The effect of yoga on the quality of life and fatigue in patients with multiple sclerosis: A systematic review and meta-analysis of randomized clinical trials.

BACKGROUND: The impact of yoga on the quality of life and fatigue in patients with multiple sclerosis (MS) has shown various results in different reports. As a result, performing a systematic review and meta-analysis to guide physicians and patients seems necessary. The present study was carried out to evaluate the effect of yoga intervention on the quality of life and fatigue in patients with MS. METHOD: The present study was designed based on PRISMA guidelines from their inception until October 2019. Two researchers independently performed all steps. We searched several international online databases such as PubMed/Medilne, Scopus, Science Direct, Cochrane Library, PsycINFO, Web of Science, CINAHL, CAM-Quest, CAMbase, IndMED and Google Scholar search engine. The data were analyzed using Comprehensive Meta-analysis Software Ver. 2, while P < 0.05 was considered significant. The protocol of this meta-analysis was registered at PROSPERO with number identifier: CRD42019127168. RESULTS: Overall, 693 patients with MS (yoga (n = 209), exercise (n = 298), control (n = 186) groups) were examined in ten randomized controlled trials (RCTs). According to this meta-analysis, the effect of yoga intervention on fatigue in patients with MS was significantly better compared to the typical MS care group [SMD = -0.872; 95%CI: -1.467 to -0.277, p = 0.004], and did not show significant difference compared to the exercise group [SMD = -0.093; 95%CI: -0.353 to 0.167, p = 0.482]. The effect of yoga intervention on the overall quality of life (compared to the typical MS care group: [SMD = 0.710; 95%CI: -0.172 to 1.592, p = 0.114], and compared to the exercise group: [SMD = -0.453; 95%CI: -0.233 to 1.138, p = 0.195]), physical component (compared to the typical MS care group: [SMD = 0.281; 95%CI: -0.157 to 0.719, p = 0.209], and compared to the exercise group: [SMD = 0.074; 95%CI: -0.125 to 0.273, p = 0.467]), psychological component (compared to the typical MS care group: [SMD = 0.250; 95% CI: - 0.132 to 0.631, p = 0.199], and compared to the exercise group: [SMD = - 0.270; 95%CI: -0.813 to 0.272, p = 0.329]), sexual function (compared to the typical MS care group: [SMD = 0.438; 95%CI: -0.350 to 1.226, p = 0.276]), and cognitive function (compared to the typical MS care group: [SMD = -0.390; 95%CI: -0.008 to 0.789, p = 0.055]) in patients with MS was not significant. CONCLUSION: Yoga is a simple exercise for patients with MS that is capable of decreasing fatigue in these patients.

An update and systematic review on the treatment of primary dysmenorrhea.

OBJECTIVES: Primary dysmenorrhea is a painful uterine contraction caused by endometrial laceration. Drug therapies and complementary medicine have been used to treat dysmenorrhea. The aim of this study was to investigate and offer an updated perspective on the treatments for dysmenorrhea. METHODS: The present study was conducted in accordance with the PRISMA checklist for systematic reviews and meta-analyses. The required information was collected based on searches for the following keywords: treatment, primary dysmenorrhea, medicinal plants, chemical drugs, and herbs. Searches were performed on databases Pubmed, Web of Sciences, Scopus, Iran medex, and SID by March 2018 to find literature in the English and Persian languages on this subject without a time limit. RESULTS: This review included 17 papers, 10 of which on complementary medicine, three on drug therapies, and four on acupuncture and acupressure. The largest and smallest samples had 303 and 24 patients, respectively. Length of treatment ranged from one to six months and the measures most commonly used in the studies were the visual analogue scale and clinical efficacy. Reported complications included gastrointestinal events, nausea, vomiting, diarrhea, abdominal pain, and liver and kidney disorders. CONCLUSION: Medicinal plants, drugs, and acupressure seem to suppress pain by reducing the level of prostaglandins, mediating nitric oxide, increasing beta-endorphin levels, blocking the calcium channel, and enhancing circulatory flow through the uterine pathway. Further trials are required to confirm the benefits of the procedures described and ensure the absence of complications.

The association between Selenium and Prostate Cancer: a Systematic Review and Meta-Analysis

Background: Evidence of relationship between selenium and prostate cancer has been inconsistent. The present metaanalysis was conducted to determine relationship between selenium and prostate cancer. Methods: A systematic review and meta-analysis was carried out using preferred reporting items for systematic reviews and meta-analysis (PRISMA). We searched PubMed, Scopus, Web of Science, ScienceDirect, Embase, CINAHL, Cochrane Library, EBSCO and Google scholar search engines and the reference lists of the retrieved papers for relevant data, without any limitation regarding language or time until 2016. Heterogeneity among studies was evaluated using Q test and I2 Index. Finally, a random effects model was used for combining results using STATA software version 11.1. P<0.05 was considered significant. Results: Thirty-eight studies including 36,419 cases and 105,293 controls were included in the final analysis. The pooled relative risk (RR) of relation between selenium and prostate cancer was 0.86 (95% Confidence Interval [CI]:0.78-0.94). Sub-group analyses based on case-control, cohort, and RCT studies gave values of 0.89 (95% CI: 0.80-1.00), 0.77 (95% CI: 0.52-1.14) and 0.90 (95% CI: 0.74-1.09), respectively. RRs based on serum, plasma and nail samples were 0.69 (95% CI: 0.51-0.95), 0.85 (95% CI: 0.61-1.17), 0.66 (95% CI: 0.41-1.05), respectively. According to 10 studies, investigated the relation between advanced prostate cancer and selenium in which the RR was 0.67 (95% CI: 0.52-0.87). Conclusions: This meta-analysis indicated that selenium most probably has a protective role against development of prostate cancer and its progression to advanced stages. Therefore, selenium supplementation can be proposed for prevention of prostate cancer.

