Effective factors of severity of traffic accident traumas based on the Haddon matrix: a systematic review and meta-analysis.

Objective: This study aims to investigate the factors affecting the severity of trauma caused by traffic accidents based on martrix Haddon; a systematic review and meta-analysis. Methods: In this study searched five international databases in this study, including Medline/PubMed, ProQuest, Scopus, Web of Knowledge, and Google Scholar, for published articles by the end of 2022. Data were entered into the statistical program and analyses were performed using STATA 17.0 software. Odds ratio (OR) values were computed for severity accidents. Results: Results of study showed that among the risk factors related to the host, not using helmet increased the risk of injury severity by 3.44 times compared to people who have used helmets (OR Not using helmet/Using helmet = 3.44, 95% CI: 2.27-5.00, P=0.001, I2=0.00%). Also, crossing over a centre divider has a protective role for the risk of injury severity compared to undertaking (OR crossing over a centre divider/undertaking=0.39, 95% CI: 0.20-0.75, P=0.01, I2=25.79%). in terms of the type of accident, accident of car-car reduces the risk of injury severity by 23% compared to accident of car-pedestrian (OR accident of car-car/accident of car-pedestrian=0.77, 95% CI: 0.61-0.96, P=0.02, I2=0.00%). Conclusions: It is necessary to pay attention to the intersection of human, vehicle and environmental risks and their contribution and how they interact. Based on the Haddon matrix approach, special strategies can be designed to prevent road damage. Safety standards for vehicles should also be addressed through stricter legal requirements and inspections.

Effects of Curcumin on the treatment of oral lichen planus symptoms: a systematic review and meta-analysis study.

BACKGROUND AND OBJECTIVES: Oral lichen planus (OLP) is a relatively common chronic T-cell-mediated disease that can cause significant pain, particularly in its erosive or ulcerative forms. This study aimed to examine the therapeutic impact of curcumin on symptoms of OLP. MATERIALS AND METHODS: This meta-analysis was performed according to the PRISMA guidelines. All related English documents indexed in electronic databases (including PubMed, Web of Science, Scopus, Embase, Wiley, Cochrane, and ProQuest databases [updated to August 15, 2023]) were retrieved. Data were double-extracted into a predefined worksheet, and quality analysis was performed using the Joanna Briggs Institute (JBI) scale. We carried out meta-analyses, and the random effects model was used to estimate the differences in erythema, lesion size, and pain between the curcumin control groups. RESULTS: The search identified 289 studies, of which 10 were found to meet the inclusion criteria. The overall findings of the meta-analysis revealed that curcumin did not have a significant effect on erythema of OLP (standardized mean difference [SMD] = -0.14; 95% CI, -0.68 to 0.40; P = 0.61; I2 = 57.50%), lesion size of OLP (SMD = -0.15; 95% CI, -0.45 to 0.15; P = 0.33; I2 = 28.42%), and pain of OLP (SMD = -0.38; 95% CI, -0.97 to 0.22; P = 0.22; I2 = 86.60%). However, subgroup analysis based on treatment duration indicated that 2-week treatment duration was significantly associated with a reduction in OLP pain (n = 3; SMD = -1.21; 95% CI, -2.19 to -0.23; P = 0.01). CONCLUSIONS: Curcumin had no significant effect on erythema, lesion size, and pain of OLP compared to the control groups. However, subgroup analysis revealed that curcumin was more effective in reducing pain in non-randomized trials and in trials with a treatment duration of 2 weeks.

Glycemic Characteristics and Clinical Outcomes in Patients with COVID-19 Admitted to Referral Shahid Sayad Shirazi Hospital in Gorgan, North of Iran.

