ABSTRACT
Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2-to end preventable child deaths by 2030-we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000-2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations.
Subject(s)
Child Mortality/trends , Infant Mortality/trends , Child , Geography , Global Health , Humans , Infant , Infant, Newborn , Organizational Objectives , Public Health , Socioeconomic Factors , United NationsABSTRACT
Exopolysaccharides (EPS) are extracellular sugar metabolites/polymers of some slim microorganisms and, a wide variety of probiotics have been broadly investigated for their ability to produce EPS. EPS originated from probiotics have potential applications in food, pharmaceutical, cosmetology, wastewater treatment, and textiles industries, nevertheless slight is recognized about their function. The present review purposes to comprehensively discuss the structure, classification, biosynthesis, extraction, purification, sources, health-promoting properties, techno-functional benefits, application in the food industry, safety, toxicology, analysis, and characterization methods of EPS originated from probiotic microorganisms. Various studies have shown that probiotic EPS used as stabilizers, emulsifiers, gelling agents, viscosifiers, and prebiotics can alter the nutritional, texture, and rheological characteristics of food and beverages and play a major role in improving the quality of these products. Numerous studies have also proven the beneficial health effects of probiotic EPS, including antioxidant, antimicrobial, anti-inflammatory, immunomodulatory, anticancer, antidiabetic, antibiofilm, antiulcer, and antitoxin activities. Although the use of probiotic EPS has health effects and improves the organoleptic and textural properties of food and pharmaceutical products and there is a high tendency for their use in related industries, the production yield of these products is low and requires basic studies to support their products in large scale.
Subject(s)
Polysaccharides, Bacterial , Probiotics , Antioxidants , Food Industry , Prebiotics , HumansABSTRACT
Saccharomyces cerevisiae var. boulardii (S. boulardii) has been isolated from lychee (Litchi chinensis), mangosteen fruit, kombucha, and dairy products like kefir. Dairy products containing S. boulardii have been revealed to possess potential probiotic activities owing to their ability to produce organic acids, essential enzymes, vitamins, and other important metabolites such as vanillic acid, phenyl ethyl alcohol, and erythromycin. S. boulardii has a wide spectrum of anti-carcinogenic, antibacterial antiviral, and antioxidant activity, and is known to reduce serum cholesterol levels. However, this yeast has mainly been prescribed for prophylaxis treatment of gastrointestinal infectious diseases, and stimulating the immune system in a number of commercially available products. The present comprehensive review article reviews the properties of S. boulardii related to their use in fermented dairy foods as a probiotic microorganism or starter culture. Technical aspects regarding the integration of this yeast into the dairy foods matrix its health advantages, therapeutic functions, microencapsulation, and viability in harsh conditions, and safety aspects are highlighted.
Subject(s)
Probiotics , Saccharomyces boulardii , Saccharomyces cerevisiae/metabolism , Saccharomyces boulardii/metabolism , Probiotics/metabolism , Antioxidants/metabolism , Dairy ProductsABSTRACT
Although coronary artery bypass graft (CABG) surgery is one of the most worldwide commonly performed cardiac surgeries to enhance myocardial perfusion in high-grade myocardial occlusion, it remains a high-risk procedure. Photobiomodulation (PBM) is one of the methods which have been shown to have positive effects on the healing process after CABG and postoperative complications. The aim of this study was to evaluate the efficacy of PBM in patients who underwent a coronary artery bypass graft (CABG). Ths study was conducted with 192 volunteers who electively submitted to CABG. The volunteers were randomly allocated into two groups: laser-treated (transdermal: 980 nm, 200 mW, continuous, average energy fluency of 6 J/cm2 and intravenous: 405 nm, 1.5 mW, continuous for 30 min) and standard treatment and control group (standard treatment only). Intravenous laser was illuminated the day before the surgery, immediately after transferring the patient to CCU post-operation and IV laser in addition to transdermal laser was applied every day after surgery for 6 days. A total of 170 out of 192 participants completed the study, 82 (48.2%) in the PBM group and 88 (51.8%) in the control group. Level of LDH and CPK was significantly lower in the PBM group (P < 0.05) in the 4th day postoperatively. The PBM group also showed significantly lower post-surgery complications, including pericardial effusion, ejection fraction, pathologic ST changes, pathologic Q, rehospitalization, heart failure, and mediastinitis (P < 0.05). Likewise, the VAS pain score after surgery was significantly lower in patients in the laser group (P < 0.05). PBM seems a promising, safe, cost-benefit therapeutic modality to reduce postoperative complications of CABG. Trial registration number: IRCT2016052926069N4 .
