Prevalence of non-alcoholic fatty liver and its related factors in Iran: Systematic review and meta-analysis.

Non-alcoholic fatty liver disease (NAFLD) is a systemic disorder with a complex multifactorial and heterogeneous pathogenesis and has become the most common cause of chronic liver disease in many countries around the world. Numerous studies in Iran have presented different results on the prevalence and risk factors of NAFLD, in this study, which has been done in a systematic review and meta-analysis, provides a good estimate of the prevalence and risk factors of the disease in Iran. Following the peer review of electronic search strategies (PRESS and the preferred reporting items for systematic reviews and meta-analyses [PRISMA] statement, we searched Web of Science, PubMed, Embase, Scopus, and Persian scientific searcher (Elmnet) from inception to September 19, 2022. In the present study, 71 articles were reviewed for qualitative and meta-analysis. The overall mean prevalence of NAFLD in children studies was 22.4% (95% confidence interval [CI]: 10.9% to 33.9%). The prevalence was notably higher in adult studies 40.5% (95% CI: 35.1% to 46%). In 24 studies, the association between NAFLD and sex was reported, 10 of which showed significant relationships. Out of 46 studies observed that NAFLD prevalence increased significantly with body mass index (BMI). Eight out of 14 studies reported significant associations between FBS and NAFLD in children's studies. Though Iran has a high NAFLD prevalence compared to most areas, and due to the unfavorable situation of risk factors contributing to the NAFLD, it is necessary to take the necessary interventions to control these risk factors and prevent NAFLD.

Analysis of the Home Accidents and Their Risk Factors in Iran: A Systematic Review and Meta-Analysis.

Background: Home accident is among the most common type of trauma, in the second place after traffic accident. We aimed to determine the prevalence and factors affecting the occurrence of home accidents in Iran. Methods: PubMed, Scopus, Web of Science, and national Persian databases including SID, MagIran, and Medical Articles Bank were searched for articles published until September 12, 2021. The pooled prevalence and factors affecting the occurrence of home accidents were calculated. Results: Twenty articles were included in the meta-analysis. The pooled prevalence of home accident was 44% (95%CI: 32% to 56%). The pooled prevalence of foreign object/fall, stab or cut, suffocation, burn, poisoning and were 15% (95%CI: 10% to 20%), 24% (95%CI: 10% to 38%), 1% (95%CI:0.7% to 1.3%), 31% (95%CI:19% to 42.2%), and 6.8% (95%CI:4.2% to 429.4%), respectively. Conclusion: The prevalence of home accidents in Iran is moderate but higher than in other countries. The findings of this review highlight the need for more attention to home accident in children and elderly in the South and Southeast regions of Iran.

How does multiple sclerosis affect sexual satisfaction in patients' spouses?

Background: Sexual dysfunction (SD) is a common complaint among multiple sclerosis (MS) patients with a significant impact on the quality of life (QoL) of afflicted couples. The purpose of this study was to determine sexual satisfaction (SS) in the spouses of MS patients and its impact on the QoL. Methods: A total of 214 spouses of MS patients were enrolled in this cross-sectional study. They completed the Larson Sexual Satisfaction Questionnaire and SF-8 Health Survey. Results: The mean ± SD age of the spouses was 39.8 ± 9.7 years, and the duration of MS was 5 years or less in most of their partners. The mean ± SD score of QoL was 71.0 ± 20.3 (out of 100), and the mean SS score was 89.2 ± 18.6 (out of 125), showing moderate satisfaction. The highest score was among male spouses younger than 40 years old. The SS scores were also lower among female spouses. In the final model, it was found that SD, psychiatric symptoms, cognitive impairment, and the level of disability of patients were independent explanatory factors for the SS of their spouses. Conclusion: The findings supported the role of SS in the QoL of spouses of MS patients. Therefore, the attention of physicians to this hidden aspect of the life of MS patients is crucial.

