The effect of air pollution on systemic lupus erythematosus: A systematic review and meta-analysis.

BACKGROUND: Systemic lupus erythematosus (SLE) is an autoimmune disease resulting from impaired inflammatory responses. Given the role of air pollution on increasing inflammatory mediators, thus, we aimed to systematically review and meta-analyze evidence regarding an association between short-term exposure to air pollution and SLE onset, activity, and hospitalization. METHODS: Electronic databases including Web of Science, PubMed, Scopus, and Embase were searched for all published articles until July 5, 2021. Newcastle Ottawa Scale (NOS) checklist was used to assess the quality of individual studies. Relevant demographic data and the intended results of the selected studies were extracted, and their adjusted risk ratios (RRs) were pooled using random and fixed effect analysis based on the heterogeneity index. FINDINGS: Twelve studies were entered in our systematic review, and finally, six publications were enrolled in meta-analysis. Overall, Meta-analysis showed no significant association between an increase of PM2.5 on the third day and SLEDAI score with pooled adjusted RR of 1.212 (95% CI, 0,853-1.721), p-value = 0.284. However, there was a positive relationship between 6 days increase of Particulate matter (PM) 2.5 and the systemic lupus erythematosus disease activity Index (SLEDAI) score (pooled adjusted RR 1.112; 95% CI, 1.005-1.231), p-value = 0.040. There was no significant association between carbon monoxide (CO), nitrogen dioxide (NO2), PM2.5, and PM10 increase in the air and hospitalization of SLE patients with pooled RR of 1.021 (95% CI, 0,986-1.1.057), p-value = 0.249, 1.034 (95% CI, 0.996-1.068); p-value = 0.079, 1.042 (95% CI, 0.994-1.092); p-value = 0.084 and 1.004 (95% CI, 0.996-1.013); p-value = 0.323, respectively. Also, analysis showed a significant relation between ozone (O3) increase and hospitalization with a pooled RR of 1.076 (95% CI, 1.009-1.147); p-value = 0.025. Finally, analysis of SO2 increase and risk of hospitalization demonstrated no significant relationship with the pooled RR of 1.011; (95% CI, 0.962-1.062), p-value = 0.0.671. CONCLUSION: Our findings prove that PM2.5 was associated with increased SLE risk. We also showed that only O3 was associated with increased hospital admissions of SLE patients.

Evaluation of the Effect of Religious Fasting on Retinal Vessel Density and Retinal Thickness Using Optical Coherence Tomography Angiography.

We conducted this study to assess the effect of religious fasting on intraocular pressure (IOP) as well as retinal parameters and retinal thickness during Ramadan using optical coherence tomography angiography (OCTA) performed on a spectral domain device. All the participants ate a pre-dawn meal and drink, and then fasted for at least 15 hours. We assessed a total of 61 eyes from 31 healthy volunteers with a mean age of 32.87 ± 8.07. A significant decrease was found in the median IOP after fasting at 10.00 mmHg in comparison with the pre-fasting value of 12.00 mmHg (p < .0001). Retinal peri-papillary capillary (RPC) whole image, RPC inside disk, and RPC mean values showed significant decreases after fasting (p = .011, .012, and .032 respectively). RPC whole vessel density (VD), RPC inside VD, and RPC VD mean values also showed significant decreases after fasting period (p = .025, <.0001, and .003, respectively). Religious fasting during the warm season could decrease IOP. It could also reduce the blood flow of the retina, specifically the macula, and the retinal peri-papillary VD.

Administration of Silver Nanoparticles in Diabetes Mellitus: A Systematic Review and Meta-analysis on Animal Studies.

