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Background: The increase in the average age of the population, the decrease in the size of the household and rising in the number of working women impose an increasing burden on home caregivers in Iran. The aim of this study was to measure care burden of informal caregivers in Iran through systematic review and meta-analysis of existing literature. Materials and Methods: A systematic review was conducted by using national and international databases of Scopus, PubMed, Embase, Web of Science, SID, Magiran, and IranDoc papers in English and Persian language up to the first half of 2020. In this meta-analysis, we calculated the pooled care burden and 95% confidence intervals in Statistical Software For Data Science (STATA) V.15. Results: Forty-four papers were included in the current study based on inclusion and exclusion criteria comprising of 8626 samples. Pooled mean of Burden of Care was 52.01 (95% CI: 48.21-55.82). Highest pooled mean(SD) of care burden (64.37) was related to caregivers of schizophrenia patients (95% CI: 56.09–72.64). Highest care burden (53.45) was observed in most deprived areas (95%CI = 47.05–59.86). A statistically significant relationship was observed between caregivers gender and care burden (p < 0.05). Conclusions: The reported care burden of informal caregivers requires the establishment of a support system to control mental and physical stress. Due to the dispersion and cultural diversity in Iran, more studies are needed to obtain more accurate data. [ABSTRACT FROM AUTHOR]

Objective: Ambiguity arises when more than one meaning and concept can be understood from a word, phrase or sentence. Since it seems necessary to understand this by the information retrieval system in order to increase the accuracy of the information retrieval system and increase the retrieval of related resources, the present research aims to identify the ambiguous and disambiguating factors through a systematic review of studies. It has been done in Iran. Methodology: The research method is applied in terms of purpose, in terms of approach, qualitative and in terms of information gathering method, systematic review using PRISMA standard. The statistical population includes journal articles, conferences, and dissertations indexed in Iranian databases, including: Magiran, Noormags, Shiraz Regional Center for Science and Technology, Civilica, and Academic Jihad Center (SID) and Scientific Information of Iran (treasure). 175 scientific sources and 138 scientific sources were excluded based on the output criteria and 37 scientific sources were selected based on the input criteria. Input criteria: focusing on the studies conducted on the subject of ambiguity and disambiguation, in the fields of linguistics, information technology, artificial intelligence, computer and information science, and epistemology, scientific sources published in Persian language, without publication time limits, review articles, Scientific research, master's and doctorate theses and national and international conference papers held inside Iran. Output criteria: studies carried out except for ambiguity and disambiguation, non-Persian language scientific sources, books, reports, editorials, abstract writings and short articles (less than 5 pages). Findings: The results show that the main topic of interest in this research was "ambiguity of the meaning of words" (53%) and "disambiguation of words" (44%) and the least topics of ambiguity in machine translation (21%) and disambiguation through ontology (5 percent). The most research methods with the "neural network" approach (22 percent) and the least research methods used were content analysis, methodology and machine learning (5 percent), the largest number of sources related to the articles of conferences and national conferences and was international (48 percent) and the least were master theses and doctoral dissertations (5 percent). Computer and linguistics fields (27 percent) have had the most scientific productions in this regard, and information science and epistemology fields (9 percent) have had the lowest productions. Conclusion: The present research is considered innovative in the sense that it deals with the issue of ambiguity and disambiguation in information retrieval with a systematic review approach. Its findings indicate that most Iranian researches were focused on disambiguation, which were mostly presented in national and international conferences and meetings. The topic of ambiguity and disambiguation is more important in the fields of computer science and linguistics, and the fields of information science and epistemology have not dealt with it. The semantic ambiguity of words and, by nature, the disambiguation of words has been the concern of format in Iranian researches. Ontology as a new approach to disambiguation has received less attention. [ABSTRACT FROM AUTHOR]

Objective: Antiplatelet drugs, such as Aspirin and Clopidogrel (Plavix) are effective in the primary prevention of thromboembolic events. They are commonly used to reduce the risk of recurrence of thromboembolism. The body's hemostatic system responds differently to these drugs in different people. Resistance testing for aspirin and Clopidogrel is now recommended before starting antiplatelet therapy. Methods: A systematic literature search was performed on May 12, 2021, using the medical search engines PubMed, Scopus, and Web of Science, and the local databases SID and Magiran. After data extraction, a meta-analysis was performed using Comprehensive Meta-Analysis (CMA2) software. The I2 statistic was used to measure heterogeneity between estimates. Results: Among the 949 papers, Clopidogrel resistance was assessed in 136 patients and Aspirin resistance in 400 patients. The prevalence of Aspirin resistance was found to be 52.1% and the prevalence of Clopidogrel resistance was found to be 20.5%. Conclusion: It seems that in Iran, the issue of Aspirin and Clopidogrel resistance is suboptimally addressed. This pattern could also occur in other developing countries in the Middle East region. [ABSTRACT FROM AUTHOR]

Introduction: Vitamin D deficiency (VDD) affects more than one billion individuals globally. We aimed to review all the published papers on vitamin D deficiency in in the country. Method: PubMed, Google Scholar, Web of Science, Scopus, Science direct and scientific information databases were searched for papers related to the prevalence of vitamin D insufficiency for all age groups in Iran from 2000 to 2018. The Joanna Briggs Institute prevalence critical appraisal tool was applied for the assessment of the methodological quality of these studies. The Meta-analysis is based on the random effect model using Comprehensive Meta-analysis data analysis. Results: Eighty-seven original articles reported on participants with vitamin D insufficiency in Iran. According to the meta-analysis of the prevalence of moderately deficient of vitamin D in men and women as well as younger and older individuals (>18 years) using a cut-off point of 25(OH) D3<20 ng/mL was 39% and 51%, respectively. Vitamin D concentrations <30 ng/mL among Iranian populations in the cities of Tehran, Shiraz, Mashhad, and Zahedan were reported to be higher than 90%. The prevalence of vitamin D insufficiency in Iranian women was higher than in men in various age groups. The highest prevalence of vitamin D insufficiency in neonates, children, adults and pregnant women was observed in the Middle East. Most countries had a high prevalence of VDD in elderly people. Conclusion: Vitamin D insufficiency is common in the Iranian population and is an important public health problem that should be considered seriously. [ABSTRACT FROM AUTHOR]

Aim: This systematic review and meta-analysis evaluated the subtyped Blastocystis sp. isolated from humans in Iran. Background: Blastocystis sp. is an anaerobic intestinal protozoan that infects humans as well as domestic and wild animals, i.e. mammals, amphibians, reptiles, and arthropods. Methods: A comprehensive search for papers published before April 2022 was undertaken utilizing English and Persian databases. The following MeSH keywords were used in the electronic search: (Blastocystis sp.) AND (molecular OR subtype) AND (prevalence OR epidemiology) AND Iran. The quality of the included studies was evaluated. Thereafter, a random-effects meta-analysis was conducted to estimate the pooled prevalence and odds ratios regarding the included studies. Results: A total of 32 studies comprised of five case-control studies and 27 cross-sectional studies met the eligibility criteria. The overall pooled prevalence of subtyped Blastocystis sp. in Iran was estimated to be 10% (95% confidence interval: 6 to 15%). Eight subtypes of Blastocystis sp. (ST1-ST7 and ST9) were identified in our study, of which ST3 was the most common subtype (0.04); 0.02-0.07). The difference in subtypes between two case and control groups in reported studies was not significant, but the odds ratio of infection by ST3 (0.98; 95% CI, 0.30 to 3.20) was higher in cases. Conclusion: The current systematic review showed that with the exception of ST8 and ST12, all human Blastocystis sp. subtypes reported in the world are found in different parts of Iran. [ABSTRACT FROM AUTHOR]

