saeed khorramnia

Cytomegalovirus is one of the most significant causes of infection in infants, leading to congenital disabilities, developmental disabilities, hearing loss, and even death. This study aimed to determine the prevalence of cytomegalovirus infection among infants in Iran through a systematic review and meta-analysis.

PubMed, Scopus, Web of Science, Science Direct, Scientific Information Database, as well as Magiran electronic databases were searched to find relevant articles published up to September 2024. A hand search was also conducted on primary review sources and key studies. The languages of the studies were limited to Persian and English. Bias assessment of the studies was performed using the Newcastle-Ottawa Scale checklist. Data analysis was conducted using Comprehensive Meta-Analysis software version 3.

A total of 15 observational studies, including 5889 infants were included in the analysis. The results of the meta-analysis showed that the prevalence of cytomegalovirus in infants was 3% (95% confidence interval [CI]: 0.01–0.10; P < 0.05). Additionally, the prevalence of cytomegalovirus in male and female infants was 2% (95% CI: 0.004–0.10; P < 0.05) and 3% (95% CI: 0.007–0.16; P < 0.05), respectively. No statistically significant relationship was observed between the prevalence of cytomegalovirus in infants and the year of publication of the studies (P > 0.05). However, a statistically significant relationship was observed between the prevalence of cytomegalovirus in infants and the sample size of the studies (P < 0.05). Publication bias was noted in the study (P < 0.05).

The findings showed that cytomegalovirus prevalence is high in infants, and comprehensive surveillance programs are necessary for the effective management and prevention of cytomegalovirus infections in infants.

Mood-behavioral disorders are highly prevalent in patients with epilepsy and have significant effects on the quality of life of these patients. Mood-behavioral disorders in patients with epilepsy have received less attention due to the focus on seizure management. This study was conducted with the aim of investigating the prevalence of mood-behavioral disorders in patients with epilepsy in Iran.

An electronic search was conducted in PubMed, Scopus, Web of Science, Science Direct, SID, and Magiran databases until August 2024. Also, a manual search was performed in the sources of primary review and key studies. The language of studies was limited to Farsi and English. Assessment of study bias was done with the Newcastle-Ottawa Scale checklist. Data analysis was done using Comprehensive Meta-Analysis version 3 software.

A total of 18 studies, including 2919 patients, were included in the study. The results of the meta-analysis showed that the prevalence of depression, anxiety, obsessive-compulsive disorder, phobia, bipolar disorder, stress, and panic in patients with epilepsy is 36% respectively (confidence interval 95% [0.24-0.49], P=0.03), 27% (95% [0.17-0.41], P<0.001), 27% (95% [0.24-0.30], P<0.001), 18% (95% [0.11-0.28], P<0.001), 3% (95% [0.01-0.08], P<0.001), 13% (95% [0.07-0.19], P=0.71), and 5% (95% [0.04-0.07], P<0.001).

The prevalence of mood and behavioral disorders in patients with epilepsy is high. This situation not only affects the mental health of patients but can also lead to a decrease in the quality of medical care and an increase in treatment burden. Therefore, timely identification and treatment of mood-behavioral disorders in these patients is essential.

Nurses in intensive care units face unique challenges that can have serious effects on their mental health and job performance, leading to depression, stress, and anxiety. This study was conducted to determine the prevalence of depression, stress, and anxiety among nurses in critical care units in Iranian hospitals through a systematic review and meta-analysis.

An electronic search was conducted in PubMed, Scopus, Web of Science, ScienceDirect, Scientific Information Database, and Magiran until June 2024. A manual search was also conducted in key review articles and primary sources. The studies were limited to Persian and English languages. Study bias was evaluated using the Newcastle-Ottawa Scale checklist, and data analysis was carried out using Comprehensive Meta-Analysis software version 3.

A total of 18 observational studies involving 2,611 nurses were included in the study. The results of the meta-analysis indicated that the prevalence of depression, stress, and anxiety among ICU nurses was 28% (95% confidence interval [CI] 0.14-0.47, P=0.03), 68% (95% CI 0.53-0.80, P=0.01), and 53% (95% CI 0.29-0.76, P=0.76), respectively. There was no significant relationship between the prevalence of stress and the year of publication of the study (P>0.05). Publication bias was not observed in the study.

