The association between diet quality and obesity-related metabolic risks.

BACKGROUND: The aim of this study was to examine the association between dietary quality measured by inflammatory potential of a diet and Alternative Healthy Eating Index-2010 (AHEI-2010), and obesity-related metabolic risks in a representative sample of Iranian obese adults. METHOD: This cross-sectional study was conducted on 300 obese adults. Dietary intake was assessed using a validated 168-item semi-quantitative food frequency questionnaire (FFQ). Diet quality was measured using AHEI-2010 and Empirical Dietary Inflammatory Pattern (EDIP) scores. RESULTS: Those in the upper quartile of AHEI-2010 were associated with lower serum level of triglycerides (TG), and higher body mass index (BMI), compared to participants in the lower quartile. Those in the higher quartile of EDIP score were associated with higher serum level of TG. Greater adherence to AHEI-2010 had 70% lower odds of high fasting blood glucose (FBG), compared with those in the first quartile [Q4 vs Q1: OR, 0.3 (95% CI: 0.1-0.8), p trend = 0.02] Those in the highest quartile of EDIP score had a 60% higher odds of high diastolic blood pressure, compared with those in the lowest quartile [Q4 vs Q1: OR, 2.4 (95% CI: 1.1-5.5), p trend = 0.05] after controlling for potential covariates. CONCLUSIONS: High diet quality incorporating more anti-inflammatory diet may have a potential benefit in reducing obesity-related metabolic risks.

Association between place of delivery for pregnant mothers and neonatal mortality: a systematic review and meta-analysis.

BACKGROUND: Neonatal mortality is a major health problem mainly in the developing countries and its reduction was remain stagnant during the era of Millennium Development Goal. Current global health policies emphasize institutional deliveries as a pathway to achieving reductions in neonatal mortality in developing countries. There are inconsistent conclusions of evidence about this fact, mainly in developing countries. Therefore, this study was conducted to assess the association between health facility delivery and neonatal mortality. METHODS: We systematically searched EMBASE, PubMed, ISI Web of Science and Scopus through 18 March 2018 and then updated on 14 February 2019. I2 test statistic was used to assess heterogeneity. Publication bias was checked using a funnel plot and meta-bias test. Random-effects model was used to determine the pooled effect size. RESULTS: Nineteen articles were included in the meta-analysis. The pooled odds ratios (ORs) indicated that health facility delivery was significantly associated with the odds of neonatal mortality (OR = 0.48; 95% CI: 0.38, 0.58). This significant inverse association was consistently found regardless of study design, geographical region and quality of the study. There is evidence of publication bias with high heterogeneity between studies (I2 = 84.5%). CONCLUSION: The odds of neonatal mortality were much likely lower among those delivered at a health facility than those delivery at home. Therefore, encouraging delivery in a health facility and minimizing any barrier to health facility are important. Further longitudinal studies based on larger, more representative samples are therefore needed to further assess the underlying relationships.

Resistance of Mycobacterium tuberculosis strains to Rifampicin: A systematic review and meta-analysis.

INTRODUCTION: Antitubercular drug resistance strain is a horrifying barrier to effective TB treatment and prevention. The present study aimed to determine the prevalence and geographical distribution of rifampicin-resistance M. tuberculosis (MTB) strains. METHODS: We searched two electronic databases, PubMed and EMBASE, until 26 March 2017 and updated our search on 27 April 2018 and accessed all prevalence studies of MTB strain and their drug susceptibility patterns to rifampicin. The pooled prevalence estimate was determined using random effects model. RESULTS: We identified 23 studies satisfying the inclusion criteria. The proportion of rifampicin resistance strains was diverged depending on the type of strains, country and Regions. The pooled estimate of rifampicin-resistance strains of MTB for the included studies was 4% (95% CI: 3-5%). In subgroup analysis based on World Health Organization (WHO) Regions, the pooled estimate of rifampicin-resistance strains of MTB was 11% (95% CI: 9-13%) with the Western Pacific Region 24%, Europian Region 10%, South-East Asian Region 6%, African Region 3% and Region of American 1%. Beijing family was the most dominant strain resistance to rifampicin with pooled prevalence of 14% (95% CI: 10-18%). The pooled prevalence of other families, i.e. EAI, T, CAS, MANU, Haarlem, LAM and Ural, was ≤2% for each. CONCLUSION: High burden of rifampicin resistance MTB strains was identified in the Western Pacific Region. Of these, Beijing family was predominantly resistance to rifampicin in Western Pacific Region and South-East Asian Region and also spread to European Region and Region of American.

