Two Years after the Beginning of COVID-19: Comparing Families Who Had or Did not Have Patients with COVID-19 on Health Beliefs and Obsessive-Compulsive Symptoms.

Objective: This study aimed to compare health beliefs and obsessive-compulsive symptoms (OCS) in families with (FIM+) or without an infected member (FIM-) two years after the beginning of COVID-19. Additionally, this research intended to predict a decrease in OCS from baseline (T1) to 40 days later (T2) based on health beliefs. Method : In a longitudinal survey, 227 participants in two groups, including FIM+ (n = 98; M = 30.44; SD = 5.39) and FIM- (n = 129; M = 29.24; SD = 4.93), were selected through purposive sampling. They responded to measurements consisting of demographic characteristics, the Obsessive-Compulsive Inventory-Revised (OCI-R), Patient Health Questionnaire (PHQ-9), Impact of Event Scale-Revised (IES-R), and COVID-19 Health Belief Questionnaire (COVID-19-HBQ) at the final assessment phase (T2). To investigate differences between the two groups and predict OCS changes from T1 to T2, data were analyzed using Chi-squared, t-tests, U-Mann-Whitney, Kruskal-Wallis, Pearson correlations, and linear regression analyses. Results: At T1, FIM+ demonstrated significantly greater OCS, health beliefs, posttraumatic stress symptoms (PTS), and depressive symptoms than FIM-. Furthermore, FIM+ showed a decrease in OCS from T1 to T2 after its infected member recovered from COVID-19 (P < 0.001). A decrease in OCS was correlated with a decrease in perceived susceptibility, severity, and barriers. Lack of a vulnerable family member, lower educational attainment, and being a primary caregiver were associated with a greater decrease in OCS. Changes in perceived severity and self-efficacy accounted for 17% of variation in OCS. Conclusion: Even two years after the onset of the pandemic, COVID-19 not only impacts the life of patients with COVID-19 but family members who care for such patients respond to the disease by engaging in excessive health behaviors in the form of OCS.

Efficacy of topical galbanum oil with dry cupping in hospitalized COVID-19 patients: A randomized open-label clinical trial.

Objective: This study was designed to detect the therapeutic effects of galbanum oil plus dry cupping (a Persian medicine-based method) in hospitalized patients with coronavirus disease-2019 (COVID-19). Materials and Methods: In this randomized controlled trial, 60 hospitalized COVID-19 patients with positive polymerase chain reaction test (PCR), pulmonary involvement and blood oxygen saturation (SpO2) ≤93 mmHg, were randomly assigned into two groups to take the standard therapeutic regimen alone or alongside cupping and topical galbanum oil (Ferula gommosa oleo-gum resin) for 3-5 days. The SpO2 level, the severity of signs and symptoms of patients and laboratory parameters were compared between the two groups. Results: Fifty-eight patients were analyzed. The SpO2 level changed from 89.27±3.82 to 90.29±3.09 mmHg (p=0.038) in control group, while it increased from 88.74±3.45 to 94.23±2.1 mmHg (<0.001) in galbanum group with a significant difference between the groups (p<0.001). Fever, cough, dyspnea, and anorexia alleviated in the galbanum group more than the control (p=0.003, 0.001, 0.01, and 0.04, respectively). No adverse effects were reported due to galbanum oil and cupping therapy. Conclusion: Dry cupping with galbanum oil alongside the routine therapeutic regimen could be more effective than the routine therapeutic regimen alone for improving SpO2 level and alleviating fever, cough, and dyspnea in COVID-19 patients.

Time to Noise-Induced Hearing Loss among Different Type of Shift Work among Steel Workers: A Survival Study.