Prevalence of Violence in Iranian Pregnant Women: A Systematic Review and Meta-Analysis.

BACKGROUND AND AIMS: Violence against pregnant women is a significant public health problem, resulting in disability and various physical and mental health disorders. This systematic review and meta-analysis explored the prevalence of physical, verbal, sexual, psychological, emotional, economic, and other types of violence among pregnant women in Iran. METHODS: Bibliographic databases including PubMed, Embase, Web of Science (WoS), and Scopus, and also Iranian databases including Scientific Information Database (SID), Magiran, and Civilica were searched from 2002 to September 16, 2020. Following a random-effects meta-analysis, we estimated the pooled prevalence of exposure to different types of violence among Iranian pregnant women. Overall, 61 articles that met the inclusion criteria were analyzed in this systematic review. RESULTS: The prevalence of physical violence was 19.0% (95% confidence intervals [CI]: 14.0, 24.0), verbal violence was 42.0% (95% CI: 24.0, 61.0), sexual violence was 26.0% (95% CI: 20.0, 32.0), psychological violence was 37.0% (95% CI: 28.0, 46.0), emotional violence was 51.0% (95% CI: 40.0, 62.0), economic 39.0% (95% CI: 19.0, 60.0), and the prevalence of other types of violence was 54.0% (95% CI: 46.0, 62.0). CONCLUSIONS: This study revealed that Iranian pregnant women are often exposed to different types of violence. Therefore, screening for violence in this vulnerable group seems necessary due to the sensitive nature of pregnancy and its importance in maternal health. This alarming rate of violence calls for adopting upstream policies and interventions to reduce violent practices against pregnant women in Iran.

Ambient temperature and Covid-19 transmission: An evidence from a region of Iran based on weather station and satellite data.

BACKGROUND: The SARS-CoV-2 virus pandemic is primarily transmitted by direct contact between infected and uninfected people, though, there are still many unknown factors influencing the survival and transmission of the virus. Air temperature is one of the main susceptible factors. This study aimed to explore the impact of air and land surface temperatures on Covid-19 transmission in a region of Iran. METHOD: Daily Land Surface Temperature (LST) measured by satellite and Air Temperature measured by weather station were used as the predictors of Covid-19 transmission. The data were obtained from February 2020 to April 2021. Spatio-temporal kriging was used in order to predict LST in some days in which no image was recorded by the satellite. The validity of the predicted values was assessed by Bland-Altman technique. The impact of the predictors was analyzed by Distributed Lag Non-linear Model (DLNM). In addition to main effect of temperature, its linear as well as non-linear interaction effect with relative humidity were considered using Generalized Additive Model (GAM) and a bivariate response surface model. Sensitivity analyses were done to select models' parameters, autocorrelation model and function of associations. RESULTS: The dose-response curve revealed that the impact of both predictors was not obvious, though, the risk of transmission tended to be positive due to low values of temperatures. Although the linear interaction effect was not statistically significant, but joint patterns showed that the impact of both LST and AT tended to be different when humidity values were changed. CONCLUSION: However the findings suggested that both LST and AT were not statistically important predictors, but they tended to predict the Covid-19 transmission in some lags. Because of local based evidence, the wide confidence intervals and then non-significant values should be cautiously interpreted.

Heat and cold-related morbidity risk in north-east of Iran: a time-stratified case crossover design.

This study aimed to estimate morbidity risk/number attributed to air extreme temperatures using time-stratified case crossover study and distributed lag non-linear model in a region of Iran during 2015-2019. A time-stratified case crossover design based on aggregated exposure data was used in this study. In order to have no overlap bias in the estimations, a fixed and disjointed window by using 1-month strata was used in the design. A conditional Poisson regression model allowing for over dispersion (Quasi-Poisson) was applied into Distributed Lag Non-linear Model (DLNM). Different approaches were applied to estimate Optimum Temperature (OT). In the model, the interaction effect between temperature and humidity was assessed to see if the impact of heat or cold on Hospital Admissions (HAs) are different between different levels of humidity. The cumulative effect of heat during 21 days was not significant and it was the cold that had significant cumulative adverse effect on all groups. While the number of HAs attributed to any ranges of heat, including medium, high, extreme, and even all values were negligible, but a large number was attributable to cold values; about 10000 HAs were attributable to all values of cold temperature, of which about 9000 were attributed to medium range and about 1000 and less than 500 were attributed to high and extreme values of cold, respectively. This study highlights the need for interventions in cold seasons by policymakers. The results inform researchers as well as policy makers to address both men and women and elderly when any plan or preventive program is developed in the area under study.