Total Calcium (Dietary and Supplementary) Intake and Prostate Cancer: a Systematic Review and Meta-Analysis

Background: Controversial results have been reported concerning the influence of calcium intake on prostate cancer risk. The aim of this study was to determine any association between total calcium (in the diet and in supplements) intake and prostate cancer. Materials and Methods: The present systematic review and meta-analysis study was carried out following a PRISMA guidelines. Two reviewers independently using MeSH keywords searched international databases including PubMed, Science Direct, Cochrane, EMBASE, Web of Science, CINAHL, EBSCO and search engines such as Google Scholar. The searches were performed without any time limit until May 2016. The results were pooled using a random effects model and homogeneity was confirmed using the Q test and I2 index. Subgroup analyses was performed according to continents and study designs. The data were analyzed using STATA software version 3.2, with p<0.05 considered significant. Result: Overall, 12 studies with a total sample size of 905,046 were entered into the final meta-analysis. The main age range of the participants was 50 to 70 years. The relative risks (RR) for total calcium with total prostate cancer, localized prostate cancer, and advance prostate cancer were estimated to be 1.15 (95% CI: 1.04-3.46), 1.05 (95% CI: 0.96-1.14), and 1.15 (95% CI: 0.89-1.50), respectively. Only the relationship between total calcium and total prostate cancer was significant (P<0.05). Conclusions: High calcium intake can be considered as a risk factor for total prostate cancer. Therefore, calcium intake might be a target for prevention.

Prevalence and risk factors of retinopathy of prematurity in Iran: a systematic review and meta-analysis.

BACKGROUND: Retinopathy of prematurity (ROP) refers to the developmental disorder of the retina in premature infants and is one of the most serious and most dangerous complications in premature infants. The prevalence of ROP in Iran is different in various parts of Iran and its prevalence is reported to be 1-70% in different regions. This study aims to determine the prevalence and risk factors of ROP in Iran. METHODS: This review article was conducted based on the preferred reporting items for systematic review and meta-analysis (PRISMA) protocols. To find literature about ROP in Iran, a comprehensive search was done using MeSH keywords in several online databases such as PubMed, Ovid, Science Direct, EMBASE, Web of Science, CINAHL, EBSCO, Magiran, Iranmedex, SID, Medlib, IranDoc, as well as the Google Scholar search engine until May 2017. Comprehensive Meta-analysis Software (CMA) Version 2 was used for data analysis. RESULTS: According to 42 studies including 18,000 premature infants, the prevalence of ROP was reported to be 23.5% (95% CI: 20.4-26.8) in Iran. The prevalence of ROP stages 1, 2, 3, 4 and 5 was 7.9% (95% CI: 5.3-11.5), 9.7% (95% CI: 6.1-15.3), 2.8% (95% CI: 1.6-4.9), 2.9% (95% CI: 1.9-4.5) and 3.6% (95% CI: 2.4-5.2), respectively. The prevalence of ROP in Iranian girls and boys premature infants was 18.3% (95% CI: 12.8-25.4) and 18.9% (95% CI: 11.9-28.5), respectively. The lowest prevalence of ROP was in the West of Iran (12.3% [95% CI: 7.6-19.1]), while the highest prevalence was associated with the Center of Iran (24.9% [95% CI: 21.8-28.4]). The prevalence of ROP is increasing according to the year of study, and this relationship is not significant (p = 0.181). The significant risk factors for ROP were small gestational age (p < 0.001), low birth weight (p < 0.001), septicemia (p = 0.021), respiratory distress syndrome (p = 0.036), intraventricular hemorrhage (p = 0.005), continuous positive pressure ventilation (p = 0.023), saturation above 50% (p = 0.023), apnea (p = 0.002), frequency and duration of blood transfusion, oxygen therapy and phototherapy (p < 0.05), whereas pre-eclampsia decreased the prevalence of ROP (p = 0.014). CONCLUSION: Considering the high prevalence of ROP in Iran, screening and close supervision by experienced ophthalmologists to diagnose and treat the common complications of pre-maturity and prevent visual impairment or blindness is necessary.

The Effect of Yoga on Stress, Anxiety, and Depression in Women.