Introduction: In recent decades, the incidence and mortality rate of brain tumours, especially in adults, has increased. In order to better plan to reduce the burden of this cancer, knowledge of the epidemiological aspects of this disease is essential. Therefore, due to the lack of a comprehensive study on brain cancer in Iran, this study aimed to investigate the epidemiological aspects of this cancer in Iran. Methods: In June 2020, keywords of 'brain tumour', 'nervous system tumours', 'nervous system neoplasm', 'nervous system cancer', 'central nervous system (CNS)' and 'Iran' were searched on Medline/PubMed and Web of Science databases Scopus, Embase, SID, IranMedex, and Google Scholar. The search results were entered Endnotes Version 8; finally, 35 full papers were reviewed and included in the study. Results: The incidence of brain cancer and CNS tumour is lower in children in central Iran. The incidence of CNS cancer was relatively high among children in Golestan province. Furthermore, the standardised incidence of primary CNS tumours in Iran is 5.69 per 100,000, which is lower than in other countries. Nervous system malignancies were more common in men than in women (age-standardized rate 3 versus 2.2 per 100,000 in men and women, respectively). Tehran had the highest incidence of CNS tumours. Meningiomas were the only most common tumour in women. Gliomas were the most common primary brain tumour, and most of the lesions in this subgroup were in low-grade astrocytoma and ependymomas. Brain cancer mortality was higher in men than in women. Age is a potential risk factor, and the incidence of CNS tumours increases with increasing age after 30 years. Conclusion: Nervous system cancers are on the rise in Iran due to lifestyle changes and increased risk factors. Planning to reduce risk factors and early detection of the disease can be helpful in reducing cases and reducing mortality. [ABSTRACT FROM AUTHOR]

Probiotics have been shown to have beneficial effect on the growth performance of newborn animals. However, the results are inconsistent, especially in Iran. A meta-analysis was carried out to evaluate the effects of probiotics on dry matter intake (DMI), daily weight gain (DWG) and feed efficiency (FE) in suckling calves using data from the studies conducted in Iran. The literature review resulted in 13 documents including 6 and 5 papers written in English and Farsi respectively, as well as 2 papers presented in national conferences. Random effect meta-analysis was performed to evaluate the effect of probiotics on growth performance of the suckling calves using STATA statistical software on 8 papers that were identified as suitable for the objective of this study. Univariate and multivariate meta-regression analyses were also performed to evaluate the effects of experimental period (≤8 weeks vs. ≥8 weeks), gender of calf (male vs. female), type of probiotic (bacteria vs. a combination of yeast and bacteria), and probiotic administration manner (in milk vs. in starter) on the study outcomes. The results of meta-analysis showed no significant effect of probiotics on DMI. However, a significant difference was identified by subgroup meta-analysis between the experimental period subgroups for the effect of probiotics on DMI. Probiotics administration increased DWG of suckling calves by 47 g/day (P<0.01). The effect of probiotics on feed efficiency was not significant. The results indicated that the probiotic administration may improve DMI and DWG in suckling calves. [ABSTRACT FROM AUTHOR]

Non-adherence with treatment is a common problem among hemodialysis (HD) patients and was considered as a reliable factor in patients deteriorating, increasing admission chance and inappropriate responding to HD treatment. According to multiple factors related to Non-adherence to HD treatment and its importance in patients' quality of life, this study aimed at a systematic reviewing of Nonadherence with treatment in dialysis patients in Iran. Treatment with adherence status is one of the problems that patient has on dialysis. This study aims at detecting the most important causes of Non-adherence in patients on dialysis according to previous studies. First, all of the studies related to our title were searched using some keywords (dialysis, hemodialysis, adherence, and nonadherence) for English and Persian databases; Iranmedex, Magi ran, SID, Iran doc, Google, Google scholar, PubMed, Embase, CINAHL, PsycInfo, and Cochrane Database of Systematic that covering the period from 2010 to 2018 was reviewing following a predefined inclusion and exclusion criteria. As a result, 40 papers related to inclusion and exclusion criteria were identified and analyzed. Data were collected according to study features, measures of Nonadherence, prevalence rates and factors related to Non-adherence. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed to conduct this systematic review. According the results of present study six main categories were found. The main reasons for Non-adherence with treatment in dialysis patients listed in the papers included: Patient related factors, socioeconomic factors, Psychological factors, Health care related factors, Therapy related factors and Disease-related Factors below is provided for each explanation. Treatment for improving adherence is so important and can play a very significant role to improve the health in patients on dialysis. [ABSTRACT FROM AUTHOR]

Background: Maternal near miss (MNM) is one of the important criteria for checking the quality of care in maternal health. This systematic review and meta analysis study was conducted in 2017 to evaluate the incidence ratio of MNM using the World Health Organization approach in Iran. Materials and Methods: This study was designed based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist for systematic reviews, and Web of Science and PubMed databases were searched systematically, which, respectively, yielded 171 and 137 papers published before June 9, 2017. To include papers written in Persian by Iranian scholars, Google Scholar database was searched and 542 papers were retrieved. Finally, 12 papers which had covered the topic more appropriately were included in the study. Random-effects meta- analysis was used to pool the incidence ratio. Heterogeneity was explored using formal tests and subgroup analyses, then the study quality was also explored. Results: The pooling of overall potentially life-threatening conditions ratio was I2 (97.60%, p < 0.001, ratio = 2.50/1000 live births [LBs] [95% CI: 2.00 3.00]), which is divided into two indicators: severe complication ratio (2.40/1000 LBs) and critical intervention ratio (2.54/1000 LBs). The pooling of overall life threatening conditions ratio was I2 (95.10%, p < 0.001, ratio = 0.86/1000 LBs [95% CI: 0.64 1.07]). Conclusions: The incidence ratio of MNM needs more attention in Iran. Therefore, it is necessary to identify the factors related to MNM and then implement suitable strategies to reduce the risk factors of the maternal morbidity and improve the quality of maternal care in facilities. [ABSTRACT FROM AUTHOR]

Introduction: Anxiety is the most common psychological response of women to labor. The aim of the present systematic review was to evaluate and summarize the available clinical evidence on the anxiolytic effects of aromatherapy during the first stage of labor. Methods: Electronic databases including: Cochrane Library, MEDLINE/ PubMed, Scopus, CINAHL, SID, Iran Doc, ProQuest, and Google Scholar were searched up to Sep10, 2017 with the keywords of 'aroma*', 'aromatherapy', 'essential oil', 'anxiety', and ' labor '. The risk of bias in the included studies was assessed using the Cochrane Collaboration's 'Risk of bias' tool. The results were reported qualitatively. Results: A total of 14 published papers and 2 unpublished papers were retrieved which met the inclusion criteria. The studies were conducted in Iran, Egypt, Korea, and Italy. Essential oils had been used were lavender in 5 articles, rose, clary sage, geranium and frankincense in 3 articles, chamomile, bitter orange, sweet orange and peppermint in 2 articles, mandarin orange, jasmine and clove in 1 article. A majority of the studies suggested a positive effect of aromatherapy in reducing women's anxiety during the first stage of labor. Conclusion: It is recommended that aromatherapy could be applied as a complementary therapy for reducing anxiety during the first stage of labor, but methodologically rigorous studies should be conducted in this area. [ABSTRACT FROM AUTHOR]

Background and objectives: Intestinal parasitic infections are a major public health problem worldwide, especially in developing countries. It is estimated that around 3.5 billion people are infected with intestinal parasites. Human intestinal parasites (HIP) are clinically important due to broad epidemiological distribution, reinfection and drug resistance. In the last decades, bioactive compounds from herbs were used against a wide variety of microorganisms including parasites. We aimed to perform a systematic review on studies on the effects of medicinal herbs on HIPs in Iran. Methods: Relevant scientific publications until April, 2015 were extracted from five English databases (PubMed, Google Scholar, Ebsco, Science Direct and Scopus) and four Persian databases (Magiran, Irandoc, IranMedex and the Scientific Information Database). Results: A total of 18 papers and two dissertations met the inclusion criteria. Overall, 22 different plant extracts were used against Giardia lamblia, Entamoeba histolytica, Cryptosporidium and Hymenolepis nana. Based on the results, the extracts could exert time- and dose-dependent inhibitory effects against the tested HIPs. Five plants types including Allium, Chenopodium botrys, Carum copticum, F. asafoetida and Artemisia annua were able to completely inhibit the tested parasites, while Thymus vulgaris and A. paradoxum showed the lowest inhibitory effect (7%). Conclusions: Given the findings, it is recommended to conduct in vivo studies on medicinal herbs with favorable in vitro effects against HIPs. [ABSTRACT FROM AUTHOR]

