Association between sleep quality with maternal and neonatal outcomes during the covid-19 pandemic.

AIM: Sleep disorders during pregnancy can impact maternal and neonatal outcomes. The objective of this study is to examine the relationship between sleep quality and maternal and neonatal outcomes during the COVID-19 pandemic. METHOD: This prospective cohort study was conducted at the Educational-Therapeutic Center of Shohadaye Yaftabad Referral Hospital in Tehran, Iran, from December 2020 to September 2022. A total of 198 eligible participants were randomly assigned to either the sleep disorders group or the no sleep disorders group. Data were collected through demographic questionnaires, the Corona Disease Anxiety Scale (CDAS) questionnaire, the Pittsburgh Sleep Quality Index (PSQI), and the checklist for maternal and neonatal outcomes. RESULTS: At baseline, the sleep disorders and no sleep disorders groups were similar in terms of age, body mass index (before pregnancy), education level, employment status, gravida, parity, abortion, and history of COVID-19. Within the sleep disorders group, there was a statistically significant, direct linear correlation between sleep disorders and FBS 34-36 weeks (r = 0.33, P < 0.001) as well as Corona Disease Anxiety (CDA) (r = 0.35, P < 0.001). The linear regression results indicated that for every unit increase in sleep disorders, the risk of FBS 34-36 weeks increased by 1.09 times (ß = 1.09, P < 0.001). Additionally, sleep disorders increased the risk of CDA by 1.36 times (ß = 1.36, P < 0.001). The results showed no statistically significant differences in terms of birth weight, type of delivery (vaginal or cesarean section), gestational age (preterm or full term), length of labor stages (first and second stage), Apgar score at minutes 1 and 5, and NICU admission between the two groups. CONCLUSION: Based on the results, a certain degree of correlation exists between sleep quality and FBS at 34-36 weeks and CDA. These findings underscore the need for future public health guidelines to formulate detailed strategies to improve sleep quality during the COVID-19 pandemic.

The effect of mass media campaigns on oral health knowledge: A systematic review and meta-analysis.

OBJECTIVES: Knowledge and awareness gained from mass media can prepare people for lifestyle changes and impact their health and well-being. Considering the differences in the results of primary studies, we decided to conduct this study to evaluate the effect of mass media campaigns on oral health knowledge as a systematic meta-analysis and review. METHOD: The databases such as the Web of Sciences (ISI), Scopus, PubMed/Medline, and the Cochrane Library were searched systematically until February 2022. Data pooling was performed using a random effects model. The effect sizes were estimated as odds ratios (ORs) with their 95% confidence intervals (CIs). Additional analyses, including sensitivity, subgroup, and publication bias analyses, were also conducted. RESULTS: Our meta-analysis comprised a total number of seven articles. The pooled results indicated significant increases in oral health knowledge among included studies (OR = 1.64, 95% CI: 1.20-2.24, p < 0.001). In subgroup analyses, the effects of mass media campaigns on oral health knowledge remained significant for the studies with follow-up of less than 150 weeks (OR = 1.69, 95% CI: 1.49-1.91) and working-age populations (OR = 1.80, 95% CI: 1.40-2.32) compared to other categories. CONCLUSION: In general, this study showed that mass media campaigns may have positive effects on oral health knowledge, especially in the working-age population; it seems that for improving health knowledge among children, more initiatives are needed. Besides, the effects of these campaigns seem to be time-dependent and higher in shorter follow-up periods.

The effect of green cardamom on blood pressure and inflammatory markers among patients with metabolic syndrome and related disorders: A systematic review and meta-analysis of randomized clinical trials.

Research shows that herbal spices, including seeds of Elettaria cardamomum, may exert beneficial effects on unhealthy metabolic status. This study is a systematic review of the effect of green cardamom in patients with metabolic syndrome and its related disorders. PubMed/Medline, Scopus, EMBASE, Web of Science, and Cochrane Library were searched to identify the relevant randomized clinical trials. The data were pooled using the random-effects model, and weighted mean difference (WMD) was considered as summary effect size. Of 625 clinical trials, eight reports with 595 patients (299 in intervention group and 296 in control group) were included. The findings indicated that green cardamom significantly decreased diastolic blood pressure (WMD: -0.91 mmHg, 95%CI; -1.19, -0.62), high-sensitivity C-reactive protein (WMD: -1.21 mg/L, 95%CI; -2.18, -0.24), interleukin 6 levels (WMD: -2.41 ng/L, 95%CI; -4.35, -0.47). However, cardamom supplementation did not significantly affect systolic blood pressure. This meta-analysis demonstrated that green cardamom could improve blood pressure control and exert antiinflammatory effects which could help patients with unhealthy metabolic profile better manage their health. Importantly, there were few eligible randomized trials with quite a low number of participants. Further prospective studies on larger sample sizes and longer duration of supplementation are warranted for its widespread use.

