Complementary and alternative medicine therapies and COVID-19: a systematic review.

OBJECTIVES: Despite the high prevalence of coronavirus and various treatment approaches, including complementary and alternative medicine (CAM), there is still no definitive treatment for coronavirus. The present study aimed to evaluate the effect of CAM interventions on COVID-19 patients. CONTENT: Four databases (Web of Science, PubMed, Scopus, and EMBASE) were searched from the inception of databases until July 16, 2020. Keywords included complementary and alternative medicine therapies and Coronavirus. SUMMARY AND OUTLOOK: Of the 1,137 studies searched, 14 studies performed on 972 COVID-19 patients entered the systematic review final stage. The results showed that different CAM interventions (acupuncture, Traditional Chinese medicine [TCM], relaxation, Qigong) significantly improved various psychological symptoms (depression, anxiety, stress, sleep quality, negative emotions, quality of life) and physical symptoms (inflammatory factors, physical activity, chest pain, and respiratory function) in COVID-19 patients. The results showed that various CAM interventions have a positive effect on improving the various dimensions of coronavirus disease but since there are few studies in this regard, further studies using different CAM approaches are recommended.

The effect of yoga on uterine artery Doppler indices, maternal and fetal complications in pregnant women: A quasi-experimental study.

BACKGROUND: Today, the effect of yoga has been examined on various physical and psychological dimensions of pregnant women. However, there are still sparse studies on the effect of yoga on the uterine artery indices as well as maternal and fetal complications. OBJECTIVE: The aim was to determine the effect of yoga on uterine artery Doppler indices, maternal and fetal Complications. MATERIALS AND METHODS: This quasi-experiential study was conducted, on 100 pregnant women. The participants were assigned to yoga and control groups. In the yoga group, the participants exercised yoga for 1 h. On the other hand, the control group received routine care. RESULTS: The results showed that in the yoga group, the functional indices of the uterine artery (S/D, PI, RI, and DN) improved more significantly compared to the control (p = 0.01). The results also showed that in the yoga group, maternal complications (diabetes and preeclampsia), as well as fetal complications (SAG, IUGR), were significantly lower compared to the control (p = 0.01). CONCLUSION: This study revealed the positive effects of yoga on improving fetal development indices and reducing maternal and fetal complications following pregnancy. It can be used as a Complementary therapy alongside other treatments for mothers.

Global Prevalence and Device Related Causes of Needle Stick Injuries among Health Care Workers: A Systematic Review and Meta-Analysis.

Background: Healthcare workers (HCWs) suffer more than 2 million occupational needle-stick injuries (NSIs) annually. Goal: To determine the global prevalence and causes of NSIs among HCWs. Methods: In this systematic review and meta-analysis, three databases (PubMed, Web of science, and Scopus) were searched for reports from January 1, 2000 to December 31, 2018. The random effects model was used to determine the prevalence of NSIs among HCWs. Hoy et al.'s instrument was employed to evaluate the quality of the included studies. Findings: A total of 87 studies performed on 50,916 HCWs in 31 countries worldwide were included in the study. The one-year global pooled prevalence of NSIs among HCWs was 44.5% (95% CI: 35.7, 53.2). Highest prevalence of NSIs occurred in the South East Asia region at 58.2% (95%, CI: 36.7, 79.8). By job category, prevalence of NSIs was highest among dentists at 59.1% (95% CI: 38.8, 79.4), Hypodermic needles were the most common cause of NSIs at 55.1% (95% CI: 41.4, 68.9). Conclusion: The current high prevalence of NSIs among HCWs suggests need to improve occupational health services and needle-stick education programs globally.

Quality of life of chronic heart failure patients: a systematic review and meta-analysis.