Intensive care unit nurses experience depression, stress, and anxiety. Therefore, implementing effective measures to identify and alleviate these issues among nurses can enhance their well-being and positively impact the quality of patient care.

Casirivimab/imdevimab and bamlanivimab are monoclonal antibodies that are used in the treatment of patients with COVID-19. The aim of the present study was to compare the effectiveness and safety of the casirivimab/imdevimab versus bamlanivimab in COVID-19 patients through a systematic review and meta-analysis.

A systematic search was conducted in PubMed, Scopus, Cochrane Library, and Web of Science databases to identify relevant articles up to March 2024. Moreover, a manual search was performed in the sources of primary review and key studies. There was no restriction on the language of the studies. The risk of bias of the studies was conducted using the ROBINS-I tool. Data analysis was performed using Review Manager Software version 5.4.

A total of 10 observational studies involving 10695 patients were included in the study. The results of the meta-analysis showed that casirivimab/imdevimab significantly reduced the hospitalization rate compared to bamlanivimab (odds ratio [OR]: 0.56, %95, 0.40-0.79, P<0.001). However, there was no significant difference between casirivimab/imdevimab and bamlanivimab groups in terms of mortality rate (OR: 0.53, %95, 0.25-1.13, P=0.10), emergency department visit (OR: 0.91, %95, 0.71-1.17, P=0.48), ICU admission (OR: 0.65, %95, 0.33-1.26, P=0.20), mechanical ventilation (OR: 0.28, %95, 0.05-1.54, P=0.14) and adverse events (OR: 0.44, %95, 0.15-1.34, P=0.15).

The results of this meta-analysis showed that there is no difference between casirivimab/imdevimab and bamlanivimab in terms of clinical effectiveness and safety. However, casirivimab/imdevimab has better effectiveness compared to bamlanivimab in reducing hospitalization rates in the patients with COVID-19.

Monoclonal antibodies cazirivimab and imdevimab are used as a combination drug in the treatment of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). The aim of this study was to investigate the clinical effectiveness of the combined medication of casirivimab and imdevimab in patients with COVID-19.

Searches were conducted in the electronic databases of PubMed, Scopus, Cochrane Library, and Web of Science to identify relevant articles from 2020 to 2023. Additionally, a manual search was performed in primary review sources and key studies. There were no language restrictions for the studies. The quality assessment of the studies was conducted using the ROBINS-I tool. Data analysis was performed using Review Manager Software version 5.4.

A total of 14 studies involving 461598 patients were included in the study. The results of the meta-analysis showed that there was a significant difference between the casirivimab and imdevimab and standard of care groups in terms of mortality rate (odds ratio [OR]: 0.29, %95, 0.10-0.86, P<0.00001), hospitalization rate (OR: 0.35, %95, 0.22-0.44, P<0.00001), need for oxygen therapy (OR: 0.23, %95, 0.12-0.46, P<0.00001), hospitalization or death (OR: 0.40, %95, 0.38-0.43, P<0.00001), and mechanical ventilation (OR: 0.19, %95, 0.08-0.43, P<0.00001).

The results of this meta-analysis study showed that casirivimab and imdevimab is an effective treatment in reducing mortality rate, hospitalization rate, need for oxygen therapy, hospitalization or death, and mechanical ventilation in patients with COVID-19.

Bamlanivimab is a monoclonal antibody for the treatment of mild to moderate cases of Coronavirus disease 2019 (COVID-19). The aim of the current meta-analysis review study was to compare the efficacy of bamlanivimab and standard treatment in the treatment of patients with Covid-19.

PubMed, Scopus, Cochrane Library and Web of Science databases were searched to identify relevant articles from 2020 to 2023. Also, a manual search was performed in the sources of primary review and key studies. There were no restrictions on the language of the studies. Evaluation of the quality of studies was done with the Newcastle tool. Data analysis was done using Review Manager software version 5.4.

