Temporal Analysis of Cutaneous Leishmaniasis Incidence in an Endemic Area of Southeast Iran.

PURPOSE: Cutaneous leishmaniasis (CL) is the most common type of leishmaniasis in tropical and subtropical areas. This study investigated the trend of CL changes from 2009 to 2022, and predicted the number of leishmaniasis cases until 2024. METHODS: This ecological study was performed on new monthly confirmed CL cases from 2009 to 2022 from the leishmaniasis registration system in southeast Iran. The time series method was used to investigate the trend of changes in CL from 2009 to 2022. SARIMA model was run to predict the number of leishmaniasis cases until 2024 by controlling the effect of climatic variables on the disease process. RESULTS: The analysis showed a significant increase in CL cases in 2015 and from 2021 to 2022. The minimum number of registered cases was observed in 2018, with 81 cases. The maximum number was also observed in 2021, with 318 patients. The leishmaniasis cases decreased from January to June and increased from July to December. According to the results of SARIMA (1, 0, 0) (1, 0, 0) multivariate analysis, the temperature in log 12 has a significant negative correlation with the number of leishmaniasis cases. This model predicted a decreasing trend in leishmaniasis cases until 2024. CONCLUSION: The southeast region of Fars province is one of the hyper-endemic regions of the disease, and it is prone to periodic outbreaks. An active surveillance system must investigate the CL incidence trend and evaluate the effectiveness of interventions to prevent the occurrence of new outbrea.

Investigate the relationship between the retraction reasons and the quality of methodology in non-Cochrane retracted systematic reviews: a systematic review.

BACKGROUND: This systematic review aimed to investigate the relationship between retraction status and the methodology quality in the retracted non-Cochrane systematic review. METHOD: PubMed, Web of Science, and Scopus databases were searched with keywords including systematic review, meta-analysis, and retraction or retracted as a type of publication until September 2023. There were no time or language restrictions. Non-Cochrane medical systematic review studies that were retracted were included in the present study. The data related to the retraction status of the articles were extracted from the retraction notice and Retraction Watch, and the quality of the methodology was evaluated with the AMSTAR-2 checklist by two independent researchers. Data were analyzed in the Excel 2019 and SPSS 21 software. RESULT: Of the 282 systematic reviews, the corresponding authors of 208 (73.75%) articles were from China. The average interval between publish and retraction of the article was about 23 months and about half of the non-Cochrane systematic reviews were retracted in the last 4 years. The most common reasons for retractions were fake peer reviews and unreliable data, respectively. Editors and publishers were the most retractors or requestors for retractions. More than 86% of the retracted non-Cochrane SRs were published in journals with an impact factor above two and had a critically low quality. Items 7, 9, and 13 among the critical items of the AMSTAR-2 checklist received the lowest scores. DISCUSSION AND CONCLUSION: There was a significant relationship between the reasons of retraction and the quality of the methodology (P-value < 0.05). Plagiarism software and using the Cope guidelines may decrease the time of retraction. In some countries, strict rules for promoting researchers increase the risk of misconduct. To avoid scientific errors and improve the quality of systematic reviews/meta-analyses (SRs/MAs), it is better to create protocol registration and retraction guidelines in each journal for SRs/MAs.

Prevalence of non-alcoholic fatty liver and its related factors in Iran: Systematic review and meta-analysis.

Non-alcoholic fatty liver disease (NAFLD) is a systemic disorder with a complex multifactorial and heterogeneous pathogenesis and has become the most common cause of chronic liver disease in many countries around the world. Numerous studies in Iran have presented different results on the prevalence and risk factors of NAFLD, in this study, which has been done in a systematic review and meta-analysis, provides a good estimate of the prevalence and risk factors of the disease in Iran. Following the peer review of electronic search strategies (PRESS and the preferred reporting items for systematic reviews and meta-analyses [PRISMA] statement, we searched Web of Science, PubMed, Embase, Scopus, and Persian scientific searcher (Elmnet) from inception to September 19, 2022. In the present study, 71 articles were reviewed for qualitative and meta-analysis. The overall mean prevalence of NAFLD in children studies was 22.4% (95% confidence interval [CI]: 10.9% to 33.9%). The prevalence was notably higher in adult studies 40.5% (95% CI: 35.1% to 46%). In 24 studies, the association between NAFLD and sex was reported, 10 of which showed significant relationships. Out of 46 studies observed that NAFLD prevalence increased significantly with body mass index (BMI). Eight out of 14 studies reported significant associations between FBS and NAFLD in children's studies. Though Iran has a high NAFLD prevalence compared to most areas, and due to the unfavorable situation of risk factors contributing to the NAFLD, it is necessary to take the necessary interventions to control these risk factors and prevent NAFLD.