Introduction: In recent decades, the inappropriate use of antibiotics and the existence of transferable resistant elements have caused the emergence of multidrug-resistant (MDR) gram-negative organisms. Antimicrobial resistance is becoming one of the major challenges to public health and has caused morbidity and mortality worldwide. The purpose of this study was the assessment of the prevalence and frequency of colistin resistance among gram-negative bacilli (Enterobacteriaceae, Acinetobacter spp., and Pseudomonas spp.) in Iran and around the world. Methods: For this systematic review and meta-analysis, we searched international and national databases, including PubMed, Google Scholar, SID, and Magiran, from 1998 to 2018 for articles and abstracts describing colistin resistance among gram-negative bacilli. We have included 92 studies that met our inclusion criteria, and the outcomes were combined using a random-effects model to derive the event rate of colistin resistance among gram-negative bacilli. Data were analyzed by the Comprehensive Meta-Analysis Software (V2), and the heterogeneity of the studies was assessed using the I2 index. Results: Out of the 11050 papers identified, 92 studies met the strict inclusion criteria and were finally included. The overall event rate of colistin resistance among gramnegative bacilli (GNB) was about 6.6%, while the event rate of colistin resistance among Acinetobacter spp. (n = 18504) was 2.8% (summary: 95% confidence interval (CI): [0.02, 0.041], P = 0.001, I2 = 70, df (Q) = 36, Q-value = 121.924). The colistin resistance among Pseudomonas spp. (n = 15094) was 3% (95% CI: [0.022, 0.041], P = 0.001, I2 = 68.3, df (Q) = 25, Q-value = 85.648), and the colistin resistance among Enterobacteriaceae spp. (n = 44772) was 0.8% (95% CI: [0.004, 0.014], P = 0.001, I2 = 87.6, df (Q) = 15, Q-value = 71.291). Therefore, the event rate of resistance to colistin among GNB was relatively low (6.6%). Conclusion: The event rate of resistance to colistin among GNB was low. Therefore, this antimicrobial agent can still be administered as a suitable option against GNB that are resistant to other antibiotics such as carbapenems. [ABSTRACT FROM AUTHOR]

Inadequate knowledge and negative attitudes are the major hindrances to prevent the spread of the human immunodeficiency virus. This study aims to assess the knowledge and attitude toward the human immunodeficiency virus and acquired immune deficiency syndrome among youths in Iran. We conducted a systematic review, searching online databases until July 2018, focusing on knowledge and attitudes about the human immunodeficiency virus and acquired immune deficiency syndrome in Iranian youths. We included the studies that aimed to determine the knowledge and attitudes of people from Iran and were conducted in the last 18 years. In total, 14 eligible papers (out of 300) were entered into the analysis, and the overall knowledge of Iranian youth toward the acquired immune deficiency syndrome was 57.6% (95% CI: 56.7%-58.5%). Also, the results of Cochran's test showed the heterogeneity of the studies (Q=1578.2, df=13, I2=79.4%, p<0.001). We concluded that our results would guide the development of population-focused knowledge and attitude about the human immunodeficiency virus and acquired immune deficiency syndrome in Iran, which is lacking among the general public and healthcare staff. [ABSTRACT FROM AUTHOR]

Introduction: Pediculosis is an endemic parasitic infestation in many countries of the world. Iran is one of the countries with a high rate of pediculosis. Aim: To investigate the prevalence and factors associated with pediculosis in primary school students of Iran. Materials and Methods: The literature search was carried out by two researchers on national databases including: SID, Iranmedex, Magiran, Irandoc and international database including: Scopus, Pubmed and Web of Science to find relevant articles between 2000 and 2016. The search strategy was performed using keywords such as: "epidemiology", "prevalence", "infestation", "head louse", "head lice", "Pediculus humans capitis", "pediculosis", "primary school students", "primary students", "school children", and "Iran", as well as their Farsi equivalents. In this study, a random effects model and a fixed effect model were used. To test heterogeneity, the Q-Cochran test was used at an error level of less than 10% and the quantity was estimated by I2. The Begg Rank Correlation Test and Eggers Regression Method were used to measure the publication bias. Results: The results showed that 428,993 students were studied in 55 papers between 2000 and 2016 and the prevalence of head louse (Pediculosis human capitis) was 6.4% (95% CI: 6-6.9). The prevalence of lice (pediculosis) infestation among girls was 6.1% (95% CI: 4.6-7.4) and in boys was 1.2% (95% CI: 0.8-1.7) and in rural areas prevalence was more than urban areas. Conclusion: The results of this study demonstrated a high incidence of pediculosis among rural school-girls. It is recommended that, creating awareness among this population is required, especially schools that do not have a health teacher. Large families, having low education among parents, must be educated about the condition and its prevention. [ABSTRACT FROM AUTHOR]

Objective. To describe perinatal and neonatal outcomes in newborns exposed to SARS-CoV-2. Methods. A systematic review was conducted by searching PubMed Central, LILACS, and Google Scholar using the keywords 'covid ' AND 'newborn' OR 'child' OR 'infant,' on 18 March 2020, and again on 17 April 2020. One researcher conducted the search and extracted data on demographics, maternal outcomes, diagnostic tests, imaging, and neonatal outcomes. Results. Of 256 publications identified, 20 met inclusion criteria and comprised neonatal outcome data for 222 newborns whose mothers were suspected or confirmed to be SARS-CoV-2 positive perinatally (17 studies) or of newborns referred to hospital with infection/pneumonia (3 studies). Most (12 studies) were case-series reports; all were from China, except three (Australia, Iran, and Spain). Of the 222 newborns, 13 were reported as positive for SARS-CoV-2; most of the studies reported no or mild symptoms and no adverse perinatal outcomes. Two papers among those from newborns who tested positive reported moderate or severe clinical characteristics. Five studies using data on umbilical cord blood, placenta, and/or amniotic fluid reported no positive results. Nine studies reported radiographic imaging, including 5 with images of pneumonia, increased lung marking, thickened texture, or high-density nodular shadow. Minor, non-specific changes in biochemical variables were reported. Studies that tested breast milk reported negative SARS-CoV-2 results. Conclusions. Given the paucity of studies at this time, vertical transmission cannot be confirmed or denied. Current literature does not support abstaining from breastfeeding nor separating mothers and newborns. Further evidence and data collection networks, particularly in the Americas, are needed for establishing definitive guidelines and recommendations. [ABSTRACT FROM AUTHOR]

Research on the impact of inputs has a long history in the country; however, because of the dispersion and diversity in the results of various experiments, it is difficult to achieve a general conclusion. In this study, a meta-analysis approach has been used to overcome this problem in order to achieve a single result by integrating and re-analyzing the findings of independent experiments. For this purpose, scientific articles published by researchers of the country regarding the effect of salinity stress on cotton yield were investigated. Articles were selected so that, in their meta-analysis of data required to perform there. The data necessary for the implementation of the meta-analysis is present in them. The results of this study showed that from 1996 to 2017; 15 papers and thesis were published on the effects of salinity stress on yield, early maturing and number of bolls in upland cotton (Gossypiumhirsutum L.). With increasing salinity stress, yield and number of bolls decreased. The standardized values for salinity stress effect on cotton yield were significant in all five treatments (control via salinity, control via 2-3 dS m-1, control via 4-5 dS m-1, control via 6-7 dS m-1, control via 8- 9 dS m-1) compared to control (P<0.001). The standardized values of the effect of salt stress on cotton aging were significant in all five treatments compared to control. The standardized values of the effect of salt stress on cotton aging were significant in all five treatments compared to control. Results showed increasing salinity stress can cause early maturing in cotton. The standardized values for the effect of salinity stress on number of bolls per cotton plant, in the comparison of the total treatments of salinity stress, 2-3 dS m-1, 6-7 dS m-1 and 8-9 dS m-1 were significant compared to control (P<0.001). In general, the results of this study showed that salinity stress can reduce yield of cotton by reducing the number of bolls and also can cause early maturing on cotton. [ABSTRACT FROM AUTHOR]