Biological features of silver nanoparticles in rising the insulin level of diabetic animal models were considered in recent years, which resulted in decreasing hyperglycemia condition. We reviewed the published literature to investigate the possible role of silver nanoparticles (Ag-NPs) throughout the treatment of diabetes mellitus in animal studies. In this systematic review and meta-analysis, we performed a search throughout the English literature of electronic databases, including Scopus, PubMed, and ISI Web of Science, up to the date of May 22, 2020. Primary outcomes and data regarding fast blood sugar (FBS), lipid profile, and liver enzyme were collected from the available articles, while the studies that did not provide sufficient information on the effects of silver nanoparticles through the course of diabetes mellitus were excluded. Our search yielded 1283 results that included five animal studies in the meta-analysis. The comparison between the plasma insulin level of the diabetic group treated by Ag-NPs with the diabetic control group displayed no significant differences with the P values = 0.299. In addition, significant differences were revealed by comparing the FBS level of the diabetic group treated by Ag-NPs with the diabetic control group (P value < 0.001). According to the present meta-analysis, the application of Ag-NPs in animal models resulted in displaying the anti-diabetic effects, which can be applied in future treatments. Furthermore, a correlation was noticed between these nanoparticles and the reduction of serum FBS among diabetic cases.

Incidence of infectious diseases after earthquakes: a systematic review and meta-analysis.

OBJECTIVES: Evaluation of the incidence of infectious diseases after natural disasters can help develop healthcare policies. This study provides a global review of the most prevalent infectious diseases observed after earthquakes. STUDY DESIGN: A systematic review and meta-analysis were performed. METHODS: A systematic review was performed on electronic databases, including PubMed, Scopus and Web of Science, up to March 2020 (with no time limitations). Studies addressing earthquakes and infectious diseases were collected based on specified inclusion and exclusion criteria. Subsequently, the quality of the studies was assessed by the Newcastle-Ottawa scale (NOS). Data analyses were carried out on six subgroups under five different disease categories using comprehensive meta-analysis software. RESULTS: In total, 24 studies qualified for the systematic review and 18 were included in the meta-analysis. The incidences of gastrointestinal infections, dermal infections, respiratory infections, central nervous system infections and other infectious diseases were as follows: odds ratio (OR) 163.4 (95% confidence interval [CI]: 31.0-858.1), OR 84.5 (95% CI: 27.1-262.8), OR 9.9 (95% CI: 3.5-27.7), OR 0.5 (95% CI: 0.2-1.1) and OR 4.4 (95% CI: 1.9-9.9) cases per 100,000 people, respectively. The association between the incidences of infectious diseases before and after earthquakes was significant, namely, 1.561 (95% CI: 1.244-1.957) with a P-value <0.001. CONCLUSIONS: The results show an increase in the prevalence of infectious diseases after earthquakes. Governments should take essential measures to be better prepared for such unpredictable catastrophes.

The effects of melatonin therapy on the treatment of patients with Non-alcoholic steatohepatitis: A systematic review and Meta-analysis on clinical trial studies.

Melatonin has shown promising effects in controlling the progress of non-alcoholic fatty liver disease (NAFLD), introducing it as a possible candidate for NAFLD treatment. In this context, the current study is aimed to evaluate melatonin's effect on the plasma levels of Gamma-glutamyl transpeptidase, cholesterol, triglyceride, and liver aminotransferases in NAFLD patients. NAFLD and melatonin, as well as their related terms, were searched in electronic databases, until May 1st, 2020. The initial search identified 1152 studies. Considering inclusion and exclusion criteria, the final seven articles were included in the study. The methodology of the articles was assessed by the Newcastle-Ottawa Scale. Alanine transaminase levels were significantly lowered with melatonin treatment but not earlier than the 4th week (P = 0.010 and 0.519, respectively). Aspartate aminotransferase levels didn't show significant alteration before 4 weeks, although exhibiting substantial decline in total (P = 0.697 and 0.008, respectively). Alkaline phosphatase changes under 4 weeks of follow-up were not significant (P = 0.3), however, it decreased significantly in total (P = 0.006). A significant decline was detected in triglyceride levels after melatonin treatment (P = 0.015). There was a significant reduction in cholesterol levels (P = 0.005). Gamma-glutamyl transpeptidase levels were also significantly different after the administration of melatonin (P < 0.001). Melatonin could reduce the progress of NAFLD. It might also decrement hepatic function parameters. Thus, it could be used for managing NAFLD and possibly as part of the treatment plan for patients with NAFLD.

