coronary artery disease (CAD) in patients with diabetes. In recent years, with the advent of drug-eluting stents (DES), percutaneous coronary intervention (PCI) was introduced as a suitable alternative for CABG. The aim of this study was to compare the incidence of major adverse cardiac and cerebrovascular event (MACCE) during mid-term period in patients with diabetes treated with 2 revascularization strategies. METHODS: This historical cohort study was conducted on 750 consecutives patients with diabetes in a single cardiovascular center from July 2009 to March 2012 in Iran. We included previously known case of DM treated with antidiabetic medications (with or without end organ damage) and patient with preoperational evaluation FBS test > 126 (not on the day of the surgery) who were revascularized by 2 strategies. We excluded those patients whose follow-up was not possible. RESULTS: Finally, out of 697 eligible patients, 355 patients underwent a CABG and 342 underwent a PCI: 53 patients were lost to follow-up (27 in CABG and 26 in PCI groups). The mean follow-up time was 900.68 ± 462.03 days in the CABG and 782.60 ± 399.05 in PCI groups. There were 17 (9.13%) cardiac deaths in the CABG group and 8 (4.45%) in the PCI group; this difference was not significant (P = .11). There was 14 (7.58%) cerebrovascular accident in the CABG group and 4 (2.31%) in the PCI group; this difference was significant (P = .04). Moreover, the frequency of the target vessel revascularization in the CABG and PCI groups was 6 (3.32%) and 31 (17.11%) (P < .001), respectively. Myocardial infarction in the CABG group was 5 (2.77%) and 14 (7.86%) in the PCI group (P = .009). Finally, the frequency of MACCE in the CABG and PCI groups was 41(20.70%) and 47(24.16%) respectively; this difference was not statistically significant (P = .195). CONCLUSION: Patients with CABG in this study experienced more CVA, while the frequency of TVR and non-fatal MI was higher in the PCI arm.

Systematic review and meta-analysis of randomized clinical trials comparing efficacy, safety, and satisfaction between ablative and non-ablative lasers in facial and hand rejuvenation/resurfacing.

Skin aging inevitably begins from the very early days of life. The lasers used in skin rejuvenation are mainly of two types: ablative and non-ablative. This meta-analysis aimed at comparing ablative with non-ablative lasers in terms of their efficacy and safety in skin rejuvenation. Articles published by March 15, 2020 in Embase, Medline (PubMed), Scopus, Cochrane, and clinicalTrials.gov were searched. The inclusion criteria included randomized controlled clinical trials (RCTs) in English using ablative and non-ablative lasers and comparing their safety and efficiency in wrinkle improvement and photoaging therapy. Out of 1353 extracted articles, 11 were selected for qualitative synthesis and of these, 4 were quantitatively analyzed. Different modes of various lasers were implemented; the ablative lasers included Erbium: yttrium-aluminium-garnet (Er:YAG) and CO2, besides the non-ablative lasers, comprised Ytterbium/Erbium, Erbium: Glass, neodymium: yttrium-aluminum-garnet (Nd:YAG), and alexandrite. Pooled analyses on 124 participants showed insignificant differences between ablative and non-ablative lasers in the likelihood of excellent improvement with an odds ratio of 0.83 (95% CI: 0.24, 2.83). The analyses also showed good improvement with an odds ratio of 0.88 (95% CI: 0.44, 1.78), fair improvement with an odds ratio of 1.13 (95% CI: 0.56, 2.26) and side effects with an odds ratio of 0.82 (95% CI: 0.43, 1.56). The efficacy and safety of ablative laser were not higher than those of non-ablative laser in skin rejuvenation. Given the small samples of the included articles, it is recommended that further high-quality RCTs be conducted using larger samples to confirm this conclusion.

Diagnostic accuracy for alternative cervical cancer screening strategies: A systematic review and meta-analysis.

We performed a systematic review and meta-analysis to evaluate the accuracy of screening cervical cancer tests as alternative standalone methods. The combined estimates of sensitivity of visual inspection with acetic acid, visual inspection with lugol's iodine, conventional pap smear, liquid-based cytology, High risk HPV testing by clinician, High risk HPV testing by self- sampling, cervicography were 64%, 80%, 55%, 70%, 70% and 67% respectively; the combine values of specificity of these screening strategies were 88%, 88%, 96%, 59%, 94%, and 95% respectively. Our findings draw attention to an attractive opinion to facilitate the collection of specimens for DNA HPV by patients in settings where they don't have access to a regular screening programs.

