The perceived experience of adhering to vegan diet: a descriptive phenomenological study.

BACKGROUND: Today, raw vegetarianism is considered one of the most important socio-cultural developments in contemporary societies. In this regard, the present study was conducted to describe the perceived experience of people adhering to a vegan diet through a phenomenological perspective. METHODS: This qualitative study explores the perceived experiences of individuals who follow a vegan diet and are part of the self-care campaign in Kermanshah, Iran. sampling was purposeful and face-to-face interviews were conducted with 12 individuals who follow a vegan lifestyle. The data were analyzed after being collected using the seven steps of Collizi. MAXQUDA software (version 12) was used for data management. RESULTS: After qualitative data analysis, we identified 567 codes, which were categorized into 15 sub-themes. From these sub-themes, we derived 4 main themes. The main themes include: In pursuit of redemption (Meaningful framework, In awareness path, Unequaled Disappointment, Chronic and complex conditions), Seeking the New World (Starting with doubt and hesitation, The temptation to return, Constant criticism, Unfamiliar appearance), On the path of overcoming difficulties (Associate problems, Matching the new way, Perceived recommendations), and attaining the expected outcomes (Healthy lifestyle, Therapeutic feedback, Enhancing emotional wellbeing, Feeling of youth). CONCLUSION: Based on the participants' experience, despite the challenging journey, the people with a vegetarian diet experienced partial and complete improvement of all the symptoms of the diseases. They had a healthy lifestyle and felt young and energetic. Likewise, this method had a positive effect on people's mental state and mood.

General medication adherence scale in patients with chronic illnesses: Persian translation and psychometric evaluation.

OBJECTIVES: This study was conducted with the aim of determining the validity and reliability of the Persian version of "General Medication Adherence Scale (GMAS)" in chronic patients in Iran. METHODOLOGY: The study was conducted among patients with chronic diseases in five hospitals of Iran. In this study, after cultural validation, using the steps of Content, Response Reaction, and Internal structure evaluations, the research sample was increased to 150 individuals for exploratory factor analysis (EFA) and 313 chronic patients for confirmatory factor analysis (CFA) to confirm the construct validity. Cronbach's alpha coefficient was used to assess internal consistency, and test-retest method was used to evaluate the reliability of the tool. FINDINGS: The results of EFA and CFA confirmed the tool with three factors and 11 items. The R2 index in the above model was estimated at 0.99, indicating that 99% of the variation in medication adherence scores in research units was explained by GMAS with 11 items. The main indices of the model in factor analysis were all above 0.9, indicating a good fit for the model. DISCUSSION: Overall, the study results showed that the Persian version of GMAS has acceptable and practical characteristics for evaluating medication adherence, and it can be used as a valid tool in various related fields.

The Association of PTEN Gene Mutations with the Breast Cancer Risk: A Systematic Review and Meta-analysis.

Breast cancer (BC) is the most common malignancy in women in western countries. A significant part of malignant cases is caused by genetic mutation. Mutations in the gene phosphatase and tensin homologue deleted on chromosome (PTEN) have been proven in various malignancies. The present study was conducted with the aim of investigating the prevalence of BC due to PTEN gene mutation, as well as estimating the chance of developing BC due to the occurrence of PTEN gene mutation. The present study was conducted using a systematic review method based on PRISMA 2020 statements. The search was done in PubMed, Web of Science (WOS), Scopus, and direct scientific databases. The search was performed using the keywords breast cancer, breast malignancy, PTEN, polymorphism, mutation, variant, and their equivalents. Statistical analysis was performed using the second version of Comprehensive Meta-Analysis Software. A total of 2138 articles were collected. After removing duplicate articles, checking the title and abstract, and then checking the full text of the documents, finally 64 articles were approved and entered the systematic review process. Analysis of these studies with a sample size of 231,179 showed the prevalence of breast cancer patients with PTEN mutations. The combined results of 64 studies showed that the prevalence of PTEN mutations has a 3.3 (95% CI 2.2-5) in BC patients, and an analysis of 6 studies showed that the odds ratio of developing BC due to PTEN mutation is 3.7 (95% CI 1.1-11.9). The results of this study show that mutation in the PTEN gene increases the chance of developing BC. However, it was found that a small part of patients gets BC due to the occurrence of mutation in this gene.

