Critical Comments in Biomedicine

Published by Shahid Sadoughi University of Medical Sciences
Online ISSN: 2717-0403
Publications
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has been the cause of a global pandemic. Given the impact of nutritional status upon immune function, it is crucial to understand the relationship between micronutrient intake and severity of the disease. This mini-review aimed to summarize the known associations between specific micronutrients (vitamin A, D, E, C and zinc, selenium and magnesium) and the health of coronavirus-infected patients. Low serum levels of these micronutrients are associated with the incidence and severity of SARS-CoV-2. However, further studies are needed to evaluate the outcomes of supplementation with these nutrients.
 
This article is a Letter to Editor and does not include an Abstract.
 
Coronavirus disease 2019 (COVID-19) is associated with severe multiorgan clinical manifestations. Although respiratory involvement is the predominant manifestation in patients infected with COVID-19, involvement of other organs, such as the nervous system, has also been identified; which highlights the virus' ability to disrupt the organs’ function. There is ample evidence of a nervous system susceptibility to the COVID-19. In this regard, the COVID-19 pandemic effect on psychological health, including insomnia, anxiety, obsessive-compulsive disorder, and depression among health care workers and other high-risk groups has been identified. So far, many studies have examined the psychiatric manifestations in infected patients with COVID-19. Undoubtedly, awareness of these findings can help in the prevention and timely treatment of these patients. This study aimed to review the possible mechanisms of COVID-19 neuroinvasive potential, psychiatric manifestations, and the management of mental disorders in infected patients.
 
Background: People with diabetes or chronic kidney diseases (CKD) are vulnerable to Covid-19. Our aim in this study was to estimate the fatality rate among people with diabetes or CKD infected by Alpha Covid-19 variant. Methods: The authors searched PubMed, Scopus, and Embase from 1/12/2019 to 13/5/2020 to find studies that reported the fatality rate of Alpha Covid-19 variant among patients with diabetes/renal disease. A Random effects model meta-analysis was used to calculate the pooled case fatality rate (CFR). Then, a subgroup analysis was performed according to the sample size to find possible sources of heterogeneity. Results: In total, 22 papers were studied for diabetes and 10 papers for CKD. The pooled CFR was estimated at 23% (95% CI: 0.18, 0.28) among diabetes patients and 31% (95% CI: 0.16, 0.48) among renal patients. High heterogeneity was observed among the studies (Diabetes: I^2=94%, t^2=0.0173, P<0.01), (CKD: I^2=69%, t^2=0.0457, P<0.01). The subgroup analysis indicated that the sample size had a significant effect on fatality rate estimation. In the diabetes patients, the pooled CFR of Alpha Covid-19 variant was 40% (95% CI: 22%-58%; I^2=91%, t^2=0.0797, P<0.01) among the studies with the sample size of less than 52 hospitalized patients. In the studies with equal or more than 52 patients, the pooled CFR was 14% (95% CI: 11%-17%; I^2=88%, t^2=0.0048, P<0.01). In addition, in renal patients, the pooled CFR was 62% (95% CI: 0.06%-100%; I^2=85%, t^2=0.3745, P<0.01) in the studies with less than six hospitalized patients, and the pooled CFR was 23% (95% CI: 16%-31%; I^2=0%, t^2=0.00, P=0.58) among studies with more than 6 patients. Conclusions: People with either diabetes or CKD and infected with Alpha Covid-19 variant had a higher fatality rate in the general population. More care and vaccination is recommended for these patients. It is recommended that we calculate pooled estimation of the case fatality rate of the other variant of COVID-19 such as Beta, Delta, and Omicron in patients with chronic disease.
 
Background & aims: It is proposed that vitamin D supplementation might influence serum adipokines level; however, the recent meta-analyses have led to inconsistent results while they had methodological limitations. Therefore, this study aimed to examine the effects of vitamin D supplementation on serum adipokines through a systematic review and a meta-analysis of randomized placebo-controlled trials (RCTs) using a more comprehensive search strategy. Methods: PubMed, Google Scholar, and Scopus were searched to identify related articles published up to November 2017. Mean±standard deviation (SD) of changes in serum adiponectin and leptin were extracted, and the effect sizes were pooled using a random-effects model. Studies with Controlled clinical trials design were eligible. Two reviewers extracted mean values and SDs of the baseline, final and net change values of leptin and adiponectin in the intervention and control groups. Results: The pooled results indicated that vitamin D supplementation affects neither circulating leptin (Hedges’ g = 0.042, 95% CI: -0.294 to 0.378, p = 0. 0.807, n=15) nor adiponectin (Hedges’ g = -0.034, 95% CI: -0.243 to 0.174, p = 0.748, n=18) levels. Subgroup analysis showed that vitamin D supplementation might significantly decrease serum leptin level in patients with end stage renal disease (Hedges’ g = -0.634, 95 % CI: -1.221 to -0.047, p = 0.034). Conclusions: Although the current evidence does not support the significant effect of vitamin D supplementation on adiponectin and leptin levels, further research is required to reach more definitive conclusions.
 