Despite various individual studies on the quality of life (QOL) in patients with CHF, a comprehensive study has not yet been conducted; therefore, this study aims to assess the QOL of CHF patients. In the present systematic review and meta-analysis, PubMed, Scopus, and the Web of science databases were searched from January 1, 2000, to December 31, 2018, using QOL and heart failure as keywords. The searches, screenings, quality assessments, and data extractions were conducted separately by two researchers. A total of 70 studies including 25,180 participants entered the final stage. The mean QOL score was 44.1 (95% confidence interval (CI) 40.6, 47.5; I2 = 99.3%) using a specific random effects method in 40 studies carried out on 12,520 patients. Moreover, according to the geographical region, heart failure patients in the Americas had higher scores. In 14 studies, in which a general SF-36 survey was implemented, the average physical component score (PCS) and mental component score (MCS) were 33.3 (95% CI 31.9, 34.7; I2 = 88.0%) and 50.6 (95% CI 43.8, 57.4; I2 = 99.3%), respectively. The general and specific tools used in this study indicated moderate and poor QOL, respectively. Therefore, it is necessary to carry out periodic QOL measurements using appropriate tools as part of the general care of CHF patients.

Prevalence of gestational diabetes mellitus in Eastern Mediterranean region: a systematic review and meta-analysis.

PURPOSE: Gestational diabetes mellitus (GDM) is one of the costly challenges in the health field. Despite the individual studies in the Eastern Mediterranean, there is no comprehensive study in this regard. The aim of this study was to determine the prevalence of GDM in the Eastern Mediterranean region. METHODS: In this meta-analysis and systematic review, three international databases (PubMed, Web of science and Scopus) were searched from inception until 30 December 2018. The Hui tool was used to assess the quality of the included studies. RESULTS: Thirty-three studies performed on 887166 participants were included in the meta-analysis. Based on the results of random effect method, the overall prevalence of GDM was 11.7%. Between six country with have three or more study, pooled prevalence for Saudi Arabi it was 3.6 times more than Israel (17.6 vs. 4.9%), and for Pakistan, Qatar, Bahrain and Iran were 15.3%, 14.7%, 12.2%, and 8.6%, respectively. CONCLUSION: Despite the high diversity of methods, the results of the present study indicate a high prevalence of GDM in the Eastern Mediterranean region, indicating more policymakers' interest in timely screening and proper management.

Hypertension and Pre-Hypertension Among Iranian Adults Population: a Meta-Analysis of Prevalence, Awareness, Treatment, and Control.

PURPOSE OF REVIEW: This meta-analysis and systematic review was conducted to evaluate hypertension and prehypertension prevalence, awareness, treatment, and control in Iranian adults population. RECENT FINDINGS: In this study, six international and national databases were searched from inception until August 30, 2018. Forty-eight studies performed on 417,392 participants were included in the meta-analysis. Based on the results of random effect method (95% CI), the overall prevalence of pre-hypertension, hypertension, awareness, treatment, and control were 31.6% (95% CI 24.9, 38.3; I2 = 99.7%), 20.4% (95% CI 16.5, 24.4; I2 = 99.9%), 49.3% (95% CI 44.8, 53.8; I2 = 98.5%), 44.8% (95% CI 28.3, 61.2; I2 = 99.9%), 37.4% (95% CI 29.0, 45.8; I2 = 99.3%), respectively. Considering the increasing prevalence of pre-hypertension, hypertension, as well as more than half of the participants were unaware of their disease and were not treated, the results of the present study can help policy-makers to increase hypertension awareness, control, and treatment, especially in high-risk individuals.

Effect of aromatherapy on post-partum complications: A systematic review.

INTRODUCTION: and purpose: Aromatherapy is a known popular method to reduce the symptoms of various physiologic processes and diseases. The aim of the study was to determine whether aromatherapy improves symptoms commonly experienced by women during the postpartum period. METHODS: In the present systematic review, four international databases (PubMed, Google Scholar, Web of Science, and Scopus) were searched from inception of databases through August 2018. References for each study were manually reviewed to ensure that relevant works were included. RESULTS: Thirty-four (34) articles were identified with 17 studies meeting eligibility criteria and included a total of 1400 women using a variety of aromatherapies. Results demonstrated that aromatherapy can improve symptoms commonly experienced in post-partum period, including depression, stress, pain, anxiety, and fatigue. CONCLUSION: There are therapeutic effects in use of aromatherapy during the post-partum period. Aromatherapy, however, should be used with caution as safety concerns have not been conclusively demonstrated.

Causes of Chronic Kidney Disease in Iranian Children: A Meta-Analysis and Systematic Review.