Background: There have been few reports on relationships between Shift Work (SW) and time to Noise-Induced Hearing Loss (NIHL). This research explores the relation between SW and time to NIHL among male workers. Methods: Between 1990 and 2015, this historical cohort study was conducted. Two different definitions events (Low Frequency Hearing (LFH) and High Frequency Hearing (HFH)) of NIHL An average pure-tone hearing threshold was thresholds at 1, 1.5 and 2 kHz for LFH(un-normal>20) and 4, 6 and 8 kHz for HFH (un-normal>20) for Air (AC) and Bone (BC) conduction, in both ears, respectively. In this study Kaplan-Meier and Multilevel Cox Model in addition R version 3.2.1 and MLWiN software used to analysis data. P-values less than 0.05 are considered to be statistically significant. Results: There were 6632 male workers in the research survey (mean age=35(±5)). Among these subjects, 2678 (40%),278 (4%) and 3676 (56%) were Day Workers (DW), Weekly Rotating Shift workers (WRS) and Routinely Rotating Shift workers (RRS), respectively. The result of this study showed more hazard risk of ear problem in LFH (Hazard=1.55 with 95% CI= (1.06-1.39)) and HFH (Hazard=1.08 with 95% CI= (1.04-1.13)) in RRS rather than day workers. In WRS group ear problem has been seen just in LFH (Hazard=1.55 with 95% CI= (1.2-2.0)). Conclusion: The findings of the 15-year historical cohort study generally support a relationship between SW and time to NIHL. Therefore, more actions in the field of noise control, greater use of safety devices as well as increased staff training on the use of safety devices recommended for shift worker.

Mediators for Effect of Mindfulness in Promoting Marital Satisfaction: Modeling Structural Equations in an Experimental Study.

Objective: The present study evaluated the model of mediating variables concerning effectiveness of mindfulness in improving women's marital satisfaction. Method: This study was quasi-experimental with pre-test, post-test and control groups. The statistical population included every married woman in Tehran in the year 1396 (2017). The research sample was composed of 60 married women with moderate marital satisfaction. They were chosen using the convenient sampling technique and were randomly assigned to control and experimental groups. The experimental group attended 8 sessions of Mindfulness-Based Stress Reduction (MBSR) and the control group was on a waiting list. Both groups answered the Five Facet Mindfulness Questionnaire (FFMQ), the Depression, Anxiety, and Stress Scale (DASS), Difficulties in Emotion Regulation Scale (DERS), Interpersonal Reactivity Inventory (IRI), Needs for Intimacy Questionnaire of Bagarozi, Positive and Negative Affect Scale (PANAS) and the Couple Satisfaction Index (CSI) before and at end of intervention. The data were analyzed by Structural Equation Modeling (SEM) using PLS-22 and SPSS-23. Results: In the initial hypothetical model, which included the direct effect of mindfulness on marital satisfaction and its indirect effects through psychological distress, emotion regulation, empathy, marital intimacy and positive emotion on marital satisfaction, coefficients of all model paths were significant at 95% level except direct path of mindfulness to marital satisfaction (t = 1.14), marital intimacy to marital satisfaction (t = 0.48) and positive affection to marital satisfaction (t = 1.75). After removing the non-significant paths, the model was tested again and the model fit index (GOF = 0.47) was a very good fit for the modified overall model. Conclusion: The results identified mindfulness-based stress reduction intervention was effective in enhancing marital satisfaction through reducing psychological distress and improving emotion regulation and empathy.

Relationship between Dissociative Experiences and Schizotypal Personality Traits: Mediating Role of Inferential Confusion.

Objective: Previous research has shown a relationship between schizotypal personality traits and dissociative tendencies. The Inference-Based Approach (IBA) can explain this relationship to some extent. Purpose of this study was to investigate the mediating role of inferential confusion in relation to dissociative experiences and schizotypal personality traits. Method: A total of 341 students from Shahed University participated in this cross-sectional study. Sampling was conducted randomly by the cluster sampling method. Data were collected using the Inferential Confusion Questionnaire (ICQ-EV), Schizotypal Personality Questionnaire-Brief (SPQ-B), and Dissociative Experiences Scale (DES-II). Data were analyzed using SPSS-22 software based on statistical methods including Pearson correlation, Baron and Kenny hierarchical regression and the Sobel test. Results: There were significant positive relationships between dissociative experiences, schizotypal personality traits, and inferential confusion (P < 0.01). Findings showed that inferential confusion mediates the relationship between dissociative experiences and schizotypal personality traits (ß = 0.29; P < 0.001). Conclusion: According to the obtained results, the present study, considering role of inferential confusion, succeeded in explaining the relationship between dissociative experiences and schizotypal personality traits to some extent.

The composition of lung microbiome in lung cancer: a systematic review and meta-analysis.