Background: Critical patients admitted to the intensive care unit (ICU) might experience some degree of depression or anxiety, due to different treatments and medications they receive. These mental conditions can persist even years after hospital discharge. Therefore, the mental health of these patients is one of the particular interests. In this context, religious traditions and prayers are considered during the illness process. Objectives: The current article reviews the beneficial effects of prayer in light of research conducted in this area. Methods: A general search for electronic databases (Medline, Science Direct and Springer databases) was developed. The human studies of the influence of prayers in critically ill patients were evaluated. Results: The results indicated that prayer might be effective in reducing the severity of the disease in patients admitted to intensive care units and it has a positive effect on critical ICU patients. Conclusions: It is recommended that a prayer-based approach be taken to improve the mental health of these patients in a clinical setting.
 
Background: Several randomized clinical trials (RCTs) has assessed the effect of Anethum graveolens L. (AG) or dill supplementation on lipid profile in adults with cardiovascular risk factors with different results. Therefore, we decided to conduct a systematic review and meta-analysis regarding the available randomized controlled trials to assess AG supplementation's efficacy on lipid profile in adults with cardiovascular risk factors. Methods: PubMed, Embase, Cochrane's database, Ovid, Web of Science, ProQuest, Scopus, and Google Scholar were searched to find relevant articles investigating the effect of AG on the lipid profile of adults with risk factors for cardiovascular disease up to December 2020. Six trials with seven treatment armsmet the inclusion criteria. A random-effects model was used in the meta-analysis. To test heterogeneity, I2 statistics and Cochrane Q test were applied. Results: The results reported a significant improving effect of AG on TG [WMD = -29.20, 95% confidence interval (CI): -34.73,-23.68 mg/dL, p < 0.001], TC (WMD = -16.46, 95%CI: -21.54,-11.39 mg/dL, p < 0.001), LDL-C (WMD = -13.90, 95%CI: -16.08, -11.72 mg/dL, p < 0.001), and HDL-C (WMD = 4.01, 95%CI: 3.48, 4.54 mg/dL, p < 0.001). Conclusion: This meta-analysis of randomized controlled clinical trials revealed that consuming AG extract for more than six weeks might improve lipid profile in adults with cardiovascular risk factors.
 
Background: Cancer is a global problem and causes lots of deaths across the world. Due to the high cost of manufacturing and developing new drugs, there is more willingness to use medications that may have anti-neoplastic effects. Objectives: Antipsychotic drugs have a long history of clinical use. Currently, there are several reports about the anticancer effects of antipsychotic drugs in different types of malignancies. Methods: In this study, the effects and mechanisms of several antipsychotic drugs on different types of cancer were investigated. The current investigations show that some antipsychotic drugs might inhibit the proliferation of cancer cells and some others can be used to ease the symptoms caused by cancer. Results: The anticancer effects of all antipsychotic drugs haven’t been thoroughly investigated and it is reported that few drugs may reverse the effects and increase the risk of neoplasm. Conclusions: Although some studies have revealed that antipsychotic drugs might beneficially affect cancer cells, high quality clinical trials are still needed to confirm these results.
 
This article is a Letter to the Editor and does not include an Abstract.
 