Subject(s)
Coronary Artery Bypass , Heart Failure , Coronary Artery Bypass/adverse effects , Humans , Postoperative Complications , Treatment Outcome , Wound HealingABSTRACT
INTRODUCTION: Fractional CO2 has many indications in medicine including in treatment of acne scars and rejuvenation. The aim of this study was to evaluate the safety, efficacy, and cost-effectiveness of Fractional CO2 Laser in comparison with other methods of rejuvenation and acne scar treatment. MATERIALS AND METHODS: Several databases including Medline, OVID, EMBASE, CINHAL, SCOPUS, Web of science, CRD, and Cochrane were searched. After conducting the search and evaluation of selected publications, critical appraisal was done and eligible studies were accepted for inclusion in the systematic review. RESULTS AND DISCUSSION: From 2667 identified publications two of the trials were eligible. The effectiveness and complications of Fractional CO2 laser were comparable with Er:YAG but Fractional CO2 laser was 14.7% (p = 0.01) more effective than Q-Switched ND:YAG laser. Cost affectivity of this method was the same as other alternative lasers. In conclusion Fractional CO2 laser is an effective and safe method for curing of several kinds of skin diseases. Nevertheless there was not sufficient evidence to support its advantage. This device has equal or lower price in comparison to competent technologies except for the non- fractional ablative CO2 laser that has the same or lower price and comparable effects.
Subject(s)
Cicatrix/surgery , Lasers, Gas/therapeutic use , Lasers, Solid-State/therapeutic use , Skin Aging , Acne Vulgaris/complications , Cicatrix/etiology , Cost-Benefit Analysis , Humans , Laser Therapy/adverse effects , Laser Therapy/economics , Lasers, Gas/adverse effects , Lasers, Solid-State/adverse effects , RejuvenationABSTRACT
Skin graft is a standard therapeutic technique in patients with deep ulcers, but managing donor site after grafting is very important. Although several modern dressings are available to enhance the comfort of donor site, using techniques that accelerate wound healing may enhance patient satisfaction. Low-level laser therapy (LLLT) has been used in several medical fields, including healing of diabetic, surgical, and pressure ulcers, but there is not any report of using this method for healing of donor site in burn patients. The protocols and informed consent were reviewed according to Medical Ethics Board of Shahid Beheshti University of Medical Sciences (IR.SBMU.REC.1394.363) and Iranian Registry of Clinical Trials (IRCT2016020226069N2). Eighteen donor sites in 11 patients with grade 3 burn ulcer were selected. Donor areas were divided into 2 parts, for laser irradiation and control randomly. Laser area was irradiated by a red, 655-nm laser light, 150 mW, 2 J/cm2, on days 0 (immediately after surgery), 3, 5, and 7. Dressing and other therapeutic care for both sites were the same. The patients and the person who analyzed the results were blinded. The size of donor site reduced in both groups during the 7-day study period (P < 0.01) and this reduction was significantly greater in the laser group (P = 0.01). In the present study, for the first time, we evaluate the effects of LLLT on the healing process of donor site in burn patients. The results showed that local irradiation of red laser accelerates wound healing process significantly.