COVID-19 associated rhino-orbito-cerebral mucormycosis, risk factors and outcome predictors; a multicentric study.

BACKGROUND: Since the onset of the Covid-19 pandemic, an increase in mucormycosis cases has been observed in many countries, including Iran. However, the role of covid-19 and associated risk factors have not been thoroughly investigated. OBJECTIVE: This study is designed to identify epidemiologic characteristics, risk factors, and outcome predictors of Covid-19-Associated Rhino-Orbito-Cerebral Mucormycosis (C-ROCM). METHODS: Data of pathology proven Covid Associated ROCM cases were retrospectively obtained from 7 tertiary care centers throughout Iran from February 20, 2021, to July 22, 2021. Univariate and multivariate analyses were performed using binary logistic regression to assess the effects of various factors on the outcome. RESULTS: A total of 132 patients with C-ROCM were included in the study. The mean age of patients was 61.6 ± 13.9 (60.6% male). In 12 patients (9.1%), both eyes were involved. Diabetes was the most common comorbidity (94.7%). The mortality rate was 9.1%, higher in males (12.5%) than females (3.8%). Severe vision impairment was seen in 58 patients (43.9%). Main factors that had a negative impact on the outcome in the univariate analysis include older age (P < 0.001), higher steroid dosage (P < 0.001), higher HbA1c level (P < 0.001), Covid-19 severity (P < 0.001), and brain involvement (P < 0.001). However, in the multivariate analysis, the effects of age (P = 0.062), steroid dosage (P = 0.226), and Covid-19 intensity (P = 0.084) decreased, and the difference was no longer statistically significant. CRAO was a predictor of mortality in the univariate analysis (P = 0.008, OR = 4.50), but in the multivariate analysis, this effect decreased and was no longer significant (P = 0.125). CONCLUSION: The risk of C-ROCM and its complications may increase in patients with more severe Covid-19, steroid over-prescription, ICU admission due to Covid-19, and poor glycemic control during and after Covid-19 treatment.

Impact of the COVID-19 pandemic on the stage and the type of surgical treatment of laryngeal cancer.

PURPOSE: Changes in the entire health care system during COVID-19 epidemic have affected the management of patients with head and neck cancer and posed several clinical challenges for ENT surgeons. Therefore, the present study aimed to investigate the effect of COVID-19 on the stage and the type of surgical treatments used in laryngeal cancer (including total laryngectomy, supracricoid partial laryngectomy (SCPL) and transoral laser microsurgery (TLM)) and also to compare the results of April 2020 to April 2021 with the previous year. MATERIALS AND METHODS: This cross-sectional study was performed on all patients with a diagnosis of laryngeal cancer who underwent surgery in the tertiary care center from April 2020 to April 2021 and the year before the pandemic in the same time. Demographic, cancer stage, and treatment data of all patients were recorded and analysis in two groups. RESULTS: Patients referred at the time of the virus outbreak; 111 were male and 5 were female, and in the group of patients referred before COVID-19, 90 were male and 12 were female. The type of surgical treatment of laryngeal cancer, mean time elapsed from sampling to surgery, stage of disease and mean tumor volume was statistically significant differences in patients before and during the outbreak. CONCLUSION: Patients who referred for diagnosis and treatment at the time of COVID-19 outbreak had more advanced stages of the disease and also the tumor volume was higher in them than patients who had referred before the outbreak. It is necessary to provide new solutions, education and treatment management for patients with laryngeal cancer in such pandemics.

The effects of functional endoscopic sinus surgery on chronic obstructive pulmonary disease (COPD) and asthma: A comparative study.

