Background: Diabetes is referred to a group of diseases characterized by high glucose levels in blood. It is caused by a deficiency in the production or function of insulin or both, which can occur because of different reasons, resulting in protein and lipid metabolic disorders. The aim of this study was to systematically review the prevalence and incidence of type 1 diabetes in the world. Methods: A systematic search of resources was conducted to investigate the prevalence and incidence of type 1 diabetes in the world. The databases of Medline (via PubMed and Ovid),ProQuest, Scopus, and Web of Science from January 1980 to September 2019 were searched to locate English articles. The located articles were screened in multiple levels of title, abstract,and full-text and final studies that met the inclusion criteria were retrieved and included in the study. Results: From 1202 located articles, 193 studies were included in this systematic review. The results of meta-analysis showed that the incidence of type 1 diabetes was 15 per 100,000 people and the prevalence was 9.5% (95% CI: 0.07 to 0.12) in the world, which was statistically significant. Conclusion: According to the results, the incidence and prevalence of type 1 diabetes are increasing in the world. As a result, insulin will be difficult to access and afford, especially in underdeveloped and developing countries.
BackgroundColorectal cancer is the third most common cancer in Iran. The increasing trend of colorectal cancer incidence in Iran and the close relationship with the geographical location are the underlying reasons for this study.MethodsData source: Eleven databases, including MEDLINE, EMBASE, SCOPUS, and four other databases, for articles in Persian were searched from April 2014 to October 2014. Additional data were obtained from an online survey of the Central Library of Tabriz Faculty of Medicine. Study eligibility criteria: In this systematic review and meta-analysis, we included studies reporting different measures of incidence, age-standardized incidence rates, and crude incidence rates. All rates (per 100,000 person-years) were standardized to the world standard population. Study appraisal and synthesis methods: A preliminary review of the title and abstracts of these articles was used to exclude any that were clearly irrelevant. The full text review determined whether the article was relevant to our topic. All the potentially relevant manuscripts were reviewed by two other investigators (S.D., M.G.). A total of 39 studies (10 Persian and 29 English articles) from different provinces and diverse areas of Iran, were analyzed in this study using comprehensive meta-analysis software. For accuracy studies, we used estimated rates for males and females with 95 % confidence intervals.ResultsAge-standardized incidence rates were obtained based on the random effects model and were 8.16 (95 % CI: 6.64 to 9.68) and 6.17 (95 % CI: 5.01 to 7.32) for males and females, respectively. The random crude rates were 5.58 (95 % CI: 4.22 to 6.94) for males and 4.01 (95 % CI: 3.06 to 4.97) for females.ConclusionsColorectal cancer incidence rates rise due to individual and environmental risk factors as well as improvement in the registry system and increase in access to health services. A more executed organized and structured system for collecting cancer data, in all cities and rural areas of the country, is an essential priority.
Rotator cuff tendinitis is one of the main causes of shoulder pain. The objective of this study was to evaluate the possible additive effects of low-power laser treatment in combination with conventional physiotherapy endeavors in these patients. A total of 50 patients who were referred to the Physical Medicine and Rehabilitation Clinic with shoulder pain and rotator cuff disorders were selected. Pain severity measured with visual analogue scale (VAS), abduction, and external rotation range of motion in shoulder joint was measured by goniometry, and evaluation of daily functional abilities of patients was measured by shoulder disability questionnaire. Twenty-five of the above patients were randomly assigned into the control group and received only routine physiotherapy. The other 25 patients were assigned into the experimental group and received conventional therapy plus low-level laser therapy (4 J/cm(2) at each point over a maximum of ten painful points of shoulder region for total 5 min duration). The above measurements were assessed at the end of the third week of therapy in each group and the results were analyzed statistically. In both groups, statistically significant improvement was detected in all outcome measures compared to baseline (p < 0.05). Comparison between two different groups revealed better results for control of pain (reduction in VAS average) and shoulder disability problems in the experimental group versus the control (3.1 ± 2.2 vs. 5 ± 2.6, p = 0.029 and 4.4 ± 3.1 vs. 8.5 ± 5.1, p = 0.031, respectively ) after intervention. Positive objective signs also had better results in the experimental group, but the mean range of active abduction (144.92 ± 31.6 vs. 132.80 ± 31.3) and external rotation (78.0 ± 19.5 vs. 76.3 ± 19.1) had no significant difference between the two groups (p = 0.20 and 0.77, respectively). As one of physical modalities, gallium-arsenide low-power laser combined with conventional physiotherapy has superiority over routine physiotherapy from the view of decreasing pain and improving the patient's function, but no additional advantages were detected in increasing shoulder joint range of motion in comparison to other physical agents.
