The Boosting Effects of Melatonin on the In Vitro Fertilization (IVF) of Women with Polycystic Ovary Syndrome / 전남의대학술지

Polycystic ovary syndrome (PCOS) is one of the most critical disorders, which affects approximately 20% of women of childbearing age and melatonin supplementation in these women can be effective. However, human studies in this area are particularly limited to IVF candidates. The aim of this clinical trial study was to evaluate the effect of melatonin on the in vitro fertilization (IVF) in PCOS involved women. In this clinical trial study, a total of 320 women with PCOS were randomly assigned to the intervention and control groups. Patients in the intervention group (n=160) received a combination of melatonin and metformin (3 mg and 500 mg, respectively) three times a day. The control group (n=160) received metformin 500 mg from the luteal phase of the cycle before the start of gonadotropin. Oocyte and embryo quality, number of oocytes, and pregnancy outcomes were compared in both groups. Our study revealed that the frequency of Metaphase II oocytes (69.9% vs. 57.9%, p＜0.001) and the number of embryos of the top-quality (grade A) were higher in the group treated with melatonin (40.3% vs. 29.9%, p=0.001). The rate of clinical pregnancy and implantation were also higher in the intervention group. The odds of clinical pregnancy in the intervention group was 1.8 times (p=0.039). Moreover, oral melatonin supplementation was effective in patients with PCOS, who were candidates for IVF because of the increased quality of mature oocytes, top-quality embryos, and increased odds of clinical pregnancy.

Risk factors for stomach cancer: a systematic review and meta-analysis / 한국역학회지

OBJECTIVES@#This report provides information on 14 behavioral and nutritional factors that can be addressed in stomach cancer prevention programs. @*METHODS@#PubMed, Web of Science, and Scopus were searched through December 2018. Reference lists were also screened. Observational studies addressing the associations between stomach cancer and behavioral factors were analyzed. Between-study heterogeneity was investigated using the χ2, τ2, and I2 statistics. The likelihood of publication bias was explored using the Begg and Egger tests and trim-and-fill analysis. Effect sizes were expressed as odds ratios (ORs) with 95% confidence intervals (CIs) using a random-effects model. @*RESULTS@#Of 52,916 identified studies, 232 (including 33,831,063 participants) were eligible. The OR (95% CI) of factors associated with stomach cancer were as follows: Helicobacter pylori infection, 2.56 (95% CI, 2.18 to 3.00); current smoking, 1.61 (95% CI, 1.49 to 1.75); former smoking 1.43 (95% CI, 1.29 to 1.59); current drinking, 1.19 (95% CI, 1.10 to 1.29); former drinking, 1.73 (95% CI, 1.17 to 2.56); overweight/obesity, 0.89 (95% CI, 0.74 to 1.08); sufficient physical activity, 0.83 (95% CI, 0.68 to 1.02); consumption of fruits ≥3 times/wk, 0.48 (95% CI, 0.37 to 0.63); consumption of vegetables ≥3 times/wk, 0.62 (95% CI, 0.49 to 0.79); eating pickled vegetables, 1.28 (95% CI, 1.09 to 1.51); drinking black tea, 1.00 (95% CI, 0.84 to 1.20); drinking green tea, 0.88 (95% CI, 0.80 to 0.97); drinking coffee, 0.99 (95% CI, 0.88 to 1.11); eating fish ≥1 time/wk 0.79 (95% CI, 0.61 to 1.03); eating red meat ≥4 times/wk 1.31 (95% CI, 0.87 to 1.96), and high salt intake 3.78 (95% CI, 1.74 to 5.44) and 1.34 (95% CI, 0.88 to 2.03), based on two different studies. @*CONCLUSIONS@#This meta-analysis provided a clear picture of the behavioral and nutritional factors associated with the development of stomach cancer. These results may be utilized for ranking and prioritizing preventable risk factors to implement effective prevention programs.