The outcomes of cardiopulmonary resuscitation and their predictors during the coronavirus 2019 pandemic in Iran.

BACKGROUND: Coronavirus disease 2019 (COVID-19) can negatively affect different healthcare-related outcomes. Nonetheless, there is limited information about its effects on different healthcare-related outcomes. This study aimed at evaluating the outcomes of cardiopulmonary resuscitation (CPR) and their predictors during the COVID-19 pandemic in Iran. METHODS: This cross-sectional study was conducted on 1253 patients who had undergone CPR in the emergency wards of teaching hospitals in the west of Iran from the beginning of the first wave to the end of the third epidemic wave of COVID-19 in Iran, between February 20, 2020, and January 20, 2021. Data were collected using the National CPR Documentation Forms developed based on the Utstein Style and routinely used for all patients with cardiac arrest (CA). The SPSS (v. 20.0) program was used to analyze the data through the Chi-square, Fisher's exact, and Mann-Whitney U tests and logistic regression analysis. RESULTS: Participants' age mean was 64.62 ± 17.54 years. Age mean among participants with COVID-19 was eight years more than other participants. Most participants were male (64.09%) and had at least one underlying disease (64.99%). The total rates of the return of spontaneous circulation (ROSC) and CPR-discharge survival were respectively 15.3% and 3.8% among all participants, 20.25% and 5.17% among participants without COVID-19, and 8.96% and 2.04% among participants with COVID-19. The significant predictors of ROSC were age, affliction by COVID-19, affliction by underlying diseases, baseline rhythm, delay in epinephrine administration, and epinephrine administration time interval, while the significant predictors of CPR-discharge survival were age and baseline rhythm. CONCLUSIONS: The total rates of ROSC and CPR-discharge survival were respectively 15.3% and 3.8% among all participants. The rates of ROSC and CPR to discharge survival among patients without COVID-19 are respectively 2.26 and 2.53 times more than the rates among patients with COVID-19.

Evaluation of clinical outcomes, complication rate, feasibility, and applicability of transfacet pedicle-sparing approach in thoracic disc herniation: a systematic review and meta-analysis.

OBJECTIVE: This study aimed to evaluate the clinical outcomes, complication rate, feasibility, and applicability of transfacet pedicle-sparing approach for treating thoracic disc herniation. METHODS: We searched three databases including the Cochrane Library, PubMed, and Embase for eligible studies until Dec 2022. The quality of studies and their risk of bias were assessed using the methodological index for non-randomized studies. We evaluated the heterogeneity between studies using the I2 statistic and the P-value for the heterogeneity. RESULTS: A total of 328 patients described in 11 included articles were published from 2009 to 2022. Pain outcomes using the visual analog scale (VAS score) were reported in four studies. The standardized mean difference was reported as 0.749 (CI 95% 0.555-0.943). The obtained result showed the positive effect of the procedure and the improvement of patients' pain after the surgery. Myelopathy outcomes using the Nurick score were reported in five studies. The standardized mean difference was reported as 0.775 (CI 95% 0.479-1.071). The result showed the positive effect of the procedure. Eight studies assessed postoperative complications and neurological deterioration. The pooled overall complication was 12.4% (32/258) and 3.5% (9/258) neurological worsening. CONCLUSION: The results of this study demonstrated a positive effect of the transfacet pedicle-sparing approach on the clinical outcomes of patients with thoracic disc herniation surgery. The technique has been shown to be safe and effective for the right patient. The technique is associated with lower rates of complications and a shorter hospital stay compared to other surgical approaches. This information can assist clinicians in making informed decisions when selecting the most appropriate surgical technique for their patients with thoracic disc herniation.

Prevalence of migraine in Iran: a systematic review and meta-analysis.