BACKGROUND: Although recent studies have indicated that imbalance in the respiratory microbiome composition is linked to several chronic respiratory diseases, the association between the lung microbiome and lung cancer has not been extensively studied. Conflicting reports of individual studies on respiratory microbiome alterations in lung cancer complicate the matter for specifying how the lung microbiome is linked to lung cancer. Consequently, as the first meta-analysis on this topic, we integrate publicly available 16S rRNA gene sequence data on lung tissue samples of lung cancer patients to identify bacterial taxa which differ consistently between case and control groups. RESULTS: The findings of the current study suggest that the relative abundance of several bacterial taxa including Actinobacteria phylum, Corynebacteriaceae and Halomonadaceae families, and Corynebacterium, Lachnoanaerobaculum, and Halomonas genera is significantly decreased (p < 0.05) in lung tumor tissues of lung cancer patients in comparison with tumor-adjacent normal tissues. CONCLUSIONS: Despite the underlying need for scrutinizing the findings further, the present study lays the groundwork for future research and adds to our limited understanding of the key role of the lung microbiome and its complex interaction with lung cancer. More data on demographic factors and tumor tissue types would help establish a greater degree of accuracy in characterizing the lung microbial community which accords with subtypes and stages of the disease and fully capturing the changes of the lung microbiome in lung cancer.

The risk factors and related hospitalizations for cases with positive and negative COVID-19 tests: A case-control study.

BACKGROUND: The aim of this study was to evaluate the risk factors for hospitalizations of cases with positive and negative COVID-19 tests. METHODS: In this case-control study, the case and control groups consisted of 292 COVID-19 patients and 296 non-COVID-19 patients. Patients who referred to a reference laboratory in Tehran (Iran) in March 2020 were selected and interviewed. The patients were contacted by telephone and data were recorded through a questionnaire. RESULTS: The sample of this study consisted of 588 patients (349 [59%] females, 239 [41%] males) with a mean age of 42 ± 15. The results of this study showed that comorbidities like diabetes (OR = 7.42), hypertension (OR = 4.85), asthma and respiratory diseases (OR = 5.64) in addition to symptoms including fever (OR = 6.67), chills (OR = 11.2), anorexia (OR = 11.3), dyspnea (OR = 4.8), weakness and lethargy (OR = 5.7) were the most predictive variables for hospitalization of non-COVID-19 cases. Furthermore, demographical variables like male gender (OR = 3.71), high age (>50; OR = 3.12), BMI (>25; OR = 2.37), travel (OR = 2.79), comorbidities including diabetes (OR = 5.26), hypertension (OR = 3.7) and underlying immunosuppressant patients receiving corticosteroid therapy (OR = 3.62) in addition to symptoms like anorexia [OR = 2.55] and dyspnea (OR = 6.99) tend to increase the risk of hospital admission in COVID-19 patients, suggesting their predictive values for hospitalization of COVID-19 patients. CONCLUSION: Our results indicated that different factors tend to increase the odds of hospital admission in patients with positive and negative COVID-19 tests, suggesting their predictive values for hospitalization.

Real Clinical Practice and Therapeutic Management Following COVID-19 Crisis in two Hospitals in Iran: A Statistical and Conceptual View.

BACKGROUND: The Coronavirus disease 2019 (COVID-19) outbreak quickly has spread and became a pandemic. However, no approved therapeutics or effective treatment is available for the treatment of these patients. The present study was done to retrospectively assess the treatment strategies (e.g., pharmaceutical care services) for COVID-19 patients in selected hospitals and highlight the importance of such services in the management of a pandemic. MATERIALS AND METHODS: Data from a series of COVID-19 patients (978 patients; 658 males [66.9%] and 324 females [33.1%]) admitted to the selected hospitals in Tehran from 20 February to 19 March 2020 were retrieved retrospectively from the Health Information System (HIS) of the hospitals. The statistical tests were used for analyzing the effect and correlation of the variables (drugs) with the average length of stay (ALOS) in the hospital. RESULTS: Diverse medication classes and old drugs with or without strong evidence of therapeutic effects against the novel coronavirus, some previously tried as a treatment for SARS-CoV and MERS-CoV, were mostly used for the treatment of patients in the hospitals. Many medications (broad-spectrum antibiotics and antivirals) or combination therapies are used without evidence of their therapeutic effects during pandemics. CONCLUSION: Therefore, guidelines should be provided for the off-label use of these drugs by policymakers and stakeholders during a pandemic emergency due to high demands. Also, monitoring of the HIS data can play an important role in improving public health response to emerging diseases.

The effect of "mavizË® on memory improvement in university students: A randomized open-label clinical trial.