Background: Heart failure (HF) is a major complication resulting from a variety of heart diseases. HF is an increasingly important issue, whose prevalence has doubled in the last two decades. This is due to increased life expectancy, treatment and prevention of other heart diseases, and increased life expectancy. Promoting self-care through tele homecare is an emerging strategy for managing chronic diseases. Objectives: The purpose of this study is to evaluate tele-care studies in patients with chronic heart failure (CHF). This is based evaluating the types of technologies used for patients in this method, effectiveness, cost-effectiveness and safety of these technologies based on the aspects of health technology assessment. Methods: PubMed, Scopus, Web of Science, Cochrane databases, HTA (Health Technology Assessment), NHS EED (National Health System Economic Evaluation Database), DARE (Database of Abstract of Reviews of Effects), Embase, and (Society for Information Display) SID were searched using medical subject heading (Mesh) keywords. Then, studies were evaluated by two people and disputed by a third party. The quality of the extracted studies was evaluated based on the (Risk of Bias) RoB 2.0 checklist. The difference between the mean and its standard deviation was calculated (which was used as the effect size). To analyze the results, meta-analysis of random effects was performed. In addition, the subgroup and meta-regression analysis were performed to discover possible sources of heterogeneity. Finally, studies were evaluated in terms of Health Problem and Current Use of the Technology (CUR), Description and technical characteristics of technology (TEC), safety (SAF), Clinical effectiveness (EFF), Costs and economic evaluation (ECO) of 9 Aspects of Health Technology Assessment (HTA). Studies were evaluated with respect to the long-distance care in patients with CHF. We approach the method through systematic review and meta-analysis based on the principles of PRISMA-P. This systematic review examined the effectiveness of long-distance care interventions in patients with CHF, compared with conventional care methods. In general, evaluation of studies extracted in this systematic review will try to identify, evaluate and combine the effects of tele-care in patients with HF using meta-analytical methods in the evidence. Evaluating studies conducted in the field of tele-care in patients with CHF will help us to better understand how these methods work in the management of chronic heart disease [effectiveness, safety and cost reduction] and determine which care interventions Distance is more effective in patients with HF based on their characteristics according to clinical outcomes and resource use. Conclusion: The results of this study can be used as a guide to provide valid evidence for the decision of senior managers of the Ministry of Health and large hospitals to use common technologies used in distance care for patients with CHF and other chronic diseases. This study will also provide a new understanding of the various studies that have been conducted to help patients with chronic failure by different types of remote care technologies in terms of effectiveness, safety, technology, and economic costs.
 
All types of sampling methods
Background: Sampling methods are one of the main components of each research. Familiarity with a variety of sampling methods is essential for researchers. Objective: The main purpose of this study was to teach different probabilistic and non-probabilistic sampling methods to improve the knowledge of researchers in conducting more accurate research. Methods: In this tutorial article, useful information about each sampling method, as well as how to properly use each method and its strengths and weaknesses are provided. Results: Five cases of probabilistic sampling methods and four cases of non-probabilistic sampling methods that are common are mentioned. Probabilistic sampling included simple random sampling, stratified random sampling, cluster sampling, systematic random sampling, and multi-stage random sampling. In addition to introducing each method, its strengths and weaknesses are also mentioned. Conclusion: Probabilistic sampling methods despite limiting assumptions provide more reliable results. Therefore, if it is possible, researchers should use probabilistic sampling methods to increase the accuracy of the study.
 
Background: Inflammation is a process that occurs in early phase of recovery in which immune system recognizes and removes immunological stimuli. Many chronic diseases have inflammation based pathogenesis. Several studies used soy and soy products for reducing inflammatory biomarkers. Objectives: The purpose of the present systematic review and meta-analysis of randomized clinical trials is to determine the effects of soy and soy products on inflammatory biomarkers. Methods: The following databases will be investigated for randomized controlled trials published until October 2019 to evaluate the effects of soybean and soy products on the inflammatory biomarkers in healthy subjects and patients with high inflammatory biomarkers: PubMed, Scopus, ISI Web of Science and Google scholar.Two independent investigators (M.R and F.M) will screen the title and the abstract of included articles. Mean and standard deviation (SD) or standard error (SE) for outcomes will be extracted. The quality of studies will be assessed by Cochrane Risk of Bias Tool. STATA software will be used to do a standard statistical analysis. A subgroup analysis will be applied to find out potential sources of inter-study heterogeneity. A Random-effects model will be conducted to calculate pooled effect size. A fixed-effect model will be incorporated to estimate the between-subgroup heterogeneity. Moreover, sensitivity analyses, Egger's regression asymmetry test and Begg's rank-correlation methods will be conducted. Results: We will try to find a major number of articles about the effectiveness of soy and soy products on inflammatory biomarkers. Tumor necrosis factor α (TNF-α), interleukine 6 (IL-6), interleukine 2 (IL-2), interleukine 1-β (IL-1β), interferon-gamma (IFN-γ) and Interleukine 10 (IL-10) are considered to be the outcome. Conclusion: The findings of this systematic review and meta-analysis may provide evidence on the effectiveness and safety of soy and soy products for reducing inflammation.
 
