Assessing the quality of meta-analyses in systematic reviews in pharmaceutical research in Iran by 2016: A systematic review

© Iran University of Medical Sciences. Background: Meta-analyses, like all other studies, may be poorly designed and implemented. This study was designed to determine the quality of meta-analyses in systematic reviews in the field of pharmaceutical research in Iran. Methods: Web of Science Core Collection, EMBASE, Ovid Medline, CINAHL, Scopus, and PubMed were systematically searched on June 4, 2017. The search was limited to the researches in the field of pharmaceutical studies. Based on inclusion criteria, 104 systematic reviews with meta-analysis (SRMA) were selected and assessed using quality assessment tools introduced by Higgins. Results: Participants, experimental interventions, and outcomes were reported in all the articles. Comparator intervention and study design were correctly reported in 103 (99.04%) and 101 (97.12%) articles, respectively. The comprehensive search strategy was available only in 48 articles (46.16%), and there was no evidence of a comprehensive search in 56 articles (53.84%). Risk of bias was investigated in 78 articles (75%). Also, funnel plots were the most commonly used method for reporting the bias in 64 articles (46.42%). Conclusion: In many of the meta-analyses, several items of the tool that represented a high-quality meta-analysis were absent. According to the findings, the comprehensive search and quality assessment were not at an appropriate level. Thus, the importance of reproducibility of information and quality assessment of included studies should be emphasized

Association between intoxication with psychoactive substances and adverse effects occurrence in consumers

BackgroundThe prevalence of psychoactive substance use is increasing worldwide and identifying adverse effects of these types of drugs is necessary in intoxicated patients.ObjectiveWe aimed to investigate the association of psychoactive substance intoxication with their adverse effects on the functioning of the bodily organs.MethodsThis was a single-center study between March 2019 and April 2022 on intoxicated patients with psychoactive substances. Inclusion criteria were intoxication with alcohol, opioids, and stimulants, and having available results of laboratory biomarkers. Demographic and clinical data of patients at the time of admission as well as during hospitalization were reviewed, retrospectively. Data were analyzed using a generalized linear mixed model in R software and the Adjusted Odds Ratio (AOR) was estimated.ResultsA total of 800 hospitalized patients in the ICU (n = 400) and general ward (n = 400) were divided into two groups of intoxicated with alcohol (n = 200) and opioids or stimulants (n = 200). Liver (AOR = 0.15, p = 0.033; AOR = 0.13, p = 0.007) and kidney (AOR = 0.46, p = 0.004; AOR = 0.24, p = 0.021) dysfunction occurred less in the ICU and general ward, respectively, in opioids or stimulants intoxication compared to alcohol. Cardiovascular dysfunctions occurred more in opioids or stimulants intoxication compared to alcohol in both ICU (AOR = 10.32, p < 0.0001) and general ward (AOR = 4.74, p < 0.0001).ConclusionKidney dysfunctions had a greater effect on mortality compared to other dysfunctions. During the follow-up, the incidence of dysfunctions increased in those intoxicated with opioids or stimulants. Men experienced more liver and kidney dysfunctions as well as mortality, but psychoactive substance experience was a protective factor in cardiovascular dysfunctions and mortality

Comparison of Ultrasound-Guided Local Dexmedetomidine Injection vs. Corticosteroid Injection in the Treatment of Chronic Plantar Fasciitis: A Randomized Clinical Trial