BACKGROUND: Migraine headaches affect all ages, from childhood to old age. Migraine attacks cause significant changes in the living conditions of the sick person, including a decrease in personal, social, and occupational performance. This study was conducted to determine the prevalence of migraine in Iran through a systematic review and meta-analysis. METHOD: In this systematic review and meta-analysis study, the studies associated with the prevalence of migraine using the keywords: migraine, prevalence, and Iran its equivalents in international databases PubMed, Web of Science, Scopus, Science direct, and Iranian internal information databases, including SID and MagIran, was searched without limit until November 2022. Comprehensive Meta-Analysis software (Version 2) was used to analyze the data. Due to the high number of studies reviewed in this systematic review, the Begg and Mazumdar test was used at a significance level of 0.1, and the corresponding Funnel plot was used to check publication bias. Also, the I2 test was used to check the heterogeneity in this study. RESULTS: 22 records were included in the final analysis. The prevalence of migraine in the general population of Iran was 15.1% (confidence interval 95%: 10.7-20.9), and in this population, the prevalence of migraine was higher in women than in men. The prevalence of migraine based on The International Classification of Headache Disorders (ICHD) 2 criteria was reportedly 16.4% (95% CI: 10.8-24.1), and with ICHD3 criteria, this value was reported as 17.1% (95% CI: 7.7-33.6). Based on a survey of 4571 children, the prevalence of migraine was reported to be 5.2% (95% CI: 1.3-18.7). Also, the prevalence of migraine in adolescents was calculated based on eight studies (n = 8820). Accordingly, 11.2% (95% CI: 5.8-20.4) of adolescents have migraines. Meanwhile, the prevalence of migraine in boys was 8.2% (95% CI: 4.8-13.7), and in girls was 8% (95% CI: 6.2-12.7). CONCLUSION: As a result, the prevalence of migraine in Iran, based on population-based studies, was reported as 15.1%. The result showed a higher prevalence of migraine in the general population than in children and adolescents. It was also found that the prevalence of migraine in women is higher than in men.

The global prevalence of ADHD in children and adolescents: a systematic review and meta-analysis.

BACKGROUND: Attention-Deficit / Hyperactivity Disorder is a developmental neurological disorder that has three basic characteristics: Attention Deficit, Hyperactivity, and impulsivity. This study aimed to investigate the prevalence of ADHD in children and adolescents. METHODS: This investigation was carried out using the meta-analysis method under PRISMA guidelines. Until October 2020, the articles were gathered by scanning PubMed, Scopus, WOS, and Science Direct databases. The second version of Comprehensive Meta-Analysis software was used to run analyses after extracting data from chosen papers. At a significance level of 0.05, the I2 test was used to analyze study heterogeneity, and the Egger test was used to assess publication bias. RESULTS: This analysis includes 61 cross-sectional research, with 53 research used to determine the prevalence of ADHD in children, 7.6% of 96,907 children aged 3 to 12 years had ADHD (95% confidence interval: 6.1-9.4%), and 5.6% of teenagers aged 12 to 18 years have ADHD (95% confidence interval: 4.8-7%). The prevalence of ADHD in children and adolescents according to the DSM-V criterion is also higher than previous diagnostic criteria, according to studies. CONCLUSION: The findings of this study based on meta-analysis show the high prevalence of attention deficit hyperactivity disorder (ADHD). The findings of this study demonstrate the importance of management and policy in the treatment and control of ADHD in children and adolescents.

The global prevalence of primary central nervous system tumors: a systematic review and meta-analysis.

BACKGROUND: Primary central nervous system (CNS) tumors are a heterogeneous group of neoplasms, including benign and malignant tumors. Since there are many heterogeneities in the prevalence reported in previous studies on this type of tumor, this study was performed to determine the overall prevalence of different primary CNS tumors. METHOD: The study was conducted as a systematic review and meta-analysis by searching international databases, including PubMed, Scopus, Science Direct, Web of science, and the Google Scholar search engine until August 2020. After transferring the studies to information management software (EndNote) and eliminating duplicate studies, the remaining studies were reviewed based on inclusion and exclusion criteria according to three stages of primary and secondary evaluation and qualitative evaluation. Comprehensive Meta-Analysis software, Begg, Mazumdar, and I2 tests were used for data analysis, publication bias analysis, and heterogeneity analysis, respectively. RESULTS: After performing the systematic review steps, 80 studies were included for final analysis. Based on 8 studies, the prevalence of brain tumors was 70.9%. Also, studies on 7 other studies showed that the prevalence of spinal tumors was 12.2%. A review of 14 studies showed that the prevalence of neuroepithelial tumors was 34.7%. The analysis of 27 studies reported a prevalence of glioma tumors of 42.8%. Analyses performed on other studies showed that the prevalence of pituitary adenomas was 12.2%, embryonal tumors 3.1%, ependymal tumors 3.2%, meningiomas 24.1%, glial tumors 0.8%, astrocytic 20.3%, oligodendroglial 3.9%, glioblastoma 17.7%, schwannoma 6.7%, medulloblastoma 7.7% and Polycystic astrocytomas 3.8%. CONCLUSION: As a result, it can be stated that brain tumors are the most common type of primary CNS tumors. It was also observed that tumors involving neuroepithelial cells are more common in patients than other types of tumors.

