The association of dietary total antioxidant capacity and gestational diabetes: a prospective cohort study from the Mothers and their children's health (MATCH).

BACKGROUND/OBJECTIVES: There is evidence to support the hypothesis that a diet rich in antioxidants can help safeguard against the development of gestational diabetes mellitus (GDM). This study aimed to investigate the association between dietary total antioxidant capacity (DTAC) during early pregnancy and the risk of GDM. SUBJECTS/METHODS: We included 1856 pregnant women in their first trimester from the Mothers and their Children's Health (MATCH) prospective cohort study. Prepregnancy dietary intake was assessed using a validated food frequency questionnaire (FFQ) and was used to calculate the DTAC score. Incident GDM was diagnosed based on the American Diabetes Association criteria. We estimated the association between DTAC and GDM using propensity score-based inverse probability weighting (IPW). RESULTS: Overall, 369 (14.6%) of the pregnant women were identified with GDM. The mean DTAC score and the corresponding standard deviation (SD) was 2.82± (2.56) mmol/100 g, with a range of 0.01 to 18.55. The adjusted risk of GDM decreased by 34% (95% CI = 10%, 52%, p = 0.023) for each DTAC score increase. The results showed that women in the highest quartile of DTAC had a lower risk of developing GDM compared to those in the lowest quartile (adjusted RR: 0.29, 95% CI: 0.12, 0.68, p = 0.005). CONCLUSION: DTAC in early pregnancy is significantly associated with a lower risk of GDM. Additional larger cohort studies are needed to validate these findings.

The effects of web-based education on health-promoting behaviors of first-year medical sciences students: A quasi-experimental study.

BACKGROUND: Students, as a representative of young adults, are at risk for engagement in unhealthy lifestyle behaviors such as unhealthy eating, unhealthy relationships, and drug abuse. Health-promoting lifestyle (HPL) largely depends on adequate knowledge of healthy behaviors and hence, education is a strategy with potential positive effects on lifestyle. This study aimed at evaluating the effects of web-based education (WBE) on HPL among first-year medical sciences students. MATERIALS AND METHODS: This quasi-experimental study was conducted in 2020 with a single-group pretest-posttest design. Participants were 185 first-year bachelor's and doctoral medical sciences students selected from Babol University of Medical Sciences, Babol, Iran, through multistage sampling. Study intervention was a three-week web-based educational program on HPL. Educational videos about the different components of HPL were sent to participants through WhatsApp. Data were collected before, one month after, and three months after the study intervention through the Health-Promoting Lifestyle Profile (HPLP2) and the General Health Questionnaire (GHQ). The STATA software (v. 16.0) was used for data analysis. RESULTS: Among 185 participants, 154 (83.69%) participants completed the study. The mean scores of HPL and its health responsibility and stress management subscales significantly increased by 4.58 (95% CI: 0.12, 9.04), 1.77 (95% CI: 0.39, 3.15), and 0.71 (95% CI: 0.13, 1.26), respectively. However, the mean scores of the nutrition, interpersonal relations, physical activity, and self-actualization subscales of HPL and the mean score of general health did not significantly change (P > 0.05). CONCLUSION: WBE has significant positive effects on HPL and its health responsibility and stress management subscales. Therefore, WBE through social media can be used to improve HPL among young adults, particularly students.

Regulatory miR-SNP rs4636297A > G in miR-126 is linked to increased risk of rigidity feature in patients with Parkinson's disease.

INTRODUCTION: A growing body of strong evidence shows that the dysfunction of miRNAs plays key roles in the development and progression of Parkinson's disease (PD), however, little data has been reported on the association of their SNPs with PD susceptibility. In this study, we investigated the association of regulatory miR-SNP rs4636297A > G with a functional effect on the expression of miRNA-126, as a key dysregulated miRNA in the PD, with the susceptibility and clinical features of the PD. METHODS AND MATERIALS: In current study, we included a population consisting of 120 patients with PD and 120 clinically healthy individuals, and their blood samples were taken. After extracting the DNAs, the genotyping of the miR-SNP rs4636297A > G was done through RFLP-PCR technique. Finally, the association of this SNP with the risk and clinical features of PD was determined. RESULTS: Although the results showed that the two groups did not differ significantly in terms of allelic and genotype frequencies, it was clinically found that individuals with genotypes carrying the minor allele G (AG and GG genotypes) of the miR-SNP rs4636297A > G had an increased risk of developing rigidity feature in the PD compared to its homozygous major AA genotype (GG genotype; OR = 5.14, p = 0.038 & GA genotype; OR = 4.32, p = 0.032). CONCLUSION: We report for the first time a significant association of functional regulatory SNP rs4636297A > G in the miR-126 with the Parkinson's clinicopathology. Therefore, this miR-SNP can have a potential predictive biomarker capacity for rigidity in PD, although this hypothesis needs further investigation in the future.