Prevalence of Leishmania major Yakimoff and Schokhor (Kinetoplastida: Trypanosomatidae) in Sandflies in Iran: A Systematic Review and Meta-Analysis.

Cutaneous leishmaniasis is an important parasitic and vector-borne disease in Iran and can be transmitted to humans and animals through bites of infected female sand flies. The present study aimed to determine the pooled prevalence of Leishmania major in sand flies in Iran. A systematic review and meta-analysis was performed in the present study, so that databases, namely PubMed, Web of Sciences, Science Direct, ProQuest, Embase, Cochrane Reviews, and Scopus as well as IranDoc, SID, Elmnet, and Magiran were searched for finding Persian articles. Inclusion criteria of study contained the study in Iran and investigation of L. major parasite in sand flies. The quality of studies was examined by Joanna Briggs Institute Critical Appraisal Checklist for studies that reported prevalence data; and the data were analyzed by Stata 14 software. In total, 42 studies were evaluated, all of which had investigated the infection of Phlebotomus papatasi Scopoli (Diptera: Psychodidae). The infection of Phlebotomus caucasicus group was investigated in 13 studies, Phlebotomus ansarii Lewis in four studies, Phlebotomus salehi Mesghali and Rashti in five studies, and the infection of other species of sandflies in seven studies. According to the meta-analysis, the pooled prevalence of Ph. papatasi, Ph. caucasicus group, Ph. salehi, and Ph. ansarii were equal to 2.4, 6.2, 1.6, and 9.2%, respectively, with 95% confidence interval. According to reports of different rates of sand fly infection in different regions, all studies should have certain and standard forms and formats to determine the pooled prevalence of sand fly infection.

Trend of Congenital Hypothyroidism Incidence and Its Affecting Factors in Shahr-e-Kord, Western Iran.

BACKGROUND: Congenital hypothyroidism is one of the most common endocrine disrupters and metabolism, and is one of the most important preventable causes of physical and mental disabilities. METHODS: This was a case-control study, in which 54468 infants were screened from 2006 to 2014 in Shahre-Kord, western Iran. To describe the data, central and dispersion indices such as mean and standard deviation was used. For modeling, logistic regression was used. All the tests were performed at the significant level of 5%. RESULTS: Overall, 111 cases were diagnosed with hypothyroidism, which made the prevalence value equal to 2 cases per 1000 births. The prevalence in females and males was 1.9 and 2.2 per 1,000 birth, respectively. The odds ratio for this disorder was 4.47(2.42-9.28) for the neonates with a family history of hypothyroidism and 1.72(1.05-2.82) for those born through cesarean. CONCLUSION: The incidence of this disorder is similar in males and females, and the incidence of this disease in people with a family history is far more than others.

Prevalence of JC and BK viruses in Patients with Colorectal Cancer: A Systematic Review and Meta- Analysis.