The prevalence of depression and anxiety in patients with cancer in Iran: a systematic review and meta-analysis.

BACKGROUND: Cancer is one of the most prevalent diseases and is recognized as a global problem that is currently showing a growing trend. Cancer is one of the most stressful circumstances that a person may experience. Given how the mental state of patients with depression and anxiety may have a negative impact on their experience with cancer, this study was conducted with the aim to investigate the prevalence of anxiety and depression in cancer patients in Iran. METHODS: This study was conducted using a systematic review method and based on the guideline Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020). The studies used were searched for via databases, Scopus, Web of Science (WOS), Google Scholar, SID, Magiran, and using keywords related to anxiety, depression, and cancer. After extracting the required data, statistical analysis was performed based on the random model and using the second version of Comprehensive Meta-Analysis Software. RESULTS: In a review of 24 studies with a sample size of 3225 people, the overall prevalence of depression in cancer patients in Iran was reported to be 50.1% (95% CI: 40.6-59.6). Additionally, in a review of 15 studies with a sample size of 2009, the overall prevalence of anxiety in cancer patients in Iran was reported to be 40.9% (95% CI: 30.9-51.6). The highest reported prevalence of depression in cancer patients in Iran according to the Beck questionnaire is 64.6 (95% CI: 48.2-78.1). Specifically, the highest prevalence of depression was reported in patients with breast cancer with a prevalence of 66 (95% CI: 50.9-78.4). The highest prevalence of anxiety in patients with cancer in Iran according to the Depression, Anxiety, and Stress Scale was 49.2 (95% CI: 18.9-80.1). Comparatively, the highest prevalence of anxiety in patients with breast cancer was reported to be 53.2 (95% CI: 25.8-78.7). CONCLUSION: The prevalence of depression and anxiety among cancer patients in Iran, in particular patients with breast cancer, is significantly higher than in other parts of the world. The prevalence found in our study was even higher than the reported number by studies that have examined the disorder globally. Therefore, it is of great urgency for health system policymakers to work to improve the current situation.

Identification of Suitable Drug Combinations for Treating COVID-19 Using a Novel Machine Learning Approach: The RAIN Method.

COVID-19 affects several human genes, each with its own p-value. The combination of drugs associated with these genes with small p-values may lead to an estimation of the combined p-value between COVID-19 and some drug combinations, thereby increasing the effectiveness of these combinations in defeating the disease. Based on human genes, we introduced a new machine learning method that offers an effective drug combination with low combined p-values between them and COVID-19. This study follows an improved approach to systematic reviews, called the Systematic Review and Artificial Intelligence Network Meta-Analysis (RAIN), registered within PROSPERO (CRD42021256797), in which, the PRISMA criterion is still considered. Drugs used in the treatment of COVID-19 were searched in the databases of ScienceDirect, Web of Science (WoS), ProQuest, Embase, Medline (PubMed), and Scopus. In addition, using artificial intelligence and the measurement of the p-value between human genes affected by COVID-19 and drugs that have been suggested by clinical experts, and reported within the identified research papers, suitable drug combinations are proposed for the treatment of COVID-19. During the systematic review process, 39 studies were selected. Our analysis shows that most of the reported drugs, such as azithromycin and hydroxyl-chloroquine on their own, do not have much of an effect on the recovery of COVID-19 patients. Based on the result of the new artificial intelligence, on the other hand, at a significance level of less than 0.05, the combination of the two drugs therapeutic corticosteroid + camostat with a significance level of 0.02, remdesivir + azithromycin with a significance level of 0.03, and interleukin 1 receptor antagonist protein + camostat with a significance level 0.02 are considered far more effective for the treatment of COVID-19 and are therefore recommended. Additionally, at a significance level of less than 0.01, the combination of interleukin 1 receptor antagonist protein + camostat + azithromycin + tocilizumab + oseltamivir with a significance level of 0.006, and the combination of interleukin 1 receptor antagonist protein + camostat + chloroquine + favipiravir + tocilizumab7 with corticosteroid + camostat + oseltamivir + remdesivir + tocilizumab at a significant level of 0.009 are effective in the treatment of patients with COVID-19 and are also recommended. The results of this study provide sets of effective drug combinations for the treatment of patients with COVID-19. In addition, the new artificial intelligence used in the RAIN method could provide a forward-looking approach to clinical trial studies, which could also be used effectively in the treatment of diseases such as cancer.