Bone Loss Correlated with Parathyroid Hormone Levels in Adult Celiac Patients.

BACKGROUND: Celiac disease (CD) is a gluten-sensitive enteropathy with intestinal and extra-intestinal presentations in genetically predisposed cases. Musculoskeletal problems are one of the most common extra-intestinal manifestations in adult patients with CD. In the present study, we evaluated parathyroid hormone (PTH) levels in men and premenopausal women with CD who had osteoporosis and osteopenia. METHODS: This was a cross-sectional study of 387adult patients with CD who were referred to the Mashhad Celiac Disease Center between 2014 and 2019. We excluded bone loss confounding factors, including cases with endocrine disorders, corticosteroid consumption, smoking, and age of more than 55 years. Factors such as intestinal pathology, bone mineral density (BMD), serum level of anti-tTG, serum vitamin D, and PTH levels were also assessed at the time of diagnosis. RESULTS: Femoral osteopenia was found in 140 (36.2%) patients, and osteoporosis was observed in 55 (14%) patients. Spinal osteopenia and osteoporosis were observed in 127 (33%) and 63 (16.4%) patients, respectively. High levels of PTH were detected in 72/193 (27.2%) of the patients with CD. There was a significant difference between PTH levels in patients with osteopenia, osteoporosis, and normal BMD (P=0.0001). CONCLUSION: This study showed a correlation between low BMD and PTH levels in patients with CD, which suggests autoimmune endocrine disorder as a cause of osteopenia and osteoporosis.

The prevalence of ataxia telangiectasia mutated (ATM) variants in patients with breast cancer patients: a systematic review and meta-analysis.

Breast cancer is the most common cancer in women, and its high mortality has become one of the biggest health problems globally. Several studies have reported an association between breast cancer and ATM gene variants. This study aimed to demonstrate and analyze the relationship between ATM gene polymorphisms and breast cancer prevalence rate. A systematic literature review was undertaken using the following databases: Medline (PubMed), Web of sciences, Scopus, EMBASE, Cochrane, Ovid, and CINHAL to retrieve all cross-sectional studies between January 1990 and January 2020, which had reported the frequency of ATM variants in patients with breast cancer. A random-effects model was applied to calculate the pooled prevalence with a 95% confidence interval. The pooled prevalence of ATM variants in patients with breast cancer was 7% (95% CI: 5-8%). Also, the pooled estimate based on type of variants was 6% (95% CI: 4-8%; I square: 94%; P: 0.00) for total variants¸ 0% (95% CI: 0-1%; I square: 0%; P: 0.59) for deletion variants, 12% (95% CI: 7-18%; I square: 99%; P: 0.00) for substitution variants, and 2% (95% CI: 4-9%; I square: 67%; P: 0.08) for insertion variants. This meta-analysis showed that there is a significant relationship between ATM variants in breast cancer patients. Further studies are required to determine which of the variants of the ATM gene are associated with BRCA mutations.

The association between ATM variants and risk of breast cancer: a systematic review and meta-analysis.

BACKGROUND: Ataxia telangiectasia-mutated (ATM) gene contributes to repair damaged DNA and to regulate cell cycle; therefore, ATM variants seem to increase breast cancer risk; however, the results are controversial. So we conducted a systematic review and meta-analysis to clarify the pooled association between various ATM variants and the risk of breast cancer. METHODS: The relevant studies were searched through Scopus, Web of Science, PubMed and Cochrane. Stratified and subgroup analyses were performed to explore heterogeneity between studies and assess effects of study quality. The pooled estimates logarithm with standard error logarithm of odds ratio and relative risk with confidence interval were calculated. RESULTS: This study revealed that there is association between ATM variants and the risk of breast cancer; according to the seven adjusted case-control studies, OR of this association was estimated as 1.67 (95%CI: 0.73-3.82), according to nine unadjusted case-control studies, the crude OR was 2.27 (95% CI: 1.17-4.40) and according to two cohorts, the RR was estimated as 1.68 (95% CI: 1.17-2.40). CONCLUSIONS: The ATM variants are associated with an increased risk of breast cancer that ATM V2424G mutation is detected as the most predisposing factor while ATM D1853V, L546V, and S707P variants have the least predictive ability.