The Effect of Yoga Practice on Labor Pain: A Systematic Review and Meta-Analysis.

Background: Labor pain management is a critical aspect of midwifery care and an essential purpose of childbirth-related care. There is a need for comprehensive results on relevant non-therapeutic methods of reducing labor pain. This systematic review and meta-analysis study was conducted to investigate the effect of yoga practice on labor pain. Material and Methods: We performed a systematic literature search from SCOPUS, PubMed, Web of Science, and Science Direct for relevant studies from January 1, 1990 to June 2, 2022. We selected published quasi-randomized and randomized controlled trial studies that evaluated the effect of yoga practice on labor pain. Quality research was applied. We pooled the Standardized Mean Dfference (SMD) of labor pain in pregnant women with and without yoga practice during pregnancy using a random-effects model at 95% Confidence Intervals (CIs). Results: Nine studies including 660 women were included in the meta-analysis. Pregnant women in the yoga practice group experienced statistically significantly low labor pain at the beginning of the active phase compared to the control group (SMD: -1.10, 95% CI: -1.61, -0.58, p < 0.001; I2 = 89%). Yoga interventions also reduced the intensity of labor pain in active (SMD: -1.32, 95% CI: -2.03, -0.60, p < 0.001; I2 = 92%) and transition (SMD: -1.93, 95% CI: -2.87, -0.99, p < 0.001; I2 = 92%) phases compared to the control group, respectively. Conclusions: The results of the study showed that yoga practice during pregnancy reduces the intensity of labor pain in different labor phases. However, these findings should be considered cautiously due to the substantial heterogeneity between studies.

The potential causal effect of the pre-pregnancy dietary phytochemical index on gestational diabetes mellitus: a prospective cohort study.

BACKGROUND: Phytochemicals are non-nutritive bioactive compounds with beneficial effects on the metabolism of glucose. This study aimed to clarify the possible causal effect of the pre-pregnancy dietary phytochemical index (DPI) on gestational diabetes mellitus (GDM). METHODS: In this prospective cohort study 1,856 pregnant women aged 18-45 years who were in their first trimester, were recruited and followed up until delivery. The dietary intakes of participants were examined using an interviewer-administered validated 168-item semi-quantitative food frequency questionnaire (FFQ). Inverse probability weighting (IPW) of propensity scores (PS), estimated from the generalized boosted model (GBM) were used to obtain a adjusted risk ratio (aRR) for potential confounders. RESULTS: During the follow-up period, 369 (19.88%) women were diagnosed with GDM. DPI scores ranged from 6.09 to 89.45. There was no association between DPI scores and GDM (aRR: 1.01, 95% confidence interval [CI]: 0.92, 1.08; p trend = 0.922). When comparing DPI quartile 4 (most pro-phytochemical content) to quartile 1 (few phytochemical contents), there was no significant difference between them (aRR: 0.97; 95% CI: 0.75, 1.25; p = 0.852). Also, there was no significant difference between DPI quartile 3 and quartile 1 (aRR: 1.04; 95% CI: 0.81, 1.34; p = 0.741) as well as DPI quartile 2 and quartile 1 (aRR: 0.92; 95% CI: 0.71, 1.21; p = 0.593). CONCLUSIONS: Although this data did not support the association between pre-pregnancy DPI scores and GDM, further cohort studies to ascertain the causal association between them are warranted.

Association between Alzheimer's disease and Toxocara infection/exposure: a case-control study.

