Is vitamin D supplementation program in Iranian schools effective in reducing adolescent depressive symptoms? Cost effectiveness study.

PURPOSE: We aimed to assess the cost-effectiveness of the vitamin D supplementation program in Iranian adolescents reducing adolescent depressive Symptoms. METHODS: In the current cost-effectiveness analysis, the viewpoint of Iran's Ministry of Health was selected. The target population was 1,519,762 Iranian high school students (733,657 girls and 786,105 boys). The total costs of the vitamin D supplementations program were based on the reports of the Nutrition Improvement Office of Iran's Ministry of Health and were adjusted to 2018. The variable of Quality-Adjusted Life Years (QALYs) was considered a suitable variable for estimating the effectiveness of vitamin D supplementation. We chose one year as the time horizon. A decision tree model was constructed in TreeAge Pro. The results of the cost-effectiveness analysis were reported in term of the Incremental Cost-Effectiveness Ratio (ICER). RESULTS: The results of our study showed that the estimated cost per QALY gained of the vitamin D supplementation program is equal to 1528.6676 $, which indicates that vitamin D supplementation in adolescents(11-18Y) is a cost-effective and a dominant strategy in preventing depression through the cost-saving and QALYs increment compared to the no intervention. Sensitivity analysis showed that the possible variations in vitamin D supplement costs could not alter the results, and vitamin D supplementation may be a predominant and cost-effective strategy to prevent adulthood depression with a 100% probability. CONCLUSION: The national program of vitamin D supplementation among Iranian adolescents was a cost-efficient strategy reducing adolescent depressive Symptoms through the cost-saving and QALYs increment compared to the no intervention.

A systematic review and meta-analysis to evaluate blood levels of interleukin-6 in lung cancer patients.

Introduction: The exact mechanism responsible for inflammation in malignancy is not completely understood, but it is possible that interleukin-6 (IL-6) plays a major role in triggering and maintaining an inflammatory response. Aim: To conduct a systematic review and meta-analysis of the levels of IL-6 in the serum/plasma of lung cancer (LC) patients. Material and methods: The researchers searched four databases up to September 11, 2022, to find studies that reported on IL-6 levels in LC patients compared to healthy controls (HCs). They calculated effect sizes using standardized mean difference (SMD) with a 95% confidence interval (CI). To evaluate the quality of each study, they used the Newcastle-Ottawa Scale (NOS). They performed subgroup analysis, sensitivity analysis, meta-regression analysis, heterogeneity analyses, trial sequential analysis, and publication bias with the trim-and-fill method. Results: The meta-analysis included 28 studies, and the results showed that the pooled SMD was 1.71 (95% CI: 1.22, 2.19; p < 0.00001; I2 = 98%), indicating that LC patients had significantly higher levels of IL-6 in their serum/plasma than HCs. Conclusions: The study found that the publication year and quality score of the studies were positively associated with the level of IL-6, while the sample size was inversely related. The research suggests that measuring IL-6 levels in the blood could be useful for detecting and monitoring LC as it appears to be a reliable biomarker.

Survival-related factors in HIV/AIDS patients: A retrospective cohort study from 2011 to 2019 in Kermanshah, Iran.

INTRODUCTION: Accurate evaluation of the survival rate among HIV-positive populations is pivotal for HIV management. OBJECTIVE: This study aimed to investigate the survival rate and potential survival-related factors in HIV/AIDS patients from 2011 to 2019 in the city of Kermanshah in the west of Iran. METHOD: In this study, 915 HIV-positive patients registered by the Kermanshah Behavioral diseases counseling center, were surveyed from 2011 to 2019. By reading the patients' files, the proper data related to the survival factors were extracted and statistically analyzed. RESULTS: Of 915 patients, 220 (24%) died. The one-year, five-year, and ten-year survival rates were 84%, 72%, and 62%, respectively. There was a significant relationship between the survival rate and many other parameters, including treatment variables, CD4+ T cell count, the way of HIV transmission, level of education, gender, and marital status. Over time, timely initiation of treatment has increased. The data also showed that HIV transmission through drug injection has decreased, while the sexual transmission of HIV has increased. CONCLUSIONS: The results showed that in recent years, due to the appropriate treatment, the survival rate of HIV patients has increased. The highest risk factor of death was for people with low CD4+ T cell count, lack of antiretroviral therapy, low level of education, male gender, and people who inject drugs. These people need more attention to get tested for HIV- related indexes and to receive proper treatment.