Amniotic Membrane-Derived Mesenchymal Stem Cells for Heart Failure: A Systematic Review and Meta-Analysis of the Published Preclinical Studies.

Background: Ischemic cardiomyopathies are the leading causes of mortality and morbidity. Stem cell therapy using amniotic membrane mesenchymal stem cells have emerged as a promising cardiac regeneration modality. They have shown great immunological advantage when used in allogeneic or xenogeneic transplantation. The aim of the current study is to accumulate evidence from published preclinical studies on the application of amniotic membrane derived mesenchymal stem cells (AMSCs) in the treatment of ischemic cardiomyopathies including myocardial ischemia and heart failure. The aim is to define if there is enough high-quality current evidence to support starting the use of these cells in clinical trials. Methods: PubMed, SCOPUS, EMBASE, and ISI Web of Science databases were searched without temporal and language restrictions. Data were extracted from selected studies. The primary outcomes were left ventricular ejection fraction (LVEF) and LV fibrosis. The risk of bias (ROB) assessment was performed using SYRCLE's ROB tool. After qualitative synthesis, provided that data meets the criteria for quantitative analysis, a meta-analysis was performed using Stata software V12 to investigate the heterogeneity of the data and to get an overall estimate of the effect size of the treatment on each outcome. Results: On primary search, 438 citations were retrieved. After screening, three studies were selected for quantitative analysis of each of the outcomes LVEF and LV fibrosis. Their administration in acute and chronic MI alleviates heart failure and improves LVEF (SMD=3.56, 95% CI: 2.24-4.87, I-squared=83.1%, p=0.003) and reduces infarct size (SMD= -4.41, 95% CI: (-5.68)-(-3.14), I-squared=79.0%, p=0.009). These observations were achieved in the acute MI model, HF following ischemia due to coronary artery stenosis and coronary artery occlusion with the early restoration of the perfusion. Conclusion: Present low and medium quality evidence from preclinical studies confirm the efficacy of the AMSCs in the preclinical models of acute MI and HF following ischemia due to coronary artery stenosis and permanent/temporary coronary artery occlusion. High-quality preclinical studies are indicated to bridge the gaps in translation of the current findings of AMSCs research for the treatment of patients with acute and chronic myocardial ischemia and heart failure.

The effect of vaginal progesterone on Doppler findings in increased uterine artery resistance.

OBJECTIVE: The present study aimed to evaluate the effect of vaginal progesterone on Doppler finding in increased uterine artery resistance compared with aspirin. MATERIALS AND METHODS: This study is a double-blind randomized clinical trial that was conducted on 140 pregnant women with increased uterine artery resistance who were referred to the Shariati hospital (Tehran, Iran) in 2017-2018. Patients were randomized to 1 of the 3 treatment groups - group A: tablet aspirin 80 mg; group B: vaginal suppository progesterone; and group C: control group without any intervention. Low-risk pregnant women at the gestational age of 16-20 weeks, were assessed by the uterine artery Doppler. In the presence of increased resistance of the uterine artery, patients were randomly assigned to one of the three above mentioned groups. RESULTS: The results of paired t-tests for right uterine artery pulsatility index (RUA.PI), right uterine artery resistance index (RUA.RI), left uterine artery PI (LUA.PI), and left uterine artery RI (LUA.RI) before and after of intervention in the three groups were statistically significant. Also, the one-way analysis of variance (ANOVA) results for comparison between three groups showed that before the intervention only means of RUA.PI has a significant difference between three groups (p = .025), but means of all variables after intervention shows a significant difference (p < .001). CONCLUSION: The findings showed that the use of vaginal progesterone suppressed the resistance of uterine artery compared to aspirin.

Investigating the factors affecting the survival rate in patients with COVID-19: A retrospective cohort study.

