Establishing the relationship between Polycyclic Aromatic Hydrocarbons (PAHs) exposure and male infertility: A systematic review.

It has been demonstrated that human exposure to environmental chemicals may have sperm genotoxic potentiality. Among the different classes, Polycyclic Aromatic Hydrocarbons (PAHs) have been receiving attention in recent years due to reports of sperm geno-toxicity, a series of reproductive defects and male infertility. This review aims to substantiate the effects of PAHs exposure on male infertility, with focus on the sperm characteristics (count, concentration, volume, motility, DNA damage, and morphology). To this end, international databases such as Cochrane Library, PubMed, Web of Science, Embase Ovid, Scopus, and Google Scholar were used to conduct a systematic search for papers on the subject, based on PRISMA guidelines, published up to 24 March 2022. The Newcastle-Ottawa Scale was subsequently used to assess the quality of the studies. The results showed that there is a significant negative relationship between PAHs metabolites and sperm volume, concentration, motility, morphology, as well as an observed DNA degeneration. Also, the CYP1A1 genotype polymorphisms were considered as a representative of PAHs exposure to infertility; the review highlights that polymorphisms of this genotype were more common in the infertile people. In overall, this work provides a solid summary of the existing works correlating PAHs exposure and male infertility, which could impulse further protective measures and informative campaigns on users, workers, and general population.

Evidence for an increase in cannabis use in Iran - A systematic review and trend analysis.

BACKGROUND AND AIMS: Cannabis is the most widely used illicit substance globally. In this systematic review, we examined the prevalence and trends of cannabis use and cannabis use disorder in Iran. METHODS: We searched International and Iranian databases up to March 2021. Pooled prevalence of use among sex subgroups of the general population, university and high school students, combined youth groups, and high-risk groups was estimated through random-effects model. Trends of various use indicators and national seizures were examined. RESULTS: Ninety studies were included. The prevalence estimates of last 12-month cannabis use were 1.3% (95%CI: 0.1-3.6) and 0.2% (95%CI: 0.1-0.3) among the male and female Iranian general population, respectively. The prevalence of cannabis use disorder among general population in national studies rose from 0% in 2001 to 0.5% in 2011. In the 2016-2020 period, the pooled prevalence estimates of last 12-month cannabis use were 4.9% (95% CI: 3.4-6.7) and 0.3% (95% CI: 0.0-1.3) among males and females of "combined youth groups", respectively. The linear trend of last 12-month cannabis use among males of "combined youth groups" and among female university students increased significantly from 2000 to 2020. CONCLUSIONS: Prevalence of cannabis use in Iran is low compared to many countries. However, there is strong evidence of an increase in cannabis use among the youth and some evidence for an increase in cannabis use disorder.

Hepatitis B virus infection among people who use drugs in Iran: a systematic review, meta-analysis, and trend analysis.

BACKGROUND: People who use drugs (PWUD) are considered as one of the main at-risk populations for Hepatitis B virus (HBV) infection. We conducted a systematic review on the prevalence of HBV infection among PWUD in Iran. METHODS: Consistent with PRISMA guideline, international (Medline, Web of Science, Scopus, and Embase) and national (Scientific Information Database) databases were searched using a comprehensive search strategy up to September 2019. The retrieved records were reviewed, and experts were contacted for unpublished studies. Studies on Iranian PWUD reporting HBV surface Antigen (HBsAg) prevalence among people who inject drugs (PWID) and non-injecting PWUD were included. HBsAg prevalence was pooled for PWID and non-injecting PWUD and for other subgroups using random-effects model meta-analysis. The trend of HBV prevalence over time was investigated using meta-regression analysis. RESULTS: Overall, 35 studies reported data on HBV infection among PWID (33 studies) and non-injecting PWUD (11 studies). The pooled prevalence of HBsAg among PWID was 4.8% (95% CI 3.7-6.2). The only risk factor significantly associated with the odds of positive HBsAg in PWID was the previous history of imprisonment (OR 1.72, 95% CI 1.29-2.30, p value = 0.000). The pooled estimate of HBsAg among non-injecting PWUD was 2.9% (95% CI 2.5-3.2). Time trend analyses showed significant decrease in HBV prevalence among PWID reaching from 8.2% (95% CI 3.9-16.5) in 2004-2006 to 3.1% (95% CI 2.3-4.1) in 2016 and later (b = -0.07; p value = 0.05). No significant trend was detected for non-injecting PWUD. CONCLUSION: The prevalence of HBV infection among non-injecting PWUD and even PWID was not considerably higher than the Iranian general population. This might be the result of extensive harm reduction interventions in Iran. However, it seems that there are subgroups of PWID, who do not adequately benefit from existing harm reduction interventions. Future programs should more specifically target these high-risk groups.