In total, 16 studies including 23166 covid-19 patients were included in the study. The results of the meta-analysis showed that a significant difference was observed between the bamlanivimab and standard care groups in terms of mortality rate (odds ratio [OR] = 0.26, confidence interval [CI]: 0.17 to 0.42, P>0.001), hospitalization rate (OR= 0.45; 95% CI: 0.31 to 0.66, P>0.001), and ICU admission (OR= 0.39; 95% CI: 0.21 to 0.72, P=0.003).

According to evidence from the current review, bamlanivimab reduces mortality, risk of hospitalization, and intensive care unit (ICU) admission in the patients with mild or moderate Covid-19. The results of this study can help health policy makers in choosing effective treatments for Covid-19 patients.

COVID-19 continues to pose a significant healthcare challenge throughout the world. This study aimed to investigate epidemiological characteristics and associated mortality factors among hospitalized patients with COVID-19 in the Mazandaran province.

In this descriptive study, the medical information of patients admitted to 39 hospitals in 17 cities in Mazandaran province between February 20, 2020, and February 20, 2021, were initially assessed and then entered the survey based on the study criteria. For data analysis, statistical approaches such as Chi-square and Fisher's exact test were performed at a significance level of 5%.

Out of the initial 34036 patients total patients, 21007 were included in the study with a mean age of 53.75±18.23 years, and 10219(48.6%) were males. The majority of cases and the highest mortality percent belonged to the age groups of 60 to 70 and 70 to 80. The Mortality proportion was 11.6% (n=2431), with a higher value in males than females. Moreover, the highest mortality rate was seen in ICU  (n=2803, 85.7%). Underlying diseases with the highest mortality rate were diabetes  (n=2058, 43%) and chronic heart disease  (n=166, 6.83%). The most common symptoms of illness were fever  (n=9025, 43%), hemoptysis  (n=5911, 28.10%), sore throat  (n=3771, 18%), and low blood pressure  (n=3626, 17.30%).

This study showed a high mortality rate among COVID-19 cases and dissected the related risk factors, including age, gender, underlying diseases, and ICU admission.

Background & Aims:

Molnupiravir is an oral antiviral drug which is used in the treatment of patients with COVID-19. The purpose of this study was to investigate the effectiveness and safety of molnupiravir in the treatment of patients with COVID-19.

Materials & Methods:

A systematic search was conducted in PubMed, Scopus, Cochrane Library, Web of Science, Google Scholar, and Trip database from 2019 to 2022. In addition, a manual search was performed in the sources of primary review and key studies. No restrictions were considered for the language of the studies. Evaluation of the quality of studies was done with Jadad and Newcastle scoring systems. Data analysis was performed using Comprehensive Meta-Analysis version 3 software.

Ten studies with total population of 24221 patients were included in the study. The results of the meta-analysis showed that the risk ratio (RR) between the two groups of molnupiravir and control for the outcome of the mortality rate was 0.67 (0.30-1.49) (P=0.33), for the hospitalization rate was 1.40 (2.50-0.78) (P=0.26), for hospitalization or death was 1.09 (2.69-0.44) (P=0.85), for mechanical ventilation was 0.61 (1.33-0.12) (P=0.11), and for side effects was 0.93 (0.82-1.06) (P=0.29); the difference between means for these outcomes were not significant.

The findings of this study showed that molnupiravir has no effect on reducing mortality rate, hospitalization rate, hospitalization or death, and mechanical ventilation of the patients, although it was safe in the patients.

 Postoperative pain management is one of the major challenges of surgeons and anesthesiologists.

 This study aimed to determine the efficacy of topical ketorolac in post-hemorrhoidectomy pain management.

 This clinical trial was conducted on 84 candidates for hemorrhoidectomy (grade-II hemorrhoids) who visited Ali ibn Abi-Talib hospital of Rafsanjan, Kerman, Iran (2020 - 2021). The participants were selected through convenience sampling and randomly assigned to three groups of 28. The subjects were treated in topical (4 mL 0.5% Marcaine + 1 mL ketorolac at the surgical site), intramuscular (4 mL 0.5% Marcaine at the surgical site + 1 mL ketorolac intramuscularly), and control (4 mL 0.5% Marcaine at the surgical site) groups. Pain intensity was measured using the Numerical Pain Rating Scale 1, 6, 12, and 24 hours after surgery. The obtained data were analyzed using two-way repeated measures analysis of variance.