Background: Diabetes mellitus (DM) is one of the most common chronic diseases, the main manifestation of which is hyperglycemia, and is accompanied by many complications. Since the outbreak of the coronavirus disease 2019 (COVID-19) pandemic, several studies have reported the occurrence of various complications associated with different degrees of hyperglycemia in COVID-19 patients. The aim of the present study was to investigate the glycemic characteristics and clinical outcomes in patients with COVID-19. Methods: In this cross-sectional study, 418 patients with COVID-19 were evaluated in terms of hyperglycemia and its related factors, as well as the relationship between hyperglycemia and the outcome of the disease. Data were statistically analyzed using SPSS software. Results: In the present study, 350 (83.7%) out of 418 hospitalized patients with COVID-19 had hyperglycemia and 193 (55.1%) of the patients with hyperglycemia were women. 169 (48.4%) of patients with hyperglycemia during hospitalization were already diabetic. The mean age was higher in COVID-19 patients with hyperglycemia (P < 0.001), and systolic blood pressure and respiratory rate were also higher in them (P = 0.005 and P = 0.013, respectively). In patients with hyperglycemia, oxygen saturation (SpO2) at the time of admission and discharge was lower than other patients (P < 0.001). The frequency of hypertension in the patients with hyperglycemia was significantly higher than in nonhyperglycemic patients (P < 0.001 vs. 0.014). The estimated glomerular filtration rate (eGFR) of hyperglycemic patients was significantly lower than other patients (P < 0.001). Also, there was a significant inverse relationship between eGFR values and fasting (FBS) and random blood sugar (BS) (r = 0.328 and r = 0.310, P < 0.001). On the other hand, there was a direct relationship between FBS and random BS in patients with hyperglycemia with the dose of corticosteroids (r = 0.146 and r = 0.158, P < 0.01). In total, 8.2% of the patients died, although the FBS and random BS and a history of DM were not risk factors for the death of patients (P < 0.05). Conclusion: The findings of our study showed that hyperglycemia is highly prevalent in hospitalized patients with COVID-19. Hyperglycemia in previously nondiabetics appears to be associated with decreased eGFR in COVID-19 patients.

Hematological and Biochemical Laboratory Parameters in COVID-19 Patients: A Retrospective Modeling Study of Severity and Mortality Predictors.

Background: It is well known that laboratory markers could help in identifying risk factors of severe illness and predicting outcomes of diseases. Here, we performed a retrospective modeling study of severity and mortality predictors of hematological and biochemical laboratory parameters in Iranian COVID-19 patients. Methods: Data were obtained retrospectively from medical records of 564 confirmed Iranian COVID-19 cases. According to the disease severity, the patients were categorized into two groups (severe or nonsevere), and based on the outcome of the disease, patients were divided into two groups (recovered or deceased). Demographic and laboratory data were compared between groups, and statistical analyses were performed to define predictors of disease severity and mortality in the patients. Results: The study identified a panel of hematological and biochemical markers associated with the severe outcome of COVID-19 and constructed different predictive models for severity and mortality. The disease severity and mortality rate were significantly higher in elderly inpatients, whereas gender was not a determining factor of the clinical outcome. Age-adjusted white blood cells (WBC), platelet cells (PLT), neutrophil-to-lymphocyte ratio (NLR), red blood cells (RBC), hemoglobin (HGB), hematocrit (HCT), erythrocyte sedimentation rate (ESR), mean corpuscular hemoglobin (MCHC), blood urea nitrogen (BUN), and creatinine (Cr) also showed high accuracy in predicting severe cases at the time of hospitalization, and logistic regression analysis suggested grouped hematological parameters (age, WBC, NLR, PLT, HGB, and international normalized ratio (INR)) and biochemical markers (age, BUN, and lactate dehydrogenase (LDH)) as the best models of combined laboratory predictors for severity and mortality. Conclusion: The findings suggest that a panel of several routine laboratory parameters recorded on admission could be helpful for clinicians to predict and evaluate the risk of disease severity and mortality in COVID-19 patients.

Is bruxism associated with temporomandibular joint disorders? A systematic review and meta-analysis.

OBJECTIVES: The aim of this review is to examine and quantify the association between bruxism and temporomandibular joint disorders in a systematic review and meta-analysis. METHODS: Electronic searches were performed in PubMed/Medline, Embase, Cochrane, Wiley, ProQuest, Web of Science, and Scopus databases for articles published up to March 2022. Two independent reviewers assessed the quality of the studies using the Newcastle-Ottawa Scale. A random-effects model was used to estimate the pooled odds ratio (OR) and its corresponding 95% confidence interval (CI) for each study. RESULTS: The search retrieved 1651 studies, and 20 studies were eligible for meta-analysis. The results of the study showed that there is a significant relationship between bruxism and TMD, with the presence of bruxism increasing the odds of TMD by 2.25 times (OR = 2.25, 95% CI (1.94-2.56)). Based on the type of bruxism, awake bruxism was found to increase the odds of TMD by 2.51 times (OR = 2.51, 95% CI: (2.02-2.99)), while sleep bruxism increased the odds of TMD by 2.06 times (OR = 2.06, 95% CI: (1.82-2.30)). Analysis of the results from studies that reported both types of bruxism showed that bruxism increases the odds of TMD by 2.17 times (OR = 2.17, 95% CI: (2.30-3.05)). CONCLUSION: The available data demonstrate a positive relationship between bruxism and TMD, with the presence of bruxism increasing the likelihood of developing TMD in the future.

