Test and contact tracing: two wings to get rid of COVID-19 pandemic, until we get the vaccine

In tracing a positive person for COVID-19, we are more likely to come across one of these scenarios: a party, a gathering, a restaurant, a flight, and so on. By tracing people and identifying these critical transmission points, we can do active testing for COVID-19 RT-PCR, recommend the self-isolation or quarantine to all individuals at the gathering, or improve the ill-structured places they had contacted, to prevent these spread multipliers and their associated costs. According to the Washington D.C

Prioritization of Iranian Male Mental Disorders Based on latest Prevalence, Burden, Male/Female Ratio and Expert Pane; a Systematic Review

Introduction: Mental disorders are the most prevalent health problems in the world. 23.6\% of Iranians have at least one psychological disorder. Men usually neglect their mental health issues, and their top priority mental health disorders should be determined for health planning. Methods: International databases including MedLine, Scopus, Web of Science, ProQuest, and SID national database were searched from 2015 to October 2020. The latest reported prevalence and percent of total DALY (Disability-adjusted life year), their difference between sexes as well as the expert panel’s opinion about mental disorders were gathered in a matrix based on the Three-Dimensional Combined Approach Matrix (3D-CAM). Each item got a rank and prioritization was made base on mean rank. Results: Eight studies were included. The most prevalent mental disorders among the Iranian male population were Major Anxiety Disorders (MADs, 12\%) and the highest burden belonged to Major depressive disorder (MDD) comprising 2.88\% of the total DALY. Considering all parameters, the highest priority was the Drug Use Disorders (DUD) followed by Alcohol Use disorders (AUDs), Conduct disorder, MADs, Bipolar disorder, MDD, and Schizophrenia, respectively. Conclusion: Men are extremely affected by drug and alcohol use disorders in Iran and also there is a lack of practical screening and effective interventional programs for these disorders in the primary health care system. More intensive harm reduction programs are needed for decreasing devastating consequences of any substance use disorders as well as improving mental health literacy and raising awareness toward risk perception for preventive and controlling purposes

The Pooled Cut-off Point of Waist Circumference as Core Component of Metabolic Syndrome Diagnosis among the Iranian Population; a Systematic Review and Meta-Analysis

Introduction: According to a nationwide study, one-third of the Iranian population suffer from metabolic syndrome (MetS). The most controversial criteria for the diagnosis of MetS is central obesity which would be defined by waist circumference (WC) and needed to be gender and ethnic-specific. There are several national studies that reported different cut-offs for WC so the present study aimed to do a systematic review and meta-analysis to achieve an overall statistical estimate of WC for the Iranian population. Method: A comprehensive search was conducted in international databases from inception to June 2020. The search keywords were waist circumference AND metabolic syndrome AND cut AND Iran. We used the QUADAS-2 tool for quality assessment and the HSROC model for estimating pooled specificity, sensitivity, and the cut-off point from included studies in R software. Results: A total of 3571 studies were evaluated and 24 studies fulfilled the inclusion criteria. Finally, 8 studies were included. All the studies were cross-sectional. Studies with missing MetS prevalence were excluded. Most of the studies had an unclear risk of bias in patient selection. There was a wide variation among reported cut-offs for WC from national and original studies. The Pooled cut-off points of WC for the diagnosis of MetS was 90.55 cm (95%CI: 90.51-90.60) in men and 89.24 cm (95%CI: 89.13-89.36) in women. The pooled sensitivity and specificity in men were 0.67 and 0.68, respectively and the pooled sensitivity and specificity in women were 0.61 and 0.57, respectively. Conclusion:  Our results were highly consistent with the only national study and the only consensus about WC cut-off. Further nationwide studies are suggested to be involved in a Mata-analysis for calculating more precise WC cut-off

Sexual Dysfunction in Iranian Men with Diabetes; a Systematic Review and Meta-analysis