OBJECTIVE: Numerous studies demonstrated the effect of grape on memory improvement. According to Iranian traditional medicine, "mavizË® as a specific type of dried grapes can effectively improve memory. However, there is no reported clinical trial on the effect of "mavizË® on memory improvement in humans. Hence, this study was conducted to investigate "mavizË® effect on memory in university students. MATERIALS AND METHODS: This randomized open-label clinical trial was conducted on a total number of 53 students of Shahed University, Tehran, Iran, from November 2017 to February 2018. The participants were randomly allocated into an intervention group (receiving "mavizË®, 25 g in the morning for 4 weeks) or a control group (who did not take "mavizË®). The Digit Span Task and the N-Back Task were used for the measurement of working memory at the pre- and post-intervention stages. RESULTS: According to the results, no significant differences were found between the two groups regarding age, gender, marital status, and initial working memory test scores. "mavizË® consumption produced a highly significant improvement in total working memory score in the Digit Span Task (5.18 vs. 2.35, p<0.001) and Acoustic Memory Span (1.29 vs. 0.62, p=0.021). Moreover, "mavizË® consumption significantly increased the percentage of true responses in the N-Back Task and reduced the mean reaction time in the first level of the task. CONCLUSION: "mavizË® consumption was improved working memory in young healthy adults.

Effects of Viola odorata as an Add-On Therapy on Insomnia in Patients with Obsession or Depression: A Pilot Randomized Double-Blind Placebo-Controlled Trial.

Objective: The present study was conducted to investigate the effect of Viola odorata extracted syrup on the quality and patterns of sleep in patients with depression or obsessive-compulsive disorder (OCD) as add-on therapy. Design: A pilot double-blind randomized placebo-controlled trial. Settings/Location: Psychiatric Clinic of Imam Hossein Hospital, Tehran, Iran. Subjects: Participants were 16-15 years of age with mild and moderate depression or OCD having insomnia. Interventions: This pilot study was conducted on patients with insomnia divided into two groups with depression (40 patients) or OCD (43 patients). Each group randomly assigned into two arms with the same conditions at baseline. The intervention arm daily received 5 mL V. odorata syrup every 12 h for 4 weeks, and the control arm received 5 mL placebo syrup every 12 h for 4 weeks. None of the participants was deprived of their routine treatment for depression or OCD. Outcome measures: The scores of insomnia symptoms were evaluated using total score of the Pittsburgh Sleep Quality Index (PSQI) and the scores of its components, the depression score using the final Beck depression inventory-II (BDI-II) score, and OCD score using the Yale-Brown Obsessive-Compulsive Scale (YBOCS). Results: The total PSQI score was found to be improved significantly in the intervention arms with depression or OCD (p < 0.001) compared with the corresponding control arms. Significant improvements were also observed in the final mean difference of BDI-II (p = 0.009) and YBOCS (p = 0.001) scores in the intervention arms. Conclusions: V. odorata syrup significantly improved insomnia symptoms and the scores of depression and OCD.

Effect of Fenugreek Use on Fasting Blood Glucose, Glycosylated Hemoglobin, Body Mass Index, Waist Circumference, Blood Pressure and Quality of Life in Patients with Type 2 Diabetes Mellitus: A Randomized, Double-Blinded, Placebo-Controlled Clinical Trials.

BACKGROUND: Diabetes mellitus is a major cause of death globally. It causes multiple problems in various organs and incurs heavy costs for patients and the community health system.The present study was conducted to evaluate the effect of fenugreek intake on fasting blood sugar (FBS), HbA1C, body mass index (BMI), waist circumference, blood pressure and quality of life of type 2 diabetes mellitus (T2DM) patients. MATERIALS AND METHODS: This randomized, double-blinded clinical trial study was conducted on patients with T2DMin Tehran, Iran in 2018. The treatment group received 5 g of fenugreek powder,and the placebo group received 5 g of wheat flour twice daily for two months before meals. RESULTS: This study was performed on 62 patients (50% male and 50% female). Both groups had similar demographic characteristics. The results showed a significant difference between the mean FBS (P<0.001), HgA1C (P<0.001), BMI (P<0.001), waist circumference (P<0.001), diastolic blood pressure (P=0.005), and quality of life (P=0.015). There was no significant difference in mean systolic blood pressure (P=0.189) between groups. CONCLUSION: Given the positive effect of fenugreek on FBS, hemoglobin, HbA1C, BMI, waist circumference, blood pressure and quality of life, it can be recommended for controlling blood glucose in diabetic patients.

