Prevalence of tobacco use among cancer patients in Iran: a systematic review and meta-analysis

BACKGROUND

The prevalence of tobacco use among various cancer types in Iran remains a significant concern, necessitating a comprehensive analysis to understand the extent and patterns of consumption. This study aimed to systematically review and analyze existing literature to delineate the prevalence of tobacco use across different cancer types in Iran, thereby providing a robust basis for future interventions and policy formulations.

METHODS

Adhering to the PRISMA guidelines, we conducted a systematic review and meta-analysis of literature available in PubMed and Scopus databases. The initial search identified 351 records, out of which 44 studies were selected based on their relevance and design. These studies spanned various time frames, starting from the 2001s up until 2022, and encompassed diverse geographical locations and cancer types in Iran. To avoid bias and potential data overlap, we opted to incorporate a single comprehensive study from the Golestan Cohort, encompassing all data, while excluding 10 other studies. Our final analysis incorporated data from 34 studies, which accounted for 15,425 patients and 5,890 reported smokers. Statistical analyses were performed to calculate the overall proportion of tobacco consumption and to conduct subgroup analyses based on different variables such as cancer types, gender, geographical locations, and types of tobacco used.

RESULTS

The analysis revealed a substantial prevalence of tobacco use among cancer patients in Iran, with an overall consumption rate of 43%. This rate varied significantly, ranging from 10 to 88% across individual studies. Subgroup analyses further highlighted disparities in tobacco consumption rates across different demographics, geographic areas, and cancer types. Notably, the 'ever' smokers category exhibited the highest prevalence of tobacco use. The study also identified a worrying trend of high cigarette smoking rates, along with variable consumption patterns of other forms of tobacco, including waterpipe, 'Naas', and 'Pipe'.

CONCLUSIONS

This systematic review and meta-analysis underscores a significant association between tobacco consumption and various cancer types in Iran, with a prevalence rate among cancer patients being three times higher than the average Iranian population. The findings indicate substantial heterogeneity in tobacco use patterns, emphasizing the need for targeted interventions to address this pressing health issue. The study serves as a critical resource for shaping future policies and strategies aimed at curbing tobacco use and mitigating its adverse effects on cancer prevalence in Iran.

Intraparenchymal Schwannoma of Temporal Lobe: A Case Report and Review of the Literature

Intracranial schwannomas (ISs) account for approximately 8% of intracranial tumors, while IS, a rare entity, is responsible for roughly 1% of IS. A 33-year-old man with a 3-month headache and sudden onset seizure was referred to our clinic. Preoperative magnetic resonance imaging revealed a contrast-enhancing mass accompanied by cystic components in the right temporal lobe. Ganglioglioma, metastasis, or glioblastoma multiforme was suspected, and surgery was advised. During surgery, gross total resection of a noninvasive tumor was conducted. Postoperative recovery was uneventful. Based on histopathological examination and confirmatory immunohistochemistry, the intraparenchymal temporal tumor was diagnosed as schwannoma. ISs are extremely scarce brain tumors mainly located on the surface of the brain or adjacent brain ventricles. The definite preoperative diagnosis of schwannoma cannot be readily established due to radiologically indistinguishable features from metastasis and gliomas; however, histopathology and immunohistochemistry are of great assistance. Complete surgical removal is the most preferred treatment alternative with a long-term favorable prognosis without adjuvant and neoadjuvant chemotherapy requirements.

Comparison of maternal and fetal health outcomes in the pandemic period of covid-19 with the same last year duration in health centers of second largest city of Iran: A population-based cohort study

Objective

The exact link between COVID-19 pandemic and different adverse outcomes of pregnancy remains unclear. Plus, large-scale research is lacking. In the present study, we aimed to compare the maternal and fetal health outcomes during the COVID-19 pandemic with the same last year duration in Iran.

Design

Two retrospective cohorts (pre-COVID-19 and during COVID-19) were studied. The pre-COVID-19 cohort include pregnant women who had given birth between January 1, 2019 and December 31, 2019. The COVID-19 cohort, who had given birth between January 1, 2020 and December 31, 2020. The characteristics of pregnant women before COVID-19 and during COVID-19 pandemic were compared with Fisher's exact test. Univariate and multivariate log-binomial regression models were used to determine the risk ratios of the impacts of the COVID-19 pandemic on adverse pregnancy outcomes.

Results

Among 128968 women showed that women who had given birth during the pandemic were more likely to be of young age, lower rates of alcohol consumption and smoking, lower weight gain, and higher rates of using synthetic milk for feeding neonates (P < 0.05). Also, the risks of preterm labor were high (cOR 95% CI, 1.13 to 1.31; p < 0.01) and the risk of caesarian were low (cOR 95% CI, 0.95 0.92 to 0.98; p < 0.01) among pregnant women who gave birth during the COVID-19 pandemic compared with those who gave birth before the pandemic.

Conclusions

In summary, we found that during the COVID-19 pandemic there were the higher risks of preterm labor and lower risk of caesarean among pregnant women.

Dynamic Rod Constructs as the Preventive Strategy against Adjacent Segment Disease in Degenerative Lumbar Spinal Disorders: A Retrospective Comparative Cohort Study

Objectives

Adjacent segment degeneration (ASDe) and adjacent segment disease (ASDi) are potential long-term complications after lumbar fusion with rigid instrumentation. Dynamic fixation techniques (Topping-off) adjacent to the fused segments have been developed to curtail the risk of ASDe and ASDi. The current study sought to investigate whether the addition of dynamic rod constructs (DRC) in patients with preoperative degeneration in the adjacent disc was effective in reducing the risk of ASDi.