PURPOSE: Chronic Rhinosinusitis (CRS) can be accompanied by asthma and, rarely by chronic obstructive pulmonary disease (COPD). Functional endoscopic sinus surgery (FESS) is the most common surgical approach for CRS which also improves asthma symptoms, but little is known about its effects on COPD. This study investigates the effects of FESS on COPD and asthma symptoms in CRS patients referred to a university hospital in northern Iran. MATERIALS AND METHODS: In a prospective study, patients with COPD or asthma and CRS who were candidates for FESS underwent endoscopic examination, spirometry, and evaluation of symptoms of CRS, COPD, and asthma before, and 2 and 6 months after FESS. Statistical analyzes were performed using SPSS software version 21 and the level of significance was considered as P < 0.05. RESULTS: Eighty-two CRS patients (45 with asthma/ mean age: 49.24 ± 12.75 years and 37 patients with COPD/ mean age: 61.43 ± 6.93 years) enrolled. In asthmatic patients, the mean FEV1 and FVC, and ACT (Asthma Control Test) score increased significantly after FESS (P < 0.001). In COPD cases, spirometry indices decreased, but CAT (COPD Assessment Test) score improved significantly (from 15.70 to 32.11) after FESS (P < 0.001). The mean SNOT score in both groups was significantly reduced. CONCLUSIONS: In CRS patients with COPD, FESS improves the condition of SNOT-22 and CAT, although does not increase spirometry parameters. In asthmatic patients, FESS improves pulmonary function and asthma symptoms. So both patient groups (i.e. CRS with COPD and with asthma) will benefit from FESS.

Prevalence of anxiety and depression in Meniere's disease; a comparative analytical study.

BACKGROUND: Psychological problems are of most significant issues in patients with Meniere's disease (MD). This study aimed to reveal the frequency of anxiety and depression in MD patients compared to healthy individuals and patients with benign positional paroxysmal vertigo (BPPV) referred to a university hospital. METHODS: This case-control study was conducted on individuals between 18 and 65 years old assigned to three groups: the control, MD, and BPPV groups. The data collecting instruments included a demographic information form, along with Beck Anxiety Inventory (BAI) and Beck Depression Inventory-II (BDI-II) questionnaires. Data were analyzed using SPSS software v.23, and the significance level was considered as p < 0.05. RESULTS: A total of 177 participants enrolled. The average scores of anxiety and depression and the severity of anxiety and depression were higher in MD and BPPV groups than in the control group (P < 0.001). The average anxiety score and anxiety severity in the MD group was higher than in the BPPV group (P < 0.001). However, in the case of depression, only severity was higher in the MD group (P < 0.001), and the average depression score showed no significant difference between MD and BPPV groups. After controlling for underlying variables, the impacts of MD (P < 0.001; regression coefficient = 16.5) and also BPPV (P = 0.025; regression coefficient = 4.6) on anxiety were significant compared to the control group. CONCLUSION: Our results suggest that the prevalence of anxiety and depression is higher in MD and BPPV patients than the healthy people, and MD has a higher effect on the incidence of depression and anxiety compared to BPPV.

Association between prenatal period exposure to ambient air pollutants and development of postpartum depression: a systematic review and meta-analysis.

There is body of evidence supporting a role for maternal exposure to ambient air pollutants and postpartum depression (PPD). We attempted to review the literature systematically to assess the association between exposure to both ambient air particulate matters within pregnancy and PPD. The effect estimates extracting across each study were standardized to a 10 µg/m3 change. The random-effects model was applied to pool odds ratios. According to the three included cohort articles, exposure to PM10 within second trimester (OR = 1.26, 95% CI = 1.15-1.37) was significantly associated with higher odds of PPD. However, there was no significant association between having exposure to other ambient air pollutants and PPD. This meta-analysis showed that air pollutants could be associated with an increased risk of PPD.

The effect of risk communication on preventive and protective Behaviours during the COVID-19 outbreak: mediating role of risk perception.