Chest CT findings of coronavirus disease 2019 (COVID-19): A comprehensive meta-analysis of 9907 confirmed patients.

OBJECTIVES: We performed a systematic review and meta-analysis of the prevalence of chest CT findings in patients with confirmed COVID-19 infection. METHODS: Systematic review of the literature was performed using PubMed, Scopus, Embase, and Google Scholar to retrieve original studies on chest CT findings of patients with confirmed COVID-19, available up to 10 May 2020. Data on frequency and distribution of chest CT findings were extracted from eligible studies, pooled and meta-analyzed using random-effects model to calculate the prevalence of chest CT findings. RESULTS: Overall, 103 studies (pooled population: 9907 confirmed COVID-19 patients) were meta-analyzed. The most common CT findings were ground-glass opacities (GGOs) (77.18%, 95%CI = 72.23-81.47), reticulations (46.24%, 95%CI = 38.51-54.14), and air bronchogram (41.61%, 95%CI = 32.78-51.01). Pleural thickening (33.35%, 95%CI = 21.89-47.18) and bronchial wall thickening (15.48%, 95%CI = 8.54-26.43) were major atypical and airway findings. Lesions were predominantly distributed bilaterally (75.72%, 95%CI = 70.79-80.06) and peripherally (65.64%, 95%CI = 58.21-72.36), while 8.20% (95%CI = 6.30-10.61) of patients had no abnormal findings and pre-existing lung diseases were present in 6.01% (95%CI = 4.37-8.23). CONCLUSIONS: The most common CT findings in COVID-19 are GGOs with/without consolidation, reticulations, and air bronchogram, which often involve both lungs with peripheral distribution. However, COVID-19 might present with atypical manifestations or no abnormal findings in chest CT, which deserve clinicians' notice.

Association between smoking and non-alcoholic fatty liver disease: A systematic review and meta-analysis.

BACKGROUND/AIMS: Non-alcoholic fatty liver disease is one of the most common chronic liver diseases. Some risk factors are known to influence the development of non-alcoholic fatty liver disease, but the effect of tobacco smoking on the progression of non-alcoholic fatty liver disease is controversial. The main goal of this systematic review and meta-analysis is to investigate the association between smoking and non-alcoholic fatty liver disease. METHOD: Electronic databases (PubMed, Scopus, and ISI Web of Science) were searched to find published articles on non-alcoholic fatty liver disease and smoking until December 2016. All relevant studies were screened by inclusion and exclusion criteria and compatible studies were chosen. The Newcastle-Ottawa Scale was used to assess the methodological quality of eligible articles. Subsequently, information was gathered based on the following: author, publication year, keywords, country, inclusion and exclusion criteria, main results, study design, conclusion, and confounder variables (age, body mass index, gender, ethnicity, and diabetes). Finally, analyses were performed using Comprehensive Meta-Analysis Software. RESULTS: Data were extracted from 20 observational studies (9 cross-sectional, 6 case-control, 4 cohort studies, and 1 retrospective cohort study). A significant association was observed between smoking and non-alcoholic fatty liver disease with a pooled odds ratio of 1.110 (95% confidence interval, 1.028-1.199), p-value = 0.008. The statistical heterogeneity was medium with an I2 of 40.012%, p-heterogeneity = 0.074. Also there was a significant relation between non-alcoholic fatty liver disease and passive smoking with a pooled odds ratio of 1.380 (95% confidence interval, 1.199-1.588; p-value = 0.001; I2 = 59.41; p-heterogeneity = 0.117). CONCLUSION: Our meta-analysis demonstrated that smoking is significantly associated with non-alcoholic fatty liver disease. Further prospective studies exploring the underlying mechanisms of this association should be pursued. Also passive smoking increases the risk of non-alcoholic fatty liver disease about 1.38-fold. The effects of smoking cigarettes on active smokers (current smoker, former smoker, and total smoker) are less than passive smokers. Further studies are needed to compare the of effects of passive and active smoking on non-alcoholic fatty liver disease.