Pregabalin in patients with post-traumatic peripheral neuropathic pain: A meta-analysis of randomized controlled trials.

OBJECTIVE: The aim of the study was to investigate the safety and efficacy of pregabalin versus placebo in post-traumatic peripheral neuropathic pain (PTNP). METHODS: PubMed, Cochrane Library, Web of Science, and Google Scholar were searched for relevant evidence up to January 2022. The Cochran tool was used to assess the quality of randomized clinical trials (RCTs). Data analysis was performed using Comprehensive Meta-Analysis software. RESULTS: Three RCTs involving 821 patients were included in the meta-analysis. A significant difference was observed between pregabalin and placebo in terms of the pain score (the standardized mean difference [SMD] = -0.14, 95% CI: 0.28 to -0.006, p = 0.04) and sleep interference (MD = -0.25, 95% CI: -0.39 to -0.11, p = 0.00). There was also a significant difference between pregabalin and placebo regarding somnolence (risk ratio [RR] = 2.78; 95% CI: 1.64-4.71, p = 0.00), dizziness (RR = 4.13; 95% CI: 2.71-6.28, p = 0.00), and disturbance in attention (RR: 2.97; 95% CI: 1.02-8.65, p = 0.04). However, no significant difference was observed between pregabalin and placebo in terms of headache (RR = 1.20; 95% CI: 0.70-2.06, p = 0.50), fatigue (RR = 1.42; 95% CI: 0.82-2.47, p = 0.20), nausea (RR = 1.52; 95% CI: 0.88-2.62, p = 0.13), constipation (RR = 1.84; 95% CI: 0.78-4.29, p = 0.15), and discontinuation (RR = 1.52; 95% CI: 0.45-5.06, p = 0.49). CONCLUSION: Compared with placebo, pregabalin showed better efficacy in reducing PTNP and improving sleep interference. However, it was associated with higher adverse events. Further RCTs are needed to confirm these findings.

Epidemiology of Traumatic Spinal Cord Injuries in Iran; a Systematic Review and Meta-Analysis.

Introduction: Understanding the epidemiology of traumatic spinal cord injuries (TSCIs) can be helpful for policymakers and planners to consider appropriate strategies to control and prevent these injuries. This study aimed to determine the epidemiological characteristics of TSCI in Iran in order to increase knowledge and awareness of these injuries. Methods: A systematic literature search was conducted up to January 2022 in the electronic databases, including PubMed, Scopus, Web of Science, Google Scholar, SID, Iranmedex, and Magiran. The quality of included studies was evaluated using the STORBE checklist. Comprehensive meta-analysis was used to analyze the data. Results: Nineteen studies involving 9416 cases were included in the study. Participants' pooled mean age was 35.80 ± 1.07 years (95% CI: 33.69 to 37.91), of whom 69% (95% CI: 68% to 70%; P<0.05) were male. The most frequent TSCI occurred in the age group of less than 30 years. Motor vehicle collisions (MVCs) was the most common cause of TSCI (57%; 95% CI: 25% to 63%), followed by falls (32%; 95% CI: 26% to 38%). Most participants had thoracolumbar (27%; 95% CI: 10% to 55%) and cervical injuries (23%; 95% CI: 16% to 31%), respectively. The incidence of TSCI was estimated at 10.5 per million people. The prevalence of TSCI was 3 per 10000 people. The mortality rate due to TSCI was 3.9% (95% CI: 0.02 to 0.06; P<0.05). Conclusion: Based on the findings of this meta-analysis, the pooled incidence and prevalence of TSCI in the Iranian population were 10.5/1000.000 people and 4.4/10.000 people, respectively. TSCIs had occurred more frequently in males following MVCs, and in the age group under 30 years. The pooled mortality rate due to TSCI was 3.9% (95% CI: 0.02 to 0.06; P<0.05).

Knowledge and Practice of Kerman Dentists about Infection Control in Digital Radiography.

Statement of the Problem: Infection control is essential for a safe clinical environment during patients' treatment in dentistry. Transmission of the infection can occur due to contact with patients' saliva and blood in radiology clinics. Purpose: The purpose of this study was to investigate the knowledge and practice of dentists in Kerman about infection control in digital radiology. Materials and Method: This cross-sectional study was conducted on 162 dentists who worked either in private office or clinic or both. The samples were selected through simple sampling method. Data were collected through demographic data, and valid and reliable questionnaire consisted of 7 questions about knowledge and 12 questions about practice on infection control in digital radiology. Data were analyzed in SPSS 26 software using T, ANOVA, and linear regression tests. The p value was considered at 0.05% significant level. Results: 86(53.1%) of participants were men and 76 (46.9%) were female. The mean age of participants and work experience were 36.32±8.88 and 11.03±8.53 years, respectively. The mean and standard deviation of knowledge, practice, and total were 5.20±1.26, 7.98±2.00, and 13.22±2.72, respectively. There was a positive significant correlation between knowledge with age of participants (p= 0.009). There was also a direct significant correlation between knowledge and practice with work experience (p= 0.045 and p= 0.01 respectively). Conclusion: Knowledge and practice of dentists in Kerman about infection control in digital radiology were good and medium respectively. However, there was a direct significant correlation between knowledge and practice of dentists. Knowledge and practice scores in dentists who worked in private office were significantly better than those who worked only in clinics.

Changes in liver fibrosis in patients with chronic hepatitis C after successful direct-acting antiviral therapy.

INTRODUCTION AND OBJECTIVES: After successful treatment of hepatitis C virus (HCV) infection with direct-acting antivirals (DAAs), the stage of liver fibrosis decreases over time. Here, we aimed to assess the changes in the liver fibrosis stage using transient elastography (TE) after successful DAA therapy in HCV-infected cirrhotic patients who were referred to Shariati hospital from 2016 to 2017. MATERIAL AND METHODS: In this observational cohort, all HCV-infected cirrhotic patients who were treated with a combination of sofosbuvir/daclatasvir, had sustained virologic response (SVR), and had undergone pre- and post-treatment TE, were enrolled. The primary outcome was the changes in TE parameters six months after the end of treatment compared with baseline. RESULTS: A total of 442 eligible subjects received DAA therapy. Overall, the SVR rate was 96.6%. Of these, 149 patients had completed the protocol and were enrolled. The mean age of patients was 56.1 ± 10.3 years and the predominant sex was male (77.9%). The median (Q1 -Q3 ) liver stiffness (LS) value at baseline was 26.3 kPa (18.1-38 kPa), which significantly decreased to 20.9 kPa (12-29.7 kPa) [z = -8.45, P-value < .001]. Also, the liver steatosis of patients with baseline CAP ≥ 220 dB/m had a significant response to treatment [z = -2.3, P-value = .023]. Based on multivariate analysis, a higher baseline liver fibrosis stage was the only determinant of LS values improvement in our study. CONCLUSION: Successful HCV eradication in patients with liver fibrosis results in significant improvement in LS, even in cirrhotic patients.