 Female and male patients constituted 46.4% and 53.6% of the participants, respectively. The mean pain intensity was significantly lower in the topical group than in intramuscular and control treatments in all four stages of pain assessment (P < 0.001). Some participants were treated with pethidine due to high pain intensity. However, the mean pain intensity gradually reduced over time in all three groups.

 Study findings suggested that the topical administration of ketorolac and Marcaine was more effective than Marcaine used alone for relieving pain in patients undergoing hemorrhoidectomy.

Remdesivir is an antiviral drug that is widely used in patients with Covid-19. The aim of this study was to review the systematic review and meta-analysis studies of Remdesivir in patients with Covid-19.

An electronic search was conducted in PubMed, Scopus, Cochrane Library, and Web of Science databases up to December 2021. In addition, other databases were searched. A manual search of studies and other sources was also conducted to find evidence. The tool (Overview Quality Assessment Questionnaire) was used to evaluate the quality of articles.

Seventeen systematic review and meta-analysis studies were included in the study. The results showed that Remdesivir in seven studies reduced the mortality of patients with Covid-19 and in seven other studies had no effect on reducing patient mortality compared to the control group. Other findings of the study also showed that Remdesivir increased clinical improvement, increased clinical recovery, reduced clinical recovery time, and accelerated the discharge time of patients with Covid-19 from the hospital. Side effects were well tolerated in most studies in the Remdesivir group. Adverse events were mild and moderate in most studies in the Remdesivir group.

The findings of the study showed that the mortality rate in patients treated with remedsivir in studies is different, so it is better to use this drug with caution. Adverse events were well tolerated.

Favipiravir is an antiviral drug that is widely used in patients with Covid-19. The aim of this study was to review the systematic review and meta-analysis studies of Favipiravir in patients with Covid-19.

An electronic search was conducted in PubMed, Scopus, Cochrane Library, and Web of Science databases until December 2021. In addition, other databases were searched. A manual search of studies and other sources was also conducted to find evidence. The Overview Quality Assessment Questionnaire tool was used to evaluate the quality of articles.

Seven systematic review and meta-analysis studies were included in the study. The results showed that there was no statistically significant difference in mortality between Favipiravir and control groups in the patients with Covid-19. Other findings showed that the rate of clinical improvement was higher in two studies on day 7 in the Favipiravir group than that in the control group, while in another study, no statistically significant difference was found between Favipiravir and the control groups. Other findings of the study showed that negative RT-PCR result rate in four studies in the Favipiravir group was higher than that in the control group, although in one study no statistically significant difference was found between the two groups. Also, no difference in mechanical ventilation was found in the favipiravir and control groups. Regarding Side effects, most studies indicated that there was no difference between Favipiravir and control.

The results showed that Favipiravir has no effect on mortality and mechanical ventilation and only affects the rate of clinical improvement of patients and negative result for RT-PCR.

Spinal anesthesia is the mostcommonanesthesia technique used for cesarean section. Postdural puncture headache (PDPH) is one of the consequences following spinal anesthesia.

The primary aim of this study was to compare the incidence of PDPH with 25-gauge Quincke and Whitacre’s spinal needles. Secondary outcomes were mean severity of PDPH, need for analgesic, movement limitation, and associated symptoms and signs followed up for 1 week after surgery.

In this randomized trial study, 130 women were randomly divided into 2 equal groups based on the excel file and random between function. They received spinal anesthesia with either Quincke or Whitacre spinal needles. The incidence of PDPH was followed up 1 week later. Among PDPH women, secondary outcomes and symptoms/signs (such as nausea, vomiting, neck pain, and shoulder pain) were evaluated for 1 week after surgery.

All 130 women completed the study. PDPH was observed in 16 women (12.3%), including 6 (9.2%) in the Whitacre group and 10 (15.4%) in the Quincke group, which was not statically significant (P = 0.424). However, secondary outcomes and associated signs and symptoms were more common in the Whitacre group than in the Quincke group, followed up for 1 week in this trial. It can be related to more primary headache history in the Whitacre group than in the Quincke group.