Effect of Endodontic Irrigation on Mineral Content of Root Canal Dentine: A Systematic Review and Meta-Analysis.

A systematic review and meta-analysis were conducted to evaluate the effect of endodontic irrigation on the mineral content of root canal dentine. A systematic search was performed in the following databases: PubMed, Web of Science, Scopus, Cochrane, ProQuest, and Wiley. The quality assessment of the articles was performed. The meta-analysis was carried out using the random effects model in the Stata 16 software (p<0.05). The results showed that Er: YAG Laser had a significant effect on the removal of the phosphorus content of dentine (Hedges' g=-0.49; 95% CI: -0.85, -0.13; I2=0.0%). In addition, the EDTA 5Min had a lower removal effect compared to the control group on the magnesium content of dentine (Hedges' g=0.58; 95% CI: 0.00, 1.16; I2=0.0%). Other irrigations had no significant effect on other on the mineral content of root canal dentine. Evidence was found to support that most root canal irrigation protocols did not have a significantly affected in terms of the mineral content of root dentine. (EEJ-2022-11-140).

Palatal Rugae Patterns in Fars, Turkmen, and Sistani Ethnicities in the Eastern Part of the Caspian Littoral of Iran.

In forensic medicine, it is important to identify whole or fragmented bodies. This aim can be particularly challenging in mass disasters. Palatal rugae patterns can be used as a surrogate parameter in forensic medicine. This stems from the difficulty in falsifying these patterns, their resistance to trauma, to decomposition for several days postmortem, and to combustion under high-temperatures, as well as being distinguishable among different races. The present study aimed to analyze the differences in the palatal rugae patterns among three Iranian ethnicities (Fars, Turkmen, and Sistani). This retrospective study involved the use of archived materials. The study casts were selected from the database of patients who visited a private orthodontics clinic. A total of 309 dental casts (103 Fars, 103 Turkmen, and 103 Sistani) were assessed, which belonged to 181 females and 128 males aged between 12 and 30 years (mean: 16.86 ± 3.18 years). The difference in the mean number of palatal rugae in women between the three ethnicities was statistically significant. Also, the differences in the total number of straight rugae were significant between the three ethnic groups. The most common rugae shapes in the three ethnic groups were the straight and wavy shapes. The length of the palatal rugae in the primary and secondary rugae among the study subjects younger than 18-years-old was significantly different between the three ethnic groups. Thus, the present research highlighted the differences in palatal rugae patterns among three Iranian ethnicities. Therefore, palatal rugae can be used in forensic medicine as a complementary approach to human identification.

Environmental factors and building conditions for risk of cutaneous leishmaniasis in the northeast of Iran: a population-based case-control study.

BACKGROUND: Leishmaniasis is a tropical disease that significantly affects countries in the developing world. This study evaluated the environmental factors and building conditions associated with cutaneous leishmaniasis (CL) in northeast Iran. METHODS: A population-based case-control study was performed between 1 July 2018 and 1 March 2021 in northeast Iran; two controls were selected for each case. Patients and controls were compared for environmental factors, building conditions and demographic characteristics. RESULTS: There were 170 confirmed leishmaniasis cases during the study period. Familiarity with people with active leishmaniasis in open areas of the body increased the odds of getting the disease (odds ratio [OR] 2.41 [95% confidence interval {CI} 1.18 to 4.93]). In the case group, the history of contact with animals such as sheep, goats, cows, mice and camels was significantly higher. Housewives (OR 0.08 [95% CI 0.02 to 0.27]) and self-employed people (OR 0.22 [95% CI 0.07 to 0.70]) were less likely to become infected. The individuals who lived in houses with asbestos cement roofs were more likely to become infected (OR 4.77 [95% CI 1.34 to 16.91]) compared with those who lived in houses with bituminous roofs. CONCLUSIONS: The most significant risk factor identified in the present study was the type and condition of the home's roof. Housing construction improvement is vital to prevent leishmaniasis in northeast Iran.