Subject(s)
Burns/radiotherapy , Burns/surgery , Low-Level Light Therapy/methods , Skin Transplantation , Ulcer/radiotherapy , Ulcer/surgery , Wound Healing/radiation effects , Adult , Case-Control Studies , Female , Humans , Iran , Male , Tissue DonorsABSTRACT
Present study aims to assess aflatoxin M1 (AFM1) contamination in 100 samples of pasteurized milk which were conventionally gathered during spring, summer, autumn, and winter from supermarkets located in Maragheh city of northwestern Iran. Samples were evaluated for AFM1 with a high-performance liquid chromatography (HPLC) method and with fluorimetric detection. The results showed that approximately 44% (11.25) of samples in winter, 32% (8.25) of samples in spring, 24% (6.25) of samples in summer, and 20% (5.25) of samples in autumn had AFM1 concentrations that exceeded the limit (0.05 µg/l) set by the European, Codex Alimentarius Commission and Iran standards. According to the statistical analysis of the data, there was no significant variation between the mean content of AFM1 during different seasons (P = 0.076). The results of our study suggest a high level of contamination of AFM1 in pasteurized milk in all seasons which may be due to the fact that milk supply for dairy factories is provided from dairy farms that are low in livestock feed quality. In Iran, pasteurized milk is consumed more than other milk products by all age groups. The total daily aflatoxin intake from contaminated milk and possibly other food products will be a significant risk to public health.
Subject(s)
Aflatoxin M1/analysis , Food Contamination/analysis , Milk/chemistry , Animals , Chromatography, High Pressure Liquid/methods , Iran , SeasonsABSTRACT
Significant populations in burn centers are diabetic burn patients. Healing process in these patients is more difficult due to diabetes complications. The gold standard treatment for patients with grade 3 burn ulcer is split-thickness skin grafting (STSG), but in the diabetic patients, the rate of graft failure and amputation is high due to impaired tissue perfusion. The technique of low level laser therapy (LLLT) improves tissue perfusion and fibroblast proliferation, increases collagen synthesis, and accelerates wound healing. The purpose of this case report is introducing a new therapeutic method for accelerating healing with better prognosis in these patients. The protocols and informed consent were reviewed according to the Medical Ethics, Board of Shahid Beheshti Medical Sciences (IR.SBMU.RAM.REC.13940.363). Diabetic type 2 patients with 13 grade 3 burn ulcers, candidate for amputation, were enrolled in the study. We used a 650-nm red laser light, 2 J/Cm for the bed of the ulcer and an 810-nm infrared laser light 6 J/Cm(2) for the margins along with intravenous laser therapy with a 660-nm red light, before and after STSG for treating grade 3 burn ulcers in 13 diabetic ulcers. The results of this study showed complete healing in the last 8 weeks for all patients who were candidates for amputation. In this case series, we present 13 cases of diabetic ulcer with type 3 burn wound, candidate for amputation, who healed completely using LLLT and STSG. This is the first time that these two techniques are combined for treatment of burn ulcer in diabetic patients. Using LLLT with STSG might be a promising treatment for burn victims especially diabetic patients.
Subject(s)
Burns/radiotherapy , Diabetes Mellitus, Type 2/complications , Leg Ulcer/radiotherapy , Low-Level Light Therapy , Adult , Female , Humans , Male , Middle Aged , Prognosis , Skin Transplantation , Wound Healing/radiation effectsABSTRACT
The poultry industry is one of the fastest growing industries in the world. Poultry breeding has developed significantly to meet the food needs of the increasing population and it is expected that this growth will continue in the coming years. Prevalent poultry diseases are of great importance as they are responsible for vast economic losses and public health concerns. They also affect the national and international trade of the poultry products. This review will provide a quick and general view of different important poultry diseases for poultry breeders, scientists and decision makers. Based on this review, Campylobacteriosis and infectious bursal disease [IBD] in the Asian continent, and Campylobacteriosis, Newcastle disease [ND] and coccidiosis in the African continent were the most prevalent diseases. In Europe, Campylobacter species and in America, Escherichia coli species are widespread in poultry meat. Infectious Bronchitis [IB] in Europe and Coccidiosis in America were high-incident.