Objective: Workplace violence is one type of occupational hazards that is increasingly growing worldwide. In the health system, one of the important groups subject to workplace violence is emergency medical services (EMS) personnel, who provide emergency services for patients and casualties as the first responders. The aim of this study was to determine the prevalence of workplace violence and its different types among Iranian EMS personnel. Method: This study was conducted based on PRISMA guideline for systematic review and meta-analysis. The data were extracted from Scopus, PubMed, Web of Science, Google Scholar, SID and MagIran databases using Persian and English keywords. The search was conducted up to December 2018 without any limitation in publication year. The qualities of selected papers were assessed by STROBE checklist. I2 index was used to evaluate heterogeneity, and random effects model was used in meta-analysis. Data were analyzed using Stata14. Results: A total of 9 studies entered the meta-analysis. The total sample size was 1257 Iranian EMS personnel, with an average age of 32.21 ± 2.01 years. The prevalence of physical, verbal, and cultural workplace violence among EMS personnel was 36.39% (CI 95%:27.29-45.50, P<0.001, I2 = 90.8%), 73.13% (95% CI=68.64-77.62, P=0.013, I2 = 62.7%), and 16.51% (95% CI =3.49- 29.53, p<0.001. I2 = 94.7%), respectively. Conclusion: Considering the high prevalence of workplace violence among EMS personnel in Iran, more studies should be conducted to determine the underlying causes of EMS staff workplace violence in Iran. Training violence prevention methods as well as assigning national protective rules are highly suggested. Insufficient studies on Workplace violence among EMS personnel in Iran and high heterogeneity were the limitations of this study. [ABSTRACT FROM AUTHOR]

Co-infection with hepatitis B and C among HIV infected patients are prevalent among high-risk populations. This meta-analysis aimed to estimate the prevalence of HIV, HCV and HBV co-infections among high-risk populations in Iran. We systematically searched the national and international electronic databases until 2016. The primary outcome was the prevalence of HIV, HBV, HCV and HIV co-infections in different high-risk populations in Iran. All English and Persian studies conducted on Iranian high-risk groups were included in the study. The review was reported based on PRISMA guidelines and data were analysed at 95% confidence level using random effect models. Overall, 916 relevant papers were recognised and 14 articles were included in the metaanalysis. The pooled estimates of HBV/HCV, HCV/HIV, HBV/HIV and HBV/HCV/HIV were 1.3% (95%CI: 0.5-2.1), 16.3% (95%CI: 1.1-31.6), 0.5% (95%CI: 0-1.4) and 0.5% (95%CI: 0.2-0.8), respectively. Based on subgroup analysis, there was a higher proportion of all co-infections from the years 2010-2016 as compared to that of the years 2003-2009. Our results highlighted that HCV/HIV co-infection in Iranian high-risk groups including injection drug users (IDUs) and prisoners is common. In addition, the increasing trend of coinfections should be considered alarming for policymakers. [ABSTRACT FROM AUTHOR]

Summary: Background: Dermatologic complications are common in patients with end‐stage renal disease and also have a high diversity. Objectives: This meta‐analysis reviews prevalence of dermatological manifestations among hemodialysis patients in Iran. Materials and Methods: Using PubMed and NLM Gateway (for MEDLINE), Institute of Scientific Information (ISI), and SCOPUS as the main international electronic data sources, and Iran‐Medex, Irandoc, and Scientific Information Database, as the main domestic databases with systematic search capability, we systematically searched surveys, papers, and reports on the prevalence of dermatological manifestations (until February 2016). Heterogeneity of reported prevalence's between studies was assessed using the Q test; overall prevalence of dermatological manifestations was estimated using random‐effect meta‐analysis model. Results: We found 1229 records; from them, a total of eight studies comprising 917 hemodialysis patients were included. In all of studies, skin discoloration, pruritus and xerosis have the highest prevalence. According to random‐effect meta‐analysis model, the pooled prevalence of skin discoloration, pruritus, ecchymosis, xerosis, and half‐and‐half nail in hemodialysis patients were 48.03% (95% CI: 45.09‐51.01), 52.85% (95%CI: 49.23‐56.47), 19.88 (95% CI: 17.57‐22.19), 51.14% (95% CI: 48.25‐54.02), and 18.50% (95% CI: 16.0‐21.0), respectively. Conclusions: his study shows that the prevalence of dermatological manifestations seems high among the hemodialysis patients in Iran, and skin discoloration, pruritus, and xerosis are more common. [ABSTRACT FROM AUTHOR]

Introduction. Low birth weight is an important indicator of the health of babies. A low birth weight is a leading health problem and a major reason for death in newborns. This study targeted to assess the relationship between maternal and infant factors and low birth weight in Iran through a systematic review and meta-analysis. Methods and Materials. This paper was a systematic review and meta-analysis of the relationship between maternal/ infant factors and low birth weight based on the published research papers conducted in Iran. To achieve this goal, two trained researchers independently elicited all the relevant articles by using the appropriate keywords and their combinations in SID, Madlib, Iranmedex, Irandoc, Google Scholar, Pubmed, ISI, Scopus and Magiran databases. The results of the study were combined with SPSS 20 and STATA software. Results. In the initial stage, 25 more relevant articles out of 46 papers were selected. The gestational age with less than 37 weeks and prenatal care had the most (CI: 27- 14. 53, OR: 19.81) and the least (CI: 1.86, OR: 1.5) effect on the low birth weight in newborns, respectively. Conclusion. This study showed that there is a significant relationship between the low birth weight and multiple births, preeclampsia, maternal weight gaining during pregnancy, baby's gender, and pregnancy age. Hence, controlling the factors above in mothers during pregnancy by the health authorities could lead to the birth of infants with a healthy weight and consequently the number of infants with low birth weight will decrease. [ABSTRACT FROM AUTHOR]

Background: The probability of HIV transmission through contaminated blood and blood products is eye catching. 5%-10% of blood products are contaminated with HIV. Therefore, it is essential to provide safe blood supply to prevent transmission of infectious diseases. Current systematic review and meta-analysis was conducted to evaluate the weighted prevalence of HIV in Iranian blood donors. Methods: This study was reported according to PRISMA checklist for systematic reviews and meta- analysis. Required data were collected by using key words such as "HIV", "blood donation" OR "blood donors", "epidemiology" OR "prevalence", "blood transfusion" and "Iran", in international databases including PubMed, Scopus, Web of Science, Cochrane, Embase and national databases including Magiran, IranMedex and Scientific Information Databank. Papers were searched until December 2017. Cochran's Q test and I² index were used to assess the heterogeneity among studies. Results: A total of 49 studies including 5 403 170 donors entered this meta-analysis. According to analysis, the prevalence of HIV- positive patients among Iran blood donors was estimated 7.9/100 000 (95% CI: 0.000052-0.000121%). The highest prevalence was related to the central region of Iran (11.3/100,000 [95% CI:0.000063-0.0002%]) and Kermanshah province (49.2/100 000 [95% CI:0.000273-0.000888%]) and the lowest prevalence was related to the eastern region (1/100 000 [95% CI:0.000001- 0.000072%]) and Khorasan Razavi province (0.9/100 000 [95% CI:0.000001-0.000139%]. Conclusion: The overall HIV prevalence in Iranian blood donors is low and satisfying. However, the high prevalence in some regions and provinces should be reviewed more meticulously. [ABSTRACT FROM AUTHOR]

Background: Considering the importance of musculoskeletal disorders (MSDs) as one of the health consequences of job stress among nurses and significant contradictions in prevalence in different parts of the body, this study was carried out to determine the prevalence of MSDs among Iranian nurses. Methods: All published studies from June 2000 until June 2015 were considered in reliable databases such as PubMed, Google Scholar, Google search, Scopus, ScienceDirect, and Persian databases such as SID, Iran Medex, and Magiran. These studies, after quality control, were entered into meta-analysis using the random effects model, a total of 41 papers were assessed between 2004 and 2015. Results: The prevalence rate of these disorders was 60.98%, 47.76%, 46.53%, 44.64%, 42.8%, 36.8%, 24.61%, and 17.5%, respectively, obtained for the back, neck, knees, upper back, ankles, shoulders, hands, hips, thighs, and elbows. Prevalence of MSDs will lead to high costs of medical, absenteeism from work, or even unemployment. Conclusions: Due to high prevalence of these disorders among Iranian nurses, providing effective training in the field of ergonomics and undergoing appropriate exercises are necessary to control it. [ABSTRACT FROM AUTHOR]

