The prevalence of depression and anxiety in Iranian patients with diabetes mellitus: A systematic review and meta-analysis.

INTRODUCTION: This study aims to estimate the prevalence of depression and anxiety among Iranian patients with diabetes mellitus (DM) through meta-analysis. METHODS: This is a systematic review article based on MOOSE and PRISMA guidelines. Review of the literature was done using databases including Magiran, Barakat Knowledge Network System, SID, RICST, IranDoc, PubMed/Medline, Science Direct, Embase, Scopus, Cochrane Library, Web of Science and the Google Scholar search engine without time limit until December, 2018. Heterogeneity between studies was assessed using Cochran's Q test and I2 index. Data were analyzed using Comprehensive Meta-Analysis (CMA) software version 2 according to a random-effects model. P-values less than 0.05 were considered as the significance level. RESULTS: The analysis consisted of 44 studies including 10,349 Iranian patients with DM. The prevalence of depression was estimated to be 61.8% (95% confidence interval [CI]: 56.6-66.7). The lowest and highest prevalence of depression based on regions was in the North (56.7% [95%CI: 44.9-67.8]) and the East (64.2% [95%CI: 30.7-87.9]), respectively. The depression prevalence in females and males was 63.9% (95%CI: 54.0-72.8) and 46.3% (95%CI: 36.4-56.4), respectively, The prevalence of mild, moderate, severe and highly severe depression was estimated to be 24.4% (95%CI: 21.0-28.2), 19.1% (95%CI: 15.2-23.9), 11.4% (95%CI: 8.6-14.9), and 4.6% (95%CI: 3.4-6.1), respectively. In eight studies, the prevalence of anxiety in Iranian patients with DM was estimated to be 64.5% (95%CI: 42.0-82.1). CONCLUSIONS: Depression and anxiety are more prevalent among Iranian patients with DM compared with developed countries. Therefore, regular psychiatric consultation is required for the early diagnosis and treatment of depression and anxiety in these patients.

The association between anemia and postpartum depression: A systematic review and meta-analysis.

BACKGROUND: The association between anemia and postpartum depression (PPD) has been reported to be controversial in different studies. Therefore, this study aimed to provide a comprehensive assessment of anemia and PPD. METHODS: This review study was conducted according to the MOOSE protocol and results have been reported according to the PRISMA guideline. We searched epidemiologic studies published until January 2018 in nine English databases including Scopus, PubMed/Medline, Science Direct, Embase, Web of Science, CINAHL, Cochrane Library, EBSCO and Google Scholar using English MeSH keywords. The heterogeneity of the studies was assessed using the Cochran's Q test and I2 index. Data were analyzed using a random effects model and comprehensive meta-analysis (CMA) software version 2. RESULTS: In the 10 studies, the association between postpartum anemia and PPD was significant (heterogeneity test: P<0.001, I2=74.62%), and RR=1.887 (95%CI: 1.255-2.838, P=0.002). In 8 studies, anemia during pregnancy significantly increased the risk of postpartum depression (heterogeneity test: P=0.116, I2=36.422%), RR=1.240 (1.001-1.536, P=0.048). The subgroup analysis of postpartum anemia and PPD was not significant for the variables of quality of studies, study design, and the period of evaluating depression and anemia. The subgroup analysis of anemia during pregnancy and PPD was not significant for the period of evaluating depression. Publication bias did not affect the results of the studies. CONCLUSION: Meta-analysis results showed anemia during pregnancy and after pregnancy that significantly increased the risk of postpartum depression. Therefore, prevention, identification and treatment of anemia in pregnant women seem necessary.

Hearing loss in Iranian thalassemia major patients treated with deferoxamine: A systematic review and meta-analysis.

