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A Systematic Review and Meta-analysis of Randomized Controlled Trials on the Effect of Transcranial Magnetic Stimulation on Tinnitus Management
Get PDFIntroduction: Tinnitus occurs in 10-15% of the world’s population. It may lead to hearing loss, depression, and suicidal tendencies, as well as reduced quality of life. The aim of this study was to assess whether Transcranial Magnetic Stimulation (TMS) effectively reduces tinnitus handicapping after six months or more of follow-up.Methods: A systematic review of randomized controlled trials with follow-up of six months was undertaken. The review took place through searching Medline, Science Direct, and Google Scholar databases using the keywords “tinnitus” and “Transcranial Magnetic Stimulation” and limiting the search results to randomized controlled trials (RCTs) conducted on adults (19 years and older) published between 2005-2015. Meta-analysis was performed on the similarly designed studies.Results: Five RCTs with six month follow-up were found conforming to the inclusion criteria. In total, there were 119 patients in the TMS arms and 115 in the placebo arms. However, designs were different between the studies and were therefore not all comparable. Different parameters were used to measure the severity of tinnitus and depression scores. Tinnitus handicapped inventory (THI) was the common measured outcome parameter used in all studies. THI score decreased after the TMS in four studies. Meta-analysis was performed on three similarly designed RCTs with the overall effect being insignificant.Conclusion: TMS reduced the THI score and decreased the severity of tinnitus in 45% of patients and lead to a complete recovery in 32% of cases in one study. However, the meta-analysis demonstrated lack of significant effect of TMS on tinnitus management
Patterns of Physical Activity and Self-rated Health Among Adult Populations in South Asia
Get PDFIntroduction: Although South Asians are considered to be at high risk for cardiovascular diseases, research evidence on the health impacts of physical activity (PA) remains very limited. In this study we aimed to explore the patterns of PA and to investigate whether engaging in regular PA is associated with better Self-Rated Health (SRH) among South Asians.Methods: Cross-sectional data on population health were drawn from the World Health Survey of WHO. Subjects were 28,020 male and female South Asians (from Bangladesh, India, Nepal, and Sri Lanka) aged 18 years and above. Data were analysed using descriptive and multivariable logistic regression analyses.Results: The proportion of the sample population reported good SRH was 44.3%, 58.7%, 37.7%, and 73.7% in Bangladeshis, Indians, Nepalese, and Sri Lankans, respectively. Regular engagement in moderate PA was highest in Nepal (69.7%) and lowest in Bangladesh (37.4%). Vigorous PA was highest in India (29.9%) and lowest in Bangladesh (17.9%). In Bangladesh, compared to those never engaged in MPA, those who engaged for 1-2, 3-4, 5-6, or 7 days a week were 30% [AOR=1.306; 95%CI 1.085-1.572], 33% [AOR=1.326; 95%CI 1.093-1.609], 39% [AOR=1.389; 95%CI 1.125-1.716], and 46% [AOR=1.459; 95%CI 1.249-1.705] more likely to report being in good health, respectively.Conclusions: We found that self-reported engagement in physical activities varies in South Asian countries. Since engaging in PA may help improve subjective and objective health status, health policy makers need to focus on designing exercise-friendly neighbourhoods in an attempt to promote population health
Family Planning in the Republic of Tajikistan: A narrative review from Soviet times to 2017
Get PDFIntroduction: Tajikistan’s dramatic shift from a high to a low fertility society has taken place over a little more than two decades. While some fertility beliefs remained the same throughout the rapid economic and political transitions of Tajikistan, other beliefs may have changed to respond to the financial realities of the newly independent and Central Asian republic, such as having fewer children. The objective of this review was to describe and analyze the state of family planning in the Republic of Tajikistan from Soviet period (1929-1991) until 2017.Methods: The review is based on materials obtained from various sources including Google Scholar and PubMed, relevant to family planning in Tajikistan, including government policies, open-access nationally representative data, journal articles, and program reports, identified through a selective search of Google Scholar and PubMed databases, and the grey literature. Conclusion: This narrative review presents the history of family planning in Tajikistan, outlines an understanding of the health system context as it relates to family planning, and analyzes the latest national family planning policy (2017). The authors suggest further research is required to (a) understand the beliefs and practices related to family planning; and (b) define strategies to address the issue of unmet need of family planning services.