Methods

A retrospective analysis was performed on clinical data of 207 patients with degenerative lumbar disorders (DLD) from January 2012 to January 2019, who underwent posterior transpedicular lumbar fusion (without Topping-off, NoT/O), and posterior dynamic instrumentation with DRC. Clinical and radiological outcomes were evaluated using Oswestry Disability Index (ODI), Visual Analogue Scale (VAS), and lumbar radiographs one, three, and 12 months postoperatively and annually. ASDe was defined as disc height collapse > 20% and disc wedging > 5. Patients with confirmed ASDe and aggravation of ODI > 20 or VAS score > 5 at final follow-up were diagnosed as ASDi. The Kaplan-Meier hazard method was used to estimate the cumulative probability of ASDi within 63 months of surgery.

Results

Over three years of follow-up, 65 patients in the NoT/O (59.6%) and 52 cases (53.1%) in the DRC groups met the diagnostic criteria for ASDe. Furthermore, 27 (24.8%) patients in the NoT/O group showed ASDi during the follow-up, compared to 14 (14.3%) cases in the DRC group (P=0.059). Revision surgery was performed on 19 individuals in the NoT/O and 8 cases in the DRC groups (P=0.048). The Cox regression model identified a significantly decreased risk of ASDi if DRC was used (Hazard ratio: 0.29; 95% CI: 0.13-0.6).

Conclusion

Dynamic fixation adjacent to the fused segment is an effective strategy for preventing ASDi in carefully selected individuals with preoperative degenerative changes at the adjacent level.

The Prognostic Role of Corticosteroid Administration in Hospitalized Patients with Severe COVID-19: A Cross-sectional Study

BACKGROUND AND OBJECTIVE

The COVID-19 pandemic is a recent global issue with no established consensus on treatments. Therefore, the aim of this study was to assess the impact of corticosteroid (CS) pulses on the prognosis of COVID-19 patients admitted to hospitals.

METHODS

In this retrospective single-center cross-sectional study, we used hospital records of all consecutive patients aged 18 years or older admitted to the hospital from July 23rd to September 23rd, 2021. All patients included in the study had confirmed SARS-CoV-2 infection using polymerase chain reaction (PCR) testing and required hospitalization. Demographic and clinical information, as well as patient outcomes, were collected. Treatment details, including the type(s), cumulative doses, and duration of administered corticosteroids, were also recorded. CS pulse therapy was defined as the daily administration of 24 mg or more of dexamethasone or its equivalents.

RESULTS

A total of 500 patients with COVID-19 were included in this study, comprising 122 patients who received CS pulse therapy and 378 patients who did not. A higher mortality rate was observed in patients receiving CS pulse therapy (42.6%) compared to the other group (28%) (p =0.04). Additionally, logistic regression analysis showed an increased mortality risk in patients receiving CS pulse therapy in the crude model (OR=1.54, 95% CI: 1.01-2.27, p <0.01). However, after adjusting for confounding factors, such as mechanical ventilation and ICU admission, the results were reversed (OR=0.21, 95% CI: 0.07-0.62, p <0.01). ; Conclusion: In the findings of the current study, treatment with CS pulses was shown to significantly enhance recovery in patients with non-severe COVID-19.

Anti-arthritic and Antioxidant Effects of Trehalose in an Experimental Model of Arthritis

BACKGROUND

The purpose of the present study was to study the potential anti-arthritic and antioxidant effects of trehalose in an experimental model of complete Freund's adjuvant (CFA)-induced arthritis.

METHODS

Arthritis was induced via subcutaneous injection of CFA (0.1) into the right footpad of each rat. Trehalose (10 mg/kg per day) and indomethacin (5 mg/kg) as a reference drug were intraperitoneally injected into CFA-induced arthritic rats from days 0 to 21. Changes in paw volume, pain responses, arthritic score, and oxidative/antioxidative parameters were determined.

RESULTS

Trehalose administration could significantly decrease arthritis scores (p <0.01) and paw edema (p <0.001), and significantly increase the nociceptive threshold (p <0.05) in CFA-induced arthritic rats. Trehalose also significantly reduced the pro-oxidant-antioxidant balance values when compared to CFA treatment alone. In addition, no significant difference was found between the trehalose group and indomethacin as a positive control group.

CONCLUSION

The current study suggests that trehalose has a protective effect against arthritis, which may be mediated by antioxidative effects of this disaccharide.

Neglected alkaptonuric patient presented with low back pain and radiculopathy: A case report

Background:

Alkaptonuria (AKU) is a rare hereditary disorder in which excess homogentisic acid (HGA) deposits in connective tissues (ochronosis). Here, we report the unusual presentation of a lumbar disc herniation occurring in a patient with AKU warranting surgical intervention.

Case Description:

A 28-year-old male presented with 1 year of low back pain. The lumbar magnetic resonance imaging showed an extruded disc at the L4-L5 level accompanied extensive disc space narrowing and osteophyte formation. At surgery, the interspinous ligaments, facet joints, and disc herniation were black. In addition, the postoperative re-examination revealed a black discoloration of the nasal and ear cartilage. Finally, the diagnosis of AKU was confirmed when the urine specimen was positive for HGA.

Conclusion:

Rarely, younger patients with AKU who develop excess black deposits of HGA in connective tissues (i.e., ochronosis) may present with lumbar disc herniations and spondylosis.