Background: The principal aim of health service providers in the field of breast cancer is to detect and treat lesions at an appropriate time. Therefore, identification of barriers to screening can be very helpful. The present study aimed to systematically review the qualitative studies for extracting and reporting the barriers of screening for breast cancer from the womans perspective. Materials and Methods: In this systematic review; Pubmed, Google Scholar, Ovid Scopus, Cochrane Library, Iranmedex, and SID were searched using the keywords: screening barriers, cancer, qualitative studies, breast and their Persian equivalents, and the needed data were extracted and analyzed using an extraction table. To assess the quality of the studies, the Critical Appraisal Skills Programme (CASP) tool was used. Results: From 2,134 related articles that were found, 21 articles were eventually included in the study. The most important barriers from the point of view of 1,084 women were lack of knowledge, access barriers (financial, geographical, cultural), fear (of results and pain), performance of service providers, women's beliefs, procrastination of screening, embarrassment, long wait for getting an appointment, language problems, and previous negative experiences. Articles' assessment score was 68.9. Conclusions: Increasing women's knowledge, reducing the costs of screening services, cultural promotion for screening, presenting less painful methods, changing beliefs of health service providers, provision of privacy for giving service, decreasing the waiting time, and providing high quality services in a respectful manner can be effective ways to increase breast cancer screening.
Introduction: Chronic hepatitis is specified as inflammatory disease of the liver lasting for more than six months. Role of noninvasive fibrosis markers as prognostication factors of the presence or absence of significant fibrosis on liver biopsy of patients with chronic hepatitis is the aim of this study. Methods: Two hundred twenty-one patients with chronic hepatitis involved in the study between 2011 and 2013. Routine biochemical indices and serum fibrosis markers such as aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio (AAR), AST to platelet ratio index (APRI) and Fibrosis 4 score (FIB-4) were evaluated, and the histological grade and stage of the liver biopsy specimens were scored according to the Ishak scoring system. Diagnostic accuracies of these markers for prediction of significant fibrosis were assessed by Receiver Operating Characteristic (ROC) curve analysis. Results: Contemporaneous laboratory indices for imputing AAR, APRI, and FIB-4 were identified with liver biopsies. From all, 135 males (61.1%) and 86 females (38.9%), with mean age of 39.6±14.4 were studied. Significant correlation between stages of fibrosis and FIB-4, APRI and AAR were detected, with a correlation coefficient higher than that of other markers in the patients with Hepatitis B (r = 0.46), C (r = 0.58) and autoimmune hepatitis (r = 0.28). FIB-4 (AUROC = 0.84) and APRI (AUROC = 0.78) were superior to AAR at distinguishing severe fibrosis from mild-to-moderate fibrosis and gave the highest diagnostic accuracy. Conclusion: Application of these markers was good at distinguishing significant fibrosis and decreased the need for staging liver biopsy specimens among patients with chronic hepatitis.
Background: Oral cancer stands among the 10 top causes of cancer death in the world. Considering the role of epidemiologic information on planning and effective interventions, the present study aimed to investigate the epidemiology of oral cancer in Iran. Materials and Methods: The required information for this systematic review study was obtained from PubMed, Google Scholar, CINAHL,SID, Medlib, Magiran and Iranmedex databases, using key words "cancer", "oral cancer", "squamous cell carcinoma", "oral cavity carcinoma" and their Persian equivalents in combination with keywords of epidemiology, prevalence, etiology, frequency, and Iran from 1990 to 2014. From 1,065 related studies found, finally 25 were included to the study. Results: The mean age of 8,248 patients in 25 studies was 54.0±15.1 years. The male/female ratio for oral cancer was 1.91. Tongue with average percentage of 29.9 was the most involved site. Regarding microscopic grade, 65.7% of cases were grade 1. SCCs, accounting for an average of 70.0%, was the most common among all types of oral cancer. In the majority of studies, smoking including cigarette, hookah, and tobacco consumption was found to be a risk factor. Conclusions: The epidemiological pattern of oral cancer in Iran is somewhat similar to that of other countries. Yet the information on hand in this field is limited and considering the role of epidemiological data we suggest conducting more accurate studies to catch data that is required for effective programs and interventions.
Our study suggests that deficiency of 25(OH)D may be a trigger factor for BD.
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