Background: Peptic ulcer is a prevalent problem and symptoms include epigastria pain and heartburn. This study aimed at investigating the prevalence and causes of peptic ulcers in Iran using systematic review and meta-analysis. Materials and Methods: Eleven Iranian papers published from 2002 to 2016 are selected using valid keywords in the SID, Goggle scholar, PubMed and Elsevier databases. Results of studies pooled using random effects model in meta-analysis.The heterogeneity of the sample was checked using Q test and I2 index. Results: Total sample size in this study consist of 1335 individuals with peptic ulcer (121 samples per article). The prevalence of peptic ulcers was estimated 34% (95% CI= 0.25 - 0.43). The prevalence of peptic ulcers was 30% and 60% in woman and man respectively. The highest environmental factor (cigarette) has been addressed in 30% (95% CI= 0.23-0.37) of patients. The prevalence of Helicobacter pylori was estimated in 62% (95% CI= 0.49-0.75) of patients. Conclusion: The results of this study show that prevalence of peptic ulcers in Iran (34%) is higher that worldwide rate (6% to 15%). There was an increasing trend in the prevalence of peptic ulcer over a decade from 2002 to 2016. [ABSTRACT FROM AUTHOR]

Background: Hepatitis C virus (HCV) is a major cause of liver disease and a potential cause of substantial morbidity and mortality. This study aims to provide a comprehensive evidence on HCV Infection in Iranian hemodialysis (HD) patients we conducted a systematic review. Materials and Methods: In this systematic review and meta-analysis, through a comprehensive search of literature until January of 2016, we estimated the pooled prevalence of hepatitis C infection in Iranian HD patients. Using Medical Subject Headings terms, Emtree, and related equal Persian key words for Iranian databases and also international databases of PubMed and NLM Gateway (for MEDLINE), and SCOPUS. Interest outcome of HCV infection prevalence was confirmed based on positive hepatitis B surface antigen of blood samples. Random effect meta-analysis was used to estimate pooled prevalence of HCV infection in Iranian HD patients, date and language, HD patients, in adult HD patients, Institute of Scientific Information, Iran-doc, irrespective of age, living in Iran. Searches run through main domestic databanks of Iran-Medex, renal transplantation, Scientific Information Database, the relevant literature-searched concentrating on HCV infection. Results: Through searching steps, 305 publications were found from them following the excluding duplicates and overlapping studies 54 studies relevant to HCV prevalence in Iranian HD zcxw patients, with number of 23921 participants, remained in our analyses. The overall results of test of heterogeneity demonstrate sever heterogeneity between reported prevalence (I² = 96.62%, Chi-square = 1566, P < 0.001). Due to sever heterogeneity results of random effect meta-analysis showed that the estimated pooled prevalence was 11% (95% confidence interval [CI] =10%-13%). The pooled prevalence base on polymerase-chain reaction, recombinant immunoblot assay, and enzyme-Linked Immunosorbant Antibody method were 11% (95% CI = 6%-15%), 9% (95% CI = 5-13) and 12% (95% CI = 10-14), respectively. In line with previous studies, the present finding shows the significant variation in the rate of HCV in dialysis units among the regions in Iran. Conclusion: Present paper is the comprehensive updated systematic review on HCV prevalence in the Iranian HD patients. Our findings provide the reliable evidence for promotion of policies and interventional programs. [ABSTRACT FROM AUTHOR]

Background: Q fever is endemic in Iran, thus, we conducted a systematic review and meta-analysis on epidemiology of Coxiella burnetii among humans and animals in Iran. Materials and Methods: A systematic search was performed to identify all articles reporting C. burnetii prevalence in Iranian humans or animals, published from January 2000 to January 2015. Data from articles were extracted, and a pooled estimate of prevalence with corresponding 95% confidence interval (CI) was calculated using random effect method. Results: In this review, 27 papers were identified. The pooled seroprevalence of Q fever in animals was 27% (CI 95%: 23%-32%). The prevalence was 33% (CI 95%: 22%-45%) in goats, 27% (CI 95%: 21%-32%) in sheep, and 17% (CI 95%: 5%-28%) in cattle. The bacterial DNA was detected in 5% (95% CI: 3%-9%) of milk samples, and it was higher in cattle (10%; 95% CI: 6%-16%) than sheep (2%; 95% CI: 0-7%) and goats (4%; 95% CI: 0-12%). Conclusion: C. burnetii DNA or its antibody has been frequently detected among ruminants. Since these animals can transmit the infection to humans, Q fever could be a potential health problem in Iran. [ABSTRACT FROM AUTHOR]

Background: Metabolic syndrome) MetS(is a complex risk factor which increases the risk of cardiovascular diseases and type 2 diabetes. There are many studies with various populations and results about the prevalence of MetS in Iran; in order to authenticate these studies and have an overall estimation of its prevalence in Iran, performing a meta-analysis seems to be necessary. Objective: This study aimed to investigate the prevalence of MetS and its components in Iran via meta-analysis method. Methods: All associated published papers in national and international journals of PubMed, Scopus, Web of Science, Magiran, Iranmedex, Science Direct, Medlib, and SID databases were searched from January, 2000 to October, 2016. All types of studies, including local and national surveys that reported the prevalence of MetS among healthy populations in Iran were reviewed. The effects of age, sample size and publication date as possible sources of heterogeneity among the study findings was examined by meta-regression. P-values less than 0.05 were considered as significant in heterogeneity tests. All analysis was done by R Ver. 3.2.1 and STATA (version 10). Results: Seventy eligible studies were selected for meta-analysis. The overall estimation of MetS prevalence was 25% (95% CI: 22-29%) based on the Adult Treatment Panel III (ATP III) criteria, 30% (95% CI: 25-36%) according to the International Diabetes Federation (IDF), and 39% (95% CI: 26-52%) based on the Joint Interim Societies (JIS) criteria. The prevalence of MetS was lower in men than in women (26.9% versus 35.7%). The prevalence of various MetS components including High TG (triglyceride), Low HDL-C, High BP and High FBS (fasting blood sugar) was 43%, 54%, 38% and 22% among the adult population. Conclusion: Findings from the present meta-analyses study displayed a high prevalence of metabolic syndrome in Iran, especially in women, which increases with age in both sexes. It alerts health care providers and policy makers to find solutions in order to take action to reduce MetS risk in society. [ABSTRACT FROM AUTHOR]

Background: Smoking has physical, psychological, and social impacts on women's health and subsequently the community's health. Therefore, it is important to have an estimation of smoking among Iranian women. Since comprehensive data are not available in this respect, the authors performed a systematic review and meta-analyzed all high-quality studies in this field. Methods: All available electronic papers were searched by certain keywords and were included in this study according to the inclusion criteria regardless of the publication year. Furthermore, non-electronic resources including the final report of research projects, dissertations, unpublished papers (grey literature) and books published by the Iranian ministry of health were also evaluated in the study. The materials were assessed for their quality and meeting the inclusion and exclusion criteria. Considering the high degree of variability in many selected studies, we used random effect method for meta-analysis. Results: The highest and lowest rates of cigarette smoking among women were 10.5% and 0.04%, respectively. The prevalence rates of smoking were different in various subgroups; ranging from 0 to 0.4% in students, 1.1 to 3.1% in adults, and 1.4 to 8.7% in all sub-groups. According to the meta-analyses performed for the subgroups, the mean age of participants, performing the study in urban or rural areas, and the year of paper publication were major sources of heterogeneity. Conclusion: The studies were highly different with regard to their findings, and it seems that there is an age and time trend for the findings. Furthermore, the prevalence of smoking was different in various regions of the country. [ABSTRACT FROM AUTHOR]

Background: Hepatitis C virus (HCV) is the main causative agent of post‑transfusion hepatitis. The virus is distributed worldwide with varying prevalence in different countries, which could easily lead to chronic infections, cirrhosis, and even hepatocellular carcinoma. The aim of this study was to investigate prevalence of HCV infection and its trend in Iranian blood donors. Materials and Methods: Literatures on the HCV prevalence among blood donors in Iran were acquired through searching PubMed, Magiran, IranMedex, Scientific Information Databank, and Google databases. All the potentially relevant papers were reviewed independently by two investigators by assessing the eligibility of each paper and abstracting data. Prevalence was calculated using random effects model for meta‑analysis. Results: Forty‑eight studies with total samples of 10,739,221 persons from 1996 to 2011 were combined and meta‑analyzed, the pooled prevalence of HCV infection among blood donors in Iran provinces and cities was 0.5% (95% CI: 0.4‑0.6%). Trend of HCV infection was decreasing in recent years. Conclusion: This study provides a comprehensive and reliable data on the prevalence and trend of HCV infection among blood donors and may be helpful in providing insight into disease burden and opportunities for prevention. In comparison with countries in this geographic region, Iran has the lowest rate of HCV infection. [ABSTRACT FROM AUTHOR]

