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The effect of nigella sativa on biomarkers of inflammation and oxidative stress: A systematic review and meta-analysis of randomized controlled trials
Get PDFInflammation and oxidative stress are involved in the pathogenesis of a myriad of chronic disorders. This systematic review and meta-analysis was designed to determine the effects of Nigella Sativa (NS) seed and seed oil consumption on several biomarkers of inflammation and oxidative stress. The Scopus, Web of Science, and PubMed-MEDLINE databases were systematically searched until August 2019. The quality assessment and heterogeneity of the selected randomized clinical trials (RCTs) were measured using the Jadad checklist, and Q and I2 tests, respectively. Finally, a total of 10 clinical RCTs were found to be eligible for this meta-analysis. The pooled findings showed that NS consumption significantly reduced serum high-sensitivity C-reactive protein (hs-CRP; WMD: �0.67, 95 CI: �1.29, �0.05, I2 = 95.7), tumor necrosis factor-alpha (TNF-α; WMD: �2.29, 95 CI: �4.48, �0.11, I2 = 93), and malondialdehyde (MDA; WMD: �1.18, 95 CI: �2.24, �0.12, I2 = 85.4), and significantly increased total antioxidant capacity (TAC; WMD: 0.35, 95 CI: 0.10, 0.59, I2 = 77.1), and superoxide dismutase (SOD; WMD: 66.30, 95 CI: 1.03, 131.57, I2 = 99.4) levels. Overall, the results of this systematic review and meta-analysis imply that NS consumption may decrease inflammatory response and oxidative stress markers. Practical applications: Overall, the evidence supports the consumption of NS to reduce hs-CRP, TNF-α, and MDA, and to increase SOD and TAC levels. In addition, the subgroup analyses findings concluded that lower dosages of NS, longer durations of the intervention, and the use of NS seed oil may result in more effective action on inflammatory markers, but because of the limited number of trials, the results must be analyzed with caution, especially for the subgroup analysis. However, further prospective studies regarding the effect of NS consumption on biomarkers of inflammation and oxidative stress, with larger sample sizes, from various countries and longer follow-up periods, are required to confirm whether NS possesses veritable anti-inflammatory and antioxidant effects. © 2021 Wiley Periodicals LLC
Diabetes, hypertension, and incidence of chronic kidney disease: Is there any multiplicative or additive interaction?
Get PDFBackground: The burden of chronic kidney disease (CKD) is on the rise worldwide; diabetes and hypertension are mentioned as the main contributors. Objectives: The current study aimed to investigate the multiplicative and additive interaction of diabetes and hypertension in the incidence of CKD. Methods: In this population-based cohort study, 7342 subjects aged 20 years or above (46.8 male) were divided into four groups: no diabetes and hypertension; diabetes and no hypertension; no diabetes but suffer from hypertension; and both diabetes and hypertension. The multivariable Cox regression was used to determine the effect of diabetes, hypertension, and their multiplicative interaction on CKD. The following indices were used to determine the additive interaction of diabetes and hypertension: the relative excess risk of interaction, the attributable proportion due to interaction, and the synergism index. Results: Diabetes and hypertension had no significant multiplicative interaction in men (hazard ratio of 0.93, P value: 0.764) and women (hazard ratio of 0.79, P value: 0.198); furthermore, no additive interaction was found in men (Relative Excess Risk due to Interaction of 0.79, P value: 0.199; Attributable Proportion due to Interaction of 0.22, P value: 0.130; Synergy index of 1.44, P value: 0.183) and women (Relative Excess Risk due to Interaction of -0.26, P value: 0.233, Attributable Proportion due to Interaction of -0.21, P value: 0.266; Synergy index of 0.48, P value: 0.254). Conclusions: This study demonstrated no synergic effect between diabetes and hypertension on the incidence of CKD. Copyright © 2020, International Journal of Endocrinology and Metabolism. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited
The Impact of the COVID-19 Pandemic on Surgical Management of Breast Cancer: Global Trends and Future Perspectives