BACKGROUND: Infections may contribute to Alzheimer's disease (AD) risk. Limited evidence suggests Toxocara spp. infection/exposure could influence AD development. METHODS: We investigated Toxocara seropositivity and AD in Iranian adults using a matched case-control study. Our sample included 90 AD cases and 91 healthy older adults. Anti-Toxocara immunoglobulin G (IgG) antibodies were assessed via enzyme-linked immunosorbent assay. We computed the odds ratios (ORs) and 95% confidence intervals (CIs) through univariable and multivariable analyses, adjusting for potential confounders. RESULTS: There were 33/90 (36.67% [95% CI 26.75 to 47.48]) anti-Toxocara IgG seropositive individuals identified among the AD cases and 21/91 (23.07% [95% CI 14.89 to 33.09]) among the healthy controls. In univariable analysis, a significant association was identified between anti-Toxocara IgG seropositivity and AD (OR 1.93 [95% CI 1.01 to 3.69], p<0.001). Moreover, the association remained significant (OR 2.18 [95% CI 1.05 to 4.49], p<0.001) in multivariable analysis after adjustment for covariates. There was no association between anti-Toxocara IgG seropositivity and the severity of AD (OR 0.75 [95% CI 0.21 to 2.61], p=0.47). CONCLUSIONS: Our findings indicated that Toxocara exposure/infection could be a potential risk factor for development of AD. To better understand a real causality between Toxocara exposure/infection and AD and related dementias, follow-up designed and adequately powered studies are needed.

Association between insulin resistance and multiple sclerosis: a systematic review and meta-analysis.

There is increasing evidence of metabolic perturbations in multiple sclerosis (MS) patients, and insulin is an important parameter that has controversial effects on neurological disease. Therefore, this systematic review and meta-analysis study aimed to explore the association between insulin resistance (IR) and MS as well as insulin levels and MS. Three electronic databases, including Medline, Scopus, and the Web of Science, were examined up to 26 May 2023 for observational studies. Two independent reviewers assessed the studies according to a pre-specified protocol. Random-effects model using a Restricted-maximum Likelihood (REML) estimator was used to meta-analyze the association between IR [assessed by Homeostatic Model Assessment (HOMA-IR)], insulin and MS. Eighteen datasets from 2012 to 2022 were included in this meta-analysis. The standardized mean difference (SMD) for comparison IR and insulin between MS and healthy control group as outcomes 1 and 2 were 0.78 and 0.72 respectively. Furthermore, for outcome 1, we observed a greater effect size in studies that recruited different types of MS (Mix) (SMD: 1.09) than in those that included only relapsing-remitting MS (RRMS) (SMD: 0.59). The meta-analysis revealed a significant association between IR, insulin and MS, with stronger associations in studies that recruited mixed patients. However, high heterogeneity has been observed in the present study. Therefore, more studies are needed to confirm the association between these parameters and MS.

Do health-promoting lifestyle approaches manage mental health among adolescent/young college students?

OBJECTIVES: College students are often still relatively young, making their mental health more likely to be overlooked. A healthy lifestyle is considered the key to preventing and controlling mental health problems nowadays. This study aimed to investigate whether health-promoting lifestyle approaches manage mental health among adolescent/young college students. METHODS: This cross-sectional study was conducted on 187 adolescent/young college students at Babol Medical Science University, Babol, Iran. Characteristic demographics, health-promoting lifestyle profile (HPLP), and general health questionnaire-28(GHQ-28) were filled out by students. The data were analyzed using correlation coefficient and simple and multiple linear regressions. RESULTS: The majority of participants were adolescents (66.8%), single (97.9%), and bachelor's students (70.1%). The mean of the HPLP and GHQ scores was 125.09±18.12, and 33.58±10.50, respectively. HPLP was a negative significant predictor of mental health (ß = -.261, P= .0001). There was a negative significant association between HPLP dimensions (except physical activity) and mental health. After adjusting for other variables, there was a significant relationship between HPLP with mother occupation (ß =.186, P=.038), and mother education (ß = -.219, P= .034). Furthermore, gender (ß = .175, P= .031), and occupation (ß =-.157, P= .040) were predictors of GHQ in adolescent/young college students. CONCLUSIONS: Regarding the health-promoting lifestyle situation among students and its relation with the better mental health, the design and implementation of HPLP education programs is recommended.

