systematic review

significant advancements in the diagnosis and treatment of acute myeloid leukemia (AML), patients still face poor diagnosis with unsatisfactory survival, so it is imperative to explore novel diagnostic biomarkers to improve early detection and treatment outcomes. Thus, here, the potential role of circular RNAs (circRNAs) in AML diagnosis is reviewed. PubMed, Scopus, WOS, ProQuest databases, and Google Scholar search engines were searched for studies published through March 2023. The results were assessed using the modified method of GRADE assessment. The sensitivity (SEN), specificity (SPE), positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the summary receiver operating characteristic curve (AUC) were combined to investigate the diagnostic role of circRNAs in AML. The number of studies included in this systematicreview and meta-analysis was 18. For the diagnostic value of circRNAs in AML, the pooled SEN, SPE, PLR, and NLR were 0.85 (95% confidence interval [CI]: 0.80–0.89), 0.85 (95% CI: 0.82–0.88), 5.74 (95% CI: 4.49–7.33), and 0.18 (95% CI: 0.13–0.24), respectively.Furthermore, the pooled DOR and AUC were 32.71 (95% CI: 20.09–53.24) and 0.91 (95% CI: 0.88–0.93), respectively. Furthermore, through subgroup analysis, it is better to have a sample size above 120 and a control/patient ratio above 50%. In addition, Deek’sfunnel plot demonstrated nonconsiderable publication bias (P = 0.65). Finally, according to the GRADE assessment for diagnostic tests, the certainty of evidence regarding sensitivity and specificity was moderate. Our systematic review and meta-analysis suggest the analysis of circRNAs expression as promising and valuable biomarkers related to the diagnosis of AML and also can be helpful in the diagnosis of AML patients as a noninvasive and low-cost method.

 Fatty liver disease (FLD) is a significant non-communicable disease (NCD) that poses a growing public health challenge. Addressing this issue requires effective policy interventions.

The present study aimed to systematically identify and evaluate policies designed to mitigate the risk of FLD, thereby informing future public health strategies. Data Sources: The study was conducted following the Cochrane systematic review methodology, which includes seven steps: Identifying the research question, defining inclusion and exclusion criteria, searching for studies, selecting relevant studies, assessing the quality of studies, extracting data, and analyzing and presenting results. Study Selection: A total of 147 papers were preliminarily assessed, and 36 were selected for systematic review.

The findings revealed that effective policies for reducing FLD risk involve a multi-faceted approach. These include health education to raise public awareness, promoting healthy behaviors such as improved nutrition and physical activity, and strategic economic measures like increased tariffs on harmful products. Additionally, health service integration, early diagnosis strategies, and targeted public health interventions collectively contribute to a more comprehensive framework for FLD prevention and management.

These findings underscore the necessity for policymakers to implement comprehensive educational initiatives and public health interventions, alongside economic strategies such as taxation on unhealthy products, to effectively combat the rising prevalence of FLD and promote long-term public health improvements.

 With the emergence of the COVID-19 pandemic, the use of traditional and herbal medicine as low-cost complementary treatment options was proposed. Despite supporting evidence on antiviral effects and previous experiences with such treatments, data on overall efficacy remain limited. This study aimed to assess the effectiveness of herbal medicine add-on treatments for COVID-19. 

 A systematic review with meta-analysis of randomized controlled clinical trials (RCTs) was conducted to evaluate the effectiveness of herbal medicine add-on treatments for COVID-19. We searched PubMed, Scopus, Embase, Web of Knowledge, and Google Scholar for relevant articles from January 2019 to January 2024. Inclusion criteria were RCTs assessing herbal treatments for COVID-19; exclusions included non-RCTs and studies with unclear outcomes.

Fifty RCTs, comprising 6,031 subjects, were included in the meta-analysis. The results support the relative effectiveness of herbal medicine add-on treatments in improving certain outcomes among COVID-19 patients. These include reduced hospital length of stay (Los) [standardized mean difference (SMD): -0.60 days, 95% confidence interval (CI): -1.04, -0.16], shorter time for PCR tests to convert to negative (SMD: -0.56 days, 95% CI: -0.86, -0.23), reduced progression of disease to severe stages [risk ratio (RR): 0.47, 95% CI: 0.38, 0.58], decreased time to resolution of general recovery (SMD: -0.72 days, 95% CI: -1.17, -0.26), fever (SMD: -0.61 days, 95% CI: -0.93, -0.28), cough (SMD: -0.92 days, 95% CI: -1.69, -0.15), and dyspnea (SMD: -0.73 days, 95% CI: -1.22, -0.23).