Global prevalence of polypharmacy among the COVID-19 patients: a comprehensive systematic review and meta-analysis of observational studies.

BACKGROUND: Polypharmacy has traditionally been defined in various texts as the use of 5 or more chronic drugs, the use of inappropriate drugs, or drugs that are not clinically authorized. The aim of this study was to evaluate the prevalence of polypharmacy among the COVID-19 patients, and the side effects, by systematic review and meta-analysis. METHODS: This study was performed by systematic review method and in accordance with PRISMA 2020 criteria. The protocol in this work is registered in PROSPERO (CRD42021281552). Particular databases and repositories have been searched to identify and select relevant studies. The quality of articles was assessed based on the Newcastle-Ottawa Scale checklist. Heterogeneity of the studies was measured using the I2 test. RESULTS: The results of meta-analysis showed that the prevalence of polypharmacy in 14 studies with a sample size of 189,870 patients with COVID-19 is 34.6% (95% CI: 29.6-40). Studies have shown that polypharmacy is associated with side effects, increased morbidity and mortality among patients with COVID-19. The results of meta-regression analysis reported that with increasing age of COVID-19 patients, the prevalence of polypharmacy increases (p < 0.05). DISCUSSION: The most important strength of this study is the updated search to June 2022 and the use of all databases to increase the accuracy and sensitivity of the study. The most important limitation of this study is the lack of proper definition of polypharmacy in some studies and not mentioning the number of drugs used for patients in these studies. CONCLUSION: Polypharmacy is seen in many patients with COVID-19. Since there is no definitive cure for COVID-19, the multiplicity of drugs used to treat this disease can affect the severity of the disease and its side effects as a result of drug interactions. This highlights the importance of controlling and managing prescription drugs for patients with COVID-19.

Body dysmorphic disorder in individuals requesting cosmetic surgery: A systematic review and meta-analysis.

BACKGROUND: Body dysmorphic disorder (BDD) is known as a mental disorder in which a person suffers from concern and distress with the perceived defects in their appearance and subsequently can experience significant impairment in social, occupational, and interpersonal functioning. Various studies have reported different BDD prevalence rates in patients with cosmetic surgery. However, there has been no comprehensive study that has examined the results of these studies. Therefore, this study aims to determine BDD prevalence in individuals requesting cosmetic surgery in a systematic review and meta-analysis. METHODS: In this review study, a search was conducted in national and international databases of Cochrane, Embase, ScienceDirect, Scopus, PubMed, and Web of Science (WoS) between 1878 and January 2020. A random-effects model was used to analyze the data, and heterogeneity of studies was examined with the I2 index. Data analysis was done using comprehensive meta-analysis (Version 2). RESULTS: BDD prevalence in individuals requesting cosmetic surgery in 48 articles with a sample size of 14,913 was 19.2% (95% CI: 15.8-23%). Regarding heterogeneity based on meta-regression, a significant difference between the sample size (p<0.001) and BDD prevalence in patients with cosmetic surgery was observed. CONCLUSION: The results of this study showed that BDD prevalence in individuals requesting cosmetic surgery is high. Therefore, with the provision of feedback at hospitals, appropriate interventions, such as pre-screening for body image disturbance, should be mandated.