Risk factors for stomach cancer: a systematic review and meta-analysis / 한국역학회지

OBJECTIVES@#This report provides information on 14 behavioral and nutritional factors that can be addressed in stomach cancer prevention programs. @*METHODS@#PubMed, Web of Science, and Scopus were searched through December 2018. Reference lists were also screened. Observational studies addressing the associations between stomach cancer and behavioral factors were analyzed. Between-study heterogeneity was investigated using the χ2, τ2, and I2 statistics. The likelihood of publication bias was explored using the Begg and Egger tests and trim-and-fill analysis. Effect sizes were expressed as odds ratios (ORs) with 95% confidence intervals (CIs) using a random-effects model. @*RESULTS@#Of 52,916 identified studies, 232 (including 33,831,063 participants) were eligible. The OR (95% CI) of factors associated with stomach cancer were as follows: Helicobacter pylori infection, 2.56 (95% CI, 2.18 to 3.00); current smoking, 1.61 (95% CI, 1.49 to 1.75); former smoking 1.43 (95% CI, 1.29 to 1.59); current drinking, 1.19 (95% CI, 1.10 to 1.29); former drinking, 1.73 (95% CI, 1.17 to 2.56); overweight/obesity, 0.89 (95% CI, 0.74 to 1.08); sufficient physical activity, 0.83 (95% CI, 0.68 to 1.02); consumption of fruits ≥3 times/wk, 0.48 (95% CI, 0.37 to 0.63); consumption of vegetables ≥3 times/wk, 0.62 (95% CI, 0.49 to 0.79); eating pickled vegetables, 1.28 (95% CI, 1.09 to 1.51); drinking black tea, 1.00 (95% CI, 0.84 to 1.20); drinking green tea, 0.88 (95% CI, 0.80 to 0.97); drinking coffee, 0.99 (95% CI, 0.88 to 1.11); eating fish ≥1 time/wk 0.79 (95% CI, 0.61 to 1.03); eating red meat ≥4 times/wk 1.31 (95% CI, 0.87 to 1.96), and high salt intake 3.78 (95% CI, 1.74 to 5.44) and 1.34 (95% CI, 0.88 to 2.03), based on two different studies. @*CONCLUSIONS@#This meta-analysis provided a clear picture of the behavioral and nutritional factors associated with the development of stomach cancer. These results may be utilized for ranking and prioritizing preventable risk factors to implement effective prevention programs.

Quality of life in Iranian elderly population using the SF-36 questionnaire: systematic review and meta-analysis

Background: Ageing is a major known risk factor that is a threat to human health. To date, many studies have investigated quality of life [QOL] among the elderly population in the Islamic Republic of Iran. However, their results were inconsistent.

Aims: We designed this systematic review and meta-analysis to estimate the overall mean score of QOL based on the Short Form 36 Health Survey Questionnaire [SF-36] among the Iranian elderly population.

Methods: We searched international databases [Medline, Scopus and Science Direct] and national databases [Science In-formation Database, MagIran, IranMedex and Irandoc] up to February 2015. We included all cross-sectional studies that evaluated QOL among the Iranian elderly population using SF-36.

Results: Of 2150 studies identified, 15 were included in the meta-analysis. The mean scores for QOL in the 8 scales were: 47.58, 51.75, 55.42, 55.78, 59.55, 51.54, 47.85 and 51.31 for physical-role, physical function, mental health, bodily pain, social functioning, emotional-role, general health, and vitality, respectively.

Conclusions: Our results indicated that health-related QOL decreased with increasing age. QOL was worse in women than in men, especially in physical-role and general health scales. Elderly people who lived in a nursing home had lower QOL than those who lived in their own home. So, health policy-makers should design comprehensive programmes to improve health-related QOL for the Iranian elderly population

Occupational risk factors among Iranian farmworkers: a review of the available evidence / 한국역학회지