Background: Enteral feeding (EF) is the delivery of liquid nutritional support through a tube for hospitalized patients with gastrointestinal dysfunction who are incapable of eating or unable to meet their nutritional requirements via the oral route. Hospitals’ reports indicate an increased interest and demand for blenderized tube feeding (BTF) as an alternative to commercial enteral formulas particularly in families of tube fed children. In particular, by increasing food sensitivity and more complex identification in children, BTF allows families to adjust their diet to their children's needs. This systematic review aimed to summarize the published evidence regarding BTF in pediatric patients. Methods: Literature search was conducted in four databases, including Scopus, PubMed, Science Direct, and Google Scholar, using multiple keywords, such as blenderized tube feeding, blended formula, homemade enteral nutrition, pediatric, and children. Out of 103 retrieved articles, 6 were selected and reviewed. Results: Six articles were eligible to be included in the current review. The results showed that calories were approximately 1kcal/g, protein 13 -22%, fat 30 - 34%, and carbohydrates intake 45-55% of total energy intake. Conclusions: The results indicated that BTF is acceptable and can be administered to children; however, due to concerns about calorie and macronutrients deficiency, it should be providing under the supervision of a nutritionist. BTFs are a good choice among children; since they can improve gastrointestinal symptoms and are a good option for families who use EF for their children at home. Most pediatric patients use BTFs as a portion of their EF, making it necessary that nutritionists and physicians expand their knowledge about BTFs to appropriately care for these pediatric patients.
 
Introduction: Irritable bowel syndrome (IBS) might be associated with psychiatric disorders such as obsessive-compulsive disorder (OCD). This meta-analysis was conducted to compare the rate of OCD among patients with IBS and otherwise healthy controls. Methods: This study was conducted using a meta-analysis approach. International databases including PubMed, Web of Science, and Scopus, as well as the Google Scholar search engine were searched from 1985 to August 2020 to find the related studies. The standardized mean difference (SMD) of OCD between case and control groups was calculated and pooled by using a random-effects model. In addition, meta-regression and sub-group analysis were performed to identify variables that possibly explain the heterogeneity. Results: A total of 5167 patients including 1451 IBS patients for case and 3716 for control group entered 15 related studies were included in the analysis. Based on the results of the random effects analysis, the rate of obsessive-compulsive disorder in IBS patients in case group was higher than the control group (Pooled standardized mean difference, 0.76, I2 = 87.8%; 95% CI, 0.54-0.98; P <0.001). Egger’s (P = 0.083) and Begg’s (P = 0.09) tests did not show significant publication bias. Subgroup analysis also revealed that the type of studies and IBS diagnostic criteria were identified as factors affecting heterogeneity. Conclusion: The present meta-analysis demonstrated that the obsessive-compulsive disorder score in IBS patients was higher than the control group, regardless of subgroup analysis or meta-regression. Due to the significant relationship between these two disorders, psychiatrists and gastroenterologists can provide strategies and techniques for individual or group treatment of obsessive-compulsive disorder in patients with IBS based on the cognitive-behavioral therapy.
 
Background: The purpose of this study is to investigate the amount of salt consumed by the people living in Yazd, Iran and its related factors based on previous investigations. materials and methods: A general search was performed on electronic databases of Daneshgostar Barakat system, Magiran, SID and English databases such as Scopus, PubMed, Web of sciences, Science direct, and Google scholar search engines using following keywords: "salt intake" OR "sodium intake" OR "salt reduction" OR "salt content" OR "sodium reduction" OR "Diet, Reducing" regardless of the time interval. A total of 273 articles were obtained from the mentioned website. Papers published up to September 30, 2019 were retrieved. A total of 15 related articles were analyzed, and studies on the amount of salt consumed were evaluated. Results: The amount of salt received by the people of Yazd is higher than the standard of the World Organization and has an increasing trend. Conclusion: A population-based approach for salt intake reduction can lower blood pressure levels and presumably significantly reduce mortality. Therefore, the implementation of a comprehensive plan and intervention for salt consumption is necessary for this population.
 
Background: This study protocol outlines the planned, systematic review and dose-response meta-analysis of nuts intake with cancer risk and its mortality. Methods: This meta-analysis will be done based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P). A systematic literature search will be conducted using online databases, including PubMed/Medline, ISI Web of Science, and Scopus with no limitation in language or time of publication to identify observational studies investigating the association of nuts intake with cancer risk and its mortality. The target population will be adults (≥18 years of age). Random-effects models will be used to calculate pooled effect sizes (ESs) for the risk of cancer and its mortality based on the comparison between the highest and lowest categories of nut intake and to incorporate variation between studies. Linear and non-linear dose-response analyses will be done to evaluate the dose-response associations between nut intake and risk of cancer and its mortality. The Newcastle-Ottawa Scale (NOS) will be used to assess the risk of bias or quality of included studies. Conclusion: The findings of this systematic review and dose-response meta-analysis will summarize all available evidence on the association between nut intake and risk of cancer and its mortality.
 
