Khadijeh Alizadeh Feremi; Lale Alipoor; Ravanbakhsh Esmaeili
Abstract
Introduction:Sleep is one of the most important human needs affected by many factors. Sleep disorders, such as insomnia and delayed sleep, are very common and can affect the quality and quantity of sleep. The current systematic review aimed to evaluate the evidence on the effectiveness of melatonin treatment ...
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Introduction:Sleep is one of the most important human needs affected by many factors. Sleep disorders, such as insomnia and delayed sleep, are very common and can affect the quality and quantity of sleep. The current systematic review aimed to evaluate the evidence on the effectiveness of melatonin treatment on sleep quality.
Methods:The data on the effect of melatonin on sleep were collected using seven English databases, including Scopus, PubMed, Ovid, ProQuest, and Science Direct, as well as six Persian databases, including Iran Medex, SID, IRANDOC, Magiran, MEDLIB, and Noormags, from their inception up to the end of January 2020. English language, randomized clinical trials, human samples, and age of higher than 18 years were the main eligibility criteria. Nonrandomized clinical trials or those without a control group were excluded from the present study.
Results: Seven articles met the eligibility criteria for being included in this review. In the aforementioned studies, the effect of melatonin therapy on sleep quality was assessed in 343 subjects. The majority (86%) of the studies confirmed the effectiveness of melatonin treatment on sleep quality.
Conclusion: Melatonin as an orally administered drug had beneficial effects on sleep quality. These effects of melatonin attributed to more efficient healthier sleep, deeper sleep, longer sleep duration without causing fatigue and early morning drowsiness, and faster sleeping. One of the limitations of the present study was considered reviewing articles without the consideration of the medical conditions of the subjects. Moreover, the type of sleep disorder was not investigated in this review.
Maryam Salehian; Nahid Maleki-Saghooni; Fatemeh Zahra karimi
Abstract
Introduction:Child abuse is a global problem that is deeply rooted in the cultural, social, and economic performance of society. It is a behavior that occurs in various forms of physical, mental, emotional, or sexual, which can cause harm to the health, welfare, and education of the child. The present ...
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Introduction:Child abuse is a global problem that is deeply rooted in the cultural, social, and economic performance of society. It is a behavior that occurs in various forms of physical, mental, emotional, or sexual, which can cause harm to the health, welfare, and education of the child. The present study was conducted to estimate the prevalence of child abuse and its related factors in Iran.Methods:In the present systematic review study, to find articles related to the prevalence of child abuse in Iran, valid databases such as Scopus, PubMed, Cochrane, SID, Magiran, IranDoc, and Google Scholar was were searched using the keywords of “child abuse”, “physical abuse” “emotional abuse”,” neglect”, “prevalence” and “Iran”.Results: In this study, 22 articles were analyzed. Based on this review about 4.5%-58.2% of children reported physical abuse, 7.3%-91.6% emotional abuse, and 5.5%-85.3% neglect. Factors associated with child abuse were hyperactivity anxiety and mental status disorder. All studies showed a significant relationship of abuses with education, occupation, addiction, and divorce of parents. Moreover, depression and anxiety of parents and poor parental relationships were related to abuse of children. Conclusion: Child abuse has many negative effects on childish and adolescent health. It seems that child abuse in Iran is in critical condition; therefore, policymakers must take action to solve this problem and prevent it by designing special programs and effective policies in Iran.
Amir Ghaderi; Anna Bussu; Catherine Tsang; Sadegh Jafarnejad
Abstract
Background and objective: N-acetylcysteine (NAC), a precursor of L-cysteine with antioxidant, anti-inflammatory and neurotropic effects, is a promising agent in alleviating symptoms associated with schizophrenia. However, the role of NAC on parameters of Positive and Negative Syndrome Scale (PANSS) ...