Farming is one of the most important components of most economies. No comprehensive picture exists of the health status of Iranian farmers and the work-related hazards that affect them. We aimed to determine the gaps in the current knowledge regarding the occupational health of Iranian farmworkers. Electronic databases including Medline, Web of Science, Scopus, and Embase, as well as national databases including the Scientific Information Database, MagIran, and Barakat Knowledge System, were searched for articles published through March 2017. All epidemiologic studies regarding the occupational health of farmworkers in Iran were reviewed, regardless of their design, language, time of publication, and location. Of the 86 retrieved articles, 39 studies were ultimately analyzed. Most studies were conducted in Fars, Kerman, and Mazandaran provinces. According to the results of this review, chemical, physical, and biological hazards, along with work-related injuries, may be the main factors threatening the health of farmworkers. The unsafe use of pesticides was related to male infertility, eye and digestive complications, pesticide poisoning, pesticide absorption, hematological changes, non-Hodgkin lymphoma, and multiple myeloma. Chemical hazards (e.g., the unsafe use of pesticides), physical hazards, injuries, and biological hazards (e.g., work-related infectious diseases) threaten the health of Iranian farmworkers. Moreover, farmworkers lack adequate knowledge about the occupational hazards they face and the relevant risk factors.

Occupational risk factors among Iranian farmworkers: a review of the available evidence / 한국역학회지

Farming is one of the most important components of most economies. No comprehensive picture exists of the health status of Iranian farmers and the work-related hazards that affect them. We aimed to determine the gaps in the current knowledge regarding the occupational health of Iranian farmworkers. Electronic databases including Medline, Web of Science, Scopus, and Embase, as well as national databases including the Scientific Information Database, MagIran, and Barakat Knowledge System, were searched for articles published through March 2017. All epidemiologic studies regarding the occupational health of farmworkers in Iran were reviewed, regardless of their design, language, time of publication, and location. Of the 86 retrieved articles, 39 studies were ultimately analyzed. Most studies were conducted in Fars, Kerman, and Mazandaran provinces. According to the results of this review, chemical, physical, and biological hazards, along with work-related injuries, may be the main factors threatening the health of farmworkers. The unsafe use of pesticides was related to male infertility, eye and digestive complications, pesticide poisoning, pesticide absorption, hematological changes, non-Hodgkin lymphoma, and multiple myeloma. Chemical hazards (e.g., the unsafe use of pesticides), physical hazards, injuries, and biological hazards (e.g., work-related infectious diseases) threaten the health of Iranian farmworkers. Moreover, farmworkers lack adequate knowledge about the occupational hazards they face and the relevant risk factors.

Predictors of miscarriage: a matched case-control study / 한국역학회지

OBJECTIVES: The risk factors for miscarriage vary across communities and countries. This study was conducted to investigate the predictors of miscarriage in the west of Iran. METHODS: This matched case-control study was conducted in Hamadan Province from April 2013 to March 2014. Cases were selected from women who had a recent spontaneous abortion and controls were selected from women who had a recent live birth. Two controls were selected for every case and matched for date of pregnancy and area of residence. Multivariate conditional logistic regression analysis was performed and odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. RESULTS: Five hundred fifty cases were compared with 1,091 controls. The OR of miscarriage was 1.58 (95% CI=1.30-1.92) for every five-year increase in age, 0.20 (95% CI=0.14-0.28) for every live birth, and 3.43 (95% CI=2.03-5.79) for a history of previous spontaneous abortion. Compared to nulliparous women, primiparous or multiparous women had an OR of 17.85 (95% CI=6.65-47.91) for miscarriage. There was a strong association between miscarriage and abnormal amniotic status (OR, 2.46; 95% CI, 0.46-13.09) and also abnormal placenta status (OR, 10.44; 95% CI, 0.95-114.92); however, these associations were not statistically significant. No significant associations were observed between miscarriage and body mass index, previous history of stillbirth, low birth weight, congenital anomaly, ectopic pregnancy, impaired thyroid function, or high blood pressure. CONCLUSIONS: Our study suggests that miscarriage is a multifactorial outcome associated with several modifiable and non-modifiable risk factors that may vary among different communities.