Introduction: The typical sexual function involves the integrity and harmonious interaction of psychological, endocrine, vascular, and nervous systems. We aimed to determine the prevalence of sexual dysfunction (SD), more specifically erectile dysfunction in Iranian men with diabetes. Method: Using keywords including: “sexual function,” “erectile dysfunction,” “diabetes,” and “Iran”, an electronic search was done on national and international databases. All cross-sectional or baseline data in cohort studies were included. The prevalence of SD and its related risk factors were extracted and summarized. The random effect model was used for estimating the pooled prevalence.   Results: Ultimately, 16 studies were included in the qualitative synthesis, amongst which 6 were included for quantitative synthesis. The pooled prevalence of SD across included studies was 50.7%. with a total sample size of 1513. Two main correlated factors with SD were advanced age and depression. Conclusion: Our analysis showed that more than half of the Iranian men with diabetes suffer from SD. Apart from advanced age, the most important attributes for comorbidity of diabetes and SD in these patients were found to be chronic uncontrolled high blood sugar and depression.  More advanced epidemiological studies are needed to assess the temporality of the relationship between SD and its related comorbidities and to develop proper preventive programs

A review on the Current Areas of Geriatric`s Research in Iran

Introduction: Population aging is becoming a global challenge for developing countries. The aim of the present paper is to review the current literature on geriatric health and to propose possible research areas. Methods: By reviewing scientific databases, all published papers in geriatric health within the last 5 years (until 31 December, 2019) were extracted. Inclusion criteria were being about elderly health conducted on Iranian elderly population and published no longer than 5 years ago. Unrelated, foreign studies and qualitative, trend analysis, and case series were excluded. The keywords were classified into 5 macro domain of General, Biological, psychological, Social and Spiritual domains. Results: Until 31 December, 2019, 713 related studies were finally retrieved. 56.8% of keywords belonged to the Biological macro domain. Among which, neurologic disorders had the highest proportion of studies (n=108, 15.1%). The most prevalent subdomain was the “Sociological” (P=15.4%) and the most prevalent keyword was “Quality of life”. The lowest proportion of studies was belonged to Hematology and Otolaryngology (0.4% each). Among the top institutions in terms of publication output are University of Social welfare and Rehabilitation Sciences (11%), Shahid Beheshti University of Medical Sciences (9.7%), and Iran University of Medical Sciences (9%).   Conclusion: Most of the literature concerning elderly`s health in Iran has focused on biologic aspect of health. There seems to be an urgent need to develop a research roadmap to cover all aspects of research among elderlies. Various prepositions to develop and promote context-based and innovative strategies are also provided

The most well-known health literacy questionnaires: a narrative review

  Background: Health literacy is an important issue in public health and defined as the cognitive and social skills of an individual that determine his/her ability to obtain, access, understand, and apply health information. As the area of social determinant of health and structure content of the questionnaires, such as the perception of health and the health status of people, were neglected in the previous reviews, the present study was conducted to review and compare Health literacy questionnaires, which have domains in these areas, in English and Persian languages.  Methods: We reviewed the most famous health literacy questionnaires designed and validated in English and Persian languages published in PubMed, Google Scholar, Ovid, Scientific Information Database, and Barakat Knowledge Network System. After removing repetitive articles, the remaining articles were studied and the questionnaires were qualitatively analyzed.   Results: More than 31 well-known English and Persian questionnaires and articles were included in the present review. Among these tools, 17 questionnaires had a section on understanding and comprehension and 14 had calculation and analysis in addition to comprehension. Among the 31 questionnaires, three questionnaires had some items about social determinants of health and 12 had some items about perception of health. According to our study, the questionnaire that covers all areas of health literacy as well as social determinants of health is the HLS-EU-Q, which has been translated into different languages.  Conclusion: Since health literacy levels are related to many social determinants of health, the HLS-EU-Q can be used for health literacy evaluation as a strong predictor of a person’s health status

What we Know so far about Myxovirus Resistance Protein A (MxA) as a Biomarker of Interferon-Beta Therapy in Patients with Multiple Sclerosis: a Systematic Review

Introduction: Multiple sclerosis (MS) is one of the most common neurological disabling diseases in human societies with no complete cure. IFN-β has been proven to be an important advance in the MS treatment, but early identification of treatment failure is its major concern. Some researches revealed that MxA is an appropriate biomarker for predicting response to IFN-β, so we performed this study to evaluate the relationship between MxA level and response to INF- β treatment.Methods: International and internal databases were searched using “MxA”, “Myxovirus resistance protein A”, “IFN-β”, “interferon Beta”, “multiple sclerosis” and “MS keywords until October 2019. Inclusion criteria were original studies considering the MxA assays in MS patients under IFN-β therapy. Some reported cut-offs from partially the same settings (7 studies) were pooled using the weighted average. Finally, the overall statements of the included studies were compared and discussed to obtain a comprehensive conclusion about the clinical value of MxA assays in patient monitoring and designing their treatment plan. Results: A total of 456 articles were identified. The Screening was led to exclusion of 427 articles. Finally, 28 original studies met the inclusion criteria for this systematic review. Almost all studies have concluded that the MxA is significantly correlated with response to IFN-β therapy and also MxA expression is under the direct effect of Neutralizing antibody (NAb) against IFN-β. Reported cut-offs for MxA ranged from 3.3 to 6.3 NR and the weighted average of them was estimated to be 4.1 NR. Conclusion: It could be suggested that in patients under IFN-β therapy with an active disease which doesn’t fulfill the criteria for the breakthrough disease, MxA level can help to determine whether to continue the drug and follow up a patient or change the treatment regimen