ABSTRACT
Pro-and prebiotics have been indicated to modulate the gut-brain axis, which have supportive impacts on central nervous systems, and decrease or control the incidence of some mental disorders such as depression, anxiety, autism, Schizophrenia, and Alzheimer's. In this review, complex communications among microbiota, gut, and the brain, and also recent scientific findings of the impacts and possible action mechanisms of pro-and prebiotics on mental disorders have been discussed. The results have shown that pro-and prebiotics can improve the function of central nervous system and play an important role in the prevention and treatment of some brain disorders; however, in order to prove these effects conclusively and firmly and to use these compounds in a therapeutic and supportive way, more studies are needed, especially human studies/clinical trials.
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Currently, many advances have been made in avoiding food contamination by numerous pathogenic and toxigenic microorganisms. Many studies have shown that different probiotics, in addition to having beneficial effects on the host's health, have a very good ability to eliminate and neutralize pathogens and their toxins in foods which leads to enhanced food safety. The present review purposes to comprehensively discuss the role of probiotics in improving food safety by inactivating pathogens (bacterial, fungal, viral, and parasite agents) and neutralizing their toxins in food products. Some recent examples in terms of the anti-microbial activities of probiotics in the body after consuming contaminated food have also been mentioned. This review shows that different probiotics have the potential to inactivate pathogens and neutralize and detoxify various biological agents in foods, as well as in the host body after consumption.
ABSTRACT
Background: Split-thickness skin grafting (STSG) is a standard therapeutic technique in patients with extensive and deep ulcers. Hospitalization and surgery can result in complications, especially in children. Photobiomodulation (PBM) has been applied in a variety of conditions such as healing of surgical, venous, pressure, and diabetic wounds, but no clinical trial using this method for healing of burn ulcers in children was found on searching the literature. The aim of the study was to evaluate the effect of PBM on the outcome of burn ulcers in children. Materials and methods: Informed consent and protocols were reviewed according to Shahid Beheshti University of Medical Sciences' Medical Ethics Board (IR.SBMU.REC.1394.363) and the Iranian Registry of Clinical Trials (IRCT2016011726069N1). Forty children with deep burn ulcers, who were candidates for STSG, were divided into PBM and STSG groups. A 650-nm laser (power 150 mW, spot size 0.6 cm2, time 10 sec, and energy point 1.5 J) was used for irradiation over the burn area every other day until complete healing in the PBM group. STSG was performed in the STSG group. All other therapeutic care protocols were identical. Results: Thirty-nine children completed the study. The mean ulcer size in the two groups was similar before treatment (PBM = 60.72 cm2 ± 13.8 and STSG = 63.74 ± 7.6). In the PBM group, all wounds healed within 10-12 sessions. Analysis of the burn area was performed 1, 3, and 6 months after injury. There was a significant difference (t test) in the burn area after 6 months in the PBM group compared with the STSG group (t test; p > 0.001). Conclusions: This is the first study to compare PBM and STSG in burn ulcers in children. Results indicated that PBM was an effective alternative to STSG, significantly decreasing the rate of scar and hypertrophic scar formation. Potential mechanisms of PBM that may be involved in burn tissue repair are discussed.
Subject(s)
Burns , Ulcer , Burns/complications , Burns/radiotherapy , Burns/surgery , Child , Humans , Iran , Prognosis , Skin Transplantation/methods , Ulcer/surgery , Wound Healing/radiation effectsABSTRACT
The addition of prebiotics to bread is one of the most important ways to improve its techno-functional properties. In this study, the effects of resistant starch, polydextrose, and inulin on wheat flour, dough, and bread properties were investigated. The farinography results showed that resistant starch significantly increased the development time (2:18) via a boosting effect; however, polydextrose (1:48) and inulin (1:36) weakened the dough (p < 0.05). Inulin, polydextrose, and resistant starch had the greatest effect on reducing water absorption (40, 43.2, and 48.9), respectively, (p < 0.05). According to extensography data, the addition of inulin produced the best result in baking compared to other polysaccharides. In terms of baked breads, the samples containing resistant starch had high moisture content that could be due to starch gelatinization and moisture-retention, which delays the staling process of the bread. Inulin, polydextrose, and resistant starch prebiotic ingredients affected the rheological properties of the dough, overall bread quality and organoleptic characteristics; however, resistant starch was the best prebiotic used in this study.