Social stigma and its relationship with quality of life in multiple sclerosis patients.

INTRODUCTION: Multiple sclerosis (MS) is the most prevalent disease of the central nervous system that affects the behavioral characteristics and lifestyle of patients. This study aimed to determine the social stigma and its relationship with quality of life in people with MS referring to the Jahrom MS Association. METHOD: This cross-sectional study was conducted on MS patients who are members of the MS Association of Jahrom City in Fars province, southern Iran in 2022. The samples were selected by census method. The number of participants remain 223 people. The data was collected using a standard two-part demographic and Multiple Sclerosis Quality of Life-54 (MSQOL-54) questionnaire and a researcher-made 20-question Social stigma questionnaire which validity and reliability were measured. Data analysis was done in a descriptive way (frequency, percentage, mean and standard deviation), univariate regression and multivariable linear regression. Data analysis was done using SPSS version 17 and at a significance level of less than 0.05. RESULT: Based on univariate regression, marriage [B = 0.2, p-value = 0.004], physical health [B = 0.4, p-value < 0.001], emotional well-being [B = 0.4, p-value = 0.001], cognitive functioning [B = 0.4, p-value < 0.001], health distress [B = 0.5, p-value < 0.001] had a positive and significant relationship with patients' quality of life. Duration of disease [B=-0.2, p-value < 0.001], physical role limitations [B=-0.4, p-value < 0.001], emotional role limitations [B=-0.5, p-value < 0.001], pain [B=-0.4, p-value < 0.001], energy [B=-0.3, p-value = 0.02], health perception [B=-0.3, p-value = 0.001], social functioning [B=-0.4, p-value < 0.001], sexual function [B=-0.3, p-value < 0.001], change in health [B=-0.3, p-value < 0.001], sexual function satisfaction [B=-0.3, p-value < 0.001] and social stigma [B=-0.3, p-value < 0.001] had a negative and significant relationship with patients' quality of life (p < 0.05). CONCLUSION: The study has emphasized the relationship between the extent and severity of symptoms and disorders with the quality of life of people with MS. The results of the study showed factors such as marriage, physical health and health distress have a positive relationship and factors like duration of disease, physical role limitations, and social stigma have a negative relationship with the quality of life of people with MS. The quality of life of people with MS is more influenced by mental and psychological factors than the physical limitations of these patients.

Self-medication practices and their characteristics among Iranian university students.

BACKGROUND: Self-medication in students, as educated people, is one of the most important health issues. It is known that inappropriate self-medication is harmful for individuals as it has potential risks, disrupts the drug market and increases the per capita financial drug consumption. Thus, the aim of this study is to investigate the habits related to drug use and the prevalence of self-medication practices among university students. METHODS: This cross-sectional study was conducted in 2021 at Jahrom universities/Iran, using an electronic "self-medication practices and medication habits" questionnaire. A total of 848 students from four healthcare and non-healthcare universities participated in the study. RESULTS: The prevalence of self-medication among students was 44.8%. The most common medicines used for self-medication included cold remedies and sedatives that were used by 33% of the students. About 47% of students stated that they have used antibiotics without a physician's prescription. The internet and social networks were the source of information on self-medication in about 40% of students. There was no significant difference in self-medication between medical and non-medical students (OR = 0.865, 95% CI: 0.659-1.134). Self-medication in students with underlying disease was higher than students without underlying disease (OR = 2.8, 95% CI: 1.39-5.60). CONCLUSIONS: Self-medication had a high prevalence among students. The best strategy to reduce or eliminate self-medication is to raise students' awareness and knowledge about potential risk of self-medication practices.

The ever-evolving trade pattern: a global VAR approach.