Uptake of HIV testing among women of reproductive age in Tajikistan: An assessment of individual determinants
Get PDFIntroduction: Over the past decade, the incidence of human immunodeficiency virus (HIV) infections in Tajikistan increased significantly, with women particularly vulnerable to acquiring HIV. This research assessed individual determinants associated with HIV testing among women of reproductive age.Methods: Secondary data analysis was done using data from 5,867 females aged 15–49 years. Chi-square test, t-test, and multivariate analysis were applied to find associations between women\u27s socio-demographic characteristics, reproductive health variables, and HIV testing uptake.Results: Overall, only 26% (1,501) of women in the present research reported HIV testing in the past. Multiple regression indicated that HIV testing was significantly associated with participants\u27 age (25–34 age group: OR 0.7, p ? 0.001; 35–49 age group: OR 0.2, p ? 0.001), education (OR 2.2, p ? 0.001), area of residence (OR 0.6, p ? 0.001), marital status (OR 2.4, p ? 0.001), HIV knowledge (OR 1.1, p ? 0.001), and pregnancy history (OR 6.7, p ? 0.001).Conclusion: Results of this research suggest that there is a need for culturally acceptable interventions, including outreach to increase the overall HIV testing rate among women in Tajikistan
PrEP in India’s HIV Prevention Policy in the Era of Social Media and Sex Positivity
Get PDFIntroduction: The global revolution of online social media and connectivity had a tremendous effect on sexual behavior in both developed and developing countries. This global change is influencing the societal structure and existing social principles. Moreover, it has a significant impact on the epidemiology of different infectious diseases, especially HIV.Discussion: India is one of the most diverse democratic countries that has undergone a social-cultural transition in the last decade. However, having the second-highest HIV infection rate in the world, India does not have any other new prevention tools in their national HIV prevention strategy. Pre-Exposure Prophylaxis (PrEP), a boon of HIV prevention widely used in different countries, is still not implemented in India. The concept of “Digital India” by the Government of India is giving wide access of internet to the people of India. Furthermore, people are exposed to social media, and that is impacting their sex seeking behavior. Interestingly, recent legal changes in India promotes sex positivity. It also calls for introspection on existing HIV preventive strategies.Conclusion: Given the current scenario of PrEP and other existing preventive measurements of HIV, further research is needed to determine the acceptance and efficacy of PrEP and improve engagement in care for individuals in India. Various international studies recommend effective implication of PrEP to reduce the rate and economic burden of HIV infection
Factors Influencing Salt-Reducing Behavior in Young Adults: a Pilot Cross-Sectional Study from Kazakhstan
Get PDFIntroduction: In Kazakhstan, a post-Soviet country in Central Asia, salt intake is estimated as high, potentially contributing to the morbidity and mortality from cardiovascular diseases. The aim of this study was to explore salt intake in residents of the capital of Kazakhstan, Nur-Sultan.Methods: An online cross-sectional survey of knowledge, attitudes, and behaviors on salt intake among young adult residents of the capital city of Kazakhstan was conducted (n = 237). Bivariate and multivariate linear regression analyses were performed.Results: Although 95% (n=225) reported knowledge on the adverse health effects of high salt intake, older respondents were more aware of its association with high blood pressure (p = 0.007), heart disease (p = 0.037), and heart attack (p = 0.002). Only one-third (n=79) correctly identified the recommended level of daily salt intake. Females reported more awareness of Kazakhstani people consuming salt more than recommended (p = 0.0027) and that processed products constituted the major source of salt in diet (p = 0.007). General dietary concern (p < 0.001), high self-assessment of salt intake (p < 0.001), and older age (p = 0.012) were found to be adjusted predictors of salt-reducing behavior.Conclusion: Lack of reported knowledge on salt-health relationship is of concern, especially among young males. A greater dietary concern and individual awareness of the excessive salt consumption is likely to assist in reducing salt intake. Further studies are required to validate the findings of this pilot study on a bigger population level in order to provide a basis for future salt related interventions and policy changes in Kazakhstan
A Systematic Review of the Effects of Aromatherapy with Lavender Essential Oil on Depression