Telemedicine and insomnia: a comprehensive systematic review and meta-analysis.

BACKGROUND: Telemedicine has been introduced as a new and effective method in dealing with public health challenges, improving access to health care, and reducing healthcare costs in today's world. Insomnia is the most common sleep disorder that can be managed with cognitive behavioural therapy, however, access to skilled therapists is an issue. Telemedicine improves access to care and thus, it may facilitate management of insomnia. The aim of this study was to assess whether telemedicine can be as effective as traditional in person sleep medicine service for the diagnosis, follow-up, and treatment of insomnia. METHODS: In this systematic review and meta-analysis, studies related to telemedicine and insomnia were identified and selected, using the keywords of telemedicine, insomnia, sleep disorder, treatment, non-pharmacological treatment. The international databases of Embase, ProQuest, ScienceDirect, Scopus, PubMed and Web of Science (WoS), and Google Scholar were searched without a lower time limit, and until July 12, 2021. Data were analysed within the Comprehensive Meta-Analysis (version 2) software, and the significance level of the test was considered P Ë‚ 0.05. RESULTS: A systematic review of 16 selected studies showed that telemedicine interventions have a positive effect on improving insomnia in different groups. The meta-analysis was performed on 2 studies. Based on the results, CBTI interventions based on telemedicine have a greater effect on improving chronic insomnia than face to face CBTI with an average difference of 2.05 ± 0.66 based on the random effects model. Moreover, the difference between the mean in the telemedicine intervention group and the non-intervention group was 0.65 ± 0.19, which shows the positive effect of the telemedicine intervention. CONCLUSION: The use of telemedicine in treatment of insomnia not only accelerates access to sleep services, but can also improve the efficiency of health services in terms of time and cost, as well as therapeutic effects.

The effect of obstructive sleep apnea on the increased risk of cardiovascular disease: a systematic review and meta-analysis.

BACKGROUND: Obstructive sleep apnea (OSA) is a disorder characterized by intermittent airway obstruction during sleep. The association between OSA and the incidence of cardiovascular disease (CVD) has been investigated in many studies; however, the results are not entirely consistent between studies. The aim of this study was to investigate the relationship between OSA and the risk of CVD through a meta-analysis of cohort studies. METHODS: A systematic review and meta-analysis of literature was conducted using the PubMed, WoS, Embase, ScienceDirect, Scopus, and Web of Science databases up to the year 2020. In order to analyze the eligible studies, the stochastic effects model was used and the heterogeneity of the studies with the I2 index was investigated. Data analysis was performed with Comprehensive Meta-Analysis software (Version 2). RESULTS: A total of 24 studies were included in the meta-analysis according to the inclusion criteria. Twelve studies reported CVD results, 11 studies reported stroke results, 9 studies reported mortality results, and 8 studies reported CVD results. The odds ratio of CVD in patients with OSA 1.71 (1.17-2.27: 95% confidence interval) stroke in patients with OSA, 1.86 (1.28-2.69: 95% confidence interval), mortality in patients with OSA, 1.77 (1.37-2.29: 95% confidence interval) and CHD in patients with OSA, and 1.48 (1.06-2.28: 95% confidence interval) was obtained. CONCLUSION: OSA is considered a cardiovascular risk factor. There is a relationship between the severity of OSA and the risk of cardiovascular disease. OSA increases the risk of heart attack, CHD, and death from cardiovascular disease.

The global prevalence of osteoporosis in the world: a comprehensive systematic review and meta-analysis.