Get PDFIntroduction: The rapid spread of COVID-19 across the globe is forcing surgical oncologists to change their daily practice. We sought to evaluate how breast surgeons are adapting their surgical activity to limit viral spread and spare hospital resources. Methods: A panel of 12 breast surgeons from the most affected regions of the world convened a virtual meeting on April 7, 2020, to discuss the changes in their local surgical practice during the COVID-19 pandemic. Similarly, a Web-based poll based was created to evaluate changes in surgical practice among breast surgeons from several countries. Results: The virtual meeting showed that distinct countries and regions were experiencing different phases of the pandemic. Surgical priority was given to patients with aggressive disease not candidate for primary systemic therapy, those with progressive disease under neoadjuvant systemic therapy, and patients who have finished neoadjuvant therapy. One hundred breast surgeons filled out the poll. The trend showed reductions in operating room schedules, indications for surgery, and consultations, with an increasingly restrictive approach to elective surgery with worsening of the pandemic. Conclusion: The COVID-19 emergency should not compromise treatment of a potentially lethal disease such as breast cancer. Our results reveal that physicians are instinctively reluctant to abandon conventional standards of care when possible. However, as the situation deteriorates, alternative strategies of de-escalation are being adopted. Implications for Practice: This study aimed to characterize how the COVID-19 pandemic is affecting breast cancer surgery and which strategies are being adopted to cope with the situation. © 2020 AlphaMed Pres
SARS-CoV-2 antibody seroprevalence in the general population and high-risk occupational groups across 18 cities in Iran: a population-based cross-sectional study
Get PDFBackground: Rapid increases in cases of COVID-19 were observed in multiple cities in Iran towards the start of the pandemic. However, the true infection rate remains unknown. We aimed to assess the seroprevalence of antibodies against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in 18 cities of Iran as an indicator of the infection rate. Methods: In this population-based cross-sectional study, we randomly selected and invited study participants from the general population (from lists of people registered with the Iranian electronic health record system or health-care centres) and a high-risk population of individuals likely to have close social contact with SARS-CoV-2-infected individuals through their occupation (from employee lists provided by relevant agencies or companies, such as supermarket chains) across 18 cities in 17 Iranian provinces. Participants were asked questions on their demographic characteristics, medical history, recent COVID-19-related symptoms, and COVID-19-related exposures. Iran Food and Drug Administration-approved Pishtaz Teb SARS-CoV-2 ELISA kits were used to detect SARS-CoV-2-specific IgG and IgM antibodies in blood samples from participants. Seroprevalence was estimated on the basis of ELISA test results and adjusted for population weighting (by age, sex, and city population size) and test performance (according to our independent validation of sensitivity and specificity). Findings: From 9181 individuals who were initially contacted between April 17 and June 2, 2020, 243 individuals refused to provide blood samples and 36 did not provide demographic information and were excluded from the analysis. Among the 8902 individuals included in the analysis, 5372 had occupations with a high risk of exposure to SARS-CoV-2 and 3530 were recruited from the general population. The overall population weight-adjusted and test performance-adjusted prevalence of antibody seropositivity in the general population was 17·1 (95 CI 14·6�19·5), implying that 4 265 542 (95 CI 3 659 043�4 887 078) individuals from the 18 cities included were infected by the end of April, 2020. The adjusted seroprevalence of SARS-CoV-2-specific antibodies varied greatly by city, with the highest estimates found in Rasht (72·6 53·9�92·8) and Qom (58·5% 37·2�83·9). The overall population weight-adjusted and test performance-adjusted seroprevalence in the high-risk population was 20·0% (18·5�21·7) and showed little variation between the occupations included. Interpretations: Seroprevalence is likely to be much higher than the reported prevalence of COVID-19 based on confirmed COVID-19 cases in Iran. Despite high seroprevalence in a few cities, a large proportion of the population is still uninfected. The potential shortcomings of current public health policies should therefore be identified to prevent future epidemic waves in Iran. Funding: Iranian Ministry of Health and Medical Education. © 2020 Elsevier Lt