Background: As hospitalized patients with COVID-19, especially those who are admitted to ICU or die afterwards, generally have comorbidities, the aim of this study was to determine the factors affecting the survival rate of COVID-19 patients in Iran using a retrospective cohort. Methods: This retrospective cohort study was conducted on patients with COVID-19 who referred to medical centers under the supervision of Iran University of Medical Sciences, Tehran, Iran, from February 22 to March 25, 2020. The final date of follow-up was April 19, 2020. All consecutive inpatients with laboratory-confirmed COVID-19 were included in this study. Clinical laboratory, radiological, treatment, and demographic data were collected and analyzed. The associations among gender, immune disease, diabetes, liver disease, cardiovascular disease, kidney disease, chronic pulmonary disease, cancer, chronic nervous disease, type of treatment, and risk of death were analyzed. The Kaplan-Meier and Log-rank tests were used to estimate survival rate and compare survival rates, respectively. Results: The total number of deaths or desired event in the study was 329 (10.3%).The risk of death in the age groups of 50-60 years, 60-70 years, and >70 years compared to the 30-40 age group was 2.17 (95% CI: 1.03, 4.55; p: 0.040); 3.72 (95 % CI: 1.80, 7.68; p: 0.001) and 5.09 (95 % CI: 2.49, 10.40; p: 0.001), respectively. The results showed men had 11.5% more risk of deaths than women (HR: 1.11; 95 % CI: 0.89, 1.39; p: 0.341). Kidney disease increased the risk of death by 52.3% in these patients, which was not statistically significant (HR: 1.78; 95 % CI: 1.04, 3.04; p: 0.035). Also, chronic pulmonary diseases and diabetes increased the risk of death in COVID-19 patients by 89.5% and 41.3% compared to COVID-19 patients without chronic pulmonary diseases and diabetes [(HR: 1.89; 95 % CI: 1.17, 3.04; p: 0.008), (HR: 1.41; 95 % CI: 1.01, 1.96; p: 0.038)]. Conclusion: Based on the results of this study, more attention and care should be paid to COVID-19 patients with underlying diseases, such as chronic obstructive pulmonary disease, diabetes, and kidney disease to reduce the number of deaths.

Diagnostic accuracy of cerebrospinal fluid and serum-isolated extracellular vesicles for glioblastoma: a systematic review and meta-analysis.

BACKGROUND: Glioblastoma (GBM) is the most malignant brain cancer because there are no available biopsy-free methods for the diagnosis or the preoperative early detection. In this regard, the development of a non- or minimally invasive methods for early detection could increase the survival rate of GBM patients. METHODS: The present study aimed to assess the diagnostic accuracy of extracellular vesicles (EVs) derived RNAs, isolated from patients' CSF or serum for GBM diagnosis. For this purpose, we searched all literature databases and performed a backward and forward reference checking procedure to retrieve appropriate studies. We conducted a meta-analysis on EVs derived biomarkers as well as sensitivity analysis and meta-regression. RESULTS: We identified EVs-derived 24 RNAs, which can diagnose GBM. The analyzed pooled data showed 76% sensitivity, 80% specificity, and 0.85 AUC, for 16 biomarkers. Besides, the pooled PLR, NLR, and DOR were 3.7, 0.30, and 12, respectively. Subgroup analysis did not show a significant difference between serum and CSF. CONCLUSIONS: According to the pooled sensitivity, specificity, and AUC for EVs derived biomarkers, we suggest that EVs-derived biomarkers might serve as a high potential and noninvasive diagnostic tool for GBM detection using serum and CSF samples.

Signal transduction pathway mutations in gastrointestinal (GI) cancers: a systematic review and meta-analysis.

The present study was conducted to evaluate the prevalence of the signaling pathways mutation rate in the Gastrointestinal (GI) tract cancers in a systematic review and meta-analysis study. The study was performed based on the PRISMA criteria. Random models by confidence interval (CI: 95%) were used to calculate the pooled estimate of prevalence via Metaprop command. The pooled prevalence indices of signal transduction pathway mutations in gastric cancer, liver cancer, colorectal cancer, and pancreatic cancer were 5% (95% CI: 3-8%), 12% (95% CI: 8-18%), 17% (95% CI: 14-20%), and 20% (95% CI: 5-41%), respectively. Also, the mutation rates for Wnt pathway and MAPK pathway were calculated to be 23% (95% CI, 14-33%) and 20% (95% CI, 17-24%), respectively. Moreover, the most popular genes were APC (in Wnt pathway), KRAS (in MAPK pathway) and PIK3CA (in PI3K pathway) in the colorectal cancer, pancreatic cancer, and gastric cancer while they were beta-catenin and CTNNB1 in liver cancer. The most altered pathway was Wnt pathway followed by the MAPK pathway. In addition, pancreatic cancer was found to be higher under the pressure of mutation compared with others based on pooled prevalence analysis. Finally, APC mutations in colorectal cancer, KRAS in gastric cancer, and pancreatic cancer were mostly associated gene alterations.