Prevalence of Anemia in Patients with Diabetes Mellitus: A Systematic Review and Meta-Analysis / 生物医学与环境科学（英文）

OBJECTIVE@#Anemia is a common public health concern in patients with type 2 diabetes worldwide. This study aimed to identify the prevalence of anemia among patients with diabetes.@*METHODS@#Electronic databases, including PubMed, Scopus, Web of Sciences, and Google Scholar, were searched systematically for studies published between 2010 and 2021. After removing duplicates and inappropriate reports, the remaining manuscripts were reviewed and appraised using theNewcastle-Ottawa Scale (NOS) tool. A random-effects model was used to calculate the pooled estimates of the extracted data using Stata version 17. Heterogeneity of the studies was assessed using the Q statistic.@*RESULTS@#A total of 51 articles containing information on 26,485 patients with diabetes were included in this study. The articles were mainly from Asia (58.82%) and Africa (35.29%). The overall prevalence of anemia was 35.45% (95% CI: 30.30-40.76), with no evidence of heterogeneity by sex. Among the two continents with the highest number of studies, the prevalence of anemia in patients with diabetes was significantly higher in Asia [40.02; 95% CI: 32.72-47.54] compared to Africa [28.46; 95% CI: 21.90-35.50] ( P for heterogeneity = 0.029). Moreover, there has been an increasing trend in the prevalence of anemia in patients with diabetes over time, from [15.28; 95% CI: 9.83-22.21] in 2012 to [40.70; 95% CI: 10.21-75.93] in 2022.@*CONCLUSION@#Globally, approximately 4 in 10 patients with diabetes suffer from anemia. Therefore, routine anemia screening and control programs every 3 months might be useful in improving the quality of life of these patients.

Prevalence of refractive errors among primary school children in a tropical area, Southeastern Iran

Objective: To determine the prevalence of refractive errors among primary school children in Zahedan District, Southeastern Iran, as a tropical area. Methods: In this cross sectional study, a total of 400 students were selected randomly using multi-stage sampling technique. Myopia was defined as spherical equivalent (SE) of -0.5 diopter (D) or more, hyperopia was defined as SE of +2.00 D or more and a cylinder refraction greater than 0.75 D was considered astigmatism. Anisometropia was defined as a difference of 1 D or more between two eyes. Cycloplegic refractive status was measured using auto-refractometer (Topcon 8800). Data were analyzed using SPSS, version 22 software program. Results: Mean ± SD of SE was (1.71 ± 1.16) D. A total of 20 students [6.3%, 95% confidence interval (CI): 3.96%-9.64%] were myopic (≤ -0.5 D), 186 students (58.1%, 95% CI: 52.50%-63.56%) were hyperopic (≥ +2.00 D) and 114 students (35.6%, 95% CI: 30.43%-41.18%) were emmetropic. The prevalence of astigmatism (≥ 0.75 D) among students was 3.4% (95% CI: 1.82%-6.25%). Anisometropia of 1 D or more was found in 21.3% (95% CI: 16.98%-26.23%) of the studied population. The prevalence of refractive errors was higher among girls than boys (73.1% vs. 55.6%, P = 0.001), but it was not significantly different among different age groups (P = 0.790). Conclusions: Refractive errors affect a sizable portion of students in Zahedan. Although myopia is not very prevalent, the high rate of hyperopia in the studied population emphasizes its need for attention.

Evaluation of risk factors of nonalcoholic fatty liver disease in the adult population of Zahedan, Iran

Non-alcoholic fatty liver disease [NAFLD] is the most common form of chronic liver disease. It has been reported that visceral fat releases free fatty acids and arises fat accumulation in the liver. Therefore, this study aimed to evaluate the some biomarkers of NAFLD risk in adult general population. An analytical - descriptive study was carried out on a total of 1529 randomly selected individuals [797 male and 732 female] aged 30-88 years in Zahedan. The characteristics of socio-demographic, medical history, food habits and lifestyle factors were obtained by a validated questionnaire, liver ultrasonography and routine laboratory tests were performed with the use of standard techniques. The assessment of waist circumference [WC] and waist to hip ratio [WHR] was performed as central obesity indices. The mean levels of WC and WHR were 92 +/- 11.7 cm and 0.91 +/- 0.06 in men, and 91.2 +/- 12.4 cm and 0.88 +/- 0.07 in women, respectively. 39.7% and 37% of subjects had hypercholesterolemia and hypertriglyceridemia, respectively. Ultrasonography findings demonstrated diffuse fatty liver in 40.9% subjects. Data also showed low consumption of fruits and vegetables and fish, and high consumption of saturated fatty acids [SFAs] and fast foods in the majority of obesity and NAFLD subjects compared with normal subjects. The results showed that a large proportion of the study population is at risk of central obesity and NAFLD. The formation of non-alcoholic fatty liver may be associated with obesity and unhealthy dietary patterns which warrants further research

Improving Breast Cancer Preventive Behavior among Female Medical Staff: The Use of Educational Intervention based on Health Belief Model

Background: Breast cancer is one of the most common types of cancer prevalent among women worldwide. Preventive behaviors such as early diagnosis through screening tests play an important role in prevention and control of the disease. This study aimed to determine the effects of educational intervention using a health belief model on breast cancer preventive behaviors. Method: This interventional study was conducted on 130 female employees of Zahedan University of Medical Sciences who were randomly divided into intervention and control groups. A questionnaire, made and validated by the researcher, was completed before and one month after training by the study subjects. Data were analysed using regression analysis, independent sample T-test, chi-square and Pearson’s correlation coefficient using the SPSS software 18. Result: There were significant changes in the training group, following educational intervention in the awareness construct and in some constructs of the model including perceived susceptibility, perceived benefits, and perceived barriers, as well as in practice compared to the control group (P < 0.05). Nevertheless, perceived barriers remained as the only predictor in the model, such that for every unit increase in this variable, the behavior score increased by 18%. Conclusion: The use of  educational intervention based on Health Belief Model had positive effect on knowledge of breast cancer preventive behaviors among participants.