The prevalence of electronic cigarettes vaping globally: a systematic review and meta-analysis.

BACKGROUND: The purpose of this systematic review study was to determine the national, regional, and global prevalence of electronic cigarettes (e-cigarettes) vaping. METHOD: The articles were searched in July 2020 without a time limit in Web of Science (ISI), Scopus, PubMed, and Ovid-MEDLINE. At first, the titles and abstracts of the articles were reviewed, and if they were appropriate, they entered the second stage of screening. In the second stage, the whole articles were reviewed and articles that met the inclusion criteria were selected. In this study, search, selection of studies, qualitative evaluation, and data extraction were performed by two authors independently, and any disagreement between the two authors was reviewed and corrected by a third author. RESULTS: In this study, the lifetime and current prevalence of e-cigarettes vaping globally were 23% and 11%, respectively. Lifetime and current prevalence of e-cigarettes vaping in women were 16% and 8%, respectively. Also, lifetime and current prevalence of e-cigarettes vaping in men were 22% and 12%, respectively. In this study, the current prevalence of e-cigarettes vaping in who had lifetime smoked conventional cigarette was 39%, and in current smokers was 43%. The lifetime prevalence of e-cigarettes vaping in the Continents of America, Europe, Asia, and Oceania were 24%, 26%, 16%, and 25%, respectively. The current prevalence of e-cigarettes vaping in the Continents of America, Europe, Asia, and Oceania were 10%, 14%, 11%, and 6%, respectively. CONCLUSIONS: Based on the results of this study, it can be concluded that the popularity of e-cigarettes is increasing globally. Therefore, it is necessary for countries to have more control over the consumption and distribution of e-cigarettes, as well as to formulate the laws prohibiting about the e-cigarettes vaping in public places. There is also a need to design and conduct information campaigns to increase community awareness about e-cigarettes vaping.

Survival Rate of Liver Transplantation in Asia: A Systematic Review and Meta-Analysis.

Background: Liver transplantation is one of the most effective treatments for acute liver failure, chronic liver cirrhosis, and hepatocellular carcinoma. This study was implemented to evaluate the survival rate of liver transplant in Asia. Methods: Studies that investigated the survival rate of liver transplant were selected using a systematic search strategy in the following databases: Medline, Embase, Scopus, ProQuest, ISI Web of Science, and Cochrane to Nov 30th, 2020. Pooled survival rate and 95% confidence intervals were calculated using Der-Simonian and Laird method. Stata 16.0 (Stata Corp, College Station, TX, USA) was used for analysis. Results: One, 2, 3, 5, and 10-year survival rates of liver transplant were estimated to be 85%, 80%, 75%, 73%, and 71%, respectively. The results of the univariate meta-regression for defining the sources of heterogeneity for one-Year survival rate (SR) showed significant effects of bias (ß high risk/moderate risk =0.059, 95% CI: 0.002, 0.115, P-Value=0.04) and follow up time (ß= -0.0002, 95% CI: -0.0003, -0.00, P-Value=0.02) on heterogeneity. Conclusion: The survival rate of liver transplant in Asia is comparable with the corresponding rate reported in the United States and Europe. This study provides a better view of the efficiency of medical cares, regarding liver transplantation. Medical care be enhanced to increase the survival of liver transplant patients.

Factors Associated with Infant Mortality Due to Congenital Anomalies: A Population-Based Case-Control Study.