Naringenin Improves Ovalbumin-Induced Allergic Asthma in Rats through Antioxidant and Anti-Inflammatory Effects.

Asthma is a chronic disease with eosinophilic inflammation and oxidative damages leading to airway obstruction. Naringenin is a phytochemical possessing strong antioxidant and anti-inflammatory activities against chronic destructive conditions. The current study is devoted to evaluating naringenin's effects on the attenuation of inflammation and oxidative stress in lung tissue in a rat model of ovalbumin-induced asthma. Male Wistar rats were allocated to five groups of six: normal control (NC, receiving 1 ml/day of normal saline, orally), asthmatic (AS, receiving ovalbumin (1 mg/mL), and alum (1 mg/mL in saline) on days 0 and 14. Then, on days 21, 22, and 23, they were sensitized with the inhalation of ovalbumin), AS treated with dexamethasone (AS, 1 mg/kg/day, orally) [AS + D1], AS treated with naringenin (20 mg/kg/day, orally) [AS + N20], and AS treated with naringenin (40 mg/kg/day, orally) [AS + N40]. All the groups received associated drugs/agents for 28 days. Finally, bronchoalveolar lavage fluid (BALF) and lung tissue samples were taken off from the animals. The eosinophil count in BALF and malondialdehyde (MDA), glutathione (GSH), interleukin-13 and -4 (IL-13 and IL-4) levels were measured. Besides, the expression of urocortin (UCN) and surfactant protein-D (SP-D) were evaluated in the lung tissue using immunohistochemistry (IHC) and western blotting methods, respectively. Hematoxylin and eosin (H&E) staining were utilized to conduct histopathological analysis. Naringenin treatment significantly reduced MDA, remarkably increased GSH, and meaningfully reduced IL-4 and IL-13 levels in lung tissue. The count of eosinophils in the BALF of AS + N20 and AS + N40 was significantly reduced in comparison with the AS group. The UCN and SP-D protein levels were significantly decreased in the AS + N20 and AS + N40 groups compared to the AS group, using the IHC and western blot methods, respectively. Histopathological analysis data also confirm the results. Naringenin improves the symptoms of allergic asthma through antioxidant and anti-inflammatory effects.

Medicinal Plants and Phytochemicals for the Treatment of Pulmonary Hypertension.

BACKGROUND: Pulmonary hypertension (PH) is a progressive disease that is associated with pulmonary arteries remodeling, right ventricle hypertrophy, right ventricular failure and finally death. The present study aims to review the medicinal plants and phytochemicals used for PH treatment in the period of 1994 - 2019. METHODS: PubMed, Cochrane and Scopus were searched based on pulmonary hypertension, plant and phytochemical keywords from August 23, 2019. All articles that matched the study based on title and abstract were collected, non-English, repetitive and review studies were excluded. RESULTS: Finally 41 studies remained from a total of 1290. The results show that many chemical treatments considered to this disease are ineffective in the long period because they have a controlling role, not a therapeutic one. On the other hand, plants and phytochemicals could be more effective due to their action on many mechanisms that cause the progression of PH. CONCLUSION: Studies have shown that herbs and phytochemicals used to treat PH do their effects from six mechanisms. These mechanisms include antiproliferative, antioxidant, antivascular remodeling, anti-inflammatory, vasodilatory and apoptosis inducing actions. According to the present study, many of these medicinal plants and phytochemicals can have effects that are more therapeutic than chemical drugs if used appropriately.