Objective: In 1988, a new conception for endometrial cancer staging was introduced by Fédération Internationale de Gynecologie et d'Obstétrique (FIGO). In addition to pathologic development, peritoneal cytology played an important role in the staging. The goal of peritoneal cytology was to identify hidden and microscopic extensions outside the uterus. In 2009, the system was reviewed; one of the changes was removing the peritoneal cytology. The aim of this review is to evaluate the effect of peritoneal cytology on the survival of patients with endometrial cancer. Methods and analysis: This protocol is reported based on the PRISMA-P guideline. We will search "endometrial cancer," "peritoneal washing," and any other relevant words on PubMed, Cochran, EMBASE, and Scopus databases. The eligibility criteria are: All original studies performed on patients with endometrial cancer, evaluated survival, and performed peritoneal washing cytology. Only one of the non-English studies with the same respect will be included according to the research team's opinion. Also, the most recent paper among multiple articles about a single study is chosen. It should be noted that there will not be any restrictions regarding the language and publication date. For quality assessment, we will use the quality in prognosis (QUIPS) tool. If possible, a meta-analysis will also be performed using a rndom effects model, and overall survival rates and confidence intervals will be reported. Heterogeneity will be tested by using the I2 index and Cochrane's Q test. Subgroup analysis will be performed to handle the heterogeneity. The publication bias will be assessed in the presence of 10 or more relevant articles. If there is no chance of meta-analysis, the result will be reported qualitatively. Discussion: The resulting review will provide valuable information regarding the prognostic value of peritoneal cytology in patiens with endometrial cancer.
 
Background: Chronic obstructive pulmonary disease (COPD) is considered the fourth main cause of mortality worldwide, affecting 10% of adults aged up to 40 years. Due to the growing elderly population and smoking, the global burden of COPD is expected to increase in the general population. Telemedicine may help patients with COPD to decrease exacerbation episodes and the associated costs. Moreover, Telehomecare (THC) may be considered as an alternative to cut down hospitalization costs and increase the patients’ comfort. Objectives: This study explains the methodology of a systematic review and meta-analysis designed to evaluate the impact of THC interventions on the control and management of COPD and its complications. Methods: To review all published studies comparing THC interventions in controlling COPD and its complications, all studies published in PubMed, Google Scholar, Scopus, ISI Web of Science, Cochrane databases, HTA EED, DARE, Embase, SID, Magiran will be searched until the end of 2021. Randomized controlled trials (RCTs), cluster RCTs, controlled clinical trials comparing telehealth with standard monitoring of COPD patients were included. Independent reviewers will review the abstracts and full-texts of all relevant studies for eligibility, risk of bias, and data extraction using structured forms. The meta-analysis will be performed for adequately homogenous studies regarding their populations, interventions, and objectives. Conclusion: The results of this systematic review and meta-analysis will provide useful information on the impacts of THC on COPD control. The evidence provided by this systematic review can be helpful for clinical specialists, public health policymakers, and the general population.
 
Introduction: Hypertension is a chronic condition that might lead to renal and cardiovascular diseases. The previous trials examining the effect of cinnamon supplementation on blood pressure have led to conflicting results. The present systematic review aimed to summarize the effect of cinnamon supplementation on blood pressure using a meta-analysis of published randomized controlled clinical trials. Methods: To identify the eligible articles, MEDLINE, SCOPUS, ISI Web of Science, and Google Scholar were searched from inception until September 2019 for relevant articles. The risk of bias assessment was performed using the Cochrane collaboration tool. A Random-effects model was applied to calculate the summary effects. Results: Totally, 11 trials with 686 participants were included in this systematic review and meta-analysis. The dose of cinnamon supplement consumption varied from 500 to 10000 mg/d. The meta-analysis revealed that cinnamon supplementation significantly decreases systolic blood pressure (SBP) [WMD (weighted mean difference)= -5.72 mmHg, 95% confidence interval (CI): -8.63 to -2.80; P<0.001, I2= 81.1)] and diastolic blood pressure (DBP) (WMD= -4.06 mmHg, 95% CI: -6.68 to -1.44; P= 0.002, I2 = 88.6). Subgroup analysis suggested no significant reduction of DBP in subjects with diabetes (WMD= -2.015 mmHg, 95% CI: -4.55 to 0.52; P= 0.12, I2 = 72.3) and prediabetes or metabolic syndrome (WMD= -4.8 mmHg, 95% CI: -10.06 to 0.44; P= 0.073, I2= 92.5). Conclusions: Cinnamon supplementation could be beneficial in lowering SBP and DBP in adults. Further studies with different doses are recommended to confirm the present findings.
 