Investigating the relationship between organizational justice, job satisfaction, and intention to leave the nursing profession: A cross-sectional study
No full textAims: This study aims to test a hypothetical model linking various dimensions of organizational justice to the job satisfaction and nurses' intention to leave the profession based on the theoretical assumptions of the Alexander model of voluntary turnover. Design: A cross-sectional survey. Methods: This study was conducted on 317 inpatient ward nurses of six teaching hospitals in Tehran, Iran during 1 September 2017�14 November 2018. Clinical nurses were recruited by a multistage random sampling. Data were collected using structured questionnaires of organizational justice, job satisfaction, and nurses' intention to leave. Data were analysed by structural equation modelling using Amos 22 statistical program. Results: The structural equation model demonstrated adequate fit and the hypothesized correlations were partially supported. The findings suggested that the distributive justice (p <.001; β = 0.24) and interactional justice (p <.001; β = 0.44) could indirectly affect the nurses' intention to leave the nursing profession via the direct impact on job satisfaction, while job satisfaction had a significant, negative effect on the nurses' intention to leave (p <.001; β = �0.71). Conclusions: According to the results, the model fit was acceptable, suggesting the validity of the final model. Furthermore, distributive and interactional justice could reduce the intention to leave the nursing profession by influencing the job satisfaction of the clinical nurses. Impact: This was one of the first studies to determine the aspects of justice that must be further emphasized by healthcare managers to increase the job satisfaction of nurses and their retention in healthcare systems. The findings indicated that fair interactions have a greater impact on job satisfaction and retention of nurses than procedural and distributive justice. The results of this study provide valuable references for nursing managers to increase the job satisfaction of nurses and their retention in healthcare settings. © 2020 John Wiley & Sons Lt
Distribution of invasive fungal infections: Molecular epidemiology, etiology, clinical conditions, diagnosis and risk factors: A 3-year experience with 490 patients under intensive care
No full textRecently, the prevalence of invasive fungal infections (IFIs) is rising. The global mortality rate of IFIs is 10�49. This study aimed to determine the prevalence, the causative agents, and the risk factors associated with the invasive fungal infections in a tertiary health center to provide valid decision-grounds for healthcare professionals to effectively prevent, control, and treat fungal infections. The current study was conducted on 1477 patients suspected to have systemic fungal infections from different units of the hospital. After screening using routine mycological examination, the patients were confirmed with complementary mycological and molecular methods. Patients were included based on the confirmed diagnosis of IFI and excluded based on lack of a microbiologically and histologically proven diagnosis of IFI. Of the 1477 patients recruited in this study, confirmed cases of fungal infection were 490 (169 proven; 321 cases probable). Among the fungi recovered, Candida species had the highest frequency 337 (68.8) followed by Aspergillus species 108 (22.1), Zygomycetes species 21 (4.3), non-Candida yeast 9 (1.8). Others were black fungi 5 (1), mycetoma agents 5 (1), Fusarium 4 (0.8), and Trichoderma (0.2). Hematologic malignancies and diabetes mellitus were the most common underlying diseases among IFI-confirmed patients. This study observed an increased frequency of invasive candidiasis with non-albicans Candida and other invasive saprophytic fungal infections. The increased rate of invasive candidiasis with non-albicans agents highlights a new perspective in the epidemiology and treatment of invasive fungal infections. © 2020 Elsevier Lt
Intraoperative radiation therapy or external whole-breast irradiation, which is more effective in controlling the local recurrence of breast cancer? A Weibull regression model
No full textHealthcare providers experience of working during the COVID-19 pandemic: A qualitative study