Midwife-led psycho-education intervention to reduce childbirth fear: a quasi-experimental study.

This quasi-experimental study aimed to assess the impact of a midwife-led psycho-education intervention on reducing fear of childbirth (FOC) and perceived stress (PS) in pregnant women. The present study involved 96 pregnant women. The intervention group received three 30-45 min telephone sessions using 'BELIEF' (Birth Emotion-Looking to Improve Expectant Fear) psycho-education approach. The outcomes were assessed using questionnaires on childbirth attitudes and PS. Data analysis was performed using Stata version 17. In the intervention group, the mean score for FOC decreased from 39.41 ± 7.02 to 29.91 ± 5.60 (9.5; 24.1%). The mean difference (MD) of 28.22% was statistically significant (adjusted MD: -10.51, 95% CI: -11.60, -9.41, P < 0.001). In the intervention group, mean scores for PS decreased from 22.77 ± 6.94 to 18.23 ± 5.69 (4.54; 19.93%). In the control group, scores increased from 22.68 ± 6.76 to 24.82 ± 6.58 (2.14; 9.43%). The 29.36% MD was statistically significant (aMD: -6.95, 95% CI: -8.73, -5.18, P < 0.001). The findings of this study indicate that the midwife-led psycho-education intervention, utilizing the 'BELIEF' protocol over the telephone, has a significant effect on reducing FOC and PS, as well as increasing the preference for vaginal birth.

The global prevalence of Trichuris trichiura infection in humans (2010-2023): A systematic review and meta-analysis.

This systematic review and meta-analysis study aimed to evaluate global Trichuris infection prevalence, assessing progress towards the WHO's 2030 target. We searched international databases from 2010-2023, categorizing data by regions and socio-economic variables using a random-effects model. Analyzing 757 articles covering 7154,842 individuals from 78 countries, the study found a pooled global prevalence of (6.64-7.57%), with the highest rates in the Caribbean (21.72%; 8.90-38.18%) and South-East Asia (20.95; 15.71-26.71%) regions. Southern Africa (9.58; 2.11-21.46%), Latin America (9.58; 2.11-21.46%), and Middle Africa Middle Africa (8.94; 6.31-11.98%) also exhibited high prevalence. Eastern Europe had the lowest prevalence at 0.16% (0.09-0.24). Approximately 513 (480-547) million people worldwide were estimated to harbor Trichuris. Moreover ∼1.5% of people tested worldwide (2010-2023) had a moderate to heavy intensity of infection. The study emphasizes the persistent global health threat of Trichuris infection, urging tailored strategies for effective control and prevention on a global scale.

The clinical efficacy of Olibanum gum chewing in patients with Mild-to-Moderate Alzheimer disease: A randomized Parallel-Design controlled trial.

BACKGROUND: Alzheimer's disease is a common neurodegenerative disorder in elderly with progressive decline in cognitive functions. This study aimed to investigate the possible memory-improving effects of Olibanum on patients with Alzheimer's disease. RESEARCH DESIGN AND METHOD: This double-blind, randomized clinical trial was carried out on 72 participants aged 50-75 years. The intervention group (n = 36) received 1.6 g/day of olibanum chewing gum for 18 weeks. The placebo group (n = 36) received chewing gum without olibanum. Neuropsychological assessments were performed at baseline, every 4 weeks, and after 18 weeks of the intervention. RESULTS: There was no significant difference between (MD: 0.84, 95%CI: -1.10 to 2.78, p = 0.392) at baseline. Both groups had linear improvements over time. There was no significant difference between two groups regarding the improvements after the intervention (F = 0.157, p = 0.693). There were no significant differences between the groups for MMSE score (Mini-Mental State Examination) after the intervention (F = 0.141, p = 0.708). CONCLUSIONS: This study revealed that 18 weeks of gum chewing with Olibanum did not change the neuropsychological status. More clinical studies are needed to confirm these findings.

Hepatitis C infection seroprevalence in pregnant women worldwide: a systematic review and meta-analysis.