BACKGROUND: In recent decades, several medical and scientific studies on yoga proved it to be very useful in the treatment of some diseases. This study was conducted to investigate the effects of yoga on stress, anxiety, and depression in women living in Ilam, Iran. METHODS: This study is a quasi-experimental study with pre-post test. To collect data, the questionnaire of DASS-21 (Depression Anxiety Stress Scale-21) was used. For eligible samples, hatha yoga exercises and training sessions were held for 4 weeks (3 time/weeks; 60-70 min each) by a specialist. Data were analyzed using SPSS version 20. RESULTS: 52 women with a mean age of 33.5 ± 6.5 were included for analysis. Depression, anxiety, and stress decreased significantly in women after 12 sessions of regular hatha yoga practice (P < 0.001). CONCLUSIONS: Yoga has an effective role in reducing stress, anxiety, and depression. Thus, it can be used as complementary medicine.

Hearing loss in Iranian thalassemia major patients treated with deferoxamine: A systematic review and meta-analysis.

BACKGROUND: Hearing disorders are reported in thalassemia patients treated with deferoxamine. This study aimed to assess hearing loss in Iranian thalassemia major patients treated with deferoxamine. METHODS: This review article was designed based on PRISMA guidelines. To review the literature, two researchers studied national and international databases including Iranmedex, Magiran, Medlib, SID, Scopus, PubMed, Science Direct, Web of Science and Google Scholar without time limit until May 2017. Cochran's Q test and I2 index were used to assess the heterogeneity of the studies. The data were analyzed using Comprehensive Meta-Analysis software version 2 and p<0.05 was considered significant. RESULTS: A total of 17 articles involving 1,835 Iranian thalassemia major patients treated with deferoxamine were included in the meta-analysis. The overall prevalence of hearing loss was estimated 27.3% (95% confidence intervals (CI): 19-37.6). The prevalence of sensorineural, conductive and mixed hearing loss was estimated 10.6% (95% CI: 5.7-18.8), 14.6% (95% CI: 10.5-20.6) and 9.1% (95% CI: 5.6-14.6), respectively. No significant differences were noted regarding the relationship hearing loss and mean serum ferritin (P=0.29) and average daily deferoxamine (P=0.30). Meta-regression model showed an increased significance in the prevalence of hearing loss based on the year of studies (p<0.0001). CONCLUSIONS: There is a high prevalence of hearing loss in Iranian thalassemia major patients treated with deferoxamine. Therefore, periodic hearing assessments and regular check-ups after the initiation of chelation therapy are necessary.

The effect of celery (Apium graveolens L.) on fertility: A systematic review.

Background Fertility and infertility problems are among the complex issues in medicine. The use of herbal products in the treatment of fertility has been considered as an alternative to synthetic drugs. Celery containing known compounds can have an impact on the fertility rate. The aim of this study was to do a systematic review on conducted studies in conjunction with the celery and reproduction. Methods Required papers were searched from databases like Science direct, PubMed, Scopus, and Springer. Keywords used in this study were "Apium graveolens L.", "fertility", "reproductive system", "sperm", "testis", "delivery", "sexual hormone", "LH", "FSH", "testosterone", "semen", "male", and "female". Out of 238 collected articles (published in the period 1995 to 2015), 222 were excluded due to non-relevance and lack of access to the original article. Results The notable points were the different results seen by different researchers during different treatment periods or at different doses. Of the 16 studies reviewed in this study, 13 studies have mentioned the positive effect of celery on fertility, while three studies reported the inhibitory effects of this plant. Conclusions Celery can have protective effects against substances such as sodium valproate, propylene glycol, and diethyl phthalate causing damages to the testicular structure and spermatogenesis. In this regard, the doses used and the treatment time while using the plant must be accurately investigated. Since there are compounds such as apigenin, the celery can induce inhibitory effects on fertility in case of chronic use or high concentration.

The effects of multi mineral-vitamin D and vitamins (C+E) supplementation in the prevention of preeclampsia: An RCT.

BACKGROUND: Several studies have reported the uncertain role of multi-minerals and vitamins in the prevention of preeclampsia. OBJECTIVE: The present study aims to investigate the effect of multimineral-vitamin D supplements (calcium, magnesium, zinc and Vitamin D) and vitamins (C+ E) in the prevention of preeclampsia. MATERIALS AND METHODS: In this randomized clinical trial, 90 pregnant women were divided into three groups: group A received Ferrous sulfate (1 tablet/day) + one tablet of Claci-care multimineral-vitamin D containing 800mg calcium, 200mg magnesium, 8mg zinc and 400 IU Vitamin D3 per day; group B received Ferrous sulfate (1 tablet/day) + 250 mg vitamin C + 55 mg vitamin E; and the controls received only one Ferrous sulfate tablet daily. RESULTS: The incidence of preeclampsia in group A was significantly lower than the control group (p=0.03), while there was no significant difference between group B and controls (p=0.50), as well as groups A and B (p=0.063). The incidence of neonatal complications in the group A was significantly lower than the control group (p=0.01), while there was no significant difference between group B and control (p=0.48). CONCLUSION: According to the results, calcium, magnesium, and zinc supplements have a significant effect on the prevention of preeclampsia. In addition, prescription of multimineral-vitamin D during pregnancy can be a low-cost and affordable way to reduce the incidence of preeclampsia in women who are at high risk of preeclampsia.