This paper focuses on the spillover dynamics of shocks originating in China during the last two decades. More specifically, the paper compares the effects of a shock to China's GDP and exchange rate using early 2000s trade patterns with those of two decades later. We use a global vector autoregressive (GVAR) model as it allows to consider trade interactions as well as financial linkages through interest rates, stock prices, and exchange rates. Our results indicate that the shock spillovers from China have become more pronounced over the past two decades. While the world has become more exposed to China's economy, it has become more susceptible to Chinese economic shocks. This paper contributes to the literature by evaluating the dynamics of China's spillover effects and highlights the structural changes in trade between major global trade players. Supplementary Information: The online version contains supplementary material available at 10.1007/s00181-021-02182-5.

Prevalence of Posttraumatic Stress Disorder Following the Earthquake in Iran and Pakistan: A Systematic Review and Meta-Analysis.

Posttraumatic stress disorder (PTSD) is a common mental disorder following traumatic events. The present study was conducted to understand the prevalence of PTSD after the earthquake in Iran and Pakistan. The review includes all articles published from inception to March 2019. The pooled prevalence for overall PTSD was 55.6% (95% CI: 49.9-61.3). It was 60.2% (95% CI: 54.1-66.3) and 49.2% (95% CI: 39.4-59) for Iranian and Pakistani survivors, respectively. Women experienced higher incidence of PTSD than men. The variation of PTSD based on the clinical interview was lower than the self-report approach. The interval time between the earthquakes and the assessment showed that the prevalence of PTSD decreased over time. The prevalence of PTSD in Iran and Pakistan was higher than the global average, and the rate of the disorder in Iran was higher than in Pakistan. Sex, method of assessment, and time lag between the occurrence of disaster and assessment of PTSD affect the prevalence.

Risks assessment of Adherence to non-pharmaceutical measures towards COVID-19 among residents of Mashhad in the North-East of Iran during the awful wave of the epidemic.

BACKGROUND: Since the Coronavirus disease 19 (Covid-19) rampaged in Iran, three waves of the epidemic occurred. OBJECTIVE: In the present study, two issues are considered. First: What proportion of the people adhere to the mitigation approaches towards the disease? Second: Which are the reasons to disobey these rules? METHODS: A cross-sectional, population-based phone survey was applied among the population aged over 16 years in Mashhad between November 5 and December 1, 2020. A valid and reliable knowledge, attitude, and performance (KAP (designed questionnaire was used and logistic regression was performed with STATA 14. RESULTS: The final sample size was 776; 90.59, 89.8 and 48.1% of the participants had sufficient reliable knowledge, attitude, and practice, respectively; 20.1% of the participants did not wear masks; nearly half of them visited traditional healers for the prevention and cure; 97.8% of them believed the efficiency of the vaccine and stated that they will consume it if it is distributed. Among the sociodemographic factors, only the unemployed had low adherence to the preventive approach; 51.7% of the main worry was the weak economic situation and 69% of jobs and expenditures were poorly affected. The odds ratio (OR) for optimising attitude reduced from 4.64 to 3.22, and for good performance from 5.64 to 5.43 after adjusting for the economic, knowledge and perception factors. CONCLUSION: Despite all the health rules and probably COVID-19 vaccines global access (COVAX), it seems that the most effective way to reverse this horrific wave and its economic consequences is the improvement of the economy and livelihood of the society.

Incidence trend of breast Cancer in women of eastern Mediterranean region countries from 1998 to 2019: A systematic review and meta-analysis.

BACKGROUND: This study was conducted to provide evidence on the current status of breast cancer and its incidence trend in Eastern Mediterranean Region during 1998-2019. Also, this study aimed to investigate the association between the incidence of breast cancer and Human Development Index and some factors related to this index, including total fertility rate, and obesity, using a meta-analysis. METHOD: Data on incidence of breast cancer were collected from various sources, including PubMed, Embase, Web of Science, and WHO, from 1998 to 2019 using systematic review and meta-analysis. Pooled age standardized rate was calculated based on study duration and quality of data using a subgroup analysis and random effect meta-analysis. RESULTS: A total of 80 studies (545 data points) were analyzed. Pooled age standardized rate of breast cancer for Eastern Mediterranean Region was 37.1 per 100,000 person-year (95% confidence interval [CI], 34.5, 39.8) during 2011-2019. age standardized rate of breast cancer had an upward trend in Eastern Mediterranean Region from 2005 to 2019. However, the increasing trend was found to be slightly different in various regions based on quality of data. Moreover, pooled age standardized rate had a significant association with Human Development Index [- 89.2 (95% CI, - 119.8, - 58.7)] and obesity [1.2 (95% CI, 0.9, 1.5)]. CONCLUSION: Pooled age standardized rate of breast cancer in Eastern Mediterranean Region was lower than the global average. Also, the age standardized rate value and its incremental trend have been higher in countries with high-quality data than in other countries of this region in recent years. Data quality or physiological factors, such as increase in obesity rates, could be the reasons for this incremental trend.