Predictors of Testis Cancer Mortality in Iran

Introduction: Testis cancer is a rare cancer that afflicts young men. although the incidence of testis cancer is increasing, the mortality rate is decreasing. This study examines the mortality of testicular cancer and its relationship with the human development index and its components in Iran during 2005-2015. Materials and Methods: Data of patients with testis cancer were collected from the Office of National Cancer Registry in the Ministry of Health and Medical Education (MOH&ME) during 2005-2015. An additional telephone survey was conducted by trained interviewers to collect data, including survival status, demographic characteristics, age of cancer diagnosis and other clinical profiles. Kaplan-Meier survival rates were calculated according to demographic characteristics, economic status, and residential area and socioeconomic status (SES). All the analyses were done using STATA software, version 14 (StataCorp. 2015). Results: From 2005 to 2015, 5886 testicular cancer cases were diagnosed among men in all age groups. Most patients (73.9%) were 15–49 years of age at the time of diagnosis, 26.1% were 50 years of age or older. Seminoma was diagnosed among 46.78% of the patients and non-seminoma among 42.28%. Factors which had impact on survival rate were age (P=0.001), tumor histology (P=0.02, hazard ratio=1.23[0.98-1.38]) and TNM stage (P=0.001, hazard ratio=1.2[0.92-1.28]). Patients who got married at the time of diagnosis more likely presented at earlier stages and had better overall testis cancer-specific survival than patients who were single, separated, widowed, or divorced (P=0.002, hazard ratio 1.27[1.09-1.49]). Testis cancer mortality rate was significantly higher in patients who did not graduate from high school and significantly higher in patients who were tenants (P=0.057, hazard ratio =1.132[0.996-1.28]). Conclusion: Testis cancer mortality is decreasing in Iran. Age, TNM stage and histology, and marital and economic status were factors influencing mortality rate

Testosterone Level and Coronary Artery Disease in Iranian Men; a Systematic Review

Coronary artery disease (CAD) is among the most common cardiovascular diseases (CVDs), caused by the formation of plaques of lipids, calcium, and inflammatory cells. In Iran, CAD is responsible for about 50% of all deaths per year. There is also a probability of the role of androgens deficiency in CAD in men. We aimed to systematically review all the related original studies to achieve an overall insight into the associations of testosterone and CAD in Iranian men.  MedLine, Web of Science, Scopus, and Google scholar databases were searched from inception to January 2021. All types of studies on Iranian men older than 40 years of age, reporting results of comparing testosterone in normal individuals and those with CAD were included. The main findings of the articles were compared to achieve an overall statement. Ultimately, six studies were included. Most (66.7%) had directly stated that lower levels of testosterone are associated with CAD or the level of testosterone is lower in patients with proven CAD. Among them, in 3 (50%) studies, the mean age of the participants had no significant difference between patients with CAD and the normal group. It is clear that low testosterone level is associated with increased risk of cardiovascular events but it is not definitely determined whether it is independent of age in Iranian men.  Further well-designed studies are needed to clearly exclude all confounding variables including age and show the net effect of testosterone on CAD

Complications of male circumcision in Iran: A systematic review and weighted averaged analysis

Male circumcision (MC) is a minimal procedure to remove penile foreskin and is one of the oldest and most frequent surgical procedures in Iran, where the majority of the population identify themselves as Muslim. Despite numerous health benefits, MC is an issue of debate among pediatricians, urologists, and other medical professionals. Much of the debate stems from the lack of national guidelines and the incidence of minor or serious clinical complications. This study performed a systematic review on the current literature on male circumcision in Iran and summarized the major clinical complications reported by the studies