Predictors of unintended pregnancy among married women in Hamada, Western Iran: a case-control study

Literatures that focus on the risk factors of unintended pregnancy among married women are limited especially in developing countries. The aim of this study was to determine the predictors of unintended pregnancy in a west region of Iran. This case-control study was conducted from September to November 2011 in Hamadan City, western Iran. A stratified cluster random sampling method was used for data collection. All participants were enrolled voluntarily into the study including 181 cases and 391 controls. Cases were married women with unintended pregnancy. Controls were married women with planned pregnancy. Of 572 participants, 31 [5.4%] women had not used any methods of contraception prior to the recent pregnancy. The proportion of using ineffective contraceptive methods such as withdrawal was higher in cases than in controls. The most effective predictor of unintended pregnancy was the number of previous alive children so that the risk of unplanned pregnancy increased 3.68 per one child [P<0.001]. This study introduced several effective predictors for unintended pregnancy among married women which may be useful for family planning programs. The high-risk population should be strongly advised to use highly effective contraceptive methods such as tubal ligation, vasectomy or OCP provided that being used correctly

Quality of Cohort Studies Reporting Post the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement / 한국역학회지

The quality of reporting of cohort studies published in the most prestigious scientific medical journals was investigated to indicate to what extent the items in the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist are addressed. Six top scientific medical journals with high impact factor were selected including New England Journal of Medicine, Journal of the American Medical Association, Lancet, British Medical Journal, Archive of Internal Medicine, and Canadian Medical Association Journal. Ten cohort studies published in 2010 were selected randomly from each journal. The percentage of items in the STROBE checklist that were addressed in each study was investigated. The total percentage of items addressed by these studies was 69.3 (95% confidence interval: 59.6 to 79.0). We concluded that reporting of cohort studies published in the most prestigious scientific medical journals is not clear enough yet. The reporting of other types of observational studies such as case-control and cross-sectional studies particularly those being published in less prestigious journals expected to be much more imprecise.

Influenza A [H1N1] in Hamedan province, Western Iran in 2009: a case control study

The novel influenza A [H1N1] virus was first detected in March 2009 in Mexico and then disseminated to many other countries worldwide. In this study, we assessed the potential risk factors of swine flu as well as the most important clinical manifestations of this infectious disease among confirmed cases during early phase of pandemic H1N1. subjects [cases and controls] were selected from those patients with signs and symptoms of respiratory tract infection who referred to health centers of eight cities throughout Hamedan Province, western Iran from July to December 2009. characteristics of the participants were obtained by interviewers using pre-determined questionnaire. Cases were distinguished by pharyngeal soap specimens positive for influenza A virus using polymerase chain reaction [PCR]. Logistic regression model was conducted at 0.05 significance level using Stata 9.1 statistical software to assess the effects of various risk factors on H1N1 influenza infection. Totally, 245 confirmed cases of H1N1 influenza were compared with 388 controls. Case fatality rate of influenza infection was about 2.86%. In comparison with age group of 1-9 yr old, adjusted odds ratio estimates was 1.91 [95% CI: 1.06, 3.46] for age group of 20-39 yr old, 0.94 [0.37, 2.38] for age group of 40-59 yr old, and 0.34 [0.09, 1.37] for age group of 60-79 yr old. Adjusted odds ratio estimates of influenza A infection was 8.12 [95% CI: 3.11, 21.6] for pregnant women compared to non-pregnant women; 1.84 [95% CI: 1.32, 2.86] for high educated individuals in comparison with low educated individuals; 2.11 [95% CI: 1.25, 3.57] for whose who had close contact with suspected influenza patients; and 2.15 [95% CI: 1.16, 3.98] for individuals with normal body mass index [BMI= 25-30] compared with underweight individuals [BMI< 20]. There were no significant differences in clinical manifestations between cases and controls. The risk of influenza A infection is highest among children and adolescents, pregnant women, high educated individuals, and those who had close contact with suspected influenza patients during pandemic phase. In addition, there is no pathogonomonic sign or symptom to distinguish influenza infection clinically from other kinds of respiratory track infections