Factors Influencing Pregnant Women's Use of Patient Decision Aids and Decision Making on Prenatal Screening: A Qualitative Study.

Objective: We aimed to identify factors influencing pregnant women's use of patient decision aids (PtDA) and decision making on prenatal screening. Materials and methods: This qualitative study was conducted between July 2019 and June 2020 in Tehran, Iran. The sample included 26 pregnant women selected by purposive sampling. The participants used a prenatal screening PtDA, then interviewed about factors that would influence their decision making and use of decision aids. The data were analyzed by conventional content analysis. Results: Three categories were identified for the process of and factors influencing decision making, including the current decision making process, expected decision making process, and factors influencing decision making. Also, five categories were identified as factors affecting the use of PtDAs, including the content of decision aids, the appearance of decision aids, the decision aid platform, the provision of decision aids, and the sub features of decision aids. Conclusion: To design, develop, and implementation of PtDAs for pregnant women, one should identify the factors affecting pregnant women's decision making and the use of decision aids. This study helped to the identification of these factors, which is the first step towards the use of PtDAs by pregnant women and their participation in decision making.

Self-Reported and Network Scale-Up Estimates of Substance Use Prevalence among University Students in Kerman, Iran.

BACKGROUND: This study aimed to estimate the prevalence of substance use among university students measured by direct and indirect methods, and to calculate the visibility factor (VF) defined as ratio of indirect to direct estimates of substance use prevalence. STUDY DESIGN: A cross-sectional study. METHODS: Using a multistage non-random sampling approach, we recruited 2157 students from three universities in Kerman, Iran, in 2016. We collected data on substance use by individual face-to-face interview using direct (i.e. self-report of their own behaviors) and indirect (NSU: Network scale up) methods. All estimates from direct and indirect methods were weighted based on inverse probability weight of sampling university. RESULTS: The response rate was 83.6%. The last year prevalence of water pipe, alcohol, and cigarettes indirect method was 44.6%, 18.1%, and 13.2% respectively. Corresponding figures in NSU analysis were 36.4%, 18.2%, and 16.5% respectively. In the female population, VF for all types of substance was less than male. CONCLUSIONS: Considerable numbers of university students used substances like a water pipe, alcohol, and cigarettes. NSU seems a promising method, especially among male students. Among female students, direct method provided more reliable results mainly due to transmission and prestige biases.

Comparison of Lipid Ratios to Identify Metabolic Syndrome.

BACKGROUND: The objective of this study was to compare various lipid ratios for detection of metabolic syndrome (MetS) in the Iranian general population. METHODS: This cross-sectional study involved 5677 subjects aged ≥18 years from the general population in Kerman, Iran. Associations between lipid ratio quartiles and MetS were analyzed using logistic regression models. The areas under receiver operating characteristic (ROC) was calculated to determine the accuracy of lipid ratios in predicting MetS. RESULTS: The adjusted chance of having MetS across quartiles of all lipid ratios had an increasing significant pattern (P < 0.0001). The area under the curves of triglyceride/high-density-lipoprotein-cholesterol (TG/HDL-C) ratio was 0.85 (95% CI = 0.84-0.87) in men and 0.85 (95% CI = 0.84-0.86) in women, of total cholesterol (TC)/HDL-C ratio was 0.79 (95% CI = 0.77-0.81) in men and 0.79 (95% CI = 0.77-0.81) in women and of low-density-lipoprotein cholesterol (LDL-C)/HDL-C ratio was 0.73 (95% CI = 0.71-0.75) in men and 0.74 (95% CI = 0.72-0.76) in women. CONCLUSION: Our results indicate that the TG/HDL-C Ratio is a better marker than the LDL-C/HDL-C ratio and the TC/HDL-C ratio for identifying MetS in the Iranian population and could be used in clinical practice.

