Abdolhalim Rajabi

Background: Otitis media with effusion (OME) is a common pediatric condition, often managed with tympanostomy tube insertion. However, recurrence after tube extrusion remains a significant concern, with global incidence rates varying across studies. Objective: This systematic review and cumulative meta‐analysis is aimed at quantifying the global incidence of recurrent OME post‐tympanostomy. Methods: A systematic review and cumulative meta‐analysis was conducted in accordance with the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA). A comprehensive search of electronic databases (PubMed, Web of Science, Embase, Cochrane Library, ProQuest, Wiley, Ovid, and Scopus) was performed in August 2024. The quality of the studies was assessed using the Joanna Briggs Institute (JBI) critical assessment tool. Pooled incidence and 95% confidence intervals were calculated using a random‐effects model. Cumulative meta‐analyses were conducted to track global incidence trends over time. Statistical analysis was conducted using Stata Version 16 software. Results: From 1117 retrieved articles, 21 met the inclusion criteria. The global pooled incidence of recurrent OME post‐tympanostomy was 30% (95% CI: 23%–37%). Subgroup analysis showed 31% recurrence with tubes alone (95% CI: 24%–38%) versus 20% with adjunctive antibiotics (95% CI: 14%–26%). The highest recurrence (45%, 95% CI: 34%–55%) occurred in cases combining tympanostomy with cleft palate surgery. Cumulative meta‐analysis indicated a declining trend in OME recurrence between 2005 and 2019, with the incidence rate decreasing from 39% to 24% over this period. Conclusions: Approximately one‐third of children undergoing ventilation tube (VT) insertion surgery experience recurrence of OME. Although some studies suggest that adding antibiotics to VT insertion therapy may reduce recurrence in children at risk for chronic infection, this evidence is not consistent and should be interpreted with caution. In addition, patients with cleft palate have a higher likelihood of OME recurrence and require long‐term follow‐up. These findings may assist physicians in refining treatment decisions based on individual patient characteristics and recurrence risk, though further high‐quality clinical trials are needed to confirm these observations.

Background: Coronary artery disease (CAD) is recognized as an inflammatory condition and remains a leading cause of morbidity and mortality worldwide. Cardiovascular disease (CVD), more broadly, is a major contributor to global death and disability. This study aimed to compare the diagnostic performance of various noninvasive techniques for detecting CAD. Methods: A cross‐sectional study was conducted involving 758 participants, including 508 patients diagnosed with CAD and 250 without the disease. The diagnostic performance of two machine learning models—artificial neural networks (ANNs) and support vector machines (SVMs)—was evaluated. The classification models were assessed using receiver operating characteristic (ROC) curves, sensitivity, specificity, and overall accuracy. Results: The study included a total of 758 participants. Among them, 250 individuals (33.6% male and 66.4% female) were diagnosed as non‐CAD cases, while 508 participants (64% male, 36% female) were identified as having CAD. The area under the ROC curve (AUC) for CAD prediction was 0.752 (95% CI: 0.682–0.823) using the ANN model and 0.793 (95% CI: 0.733–0.853) using the SVM model. A statistically significant difference was observed between the performance of the two models in predicting CAD ( p = 0.03), with the SVM model demonstrating superior predictive performance (AUC = 0.793, 95% CI: 0.733–0.853). Conclusions: SVMs demonstrated superior performance compared to ANNs in predicting the risk of CAD using simple clinical predictors.

Background: Temporomandibular joint disorder (TMD) encompasses pain and functional impairment in the masticatory muscles and temporomandibular joint. The etiology of TMD is widely recognized as multifactorial, involving biological, psychological, social, and environmental factors. Among these, personality‐related issues are frequently identified as a significant risk factors for the onset and progression of TMD. This study aimed to systematically evaluate and quantify the association between TMD and personality‐related issues through a comprehensive systematic review and meta‐analysis.Method: A comprehensive search was conducted across PubMed, Web of Science, Scopus, ProQuest, Wiley, Cochrane, and Embase databases to identify relevant studies up to March 13, 2024. The risk of bias in the included studies was assessed using the Newcastle‐Ottawa Scale. A random‐effects model was employed for the meta‐analysis, with standardized mean differences (SMD) and 95% confidence intervals (CI) serving as measures of effect size. Study heterogeneity was evaluated using the I² statistic, while publication bias was examined using a funnel plot, along with Begg and Egger's tests.Results: After removing duplicates, 827 articles were identified, of which 14 studies met the inclusion criteria for the meta‐analysis. The meta‐analysis revealed a small but statistically significant positive association between temporomandibular joint disorders (TMD) and personality‐related issues (SMD = 0.29; 95% CI: 0.03, 0.55). This finding indicates that TMD is linked to elevated personality disorder scores. However, no statistically significant correlation was observed between TMD and personality traits.Conclusion: The findings highlight a weak yet statistically significant positive association between TMD and personality‐related issues. These results underscore the importance of considering psychological factors in the diagnosis and management of TMD to improve patient outcomes.