of the risk of bias in studies included in the systematic review
Characteristics of eligible studies.
Background: Hypertension is a major risk factor for the development of coronary, cerebrovascular, and peripheral vascular diseases, which lead to myocardial infarction, stroke, and vascular death. Green coffee extract is particularly producer a great deal of chlorogenic acids (CGA) that may reduce the risk of high blood pressure. Therefore, the target of the study was to summarize the available publications on the effect of green coffee consumption on high blood pressure. Methods: The systematic review was done with a search in PubMed-Medline and Scopus. The search strategy included keywords related to blood pressure and green coffee. Inclusion criteria were randomized controlled clinical trials conducted on people aged between 18 and 70 years. The publication date of articles was from 2004 to 2018. Exclusion criteria were articles not published in English. Results: We discussed five articles that included our criteria. Green coffee had moderate effects on high blood pressure. It sounds that the effect of green coffee on reducing blood pressure is because of its phenolic compounds, as well as caffeine and chlorogenic acids, coffee’s roasting status, participants’ ethnicity, and even gender. Conclusion: Green coffee intake for a long time might moderately decrease blood pressure. However, there is still a need for further clinical trials.
 
Background: According to the world health organization (WHO), in 2019, around 50 million people suffer from dementia, worldwide; and approximately 60% live in low- and middle-income countries. Dementia has physical, psychological, social, and economic effects on dementia sufferers, their caregivers, families, and the community. Objectives: This systematic review investigated the effect of short-term and long-term interventions with grapes and their derivatives on different cognitive functions, such as executive function, memory, attention and language in all people. Methods: Pubmed, Scopus, and Proquest were searched until June 12, 2020 for English studies. Clinical trials in which grapes and its derivatives were considered as an intervention and changes of cognition and its components as an outcome, were selected. Two independent individuals assessed the quality of the articles according to Jadad checklist and extracted the information of the articles with inclusion criteria based on a specific table. The differences were resolved with the discussion and opinion of a third person. Results: Nine Studies (211 individuals) were included in the content analysis, of which 3 studies had short-term intervention and 6 studies had long-term intervention with grape juice, freeze-dried grape powder, and a syrup made from grapes (Enoant Syrup). It can be said that the consumption of grapes and its derivatives improved various cognitive components (such as attention, executive function, immediate spatial memory, learning, and driving skill) between groups. Conclusion: In general, long-term intervention with grapes and their derivatives has led to the improvement of some cognitive functions, but its short-term intervention is not very effective and only 2 studies showed improvement in attention speed. However, the included studies were highly heterogeneous and more research is needed using similar cognitive assessment tools.
 
Background: Diabetes is one of the most serious health challenges of the 21st century. The number of adults with diabetes has roughly tripled in the last 20 years. The increased burden of chronic diseases and scarce health resources compel healthcare systems to make modern patients more self-sufficient by requiring them to play a more active part in the treatment and management of their disease. Tele-home-care is a method of distance intervention through the transmission of electronic data for follow-up, education, prevention, clinical decision-making, and treatment modulation that has a high potential for the population with diabetes. Previous studies have not systematically evaluated the effects of different features of long-distance caregiving on diabetes at different stages of disease severity. Objectives: The present study describes a protocol for a systematic review and meta-analysis for summarizing the evidence comparing telehomecare interventions on diabetes management and its complications. Methods: PubMed, Scopus, ISI Web of Science, Cochrane databases, HTA (Health Technology Assessment), NHS EED (NHS Economic Evaluation Database), DARE (Database of Abstract of Reviews of Effects), Embase, and SID will be searched using medical subject heading (MeSH) keywords. Controlled clinical trials in patients with type 1 diabetes, type 2 diabetes, and gestational diabetes will be selected based on predefined eligibility criteria. The risk of bias in studies will be checked using the JADAD score. The mean difference and its standard deviation will be calculated to be used as effect size. A random-effects meta-analysis was performed to pool the results. Subgroup analysis and meta-regression will be conducted to explore the possible sources of heterogeneity. Conclusion: The systematic review and meta-analysis provided by the results of a systematic review can be useful to endocrinologists, physicians, public health policymakers, and the general population.
 
