A systematic review and meta-analysis of the prevalence of hepatitis C virus infection in people who inject drugs in Iran

Background: Hepatitis C virus (HCV) infection is one of the major public health challenges generating a relevant burden. High-risk groups, including people who inject drugs (PWID), are at serious risk for developing HCV. In recent years, several investigations have been conducted in Iran to assess the prevalence e of HCV among PWID. The aim of the present study was to synthesize the literature performing a comprehensive search and meta-analysis. Methods: A comprehensive literature search was carried out from January 2000 to September 2019. Several international databases, namely Scopus, PubMed/MEDLINE, Embase, ISI/Web of Science, PsycINFO, CINAHL, the Cochrane Library and the Directory of Open Access Journals (DOAJ), as well as Iranian databases (Barakathns, SID and MagIran), were consulted. Eligible studies were identified according to the following PECOS (population, exposure, comparison/comparator, outcome and study type) criteria: i) population: Iranian population; ii) exposure: injection drug users; iii) comparison/comparator: type of substance injected and level of substance use, iv) outcome: HCV prevalence; and v) study type: cross-sectional study. After finding potentially related studies, authors extracted relevant data and information based on an ad hoc Excel spreadsheet. Extracted data included the surname of the first author, the study journal, the year of publication, the number of participants examined, the type of diagnostic test performed, the number of positive HCV patients, the number of participants stratified by gender, the reported prevalence, the duration of drug injection practice and the history of using a shared syringe. Results: Forty-two studies were included. 15,072 PWID were assessed for determining the prevalence of HCV. The overall prevalence of HCV among PWID in Iran was computed to be 47 (CI 95: 39-56). The prevalence ranged between 7 and 96. Men and subjects using a common/shared syringe were 1.46 and 3.95 times more likely to be at risk, respectively. Conclusion: The findings of the present study showed that the prevalence of HCV among PWIDs in Iran is high. The support and implementation of ad hoc health-related policies and programs that reduce this should be put into action. © 2020 The Author(s)

In-season weightlifting training exercise in healthy male handball players: Effects on body composition, muscle volume, maximal strength, and ball-throwing velocity

This study assessed the impact of 8 weeks biweekly in-season weightlifting training on the strength, throwing ability, and body composition of healthy male handball players. Twenty players (age: 21.2 ± 0.7 years, height: 1.83 ± 0.08 m, body mass: 83.3 ± 7.5 kg, body fat: 13.2 ± 1.4%, upper limb muscle volume: 3.16 ± 0.16 L) were randomly allocated between experimental (EG) and control (CG) groups. Measures of one-repetition maximal strength included bench press, pull-over, snatch, and clean and jerk. Throwing velocity was investigated by standing, running, and jump throws, and the power of the upper limbs was estimated from the total distance of a 3-kg medicine ball overhead throw. Muscle volumes were estimated anthropometrically. Training sessions comprised 3–4 sets of explosive weightlifting exercise at 75%–90% of 1RM (repetition maximum). Significant interaction effects (time x group) were found for all strength and throwing variables, ranging from ηp2 = 0.595 (pull-over) to ηp2 = 0.887 (medicine ball throw), with the largest between-group difference (more than 40%, Δd = 6.65) and effect size (d = 6.44) for the medicine ball throw, and the smallest (about 23%, Δd = 1.61) for the standing shot performance. Significant interaction effects were also detected for all anthropometric parameters (body mass: ηp2 = 0.433; body fat: ηp2 = 0.391; upper limb muscle volume: ηp2 = 0.920, with an almost 20% gain of muscle volume). It can be concluded that 8 weeks of biweekly in-season weightlifting training yielded substantial increases of muscle volume, maximal strength of the upper limbs, and ball throwing velocity in healthy handball players relative to their standard training program. View Full-TextAcknowledgments: This work was supported by the Sport Science Program, College of Arts and Sciences, Qatar University, Doha, Qatar.Scopu