Comparing the effects of 3 oxygen delivery methods plus intravenous ketorolac on primary headaches: A randomized clinical trial.

OBJECTIVE: To compare three different oxygen therapy methods in primary headaches. METHODS: Design: A randomized placebo-controlled clinical trial was conducted between January 2016 and October 2017. SETTING: The emergency department of a university-affiliated urban hospital in Tehran, Iran. PARTICIPANTS: Adult patients (aged 18 years and above) with moderate and severe primary headaches (VAS score of 4 or more). INTERVENTIONS: Participants were allocated to one of four groups. Group A (n = 34) received 30 mg of intravenous ketorolac plus oxygen at 15 l/min (min) through a non-rebreather mask (NRB), group B (n = 34) received 30 mg of intravenous ketorolac plus 7 l/min of oxygen through a 60% venturi mask, group C (n = 34) received 30 mg of intravenous ketorolac plus 4 l/min of oxygen through a nasal cannula and group D (n = 34) received 30 mg of intravenous ketorolac and room air. MAIN OUTCOMES MEASURED: Pain was assessed using the visual analog scale (VAS) at 0, 15, 30 and 60 min after admission. RESULTS: Altogether, 136 patients were included. The most significant VAS change occurred in the NRB group at 30 min (p-value = 0.001). At this point, pain reduction in the NRB group was clinically higher than for the venturi and nasal cannula groups, but this effect had disappeared at 60 min. CONCLUSION: Although the non-rebreather mask was significantly more effective at 30 min, after 60 min, none of the groups met the endpoint criterion of a 1.3-cm difference on the VAS scale.

Trend of some Tuberculosis Indices in Iran during 25 yr Period (1990-2014).

BACKGROUND: Investigation of tuberculosis (TB)-specific indices including prevalence of TB, mortality of TB cases excluding HIV, HIV/TB mortality, incidence of TB (all forms), HIV/TB incidence as well as case detection and related trends is a crucial step in evaluation of program performance and strategies success. Besides, estimating the number and time of change points for TB incidence can help to detect effective factors in TB control. Therefore, the current study aimed to determine the trend of aforementioned indices in Iran during a 25 yr period (1990 to 2014). METHODS: Data on trend of TB in Iran was extracted from WHO regional office reports during 1990-2014. For determining the trend of TB indices, Annual Percent Changes (APC) and Average Annual Percent Changes (AAPC) was estimated using segmented regression model. RESULTS: AAPC (95% CI) for HIV/TB mortality and HIV/TB incidence were 11.5 (9.3, 13.6) and 14.8 (13.6, 16.1), respectively, which are sign of increasing trend during the period (P<0.05). Other indices showed significantly decreasing trend (P<0.05), except for case detection rate (P =0.803). CONCLUSIONS: The incidence, prevalence, and death rates of TB had shown a decreasing trend in general population, regarded as a useful indicator of achievements of Millennium Development Goals (MDGs) and effectiveness of interventional programs. Increasing trend of incidence and mortality of TB in HIV infected patients, needs conducting more intervention strategies in health care programs.