This study aimed to determine the causes of chronic kidney disease (CKD) in Iranian children. In this systematic review and meta-analysis study, international (PubMed, Web of Science, Scopus, and Google Scholar) and national (SID, Magiran) databases were searched for articles published through December 30, 2017. The quality of the studies was determined using the Hoy instrument. Out of 2,117 initial studies, 13 studies performed on a total of 3,596 children were included in the final stage of the study. Based on the results of the random effects method (95% CI), the main causes of chronic kidney disease in stages 1-4 (CKD) were CAKUT (37%) and glomerulonephritis (19.96%); in stage 5 (ESRD) they were CAKUT (40.82%) and urological disorders (27.44%). Considering the high prevalence of CAKUT, glomerulonephritis and urinary problems, the use of comprehensive approaches can be very effective in enhancing the knowledge of patients about the causes of kidney disease. The results obtained from the present study can assist policymakers in more accurately planning screenings of the causes of CKD in Iranian children.

Knowledge, attitude, practice, and clinical recommendation toward infection control and prevention standards among nurses: A systematic review.

BACKGROUND: The purpose of this study was to systematically review the literature to describe nurses' knowledge and practice of and attitude toward infection control and prevention standards. METHODS: In the present systematic review, 4 electronic databases were searched from the inception of databases through March 2018. Quality of included studies was assessed using the Hoy tool. RESULTS: Eighteen studies conducted on 4,577 employed nurses and nursing students entered the final stage. Results indicated that nurses in most studies had adequate knowledge (n = 10, 40%-90%) and positive attitude (n = 4, 37%-100%). However, most studies reflected average and poor nursing practices with regard to adherence to infection control and prevention standards. The most frequent recommendations proposed for improving nurses' knowledge, attitude, and practice included periodic training via scientific conferences and relevant practical courses (n = 12), combining up-to-date theoretical and practical programs (n = 6), and training at the beginning of hospital employment (n = 4). CONCLUSIONS: The results of the present study indicate that although nurses in most studies had adequate knowledge of and positive attitude toward health care-associated infections, because of average and poor practices, they need systematic and integrated implementation of the presented recommendations.

Health-related quality of life of breast cancer patients in the Eastern Mediterranean region: a systematic review and meta-analysis.

PURPOSE: Breast cancer is the most common type of cancer in women around the world, and this applies to the Middle East as well. The goal of all medical care and treatment is to improve the quality of life (QoL) of patients. Accordingly, the present study aimed at evaluating the QoL of patients with breast cancer in the Middle East region. METHODS: In this meta-analysis, three electronic databases (PubMed, Web of Science, and Scopus) were searched from inception until August 2018. The hoy et tool was used to evaluate the quality of the articles included in the meta-analysis. The search, screening, quality evaluation, and data extraction were carried out by two of the researchers. RESULTS: Thirty-six studies conducted on 8347 Middle Eastern women with breast cancer entered the final stage. QoL was assessed by the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire in 20 studies, with 6034 patients. The mean of the reported QoL was between 31.1 and 75.6. Based on the results of the random effect method, the overall mean of the QoL was 60.5 (95% confidence interval 56.0, 65.0; I2 = 99.0%). In six studies performed on 1053 individuals, QoL was classified as good, moderate, or poor. Less than one-third of patients (21%) had a good QoL. CONCLUSIONS: Since less than one-third of patients had a good QoL, it seems necessary to design and implement an integrated and multidimensional educational program to improve QoL of patients with breast cancer.

Cancer Pain Management Among Oncology Nurses: Knowledge, Attitude, Related Factors, and Clinical Recommendations: a Systematic Review.