BACKGROUND: Hearing disorders are reported in thalassemia patients treated with deferoxamine. This study aimed to assess hearing loss in Iranian thalassemia major patients treated with deferoxamine. METHODS: This review article was designed based on PRISMA guidelines. To review the literature, two researchers studied national and international databases including Iranmedex, Magiran, Medlib, SID, Scopus, PubMed, Science Direct, Web of Science and Google Scholar without time limit until May 2017. Cochran's Q test and I2 index were used to assess the heterogeneity of the studies. The data were analyzed using Comprehensive Meta-Analysis software version 2 and p<0.05 was considered significant. RESULTS: A total of 17 articles involving 1,835 Iranian thalassemia major patients treated with deferoxamine were included in the meta-analysis. The overall prevalence of hearing loss was estimated 27.3% (95% confidence intervals (CI): 19-37.6). The prevalence of sensorineural, conductive and mixed hearing loss was estimated 10.6% (95% CI: 5.7-18.8), 14.6% (95% CI: 10.5-20.6) and 9.1% (95% CI: 5.6-14.6), respectively. No significant differences were noted regarding the relationship hearing loss and mean serum ferritin (P=0.29) and average daily deferoxamine (P=0.30). Meta-regression model showed an increased significance in the prevalence of hearing loss based on the year of studies (p<0.0001). CONCLUSIONS: There is a high prevalence of hearing loss in Iranian thalassemia major patients treated with deferoxamine. Therefore, periodic hearing assessments and regular check-ups after the initiation of chelation therapy are necessary.

The Effects of Creatine Monohydrate on Permeability of Coronary Artery Endothelium and Level of Blood Lipoprotein in Diabetic Rats.

BACKGROUND: Creatine monohydrate has beneficial effects on serum glucose. This study aimed to investigate the effects of creatine on serum biochemical markers and permeability of coronary arteries among diabetic rats. MATERIAL AND METHODS: 32 Wistar rats, which weighed 150-200 grams were randomly divided into 4 groups including: group I, control; group II, creatine monohydrate; group III, diabetic rats; and group IV, diabetic rats + creatine. Creatine monohydrate was applied by 400 mg/kg/daily for 5 months. Animals' weights and blood samples were taken before and after the study. Endothelial permeability rate was measured by Evans Blue method. Data were analysed by SPSS 16. RESULTS: At the end of fifth month, rats' weights in diabetic group under treatment with creatine, compared to those without, increased significantly (p<0.0001). Also, the serum levels of triglyceride (TG), cholesterol, glucose and low density lipoprotein (LDL)- cholesterol decreased significantly among those under treatment with creatine (p<0.05), but high density lipoprotein (HDL)- cholesterol increased significantly (p<0.002). Permeability rate of coronary arteries was reduced significantly in the diabetic group treated by creatine compared to untreated groups, closed to the intact group (p<0.001). CONCLUSION: Results of this study showed that creatine monohydrate caused an improvement of serum biochemical markers associated with diabetes and reduced the permeability rate of coronary arteries among diabetic rats.

Effects of Complementary Creatine Monohydrate and Physical Training on Inflammatory and Endothelial Dysfunction Markers Among Heart Failure Patients.

BACKGROUND: Previous studies have reported endothelial dysfunction and inflammatory cytokine in heart failure patients (HF). OBJECTIVES: The purpose of this study was to determine the effects of creatine monohydrate and exercise on inflammatory and endothelial dysfunction markers among HF patients. PATIENTS AND METHODS: One hundred patients were prospectively randomized into two groups: Intervention group which received 5 grams/day creatine monohydrate and exercised for 8 weeks; and control group which did not receive any interventions. Interleukine-6 (IL-6), high sensitivity C reactive protein (hs-CRP), P-selectin, intercellular adhesion molecule-1 (ICAM-1), and vascular cell adhesion molecule 1 (VCAM-1) were measured at the start and end of the study for both groups. RESULTS: In total, 100 patients including 50 controls and 50 intervention group (54% male, mean EF of 34.2 ± 10.5% and 52% male, mean EF of 35.6 ± 12.7%, respectively) were analyzed. The serum levels of hs-CRP and IL-6 increased at the end of the study in the control group compared to the baseline, (7.5 ± 1.5 mg/L vs. 6.9 ± 1.3 mg/L, P < 0.05 and 3.0 ± 0.75 ng/L vs. 2.55 ± 0.9 ng/L, P < 0.05, respectively). However, compared to the baseline, the level of both markers decreased at the end of the study in the intervention group (6.3 ± 1.6 mg/L vs.7.5 ± 1.5 mg/L, P < 0.05 and 2.1 ± 0.8 ng/L vs.2.5 ± 0.5 ng/L, P < 0.05). Also, P-selectin and ICAM-1 levels increased at the end of study (56.9 ± 1.8 ng/L vs. 51.9 ± 1.5 ng/L, P < 0.05 and 368.1 ± 25.4 µg/L vs. 353.1 ± 10.4 µg/L, P < 0.05 respectively). Inversely, the levels of these markers decreased in the intervention group, at the end of study (49.7 ± 1.9 ng/l vs. 51.4 ± 2.1 ng/l, P < 0.05 and 342.7 ± 16.5 µg/l vs. 350.4 ± 14.7 µg/l, P < 0.05, respectively). VCAM-1 level was not decreased significantly at the end of the study in the intervention group (570.5 ± 78.4 µg/L vs. 575.3 ± 86.5 µg/L, P > 0.05). CONCLUSIONS: Combination of creatine monohydrate and exercise attenuated inflammation and endothelial dysfunction markers among heart failure patients.

