ABSTRACT
The recent studies show that Rotavirus is important cause of the acute gastroenteritis. The aim of this review is to estimate the number of Rotavirus infection among Iranian children by performing a systematic review and estimating a pooled data. We performed a systematic literature review in relevant databases including PUBMED, MEDLINE, OVID, SID, MAGIRAN, and IRANMEDEX. Search in databases was done in October 10, 2013. Meta-analysis was performed using the STATA statistical package version 11. We assessed heterogeneity by Q-test and used random model for pooling measures of proportion of Rotavirus infection among Iranian children with diarrhea [and 95% confidence intervals [CI]]. Sub group analysis between in-patient and outpatient group were done and publication bias was assessed by Egger and Begg tests. A total of 154 records were identified in our searching. There were 36 studies including a total of 15,368 children with diarrhea. Out of 15,368 children, 6,338 were positive for Rota virus gastroenteritis. Overall pooled estimate of infection with Rotavirus among cases of gastroenteritis was 0.35 [95% CI, 0.28-0.41]. Pooled estimates for hospitalized children and outpatient subgroups were 0.39 [95% CI, 0.30-0.48], and 0.31 [95% CI, 0.23-0.38], respectively. This study supports the importance of Rotavirus in the Iranian population such as common cause of diarrhea among children. Therefore, decision to adopt immunization programs to prevent Rotavirus infection might be helpful in Iran
Subject(s)
Humans , Gastroenteritis , Child , Acute Disease , Meta-Analysis as Topic , DiarrheaABSTRACT
The aim of this study was to examine the quality of life in patients with Parkinson's disease [PD] using a Parkinson's Disease Questionnaire [PDQ-39] as a measure. In this cross-sectional study, 200 consecutive patients with PD who referred to Tehran University of Medical Sciences Hospitals were enrolled. The PDQ-39 was used for evaluation. Statistical tests like ANOVA, t-test and Spearman rank correlations were used to assess the relationship between duration and clinical stage of disease and the quality of life. The mean age of the patients was 57.32years [10.5 SD]. 135[67.5%] were male and 65[32.5%] female. Most of the patients [46/5%] were in mild stage. The results showed total effect of PD on patient`s quality of life, on dimensions that measured by PDQ-39. The mean of Parkinson`s disease summary index [PDSI] was 35/17 +/- 15/43.Also severity [p=0.008] and duration [p=0.0001] of disease had a significant effect on Quality of life. Quality of life deteriorated significantly with increasing disease. Paying attention to other dimensions of quality of life than clinical symptoms is suggested to improve health related quality of life in patients with Parkinson's disease.
ABSTRACT
Haemophilus Influenzae type b [Hib] is an important cause of morbidity and mortality in children. Although its burden is considerably preventable by vaccine, routine vaccination against Hib has not been defined in the National Immunization Program of Iran. This study was performed to assess the cost-benefit and cost utility of running an Hib vaccination program in Iran. Based on a previous systematic review and meta analysis for vaccine efficacy, we estimated the averted DALYs [Disability adjusted life years] and cost benefit of vaccination. Different acute invasive forms of Hib infection and the permanent sequels were considered for estimating the attributed DALYs. We used a societal perspective for economic evaluation and included both direct and indirect costs of alternative options about vaccination. An annual discount rate of 3% and standard age weighting were used for estimation. To assess the robustness of the results, a sensitivity analysis was performed. The incidence of Hib infection was estimated 43.0 per 100000, which can be reduced to 6.7 by vaccination. Total costs of vaccination were estimated at US$ 15,538,129. Routine vaccination of the 2008 birth cohort would prevent 4079 DALYs at a cost per averted DALY of US$ 4535. If we consider parents' loss of income and future productivity loss of children, it would save US$ 8,991,141, with a benefit cost ratio of 2.14 in the base case analysis. Sensitivity analysis showed a range of 0.78 to 3.14 for benefit to cost ratios. Considering costs per averted DALY, vaccination against Hib is a cost effective health intervention in Iran, and allocating resources for routine vaccination against Hib seems logical