Prevalence and extension of the anterior loop of the mental nerve in different populations and CBCT imaging settings: A systematic review and meta-analysis

Purpose@#This study aimed to identify the prevalence and extension of the anterior loop (AL) of the mental nerve in different populations and according to different cone-beam computed tomography (CBCT) imaging settings. @*Materials and Methods@#Medline/PubMed, Embase, Scopus, Web of Science, and ProQuest were searched. The main inclusion criterion was ALs evaluated in CBCT images. The quality of studies was assessed with the Joanna Briggs Institute risk of bias checklist. Subgroup analyses were conducted for sex, side, continent, voxel size, field of view, and type of CBCT-reconstruction images with a random-effects model. @*Results@#Sixty-three studies with 13,743 participants (27,075 hemimandibles) were included. An AL was found in 40.6% (95% CI: 32.8%-48.9%, P<0.05) of participants and 36.0% (95% CI: 27.5%-45.5%, P<0.05) of hemimandibles, in 34.9% (95% CI: 25.1%-46.2%, P<0.05) of males and 34.5% (95% CI: 23.5%-47.4%, P<0.05) of females. The average length of ALs was 2.39 mm (95% CI: 2.07-2.70 mm, P<0.05). Their extension was 2.13 mm (95% CI: 1.54-2.73 mm, P<0.05) in males and 1.85 mm (95% CI: 1.35-2.36 mm, P<0.05) in females. Significant differences were observed regarding the prevalence and length of ALs among continents and for its measured length on different CBCT-reconstruction images, but not between other subgroups. @*Conclusion@#AL was a relatively common finding. The voxel size and fields of view of CBCT devices were adequate for assessing AL; however, a 2-mm safety margin from anatomical structures (such as the AL) could be recommended to be considered when using CBCT imaging.

Microsporidiosis in Iran: A systematic review and meta-analysis

OBJECTIVE@#To examine all evidence about Microsporidia infection in vertebrate/invertebrate hosts and Iranian populations distributed in different regions of the country.@*METHODS@#All published articles up to December 2015, including descriptive and cross-sectional studies related to the prevalence and genotyping of Microsporidia infection in Iran, was considered in this systematic review. The meta-analysis was done using the random-effects model and Stats Direct statistical software. MEGA 5.05 software and maximum likelihood algorithm with Kimura 2-parameter model were used for phylogenetic analysis.@*RESULTS@#Of the 1152 investigated studies, 33 eligible studies reported a prevalence of Microsporidia infection in vertebrate and invertebrate hosts. According to this systematic review, the overall prevalence rate of Microsporidia infection in immunocompromised patients in Iran was 8.18%. Furthermore, the overall prevalence rate of Microsporidia infection in immunocompromised patients with chronic diarrhoea, patients with non-diarrhoea, gastroenteritis, and patients with CD4 (<200 cells/μL) was 15.4%, 4.1%, 0.5%, and 12.9% respectively. The highest prevalence rate of human and animal Microsporidia was estimated in Kerman (29%) and Khuzestan (26.5%). The overall prevalence rate of Microsporidia infection in honeybees using the random-effects model was 40%. Furthermore, the highest prevalence rate of nosemosis was described in East Azerbaijan (48.2%). The most Microsporidia isolates from immunocompromised patients and pigeons in Iran belonged to genotypes D (n = 16; 50%) and E (n = 6; 20.6%) of Enterocytozoon bieneusi.@*CONCLUSIONS@#This study may be the first systematic review and meta-analysis that provides a broad outlook on the prevalence of microsporidiosis in Iran. It is necessary to investigate Microsporidia infection in vertebrate and invertebrate hosts and environmental resources in Iran.

Microsporidiosis in Iran: A systematic review and meta-analysis

Objective To examine all evidence about Microsporidia infection in vertebrate/invertebrate hosts and Iranian populations distributed in different regions of the country. Methods All published articles up to December 2015, including descriptive and cross-sectional studies related to the prevalence and genotyping of Microsporidia infection in Iran, was considered in this systematic review. The meta-analysis was done using the random-effects model and Stats Direct statistical software. MEGA 5.05 software and maximum likelihood algorithm with Kimura 2-parameter model were used for phylogenetic analysis. Results Of the 1152 investigated studies, 33 eligible studies reported a prevalence of Microsporidia infection in vertebrate and invertebrate hosts. According to this systematic review, the overall prevalence rate of Microsporidia infection in immunocompromised patients in Iran was 8.18%. Furthermore, the overall prevalence rate of Microsporidia infection in immunocompromised patients with chronic diarrhoea, patients with non-diarrhoea, gastroenteritis, and patients with CD4 (<200 cells/μL) was 15.4%, 4.1%, 0.5%, and 12.9% respectively. The highest prevalence rate of human and animal Microsporidia was estimated in Kerman (29%) and Khuzestan (26.5%). The overall prevalence rate of Microsporidia infection in honeybees using the random-effects model was 40%. Furthermore, the highest prevalence rate of nosemosis was described in East Azerbaijan (48.2%). The most Microsporidia isolates from immunocompromised patients and pigeons in Iran belonged to genotypes D (n = 16; 50%) and E (n = 6; 20.6%) of Enterocytozoon bieneusi. Conclusions This study may be the first systematic review and meta-analysis that provides a broad outlook on the prevalence of microsporidiosis in Iran. It is necessary to investigate Microsporidia infection in vertebrate and invertebrate hosts and environmental resources in Iran.