ABSTRACT
INTRODUCTION: Considering that the use of aromatase inhibitors in the treatment of infertile men is a new approach and obesity in men is one of the factors affecting infertility, we decided to compare the effect of combined therapy of Human chorionic gonadotropin (HCG) and Letrozole and either of the two methods alone on the spermogram parameters in obese men with idiopathic infertility. MATERIALS AND METHODS: This clinical trial study was performed with the participation of 15 infertile and obese men from 2018 to 2019 in Tabriz (infertility clinics); Patients were randomly divided into three groups; The first group received treatment with Letrozole 2.5 mg daily alone, the second group received treatment with HCG ampoules at a dose of 5000 units twice a week, and the third group received combination therapy with HCG ampoules at a dose of 5000 units twice a week and letrozole tablets at a dose of 2.5 mg daily; The results of testosterone and sperm tests before and after the intervention were evaluated by t-test and linear regression tests in SPSS21 software. A p-value less than 0.05 was considered significant. RESULTS: There was no statistically significant difference between semen indices and hormones studied before the intervention (P < 0.05), while after the intervention there were statistically significant differences between all variables compared to those before the intervention (P < 0.05); Also, the rate of change in the third group was much more favorable than the other two groups. CONCLUSION: The combination of HCG ampules with letrozole tablets compared to the use of these drugs alone improved sperm count, sperm motility, and sperm morphology.
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BACKGROUND: MicroRNAs (miRNAs) are about 22-nucleotide, small, noncoding RNAs that control gene expression post-transcriptionally. Helminth parasites usually express a unique repertoire of genes, including miRNAs, across different developmental stages with subtle regulatory mechanisms. OBJECTIVE: There is a necessity to investigate the involvement of miRNAs in the development of parasites, host-parasite interaction, immune evasion and their abilities to govern infection in hosts. MiRNAs present in helminth parasites have been summarized in the current systematic review (SR). METHODS: Electronic databases, including PubMed, Scopus, ProQuest, Embase, and Google Scholar search engine, were searched to identify helminth miRNA studies published from February 1993 till December 2019. Only the published articles in English were included in the study. RESULTS: A total of 1769 articles were preliminarily recorded. Following the strict inclusion and exclusion criteria, 105 studies were included in this SR. Most of these studies focused on the identification of miRNAs in helminth parasites and/or probing of differentially expressed host miRNA profiles in specific relevant tissues, while 12 studies aimed to detect parasite-derived miRNAs in host circulating system and 15 studies characterized extracellular vesicles (EV)-derived miRNAs secreted by parasites. CONCLUSION: In the current SR, information regarding all miRNAs expressed in helminth parasites has been comprehensively provided and the utility of helminth parasitesderived miRNAs in diagnosis and control of parasitic infections has been discussed. Furthermore, functional studies on helminth-derived miRNAs have also been presented.
Subject(s)
Helminths , MicroRNAs , Parasites , Animals , Helminths/genetics , Helminths/metabolism , MicroRNAs/genetics , MicroRNAs/metabolism , Parasites/genetics , Parasites/metabolism , RNA, Helminth/genetics , RNA, Helminth/metabolismABSTRACT
BACKGROUND: Oleaster or Elaeagnus angustifolia is a deciduous plant from Elaegnacea family and is well-known for its remedial applications. OBJECTIVE: This paper presents a comprehensive review of the potential application of Oleaster's flour incorporated in some food products. Emphasis is given to the physicochemical, biochemical, and functional properties of Oleaster's flour. METHODS: A comprehensive search was carried out to find publications on Oleaster's flour and its application as a prebiotic. The results of the related studies were extracted and summarized in this paper. RESULTS: Oleaster's flour as a prebiotic ingredient enhances antioxidants, polyphenols, fiber, flavonoids, Sterols, carbohydrates, and protein content of food products. CONCLUSION: Further advanced investigations on Oleaster and its functional ingredients revealed that these are efficacious and can be applied as a substitute source in pharmacological industries for medical applications.
