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Background: It is generally assumed that there have been mixed results in the literature regarding the association between ambient particulate matter (PM) and myocardial infarction (MI). The aim of this meta-analysis was to explore the rate of short-term exposure PM with aerodynamic diameters ≤2.5 μm (PM 2.5) and examine its potential effect(s) on the risk of MI. Methods: A systematic search was conducted on databases like PubMed, Scopus, Web of Science, and Embase with components: "air pollution" and "myocardial infarction". The summary relative risk (RR) and 95% confidence intervals (95%CI) were also calculated to assess the association between the PM 2.5 and MI. Results: Twenty-six published studies were ultimately identified as eligible candidates for the meta-analysis of MI until Jun 1, 2018. The results illustrated that a 10-μg/m 3 increase in PM 2.5 was associated with the risk of MI (RR = 1.02; 95% CI 1.01-1.03; P ≤ 0.0001). The heterogeneity of the studies was assessed through a random-effects model with p < 0.0001 and the I 2 was 69.52%, indicating a moderate degree of heterogeneity. We also conducted subgroup analyses including study quality, study design, and study period. Accordingly, it was found that subgroups time series study design and high study period could substantially decrease heterogeneity (I 2 = 41.61, 41.78). Conclusions: This meta-analysis indicated that exposureresponse between PM 2.5 and MI. It is vital decision makers implement effective strategies to help improve air pollution, especially in developing countries or prevent exposure to PM 2.5 to protect human health.

Background: Nosocomial infections represent a serious public health concern worldwide, and, especially, in developing countries where, due to financial constraints, it is difficult to control infections. This study aimed to review and assess the prevalence of nosocomial infections in Iran. Methods: Different databases were searched between January 2000 and December 2017. To determine the pooled prevalence, the stochastic DerSimonian-Laird model was used, computing the effect size with its 95% confidence interval. To examine the heterogeneity among studies, the I2 test were conducted. The reporting of observational studies in epidemiology (STROBE) checklist was used to assess the methodological quality of observational studies. To further investigate the source of heterogeneity, meta-regression analyses stratified by publication year, sample size and duration of hospitalization in the hospital were carried out. Results: 52 studies were included. Based on the random-effects model, the overall prevalence of nosocomial infection in Iran was 4.5% [95% CI: 3.5 to 5.7] with a high, statistically significant heterogeneity (I2=99.82%). A sensitivity analysis was performed to ensure the stability results. After removing each study, results did not change. A cumulative meta-analysis of the included studies was performed based on year of publication and the results did not change. In the present study, a high rate of infections caused by Klebsiella pneumoniae (urinary tract, respiratory tract, and bloodstream infections) was found. Conclusion: Preventing and reducing hospital infections can significantly impact on reducing mortality and health-related costs. Implementing ad hoc programs, such as training healthcare staff on admission to the hospital, may play an important role in reducing infections spreading.

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.

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.