BACKGROUND: The COVID-19 outbreak is a global pandemic, during which the community preventive and protective behaviors play a crucial role in the containment and control of infection. This study was designed to contribute to the existing knowledge on how risk communication (RC) and risk perception (RP) affect protective and preventive behaviors (PPB) during the COVID-19 outbreak. METHODS: The required data were extracted from a national online survey of Iranian adults aged 15 and older during March 15-19, 2020 (n=3213). Data analysis was performed using structural equation modeling. RESULTS: The study findings reveal that RC has direct and indirect positive effects on PB. Furthermore, this study also provides new evidence indicating that RP mediates the relationship between RC and PB and there is a two-way relationship between RC and RP. These interactions may have impact on risk communication strategies which should be adopted during this pandemic. CONCLUSION: The study findings have remarkable implications for informing future communications as well as interventions during this ongoing outbreak and subsequent national risk events.

Adsorption of Cationic Dyes on a Magnetic 3D Spongin Scaffold with Nano-Sized Fe3O4 Cores.

The renewable, proteinaceous, marine biopolymer spongin is yet the focus of modern research. The preparation of a magnetic three-dimensional (3D) spongin scaffold with nano-sized Fe3O4 cores is reported here for the first time. The formation of this magnetic spongin-Fe3O4 composite was characterized by X-ray diffraction (XRD), thermogravimetric analysis (TGA), differential thermal analysis (DTA) (TGA-DTA), vibrating sample magnetometer (VSM), Fourier-transform infrared spectroscopy (FTIR), and zeta potential analyses. Field emission scanning electron microscopy (FE-SEM) confirmed the formation of well-dispersed spherical nanoparticles tightly bound to the spongin scaffold. The magnetic spongin-Fe3O4 composite showed significant removal efficiency for two cationic dyes (i.e., crystal violet (CV) and methylene blue (MB)). Adsorption experiments revealed that the prepared material is a fast, high-capacity (77 mg/g), yet selective adsorbent for MB. This behavior was attributed to the creation of strong electrostatic interactions between the spongin-Fe3O4 and MB or CV, which was reflected by adsorption mechanism evaluations. The adsorption of MB and CV was found to be a function of pH, with maximum removal performance being observed over a wide pH range (pH = 5.5-11). In this work, we combined Fe3O4 nanoparticles and spongin scaffold properties into one unique composite, named magnetic spongin scaffold, in our attempt to create a sustainable absorbent for organic wastewater treatment. The appropriative mechanism of adsorption of the cationic dyes on a magnetic 3D spongin scaffold is proposed. Removal of organic dyes and other contaminants is essential to ensure healthy water and prevent various diseases. On the other hand, in many cases, dyes are used as models to demonstrate the adsorption properties of nanostructures. Due to the good absorption properties of magnetic spongin, it can be proposed as a green and uncomplicated adsorbent for the removal of different organic contaminants and, furthermore, as a carrier in drug delivery applications.

Effect of calcium dobesilate on retrobulbar blood flow and choroidal thickness in patients with non-proliferative diabetic retinopathy.

INTRODUCTION: Diabetic retinopathy is one of the most common causes of blindness in work-aging adults and develops in one third of diabetic patients. Calcium dobesilate (CaD) treatment have protective effects on blood retinal barrier (BRB) and anti-oxidant as well as anti-inflammatory properties. OBJECTIVES: To assess effects of CaD administration on retrobulbar blood flow and choroidal thickness in patients with diabetic retinopathy. METHODS: In this quasi-experimental study, diabetic patients with diabetic retinopathy (DR) were recruited from Shahid Motahari and Poostchi ophthalmology clinic affiliated to Shiraz University of Medical Sciences. Patients were treated with CaD, 1 gr per day for seven days. Before and after CaD administration, retrobulbar blood flow and subfoveal choroidal thickness were assessed. Retrobulbar blood flow were evaluated by measuring peak systolic velocity (PSV), end diastolic velocity (EDV) and resistive index (RI) of ophthalmic artery (OA), central retinal artery (CRA) and short ciliary artery (SCA). RESULTS: In this study, 26 DR patients with a mean age of 56.15 ± 8.93 years and mean diabetes mellitus duration of 15.04 ± 7.64 years were enrolled. Subfoveal choroidal thickness was significantly increased from 316.08 ± 61.69 to 327.81 ± 58.03 after CaD treatment (P value < 0.001). PSV of CRA and EDV of all arteries were significantly increased after CaD administration. In addition, RI of all arteries was significantly reduced after CaD treatment (P < 0.001). CONCLUSION: CaD treatment may improve the ophthalmic blood flow and increase the subfoveal choroidal thickness in DR patients. These results may be suggestive of protective effects of CaD on endothelium function as well as microvascular circulation.