Background: It is suggested that palm oil consumption might increase chronic diseases including cardiovascular disease. Previous studies that investigated the effect of palm oil intake on anthropometric measures, blood glucose control, inflammation, and oxidative stress markers have led to inconsistent results. This is while no systematic review and meta-analysis has been conducted to summarize the data in this regard. Objectives: The present study describes a protocol for a range of systematic reviews and meta-analyses to examine the effect of palm oil intake on body weight and fat, inflammatory markers, oxidative stress, liver enzymes, blood pressure, and blood glucose control indices. Methods: ISI web of science, EMBASE, MEDLINE, Scopus, and Google Scholar will be searched using medical subject heading (MeSH) and non-MeSH keywords. Controlled clinical trials will be selected based on predefined eligibility criteria. The intra-study risk of bias will be checked by using the Cochrane collaboration tool. Mean difference (MD) (the difference between mean change values in the intervention group/period and control group/period) and its corresponding standard deviation will be calculated to be used as effect size. A random-effects meta-analysis will be performed to pool the results. Subgroup analysis and meta-regression will be conducted to explore the possible sources of heterogeneity. Sensitivity analysis will be conducted by removing the studies one-by-one from the overall analyses. Publication bias will be assessed by inspecting funnel plots and asymmetry tests. Conclusion: The results of systematic reviews and meta-analyses might provide helpful information about the effects of palm oil consumption on different aspects of health among adults. The evidence provided by the results of systematic reviews can be useful for dietitians, clinicians, public health policy-makers, and the public.
 
Background: It is suggested that palm oil consumption might increase chronic diseases including cardiovascular disease. Previous studies that investigated the effect of palm oil intake on anthropometric measures, blood glucose control, inflammation, and oxidative stress markers have led to inconsistent results. This is while no systematic review and meta-analysis has been performed to summarize the data in this regard. Objectives: The present study describes a protocol for a range of systematic reviews and meta-analyses to examine the effect of palm oil intake on body weight and fat, inflammatory markers, oxidative stress, liver enzymes, blood pressure, and blood glucose control indices. Methods: ISI web of science, EMBASE, MEDLINE, Scopus, and Google Scholar will be searched using medical subject heading (MeSH) and non-MeSH keywords. Controlled clinical trials will be selected based on predefined eligibility criteria. The intra-study risk of bias will be checked by using the Cochrane collaboration tool. Mean difference (MD) (the difference between mean change values in the intervention group/period and control group/period) and its corresponding standard deviation will be calculated to be used as effect size. A random-effects meta-analysis will be performed to pool the results. Subgroup analysis and meta-regression will be conducted to explore the possible sources of heterogeneity. Sensitivity analysis will be conducted by removing the studies one-by-one from the overall analyses. Publication bias will be assessed by inspecting funnel plots and asymmetry tests. Conclusion: The results of systematic reviews and meta-analyses might provide helpful data about the effects of palm oil consumption on different aspects of health among adults. The evidence provided by the results of systematic reviews can be useful for dietitians, clinicians, public health policy-makers, and the public.
 
Background: Almost 90% of people with diabetes have type 2 diabetes and the upward trend of this chronic disease is still ongoing, so that after about four decades, this disease is still one of the top 10 causes of death, while half of these deaths occur in people under 60 years of age. Therefore, prevention is essential and the implementation of the most effective intervention approach is required after recognizing at-risk individuals. This study aimed to evaluate the effect of lifestyle modification interventions and metformin on the prevention of type 2 diabetes and improvement in four risk factors related to diabetes. Methods: The study was conducted by searching PubMed, Scopus, Web of science, and Google Scholar without time and language restrictions. Randomized controlled trials which examined the effect of both lifestyle modification interventions and metformin in a population over the age of 18 years with no history of any type of diabetes were included. After the withdrawal of poor quality studies and those withfollow-up time of less than 6 months, structured review and meta-analysis will be performed to calculate the relative risk of type 2 diabetes incidence and mean difference in weight, body mass index, plasma fasting glucose, and hemoglobin A1c. Data analysis was performed using comprehensive meta-analysis software version 2.2.064. Conclusion: This study will make it possible to choose between two conventional therapeutic approaches (lifestyle modification and metformin) to prevent type 2 diabetes and its impact on four risk factors.
 
Background: Functional Gastrointestinal Diseases (FGIDs) impose a huge health burden, and lead to metabolic and mental disorders, impaired social function and productivity, reduced quality of life, higher total mortality and health care cost. Beverages are one of the major components of habitual dietary habits that may influence the symptoms of FGIDs. Objective: The purpose of this study was to review the effect of frequent dietary fluids on common causes of FGIDS including functional dyspepsia (FD), irritable bowel syndrome (IBS), gastroesophageal reflux disease (GERD) and functional constipation (FC). Methods: A literature search was done using the following search engines: PubMed, Google Scholar and ISI web of science with the following search terms “beverages”, tea”, “caffeine”, “coffee”, “milk”, “water”, “fruit juice”, “carbonated beverage”, “constipation”, “irritable bowel syndrome”, “gastroesophageal reflux disease”, “dyspepsia”,. Results: In this review, 85 studies were evaluated. It was shown that to higher intakes of caffeinated drinks, fruit juice, milk, soft drinks and carbonated beverages are associated with aggravating symptoms in GERD, IBS and FD. The data on the relation between water consumption with GERD, IBS and FD are limited and inconsistent. However, consumption of fruit juices and water was related to an improvement in constipation. Conclusion: Fluid intake can be effective in the management of FGIDs symptoms. However, further investigation on the role of various fluids consumption on symptoms of FGIDS is required.
 