Perfluorocarbon attenuates inflammatory cytokines, oxidative stress and histopathologic changes in paraquat-induced acute lung injury in rats.

The effects of perfluorocarbon (PFC) on paraquat (PQ) induced acute lung injury (ALI) was evaluated among rats. Twenty four Wistar rats were divided into 4 groups: control group injected by saline physiologic 0.9%, PFC group injected by Perfluorocarbon, PQ group injected by PQ and PQ+PFC group injected by PFC one hour after receiving paraquat. Bronchoalveular fluid content, inflammatory cytokines, oxidative and histopathologic changes were measured after 72 h. The levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and transforming growth factor-ß1(TGF-ß1) in the PQ group were increased compared to either control or PFC groups, but their levels decreased in PQ+PFC group significantly (p<0.05). Also, histopathologic evaluation revealed an increase in malondialdehyde (MDA) and hydroxyproline (HP) in the PQ group but a decrease in PQ+PFC group significantly (p<0.01). PFC emulsion by its anti-inflammatory, anti-oxidative and anti-fibrotic properties can reduce the inflammatory and fibrotic alterations, pulmonary oedema, and pulmonary histopathologic changes created by PQ.

Prenatal Exposure to Phthalic Acid Induces Increased Blood Pressure, Oxidative Stress, and Markers of Endothelial Dysfunction in Rat Offspring.

Previous studies have reported the harmful effects of exposure to phthalic acid (PA) on heart. No studies have reported the effects of prenatal PA exposure on the structure or function of heart. The current study aimed to investigate the effects of prenatal PA exposure on the markers of oxidative stress and cardiac structure in rats' offspring. Twenty-four pregnant rats were randomly categorized into three groups of control, exposed to 2.5 and 5 % PA. The morphometric properties of coronary arteries, markers of oxidative stress, and NOS activity were measured in offspring rats. By a dose-dependent manner, the body weight (BW), heart weight (HW), and HW/BW of the intervention groups were reduced and their heart rate and blood pressure were conversely increased compared to the control group. Also, the wall thickness, cross-sectional area of the aorta and septal branch of the descending left coronary artery were significantly increased in the intervention group. In addition, PA significantly increased the level of malondialdehyde and decreased the level of superoxide dismutase and glutathione peroxidase, compared to the control group. This study revealed that prenatal exposure of rats to PA causes vascular dysfunction, increasing oxidative stress, and reduction in cardiac nitric oxide synthetase activity among offspring rats.

Sex determination using mandibular anthropometric parameters in subadult Iranian samples.

INTRODUCTION: Sex determination is the first step in the identification of corpses and skeletal remains. The mandible is the largest and strongest bone of the face and has high durability. It is known that skeletal features vary by population, thus the need to establish population-specific standards. In this study, for the first time, we investigated mandibular anthropometric parameters for sex determination in subadult Iranian cadavers. METHODS: Eight mandibular anthropometric parameters were measured in 45 Iranian cadavers below the age of 20 (23 males and 22 females corpses), and the relationships of these variables with gender were determined. Collected data were analyzed using descriptive analysis, ROC curve, cross tabulation and discriminant analysis in SPSS 13. RESULTS: No significant statistical difference was seen in the mandibular anthropometric values between the two genders in samples below the age of 12. In the 12-19 age group, accuracy of symphysial height and bigonial breadth in differentiation of gender was 69% and 86.2% respectively. CONCLUSION: Although mandibular anthropometric parameters are not helpful in sex determination below the age of 12, if for some reasons such as explosions, air disasters and other accidents, only the mandible is available, symphysial height and mandibular bigonial breadth could be used to determine the gender with high accuracy.