Background: Monitoring progress towards the WHO global target to eliminate hepatitis C virus (HCV) infection by 2030, entails reliable prevalence estimates for HCV infection in different populations. Little is known about the global burden of HCV infection in pregnant women. Here, for the first time to our knowledge, we estimated the global and regional seroprevalence of HCV antibody (Ab) and determinants in pregnant women. Methods: In this systematic review and meta-analysis study, we searched PubMed/MEDLINE, Web of Science, Embase, Scopus, and SciELO databases for peer-reviewed observational studies between January 1, 2000 and April 1, 2023, without language or geographical restrictions. Pooled global seroprevalence (and 95% confidence interval, CI) were estimated using random-effects meta-analysis and seroprevalences were categorised according to World Health Organization regions and subregions, publishing year, countries' income and human development index (HDI) levels. We used sensitivity analysis to assess the effect of four large sample size studies on pooled global prevalence through the "leave-one-out" method. We also investigated the association of potential risk factors with HCV seropositivity in pregnant women by subgroup and meta-regression analyses. The Protocol was registered in PROSPERO CRD42023423259. Findings: We included 192 eligible studies (208 datasets), with data for 148,509,760 pregnant women from 53 countries. The global seroprevalence of HCV Ab in pregnant women was 1.80% (95% CI, 1.72-1.89%) and 3.29% (3.01-3.57%) in overall and sensitivity analyses, respectively. The seroprevalence was highest in the Eastern Mediterranean region (6.21%, 4.39-8.29%) and lowest in the Western Pacific region (0.75%, 0.38-1.22%). Subgroup analysis indicated that the seroprevalence of HCV Ab among pregnant women was significantly higher for those with opioid use disorder (51.94%, 95% CI: 37.32-66.39) and HIV infection (4.34%, 95% CI: 2.21-7.06%) than for the general population of pregnant women (1.08%, 95% CI: 1.02-1.15%), as confirmed by multivariable meta-regression (p < 0.001). A significant decreasing trend was observed with increasing human development index levels. Other important risk factors for HCV seropositivity included older age, lower educational levels, poly sexual activity, history of blood transfusion, hospitalization, surgery, abortion and sexual transmitted diseases, having scarification/tattoo or piercing, and testing hepatitis B positive. Interpretation: This meta-analysis showed relatively high burden of exposure to HCV infection (2.2-5.3 million) in pregnant women globally. However, due to substantial heterogeneity between studies, our estimates might be different than the true seroprevalence. Our findings highlighted the need to expand HCV screening for women of reproductive age or during pregnancy, particularly in countries with high prevalence; as well as for more studies that assess safety of existing therapeutic drugs during pregnancy or potentially support development of drugs for pregnant women. Funding: There was no funding source for this study.

Relationship between fine particulate matter (PM2.5) concentration and risk of hospitalization due to chronic obstructive pulmonary disease: a systematic review and meta-analysis.

BACKGROUND: Short-term exposure to PM2.5 has been associated with human health risks. However, evidence on the association between short-term exposure to PM2.5 and the risk of chronic obstructive pulmonary disease (COPD) remains limited and controversial. This study aimed to specifically assess the relationship between exposure to PM2.5 and the risk of hospitalization due to COPD. METHODS: A systematic search was conducted in PubMed, Web of Science, and Google Scholar databases from January 1, 2010 to May 1, 2022. The odds ratio (OR) statistic was calculated as a common measure of effect size. Publication bias was also examined in all eligible studies on COPD hospitalization using funnel plots and Egger's test, as well as trim-and-fill method for missing studies on COPD hospitalization. RESULTS: A total of 19 studies were included in this meta-analysis. Random-effects models were plotted to calculate the pooled effect size by measuring OR (χ2 = 349.95; df = 18; I2 = 94.86%; P = 0.007; Z = 2.68; P < 0.001). A 10-mg/m3 daily increase in PM2.5 concentration was associated with a 1.6% (95% CI: 0.4-2.9%) increase in COPD hospitalization. There was no publication bias regarding the association between COPD hospitalization and PM2.5 (bias = 1.508; 95% CI: -1.475, 4.491; t = 1.066; P = 0.301). The subgroups of age ≥ 65 years and Asian countries were associated with an increased risk of COPD hospitalization. Besides, higher risks were estimated in the subgroups of studies performed in the warm season, case-crossover studies, studies with three lag days, and studies without adjustments for humidity and temperature confounders, with very small heterogeneity. CONCLUSION: Evidence suggests that short-term exposure to PM2.5 increases COPD hospitalization. Further studies are needed to understand the mechanism of the association between PM2.5 and COPD for reducing air pollution, which can be beneficial for COPD patients.