Background and Objective: Family-centered empowerment involves engaging clients and their families in decision-making processes to improve health outcomes, thereby enabling them to exert control over their health status through informed choices. Self-efficacy is considered the most crucial component of empowerment and holds significant importance in the management of chronic diseases ...

Studies have consistently demonstrated a strong link between cigarette smoking and an increased risk of cardiovascular diseases (CVD). On the other hand, studies have shown that most smokers do not have a real understanding of the cardiovascular health hazards of smoking. Therefore, the study aimed to determine the perceived risk of Myocardial Infarction (MI), Hypertension (HTN), and Stroke among current smokers in Iran. This cross-sectional study was conducted between January and May 2023, and recruited 380 smokers by convenience sampling who smoked at least 100 cigarettes in their lifetime. The data were collected using three questionnaires (1) the questionnaire to assess the risk perception for MI, HTN, and Stroke, (2) the smoking stage of change questionnaire, and (3) the Fagerström Test for nicotine dependence (FTND). The CVD risk perception consisted of two parts, perceived susceptibility and perceived severity. Each part scores between 0 and 10 and finally gets a total score of 0–20. A score of zero indicated the lowest risk perception while a score of 20 indicated the highest risk perception. We examined the relationship between the demographic and smoking-related variables and the smokers’ perceived risk of MI, stroke, and HTN by using multiple linear regression. The mean age of participants was 35.57 ± 12.05 years, and 77.1% were male. The perceived risk score of MI was 10.68 ± 4.69 out of 20. The scores related to stroke and HTN were 10.00 ± 4.65 and 10.89 ± 4.73, respectively. Identified variables collectively contributed significantly to predicting the perceived risk of MI (p <.0001, Adj R-squared = 0.05%), stroke ( p <.0001, Adj R-squared = 0.08%), and HTN (p <.0001, Adj R-squared = 0.06%). We found that longer smoking duration [coefficient=-1.96 (95% CI= -3.91, − 0.09)] for 20–29 years and − 4.08 ( 95% CI= -6.70, -1.46 ) for 30 + years), older smoking age onset [coefficient=-2.10 ( 95% CI= -3.24, − 0.96 )] for 20 + years), and dual tobacco users [coefficient= -1. 04 (95% CI= -2.08, − 0.06)] were significantly associated with lower perceived risk for MI. We also found that longer smoking duration [coefficient=-2.23 (95% CI= -4.13, − 0.32)] for 20–29 years and − 5.01 (95% CI= -7.565734, -2.462361 ) for 30 + years), older smoking age onset [coefficient=-1.86 (95% CI= -2.970021, − 0.75 ] for 20 + years), and being male [coefficient= -2. 00, (95% CI= -3.53, − 0.47)] were significantly associated with lower perceived risk for stroke. We found that longer smoking duration (coefficient=-4.40 for 30 + years), older smoking age onset [coefficient=-2.02 (95% CI= -3.14, − 0.87,)] for 20 + years), and being dual users [coefficient=-1.36, 95% CI= -2.40, − 0.3241238)] were significantly associated with lower perceived risk for HTN. The results of this study demonstrated a moderate perceived risk of participants to CVD. Also, the perceived risk decreases as the duration of smoking and the age for the smoking onset increases to 20 years and above. It seems necessary to carry out interventions to inform the public about the harms of smoking, especially for adolescents and young adults, and its risks in causing cardiovascular disease.

Background: Self-care is defined as a strategy to adapt the events and stresses of life, which improves health and includes special activities that alleviate the symptoms of the disease. This study aimed to investigate the impact of a self-care program on the self-esteem of patients with type 2 diabetes mellitus (T2DM) attending rural ...