A new multi-epitope peptide vaccine induces immune responses and protection against Leishmania infantum in BALB/c mice.

Visceral leishmaniasis (VL) is a tropical and subtropical disease which is endemic in more than eighty countries around the world. Leishmania infantum is one of the main causative agents of VL disease. Currently, there is no approved-to-market vaccine for VL therapy. In this study, we evaluated cellular and humoral immune responses induced by our newly designed multi-epitope vaccine in BALB/c mice. Four antigenic proteins, including histone H1, sterol 24-c-methyltransferase (SMT), Leishmania-specific hypothetical protein (LiHy), and Leishmania-specific antigenic protein (LSAP) were chosen for the prediction of potential immunodominant epitopes. Moreover, to enhance vaccine immunogenicity, two toll-like receptors 4 (TLR4) agonists, resuscitation-promoting factors of Mycobacterium tuberculosis (RpfE and RpfB), were employed as the built-in adjuvants. Immunization with the designed multi-epitope vaccine elicited a robust Th1-type immune response, compared to other groups, as shown by increased levels of IL-2, IFN-γ, TNF-α, and IgG2a. Furthermore, a significant decrease was observed in Th-2-type-related cytokines such as IL-4 in immunized mice. The designed construct also induced a significant reduction in parasite load (p < 0.0001), conferring protection against L. infantum challenge. This study could be promising in gaining insight towards the potential of peptide epitope-based vaccines as effective protective approaches against Leishmania species.

The effects of quercetin supplementation on lipid profiles and inflammatory markers among patients with metabolic syndrome and related disorders: A systematic review and meta-analysis of randomized controlled trials.

Aims: This systematic review and meta-analysis of randomized controlled trials (RCTs) was performed to determine the effect of quercetin administration on lipid profiles and inflammatory markers among patients with metabolic syndrome (MetS) and related disorders.Methods: We searched systematically online databases including Cochrane Library, EMBASE, MEDLINE, and Web of Science to identify the relevant RCTs until November 2018. Q-test and I2 statistics were applied to assess heterogeneity among included studies. Data were combined using fixed- or random-effects model and presented as standardized mean difference (SMD) with 95% confidence interval (CI).Results: Out of 591 citations, 16 RCTs were included in the meta-analysis. The pooled findings showed that quercetin consumption significantly decreased total-cholesterol (SMD = -0.98; 95% CI, -1.48, -0.49; p < 0.001; I2: 94.0), LDL-cholesterol (SMD = -0.88; 95% CI, -1.35, -0.41; p < 0.001; I2: 92.7) and C-reactive protein (CRP) levels (-0.64; 95% CI, -1.03, -0.25; p = 0.001; I2: 90.2). While, quercetin supplementation did not significantly affect triglycerides (TG) (SMD = -0.32; 95% CI, -0.68, 0.04; p = 0.08; I2: 84.8), HDL-cholesterol (SMD = 0.20; 95% CI, -0.20, 0.24; p = 0.84; I2: 70.6), interleukin 6 (IL-6) (SMD = -0.69; 95% CI, -1.69, 0.31; p = 0.17; I2: 94.5) and tumor necrosis factor-alpha (TNF-α) levels (SMD = -0.06; 95% CI, -0.25, 0.14; p = 0.58; I2: 35.6)Conclusions: In summary, the current meta-analysis demonstrated that quercetin supplementation significantly reduced total-cholesterol, LDL-cholesterol, and CRP levels, yet did not affect triglycerides, HDL-cholesterol, IL-6 and TNF-α among patients with MetS and related disorders.

The effects of resveratrol intake on weight loss: a systematic review and meta-analysis of randomized controlled trials.

This systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to summarize the effect of resveratrol intake on weight loss. We searched the following databases until July 2018: MEDLINE, EMBASE, Web of Science and Cochrane Central Register of Controlled Trials. Data were pooled using the inverse variance method and expressed as standardized mean difference (SMD) with 95% confidence intervals (95% CI). Out of 831 reports, 36 RCTs were eligible for including to our meta-analysis. The pooled results, using random-effects model showed that resveratrol supplementation significantly decreased body weight (SMD = -0.17; 95% CI, -0.33, -0.01; P = 0.03; I2: 62.6), body mass index (BMI) (SMD = -0.20; 95% CI, -0.35, -0.05; P = 0.01; I2: 60.6), fat mass (SMD = -0.32; 95% CI, -0.62, -0.03; P = 0.03; I2: 77.9) and waist circumference (WC) (SMD = -0.42; 95% CI, -0.68, -0.16; P = 0.001; I2: 75.2), and significantly increased lean mass (SMD = 1.21; 95% CI, 0.75, 1.67; P < 0.001; I2: 87.6). We found no significant effect of resveratrol administration on leptin (SMD = -0.20; 95% CI, -0.68, 0.27; P = 0.40; I2: 85.3) and adiponectin levels (SMD = 0.08; 95% CI, -0.39, 0.55; P = 0.74; I2: 91.0). Resveratrol supplementation significantly decreased body weight in obese patients (SMD -0.43; 95% CI, -0.60, -0.26) compared with other diseases (SMD 0.02; 95% CI, -0.29, 0.33), and type 2 diabetes mellitus (SMD -0.17; 95% CI, -0.37, 0.02). Overall, the current meta-analysis demonstrated that resveratrol intake significantly reduced weight, BMI, WC and fat mass, and significantly increased lean mass, but did not affect leptin and adiponectin levels.

The effects of resveratrol on lipid profiles and liver enzymes in patients with metabolic syndrome and related disorders: a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: There are current trials investigating the effect of resveratrol supplementation on lipid profiles and liver enzymes among patients with metabolic syndrome (MetS) and related disorders; however, their findings are controversial. This systematic review and meta-analysis were aimed to determine the effects of resveratrol supplementation on lipid profiles and liver enzymes among patients with MetS and related disorders. METHODS: We performed a comprehensive search of the following online databases up to November 2018: Cochrane Library, PubMed, Embase, and Web of Science. The relevant articles were assessed for quality of studies using the Cochrane risk of bias tool. RESULTS: Out of 2459 citations, 31 articles were appropriate for including to the current meta-analysis. The pooled results indicated that resveratrol use significantly decreased total cholesterol [weighted mean difference (WMD) = - 7.65 mg/dL; 95% CI, - 12.93, - 2.37; P < 0.01; I2: 83.4%] and increased gamma-glutamyl transferase (GGT) concentrations (WMD = 1.76 U/l; 95% CI, 0.58, 2.94; P < 0.01; I2: 20.1%). We found no significant effect of resveratrol supplementation on triglycerides (WMD = - 5.84 mg/dL; 95% CI, - 12.68, 1.00; P = 0.09; I2: 66.8%), LDL- (WMD = -2.90 mg/dL; 95% CI, - 10.88, 5.09; P = 0.47; I2: 96.0%), HDL-cholesterol (WMD = 0.49 mg/dL; 95% CI, - 0.80, 1.78; P = 0.45; I2: 74.0%), alanine aminotransferase (ALT) (WMD = -0.14 U/l; 95% CI, - 3.69, 3.41; P = 0.93; I2: 79.6%), and aspartate aminotransferase (AST) (WMD = -0.34 U/l; 95% CI, - 2.94, 2.27; P = 0.80; I2: 88.0%) concentrations. CONCLUSIONS: This meta-analysis demonstrated that resveratrol supplementation among patients with MetS and related disorders significantly reduced total cholesterol and increased GGT concentrations, but did not affect triglycerides, LDL-, HDL-cholesterol, ALT, and AST concentrations. This data suggests that resveratrol may have a potential cardio-protective effect in patients with MetS and related disorders.

A multivariate multilevel analysis of the risk factors associated with anthropometric indices in Iranian mid-adolescents.