Get PDFIntroduction: Depression is considered as one of the most serious health issues worldwide, and the search for the most effective and safe treatments for depression is essential. Aromatherapy with lavender have attracted the attention of many researchers due to their low cost and ease of use, so this study was conducted to review of the effects of aromatherapy with lavender essential oil on depression.Methods: This systematic review study was conducted by searching the databases (SID, Magiran, Google-Scholar, Medline via PubMed, Scopus, and Web of Science) by using the keywords such as depression, Lavandula, Lavender, and Aromatherapy, as well as applying OR and AND operators to the end of January 1, 2020 A.D. The inclusion criteria were: 1) Interventional studies that determined keywords were in the title or keywords of the article, 2) aromatherapy was conducted through inhalation or massage, 3) the full text of paper was accessible, and 4) published in English or Persian. Finally, the information obtained from articles was extracted using a checklist.Results: Out of 278 studies, 9 studies were included to the systematic review process after screening and eliminating duplicate papers according to the purpose of the study. Aromatherapy with lavender essential oil was conducted on the patients suffering from migraine, patients with the acute coronary syndrome, patients undergoing hemodialysis, community-dwelling older adult, and postpartum depression. The results obtained from some studies showed the positive effect of aromatherapy with lavender essential oil on depression whereas some studies did not report the effect of aromatherapy with lavender on depression significantly.Conclusion: It seems that aromatherapy with lavender probably can be used as a complementary, simple, and inexpensive method to improve mild and moderate depression. It is recommended to earmark using a collaborative approach and make use of interdisciplinary and psychology specialists as well as complementary medicine in applying aromatherapy with lavender essential oil
Recommendations for Mental Health Reforms in Uzbekistan: A Policy Report
Get PDFIntroduction: There are large differences in the development of mental health systems of the West and the countries of the former Eastern Bloc. The latter is characterized by a more biological approach to mental health and reliance on psychiatric hospitals. In 2018, Uzbekistan authorities showed interest in reforming mental health care of the country. The policy report provides an overview of progress towards the provision of community mental health (CMH) care across Eastern Europe and recommendations for this transition within Uzbekistan.Methods: A literature search on mental health care in Uzbekistan was conducted to understand its strengths and weaknesses. Progress towards the provision of CMH care across Eastern Europe was assessed using data on the number of psychiatric beds and availability of mental health services in community settings reported within the published literature. Countries identified as making the greatest progress towards CMH care were reviewed in detail to better understand the process of reform assets and barriers.Results: Mental health care in Uzbekistan is highly institutionalized, underfunded and understaffed. Social care services are poorly developed. However, current leadership has kindled the promise of mental health reform. Georgia, Lithuania and Poland have made the most progress in terms of CMH care availability. However, due to various obstacles such as dual financial burden, high stigma and lack of political will, their programs lack social integration and/or uniform availability and underfunding along with scarcity of mental health specialists are common. On the other hand, research and evaluation, involvement of service users into service planning and cooperation with donors facilitated reform implementation.Conclusion: Uzbekistan may develop into a modern mental health system and avoid the setbacks encountered by other countries in the region, through careful financial planning, stigma reduction, improving mental health literacy, human resources strategic development and civil society engagement
Erratum to: A Systematic Review of the Effects of Aromatherapy with Lavender Essential Oil on Depression
Get PDFThe editors of the Central Asian Journal of Global Health regretfully published the article “A Systematic Review of the Effects of Aromatherapy with Lavender Essential Oil on Depression” with a misspelled word in the title. This mistake has been corrected. The original article has been updated to reflect this change.Jafar-Koulaee A, Elyasi F, Taraghi Z, Ilali ES, Moosazadeh M. A systematic review of the effects of aromatherapy with lavender essential oil on depression. Cent Asian J Glob Health. 2020;9(1) doi:10.5195/cajgh.2020.442
Self-blame Attributions of Patients: a Systematic Review Study
Get PDFIntroduction: Psychological aspects are important issues in patients that will have significant effects on disease progression. A new and important psychological concern is self-blame. This review was performed with the aim of systematic review on studies around patient’s self-blame.Methods: This is a systematic review using international databases including PubMed (since 1950), Scopus (since 2004), Web of Sciences (since 1900), and ProQuest (since 1938) and Iranian databases including SID (since 2004) and Magiran (since 2001). Mesh terms including “patient,” “regret,” and “guilt” and non-Mesh terms including “self-blame attribution,” “characterological self-blame,” “behavioral self-blame,” and “blame” were used in Iranian and international databases with OR and AND operators.Results: The review yielded 59 articles; 15 articles were included in the present study. The ages of patients ranged from 29-68.4 years. Most of studies (86.6%) had cross-sectional design and use characterological self-blame and behavioral self-blame variables for assessing self-blame attributions. The results showed that in most studies, a significant relationship among self-blame and psychological distress, anxiety, and depression were reported.Conclusion: A significant relation was reported between self-blaming and the degree of distress, anxiety, and depression in patients in most of the studies