Trichomonas vaginalis infection and risk of cervical neoplasia: A systematic review and meta-analysis.

OBJECTIVES: The evidence in the literature regarding the relationship between Trichomonas vaginalis (TV) infection and cervical neoplasia is conflicting. The main aim of this study was to evaluate the magnitude of the risk of cervical neoplasia associated with TV infection. METHODS: A meta-analysis of observational studies, which provided raw data on the association of TV infection with cervical neoplasia, was performed. For this aim, we searched scientific databases (PubMed/Medline, Scopus, the Web of Sciences, and Embase) from inception to March 15, 2023. A random-effects model was applied by Stata 17.0 to calculate the pooled and adjusted odds ratios (ORs) with 95% confidence intervals (CI), including subgroup, sensitivity, and cumulative analyses to explore sources of heterogeneity. RESULTS: Of the 2584 records initially identified, 35 eligible studies contributed data for 67,856 women with cervical neoplasia, and 933,697 healthy controls from 14 countries were included. The pooled (2.15; 1.61-2.87; I2 = 87.7%) and adjusted (2.17; 1.82-2.60; I2 = 31.27%) ORs indicated a significant positive association between TV infection and the development of cervical neoplasia. There was no significant change in pooled and adjusted ORs by applying sensitivity and cumulative analyses, indicating the robustness of our findings. The pooled OR was significant in most sub-group analyses. There was no publication bias in the included studies. CONCLUSION: Our findings indicated that women with a TV infection are at significantly greater risk of cervical neoplasia. Future research, particularly longitudinal and experimental studies, should be done to better understand the various aspects of this association.

Does vitamin D reduce the mortality rate of Plasmodium infection?: a systematic review and meta-analysis.

BACKGROUND: Vitamin D supplementation is recommended as an effective adjunct to counteract malaria pathogenesis, but the evidence on this point is limited and controversial. This systematic review and meta-analysis aimed to investigate the effect of vitamin D administration on the survival rate of Plasmodium-infected animals in experimentally-induced malaria on days 6 and 10 post-infection. METHODS: Five electronic databases were searched up to 20 December 2021. The pooled risks ratio (RR) and associated 95% confidence interval were estimated using the Restricted-maximum likelihood (REML) random-effects model. Heterogeneity was assessed by Cochran's Q test and I2 value. Sub-group analyses were used to identify the sources of heterogeneity for several variables, such as type of vitamin D, type of intervention, and dose of vitamin D. RESULTS: Out of 248 articles found in the electronic database, six were eligible for inclusion in the meta-analysis. The current study found that the pooled random effect of risks ratio favored a statistically significant effect of vitamin D administration on survival rate in infected mice on day 6 post Plasmodium infection (RR = 1.08, 95%CI 1.03, 1.15, p < 0.99; I2 = 0%). It also found that vitamin D administration significantly affected the survival rate on day 10 post-infection (RR = 1.94, 95%CI 1.39, 2.71, p < 0.001; I2 = 69.02%). Subgroup analyses demonstrated a significant pooled RRs of the positive effect of vitamin D administration for cholecalciferol (RR = 3.11, 95%CI 2.41, 4.03, p < 0.001; I2 = 0%), doses higher than 50 µg/kg (RR = 3.37, 95%CI 2.55, 4.27, p < 0.001; I2 = 0%), and oral administration (RR = 3.01, 95%CI 2.37, 3.82, p < 0.001; I2 = 0%). CONCLUSION: This systematic review and meta-analysis showed that vitamin D administration positively affects the survival rate in Plasmodium-infected mice. Since, the mouse model may not accurately reproduce the clinical and pathological features of human malaria, future research should investigate the impact of vitamin D in human malaria.

Impact of Negative Fluid Balance on Mortality and Outcome of Patients with Confirmed COVID-19.