INTRODUCTION: Polyomaviruses including BK virus (BKV) and JC virus (JCV) are widespread in human and have been associated with colorectal cancer (CRC) in some studies. The aim of present systematic review and meta-analysis article is to calculate the pooled prevalence of BKV and JCV in patients with CRC and assessing their association with this malignancy. MATERIALS AND METHODS: Domestic databases and Sciences Direct, PubMed, ProQuest, Web of Sciences and Scopus were searched for relevant articles up to 2nd  June 2019Two independent reviewers extracted the related data from eligible articles. The pooled prevalence and pooled odds ratio (POR) and their 95% confidence interval (95% CI) were calculated using "metaprop" and "metan" commands in Stata 14. Where I2 statistics were >50%, the random effect model was used. RESULTS: From 1461 relevant studies, 24 articles were eligible and included in the qualitative while 19 articles included in quantitative analysis. The pooled prevalence based on diagnostic methods varies from 29% using immunohistochemistry to 52% using nested-PCR method. The likelihood of being infected with JCV  was significantly higher in CRC patients compared to healthy (POR: 4.41, 95% CI: 2.13 - 9.13) controls, normal adjacent mucosa (POR: 2.79, 95% CI: 1.3-5.9) and colorectal adenoma (POR: 3.1, 95% CI: 1.5-6.5) but was not significant when non-CRC patients used as control group. CONCLUSION: The prevalence of JCV in colorectal patients was substantially variable by different methods and targets. The significant association between JCV and CRC that was observed in the present study is not indicative of causation and should be studied more in large-scale prospective designs.

Global prevalence of classic phenylketonuria based on Neonatal Screening Program Data: systematic review and meta-analysis.

Phenylketonuria is a disease caused by congenital defects in phenylalanine metabolism that leads to irreversible nerve cell damage. However, its detection in the early days of life can reduce its severity. Thus, many countries have started disease screening programs for neonates. The present study aimed to determine the worldwide prevalence of classic phenylketonuria using the data of neonatal screening studies. The PubMed, Web of Sciences, Sciences Direct, ProQuest, and Scopus databases were searched for related articles. Article quality was evaluated using the Joanna Briggs Institute Critical Appraisal Evaluation Checklist. A random effect was used to calculate the pooled prevalence, and a phenylketonuria prevalence per 100,000 neonates was reported. A total of 53 studies with 119,152,905 participants conducted in 1964-2017 were included in this systematic review. The highest prevalence (38.13) was reported in Turkey, while the lowest (0.3) in Thailand. A total of 46 studies were entered into the meta-analysis for pooled prevalence estimation. The overall worldwide prevalence of the disease is 6.002 per 100,000 neonates (95% confidence interval, 5.07-6.93). The metaregression test showed high heterogeneity in the worldwide disease prevalence (I2=99%). Heterogeneity in the worldwide prevalence of phenylketonuria is high, possibly due to differences in factors affecting the disease, such as consanguineous marriages and genetic reserves in different countries, study performance, diagnostic tests, cutoff points, and sample size.

Distribution of Leishmania Infection in Humans, Animal Reservoir Hosts and Sandflies in Golestan Province, Northeastern Iran: A Systematic Review and Meta-Analysis.

BACKGROUND: Leishmaniasis is one of the most important parasitic diseases in the Golestan Province, northeastern Iran. In this study, we summarize the results of studies on the disease and its causative agent Leishmania in humans, vectors and reservoirs in the Golestan Province, Iran. METHODS: We retrieved all articles related to leishmaniasis in the Golestan Province, northern Iran from 1994 to 2018 in various databases including PubMed, Scopus and Web of Science. Articles in Persian were retrieved from the IranMedex, SID and Magiran. Reference lists of relevant articles were also hand-searched. Local active researchers in the field of leishmaniasis were contacted to avoid missing any relevant articles. Overall, 54 papers were extracted, later evaluated by two research team members based on inclusion criteria. All analyses were performed using the Stata 14 software. Pooled prevalence was calculated using the metaprop command and a random-effect model. The I2 statistic was used for measuring heterogeneity of studies. RESULTS: Ten articles in the province were related to detection of Leishmania species in patients with suspected cutaneous or visceral leishmaniasis. Fifteen articles were dedicated to identification of Leishmania species in disease reservoirs and five articles were about detection of the parasite in sand flies. The pooled prevalence of L. major in patients with acute ulcer, wild rodents and sandflies was 83%, 29% and 11%, respectively. CONCLUSION: Our findings highlight the need for implementation of control measures among the reservoirs of both cutaneous and visceral leishmaniasis in the Golestan Province, Iran.