Background: Congenital anomalies are one of the major public health problems and one of the leading cause of infant mortality and morbidity. We aimed to investigate some factors associated with infant mortality due to congenital anomalies in several provinces of Iran. Methods: This case-control study was conducted on 2199 women referring health centers of nine provinces of Iran 2015-2018. Cases were defined as mothers with infant death due to congenital anomalies, and control group comprised of mothers with live birth or infant deaths due to other causes (n=1986). The descriptive data were expressed as percentage and frequency. Factors associated with infant death due to congenital anomalies were evaluated and analyzed at 95% confidence level by logistic regression analysis. Results: The multiple logistic regression analysis reveal that history of cesarean delivery [OR:2.13 ;95%CI (1.58-2.87)], maternal age [OR:1.94 ;95%CI (1.31-2.86)])], area of living [OR: 1.69;95%CI (1.22-2.33)], maternal smoking during pregnancy [OR: 1.41; 95%CI (1.02-1.95)], consanguineous marriage [OR:1.53;95%CI (1.12-2.08)], also low birth weight [OR: 3.09; 95%CI (2.23-4.30)] were significantly associated with infant death due to congenital anomalies. Conclusion: Identification of factors associated with congenital anomalies has been shown to reduce treatment costs and medical complications of neonates. Therefore, genetic counseling and educational programs for high-risk women, and prenatal screening are essential to identify and prevent factors contributing to congenital abnormalities.

Prevalence of Syphilis Infections among the Iranian Population: A Systematic Review and Meta-Analysis.

Background: Syphilis is one of the most important sexually transmitted infections (STI) and a public health problem, but the literature describing the true burden of syphilis is limited. In Iran, there are no accurate results on the prevalence of syphilis. This study aimed to conduct a systematic review and meta-analysis of syphilis in Iran. Methods: Following PRISMA guidelines, we conducted a systematic review and meta-analysis of studies published on the prevalence of Syphilis in Iran. We systematically reviewed the literature to identify eligible studies as of Sep 13, 2020, in international and national databases. The results are presented in the form of forest plots and tables. Pooled prevalence and 95% confidence intervals were calculated using Der Simonian and Laird method. Perform subgroup analysis through population, gender, city, and diagnostic tests to assess the source of heterogeneity. Results: We reviewed 1,229 papers and reports, and extracted data from 15 eligible records. The prevalence of combined syphilis in Iran is 0.1% (95% confidence interval [95% CI] 0.1-0.1%). The prevalence of syphilis was 0.4% in men (95% confidence interval [95% CI] -0.3, 1%) and 0.6% in women (95% confidence interval [95% CI] (0.1, 1%)). The cumulative meta-analysis showed a decline in the prevalence of syphilis between the years 1999 and 2015. Conclusion: The prevalence of syphilis in Iran is low. In the past few decades, the prevalence of syphilis across the country has declined. Syphilis infection is a small burden that needs to be revised in the implementation of high-cost screening programs.

The global survival rate of graft and patient in kidney transplantation of children: a systematic review and meta-analysis.

BACKGROUND: This study is a systematic review and meta-analysis on published studies about the Global Survival Rate of Graft and Patients in the Kidney Transplantation of children. METHODS: Studies that investigated the survival rate of kidney transplants published until the 30th of December 2020 were selected using a systematic search strategy in the following databases: Medline, Embase, Scopus, ProQuest, ISI Web of Science, and Cochrane. The extracted data were entered into the Excel software and STATA 16.0. The search identified 6007 study references. From the total, we excluded 1348 duplicates, 3688 reference titles and abstracts that were deemed irrelevant, and 846 references that were not original articles (i.e., letter, commentary, review) or did not meet the inclusion criteria. As such, 89 studies involving 12,330 participants were included in this meta-analysis. RESULTS: In this study 1, 3, 5, 7 and 10-year survival rates of graft were estimated to be 92, 83, 74.40, 67.10, and 63.50%, respectively. Also, 1, 3, 5, 7 and 10-year survival rates of patients were estimated to be 99.60, 97.30, 95.20, 74.60, and 97.90%, respectively. CONCLUSIONS: The findings suggest differences in graft and patient survival among children with kidney transplants. Although differences in ethnic origin, incompatibility with deceased donor kidneys, and types of kidney disease are unavoidable, interventions to improve preventive and living-donor transplantation are particularly needed in minority groups. In addition, more research is needed to establish and address the contribution of medical and sociocultural barriers to preferential treatment of these groups.

The survival rate of liver transplantation in children: a systematic review and meta-analysis.