Gender Differences in Clinical Presentations of Cystic Fibrosis Patients in Azeri Turkish Population / 결핵및호흡기질환

BACKGROUND: Cystic fibrosis (CF) is an autosomal recessive disorder with several clinical presentations. This study was undertaken in the Azeri Turkish population in Iran, to investigate gender differences in the age at onset and diagnosis, age of death, and duration of illness of CF. METHODS: The data of 331 CF patients from 2001 to 2015 was surveyed. Parameters including age, sex, ΔF508 mutation, age at onset, age at diagnosis, age of death and clinical presentations were evaluated for both sexes, using descriptive analysis. The association of gender with these variables was studied using logistic regression, chi-square test and Mann-Whitney U test by SPSS version 18. Odds ratio with a confidence interval of 95% and p≤0.05 was considered statistically significant. RESULTS: The study included 191 males (57.7%) and 140 females (42.3%), all showing statistically significant difference (p<0.001). Age duration differed between genders. Male and female patients were further under 9 and 4 years, respectively. The occurrence of ΔF508 mutation was 0.51 times more in females than in males. Age, diagnosis and sex were closely associated: males were diagnosed at a significantly later age than females (p=0.05). While this compression performed based on clinical presentations, males with respiratory disease had a later median age at diagnosis than females at lifespan (p=0.001). The risk of infertility in males was approximately two times greater than in females (p=0.02). CONCLUSION: These findings indicate gender differences in CF patients. Future studies are needed to establish other differences and evaluate the causes for the gender variations.

Intercontinental comparison of caustic ingestion in children / 소아과

PURPOSE: To investigate the caustic ingestion in children among different continents according to demographic characteristics (core purpose), main symptoms, common caustic agents, signs and symptoms, management, treatment and complications. METHODS: This systematic review was performed by searching the databases Science Direct, ProQuest, Google Scholar, and PubMed, electronically and manually. We included studies that were published from 1980 to 2013, at University of Medical Sciences of Tabriz, Iran. A strategic search was performed with keywords including caustic, corrosive, ingestion and children, and was limited to articles in English and Persian. Statistical analysis was performed by SPSS ver. 18. RESULTS: Of 63 selected articles of caustic ingestion with 9,888 samples, the proportion of Africa was 3 articles (4.8%) and 95 samples (1%), America 9 articles (14.3%) and 305 sample (3%), Asia 29 articles (46%) and 2,780 samples (28.1%), Europe 17 articles (27%) and 3,002 samples (30.4%), and Oceania 5 articles (7.9%) and 3,706 samples (37.5%). The average age was in the Africa 3.07+/-2.02 years, America 3.17+/-1.83 years, Asia 3.34+/-1.58 years, Europe 3.58+/-2.09 years and Oceania 3.52+/-2.02 years. Sex distribution was in Africa 76 males (0.91%) and 19 females (0.23%), America 49 males (0.58%) and 41 females (0.49%), Asia 1,575 males (18.76%) and 1,087 females (12.95%), Europe 1,018 males (12.13%) and 823 females (9.8%), and Oceania 1,918 males (22.85%) and 1,788 females (21.3%). Statistical analysis of the data indicated higher consumption in Europe and Oceania in the boys with higher average age of years. CONCLUSION: The comparison of caustic ingestion indicated that the cause substances of caustic ingestion in children are different among continents, therefore prevention strategy and different treatment guidelines among continents will be needed.

Comparison of the effect of gonadotropin-releasing hormone agonist and dopamine receptor agonist on uterine myoma growth. Histologic, sonographic, and intra-operative changes.

OBJECTIVE: To investigate the effect of 2 medications; Diphereline and Cabergoline, on uterine leiomyoma growth, and its histologic, sonographic, and intra-operative changes. METHODS: In an effort to treat large uterine leiomyoma in symptomatic patients in the Gynecology Clinics of the Alzahra Teaching Hospital of Tabriz University of Medical Sciences, Tabriz, Iran, from September 2007 to November 2008, 60 candidates randomized to receive Diphereline 3.75 mg, 4 times every 28 days (group I), and Cabergoline 0.5 mg, once a week for 6 weeks (group II), were included in this study. Clinical symptoms, feasibility of intra-operative dissection, intraoperative complications, sonographic, and pathologic characteristics of the tumor were evaluated. RESULTS: Thirteen patients from group I, and 10 patients from group II underwent surgery. There was a significant difference between the groups in the rate of lymphocyte infiltration (p=0.003), but not in other pathologic features. In both groups, the mitotic index was between 0-10. While there was no significant difference between the groups in the number (p=0.30), and volume of leiomyomas (p=0.65), however, changes in the uterine artery circulation was significant (p=0.001 [group I], p=0.026 [group II]). In addition, there was a significant difference between the groups for intra-operative hemorrhage and adhesion of leiomyomas to the uterine wall. CONCLUSION: This study found that Cabergoline is as effective as Diphereline in the shrinkage of myomas, accompanied by improvement in the sonographic, clinical, and intra-operative outcomes without any adverse pathological changes, and could be a good medical regimen as an adjunct to surgical management.

