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Context: Migraine is a major dilemma and problem which affects public health and results to reduced quality of life. This study aimed to determine the prevalence of migraine in Iran.Evidence Acquisition: A systematic search was conducted using Pub Med, Web of Science, Embase, Scopus, Ovid, Google Scholar, as well as Iranian databases including: MagIran, IranMedex and Scientific Information Databank, from 2000 to November, 2015. The Der-Simonian/Laird's random-effects model, with a 95% confidence interval was employed to estimate the overall pooled prevalence. Heterogeneity was investigated using subgroup analysis based on sample size and time of study.Results: Thirty studies comprising 33,873 participants met the inclusion criteria for the analysis. The overall prevalence of migraine in Iran was 14% (95% CI, 12% to 17%), respectively. The overall prevalence was (8%; 95% CI 6% to 11%) according to the international classification of headache disorders (ICHD-1), (17%; 95% CI 13% to 21%) according to ICHD-2, and (18%; 95% CI 7% to 30%) according to the other questionnaire for migraine screener (ID Migraine), respectively. Meta-regression demonstrated that the prevalence of migraine increased by year of publication and decreased by sample size. Conclusions:The prevalence of migraine in Iran, which was estimated as 14%, was similar or even higher than that reported worldwide. Migraine can have impact on the economic productivity of any country; therefore it is necessary to educate people on the early detection and the discovery of an effective treatment of migraine. More thorough review of further studies in this field is recommended.

IntroductionCeliac disease (CD) is a chronic autoimmune-mediated disorder with both intestinal and systemic manifestations. The aim of this study was to determine the prevalence of celiac disease in Iran.MethodsWe conducted a systematic search on Embase, Pub Med, Web of Science, Google Scholar, MagIran, Scientific Information database (SID) and Iranmedex from 2003 through to November 2015. The Der-Simonian/Laird’s (DL), with a 95% confidence interval employed to estimate the overall pooled prevalence. Heterogeneity was investigated by using subgroup analysis based on sample size and time of study.ResultsSixty-three studies with 36,833 participants met inclusion criteria for analysis. The overall prevalence of celiac disease in 63 studies that had used serological tests for the diagnosis was observed as 3% (95% CI: 0.03–0.03) and the overall prevalence of celiac disease in studies that had used biopsy method for diagnosis was observed as 2% (95% CI: 0.01–0.02).ConclusionThe prevalence of celiac disease in Iran was similar or even higher than world-wide reported.

BackgroundDiabetes mellitus is one of the most prevalent diseases worldwide. Diabetes is a chronic disease associated with micro- and macro-vascular complications and deterioration in general health status. Therefore, the aim of this study was to estimate general health status among Iranian diabetic patients through a systematic review and meta-analysis of study utilizing the Short-Form-36 questionnaire.MethodsSearching the EMBASE, PubMed, ISI/Web of Sciences (WOS), MEDLINE via Ovid, PsycoINFO, as well as Iranian databases (MagIran, Iranmedex, and SID) from January 2000 to December 2017. The methodological quality of the studies was evaluated using the “A Cochrane Risk of Bias Assessment Tool: for Non-Randomized Studies of Interventions” (ACROBAT-NRSI). Random-effect model was used and the means were reported with their 95% confidence interval (CI). To evaluate the heterogeneity between studies, I2 test was used. Egger’s regression test was used to assess the publication bias.ResultsFourteen studies were retained in the final analysis. The mean general health status using SF-36 in diabetic patients of Iran was 51.9 (95% CI: 48.64 to 53.54). The mean physical component summary was 52.92 [95% CI: 49.46–56.38], while the mean mental component summary was 51.02 [95% CI: 46.87–55.16].ConclusionThe findings of this study showed that general health status in Iranian diabetic patients is low. Health policymakers should work to improve the health status in these patients and take appropriate interventions.Electronic supplementary materialThe online version of this article (10.1186/s12902-018-0262-2) contains supplementary material, which is available to authorized users.