Short-term and long-term efficacy of classical ketogenic diet and modified Atkins diet in children and adolescents with epilepsy: A systematic review and meta-analysis.

OBJECTIVES: Classical ketogenic diet (KD) and modified Atkins diet (MAD) are two types of KD commonly used for the treatment of intractable epilepsy throughout the world. Studies have shown the efficacy of these diets. However, no systematic review and meta-analysis study has to date compared the efficacy of KD and MAD in a time trend. Therefore, the objectives of the present study were to compare the short-term and long-term efficacy of classical KD and MAD in children and adolescents with epilepsy and to determine the efficacy of classical KD and MAD at multiple time points and in a time trend. METHODS: Main electronic literature databases, including MEDLINE/PubMed, Web of Science, Scopus, and EMBASE, were searched in November 2016. Rate difference and random effects model were used to compare the efficacy of the classical KD and MAD. RESULTS: Overall, 70 studies were eligible for inclusion. Meta-analysis revealed a non-significant trend toward a higher efficacy of MAD at month-3 and month-6 (P > 0.05). In the classical KD group, the percentage of responder patients achieving ≥50% seizure reduction was 62, 60, 52, 42, and 46% at month-1, 3, 6, 12 and 24 and for the MAD group was 55, 47, 42, and 29% at month-1, 3, 6, and 12, respectively. DISCUSSION: Classical KD does not differ substantially from MAD in ≥50% and ≥90% reduction of seizure frequency at month-3 and month-6. Overall, the number of patients achieving seizure freedom increases over time.

Prevalence of and risk factors for multidrug-resistant tuberculosis in Iran and its neighboring countries: systematic review and meta-analysis.

Tuberculosis, in particular drug-resistant tuberculosis, is of global concern due to the high mortality and morbidity associated with it annually. The aim of this study was to determine the prevalence of and the risk factors for multidrug-resistant tuberculosis in Iran and its neighboring countries. Four databases (PubMed, BioMed Central, EMBASE, and Web of Science) were searched using key terms. Nineteen eligible articles were identified, of which 12 and seven were used for quantitative and qualitative analysis, respectively. The overall pooled estimate of the prevalence of multidrug-resistant tuberculosis, including both new and previously treated tuberculosis cases, in Iran, Iraq, Turkey and Pakistan was 16% (95% confidence interval [CI] 11-20). The patients with a previous tuberculosis treatment history (odds ratio [OR] = 6.45; 95% CI 5.12-7.79), those aged <45 years (OR = 1.57; 95% CI 1.12-2.03), and those who were males (OR = 1.83; 95% CI 1.19-2.48) had an increased pool risk of developing multidrug-resistant tuberculosis. The forest plot revealed that the pooled odds for the development of multidrug- resistant tuberculosis were 2.01 (95% CI 1.65-2.36). Poor adherence to treatment was one of the predictors of unsuccessful treatment outcomes. Multidrug-resistant tuberculosis is a great concern for public health programs in many countries globally, including those included in this review. The risk factors for the development of multidrug-resistant tuberculosis, specifically a previous tuberculosis treatment history, should be targeted through the implementation of specialized interventions.

Prevalence of and risk factors for multidrug-resistant tuberculosis in Iran and its neighboring countries: systematic review and meta-analysis