Liver transplantation is a life-saving treatment for children who are in liver failure. The survival rate index is used to assess the success rate of liver transplantation. The study aimed to assess the survival rate of liver transplantation in children. We searched 5 international databases in this study, including Medline/PubMed, ProQuest, Scopus, Web of Knowledge, and Google Scholar, for published articles by the end of 2020. Also, meta-regression analysis was performed based on the year of the study, and subgroup analysis was performed according to continents. A total of 425 titles were reviewed. Based on the results, 96 articles were entered in the meta-analysis. Established on the random-effect model, the survival rates of 1, 3, 5, and 10 years of transplantation were 86.62%, 77.74%, 73.95%, and 68.60%, respectively. Also, based on the meta-regression results, there was a relationship between the year of the study and the survival rate, as the study year gets more recent, the survival rate is increased. This study can provide documented and comprehensive evidence which can be the basis of many policies and decisions in various sectors of health development, including evaluating treatment options and health interventions in transplantation.

Association between type 2 diabetes (T2D) and tooth loss: a systematic review and meta-analysis.

BACKGROUND: Several studies have assessed the relationship between type 2 diabetes (T2D) and tooth loss; however, results have been inconsistent. Therefore, the present systematic review and meta-analysis of observational studies was designed to examine the association between T2D and tooth loss. METHODS: This systematic review and meta-analysis was conducted based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Guideline. We searched all the relevant studies in international databases of Scopus, PubMed, ProQuest, Web of Science, Cochrane Library, and Google scholar search engine until February 2022. The heterogeneity of the studies was calculated using the I2 index. Measure of effect and 95% confidence interval (CI) were extracted from each study. The results of the study were analyzed using the random effects model. RESULTS: In the present study, 22 eligible studies were included. Meta-analysis of unadjusted and adjusted results showed that T2D significantly increased the risk of tooth loss, and Odds Ratio (OR) unadjusted was 1.87 (95% CI: 1.62-2.13, p < 0.001), and OR adjusted was 1.20 (95% CI: 1.10-1.30, p < 0.001), respectively. Subgroup analysis based on study design for adjusted OR indicated that in the cohort study (OR: 1.29, 95% CI: 1.07-1.51), in the cross-sectional study (OR: 1.15, 95% CI: 1.06-1.23), and in the case-control study (OR: 5.10, 95% CI: 1.01-9.18) there was a significant association between T2D and tooth loss. Other subgroups analyses showed consistent results and no publication bias existed. CONCLUSIONS: The findings suggest that T2D is associated with increased risk of tooth loss. This conclusion may provide useful evidence for correlated clinical researches.

Modeling the diagnosis of coronary artery disease by discriminant analysis and logistic regression: a cross-sectional study.

PURPOSE: Coronary artery disease (CAD) is one of the most significant cardiovascular diseases that requires accurate angiography to diagnose. Angiography is an invasive approach involving risks like death, heart attack, and stroke. An appropriate alternative for diagnosis of the disease is to use statistical or data mining methods. The purpose of the study was to predict CAD by using discriminant analysis and compared with the logistic regression. MATERIALS AND METHODS: This cross-sectional study included 758 cases admitted to Fatemeh Zahra Teaching Hospital (Sari, Iran) for examination and coronary angiography for evaluation of CAD in 2019. A logistics discriminant, Quadratic Discriminant Analysis (QDA) and Linear Discriminant Analysis (LDA) model and K-Nearest Neighbor (KNN) were fitted for prognosis of CAD with the help of clinical and laboratory information of patients. RESULTS: Out of the 758 examined cases, 250 (32.98%) cases were non-CAD and 508 (67.22%) were diagnosed with CAD disease. The results indicated that the indices of accuracy, sensitivity, specificity and area under the ROC curve (AUC) in the linear discriminant analysis (LDA) were 78.6, 81.3, 71.3, and 81.9%, respectively. The results obtained by the quadratic discriminant analysis were respectively 64.6, 88.2, 47.9, and 81%. The values of the metrics in K-nearest neighbor method were 74, 77.5, 63.7, and 82%, respectively. Finally, the logistic regression reached 77, 87.6, 55.6, and 82%, respectively for the evaluation metrics. CONCLUSIONS: The LDA method is superior to the Quadratic Discriminant Analysis (QDA), K-Nearest Neighbor (KNN) and Logistic Regression (LR) methods in differentiating CAD patients. Therefore, in addition to common non-invasive diagnostic methods, LDA technique is recommended as a predictive model with acceptable accuracy, sensitivity, and specificity for the diagnosis of CAD. However, given that the differences between the models are small, it is recommended to use each model to predict CAD disease.