Background: Heel pain is commonly caused by chronic plantar fasciitis, associated with pain and activity limitation in patients. Although steroid injection is a popular method to treat this disease, it has side effects and provides short-term pain relief. The study was designed to investigate the effects of dexmedetomidine and corticosteroid injection in treating chronic plantar fasciitis. Materials and Methods: A total of 70 participants were divided into two groups. The intervention group received a mixture of dexmedetomidine (1μg/kg) with 1 ml of lidocaine 2%. The control group received a combination of 1ml of corticosteroid (40mg triamcinolone) with 1ml of lidocaine 2%. Outcome measures were evaluated with Numerical Rating Scale (NRS) and Maryland foot score (MFS) before, one, and three months after the intervention. Results: Significant improvements in NRS and MFS were observed in both groups at 1 and 3 months of follow-up compared to baseline(P<0.001). NRS score improvement in the first month was more significant in the corticosteroid group compared to the dexmedetomidine group. However, after three months, the dexmedetomidine group experienced greater pain reduction (P=0.012) and higher functional ability (P<0.001) than the corticosteroid group. Conclusion: Local injection of dexmedetomidine provided significant and long-term effects on pain severity and physical activity. Corticosteroids caused an immediate but short‑term effect, whereas sustained improvement in the dexmedetomidine group was observed during the follow-up

Early Effects of Hypertonic Dextrose versus Corticosteroid on Pain and Activity, in Knee Osteoarthritis; A Randomized Clinical Trial

Background: Knee osteoarthritis is highly prevalent and causes debilitating pain, progressive movement limitation, and significant socio-economic costs. Intra-articular corticosteroids are widely used to control it, but only short-term effects have been proven for them. Also, they have shown many local and systemic side effects, including cartilage destruction and infection susceptibility. Knee prolotherapy in various forms of hypertonic dextrose injection has shown significant restorative effects, long-lasting pain and activity improvement, negligible side effects, and low cost. The objective is to compare the early effectiveness of intra-articular dextrose with corticosteroids regarding pain and activity changes in knee osteoarthritis. Materials and Methods: In this short-term blinded randomized clinical trial, 70 participants (knees) with primary osteoarthritis grade II or more were divided (1=1) into two random groups that received a single injection of triamcinolone 40 mg or hypertonic dextrose 20% five cc. Visual analog score (VAS) for pain and the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) score for activity were assessed before, one week after, and one month after injection. The data was analyzed using independent t-test, chi-square, Fisher's exact tests, Repeated measure test, and the linear mixed model regression. Results: The rest and activity VAS score and WOMAC score were reduced in both groups one week and one month after injection, and the difference between the two groups was non-significant for the VAS score but significant for the WOMAC score in favor of the dextrose group. Conclusion: The early analgesic and activity-improvement effects after hypertonic dextrose injection in the arthritic knee are significant and comparable to corticosteroids

Traumatic injuries in pregnant women: a case of motor vehicle accident for “Ground Round” discussion

The main objective for introducing this case study is to create a platform from which the importance of road traffic related injuries and traumas can be emphasized and discussed within and across various fields of investigation. The long term goal is to entice public campaign around unmet needs for higher road safety measures to reduce primary, secondary, and tertiary risks of injuries and traumas

Comparison of Ultrasound-Guided Local Dexmedetomidine Injection vs. Corticosteroid Injection in the Treatment of Chronic Plantar Fasciitis: A Randomized Clinical Trial

Background: Heel pain is commonly caused by chronic plantar fasciitis, associated with pain and activity limitation in patients. Although steroid injection is a popular method to treat this disease, it has side effects and provides short-term pain relief. The study was designed to investigate the effects of dexmedetomidine and corticosteroid injection in treating chronic plantar fasciitis. Materials and Methods: A total of 70 participants were divided into two groups. The intervention group received a mixture of dexmedetomidine (1μg/kg) with 1 ml of lidocaine 2%. The control group received a combination of 1ml of corticosteroid (40mg triamcinolone) with 1ml of lidocaine 2%. Outcome measures were evaluated with Numerical Rating Scale (NRS) and Maryland foot score (MFS) before, one, and three months after the intervention. Results: Significant improvements in NRS and MFS were observed in both groups at 1 and 3 months of follow-up compared to baseline(P<0.001). NRS score improvement in the first month was more significant in the corticosteroid group compared to the dexmedetomidine group. However, after three months, the dexmedetomidine group experienced greater pain reduction (P=0.012) and higher functional ability (P<0.001) than the corticosteroid group. Conclusion: Local injection of dexmedetomidine provided significant and long-term effects on pain severity and physical activity. Corticosteroids caused an immediate but short‑term effect, whereas sustained improvement in the dexmedetomidine group was observed during the follow-up