The hepatitis C infection in Iran: A policy analysis of agenda-setting using Kingdon's multiple streams framework

Background: Hepatitis C virus (HCV) infection causes a large number of deaths annually worldwide. Policies play an important role in regulating healthcare agendas and prioritising of health-related issues. Understanding these priorities is very important in health. The objective of this study was to investigate HCV-related issues and their influence on agenda-setting in Iran. Methods: A qualitative design was used. Data were collected by carrying out a review of documents and interviews. A comprehensive search was conducted to identify documents related to HCV-related policies in Iran. Semi-structured interviews were conducted with both purposive and snowball sampling of 14 interviewees related to the HCV programme in Iran, including government officials, civil society, development partnership members and academicians. Documents and interview data were analysed manually and using MAXQDA Version 10 software. Kingdon's multiple streams framework was used to guide data analysis. Results: The factors which influenced HCV-related agenda-setting were lack of proper information of the HCV epidemiology before the 1990s, lack of diagnostic facilities, neighbouring countries with high HCV prevalence, the stigma of HCV, high prevalence in prisoners, international evidence and high costs generated by HCV. The factors related to policy were effective treatment methods, drug production inside Iran, Iran Hepatitis Network, support outside government group elites and academicians. The factors related to political will were international influence, changes in the government and parliament support. Conclusion: The findings of this study showed that there are various national and international factors that play a role in shaping HCV-related policies. It seems that, if HCV is put into the agenda, it can be eliminated in Iran by 2030 by supporting and implementing appropriate programmes from decision- and policy-makers. © 2019 The Author(s)

Prevalence of Hepatitis C Virus in Tuberculosis Patients: A Systematic Review and Meta-Analysis

Background: Infection with Hepatitis C Virus (HCV) increases the hepatotoxicity of anti-tuberculosis drugs. The purpose of this systematic review and meta-analysis is to determine the prevalence of HCV infection in patients with tuberculosis (TB). Methods: PubMed/MEDLINE, ISI/Web of Sciences, CINAHL, EMBASE, the Cochrane Library and Scopus were searched from January 2000 to March 2018. The overall prevalence of HCV in patients with TB was calculated using the random-effect model with 95 confidence interval (CI). To evaluate heterogeneity, I2 test was used. Egger's regression test was utilized to check publication bias. Results: Twenty-one articles were selected for the final analysis based on the inclusion/exclusion criteria. A total of 15,542 patients with TB participated in the studies. The overall prevalence of HCV infection in patients with TB was 7 95%CI: 6-9. Subgroup analysis revealed that diagnostic test (P=0.0039), geographical background (P=0.0076) and gender distribution (P=0.0672) were statistically significant moderators. Men had a higher risk for HCV than women (Odds Ratio, OR=2.02; 95%CI: 1.28-3.18). Conclusion: The results of this study highlighted the importance of screening HCV in TB patients. Knowing whether HCV is present or not in these patients can be helpful in effectively treating them

Patient safety culture assessment in Iran using the �Hospital survey on patient safety culture� tool: A systematic review and meta-analysis

Background: Paying attention to patient safety is a crucial aspect of the healthcare provision delivery. Integrating and coordinating the different parts of the health system can ensure a safe, high-quality and efficient care. Patient safety culture (PSC) is a broad, complex and multi-dimensional conceptual framework. In recent years, several studies have been conducted to evaluate PSC using the �Hospital Survey on Patient Safety Culture� (HSOPSC) tool. The aim of this study was to examine the level of PSC in Iranian hospitals. Methods: ISI/Web of Sciences (WoS), PubMed/MEDLINE, Embase, CINAHL, PsychINFO and Scopus as well as Iranian databases including MagIran and SID were searched from January 2000 to July 2018. The Newcastle-Ottawa Scale checklist was used to assess the quality of the studies. The mean score of the participants� responses for each dimension of the questionnaire was calculated using the DerSimonian-Laird's random model with a 95 confidence interval. Results: In the current systematic review and meta-analysis, 27 studies conducted between 2012 and 2017 were included. The participants were 9264. Low scores (in the range 37.79�65.43) were found, especially when compared to other countries such as Lebanon, Turkey and the USA. Conclusion: Our results showed that in Iran the level of PSC is low and requires special attention from healthcare managers and providers. PSC should be a very important priority in Iran's health sector. Health decision- and policy-makers should pay particular attention to offering training programs to promote and develop PSC. © 2019 INDIACLE

