Prevalence of stress, anxiety, depression among the general population during the COVID-19 pandemic: a systematic review and meta-analysis

Abstract: Background: The COVID-19 pandemic has had a significant impact on public mental health. Therefore, monitoring and oversight of the population mental health during crises such as a panedmic is an immediate priority. The aim of this study is to analyze the existing research works and findings in relation to the prevalence of stress, anxiety and depression in the general population during the COVID-19 pandemic. Method: In this systematic review and meta-analysis, articles that have focused on stress and anxiety prevalence among the general population during the COVID-19 pandemic were searched in the Science Direct, Embase, Scopus, PubMed, Web of Science (ISI) and Google Scholar databases, without a lower time limit and until May 2020. In order to perform a meta-analysis of the collected studies, the random effects model was used, and the heterogeneity of studies was investigated using the I2 index. Moreover. data analysis was conducted using the Comprehensive Meta-Analysis (CMA) software. Results: The prevalence of stress in 5 studies with a total sample size of 9074 is obtained as 29.6% (95% confidence limit: 24.3–35.4), the prevalence of anxiety in 17 studies with a sample size of 63,439 as 31.9% (95% confidence interval: 27.5–36.7), and the prevalence of depression in 14 studies with a sample size of 44,531 people as 33.7% (95% confidence interval: 27.5–40.6). Conclusion: COVID-19 not only causes physical health concerns but also results in a number of psychological disorders. The spread of the new coronavirus can impact the mental health of people in different communities. Thus, it is essential to preserve the mental health of individuals and to develop psychological interventions that can improve the mental health of vulnerable groups during the COVID-19 pandemic

The role of krüppel-like factor 4 (klf4) gene in breast cancer tissue samples: a systematic review and meta-analysis

Background: Breast cancer is the most common cancer and the primary cause of mortality due to cancer in female around the World. As a result, the aim of this research is to conduct a comprehensive systematic review and meta-analysis to determine the role of Krüppel-like factor 4 (KLF4) as the main gene expression in breast cancer tissue. Methods: The studies used in this systematic review were selected from the articles published from up to February 1, 2020, in national and international databases including SID, WoS, Magiran, PubMed, Scopus, IranDoc, Science Direct, IranMedix as well as Google Scholar. Results: From the systematic review, a meta-analysis was performed on 8 articles which were satisfied the inclusion criteria. The sample including 869 individuals was then selected to perform the meta-analysis. Based on the results derived from this meta-analysis, the total expression of klf4 gene in breast cancer tissue’s samples was 60.1% (95% CI: 45.1–73.4%). The highest and lowest Klf4 gene expression levels in breast cancer tissue samples were obtained 89.7% in Alabama in 2004 (95% CI: 83.7–93.7%) and 32.1% in Japan in 2016 (95% CI: 23.1–42.8%), respectively. The results showed that with increasing sample size and year of publication, klf4 gene expression was reduced in breast cancer tissue samples, which was statistically significant (P < 0.05). Conclusion: Identifying the expression profiles of genes involved in breast cancer using its various pathway inhibitors can address many challenges for researchers and is very important for advancing cancer health and treatment

Candida albicans skin infection in patients with type 2 diabetes: a systematic review and meta-analysis

Background: Fungal infections including Candida albicans is one of the most important health concerns among type 2 diabetic patients. Therefore, this study aimed to determine the prevalence of C. albicans skin infection in patients with type 2 diabetes in a systematic review and meta-analysis. Methods: In this review study, data were extracted from national and international databases of SID, MagIran, IranMedex, IranDoc, Google Scholar, Cochrane, Embase, ScienceDirect, Scopus, PubMed, and Web of Science (WoS) with no time limit until January 2021. The random effects model was used for doing analysis and the I2 index was used for assessing the heterogeneity of studies. Data were analyzed using Comprehensive Meta-Analysis (Version 2). Results: The prevalence of C. albicans skin infection in patients with type 2 diabetes was 11.4% (95% CI: 8.9%-14.4%) in 13 reviewed articles with a sample size of 1348. Regarding the heterogeneity based on meta-regression, there was a significant difference between the effect of sample size (P < 0.05) and the prevalence of C. albicans skin infection in patients with type 2 diabetes. Conclusion: The results of this study showed that C. albicans skin infection was high in type 2 diabetic patients in Iran. Therefore, to improve the aforementioned situation and to troubleshoot and monitor at all levels, appropriate policies should be adopted

Associations between obstructive sleep apnea and cardiac troponin T levels: a meta-analysis