BACKGROUND: Osteoporosis affects all sections of society, including families with people affected by osteoporosis, government agencies and medical institutes in various fields. For example, it involves the patient and his/her family members, and government agencies in terms of the cost of treatment and medical care. Providing a comprehensive picture of the prevalence of osteoporosis globally is important for health policymakers to make appropriate decisions. Therefore, this study was conducted to investigate the prevalence of osteoporosis worldwide. METHODS: A systematic review and meta-analysis were conducted in accordance with the PRISMA criteria. The PubMed, Science Direct, Web of Science, Scopus, Magiran, and Google Scholar databases were searched with no lower time limit up till 26 August 2020. The heterogeneity of the studies was measured using the I2 test, and the publication bias was assessed by the Begg and Mazumdar's test at the significance level of 0.1. RESULTS: After following the systematic review processes, 86 studies were selected for meta-analysis. The sample size of the study was 103,334,579 people in the age range of 15-105 years. Using meta-analysis, the prevalence of osteoporosis in the world was reported to be 18.3 (95% CI 16.2-20.7). Based on 70 studies and sample size of 800,457 women, and heterogenicity I2: 99.8, the prevalence of osteoporosis in women of the world was reported to be 23.1 (95% CI 19.8-26.9), while the prevalence of osteoporosis among men of the world was found to be 11.7 (95% CI 9.6-14.1 which was based on 40 studies and sample size of 453,964 men.). The highest prevalence of osteoporosis was reported in Africa with 39.5% (95% CI 22.3-59.7) and a sample size of 2989 people with the age range 18-95 years. CONCLUSION: According to the medical, economic, and social burden of osteoporosis, providing a robust and comprehensive estimate of the prevalence of osteoporosis in the world can facilitate decisions in health system planning and policymaking, including an overview of the current and outlook for the future; provide the necessary facilities for the treatment of people with osteoporosis; reduce the severe risks that lead to death by preventing fractures; and, finally, monitor the overall state of osteoporosis in the world. This study is the first to report a structured review and meta-analysis of the prevalence of osteoporosis worldwide.

Association between PNPLA3 rs738409 polymorphism and nonalcoholic fatty liver disease: a systematic review and meta-analysis.

BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is a common disorder that is known to be the leading cause of chronic liver disease worldwide. This study aims to systematically review and meta-analyze the association between PNPLA3 rs738409 polymorphism and non-alcoholic fatty liver. METHODS: Following a systematic review and meta-analysis method, articles without any time limitation, were extracted from SID, MagIran, IranDoc, Scopus, Embase, Web of Science (WoS), PubMed and ScienceDirect international databases. Random effects model was used for analysis, and heterogeneity of studies was investigated considering the I2 index and using Comprehensive Meta-Analysis software. RESULTS: The odds ratio of CC genotype in patients with non-alcoholic fatty liver demonstrates the protective effect of CC genotype with the ratio of 0.52, whereas CG genotype presents an increasing effect of CG genotype with the ratio of 0.19, and GG genotype also showed an increasing effect of GG genotype with the ratio of 1.05. Moreover, CG + GG genotypes as a single group demostrated an odds rartio of 0.88. CONCLUSION: This meta-analysis highlights that people with CC genotype has 52% lower chance of developing non-alcoholic fatty liver disease, and those with CG genotype had 19% higher risk of developing non-alcoholic fatty liver. Those with GG genotype were 105% more likely to develop non-alcoholic fatty liver than others. Moreover, those present in a population with CG + GG genotypes were 88% more likely to have non-alcoholic fatty liver disease.

The effect of polymorphisms (174G> C and 572C> G) on the Interleukin-6 gene in coronary artery disease: a systematic review and meta-analysis.

BACKGROUND: Coronary Artery Disease (CAD) is caused by the blockage of the coronary arteries. it is argued that there has an association between the Interleukin-6 gene and the occurrence of atherosclerosis, coronary artery disease, Due to the short half-life and high variability of Interleukin-6 (IL-6), limited studies have been performed on the association of serum levels of interleukin-6 with coronary artery disease. The aim of this study is to investigate the relationship between IL-6 gene polymorphisms and coronary artery disease. METHODS: This study was conducted as a meta-analysis of selected articles with no lower time limit and upto March 2020. Articles related to the subject were obtained by searching several data sources,such as the SID, IranDoc, Scopus, Embase, Web of Science (ISI), PubMed, Science Direct, and Google Scholar databases. The heterogeneity of the studies was assessed using the I2 index in the Comprehensive Meta-Analysis software. RESULTS: The GG genotype of the IL-6174 G> C polymorphism with a 0.8 odds ratio tended to reduce the risk of CAD by 20%. The odds ratio of CAD in CG and GG genotypes were found to be 1.16 and 1.48 times respectively, indicating the increasing effect of these two genotypes. In the IL-6-572 C>G polymorphism, CG and GG genotypes increased the risk of CAD by 1.21 and 1.27 times respectively, and the CC genotype tended to reduce the risk of CAD by 15%, considering the odds ratio of 0.85. CONCLUSION: This study showed a relationship between IL-6174G> C and Interleukin-6 (IL-6) 572 C>G genes and coronary artery disease. Moreover, the protective effects of GG genotype in IL-6 gene 174 G> C and CC genotype in IL-6 gene 572 C>G gene were reported. The study also confirmed that the CG and CC genotypes of the G>C IL-6174 gene have an increasing effect on coronary artery disease. Moreover, CG and GG genotypes in the IL-6 gene 572 C>G increased the risk of developing CAD. It should be noted that the increased risk of developing CAD was limited to meta-analytic studies in reported literatures.