The current study evaluated the oncology nurse's knowledge, attitude, related factors of cancer-related pain management (CPM), and clinical recommendations for improving knowledge and attitude. In this systematic review, international databases (PubMed, EMBASE, Web of science (WOS), Science Direct, and Scopus) were searched for relevant studies published in English language from March 30, 2000 to March 30, 2018. The quality of the studies was evaluated using the Hoy instrument. Out of 888 initial studies, 12 studies performed on 3574 participants were included in the final stage of the review. Based on the results, most studies indicated that nurses had a poor (n = 4) or moderate (n = 4) knowledge of CPM. The lowest and the highest knowledge levels were 28.5% and 75%, respectively. According to most studies, nurses had a fair (average) (n = 4) or negative (n = 3) attitude toward CPM. The important factors related to the nurses' knowledge of CPM included previous pain-related education programs (n = 7) and having work experience with cancer patients (n = 4). The most important barrier was the deficit in staff's knowledge of pain (n = 2). The important clinical recommendations for improving nurses' levels of knowledge included the implementation of educational programs (n = 9), training programs (n = 3) on CPM and including CPM topics in nursing curricula (n = 5). This systematic review showed that most nurses had poor knowledge of CPM and a fair attitude toward CPM, indicating the importance of considering the barriers to knowledge, strengthening the positive relevant factors, and using clinical recommendations based on clinical guidelines such as including CPM topics in nursing curricula and implementing educational programs on CPM to improve the knowledge, attitude, and skills of oncology nurses. The results of the present study could be used by policymakers to provide care for cancer patients and manage their pain.

Prevalence of Chronic Kidney Disease in Iranian General Population: A Meta-Analysis and Systematic Review.

The aim of this study was to determine the prevalence of CKD in the Iranian general population. In this systematic review and meta-analysis study, international (PubMed, Web of Science, Scopus, and Google scholar) and national databases (SID, Magiran) were searched until December 30, 2017. The quality of the studies was evaluated using the Hoy instrument. Out of 1170 initial studies, 9 studies with a total of 70 605 participants were included in the final stage of this study. Based on the results of the random effect method (95% CI), the overall prevalence of chronic kidney disease in 70 605 people was 15.14% (I2 = 99.77%). The prevalence of CKD in female patients (18.80%) was 1.7 times higher than in male patients (10.83). The results of the present study indicate a higher than the global average prevalence of CKD in Iran and the need for additional attention of policy makers on better planning for control and implementation of screening programs in high-risk populations, such as patients with hypertension and diabetes.

Effect of aromatherapy interventions on hemodialysis complications: A systematic review.

BACKGROUND AND PURPOSE: Aromatherapy, a CAM therapy, is a natural way of treating the mind, body and soul of individuals. The purpose of this study was to systematically review the literature to determine the effect of aromatherapy on hemodialysis complications. METHODS: In this systematic review, international (PubMed, Google Scholar, Web of Science, CINHAL, EMBASE and Scopus) and national databases (SID and Magiran) were searched from inception of the databases to 30 December 2017. RESULTS: The results showed that aromatherapy reduced some of the complications of hemodialysis, including anxiety, fatigue, pruritus, pain of arteriovenous fistula puncture, sleep quality, depression, stress and headache. In one case, it improved the quality of life of hemodialysis patients. CONCLUSION: Considering the complications and heavy costs of managing complications in patients undergoing hemodialysis, it appears that aromatherapy can be used as an inexpensive, fast-acting and effective treatment to reduce complications in hemodialysis patients.

Evaluation of the Effect of Oral Pyridostigmine on the Ileus after Abdominal Surgery: A Blinded Randomized Clinical Trial.

Postoperative ileus is one of the most important and common complications after abdominal surgery. This single-blind randomized clinical trial study was conducted with the aim of evaluating the effect of oral pyridostigmine (60 mg) on the duration and frequency of response to the treatment of ileus after abdominal surgery on 40 patients in two 20-subject groups of oral pyridostigmine (interventional) and starch (control) in 2015. All 40 people completed the study process and entered the final analysis. In the oral Pyridostigmin group (60 mg) the mean response time for the disposal of gas and stool were 5.4 ± 4.7 h and 4.9 ± 3.4 h, respectively. Most of the participants 10 (50%) (Disposal of stool) responded to treatment 4 h after the administration of oral pyridostigmine. In the starch group, the mean response time for the disposal of gas and stool were 32.4 ± 9.9 h and 36.2 ± 10.3 h, respectively. The mean treatment response time in two groups showed a significant difference between both groups (p = 0.001). Regarding the frequency of response to treatment (disposal of gas or stool) in the 24-h period after the initiation of treatment in the oral pyridostigmine group, 95% (n = 19) of the subjects responded to the treatment in the first 24 h. However, in the starch group, only 50% (n = 10) responded to treatment in the first 24 h, the results showed a significant difference between the two groups (p = 0.001). The results indicate that oral pyridostigmine can be used as a simple and effective treatment for gastrointestinal ileus.