Larval habitat characteristics and predicting the distribution of Culex tritaeniorhynchus using maximum entropy (MaxEnt) modelin Golestan Province (north of Iran).

BACKGROUND & OBJECTIVES: Culex tritaeniorhynchus is a widely distributed and medically important mosquito species (Diptera: Culicidae). The aim of this study was to determine characteristics of larval habitats and predict the distribution of Cx. Tritaeniorhynchus using maximum entropy (MaxEnt) model in Golestan Province (north of Iran). METHODS: Overall, 53 villages and cities from the 14 counties in the Golestan Province were studied. Suitable habitats for sampling of mosquitoes were determined in the selected villages. Larval sampling was carried out 10 times using a standardized dipper (350 ml). Captured larvae in each dipper were counted and kept in special containers. Larvae were put in lactophenol and were then mounted on microscope slides prepared according to the de Faure's formula. All villages where Cx. tritaeniorhynchus was isolated from were considered as the species presence points, and their coordinates were extracted from the GIS. The obtained data were entered into the model in Microsoft Excel 2003. Layers required for the study were obtained from the World Clim global climate database at a spatial resolution of 1 km2. The MaxEnt software (version 3.3.3) was used to predict the most suitable ecological niches of Cx. tritaeniorhynchus. RESULTS: Out of the 5168 specimens collected from 53 villages and cities, 1097 specimens (21%) were identified as Cx. tritaeniorhynchus. The central and western areas of the province are environmental suitability areas for distribution of this species compared to the other areas. Area under curve (AUC) value for Cx. tritaeniorhynchus was 0.888. Environmental variables with highest gain in the model were precipitation of coldest quarter (bio19), maximum temperature of warmest month (bio5) and slope. INTERPRETATION & CONCLUSION: Precipitation and temperature are important determinants of Cx. tritaeniorhynchus distribution in Golestan Province.

Fauna and Larval Habitats Characteristics of Mosquitoes (Diptera: Culicidae) in Golestan Province, Northeast of Iran, 2014-2015.

BACKGROUND: Mosquitoes (Diptera: Culicidae) is one of the most medically important families of Diptera. The aims of this study were to determine fauna and larval habitat characteristics of mosquitoes in Golestan Province, during 2014-15. METHODS: This study was conducted in larval habitats of mosquitoes and installed ovitraps in 14 districts of Golestan Province, Northern Iran in 2015. Samples were collected with a scoop by ladle handling for entomology. The collected larvae were transferred to Laboratory of Medical Entomology in lactophenol solution. Then microscopic slides were prepared using de Faure's formula. Species of each sample was recognized using diagnostic criteria to identify the Culicidae species. Characteristics of larval breeding places were studied based on the habitat type (Permanent or temporary), water conditions (Clear or turbid, stagnant or running), vegetation (out, in, underwater vegetation or without vegetation), sunlight exposure (Full or partial sunlight) and so on. Data were analyzed using SPSS. RESULTS: Overall, 5661 third- and fourth- instars larvae of mosquitoes were collected and 5 genera and 14 species were identified: Anopheles hyrcanus, An. maculipennis, An. pseudopictus, An. superpictus, Culex hortensis, Cx. mimiticus, Cx. perexiguus, Cx. pipiens, Cx. pusillus, Cx. theileri, Cx. tritaeniohynchus, Culiseta longiareolata, Ochlerotatus caspius, Uranotaenia unguiculata. Culex pipiens was recognized as predominant species of the family. Among the detected species, Cx. pusillus reported for the first time from Golestan Province. CONCLUSION: Due to the high species diversity of Culicidae, ecology of medical important species such as Cx. pipiens and Cx. tritaeniorhynchus needs more investigations.