The prevalence of sleep disturbances among physicians and nurses facing the COVID-19 patients: a systematic review and meta-analysis.

BACKGROUND: In all epidemics, healthcare staff are at the centre of risks and damages caused by pathogens. Today, nurses and physicians are faced with unprecedented work pressures in the face of the COVID-19 pandemic, resulting in several psychological disorders such as stress, anxiety and sleep disturbances. The aim of this study is to investigate the prevalence of sleep disturbances in hospital nurses and physicians facing the COVID-19 patients. METHOD: A systematic review and metanalysis was conducted in accordance with the PRISMA criteria. The PubMed, Scopus, Science direct, Web of science, CINHAL, Medline, and Google Scholar databases were searched with no lower time-limt and until 24 June 2020. The heterogeneity of the studies was measured using I2 test and the publication bias was assessed by the Egger's test at the significance level of 0.05. RESULTS: The I2 test was used to evaluate the heterogeneity of the selected studies, based on the results of I2 test, the prevalence of sleep disturbances in nurses and physicians is I2: 97.4% and I2: 97.3% respectively. After following the systematic review processes, 7 cross-sectional studies were selected for meta-analysis. Six studies with the sample size of 3745 nurses were examined in and the prevalence of sleep disturbances was approximated to be 34.8% (95% CI: 24.8-46.4%). The prevalence of sleep disturbances in physicians was also measured in 5 studies with the sample size of 2123 physicians. According to the results, the prevalence of sleep disturbances in physicians caring for the COVID-19 patients was reported to be 41.6% (95% CI: 27.7-57%). CONCLUSION: Healthcare workers, as the front line of the fight against COVID-19, are more vulnerable to the harmful effects of this disease than other groups in society. Increasing workplace stress increases sleep disturbances in the medical staff, especially nurses and physicians. In other words, increased stress due to the exposure to COVID-19 increases the prevalence of sleep disturbances in nurses and physicians. Therefore, it is important for health policymakers to provide solutions and interventions to reduce the workplace stress and pressures on medical staff.

The Prevalence of Restless Legs Syndrome in Patients with Migraine: A Systematic Review and Meta-Analysis.

Background: Migraine is a severe and debilitating neurologic disorder and is claimed to be the sixth disabling illness in the world. This study aimed to determine the overall prevalence of restless legs syndrome (RLS) in patients with migraine through a systematic review and meta-analysis. Methods: To identify and select related studies, the Scopus, ScienceDirect, Embase, SID, IranDoc, Web of Science, Knowledge Network System Medline (PubMed), and Google Scholar databases were searched. All related cross-sectional studies, published in English or Persian language between January 2000 and December 2019 and using the keywords such as migraine, restless leg syndrome, sleep disorder, RLS, and migraine disorder, were collected. The heterogeneity of the studies was assessed using the I 2 index, and the data analysis was performed using the Comprehensive Meta-Analysis software. Results: Analysis was conducted on the reported results of the final 12 articles with the total sample size of 15196. The overall prevalence of RLS in patients with migraine was 16.3% (95% CI: 12.6-20.8%). The prevalence of RLS migraine patients decreased with increasing the sample size, and the prevalence of RLS migraine patients increased with increasing the research year, which was statistically significant (P < 0.05). Conclusion: This study highlights that RLS is high in patients with migraine, and therefore, the clinicians should be aware of its incidence and take preventive measures.