Get PDFBackground: The COVID-19 pandemic has had a far-reaching negative impact on healthcare systems worldwide and has placed healthcare providers under immense physiological and psychological pressures. Objective: The aim of current study was to undertake an in-depth exploration of the experiences of health-care staff working during the COVID-19 crisis. Methods: Using a thematic analysis approach, a qualitative study was conducted using semi-structured interviews with 97 health care professionals. Participants were health care professionals including pre-hospital emergency services (EMS), physicians, nurses, pharmacists, laboratory personnel, radiology technicians, hospital managers and managers in the ministry of health who work directly or indirectly with COVID-19 cases. Results: Data analysis highlighted four main themes, namely: �Working in the pandemic era�, �Changes in personal life and enhanced negative affect�, �Gaining experience, normalization and adaptation to the pandemic� and �Mental Health Considerations� which indicated that mental ill deteriorations unfolded through a stage-wise process as the pandemic unfolded. Conclusions: Participants experienced a wide range of emotions and development during the unfolding of the pandemic. Providing mental health aid should thus be an essential part of services for healthcare providers during the pandemic. Based on our results the aid should be focused on the various stages and should be individual-centred. Such interventions are crucial to sustain workers in their ability to cope throughout the duration of the pandemic. © 2020 Association for Professionals in Infection Control and Epidemiology, Inc
Nanomaterials modulating stem cell behavior towards cardiovascular cell lineage
No full textThe cardiovascular system is one of the most complex and indispensable systems in the body and is responsible for the circulation of nutrition, oxygen, carbon dioxide, hormones to other parts of the body. Injuries and scar formation in various parts of the cardiovascular system could be overwhelming due to the limited regenerative ability of cardiomyocytes. Furthermore, surgeries for cardiovascular complications have major risks, and the shortage of organs is inevitable. However, cardiovascular tissue engineering is promising since it can promote cardiovascular regeneration. Although tissue engineering and regenerative medicine could offer solutions to overcoming these challenges, interactions between nanomaterials and stem cells are not fully understood. Therefore, controlling the behavior of stem cells is challenging due to the limited knowledge in this area. In this review, we discuss various nanomaterials that have recently been utilized in cardiovascular tissue engineering. We also highlight the effects of these nanomaterials on stem cell behavior, with specific emphasis on proliferation and differentiation. It is expected that a better understanding of the interactions of stem cells and nanomaterials would facilitate the design of nanomaterials for regenerative medicine and cardiovascular tissue engineering applications. © The Royal Society of Chemistry
How much should we pay to deliver comprehensive mental and social health services? Experiences from Iran
Get PDFObjective: Comprehensive mental and social health services is the new benefit package which had been aimed to provide mental health services to people who suffer from mental disorders. The aim of this study was to estimate the cost of plan and its drivers to provide evidence for decision-making by national policymakers. Method: We used the bottom-up costing approach to estimate the cost of plan. We identified the cost centers, services delivery process, and facilities. Data were collected via different sources and tools such as the new financial system, registration forms, and performance reporting forms. We categorized the cost into 4 groups and selected appropriate measures to estimate the cost. We estimate the total and unit cost for 3 levels in 2 scenarios by considering the 2017 prices. Results: Screening resulted in 8.9 new detection with a different incidence in urban and rural areas (urban: 16.5; rural: 2.7). Also, 61 842 million IRR was spent for the screening, diagnose, treatment, and rehabilitation of detected people in 2017. Personal cost is responsible for 90.6 and primary screening for 66.4 of the total cost. Conclusion: For the development of the program (from screening to rehabilitation) 530 513 IRR should be spent per capita. The cost of detection per client can vary due to differences in disease prevalence, especially treatment and rehabilitation costs. It is suggested to consider the variation of the prevalence in expanding the plan to the whole country. Integrating the services in primary health care lead to huge cost saving. Copyright © 2021 Tehran University of Medical Sciences