Sonographic evaluation of mean carotid intima-media thickness of patients with moderate to severe non-alcoholic fatty liver disease

Nonalcoholic fatty liver disease is a highly prevalent condition that is strongly associated with obesity, type II diabetes, and dyslipidemia. The purpose of this study is to investigate mean common carotid artery intima-media thickness as a marker of atherosclerosis in moderate to severe nonalcoholic fatty liver patients in comparison with control group. In this study, the mean common carotid artery intima-media thickness [CCIMT] and other cardiovascular risk factors were measured in 39 nonalcoholic fatty liver patients and 39 control subjects. All were selected from general population in Zahedan. Then, the data were analyzed using chi[2] and independent t-tests. The results showed that nonalcoholic fatty liver patients had significantly higher common carotid intima-media thickness, waist circumference, waist/hip ratio, body mass index, triglyceride, total cholesterol [p=0.001], ALT [p=0.04], ALP [p=0.048], compared with the control group. Nonalcoholic fatty acid liver patients are at significantly higher risk for atherosclerosis and cardiovascular diseases. Therefore, all of these patients should be evaluated for common carotid intima-media thickness and other cardiovascular risk factors

Evaluation of the efficacy of zinc sulfate in the prevention of chemotherapy-induced mucositis: a double-blind randomized clinical trial

Oral mucositis is a serious complication of chemotherapy that results in painful debilitating inflammation, necessitating the administration of analgesics. There is no cure for mucositis. Some studies have evaluated the effect of zinc sulfate on mucositis. The present study aims to evaluate the effect of oral zinc sulfate on prevention of mucositis, xerostomia, and pain induced by chemotherapy. This double-blind, randomized controlled trial was carried out on 50 adult patients who underwent chemotherapy during 2008-2009. Patients were divided in two groups. Patients in the intervention group were administered three, 220 mg zinc sulfate capsules daily until the end of their chemotherapy treatment. Patients in the placebo group received three placebo capsules daily, which were similar in shape, taste, and color to the zinc sulfate capsules. Data were analyzed by SPSS version 17 software, using the independent samples t-test, Mann-Whitney U and Friedman tests. The incidence of grade 3 mucositis was lower in the zinc sulfate group. In the first follow up, grade 3 mucositis was detected in 10% of patients. In the placebo group, grade 3 mucositis was seen in 46.6% of patients. By the fourth follow up, grade 3 mucositis was detected in 3.33% of patients in the intervention group and in 20% of patient in the placebo group. At the end of the study there was no grade 3 mucositis detected in the zinc sulfate group, whereas there were 3.57% of patients in the placebo group with grade 3 mucositis. The results also showed that zinc sulfate decreased the effects of xerostomia and pain in patients under chemotherapy treatment. It can be concluded that zinc sulfate might decrease the intensity of mucositis

study on attitude of pregnant women with intention of elective cesarean based on theory of planned behavior

The purpose of this research was to study the attitudes of pregnant women with intention of elective cesarean section, based on the theory of planned behavior. This cross-sectional study was carried out on 150 pregnant women in their third trimester of pregnancy with an intention or decision to elective cesarean section, who were selected through probability sampling. The collection tool of information was a questionnaire based on the theory of planned behavior. In a majority of women, the attitude and the control of perceived behavior was weak or intermediate. The ANOVA test showed a significant statistical correlation between the means scores of attitude with education level and the control of perceived behavior with type of previous labor. Obedience incentive was based on physicians, mothers, and spouses' decisions, respectively. Continuous classes for training psychological skills and the preparation of mothers for delivery should be established to decrease the interest of pregnant women toward elective cesarean section.

Reasons for elective cesarean section amongst pregnant women; a qualitative study

A qualitative study was carried out on 200 pregnant women attending obstetric offices and Imam Ali Women's Clinic in Zahedan, Iran during January 2010 to August 2011. Twenty-nine focus group discussions [FGDs] with 5-8 participants in each group were formed. The study included women in the third trimester of pregnancy with the intention or decision to undergo elective cesarean section. The women's views were explored and analyzed in group sessions. Subsequently, the responses were divided into four major categories. The majority [50%] of the opinions expressed were psychological in origin, or stemmed from low perceived behavioral control, improper subjective norms, or wrong attitudes about vaginal delivery. Twenty-nine focus group discussions [FGDs] with 5-8 participants in each group were formed. The study included women in the third trimester of pregnancy with the intention or decision to undergo elective cesarean section. The women's views were explored and analyzed in group sessions. The responses were divided into four major categories. The majority [50%] of the opinions expressed were psychological in origin, or stemmed from low perceived behavioral control, improper subjective norms, or wrong attitudes about vaginal delivery. It is necessary to hold psychological skills training classes for pregnant women and their husbands to persuade them attend group discussion sessions to increase their control on perceived behavior, highlight their positive attitudes and direct them toward natural vaginal delivery