Comparing the effects of relaxation technique and inhalation aromatherapy on fatigue in patients undergoing hemodialysis.

This study aimed to compare the effects of relaxation techniques on fatigue in hemodialysis patients. This clinical trial study was conducted on 105 hemodialysis patients. The subjects were categorized into three groups as: relaxation, aromatherapy and control. In the relaxation group, Benson muscle relaxation techniques were employed; in the aromatherapy group, the inhalation of two drops of 5% lavender essential oil used and the control group only received regular healthcare actions. Data collected by using brief fatigue inventory, before and after the intervention. Results of the current study indicated significant differences in the mean of changes in fatigue scores before and after the intervention between the relaxation and aromatherapy groups, but the difference was insignificant in the control group. Aromatherapy with lavender essential oil can decrease the level of fatigue in the patients undergoing hemodialysis compared to Benson relaxation techniques.

Knowledge and Source of Information About Early Detection Techniques of Breast Cancer Among Women in Iran: A Systematic Review.

BACKGROUND: An increase of access to knowledge about early detection techniques of breast cancer can reduce this mortality rate. This study aimed to determine the knowledge and source of information about early detection techniques of breast cancer among Iranian women. METHODS: Both International (PubMed, Web of Science, and Google Scholar) and national (scientific information database [SID] and Magiran) databases were reviewed launching to September, 2017 to obtain related articles. Steps involving the screening, analysis of quality of the studies and extraction of papers were performed by two researchers. RESULTS: Of the 749 studies searched initially, 25 studies performed on 11,756 people were selected for the final stage. General knowledge for breast cancer screening among women ranged from 4.5% to 45%. The number of people with sufficient knowledge about breast self-examination in various studies was between 5% and 79.8%. The most important source of information was the Healthcare team. CONCLUSIONS: Considering the poor knowledge and different source of information, it is suggested that educational programs be conducted around the country especially in at-risk populations.

Health-related quality of life of Iranian breast cancer patients: a meta-analysis and systematic review.

PURPOSE: Quality of life is the most important psychological factor affecting breast cancer patients. This study aimed to examine the health related quality of life of breast cancer patients in Iran. METHODS: International (PubMed, Web of science, Scopus and Google scholar) and national (SID, Magiran) databases were searched for related studies to September 2017. The quality of the articles was evaluated using the Hoy tool. RESULTS: Out of 232 initial studies, 18 studies performed on 2263 people were included in the final stage of the study. Based on the EORTC-QLQ-C30 and random effect method, the pooled mean score of quality of life in 1073 people was 57.88 (95% CI 48.26-67.41, I2 = 97.90%) and the pooled mean score of quality of life based on WHOQOL-BREF in 357 people was 66.79 (95% CI 45.96-87.62, I2 = 99.50%). CONCLUSION: According to the results of the study, a moderate level of quality of life in women with breast cancer was indicated. Therefore, the use of multidimensional approaches can improve their quality of life.

Attitude and Practice Regarding Breast Cancer Early Detection among Iranian Women: A Systematic Review

Objectives: To determining attitudes and practice regarding breast cancer early detection techniques (breast self-examination (BSE), clinical breast examination (CBE) and mammography) among Iranian woman. Methods: International (PubMed, ISI, and Google Scholar) and national (SID and Magiran) databases were reviewed up to September 2017 to identify articles related to the attitudes and practices of Iranian women concerning breast cancer screening behavior with reference to BSE , CBE and mammography. The screening steps, analysis of quality of the studies and extraction of the papers were performed by two reviewers. Results: Of the 532 studies included initially, 21 performed on 10,521 people were considered eligible. Subjects with a positive attitude toward BSE in various studies were 13.5% to 94.0% with an average of 47.6%. Positive attitudes to CBE and mammography were found in 21.0% and 26.4%, respectively. Participant performance of BSE ranged from 2.6% to 84.7%, with an average of 21.9%. The respective figures for CBE and mammography were 15.8% and 16.7%. Conclusion: Considering the poor performance and low rates for positive attitudes, it is suggested that educational programs should be conducted across the country.