The Psychometric Properties of the Persian Version of the Contamination Cognition Scale (CCS).

Objective: In recent years, many researchers have been searching for effective cognitive factors in the development of obsessive-compulsive disorder (OCD). One of the scales designed to measure this characteristic is the contamination cognition scale (CCS) that evaluates 2 dimensions: overestimating the likelihood and severity of contamination. The aim of the present study was to evaluate the psychometric properties of the Persian version of CCS. Method : The study population of this descriptive psychometric study included students of Shahed University. A total of 490 students were selected via cluster sampling and completed the CCS. CCS was translated and back- translated before given to the students. The Obsessive Beliefs Questionnaire (OBQ) and the Padua Inventory (PI) were used. To assess the evidence for the validity of the scale, the exploratory and confirmatory factor analyses were used. The gathered data were analyzed by SPSS-22 and Amos-22 software. Results: The results of the confirmatory factor analysis (CFA) showed that one-factor model did not have adequate fitness (RMSEA>.05). Therefore, to explore the factors of this scale, exploratory factor analysis (EFA) was used, and it revealed 3 factors (public equipment, food, and restroom) for each of the dimensions (likelihood and severity). CFA by AMOS-22 confirmed the three-factor model (GFI, CFI, and NFI>.95; RMSEA<.05). Furthermore, the results supported criteria validity of CCS with the PI total score (0.56- 0.47, p<0.001) and PI-contamination subscale (0.71-0.75, p<0.001). Also, the correlation between CCS and responsibility/threat subscale of the OBQ was significant (0.47- 0.49, p<0.001) The Cronbach's alpha for likelihood dimensions total was 0.93 and it was 0.94 for severity dimension total. The composite reliability was 0.95 for the likelihood dimension and 0.96 for severity dimension of CCS. Also, the test-retest reliability after a 4-week interval was confirmed (likelihood: r = 0.78; severity: r = 0.81, p<.001). Conclusion: The results indicated that one-factor model of CCS did not have adequate fitness, but three-factor model was confirmed in both dimensions (likelihood and severity). According to the results of the present study, the reliability and validity of the Persian version of CCS were acceptable.

Comparative evaluation of the safety and efficacy of recombinant FVIII in severe hemophilia A patients.

OBJECTIVE: This study compared the safety and efficacy of Safacto® versus xyntha® in patients with severe hemophilia A. METHODS: Thirty-three male patients with severe hemophilia A were randomly divided into two groups. Seventeen patients received Safacto® and 16 patients received Xyntha® for four consecutive times. The dosage of FVIII was 40-50 IU/kg for each injection. Plasma level of FVIII activity was evaluated before every injection, 15 minutes after the injection and one month after the start of the trial. The rate of factor VIII activity, pain and joint motion were also assessed before and after the treatment. RESULTS: Plasma level of FVIII clotting activity in Safacto® and Xyntha® were 1.96±0.5 IU/dl and 1.63±0.5 IU/dl and increased to 88.84±25.2 IU/dl and 100.09±17.8 IU/dl, respectively (P<0.001). Pain score and range of motion improvement were 9.3±0.9 and 8.7±0.1 in Safacto® (P=0.17); and 9.4±0.8 and 8.8±0.3 in Xyntha® (P=0.35), respectively. No allergic or other unfavorable reactions was observed with either of the preparations. CONCLUSION: This study showed that Safacto® has a favorable efficacy and safety profile.

Identification of candidate microRNA biomarkers in diabetic nephropathy: a meta-analysis of profiling studies.

AIMS: The aim was to perform a meta-analysis on the miRNA expression profiling studies in diabetic nephropathy (DN) to identify candidate diagnostic biomarkers. METHODS: A comprehensive literature search was done in several databases and 53 DN miRNA expression studies were selected. To identify significant DN-miR meta-signatures, two meta-analysis methods were employed: vote-counting strategy and the robust rank aggregation method. The targets of DN-miRs were obtained and a gene set enrichment analysis was carried out to identify the pathways most strongly affected by dysregulation of these miRNAs. RESULTS: We identified a significant miRNA meta-signature common to both meta-analysis approaches of three up-regulated (miR-21-5p, miR-146a-5p, miR-10a-5p) and two down-regulated (miR-25-3p and miR-26a-5p) miRNAs. Besides that, subgroup analyses divided and compared the differentially expressed miRNAs according to species (human and animal), types of diabetes (T1DN and T2DN) and tissue types (kidney, blood and urine). Enrichment analysis confirmed that DN-miRs supportively target functionally related genes in signaling and community pathways in DN. CONCLUSION: Five highly significant and consistently dysregulated miRNAs were identified, and future studies should focus on discovering their potential effect on DN and their clinical value as DN biomarkers and therapeutic mediators.