Background: One of the most common causes of mortality in critical patients admitted to the intensive care unit (ICU) is sepsis. In recent years, the administration of high doses of vitamin C and HAT (hydrocortisone, ascorbic acid and thiamine) therapy has attracted much attention in patients with sepsis. Objectives: The current article reviews the beneficial effects of HAT therapy in light of research conducted in this area. Methods: A general search for electronic databases was developed. The human studies of the influence of HAT therapy in critically ill patients were evaluated. Results: The results indicated that HAT therapy may improve clinical outcome in septic patients; however, widespread use of these therapeutic approaches in sepsis requires large clinical trials in order to more confidently recommend this therapeutic approach in septic patients admitted to intensive care units. Conclusions: HAT therapy may improve clinical outcome in septic critically ill patients.
 
The article's abstract is not available.
 
Background: Social life can be affected by skin condition. Acne Vulgaris (AV) is a multi-factorial skin disorder that affects many people. Several dietary factors are associated with AV. Objectives: Different findings on glycemic indices led us to investigate the effect of the dietary glycemic index (GI) and glycemic load (GL) on AV by a systematic review and meta-analysis. Methods: Observational studies and clinical trials were extracted from PubMed, EMBASE, Scopus, and Google Scholar. The mean ± Standard division (SD) for acne grading in clinical trials and the mean ± SD GI or GL of the diet for observational studies were used for meta-analysis. Results: We found that nine out of 15 studies were eligible for systematic review clinical trials (N = 3) and observational studies (N = 6) designs. The meta-analysis of three studies clinically assessed the effect of GI/GL on acne and showed that a diet with lower GI/GL reduced the acne severity (Hedges’g = -0.91, 95% CI: -1.57, -0.25, P = 0.007). The analysis of six observational studies showed that dietary habit with higher GI might not affect the acne severity in patients with AV (Hedges’g = 0.07, 95%CI: -0.23, 0.38, P = 0.636), but individuals with higher acne severity had a diet with higher GL (Hedges’g = 0.64, 95%CI: 0.01, 1.26, P = 0.045). Conclusions: Diet, as a part of life style, is associated with AV. Adherence to lower GL diet may reduce the severity of AV. Further well-designed clinical trials are required to confirm these results.
 
Background: Researchers should seek applicable solutions and appropriate opportunities to solve or ravage barriers and limitations that worsen diabetes self-management and outcomes. Objectives: The aim of this critical review and research synthesis was to explore whether the enhancement of nutritional literacy can optimize diabetes self-management and to identify barriers and limitations that obstacle diabetes self-management and to suggest the best available solutions and opportunities that were tailored to eliminate these barriers. Methods: Data sources were PubMed and Medline databases. Studies were authorized if they were in English, used an observational or interventional design and were tailored based on the individual's nutritional knowledge or literacy in diabetes management among patients with diabetes. Databases were searched from February 1988 to December 2018. In order to evaluate the studies' quality, the abstracts that met PICO criteria for qualitative studies underwent dual review for data extraction. A qualitative synthesis was also conducted and the GRADE criteria were used to evaluate the quality of studies. Results: A structured inventory consisted of six constructs (socioeconomic determinants, cultural determinants, education, access to health care services, family structure, and thoughts and personal practices) was designed based on the barriers and limitations. As a result, 151 solutions and opportunities were proposed. Most repeated solutions that were frequently suggested to eliminate the existing barriers, were: "The access to optimal nutrition and health literacy", "Improved health care services", "Health policies of governments", "Sustainable lifestyle-based healthcare system", "Proper implementation of nutritional intervention programs", and "Comprehensive culturally sensitive diabetes education, and care programs". Conclusion: Identification and classification barriers and limitations to obstacle diabetes self-management are critical advances in accomplishing the interventions that can improve optimal diabetes outcomes, for different diabetic societies. Well-designed nutrition literacy intervention programs and preventive procedures may ameliorate the health status in diabetic population.
 
This article is an Editorial and does not include an Abstract.
 
Top-cited authors
Farzan Madadizadeh
  • Shahid Sadoughi University of Medical Sciences and Health Services
Mojtaba Mojtahedzadeh
  • Tehran University of Medical Sciences
Majid Motaghinejad
  • Tehran and Iran University of Medical Science
Mobina Abbasi
  • UiT The Arctic University of Norway
Razie Hormoznejad
  • Ahvaz Jundishapur University of Medical Sciences