Background: Studentship period is a time when most behavioral traits are being created and fixed; this is a special time when students may start smoking. Thus in the present research, prevalence of smoking in university students in Iran has been evaluated. Materials and Methods: Having extensively explored Iranian and International databases (SID, Iranmedex, Magiran, Medlib, Irandoc, Pubmed, Google Scholar, and WHO) with broad keywords, we looked for relevant papers about the frequency of cigarette smoking among students in Iranian universities in recent years. We recruited only those primary papers with required information and acceptable methodology by reviewing their titles, abstracts, and full-texts. The main data about the prevalence of smoking, age and sex distribution of subjects, sample size, date, and location of studies were extracted from the full-text of eligible papers. Results: A total of 22 valid articles were selected. Among the findings of these studies, the lowest and highest prevalence of smoking among male students was 13.4 and 39.9, respectively, while it was 0.7 and 25.5%, respectively, among female students. Meta-analysis results reveals that smoking frequency among male and female students in Iran’s universities is 19.8% (17.7-21.9) and 2.2% (1.4-3.02), respectively. Conclusion: The variation of smoking in students in different universities shows that the tendency of smoking varies in different locations. Furthermore, compatible with the prevalence of smoking in the general population in Iran, female students smoke much less than male students. [ABSTRACT FROM AUTHOR]

BACKGROUND Obesity is currently emerging as a global epidemic, affecting 10% of adult population worldwide. The primary objective of the current systematic review is to describe the trend of overall prevalence of obesity in Iranian women and men through a meta-analysis. METHODS We searched the medical literature published from 1990 to 2007 in Medline (PubMed), EMBASE database, and the Iranian digital library. All published reports of research projects, papers in relevant congresses, unpublished crude data analysis, proceedings, books and dissertations were reviewed. Data from eligible papers that fulfilled the qualification criteria entered meta-analysis (Random Model). RESULTS Data from 209,166 individuals were analyzed. The overall prevalence of obesity in adults was 18.5% (95% CI: 15.1-21.8), respectively. The prevalence of obesity in men and women was 12.9% (95% CI: 10.9-14.9) and 26.2% (95% CI: 21.3-30.5), respectively. The trend of obesity was similar in both genders; women had almost a constantly higher risk of obesity than men during the recent two decades. CONCLUSION Data from 209,166 individuals were analyzed. The overall prevalence of obesity in adults was 18.5% (95% CI: 15.1-21.8), respectively. The prevalence of obesity in men and women was 12.9% (95% CI: 10.9-14.9) and 26.2% (95% CI: 21.3-30.5), respectively. The trend of obesity was similar in both genders; women had almost a constantly higher risk of obesity than men during the recent two decades. [ABSTRACT FROM AUTHOR]

BACKGROUND: Over the past decade, cardiovascular diseases have been recognized as the leading cause of mortality worldwide. Myocardial infarction (MI) is one of the most prevalent types of cardiovascular diseases that is caused by the closure of coronary arteries and ischemic heart muscle. Numerous studies have analyzed the role of H. pylori as a possible risk factor for coronary artery diseases, in most of which the role of infection in coronary artery disease is not statistically significant. METHODS: These contradictory findings made us conduct a systematic review to analyze all relevant studies in Iran through a meta-analysis and report a comprehensive and integrated result. All published studies from September 2000 until September 2016were considered Using reliable Latin databases like PubMed, Google Scholar, Google search, Scopus, Science Direct and Persian databases like SID, Irandoc, Iran Mede and Magiran. After quality control, these studies were entered into a meta-analysis by using the random effects model. After evaluating the studies, 11 papers were finally selected and assessed. RESULTS: A total of 2517 participants had been evaluated in these studies, including 1253 cases and 1264 controls. Based on the results of meta-analysis and using random effects model, an overall estimate of OR Helicobacter Pylori with Presence of Myocardial Infarction in Iran was OR=2.53 (CI=1.37-4.67). CONCLUSIONS: The results of this review study show that H. pylori are associated with the incidence of MI so that the odds ratio of MI in the patients with helicobacter pylori is twice greater than that of the people without H. pylori. Future studies are recommended to evaluate the mechanisms associated with relation of H. pylori with MI as well as its association with time. [ABSTRACT FROM AUTHOR]

Background: Seroepidemiologic studies indicate a high prevalence of herpes simplex virus (HSV) infection. This infection leads to ophthalmic, dermatologic, oral, neurologic, vaginal and cervical problems. Different studies have been carried out to estimate the HSV seroprevalence in Iran. Combining the results of these studies would be useful for health policy-making. Objective: This study aims to estimate the pooled prevalence of HSV infection using meta-analysis. Materials and Methods: Using relevant keywords, national and international data banks were searched. Restricting the search strategy, excluding duplicates and investigating the titles and abstracts, relevant articles were identified. To increase the search sensitivity, the lists of references were investigated. To find un-published studies, specialized experts as well as research centers were interviewed. The heterogeneity between the results was assessed using Cochrane test and I-squared indicator. The pooled prevalence of HSV infection was estimated using random effects model. Results: We recruited 33 eligible papers investigated 7762 individuals. The total prevalences (95% confidence intervals) of HSV1, HSV2 and HSV infections were estimated as of 42.04% (20.9-63.1), 6.5% (4.7-8.2) and 25.7% (8.8-42.5) respectively. Conclusion: This meta-analysis showed that the HSV2 seroprevalence among Iranian people is considerably lower than HSV1 infection. [ABSTRACT FROM AUTHOR]

Context: The hepatitis C virus (HCV) is classified into seven genotypes and more than 100 subtypes. The treatment regimen, duration and efficacy of HCV therapy may vary according to the HCV genotype. Therefore, the HCV genotype should be determined prior to antiviral therapy. The objective of the current study was to review systematically all studies reporting the distribution of HCV genotypes in the countries that make up the Middle East. Evidence Acquisition: Articles were identified by searching electronic databases, including Scopus, PubMed and Google scholar, with timeline limits (articles published between 1995 and 2016). We carried out a systematic search regarding the distribution of HCV genotypes in Middle Eastern countries. Results: A total of 579 studies were identified by the electronic search. Of these, a total of 187 were identified as eligible papers including 60,319 patients who were meta-analyzed for pooled distribution of HCV genotypes. In Turkey, Israel, Cyprus, and Iran, genotype 1 was the most prevalent HCV genotype with rates of 82% (95% CI, 82%-83%), 68% (95% CI, 67%-69%), 68% (95% CI, 59%-77%), and 55% (95% CI, 54%-55%), respectively. In Egypt, Iraq, Saudi Arabia, and Syria, HCV genotype 4 was the most common genotype with rates of 86% (95% CI, 85%-88%), 60% (95% CI, 56%-64%), 56% (95% CI, 54%-55%), and 57% (95% CI, 54%-61%), respectively. On the basis of adjusted data, HCV genotype 4 was the most prevalent genotype in the Middle East region, with a rate of 74.7% (95% CI, 73.4%-76%), followed by genotype 1 at 15.1% (95% CI, 14.1%-16%). Conclusions: Our results showed that HCV genotype 4 is the most prevalent genotype in the Middle East region. However, HCV genotype 1 is the most prevalent among non-Arab countries in the region including Turkey, Iran, Cyprus, and Israel. [ABSTRACT FROM AUTHOR]