Quality assessment of persian mental disorders websites using the webmedqual scale.

INTRODUCTION: Nowadays, anyone with any level of Internet knowledge can act as producer and distributor of information. It differs from most traditional media of information transmission, lack of information control and lack of quality management to contents. This leads to quality of health information on the internet is doubtful. The object of this study is guidance patients to select valid mental disorders and determine the quality of Persian mental disorders websites. METHODS: The sample of this study comprised 29 Persian mental disorders websites that were chosen by searching the Google, Yahoo and AltaVista search engines for the Persian equivalents of the three concepts "depression," "anxiety," and "obsession". website was created by individuals or organizations. Data collection was performed with the WebMedQual checklist. Websites was assessed based on indicators as content, authority of source, design, accessibility and availability, links, user support, and confidentiality and privacy (Maximum score for any website was 83, mean score 41.5 and minimum score was 0). Collected data analyzed by one sample T- test in SPSS 20. Findings presented by Mean score and optimal score. RESULTS: Based on the WebMedQual scale the mean score of Persian mental disorders websites in sex constructs including "content" (7.02±2.10), "authority of source" (4.71±1.96),"accessibility and availability" (2.19±0.47), "links" (1.45±0.97), "user support" (4.28±1.33), and"confidentiality and privacy" (2.81±2.81) are poor and below average, but the score for the "design" (9.17± 1.59) is above average. The best website of mental disorders was that of the "IranianPsychological Association". CONCLUSIONS: According to the results, only one website obtained the average score, so the quality of Persian mental disorders websites is low. Therefore, it is essential for users to criticize websites' content and not trust them before evaluating them. It is better to use the ranked list websites or search on the internet by help information experts.

Quality of persian addiction websites: a survey based on silberg, discern and wqet instruments (2011).

BACKGROUND: Nowadays, World Wide Web is an accessible and widespread resource to attain medical information. So physicians and health institutions try to inform patients about different domains of medicine through Web. Addiction is a noteworthy subject in medicine and a controversial issue among them. However, quality of health information on the internet is doubtful. The objective of this study is to determine the quality of Persian addiction websites to offer recommendation for their improvement. METHODS: This was survey and an applied study that the study population was all Persian addiction websites. Sample of this study was 28 Persian addiction website which were chosen by searching Persian equivalences of 7 key terms (addiction, addict, addiction center, drug, treatment of addiction, recovery of addiction, addiction withdrawal) into the Google and Yahoo search engines. Finally, the websites were ranked based on the Silberg, DISCERN and WQET instruments. Data were analyzed with Excel software using descriptive statistics. RESULTS: The overall mean of websites in Silberg, DISCERN and WQET instruments were 1.42, 41.89, 64.57. Also the results showed that "Unit of Substance Abuse Treatment" belonging to Mashhad University of Medical Sciences was ranked first based on the Silberg, DISCERN and WQET instruments. 5 (from total of 9), 60 (from total of 80) and 82 (from total of normalized grade 82) were grades for this website for these instruments respectively. CONCLUSION: It showed that the quality of Persian websites according to Silberg, DISCERN and WQET instruments was "low", "more than half" and "very good" respectively. Not assigning date of entering data, author names, and references of information (authority) were most important missing characteristics of these websites. In addition, lack of interactive opportunities like chat rooms was another problem that leads to dissatisfaction of users.

A scientometric study of general internal medicine domain among muslim countries of middle East (1991 - 2011).

BACKGROUND: The position of General Internal Medicine in the Islamic countries in the Middle East has been investigated in the present study. MATERIAL AND METHODS: The scientific productions of the countries in the area on Web of science database during 1990-2011 constitute were examined. RESULTS: The result of the survey showed that the share of these countries in world scientific productions is very low. Turkey, Saudi Arabia and Iran are the first to third ones in this domain in order. In view of annual growth rate, Kuwait having high growth rate, is the first one. Libya and Syria are the next ones. The scientific poverty line of Islamic countries in the area was surveyed. The result showed that in view of the scientific poverty line, the highest is Kuwait with the population of 0.04 percent of the world. Next to it, Saudi Arabia and Bahrain are the second and third ones. CONCLUSION: The results of this research showed that the share of Islamic countries in the Middle East in scientific production of this medicine domain is very low. It needs to be paid more attention by the countries in the area.