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Background and objective: N-acetylcysteine (NAC), a precursor of L-cysteine with antioxidant, anti-inflammatory and neurotropic effects, is a promising agent in alleviating symptoms associated with schizophrenia. However, the role of NAC on parameters of Positive and Negative Syndrome Scale (PANSS) remain uncertain. This systematic review and meta-analysis explored the effect of NAC on parameters of PANSS in patients with chronic schizophrenia. Methods: We searchedPubmed/MEDLINE™, PsycNET™, PsycLIT™, Scopus™ and Google Scholar™ for studies on the effect of NAC on PANSS in patients with schizophrenia from inception to March 2019. We adopted medical and non-medical subjects headings (MeSH, non-MeSH) and several keywords, including “NAC”, “N-acetylcysteine”, “N-acetyl cysteine”, “Acetylcysteine”, “N-Acetyl-L-cysteine”, “schizophrenia”, “psychotic disorder”, “psychosis”, “schizoaffective” and “dementia praecox”. Results: We identified seven trials with274 patients meeting the inclusion criteria, with follow up between 8-52 weeks, and NAC supplementation between 1200-3600 mg/day. Significant improvements in PANSS were identified following NAC for total (SMD=-0.61, 95% CI = -0.91, -0.31 ; p <0.001), general (SMD = -0.58; 95% CI = -0.90, -0.26; P=0.0004); and negative (SMD = -0.56; 95% CI = -0.92, -0.21; P = 0.001) scores, respectively. No significant heterogeneity was found among studies. Significant reductions were observed following sub-group analysis in trials ≤ 24 weeks duration, with appreciable effect size for total (SMD= -0.83), general (SMD= -0.67) and negative (SMD=-1.09) scores. Conclusion: Supplementation of NAC was effective in alleviating PANSS symptoms associated with schizophrenia in trials ≤ 24 weeks duration. The use of NAC as an adjunct seems promising and further investigation is warranted to determine its precise role.
Yalda Ravanshad; Abbasali Zeraati; Mohadese Golsorkhi; Sahar Ravanshad; Anoush Azarfar; Hanieh Jafari
Abstract
Introduction: To date, several randomized trials have compared calcineurin inhibitors, especially tacrolimus, with cyclosporine in patients with steroid-resistant nephrotic syndrome, proposing conflicting results. Use of immunosuppressive therapy for the treatment of resistant nephrotic syndrome ...
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Introduction: To date, several randomized trials have compared calcineurin inhibitors, especially tacrolimus, with cyclosporine in patients with steroid-resistant nephrotic syndrome, proposing conflicting results. Use of immunosuppressive therapy for the treatment of resistant nephrotic syndrome remains a matter of debate, and the evidence on its efficacy and safety is inconclusive.The present study aimed to compare the benefits and limitations of tacrolimus and cyclosporine in the treatment of steroid-resistant nephrotic syndrome. Methods: This systematic review and meta-analysis was conducted via searching for the relevant trials performed until January 2018 in electronic databases such as PubMed, Scopus, ScienceDirect, Cochrane Library, and Web of Science. In total, 285 potentially relevant articles were identified, and four articles were selected for the review. A random effects model was used to analyze data, and the heterogeneity of the articles was assessed using Chi-square-based Cochran’s Q and I2 statistics, and heterogeneity was considered statistically significant with I2>50%. The outcomes were presented as relative risk with 95% confidence interval, and P-value of less than 0.05 was considered statistically significant. In addition, meta-analysis was used for further data analysis. Result: Four eligible randomized controlled trials were evaluated in this systematic review. In terms of partial and complete remission, no significant differences were observed between tacrolimus and cyclosporine. However, lack of response to therapy was significantly lower with tacrolimus (RR=0.289; P=0.02) compared to cyclosporine. No significant differences were observed between the drugs in terms of the infection rate, hypertension, ALT/AST elevation, and gastrointestinal symptoms, while nephrotoxicity (RR=0.395; P=0.004) and hypertrichosis (RR=0.018; P<0.001) were significantly lower with tacrolimus. Conclusions: In conclusion, Tacrolimus is superior to Cyclosporine in treating in patients with steroid resistance nephrotic syndrome in terms of no response to therapy, nephrotoxicity and hypertrichosis
Reihaneh Shagholi; Saeed Eslami Hasan Abadi; Akram Moghaddasi; Tayyebeh Sayyadee; Maryam Tayefi
Abstract
Introduction: In order to know the procedure of one-minute preceptor (OMP) teaching method, the relevant English language articles were searched in 5 databases, namely Clinical Key, ProQuest, PubMed, Scopus, and Web of Science in-process. Methods: The search process was conducted on the articles published ...