Purpose: Maintaining the proper fluid balance is a fundamental step in the management of hospitalized patients. The current study evaluated the impact of negative fluid balance on outcomes of patients with confirmed COVID-19. Methods: We considered the negative fluid balance as a higher output fluid compared to the input fluid. The fluid balance was categorized into four groups (group 4: -850 to -500 ml/day; group 3: -499 to -200 ml/day, group 2: -199 to 0 ml/day, and group 1 : 1 to 1000 ml/day) and included ordinally in the model. The outcomes were all-cause mortality, length of hospitalization, and improvement in oxygen saturation. Results: The fluid balance differed significantly among nonsurvivors and survivors (MD: -317.93, 95% CI: -410.21, -225.69, and p < 0.001). After adjusting for potential confounders, there was a significantly lower frequency of mortality in patients with negative fluid balance compared to the controls (aRR: 0.69, 95% CI: 0.57, 0.84, and p < 0.001). Similarly, the length of hospitalization was significantly shorter in the negative fluid balance group in comparison to the control group (aMD: -1.01, 95% CI: -1.74, -0.28, and p=0.006). Conclusion: We determined that the negative fluid balance was associated with favorable outcomes in COVID-19 patients. The negative fluid balance was associated with the reduced mortality rate and length of hospitalization as well as improvement in oxygen saturation. Moreover, the NT-proBNP >781 pg/mL and fluid balance >-430 mL might be the predictors for positive fluid balance and mortality, respectively.

Psychiatric Symptoms in Women with High-risk Pregnancy in the Postpartum Period: A Case-control Study.

OBJECTIVE: Psychiatric symptoms are common mental issues in pregnancy and the postpartum period. There is limited information regarding the psychiatric symptoms of women with high-risk pregnancy in the postpartum period. This study aimed to compare the severity of psychiatric symptoms and psychological distress in women with high-risk and low-risk pregnancies in the postpartum period. METHODS: This case-control study examined 250 women in the postpartum period in two groups with low-risk (n = 112) and high-risk (n = 138) pregnancies. Women completed the Brief Symptom Inventory-53 (BSI-53) and the Risk Postnatal Psychosocial Depression Risk Questionnaire (PPDRQ). RESULTS: The mean severity of psychiatric symptoms in women with high-risk pregnancies was significantly higher than that in women with low-risk pregnancies (39.34 ± 17.51 vs. 30.26 ± 17.08). Additionally, the frequency of psychological distress in women with high-risk pregnancies was approximately twice higher than that in women with low-risk pregnancies (30.3% vs. 15.2%). Furthermore, the risk factors for depression in women with high-risk pregnancies were almost 1.5 times (59.8% vs. 39.8%) higher than the factors in women with low-risk pregnancies. The results of the logistic analysis indicated that high-risk pregnancies could be twice the odds ratio of developing postpartum psychological distress (ß = 2.14, 95% CI 1.4-6.3, p= 0.036). CONCLUSION: Psychiatric symptoms and the psychological distress index are higher in postpartum women with high-risk pregnancies than in postpartum women with low-risk pregnancies. The study suggests that obstetricians and pregnant women's health care providers should strongly consider screening of psychiatric symptoms in women with high-risk pregnancies both during pregnancy and after delivery as the women's routine care priorities.

Elevated expression of the AIM2 gene in response to Helicobacter pylori along with the decrease of NLRC4 inflammasome is associated with peptic ulcer development.