Cardiac troponin T (cTnT) is a sensitive indicator of heart damage and an important clinical marker for acute myocardial infarction (MI). The recent development of a high-sensitivity cardiac troponin T (hs-cTnT) assay allows a more accurate diagnosis of serum cTnT level. There appears to be an association between Obstructive Sleep Apnea (OSA) and changes in serum cTnT level. However, existing research shows mixed results. Therefore, this meta-analysis was performed to evaluate the relationship between cTnT level and OSA. The Scopus, EMBASE, Web of Science, PubMed and Science Direct databases were searched without a lower time limit and until April 2020. In order to perform the meta-analysis, the heterogeneity of articles was examined using the I2 test, and subsequently a random effects model was applied. Data analysis was performed within the Comprehensive Meta-Analysis software (version 2). Six studies comprising of 1689 cases and 2171 controls were included in this meta-analysis. The odds ratio of cTnT level in patients with OSA is 1.25 (95% confidence interval: 0.97–1.61), indicating that OSA patients have 25% higher odds to develop cTnT level than people without OSA. Our study showed that OSA is associated with higher serum hs-cTnT level compared to individuals with no OSA. Given that elevated cTnT level can indicate cardiovascular disease, these individuals should be prioritized for screening, early detection and swift interventions. Further studies are needed to determine the causality of this association

Evaluation of skin lesions in diabetic patients:A systematic review and meta-analysis

Backgroud: Prevalence of skin lesions among diabetic patients is a major health concern. Therefore, this systematic review and meta-analysis study was conducted to determine the prevalence of skin lesions in diabetic patients. Methods: To identify and select relevant articles, the SID, MagIran, IranMedex, IranDoc, Google Scholar, Cochrane, Embase, ScienceDirect, Scopus, PubMed, and Web of Science (WoS) databases were searched without a lower time limit and until April 2020. The random effects model was used to perform the analysis, and the heterogeneity of studies was assessed using the I2 index. Data were analyzed within the Comprehensive Meta-Analysis (Version 2) software. Results: After evaluating the 22 final articles with a total sample size of 8406, the prevalence of skin lesions among diabetes patients were found as 70.3% (95% CI: 63–76.7%). Moreover, according to the meta-regression analysis, the effect of ‘sample size’ on th prevalence of skin lesions was significantly different in diabetes patients (p <0.05). Conclusion: The results of this study show that skin lesions are common in diabetes patients. Therefore, appropriate policies needs to be adopted to improve the situation and to monitor patients and outcomes at all levels

Liposomes, new carriers for delivery of genes and anticancer drugs: a systematic review

Today, nanoscience has grown and developed in various fields of medicine and treatment, including cancer treatment. Currently, the existing treatments, including chemotherapy and radiotherapy, cause side effects that are unpleasant to the patient. Due to the fact that anticancer drugs cause severe and widespread side effects, liposomes are considered as new drug carriers to minimize the untimely destruction of the drug when it is delivered to the target tissue and to prevent the side effects of toxic drugs. This systematic review study examined the importance of using liposomes as new drug carriers for the delivery of genes and anticancer drugs. The articles published in English in the databases of Google scholar, WoS, PubMed, Embase, Scopus and science direct were reviewed. According to the results of this study, a new targeted nanosystem has been used for loading and delivering anticancer drugs, genes and controlled drug release which has a significant therapeutic effect compared to the same amount of free drug. In general, liposomal systems have been considered because of their capability in preserving the effect of the drug along with reducing the side effects and toxicity of the drug, especially in the case of anticancer drugs. Accumulation of the drug in a target tissue which results in a reduction of the drug entry into other tissues is the main reason for reducing the side effects of these drugs

Association between serum paraoxonase 1 activity and its polymorphisms with multiple sclerosis : a systematic review

BACKGROUND: Human serum paraoxonase (PON) is an enzyme that is synthesized by the liver and enters the bloodstream, and it is transmitted by high-density lipoproteins (HDL). Paraoxonase 1 (PON1) is a hydrolytic enzyme with a wide range of substrates and the ability to protect against lipid oxidation. In this study, due to the activity of PON1 in the brain and its antioxidant effects on the reduction of neurological disorders in the central nervous system, the role of PON1 and its polymorphisms related to multiple sclerosis has been examined to enhance treatment methods. METHODS: This article is a systematic review. In this study, the role of PON1 and its polymorphisms in multiple sclerosis (MS) has been investigated. Articles published in Persian and international databases of SID, Google Scholar, ISI (WoS), Magiran, PubMed, Scopus, IranDoc, Science Direct, and Iran Medix were examined, using the search keywords of Paraoxonase 1, polymorphism, multiple sclerosis, and PON1. RESULTS: PON1 is undoubtedly a potential factor in the pathogenesis of multiple sclerosis, and it plays an important role in protecting antioxidants in the blood. Oxidative stress and lipid peroxidation are factors in the pathogenesis of MS. Both inflammatory cytokines and oxidative stress have a detrimental effect on PON1. However, reducing the activity of PON1 may help to restore the pathogenesis of the disease. CONCLUSION: Decreased PON1 activity and PON1 polymorphism are associated with several neurological diseases, including ischemic stroke, white matter lesions (WMLs), amyotrophic lateral sclerosis (ALS), dementia, and Parkinson's disease. PON1-55M alleles in Italians and PON1-192Q alleles in Poles were associated with a high risk of MS. Moreover, PON1-55 and PON1-192 polymorphisms were not associated with MS onset age, nor its evolutionary type