Comparison of laparoscopy-assisted hysterectomies with conventional hysterectomies.

OBJECTIVE: To compare operative and early postoperative outcomes of laparoscopic-assisted vaginal hysterectomy (LAVH) and laparoscopy assisted supracervical hysterectomy (LASH) with conventional hysterectomy by laparotomy or vaginally, including patients undergoing total or subtotal hysterectomy for benign gynecologic disease. METHODS: Three different methods of hysterectomies: laparoscopic, vaginal, and abdominal, were compared at the Department of Obstetrics and Gynecology of Tabriz University of Medical Sciences, Tabriz, Iran, including all patients with indication of uterus removal for benign uterine disease from January 2005 to December 2007. The regional medical research ethics committee approved the study. RESULTS: A total of 288 hysterectomies were performed: 165 (57.3%) abdominal hysterectomy, 85 (29.5%) vaginal hysterectomy, and 38 (13.2%) laparoscopic-assisted hysterectomy. Laparoscopy assisted hysterectomy (LAVH, LASH) was associated with significantly lower early postoperative pain scores and complication rates, less blood loss, short hospital stay, and resulted in lower hospital charge with reusable devices statistically (p=0.03). CONCLUSION: Laparoscopy is preferred to abdominal hysterectomy by laparotomy and to vaginal hysterectomy. Though vaginal hysterectomy had less complications and rapid recovery and patient satisfaction as compared with abdominal, but it was limited for multiparous patients with some degree of pelvic organ prolapse.

Comparison study on the effect of prenatal administration of high dose and low dose folic acid.

OBJECTIVE: To evaluate the effect of high dose and low dose folic acid on the levels of hemocysteine (Hcy) concentration during the first trimester of pregnancy and at delivery, and to examine the association of Hcy serum levels and preeclampsia. METHODS: In a single blinded randomized clinical trial, which was conducted in Tabriz, Iran, from 2005-2008, 246 nulliparous pregnant women in 2 similar groups, received folic acid daily from early pregnancy until delivery (5 mg/day in group one and 0.5 mg/ day in group 2). The incidence of hypertension and laboratory changes in the levels of serum Hcy, lactate dehydrogenase, and uric acid in addition to the levels of urine creatinine and protein were compared between the groups. RESULTS: There was no presence of any type of hypertension in each group. The systolic blood pressures (BP) (mm Hg) at the first trimester were 114.01 +/- 8.78 for group one, 114.16 +/- 9.05 for group 2, and at delivery, 117.24 +/- 6.91 for group one, and 117.23 +/- 11.48 for group 2 (p=0.32). The diastolic BP at the first trimester were 74.90 +/- 7.45 for group one, 73.30 +/- 8.90 for group 2, and at delivery 76.46 +/- 5.58 for group one, and 76.69 +/- 8.62 for group 2 (p=0.42). Although the level of Hcy (micromol/L) decreased significantly at the delivery time in group one (11.81+/- 3.85 decreased to 6.44 +/- 1.88), and 2 (9.08+/- 3.24, decreased to 7.44 +/- 2.99), this decrement was more significant in the first group (p<0.001). CONCLUSION: The results show that folic acid supplement throughout pregnancy, irrespective of the dosage, could eliminate hypertensive disorders, and decreases serum level of Hcy, although it is reduced more significant in the first group.

Hepatitis B virus infection and the risk of coronary atherosclerosis

<p><b>INTRODUCTION</b>Many studies have reported on the association between human coronary artery disease (CAD) and certain persistent bacterial and viral infections. Currently, it is unclear whether hepatitis B virus infection is associated with the risk of the atherosclerosis. The aim of this study was to investigate the possible association between hepatitis B virus infection and angiography-proven CAD.</p><p><b>MATERIALS AND METHODS</b>Sera from 5,004 patients who underwent coronary angiography were tested for hepatitis B surface antigen (HBsAg) by enzyme-linked immunosorbant assay at Madani Heart Hospital, Tabriz University of Medical Sciences, Iran.</p><p><b>RESULTS</b>Our study population comprised 66% male and 34% female, with an age range of 36 to 86 years. The prevalence of HBsAg positivity tended to be higher in CAD patients than in those without CAD (3.28% versus 2.17%), but the difference was not statistically significant.</p><p><b>CONCLUSION</b>Our results suggest that hepatitis B virus infection is not associated with coronary atherosclerosis in this population.</p>