Identification of candidate microRNA biomarkers in renal fibrosis: a meta-analysis of profiling studies.

The prognostic, diagnostic and therapeutic value of microRNA (miRNA) expression aberrations in renal fibrosis has been studied in recent years. However, the miRNA expression profiling efforts have led to inconsistent results between the studies. The aim of this study was to perform a meta-analysis on the renal fibrosis miRNA expression profiling studies to identify candidate diagnostic biomarkers. We performed comprehensive literature searches in several databases to identify miRNA expression studies of renal fibrosis in animal models and humans. The miRNAs expression data were extracted from 20 included studies, and both miRNA vote-counting strategy and Robust Rank Aggregation method were utilized to identify significant miRNA meta-signatures. The predicted and validated targets of miRNA meta-signature were obtained by using MultiMiR package in 11 databases. Then a gene set enrichment analysis (KEGG, PANTHER pathways and GO processes) were carried out with GeneCodis web tool to recognize pathways that are most strongly influenced by modified expressions of these miRNAs. We recognized in both meta-analysis approaches a significant miRNA meta-signature of five up-regulated (miR-142-3p, miR-223-3p, miR-21-5p, miR-142-5p and miR-214-3p) and two down-regulated (miR-29c-3p and miR-200a-3p) miRNAs. Enrichment analysis confirmed that miRNA meta-signature cooperatively target functionally related genes in signalling and developmental pathways in renal fibrosis. This meta-analysis identified seven highly significant and consistently dysregulated miRNAs from 20 datasets, as the focus of future investigations to discover their potential influence to renal fibrosis and their clinical utility as biomarkers and/or as therapeutic mediators against chronic kidney disease..

Developing a model for hospital inherent safety assessment: Conceptualization and validation.

BACKGROUND: Paying attention to the safety of hospitals, as the most crucial institute for providing medical and health services wherein a bundle of facilities, equipment, and human resource exist, is of significant importance. OBJECTIVE: The present research aims at developing a model for assessing hospitals' safety based on principles of inherent safety design. METHODS: Face validity (30 experts), content validity (20 experts), construct validity (268 examples), convergent validity, and divergent validity have been employed to validate the prepared questionnaire; and the items analysis, the Cronbach's alpha test, ICC test (to measure reliability of the test), composite reliability coefficient have been used to measure primary reliability. The relationship between variables and factors has been confirmed at 0.05 significance level by conducting confirmatory factor analysis (CFA) and structural equations modeling (SEM) technique with the use of Smart-PLS. RESULTS: R-square and load factors values, which were higher than 0.67 and 0.300 respectively, indicated the strong fit. Moderation (0.970), simplification (0.959), substitution (0.943), and minimization (0.5008) have had the most weights in determining the inherent safety of hospital respectively. CONCLUSIONS: Moderation, simplification, and substitution, among the other dimensions, have more weight on the inherent safety, while minimization has the less weight, which could be due do its definition as to minimize the risk.

Simultaneous effect of shift work on blood pressure and lipid profile: a path analysis.

The aim of this study was to assess the direct and indirect effects of shift work (SW) on the systolic blood pressure (SBP) and lipid profile of male workers. For this purpose, a cross-sectional study was conducted involving 6539 male workers of Esfahan Mobarakeh Steel Company. From all of the participants, 3065 (46.8%) were day workers and the remainder were shift workers. The results of path analysis revealed that the most effective variables on SBP were body mass index, fasting blood sugar, triglycerides and SW with a total effect of 0.241, 0.095, 0.064 and 0.056, respectively.

Inactive Hepatitis B Carrier and Pregnancy Outcomes: A Systematic Review and Meta-analysis.

