Prevalence, Incidence and Ecological Determinants of Diabetic Retinopathy in Iran: Systematic Review and Meta-analysis

Purpose: To estimate the pooled prevalence and incidence of diabetic retinopathy (DR) in Iran and to investigate their correlations with the Human Development Index (HDI), healthcare access (i.e., density of specialists and sub-specialists), and methodological issues. Methods: Electronic databases such as PubMed, Embase, Scopus, Web of Science, Google Scholar, and local databases were searched for cohort and cross-sectional studies published prior to January 2018. Prevalence and incidence rates of DR were extracted from January 2000 to December 2017 and random effects models were used to estimate pooled effect sizes. The Joanna Briggs Institute critical appraisal tool was applied for quality assessment of eligible studies. Results: A total of 55,445 participants across 33 studies were included. The pooled prevalence (95% CI) of DR in diabetic clinics (22 studies), eye clinics (4 studies), and general population (7 studies) was 31.8% (24.5 to 39.2), 57.8% (50.2 to 65.3), and 29.6% (22.6 to 36.5), respectively. It was 7.4% (3.9 to 10.8) for proliferative DR and 7.1% (4.9 to 9.4) for clinically significant macular edema. The heterogeneity of individual estimates of prevalence was highly significant. HDI (P < 0.001), density of specialists (P = 0.004), subspecialists (P < 0.001), and sampling site (P = 0.041) were associated with heterogeneity after the adjustment for type of DR, duration of diabetes, study year, and proportion of diabetics with controlled HbA1C. Conclusion: Human development and healthcare access were correlated with the prevalence of DR. Data were scarce on the prevalence of DR in less developed provinces. Participant recruitment in eye clinics might overestimate the prevalence of DR

Comparison between Management and Pharmacotherapy of COVID-19 in Iran and Switzerland: Management and Pharmacotherapy of COVID-19 in Iran and Switzerland

Background: On 30 January 2020, the WHO declared the outbreak of SARS-CoV-2 as a public healthemergency. In the present study, we compared the preventative and therapeutic strategies and the success rates of Iran and Switzerland during the COVID-19 outbreak.Materials and Methods: This study was conducted using electronic databases such as PubMed, Scopus, andWeb of Science. In addition, the official documents of developed countries and WHO from 1st February until 15th May 2020 were studied. Relevant documents were reviewed in detail, and vital data were extracted.Results: Both countries have restriction policies to reduce the infection rate in the prevention setting. Thesepolicies, such as the recommendation to all citizens to stay home unless necessary, army participation, andnon-face-to-face counseling, were surveyed by similar techniques in both countries. Some policies wereimplemented in both countries with different protocols. These policies, including social distancing practices,smart distancing methods, business activities, border closures, border controls, and restrictions, travelrestrictions, testing and screening for infection and fever, and decreased working hours, were performed inboth countries. In the treatment setting, the therapeutic strategy used in Iran consisted of hydroxychloroquineor chloroquine phosphate and anti-viral drugs. Switzerland followed the guidelines of the European countries.The infection rate, recovery rate, and death rate were 0.139%, 78.73%, and 5.91% in Iran, while these rateswere 0.352%, 88.81%, and 6.15% in Switzerland, respectively.Conclusion: Due to the lack of special treatment for the disease, prevention must be considered the mostimportant factor in policymaking. Importantly, observing social distance is the most effective method amongthe preventative strategies. The capacity of the health care systems to provide optimal services and facilities isan important factor for patients recovery