Abstract Tuberculosis, in particular drug-resistant tuberculosis, is of global concern due to the high mortality and morbidity associated with it annually. The aim of this study was to determine the prevalence of and the risk factors for multidrug-resistant tuberculosis in Iran and its neighboring countries. Four databases (PubMed, BioMed Central, EMBASE, and Web of Science) were searched using key terms. Nineteen eligible articles were identified, of which 12 and seven were used for quantitative and qualitative analysis, respectively. The overall pooled estimate of the prevalence of multidrug-resistant tuberculosis, including both new and previously treated tuberculosis cases, in Iran, Iraq, Turkey and Pakistan was 16% (95% confidence interval [CI] 11-20). The patients with a previous tuberculosis treatment history (odds ratio [OR] = 6.45; 95% CI 5.12-7.79), those aged <45 years (OR = 1.57; 95% CI 1.12-2.03), and those who were males (OR = 1.83; 95% CI 1.19-2.48) had an increased pool risk of developing multidrug-resistant tuberculosis. The forest plot revealed that the pooled odds for the development of multidrug- resistant tuberculosis were 2.01 (95% CI 1.65-2.36). Poor adherence to treatment was one of the predictors of unsuccessful treatment outcomes. Multidrug-resistant tuberculosis is a great concern for public health programs in many countries globally, including those included in this review. The risk factors for the development of multidrug-resistant tuberculosis, specifically a previous tuberculosis treatment history, should be targeted through the implementation of specialized interventions.

Vitamin D (FokI) Receptor Gene Polymorphism is associated with Vitamin D Deficiency and Chronic Musculoskeletal Pain. A meta-analysis.

Background: Musculoskeletal pain is the most common chronic pain experienced by older adults. The aim of this study is to explore the associations between vitamin D (FOKI) receptor gene polymorphism (VDR) and vitamin D deficiency (VDD) and chronic musculoskeletal pain. Methods: Cross-sectional studies published in English from January 2000 to January 2015which reported prevalence of chronic pain (CP) and chronic musculoskeletal pain (CMP) were included in this systematic review and meta-analysis. A heat map was used to visualize and observe the correlation between VDR and CMP, CP and VDD. Results: 20 studies (N = 216,365) were included in the analysis, which showed an overall pooled prevalence estimate of CMP and CP as 30.6 per 100 (95 % CI: 30.59, 30.69) and 27.9 per 100 (95 % CI: 27.68, 28.24) respectively. The heat map clustering analysis visualizes the similarity between CP and CMP. Moreover, a direct correlation was observed between the three disease conditions (namely CMP, CP, and VDD) and FokI VDR polymorphism (FF). Spearman's correlation analyses with adjusted r2 revealed that there is a statistically significant interaction effect of the FF genotype and VDD on CMP (r2 = 0.19, p = 0.03), a marginally significant interaction effect of the ff genotype and VDD on CMP (r2 = 0.11, p = 0.08). VDD was also associated with increased CMP (r2 = 0.19, p = 0.028). The pooled estimates of the prevalence of CMP in this review were found to be high. Conclusion: FokI VDR gene polymorphism (FF) plays an important role in the relationship between VDD and CMP.

Mediatory effect of circulating vaspin on resting metabolic rate in obese individuals.

BACKGROUND/OBJECTIVE: Vaspin is a recently identified adipokine related to obesity and insulin sensitivity. The precise mechanism of vaspin in the body is not well known, and its function in resting metabolic rate (RMR) is even less understood. Therefore, the main aim of this study was to investigate the effect of circulating vaspin on RMR in obese people. MATERIALS AND METHODS: A total of 222 obese participants were included in the current comparative cross-sectional study. Body composition was measured using body composition analyzer. RMR was measured by means of indirect calorimetry. For the measurement of vaspin serum concentrations, an enzyme-linked immunosorbent assay was used. Dietary intake was assessed using 3-day 24-h dietary recall. RESULTS: Between low and high circulating vaspin groups, there was significant difference for sex (P = 0.03), fat percent (P = 0.008), RMR per weight (P < 0.001), and RMR per fat free mass (FFM) (P = 0.007). However, there was no statistical difference between the groups in dietary intake after adjustment for energy intake (P > 0.05). Furthermore, individuals with higher level of RMR had higher vaspin concentration. Weight, visceral fat, FFM, and fat mass had significant effect on increasing RMR (P < 0.05) but after adding vaspin as a covariate in the general linear model; visceral fat (P = 0.078) and fat mass (P = 0.339) missed their effectiveness. CONCLUSION: Circulating vaspin level is higher in women than in men in obese individuals. Moreover, it was found that vaspin had mediator effect between visceral fat and fat mass associations with RMR in obese participants.