BACKGROUND: We aimed to explore whether maternal asymptomatic hepatitis B (HB) infection effects on pre-term rupture of membranous (PROM), stillbirth, preeclampsia, eclampsia, gestational hypertension, or antepartum hemorrhage. METHODS: We searched the PubMed, Scopus, and ISI web of science from 1990 to Feb 2015. In addition, electronic literature searches supplemented by searching the gray literature (e.g., conference abstracts thesis and the result of technical reports) and scanning the reference lists of included studies and relevant systematic reviews. We explored statistical heterogeneity using the, I2 and tau-squared (Tau2) statistical tests. RESULTS: Eighteen studies were included. Preterm rupture of membranous (PROM), stillbirth, preeclampsia, eclampsia, gestational hypertension and antepartum hemorrhage were considerable outcomes in this survey. The results showed no significant association between inactive HB and these complications in pregnancy. The small amounts of P-value and chi-square and large amount of I2 suggested the probable heterogeneity in this part, which we tried to modify with statistical methods such as subgroup analysis. CONCLUSION: Inactive HB infection did not increase the risk of adversely mentioned outcomes in this study. Further, well-designed studies should be performed to confirm the results.

Combination of sofosbuvir, pegylated-interferon and ribavirin for treatment of hepatitis C virus genotype 1 infection: a systematic review and meta-analysis.

BACKGROUND: Hepatitis C virus (HCV) infection is an important cause of chronic liver disease which has been affected 3% of world's population. Some studies have shown that adding Sofosbuvir (SOF), an HCV polymerase inhibitor to the conventional therapy of Pegylated-interferon (PegIFN) plus Ribavirin (RBV) can increase the rate of sustained virologic response (SVR) among HCV-infected patients. This study was conducted to determine the effect of combination therapy with PegIFN and RBV plus SOF for chronic hepatitis C genotype 1 infection using systematic review with meta-analysis. METHODS: In this study, electronic databases including PubMed, Scopus, Science Direct, and Web of Science were comprehensively searched using appropriate strategies containing all related keywords of "hepatitis C", "PegIFN", "RBV" and "SOF". Studies assessed the efficacy of combination therapy with PegIFN and RBV plus SOF for chronic hepatitis C genotype 1 infection were included in the meta-analysis. RESULTS: After screening of 757 records, we included five articles with total sample size of 411 to the meta-analysis. Based on the fixed-effect model (χ 2 = 5.29, P = 0.26 and I2 = 24.4%), pooled SVR rate for treatment regimen of PegIFN and RBV plus SOF was calculated as 88.54% (95% CI = 85.77%-91.32%). CONCLUSIONS: Combination therapy with PegIFN and RBV plus SOF results in high treatment response in patients with HCV genotype 1 infection.

Combination of Ledipasvir and Sofosbuvir for Treatment of Hepatitis C Virus Genotype 1 Infection: Systematic Review and Meta-Analysis

ABSTRACT Background and aim. The combination of Sofosbuvir (SOF) and Ledipasvir (LDV) has been lead to considerable enhancement of treatment of hepatitis C virus (HCV) genotype 1 infection. A meta-analysis of the currently available studies was undertaken with the aim to evaluate the antiviral efficacy of SOF/LDV therapy for 12 or 24 weeks with or without Ribavirin (RBV) in patients with HCV genotype 1 infection. Material and methods. In this meta-analysis, we searched databases including PubMed, Scopus, Science Direct and Web of Science using appropriate keywords. All papers which evaluated the efficacy of combination therapy of SOF/LDV with or without RBV for 12 or 24 weeks among patients with HCV genotype 1 infection were included. Results. The 20 published articles were assessed for eligibility and finally 10 articles pooling 2248 participants were included in this meta-analysis. Pooled SVR12 for four SOF/LDV regimens were 95% (95%CI = 93%-97%) for 12 weeks of treatment with SOF/LDV, 97% (95%CI = 95%-98%) for 24 weeks of treatment with SOF/LDV, 96% (95%CI = 94%-97%) for 12 weeks of treatment with SOF/ LDV/RBV and 98% (95%CI = 97%-99%) for 24 weeks of treatment with SOF/LDV/RBV. Only in treatment regimen of SOF/LDV for 12 weeks, cirrhosis had a significant effect on the SVR12 (OR = 0.21, 95%CI = 0.07-0.66). Furthermore, NS5A resistance-associated substitutions at baseline were associated with decrease in the rate of SVR (OR = 0.31, 95%CI = 0.2-0.5). Conclusions. The Interferon-free regimen of SOF/LDV for 12 or 24 weeks with or without RBV is highly effective for treatment of patients with HCV genotype 1 infection.