Helicobacter Pylori (H. Pylori) cause peptic ulcer disease (PUD), but the inflammasome's role in PUD is not well understood. Therefore this study has investigated inflammasome compartment expression and IL-1ß production in gastritis (G) and peptic ulcer disease. This study was based on gene expression of inflammasome compartments on stomach biopsies of 50 patients with PUD as cases and 50 individuals with gastritis as controls. The expression of NLRC4, ASC, IL-18, and serum IL-1ß decreased in the PUD group compared to the control group. AIM2 gene expression increased, and NLRP12 gene expression decreased in H. pylori-seropositive positive (HP+ ) individuals compared to H. pylori-seronegative (HP- ) individuals. The G-HP+ subjects had higher serum IL-1ß and AIM2 gene expression than G-HP- subjects but lower NLRP3 and NLRP12 gene expression. The PUD-HP+ had lower serum IL-1ß, but higher AIM2 and IL-18 expression than PUD-HP- . The PUD-HP- patients had decreased IL-18 expression than G-HP- group. The PUD-HP+ had lower serum IL-1ß and NLRC4 expression than G-HP+, while NLRP1 and NLRP3 were higher in expression in PUD-HP+ . The expression of caspase-1, NLRP3 and NAIP were correlated with IL-1ß and IL-18. In conclusion, a decrease in NLRC4, IL-18, ASC genes, and IL-1ß levels in PUD patients compared to gastritis may act in the development of PUD. H. pylori caused AIM2 induction and reduced NLRP12, indicating their contribution to bacterial responses. Decreased NLRC4 expression and IL-1ß protein, together with enhanced NLRP1, and NLRP3 expression, promotes H. pylori to develop peptic ulcers.

The effects of royal jelly supplementation on oxidative stress, inflammatory mediators, mental health, cognitive function, quality of life, and clinical outcomes of patients with ischemic stroke: study protocol for a randomized controlled trial.

BACKGROUND: Stroke is a debilitating disease that affects over 15 million people worldwide each year, resulting in the death of one-third of those people and severe disability in two-thirds of survivors. Previous studies reported various health benefits of Royal jelly in the context of its anti-inflammatory properties. We will aim to investigate the effects of royal jelly supplementation on oxidative stress, inflammatory mediators, mental health, cognitive function, quality of life, and clinical outcomes of patients with ischemic stroke. METHODS: The present study will be a triple-blind randomized placebo trial. Patients who meet our eligibility criteria will be assigned to the intervention or the control groups to receive allocated intervention for 12 weeks. Individuals of the intervention group will consume 1000 mg of Royal jelly dragee daily after breakfast. Subjects of the control group will receive a placebo dragee identical to the Royal jelly dragee. The severity of the stroke, cognitive function, mental health, quality of life, clinical outcomes, and biochemical measures will be assessed at baseline and post-intervention. DISCUSSION: The current study is designed to investigate the effectiveness and safety of royal jelly supplementation in a randomized, parallel, two-arms, single-center, triple-blind, placebo-controlled manner. This study will provide evidence as a phase III clinical trial. TRIAL REGISTRATION: IRCT20180818040827N4, registered on 16 October 2021. https://www.irct.ir/trial/59275.

The global prevalence of methicillin-resistant Staphylococcus aureus colonization in residents of elderly care centers: a systematic review and meta-analysis.

BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) is a difficult to treat infection, particularly in residents of elderly care centers (ECCs). Despite the substantial burden of MRSA, an inadequate number of studies have analyzed MRSA prevalence in ECCs. OBJECTIVES: We conducted a worldwide systematic review and meta-analysis on the prevalence and risk factors of MRSA in ECCs. METHODS: We searched MEDLINE/PubMed, EMBASE, Web of Science, and Scopus databases and the gray literature sources for all studies published between January 1980 and December 2022 on the prevalence of MRSA in ECCs. A random-effects model was utilized to estimate pooled prevalence rates at 95% confidence intervals (CI). Moreover, the data were analyzed based on World Health Organization-defined regions, income, and human development index levels. RESULTS: In total, 119 studies, including 164,717 participants from 29 countries, were found eligible for meta-analysis. The pooled global prevalence of MRSA was 14.69% (95% CI 12.39-17.15%; 16,793/164,717). Male gender [prevalence ratio (PR) = 1.55; 95% CI 1.47-1.64], previous MRSA infection (PR = 3.71; 95% CI 3.44-4.01), prior use of antibiotics (PR = 1.97; 95% CI 1.83-2.12), hospitalized within the previous year (PR = 1.32; 95% CI 1.20-1.45), have had any wound (PR = 2.38; 95% CI 2.23-2.55), have used urinary catheter (PR = 2.24; 95% CI 2.06-2.43), have used any medical device (PR = 1.78; 95% CI 1.66-1.91), and those with diabetes (PR = 1.55; CI 1.43-1.67) were more likely to be colonized by MRSA than other patients. CONCLUSION: Screening programs and preventive measures should target MRSA in ECCs due to the high global prevalence rates.