Prevalence of hepatitis C virus infection among prisoners in Iran: A systematic review and meta-analysis

Background: Hepatitis C virus (HCV) is one of the major public health problems both in developed and developing countries. Prison represents a high-risk environment for prisoners, in that it is characterized by high-risk behaviors such as injecting drug use (IDU), tattooing, unprotected sexual intercourses, or sharing syringes. The aim of this study was to quantitatively evaluate the prevalence of HCV among Iranian prisoners conducting a systematic review and meta-analysis. Methods: We searched different scholarly databases including Embase, PubMed/MEDLINE, ISI/Web of Sciences, the Cochrane library, Scopus, CINAHL, and PsycINFO as well as Iranian bibliographic thesauri (namely, Barakatns, MagIran, and SID) up to December 2017. The Newcastle Ottawa Scale (NOS) was used to assess the quality of the studies included. HCV prevalence rate with its 95 confidence interval (CI) was estimated using the DerSimonian-Laird random-effects model, with Freeman-Tukey double arcsine transformation. Egger's regression test was used to evaluate publication bias. Results: Finally, 17 articles were selected based on inclusion and exclusion criteria. Overall, 18,693 prisoners were tested. Based on the random-effects model, the prevalence of HCV among Iranian prisoners was 28 (CI 95 21-36) with heterogeneity of I 2 = 99.3 (p = 0.00). All studies used an ELISA test for the evaluation of HCV antibodies. The findings of this study showed that the highest prevalence rate (53) was among prisoners who inject drugs. Conclusion: The findings of our study showed that the prevalence of HCV among Iranian prisoners is dramatically high. Managing this issue in Iran's prisons requires careful attention to the availability of health facilities and instruments, such as screening, and harm reduction policies, such as giving sterile syringes and needles to prisoners. An integrated program of training for prisoners, prison personnel and medical staff is also needed to improve the level of health condition in prisons. © 2018 The Author(s)

Prevalence of hepatitis C virus infection among prisoners in Iran: A systematic review and meta-analysis

Background: Hepatitis C virus (HCV) is one of the major public health problems both in developed and developing countries. Prison represents a high-risk environment for prisoners, in that it is characterized by high-risk behaviors such as injecting drug use (IDU), tattooing, unprotected sexual intercourses, or sharing syringes. The aim of this study was to quantitatively evaluate the prevalence of HCV among Iranian prisoners conducting a systematic review and meta-analysis. Methods: We searched different scholarly databases including Embase, PubMed/MEDLINE, ISI/Web of Sciences, the Cochrane library, Scopus, CINAHL, and PsycINFO as well as Iranian bibliographic thesauri (namely, Barakatns, MagIran, and SID) up to December 2017. The Newcastle Ottawa Scale (NOS) was used to assess the quality of the studies included. HCV prevalence rate with its 95 confidence interval (CI) was estimated using the DerSimonian-Laird random-effects model, with Freeman-Tukey double arcsine transformation. Egger's regression test was used to evaluate publication bias. Results: Finally, 17 articles were selected based on inclusion and exclusion criteria. Overall, 18,693 prisoners were tested. Based on the random-effects model, the prevalence of HCV among Iranian prisoners was 28 (CI 95 21-36) with heterogeneity of I 2 = 99.3 (p = 0.00). All studies used an ELISA test for the evaluation of HCV antibodies. The findings of this study showed that the highest prevalence rate (53) was among prisoners who inject drugs. Conclusion: The findings of our study showed that the prevalence of HCV among Iranian prisoners is dramatically high. Managing this issue in Iran's prisons requires careful attention to the availability of health facilities and instruments, such as screening, and harm reduction policies, such as giving sterile syringes and needles to prisoners. An integrated program of training for prisoners, prison personnel and medical staff is also needed to improve the level of health condition in prisons. © 2018 The Author(s)