Cigarette smoking causes serious complications and diseases in a person’s life, such as Chronic Obstructive Pulmonary Disease (COPD) and some cancers, including lung cancer. On the other hand, studies have shown that smokers do not have a real understanding of the health hazards of smoking. This study was conducted to determine the perceived risk of lung cancer and COPD in current smokers. This cross-sectional study which was conducted between January-May 2023, recruited 380 current smokers by convenience sampling in community setting. The data were collected face to face using three questionnaires (1) the risk perception for lung cancer and COPD questionnaire, (2) the smoking stage of change questionnaire, and (3) the Fagerström test for nicotine dependence. We examined the relationship between the included variables and the smokers’ perceived risk of lung cancer and COPD by using multiple linear regression. We found that lower education (coefficient = 3.60, 95%CI [1.00, 6.19], P < 0.0001) for elementary level and (coefficient = 2.81, 95% CI [0.36, 5.26], P < 0.05) for secondary level had greater lung cancer perceived risk. Besides, smoking age onset for 20 + years (coefficient=-1.36, 95%CI [-2.42, -3.17], P < 0.0001) lower than those who started before the age of 20 were associated with lower perceived risk for lung cancer. Regarding COPD, results indicated that lower education (coefficient = 4.54, 95% CI [1.87, 7.21], p < 0001) for elementary level (coefficient = 3.35, 95% CI [0.83, 5.87], p < 0.001) for secondary level and (coefficient = 3.03, 95% CI[-0.67, 4.25], P < 0.05) for high school dropout, and employment status (coefficient = 3.62, 95% CI[0.66, 6.59], p < 0.05) of employer and (coefficient = 3.23, 95% CI [0.14, 6.33], p < 0.05) for homemaker reported greater perceived risk. This study’s results showed that participants’ perceived risk was relatively low. It seems necessary to carry out interventions to inform about the harms of smoking and to enhance public awareness about the heightened risks of diseases such as lung cancer and COPD among cigarette smokers.

Hookah consumption is harmful to human health and can cause various diseases. Developing lung cancer and other lung diseases are one of the health consequences of hookah consumption. Measuring the perceived risk for being diagnosed with these conditions among hookah users is necessary. Therefore, this study was conducted to determine the perceived risk of lung cancer and Chronic Obstructive Pulmonary Disease (COPD) in hookah users in Iran. This cross-sectional study was conducted with a descriptive-analytical approach on 340 hookah users between January-May 2023. These people were recruited through convenience sampling. The information on the perceived risk of participants was collected through a questionnaire on the perceived risk of lung cancer and COPD. Data were analyzed through descriptive tests and multiple linear regression tests. These analyses were performed using Stata statistical software version 17. The mean and standard deviation of the perceived risk for lung cancer was 8.41 ± 5.50 and for COPD was 8.51 ± 5.58 out of 20 possible scores. The results of multiple linear regression generally showed that the using other type of tobacco (β = 3.14, p < 0.0001), 2 or more use of hookah in past month (β=-3.41, p = 0.025), unskilled workers (β = 1.79, p = 0.017), married smokers (β=-1.31, p = 0.026), negative attitude toward hookah (β = 0.46, p < 0.0001) were the predictive variables regarding to lung cancer perceived risk. In line with COPD the using other type of tobacco (β = 3.47, p < 0.0001), once a month use of hookah in past month(β=-3.74, p = 0.041) and twice or more use of hookah in past month (β=-4.82, p = 0.008), smokers in contemplation stage (β = 3.91, p < 0.0001), female smokers (β = 3.08, p < 0.0001), unskilled workers (β = 2.42, p = 0.007), negative attitude toward hookah (β = 0.46, p < 0.0001) were the predictive variables to COPD perceived risk. In general, the perceived risk of developing lung cancer and COPD among hookah users was low. Therefore, it is necessary to provide widespread information about the potential harm of hookah in causing lung cancer and COPD, at the community level.

Background and Objective: Opium use is one of the most common problems that impose significant social, psychological, and economic burdens on societies. Understanding the factors involved in the treatment of opium use is essential. This study aimed to evaluate inhibitory response and impulsivity in opium users. Methods: This descriptive-analytical study ...