BACKGROUND: The present study was conducted to jointly assess some specific factors related to body fat measures using a multivariate multilevel analysis in a representative sample of Iranian mid-adolescents. METHODS: This study was conducted among 2538 students (1286 boys) aged 14-20 years old, who were randomly selected among 16 public high schools by multi-stage random sampling procedure from all education districts of Shiraz, Iran. Data on demographic characteristics, family history of obesity, physical activity, socio-economic (SES) variables and screen time were collected. Height, weight, triceps (TST), abdominal (AST), and subscapular (SST) skinfold thickness were measured and their body mass index (BMI) was calculated. A multivariate multilevel approach was used to analyze the factors associated with obesity measures of the TST, AST, SST at the child and district levels. RESULTS: In this study, the prevalence of overweight and obesity was estimated to be 10.2 and 5.1%, respectively. Overall, the major portion of the total variance in TST (97.1%), AST (97.7%), and SST (97.5%) was found at the child level. The results of multivariate multilevel method revealed that being girls, having a family history of obesity, and SES were significantly associated with increasing of three body fat measures (all the p-values were less than 0.05). There were significant positive associations between moderate to vigorous physical activities with AST and SST (for AST: ß =2.54, SE = 1.40, p = 0.05; for SST: ß =2.24, SE = 1.20, p = 0.05). Compared to children in 14-16 age group, children in age group 16-18 years had less TST (ß = - 0.67, SE = 0.34, p = 0.04). Furthermore, other age groups and screen time did not play an important role in three outcome variables. CONCLUSIONS: The results showed some factors that contribute to three body fat measures. Therefore, it is necessary to develop effective interventions to prevent the effects of individual and environmental undesirable factors on childhood obesity in both family and community levels.

Are Industry Payments Associated With the Level of Evidence in Oral and Maxillofacial Surgery?

PURPOSE: The purpose of the present study was to determine whether the industry payments in oral and maxillofacial surgery (OMS) are associated with a study's level of evidence (LOE). MATERIALS AND METHODS: A retrospective cohort study was designed and implemented to query the Journal of Oral and Maxillofacial Surgery from 2002 to 2016. The primary predictor variables were the presence of a self-reported conflict of interest (COI) and the type of COI. The outcome variable was the LOE. The secondary outcome variables investigated were the topic of the study and the inclusion of trainees. The inclusion criteria entailed contributions from domestic academic OMS training programs. Disclosure of the COIs and type of COI, the LOE, topic of the study, and inclusion of trainees were recorded for every report from January 2002 until December 2016. Descriptive statistics were calculated, and χ2 tests were performed to determine a significant relationship primarily between the COIs and LOE. RESULTS: The sample included 1455 reports, and 4.2% of the sample size had disclosed a COI. The studies that disclosed industry payments demonstrated a significant positive correlation with the LOE (P < .01), especially for cohort studies. Also, the type of COI was significantly associated with the LOE (P < .05). Industry payments were not shown to be significantly related statistically to topic of the study (P = .16); however, the stock-related payments were associated with the topic (P < .05). No association was found between COI disclosure and trainee contribution. CONCLUSIONS: The results have indicated that industry payments are associated with the LOE in the OMS literature. Further studies are needed to elucidate both the accuracy of the financial disclosures by comparing them with publicly available open payment databases and the perceptions of the OMSs, their trainees, and their patients regarding the influence of industry payments on the specialty's academic interests.

The effects of statin use on inflammatory markers among patients with metabolic syndrome and related disorders: A systematic review and meta-analysis of randomized controlled trials.

Current evidence suggests that statin use decreases the incidence of cardiovascular diseases (CVD) through reducing LDL cholesterol and decreasing inflammation. Metabolic syndrome (MetS) is usually associated with increased inflammatory markers and increased risk of CVD. We conducted a systematic review and meta-analysis to determine the effect of statin use on inflammatory markers including C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and interleukin-1 (IL-1) among patients with MetS and related disorders. PubMed, EMBASE, Web of Science databases, and Cochrane Library were searched for randomized controlled trials (RCTs) through April 2018. Three independent investigators evaluated study eligibilities, extracted data, and assessed study quality using the Cochrane Collaboration risk of bias tool and Jadad's quality scales. Heterogeneity was determined using Cochran's Q statistic and I-square (I2) test. Based on the heterogeneity results, we pooled data using random-effect or fixed effect models presented as standardized mean differences (SMD) and corresponding 95% confidence intervals (CI). One hundred thirteen RCTs (19,644 patients) were included in our meta-analysis. The pooled results using random effects model showed that statin use statistically significantly decreased CRP level (SMD= -0.97; 95% CI, -1.10, -0.85; P < 0.001; I2: 95.1%), TNF-α (SMD= -1.88; 95% CI, -2.40, -1.38; P < 0.001; I2: 97.2%), IL-6 (SMD= -1.67; 95% CI, -1.98, -1.34; P < 0.001; I2: 96.5%), and IL-1 concentrations (SMD= -8.35; 95% CI, -10.49, -6.22; P < 0.001; I2: 98.4%) among patients with MetS and related disorders. Our meta-analysis showed beneficial effects of statin use on reducing inflammatory markers in patients with MetS and related disorders.