Tuberculosis in Iran: a historical overview from al-Tabari, Rhazes, Avicenna and Jorjani to Abolhassan Ziy�-Zarifi. Old and new pioneers in the fight against tuberculosis: challenges, pitfalls and hopes

Tuberculosis is a serious respiratory infectious disease, caused by Mycobacterium tuberculosis bacteria. It has always represented a permanent, serious public health challenge over the course of human history, because of its severe epidemiological, clinical and societal implications. The present review aims at over-viewing the contributions of the Iranian medicine to the control, management and treatment of tuberculosis, from the glorious past of the eighth-ninth centuries to the present, from Ali Abu al-Hasan Ahmad ibn Sahl-e Rabban al-Tabari to Rhazes, Avicenna, Jorjani and Abolhassan Ziy�-Zarifi. However, despite the efforts, tuberculosis and, in particular, multidrug-resistant tuberculosis still represent a great public health concern in Iran. On the other hand, this country can capitalize on its millennial, incredibly rich story of major achievements in the battle against tuberculosis to develop and implement ad hoc public health programs for the control of the disorder, including targeted and specialized interventions. ©2020 Pacini Editore SRL, Pisa, Italy

Current and former smokers among adolescents aged 12-17 years in Iran: A systematic review and meta-analysis

Background: Smoking, especially among adolescents, is considered a serious public health concern worldwide being associated with increased mortality. The present study was designed as the first systematic review and meta-analysis of the prevalence of current and former smoking behavior among adolescents in Iran. Methods: Seven international scholarly databases, namely Scopus, Embase, Pubmed/Medline, ISI/Web of Science (WOS), the Cochrane Library, Psyc Info and Cinahl, were extensively searched from January 2000 to September 18, 2019. Google Scholar was also mined. Iranian databases were searched as well (namely, MagIran, Scientific Information Database (SID), and Barakatkns). The DerSimonian-Laird's approach, via the Freeman-Tukey double arcsine method, was used to synthesize the prevalence estimates. Results: The prevalence of current smokers among Iranian adolescents was estimated to be 9 (95 CI: 7 to 10). Stratifying based on gender, the prevalence was 12 among boys (95 CI: 10 to 14) and 6 among girls (95 CI: 5 to 8). The prevalence of former smokers among Iranian adolescents using the random-effect model was computed to be 24 (95 CI: 21 to 27). Conclusion: The findings of this study showed that the prevalence of current and former smoking behavior among Iranian adolescents is a relevant public health concern. The country's young population should be given more attention by health policy- A nd decision-makers and implementation of ad hoc prevention and control policies should be on their agenda. © 2020 The Author(s)

The ball kicking speed: A new, efficient performance indicator in youth soccer

Success in different soccer skills like kicking depends on motor abilities achieved. Kicking is a soccer fundamental, which depends on many different and complex factors (technique, foot-ball interaction, ball flight, etc.). Therefore, it is important to identify players that are able to perform faster kicks using both dominant and non-dominant leg. The current study investigated some basic variables of different soccer kicking speed and their relevance to success in youth soccer academy. 119 players from the first and the second division participated to this study. They were randomly divided into age groups (U-15, U-17, and U19) and team status (first team, reserves). The diagnostic ability of the different ball kicking speed tests in capturing differences between first team players and reserves among different age categories were computed using the receiver operating characteristics analysis. Results demonstrated that first team players achieved better results when comparing to reserves in each category. In addition, differences were greater in the U-15 and the U-17 than in the U-19 age group. In conclusion, ball kicking speed could be one of the possible identification tools to evaluate players' success in youth soccer.Scopu