Subject(s)
Elaeagnaceae , Ethnobotany/methods , Flour/analysis , Plant Extracts/analysis , Prebiotics/analysis , Animals , Anti-Inflammatory Agents/administration & dosage , Anti-Inflammatory Agents/analysis , Anti-Inflammatory Agents/chemistry , Antioxidants/administration & dosage , Antioxidants/analysis , Antioxidants/chemistry , Cardiotonic Agents/administration & dosage , Cardiotonic Agents/analysis , Cardiotonic Agents/chemistry , Elaeagnaceae/chemistry , Flavonoids/administration & dosage , Flavonoids/analysis , Flavonoids/chemistry , Humans , Plant Extracts/administration & dosage , Plant Extracts/chemistry , Polyphenols/administration & dosage , Polyphenols/analysis , Polyphenols/chemistry , Prebiotics/administration & dosageABSTRACT
Recent evidence suggests that, in some foci, elimination of onchocerciasis from Africa may be feasible with mass drug administration (MDA) of ivermectin. To achieve continental elimination of transmission, mapping surveys will need to be conducted across all implementation units (IUs) for which endemicity status is currently unknown. Using boosted regression tree models with optimised hyperparameter selection, we estimated environmental suitability for onchocerciasis at the 5 × 5-km resolution across Africa. In order to classify IUs that include locations that are environmentally suitable, we used receiver operating characteristic (ROC) analysis to identify an optimal threshold for suitability concordant with locations where onchocerciasis has been previously detected. This threshold value was then used to classify IUs (more suitable or less suitable) based on the location within the IU with the largest mean prediction. Mean estimates of environmental suitability suggest large areas across West and Central Africa, as well as focal areas of East Africa, are suitable for onchocerciasis transmission, consistent with the presence of current control and elimination of transmission efforts. The ROC analysis identified a mean environmental suitability index of 0·71 as a threshold to classify based on the location with the largest mean prediction within the IU. Of the IUs considered for mapping surveys, 50·2% exceed this threshold for suitability in at least one 5 × 5-km location. The formidable scale of data collection required to map onchocerciasis endemicity across the African continent presents an opportunity to use spatial data to identify areas likely to be suitable for onchocerciasis transmission. National onchocerciasis elimination programmes may wish to consider prioritising these IUs for mapping surveys as human resources, laboratory capacity, and programmatic schedules may constrain survey implementation, and possibly delaying MDA initiation in areas that would ultimately qualify.
Subject(s)
Disease Eradication , Onchocerciasis/epidemiology , Africa/epidemiology , Environment , Forecasting , Humans , Ivermectin/administration & dosage , Mass Drug Administration , Onchocerciasis/drug therapy , Onchocerciasis/transmission , ROC CurveABSTRACT
BACKGROUND: Probiotics and their nutrient sources (prebiotics) have been shown to have positive effects on different organs of the host. The idea of their potential benefits on Central Nervous Systems (CNS) and the incidence of Anxiety, Schizophrenia, Alzheimer, Depression, Autism, and other mental disorders has proposed a new category of medicines called "psychobiotic" which is hoped to be of low-side effect anti-inflammatory, antidepressant, and anti-anxiety constitutes. OBJECTIVE: In the current review, we present valuable insights into the complicated interactions between the GI microbiota (especially in the colon), brain, immune and central nervous systems and provide a summary of the main findings of the effects of pro- and prebiotics on important mental disorders from the potential mechanisms of action to their application in clinical practice. METHODS: Google Scholar, Pub Med, Scopus, and Science Direct databases were searched using following key words: "probiotics", "prebiotics", "mental disorders", "psychological disorders", "depression", "anxiety", "stress", "Alzheimer" and "autism spectrum". The full text of potentially eligible studies was retrieved and assessed in detail by the reviewers. Data were extracted and then summarized from the selected papers. RESULTS: The results of the provided evidence suggest that probiotic and prebiotics might improve mental function via several mechanisms. The beneficial effects of their application in Depression, Anxiety, Alzheimer and autism spectrum diseases have also been supported in clinical studies. CONCLUSION: Pro and prebiotics can improve mental health and psychological function and can be offered as new medicines for common mental disorders, however, more clinical studies are necessary to conduct regarding the clinical significance of the effects and their bioequivalence or superiority against current treatments.