The effects of ginger intake on weight loss and metabolic profiles among overweight and obese subjects: A systematic review and meta-analysis of randomized controlled trials.

This systematic review and meta-analysis of randomized controlled trials (RCTs) was performed to summarize the effect of ginger intake on weight loss, glycemic control and lipid profiles among overweight and obese subjects. We searched the following databases through November 2017: MEDLINE, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials. The relevant data were extracted and assessed for quality of the studies according to the Cochrane risk of bias tool. Data were pooled using the inverse variance method and expressed as Standardized Mean Difference (SMD) with 95% Confidence Intervals (95% CI). Heterogeneity between studies was assessed by the Cochran Q statistic and I-squared tests (I2). Overall, 14 studies were included in the meta-analyses. Fourteen RCTs with 473 subjects were included in our meta-analysis. The results indicated that the supplementation with ginger significantly decreased body weight (BW) (SMD -0.66; 95% CI, -1.31, -0.01; P = 0.04), waist-to-hip ratio (WHR) (SMD -0.49; 95% CI, -0.82, -0.17; P = 0.003), hip ratio (HR) (SMD -0.42; 95% CI, -0.77, -0.08; P = 0.01), fasting glucose (SMD -0.68; 95% CI, -1.23, -0.05; P = 0.03) and insulin resistance index (HOMA-IR) (SMD -1.67; 95% CI, -2.86, -0.48; P = 0.006), and significantly increased HDL-cholesterol levels (SMD 0.40; 95% CI, 0.10, 0.70; P = 0.009). We found no detrimental effect of ginger on body mass index (BMI) (SMD -0.65; 95% CI, -1.36, 0.06; P = 0.074), insulin (SMD -0.54; 95% CI, -1.43, 0.35; P = 0.23), triglycerides (SMD -0.27; 95% CI, -0.71, 0.18; P = 0.24), total- (SMD -0.20; 95% CI, -0.58, 0.18; P = 0.30) and LDL-cholesterol (SMD -0.13; 95% CI, -0.51, 0.24; P = 0.48). Overall, the current meta-analysis demonstrated that ginger intake reduced BW, WHR, HR, fasting glucose and HOMA-IR, and increased HDL-cholesterol, but did not affect insulin, BMI, triglycerides, total- and LDL-cholesterol levels.

The effects of caffeine intake on weight loss: a systematic review and dos-response meta-analysis of randomized controlled trials.

This systematic review and meta-analysis of randomized controlled trials (RCTs) was performed to summarize the effect of caffeine intake on weight loss. We searched the following databases until November 2017: MEDLINE, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials. The relevant data were extracted and assessed for quality of the studies according to the Cochrane risk of bias tool. We estimated an intake-status regression coefficient (Beta) for each primary study and estimated the overall pooled Beta and SE using random effects meta-analysis on a double-log scale. Heterogeneity between studies was assessed by the Cochran Q statistic and I-squared tests (I2). Thirteen RCTs with 606 participants were included in the meta-analyses. The overall pooled Beta for the effect of caffeine intake was 0.29 (95%CI: 0.19, 0.40; Q = 124.5, I2 = 91.2%) for weigh, 0.23 (95%CI: 0.09, 0.36; Q = 71.0, I2 = 93.0%) for BMI, and 0.36 (95% CI: 0.24, 0.48; Q = 167.36, I2 = 94.0%) for fat mass. For every doubling in caffeine intake, the mean reduction in weight, BMI, and fat mass increased 2 Beta-fold (20.29 = 1.22, 20.23 = 1.17, and 20.36 = 1.28), which corresponding to 22, 17, and 28 percent, respectively. Overall, the current meta-analysis demonstrated that caffeine intake might promote weight, BMI and body fat reduction.