Overall, the Whitacre spinal needle is better than Quincke in reducing the incidence of PDPH, but primary headache history in young women causes higher mean severity of PDPH in them. Also, primary headache history causes more associated symptoms and signs in women with PDPH.

Bacterial infections in hospitals are one of the most common causes of death in neonates admitted to the intensive care units. In order to control and prevent these infections in neonates admitted to intensive care unit, it is not possible to know the prevalence of these infections. The purpose of this systematic review and meta–analysis was to estimate the prevalence of bacterial infections in neonatal intensive care units.

A systematic review of the literature for related articles was conducted in SID, Mag Iran, PubMed, Scopus, Science direct, and Google Scholar databases up to November 2019. The articles were limited to the English and Persian languages. In order to increase the sensitivity of the search, the reference lists of studies that entered the final phase was manually scanned. The quality of the studies was evaluated with the STROBE. Meta-analysis of data was performed using CMA version 2 software.

14 studies were included in the meta-analysis. Since the studies were not homogeneous enough, the random-effects modeling method was used. The meta-analysis findings showed that the prevalence of bacterial infections in the neonatal intensive care unit was 10.3% C.I = (0.078,0.135).

The meta-analysis results showed that the prevalence of nosocomial bacterial infections in neonatal intensive care units is 10%.

APACHE scoring systems are performed to predict the mortality rate of patients admitted to the hospitalchr('39')s intensive care unit (ICU). At present, APACHE II, III and VI are used in ICUs of Iranian hospitals. Due to the high mortality rate in the ICU, compared to other parts of the hospital and the use of APACHE systems in predicting the mortality rate, determining the best predictor is very important. Therefore, this study was performed to determine the best system for predicting the mortality of patients admitted to the ICU.

An electronic search in SID, Magiran, PubMed, Scopus, ScienceDirect and Google Scholar databases was performed until November 2019 using keywords. The list of key study sources was also reviewed to find studies that may not have been found through electronic search. The quality of studies was assessed with STROBE checklist. Data analysis was performed using CMA software version 2.

21 studies involving 3576 patients were meta-analyzed. 14 studies used the APACHE II, three studied used Apache III, and four studied used Apache IV. The meta-analyses found that the final estimate of the accuracy of the APACHE II in predicting mortality was 0.052 (CI = 0.030; 0.091), APACHE III 0.09 (CI = 0.029; 0.245), and APACHE IV 0.088 (C.I = 0.031; 0.228).

The findings of this study showed that the APACHE III had more accuracy in predicting the mortality rate of patients admitted to the ICU compared to APACHE II and IV. The ward has special care. It is recommended that this scoring system be used in hospitals to prioritize patients admitted to the ICU.

The mortality rate index in the Intensive Care Unit (ICU) can be used to evaluate new treatments and specialist human resources and optimize resource allocation. Mortality in the ICUs of Iranian hospitals has been sporadically reported. The purpose of this study was to estimate the overall mortality rate of ICU patients in Iranian hospitals.

A systematic review was conducted in SID, MagIran, PubMed, Scopus, Web of Science, and Google Scholar for related articles until November 2019. Also, the reference lists of key studies were checked for additional citations. Quality assessment of studies was performed using the STROBE checklist. The results of the studies were analyzed using Comprehensive Meta-Analysis (CMA) software version 2.

Twenty-six studies involving 8980 patients were included in the review. The findings of the meta-analysis indicated that the overall mortality in ICU patients was 29.8% (95% CI, 0.259_0.34; P<.05). The prevalence of mortality in men and women was 29.8% (95% CI, 0.211_0.389; P<.05) and 29.2% (95% CI, 0.235_0.369; P<.05), respectively.

Mortality rate in ICU patients in Iranian hospitals is high compared to other countries. Therefore, resources and facilities should be considered in the ICUs.