Introduction: Anemia, particularly Iron Deficiency Anemia (IDA), is the most common hematological disorder during pregnancy with considerable complications in both mothers and fetuses. The estimation of anemia prevalence is an important step for health policy makers. Despite being considered a hot topic in epidemiological studies in Iran for the last twenty years, lack of a comprehensive overview on the findings encouraged the authors to carry out this study. Materials and Methods: All published papers in main national and international databases were systematically searched for some specific keywords to find the related studies between the years 1993 and 2007. All published studies which had reported the prevalence of anemia were included in the study except studies on refugees, patients undergoing hemodialysis, patients with thalassemia or cancer or other selective sub- populations. Two trained reviewers independently assessed the inclusion/exclusion criteria and the quality of the selected papers, summarized them and eventually analyzed the data. Results: Ten eligible papers including 11,037 participants were entered into the analysis. The maximum and minimum reported prevalence rates of anemia during pregnancy were 4.3% and 21.5%, respectively. The overall estimate of anemia prevalence in Iranian pregnant women was 13.6 (95% CI: 8.3 - 18.9). Excluding the only out-layer from the meta-analysis, the overall estimated prevalence was 12.4% (95% CI: 9.6% - 17.9%). Conclusion: The prevalence of anemia in Iranian women during pregnancy is considerably lower than that of most EMRO countries or the one reported by WHO for Iran (>40%) which had been performed on a small group 16 years ago. The lower prevalence rate of anemia in pregnant women versus the regional rates could be due to the improvements of the national health system and prenatal programs in recent years. [ABSTRACT FROM AUTHOR]

Context: The hepatitis B virus (HBV) is a major global public health problem, affecting more than 2 billion people worldwide. Accurate and updated data on HBV prevalence is important for further planning to control the infection. The aim of this study was to update the prevalence estimate of HBV infection in the general population of Iran. Evidence Acquisition: A systematic review was done for data on the prevalence of HBV infection in the general Iranian population published between Jan. 1, 1990, and Jan. 1, 2016, in both international and national databases, including PubMed, Scopus, Web of Science, Scientific Information Database, IranMedex, and Magiran. All papers with clearly described time and location of the study, proper sampling strategies, and proper analysis methods were included in the present study. Data were extracted by two independent reviewers. Prevalence of HBV infection with a 95% confidence interval (CI) was calculated using Stata software, version 13. Results: The polled estimated prevalence of HBVinfection in the general population of Iranwas2.2% (95% CI: 1.9% - 2.6%). The highest prevalence of HBV infection (8.9%, 95% CI: 7.6% - 10.2%) was reported from Golestan province, and the lowest prevalence (0.7%, 95% CI: 0.4% - 1.1%) was seen in Kermanshah province. The prevalence of HBV infection was estimated at 3% (95% CI: 2.2% - 3.8%) for Iranian males and 1.7% (95% CI: 1.2% - 2.3%) for Iranian females. The prevalence of HBV infection in the general population of Iran was 2.9% (95% CI: 2.5% - 3.4%) before 2010 and 1.3% (95% CI: 0.9% - 1.7%) after 2010. Conclusions: In total, Iran was classified within the low--intermediateHBVprevalence areas (2% - 4%), while according to recent data (after 2010), Iran was classified within the low HBV prevalence areas (< 2%), indicating that preventive measures conducted in Iran have been effective. [ABSTRACT FROM AUTHOR]

Aim: In this study, we aimed to estimate one- to five-year survival rates in Iranian patients with gastric cancer (GC). In addition, we preformed subgroup analyses and meta-regression to explore possible sources of heterogeneity between studies. Background: According to literatures, there has been increasing attention to the long-term survival rate in patients with GC in Iran. However, results have been inconsistent and remain controversial in overall survival rates. Patients and methods: Literature searches were conducted using PubMed, Scopus, and ISI, as well as Magiran, Medlib, SID, and Iran Medex databases. Studies were pooled and summary one to five survival rates were calculated. Univariate and multivariate regression analyses were used to explore possible sources of heterogeneity among studies. Subgroup analyses were also conducted. Analyses were conducted using the STATA statistical software package. Results: Final analysis of 29361 patients from 26 eligible studies was performed. The overall survival rate (one to five years) in all studies, by meta-analysis of 24, 14, 23, 12 and 22 studies were 52%, 31%, 24%, 22%, and 15%, respectively. Metaregression analysis showed an increase in one- and five-year survival rate over the time (Reg Coef = 0.016, p= 0.04) and (Reg Coef= 0.021, p= 0.049), respectively. Positive heterogeneity was observed between quality of papers and data sources (P<0.001). Conclusion: More than half of GC deaths happened in the first year at diagnosis, and another 30% plus they occurred during the second year after confirmed diagnosis. Our results admit lower survival rates in Iran, similar to other developing countries. [ABSTRACT FROM AUTHOR]

Obesity is one of the main public health problems which underlie many chronic illnesses and socioeconomic difficulties. According to the literature review, there are limited data on the prevalence of obesity in different parts of Iran as well as its trend and prevalence among different age and gender groups. The aim of this study was to estimate the obesity prevalence in Iran using meta-analysis. All the corresponding articles published in the external and internal journals, final reports of research projects, articles of related congresses and the reference index of the correlated papers published between 1995 and 2010 were collected via the electronic research engines (PubMed, Scopus, SID, Magiran, IranMedex). Data were analyzed using meta-analysis (random effects model) and meta-regression). A total of 144 articles with the sample size of 377858 people (134588 males and 164858 females) were enrolled in the study. The prevalence of obesity in populations above the age of 18 was estimated as 21.7% (CI 95%: 18.5% - 25%) and in populations below 18 as 6.1% (CI 95%: 6.8%-5.4%). Meta-regression analysis showed an ascending trend in the prevalence of obesity in Iran. The prevalence rates of obesity according to the BMI index, NCHC and percentile above 95 were 17.4%, 7.6% and7.4%, respectively. The BMI mean was 19.3 in populations below the age of 18 (CI 95%: 17-21.6) and 25.2 in those above the age of 18 (CI 95%: 27.1-23.3). Considering the increasing rate of obesity in Iran and its effects on the public health, corresponding health authorities should revise the obesity preventive programs and, using public health interventions, reduce the rate of obesity in the country. [ABSTRACT FROM AUTHOR]

Context: Hepatitis C virus (HCV) is a global public health problem and a major etiology of chronic liver disease, which may develop into cirrhosis and hepatocellular carcinoma. Genotypes of HCV indicate the route of acquisition, the clinical outcome, response to treatment, prognosis and control strategies. Objectives: The aim of this study was to estimate the overall prevalence and trend of HCV genotypes or subtypes in Iran Data Sources: A literature review was done for papers reporting HCV genotypes in Iranian patients in PubMed, Magiran, IranMedex, Scientific Information Databank, and Google scholar databases. Study Selection: Data were selected according to inclusion and exclusion criteria. Data Extraction: Data were abstracted by two independent authors. Data were analyzed based on random-effects model using the Meta R. Pooled statistical software. Prevalence of HCV genotypes in cities and provinces of Iran with 95% confidence interval (CI) were calculated. Results: Fifty-three articles published between 1999 and 31 June 2014 including 22952 HCV infected individuals were included in the meta-analysis. Subtype 1a was predominant with a rate of 39% (95% CI: 34-44%); followed by subtype 3a, 32% (95% CI: 26-39%); subtype 1b, 13% (95% CI: 10-15%); genotype 4, 5.18% (95% CI: 3.27-7.5%); and genotype 2, 3.6% (95% CI: 1.6-8.3%). Untypeable HCV had a rate of 0.11% (95% CI: 0.07-0.16%). Conclusions: The most frequent subtypes of HCV in Iran were 1a, 3a and 1b, respectively. This frequency differed in various provinces of Iran and fluctuated with time. It is important to determine the distribution of HCV genotypes in different geographical areas and its trend with time for epidemiological and patients' management purposes. [ABSTRACT FROM AUTHOR]

Objectives: To generate synthesized information on the epidemiology of VZV infection, as well as an estimation of prevalence of age-specific antibody in Iranian less than 40. Material and Methods: After exclusion of irrelevant and overlapping reports, 15 papers were included (from nine major cities). Studies were pooled according to the heterogeneity test results. Random effect model methods were used for metaanalysis where significant heterogeneity was observed (age 1-16years ).For other age groups, fixed model were used. Results: Significant heterogeneity was observed in prevalence rates of all childhood age-groups. The seropositivity prevalence increased steeply from the age of 1-5 to 6-10 [from 21.9% (95% CI; 10.8-33.1) to 42.1 %(95% CI; 33.6-50.6)]. At the age of 11-15, 59.4% (95% CI; 46.1-72.8) of children showed to be infected. The rate of seropositivity was more than 87% in individuals of 40 and older. Conclusion: The varicella seroeprevalence in Iran is in accordance with average tropical and temperate areas. Comparison of conducted studies during 2003 to 2011 didn't show any alteration in VZV seroprovalence in Iran. [ABSTRACT FROM AUTHOR]