Subject(s)
Alzheimer Disease/drug therapy , Antidepressive Agents/therapeutic use , Anxiety/drug therapy , Autism Spectrum Disorder/drug therapy , Depression/drug therapy , Prebiotics , Probiotics/therapeutic use , Alzheimer Disease/microbiology , Anxiety/microbiology , Autism Spectrum Disorder/microbiology , Depression/microbiology , Gastrointestinal Tract/drug effects , Gastrointestinal Tract/microbiology , Humans , Mental Health , Microbiota/drug effectsABSTRACT
BACKGROUND: Probiotics can be used for the treatment of viral gastroenteritis. OBJECTIVE: This systematic review is to evaluate the evidence regarding the effect of probiotics on human cases of viral gastroenteritis. METHODS: The objective of this review is to evaluate the effectiveness of probiotics against placebo or standard treatment for viral gastroenteritis. A comprehensive search of Cochrane Library, EMBASE, MEDLINE via PubMed and Ovid databases, and unpublished studies (till 27 January 2018) was conducted followed by a process of study selection and critical appraisal by two independent reviewers. Randomized controlled trials assessing probiotic administration in human subjects infected with any species of gastroenteritis viruses were considered for inclusion. Only studies with a confirmed viral cause of infection were included. This study was developed using the JBI methodology for systematic reviews, which is in accordance with the PRISMA guideline. Meta-analysis was conducted where feasible. Data were pooled using the inverse variance method with random effects models and expressed as Mean Differences (MDs) with 95% Confidence Intervals (CIs). Heterogeneity was assessed by Cochran Q statistic and quantified by the I2 statistic. We included 17 RCTs, containing 3,082 patients. RESULTS: Probiotics can improve symptoms of viral gastroenteritis, including the duration of diarrhea (mean difference 0.7 days, 95% CI 0.31 to 1.09 days, n = 740, ten trials) and duration of hospitalization (mean difference 0.76 days, 95% CI 0.61 to 0.92 days, n = 329, four trials). CONCLUSION: The results of this review show that the administration of probiotics in patients with viral gastroenteritis should be considered.
Subject(s)
Diarrhea/drug therapy , Gastroenteritis/drug therapy , Probiotics/therapeutic use , Dietary Supplements , Gastroenteritis/virology , Humans , Randomized Controlled Trials as Topic , Rotavirus Infections/drug therapy , Rotavirus Infections/virology , Treatment OutcomeABSTRACT
BACKGROUND: Crimean Congo Hemorrhagic Fever (CCHF) is an acute and fatal disease with various clinical and paraclinical characteristics. INTRODUCTION: In this article, we report data on confirmed CCHF cases from Iran and describe the association between studying factors and outcomes of the disease. METHODS: In the study design, we evaluated demographic characteristics, clinical, laboratory and sonographic findings of 160 CCHF confirmed cases during 2003 and 2012 in Zabol (A city in Sistan and Baluchestan province of Iran). The association between these factors and the fatal outcome were evaluated by regression analysis. RESULTS: The disease had a fatal outcome in 7 (4.4%) patients. Females had more severe symptoms and higher odds for death (odds ratio11.57, p=0.005). Leukocytosis (p<0.001), PT (p<0.001) and PTT (p=0.008) elongation, AST (p=0.010) and ALT (p>0.001) elevation were significantly associated with fatal outcome. CNS related symptoms (odds ratio 5.9, p=0.027) in clinical examination and ascites (odds ratio 38.4, p=0.012) and liquid in the pelvic cavity (odds ratio 24.2, p=0.004) were also identified as risk factors of death in this study. CONCLUSION: Our data suggest that in addition to clinical and laboratory findings practitioners consider sonography for CCHF prognosis.