Description of Epidemiological Features, Symptoms and Mortality of the Patients with COVID-19 in Some Provinces of Iran

Background: Clinical manifestations of COVID-19 are different. There are some risk factors for COVID-19. This study aimed to describe the epidemiological features, symptoms and mortality of the patients with COVID-19 in Iran. Methods: This were a cohort study performed on 103,179 patients with COVID-19. The demographic and clinical data were collected in selected provinces. The required data of all patients was extracted from the COVID registry system and analyzed using STATA version 14 and Excel 2016. Results: The mean age was 52.40 years for men and 52.41 years for women. About 55.2% of the study population were male and 44.8% were female. Totally, 60.9% (5085) of deaths happened in men and 39.1% (3263) in women. The mean time from onset of symptoms to hospitalization in men and women were 3.47 and 3.48 days, respectively. The mean time from onset of symptoms to isolation was 2.81 days in men and was 2.87 days in women, from onset of symptoms to death was 9.29 and 9.54 days, respectively, from onset of symptoms to discharge was 7.47 and 7.39 days, and from hospitalization to death was 6.76 and 7.05 days. Cough and shortness of breath were the most common symptoms in the patients. Conclusion: According to the results, the overall mortality rate was higher in men than women. Women with cardiovascular disease and diabetes were more likely to die. The mean time from onset of symptoms to hospitalization, isolation, and discharge was similar in men and women

Quality assessment of papers published in Iranian medical journals [Letter to the Editor]

Quality assessment of papers published in Iranian medical journal

How to Select a Journal to Submit and Publish Your Biomedical Paper?

Introduction: selection of journal for publication purpose is one of concerns of biomedical researchers. They apply various criteria to choose appropriate journal. Here, we have tried to collect main criteria biomedical researchers use to select a journal to submit their work. Methods: we collected these criteria through focus group conversations with researchers during our careers, feedbacks from participants of our scientific writing workshops and non-systematic reviewing of some related literature. Results: we have presented a summative and informative guidance in selection of biomedical journals for biomedical paper submission and publication. Conclusion: Categorized criteria as a mnemonic tool for authors may help the authors in journal selection process

Early Effects of Hypertonic Dextrose versus Corticosteroid on Pain and Activity, in Knee Osteoarthritis; A Randomized Clinical Trial: A randomized clinical trial

Background: Knee osteoarthritis is highly prevalent and causes debilitating pain, progressive movement limitation, and significant socio-economic costs. Intra-articular corticosteroids are widely used to control it, but only short-term effects have been proven for them. Also, they have shown many local and systemic side effects, including cartilage destruction and infection susceptibility. Knee prolotherapy in various forms of hypertonic dextrose injection has shown significant restorative effects, long-lasting pain and activity improvement, negligible side effects, and low cost. The objective is to compare the early effectiveness of intra-articular dextrose with corticosteroids regarding pain and activity changes in knee osteoarthritis.Materials and Methods: In this short-term blinded randomized clinical trial, 70 participants (knees) with primary osteoarthritis grade II or more were divided (1=1) into two random groups that received a single injection of triamcinolone 40 mg or hypertonic dextrose 20% five cc. Visual analog score (VAS) for pain and the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) score for activity were assessed before, one week after, and one month after injection. The data was analyzed using independent t-test, chi-square, Fisher's exact tests, Repeated measure test, and the linear mixed model regression.Results: The rest and activity VAS score and WOMAC score were reduced in both groups one week and one month after injection, and the difference between the two groups was non-significant for the VAS score but significant for the WOMAC score in favor of the dextrose group.Conclusion: The early analgesic and activity-improvement effects after hypertonic dextrose injection in the arthritic knee are significant and comparable to corticosteroids