More than 80% cardiovascular disease (CVD) is preventable despite the fact that it is currently the ultimate cause of disability in the world. Assessment of the nationwide prevalence of dyslipidemia as a major CVD risk factor is essential to efficiently conduct prevention programs. We extracted data according to the cut-off points of dyslipidemia used in each study. All published papers on this topic in Iranian and international journals with affiliation of "Iran" were reviewed using standard keywords up to September 2011. We included all available population-based studies and national surveys conducted in individuals aged ≥ 15 years. We excluded studies with < 300 individuals, non-population-based studies, or duplicated citations. We analyzed by random effect method due to between-study heterogeneity. The estimated prevalence and 95% confidence intervals in 29 eligible articles and one un-published data for hypercholesterolemia (≥200 mg/dl), hypertriglyceridemia (≥150 mg/dl), high levels of low density lipoprotein cholesterol ([LDL-C] [ ≥ 130 mg/dl]) and low levels of high density lipoprotein cholesterol ([HDL-C] <40 mg/dl in males, <50 mg/dl in females), in Iranian people were 41.6% (36.1-47.0), 46.0% (43.3-48.7), 35.5% (24.0-47.1) and 43.9% (33.4-54.4), respectively among both sexes and in both rural and urban areas. Hypercholesterolemia, high LDL-C and low HDL-C were more prevalent in women, whereas hypertriglyceridemia was more prevalent in men. All types of lipid component abnormalities were more prevalent in urban residents. Prevalence of dyslipidemia is considerable in Iran. It is necessary to enforce current measures of dyslipidemia control in the Iranian people to reduce CVD burden. [ABSTRACT FROM AUTHOR]

Background: Our information regarding immunity to toxoplasmosis among reproductive age women is indeterminate and there is significant variation between reported results; it is necessary to perform a Meta-analysis study on subjects to obtain required findings and develop preventive measures accordingly. Objective: Estimation level of immunity to toxoplasmosis in reproductive ages. Materials and Methods: All published papers in main national and international databases were systematically searched for some specific keywords to find the related studies up to 2012. We selected only original articles that either reported percentage of positive anti toxoplasma IgG or total anti toxoplasma antibody by using EL1SA or IFAT method (provided that the titer ⩾1.20 is considered positive for IFAT) in childbearing age women. Results: Studies involved a total of 13480 participants. The maximum and minimum reported prevalence rates of anti-toxoplasma IgG antibody using IFTA serological method were 21.8% and 54%; and using ELISA serological method were 23% and 64%, respectively. The overall estimation for prevalence of anti-toxoplasma IgG antibody using IFTA serological method was 34.5% (95% CI: 28.5-40.5); and using ELISA method was 37.6% (95% CI: 30.4-44.9). The overall estimation for prevalence of anti-toxoplasma total antibody was 39.9% (95% CI: 26.1-53.7). Conclusion: In Iran, screening of toxoplasma is not routinely performed yet, while the incidence of toxoplasmosis is too high to justify routine screening. Prenatal screening can help to identify mothers susceptible to infection. Screening for the presence of antibodies allows primary prevention of toxoplasmosis infection where eating habits and hygiene practices have clearly been identified as risk factors. [ABSTRACT FROM AUTHOR]

Background: In recent years, there has been growing interest in measuring the efficiency of hospitals in Iran and several studies have been conducted on the topic. The main objective of this paper was to review studies in the field of hospital efficiency and examine the estimated technical efficiency (TE) of Iranian hospitals. Methods: Persian and English databases were searched for studies related to measuring hospital efficiency in Iran. Ordinary least squares (OLS) regression models were applied for statistical analysis. The PRISMA guidelines were followed in the search process. Results: A total of 43 efficiency scores from 29 studies were retrieved and used to approach the research question. Data envelopment analysis was the principal frontier efficiency method in the estimation of efficiency scores. The pooled estimate of mean TE was 0.846 (±0.134). There was a considerable variation in the efficiency scores between the different studies performed in Iran. There were no differences in efficiency scores between data envelopment analysis (DEA) and stochastic frontier analysis (SFA) techniques. The reviewed studies are generally similar and suffer from similar methodological deficiencies, such as no adjustment for case mix and quality of care differences. The results of OLS regression revealed that studies that included more variables and more heterogeneous hospitals generally reported higher TE. Larger sample size was associated with reporting lower TE. Conclusions: The features of frontier-based techniques had a profound impact on the efficiency scores among Iranian hospital studies. These studies suffer from major methodological deficiencies and were of sub-optimal quality, limiting their validity and reliability. It is suggested that improving data collection and processing in Iranian hospital databases may have a substantial impact on promoting the quality of research in this field. [ABSTRACT FROM AUTHOR]

Background: Employees feeling and attitude to their job has a significant role on their performance. Present study sought to investigate documents related to nurses job satisfaction, using systematic review and meta-analysis to estimate nurses job satisfaction in Iran. Materials and Methods: Papers on nurses job satisfaction were identified by searching different data bases using appropriate key words. Seventeen studies were extracted using inclusuion criteria. Data were analyzed using Meta-analysis command in STATA 11. Results: Considerable hetrogenecity is apparent in results of nurses job satisfaction studies. Although, according to random effect model, nurses total job satisfaction was estimated at 46.3 (CI: 32.1-60.4), this was estimated at 51.9 (CI = 51.1-52.8) using fixed effect model. Additionally, a reverse relationship was observed between nurses overall job satisfaction and their age. Conclusion: Nurses' job satisfaction in Iran is at a good level compared with other countries. The more satisfied the nurses are with their working conditions, the less is their intention to leave their job. Dissatisfaction is associated with higher resignment and turnover, paying deep attention to efficient factors on nurses dissatisfaction and trying to overcome them is important to improve nurses' working conditions. [ABSTRACT FROM AUTHOR]

Background: Cardiovascular disease is the cause of more than 50% of mortalities globally, and this rate has grown by 8.6% since the 60 s. One of the risk factors associated with cardiovascular disease and its resulting mortality rate is the metabolic syndrome. Different studies have reported inconsistent rates for the metabolic syndrome. However, no comprehensive study has been conducted to combine the results of existing studies. Thus, the present study was performed with the aim of determining the prevalence of metabolic syndrome among cardiovascular patients in Iran through a systematic review and meta-analysis. Method: : In this review study, the Scientific Information Database, Google Scholar, Science Direct, Scopus, PubMed, and Web of Science (ISI), databases were searched from January 2005 and until May 2020, to identify and extract related articles. To conduct the analysis, a random effects model was used, and the heterogeneity of the studies was examined using the I2 index. Data analysis was performed within Comprehensive Meta-Analysis (version 2) software. Results: The prevalence of metabolic syndrome in cardiovascular patients in Iran in the 27 papers examined with a sample size of 44,735 patients was 34.2% (95% CI: 26.8–42.6%). A sensitivity analysis was performed to ensure the stability of the results, these results show that by omitting the prevalence from each study, the overall prevalence (34.2%) does not change significantly. the highest prevalence of metabolic syndrome in studies conducted in the period between 2015 and 2020, and this was reported as 55.3 (95% CI: 47.9–62.3) and the highest prevalence of metabolic syndrome in studies conducted in the methods of diagnosis IDF, and the rate was reported as 48 (95% CI: 36.5–59.8). based on meta-regression as the year of research increased, the prevalence of metabolic syndrome in cardiovascular patients in Iran also increased. However, with the increase in sample size, this prevalence decreased (p < 0.05). Conclusions: The results of this study indicate that metabolic syndrome is high in cardiovascular patients in Iran. Accordingly, by understanding its etiology and supervision at all levels, suitable solutions could be offered by providing feedback to hospitals. [ABSTRACT FROM AUTHOR]