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Introduction: In order to know the procedure of one-minute preceptor (OMP) teaching method, the relevant English language articles were searched in 5 databases, namely Clinical Key, ProQuest, PubMed, Scopus, and Web of Science in-process. Methods: The search process was conducted on the articles published during 2000- August 2017 using the term “one-minute preceptor” in title and abstract. Letter to the editor, articles irrelevant to OMP, articles with no full-text, and duplicate articles were removed from this study. Result: The search result led to the identification of 133 articles. After employing the exclusion criteria, 31 articles remained for detailed analysis. The main outcomes of the investigated studies were categorized into 7 main groups, namely 1. OMP and effectiveness, 2. OMP and develop 3. OMP and SNAPPS, 4. OMP and Traditional Mode, 5. OMP as a teaching tool, 6. OMP and teaching skill, and 7. Teach OMP. The commonly used study designs in the order of frequency were opinion review, and observational without control studies, non-randomized controlled trial, pretest-posttest design, randomized controlled trials, and systematic reviews. The OMP improved processes and outcomes of education. Its effectiveness was in both teaching and patient diagnosis; moreover, it improved the quality of feedback and residents’ teaching skill in the clinical setting. Furthermore, OMP did not show statistically significant improvements in teaching behavior. Conclusion: Results showed that the OMP workshop for faculty staff does not enhance the quality or quantity of residents’ perceptions. There should be a nonstop effort by faculty members to increase the quality of clinical teaching.
Susan Shafiei; Reza Bagheri; Kayvan Sadri; Amir Hossein Jafarian; Davood Attaran; Shahrzad Mohammadzadeh Lari; Reza Basiri; Amir Mohammad Hashem Asnaashari; Ramin Sadeghi
Abstract
Introduction: Sentinel node mapping is a new technique of lymph nodal staging in solid tumors, which can decrease the morbidity of regional lymph node dissection considerably. Intra-thoracic tumors including non-small cell lung cancer (NSCLC) and esophageal carcinoma (EC) are among the solid tumors in ...
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Introduction: Sentinel node mapping is a new technique of lymph nodal staging in solid tumors, which can decrease the morbidity of regional lymph node dissection considerably. Intra-thoracic tumors including non-small cell lung cancer (NSCLC) and esophageal carcinoma (EC) are among the solid tumors in which sentinel node (SN) mapping has been applied. In the current systematic review, we gathered the best available evidence (systematic reviews) in this regard and presented the results in a systematic review format.Material and methods: We searched MEDLINE and SCOPUS since the inception till 13 December 2014 using the following keywords: (lung OR esophagus OR esophageal) AND sentinel AND (“systematic review” OR meta-analysis OR metaanalysis). No language limit was imposed on the search strategy. Systematic reviews and meta-analyses on SN mapping in EC or NSCLC were included in the current study. Narrative review articles were excluded from the study.Results: Overall five systematic review were included. One of the included studies was on SN mapping in NSCLC and four were on EC. Overall detection rate and sensitivity for EC and NSCLC were high and both were related to mapping technique, pathological involvement of the mediastinal nodes, size and location of the tumors.Conclusion: SN mapping is feasible and highly accurate in EC and NSCLC. Attention to the technique (using radiotracers, peri-tumoral injection) and restriction of the patients to less advanced cases (cN0 and T1, 2) would ensure the best results with high detection rate and sensitivity.