Major Thalassemia, Screening or Treatment: An Economic Evaluation Study in Iran.

BACKGROUND: Beta-thalassemia minor and thalassemia major are an autosomal recessive disease with hypochromic, microcytic anemia, and morbidities, Today, therapeutic advances have significantly improved the life expectancy of thalassemia major patients, but at the cost of financial toxicity. The present study aimed to investigate the possibility of increasing the funding for thalassemia screening programs and comparing the cost-effectiveness of screening for thalassemia in the treatment of the patients. METHODS: In this study, screening for thalassemia minor was compared with the treatment of thalassemia major patients. A decision tree model was used for analysis. A hospital database, supplemented with a review of published literature, was used to derive input parameters for the model. A lifetime study horizon was used and future costs and consequences were discounted at 3%. The approach of purchases of services was used to evaluate the screening test costs for patients with thalassemia major. Also, a bottom-up method was applied to estimate other screening and treatment costs. All the costs were calculated over one year. The number of gained quality-adjusted life years (QALYs) was calculated using the EQ-5D questionnaire in the evaluated patients. RESULTS: In this study, 26.97 births of patients with thalassemia major were prevented by screening techniques. On the other hand, total screening costs for patients with thalassemia major were estimated equal to US$ 879879, while the costs of preventing the birth of each thalassaemia major patient was US$ 32 624 by screening techniques. In comparison, the cost of managing a patient with thalassemia major is about US$ 136 532 per year. The life time QALYs for this is 11.8 QALYs. Results are presented using a societal perspective. Incremental cost per QALY gained with screening as compared with managing thalassaemia major was US$ 11 571. CONCLUSION: Screening is a long-term value for money intervention that is highly cost effective and its long-term clinical and economic benefits outweigh those of managing thalassaemia major patients.

Mothers view about oral health status, oral hygiene behaviors, and dental services utilization of their children with hearing impairment attending special schools.

AIM: Parents are the principal decision-makers regarding their child's health. Awareness of mothers' view about their children's health, particularly with special health care needs (SHCN) (include hearing impaired children), is essential for health care providers. Therefore, the present study aimed to assess the mothers view about oral health status, oral hygiene practices, and dental services utilization of their children with hearing impairment attending special schools. METHODS: A cross-sectional study was conducted between May and September 2020 among mothers of students with hearing impairment attending special schools. Also, the telephone structured interview was used to gathering mothers view. RESULTS: 57.4% of the mothers rated their children's oral health status as excellent or good, 27.9% as moderate, and 14.7% as poor. About half of the mothers (49.2%) stated that their children used toothbrushes once daily, and 15% use dental floss. Also, 54% of the children visited the dentist before this survey's conduct. CONCLUSION: The findings of the present study suggest that children with hearing impairment can also have good oral health status and behaviors. These results may be attributed to the fact that the study sample was taken from two special schools. Also, only the mothers' perception assessment of students' oral health status was done. Further studies are required to increase the strength of evidence.

Association between mobile phone use and hearing impairment: a systematic review and meta-analysis.

OBJECTIVES: To investigate whether a possible association of mobile phone use with hearing impairment was conducted a systematic review and meta-analysis. CONTENT: This is a systematic review and meta-analysis. A comprehensive literature search was carried out based on the Meta-analysis of Observational Studies in Epidemiology (MOOSE) methodology using PubMed, Scopus, Web of Science, OVID, and Cochrane. The Robins-I tool was used for quality assessment and risk of bias. Two investigators independently reviewed all articles. Pooled effect size was calculated and meta-analysis was performed to compute an overall effect size. SUMMARY: Overall, five relevant studies (two cross-sectional and three cohort studies) with 92,978 participants were included in the analysis. The studies were stratified by design, there was no significant association between mobile phone use and hearing impairment in cross-sectional studies (OR=0.94, 95% CI=0.57-1.31) and cohort studies (OR=1.09, 95% CI=0.93-1.25). In addition, the effect estimates did not differ significantly between cross-sectional and cohort studies (Q=0.50, p=0.48). Overall, the pooled odds ratio (OR) of hearing impairment was 1.07 (95% CI: 0.94-1.20), which indicates no significant association between mobile phone use and hearing impairment. OUTLOOK: Our findings indicate no association between mobile phone use and hearing impairment. However, these findings must be interpreted with caution.