Background Organizational reforms of hospitals in Iran are mainly aimed at improving efficiency, reducing government spending on health care, and improving the quality of services. These reforms began with hospital autonomization and have continued with other initiatives such as formation of board of trustees, independent and corporatized hospitals. Objective The purpose of this scoping review was to summarize and compare the results of studies conducted on organizational reform of hospitals in Iran to paint a more clear picture of the status quo by identifying knowledge gaps, inform policymakers, and guide future studies and policies. Method This review’s methodology was inspired by Arksey and O’Malley’s methodological framework to examine the extent, range, and nature of research activity about organizational hospital reforms in Iran. A literature search was performed using PubMed, Scopus, Web of Science, and Google Scholar for English papers as well as SID, IranDoc, Magiran, and the Social Security Research Institute Database for Persian papers from 1991 to April 2020. Results Twenty studies were included in the review. Studies were grouped by the types of organizational reform, study’s objective, setting, methodology, data collection and analysis techniques, and key findings. Thematic construction was used based on the types of organizational reform to present a narrative account of existing literature. Conclusions The autonomy granted to the hospitals was unbalanced and paradoxical in terms of key effective dimensions. Poor governance and regulatory arrangements, low commitment to corporate governance, Inappropriate board composition, weak internal controls, unsustainable financing and inefficient payment mechanisms, poor interaction with stakeholders and ignoring contextual factors have been cited as the main reasons for the failure of organizational reforms in Iran. The limited use of evidence and research was obvious at different stages of policymaking, especially in the policy formulation phase and evaluation of its results.

Allopurinol and febuxostat are urate-lowering drugs used for the long-term treatment of gout through reducing the uric acid levels. More studies have indicated cost-effectiveness of febuxostat in reducing serum urate concentration and showed that it alleviates gout flares better than allopurinol. However, related studies have reported conflicting results about the cost-effectiveness of these drugs. →What this article adds:Febuxostat is more cost-effective than allopurinol in all treatment sequences in studies which have used uric acid level as the measure of effectiveness. In addition, febuxostat has been shown to be more costeffective as the second-line treatment in studies with the quality of life as the measure of effectiveness.

Background: Hepatitis B Virus (HBV) is one of the most serious infectious diseases and represents a major global health issue worldwide. It can be transmitted vertically and horizontally through contact with infected blood or body fluids. More attention to HBV infection in pregnancy is needed due to high risk of chronicity when transmitted to infants during delivery. Objectives: A comprehensive review of the HBV prevalence rate in pregnant females taking into account different geographical areas and socio-economic status is still lacking. This would be of crucial importance for HBV prevention and control programs. As such, this systematic review and meta-analysis was conducted focusing on HBV prevalence rate in pregnant females from different parts of the world. Methods: Different electronic databases, including Embase, PubMed/MEDLINE, Scopus, and ISI/Web of Science were searched from January 1st 2000 to July 31st 2016, using relevant keywords, such as "prevalence" or "seroprevalence" or "epidemiology" and "pregnancy" or "pregnant" or "antenatal" in combination with "hepatitis B virus" or "HBV" with no language restrictions. The study protocol of this systematic review was deposited at the "International Prospective Register of Systematic Reviews" and registered as CRD42016041985. Results: After scrutinizing all the extant scholarly literature from 2000 to 2016, this study found 222 relevant articles. The overall HBV prevalence rate in pregnant females worldwide was estimated using a random-effect model, giving a value of 3% (95% confidence interval or CI 2% -4%). Heterogeneity between studies was significantly high (I 2 = 99.9%, P < 0.0001). The clinical and epidemiological burden was higher in developing countries. Conclusions:This suggests that despite the recent scientific advancements and the clinical progress that has occurred in anti-viral therapy, HBV still represents a major issue worldwide, especially in underdeveloped countries. The key strategies for preventing transmission from pregnant females to their fetuses are through early birth dose and infant vaccination, as well as by the use of hepatitis B immunoglobulin (HBIG) and the screening and diagnosis of mothers at high risk and the subsequent use of anti-viral agents during pregnancy in order to reduce maternal DNA concentrations down to undetectable concentrations. Health authorities should effectively implement these approaches to better control HBV in pregnancy.

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