Headache is one of the complications of spinal anesthesia in various surgeries. Spinal anesthesia has a major role in cesarean section. This study was performed with aim to investigate the effect of semi-sitting position on headache after spinal anesthesia in women undergoing elective Cesarean Section. This interventional study was performed on 110 pregnant women with cesarean section at Rafsanjan Nikanfas Hospital in 2018. In recovery time, the subjects were placed into two groups: head position in 30 degree and flat position. The incidence and intensity of headache was assessed using the pain Visual Analogue Scale in the first, second and third days after the surgery. Data were analyzed by SPSS software (version 18) and independent t-test, Chi-square test and Two-way Repeated Measures ANOVA. P Mean of headache severity in the group with flat head position in the first, second and third days was 0.98 ± 2.41, 0.87 ± 2.16 and 0.78 ± 1.92, respectively, and in the group of 30 degrees head position was 1.41 ± 2.89, 1.30 ± 2.70 and 1.12 ± 2.33, respectively. The severity of pain in both groups was significantly decreased on different days (p <0.0001), although there was no significant difference between the two groups (p =.379). Flat head positioning during recovery of spinal anesthesia in women undergoing elective cesarean section decreased the severity of postoperative headache compared with head position at 30 degrees, although this difference was not statistically significant.

One of the annoying side effects of spinal anesthesia in cesarean section surgery is the post-dural puncture headache (PDPH) which occurs 2 to 5 days after the surgery. The aim of this study was to examine the effect of bilateral occipital nerve block (GONB) in the treatment of PDPH after cesarean section surgery. In this randomized clinical trial, 74 pregnant women who underwent cesarean section with spinal anesthesia in 2017 and referred to Rafsanjan Pain Clinic with PDPH, were randomly assigned into two groups of 37. In the first group, GONB treatment was done by bupivacaine and dexamethasone and the second group received oral drug treatment with acetaminophen and pregabalin. Patients in either group were evaluated for headache severity before intervention, 1, 6 and 24 hours after intervention. Data was analyzed using two-way repeated measures ANOVA. The results of the statistical test showed that the interaction effect of the type of treatment and the time of the evaluation of the headache was statistically significant (F=130.912, p<0.001). This means that the rate of headache reduction during the study period was significantly higher in the GONB group than in the oral treatment ones. According to the results, despite the effectiveness of both therapies, the effect of GONB on reducing headache severity was greater than that of medication. It seems that GONB can be used as an effective alternative to PDPH treatment.

Low Back Pain (LBP) is a common musculoskeletal disorder which may have an occupational or non-occupational etiology and is seen in many health care providers. It is an important cause of morbidity and workplace absence. Various factors may result in LBP but the role of occupational stress and anxiety personality disorder is still unclear.
Therefore, the aim of the present study was to investigate the effect of sedation with dexmedetomidine on the incidence of AF in patients admitted to the intensive care unit after CABG surgery.
Face-to-face interviews were conducted with 58 anesthesiologists working in the hospitals of Tehran University of Medical Sciences to evaluate the occurrence of LBP in the first year of work. The probable causes of LBP and the level of anxiety were assessed using a questionnaire designed for this purpose, based on Spielberger state-trait anxiety inventory (STAI), and the results were analyzed.
Of 58 participants, 44 (75.9%) were men and 14 (24.1%) were women. The mean age of the participants was 45.6±6.3 years. Twenty-four of 58 participants (41.4%) reported LBP in the first year of work. Six participants (10.3%) did not have anxiety state but had LBP in the first year of work. Eighteen subjects (31%) with mild to severe anxiety state also had LBP in the first year of work. Nine anesthesiologists (15.5%) did not have anxiety trait but had LBP in the first year of work. Fifteen participants (25.8%) had mild to severe anxiety trait and had LBP in the first year of work.
In general, 24 of 58 participants (41.4%) with an anxiety score of 47.52 (moderate level of anxiety) had LBP, and 34 of 58 participants with an anxiety score of 41.01 (moderate level of anxiety) did not have LBP. There was a significant correlation between the occurrence of LBP and the level of anxiety (P=0.014).
The personality type, smoking, history of psychiatric disorders, occupational satisfaction, communication with colleagues, sleep quality, history of LBP during work years, especially in the first year, duration of LBP, stress in the first year of work, and weekly hours of exercise had a significant association with anxiety (P LBP is a multi factorial disorder of human. It seems that LBP can be related to stress and mechanical factors.