Although herbal medicine may improve some outcomes in COVID-19 patients, significant heterogeneities in available studies limit the ability to conclusively suggest effectiveness. More controlled placebo trials and conclusive evidence are needed to better understand the effects and guide clinical practice.

The prevalence rate of hypertension is on the rise at an alarming rate. Studies conducted on the influence of flaxseed on blood pressure (BP) have come up with conflicting conclusions. The current investigation’s major purpose is to conduct a literature review and a meta-analysis focusing on the effect of flaxseed supplementation on BP in people with cardiovascular disease (CVD) risk factors. PubMed, Scopus, Web of Science, and Cochrane Central Library databases were searched from the inception date to April 2024 to find the randomized controlled trials (RCTs). A random-effects model combined the weighted mean difference (WMD). Standard methodologies were applied to evaluate publication bias, heterogeneity, and sensitivity analysis. Eighteen RCTs were included in the present systematic review and meta-analysis. Pooled analysis suggested that flaxseed supplementation can reduce systolic BP (SBP) (WMD: -4.75 mmHg, 95% CI: -7.05 to -2.44, P≤0.001; I2=93.6%) and diastolic BP (DBP) (WMD: -3.09 mmHg, 95% CI: -4.37 to -1.81, P≤0.001; I2=91.2%). In conclusion, the current meta-analysis has demonstrated that flaxseed supplementation can markedly lower BP in individuals exhibiting CVD risk factors. Given the significant heterogeneity, it is crucial to interpret the current results with careful consideration. In addition, further high-quality RCTs are required to better assess the causal relationships.

Accreditation of health services is one of the criteria for achieving the predetermined standards for health organizations. Therefore, the purpose of this systematic study was to investigate the primary health care (PHC) accreditation programs in the world and compile a summary of these programs in order to identify the areas and dimensions of these standards. This systematic review was conducted on online database studies, including PubMed, Scopus, Web of Science, and Google Scholar, using comprehensive terms. The inclusion criteria included all qualitative, quantitative, and mixed‑method studies published in any language from 1990 to December 2022. The studies were evaluated with Joanna Briggs Institute Critical Appraisal Tools (JBI) critical appraisal tools checklist, and finally, the data were analyzed using the framework analysis method. The findings of 10 studies that were included in this study cover four main topics regarding the functions of the health system: stewardship, resource production, financing, and service delivery, as well as 10 sub‑topics: policy making, interdepartmental leadership, monitoring and evaluation, human resources, equipment and medicine, information management, gathering of financial resources, capacity to provide services, access, and quality of services. In the accreditation of PHC, in addition to paying attention to performance indicators, indicators such as satisfaction and rights of clients and employees, access, information technology, coordination, integration of care, financing, and management of resources and equipment should also be considered. 

Patient Satisfaction (PS) is a key indicator of health‑care service quality. This review compared PS in medical and surgical wards among developed and developing countries.

This systematic review of cross‑sectional studies was conducted following Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. Related articles were identified through a search of PubMed, Scopus, and Web of Science databases using a combination of relevant terms from January 2000 to December 2022. The Newcastle–Ottawa Scale was used to evaluate the quality of related studies. Narrative synthesis was used for the extracted data.

Out of 7656 records retrieved, 61 studies met the inclusion criteria. The studies used three reporting schemes for PS: the overall status of PS, the percentage of satisfied patients, and the mean and standard deviation of PS scores. The overall status of PS was higher in developed countries compared to developing countries. In developing countries, 59.25% of studies reported high levels of satisfaction, while in developed countries, all seven studies reported high levels. The percentage of satisfied patients varied, with a higher percentage in developed countries. In developing countries, nine studies reported over 75% satisfaction, 12 studies reported 50%–75% satisfaction, and three studies reported less than 50% satisfaction. In contrast, developed countries had one study reporting over 75% satisfaction and one study reporting 35%–61% satisfaction.

Low PS in developing countries necessitates better nursing care. A global standard for assessing PS is needed for improved health‑care service quality monitoring worldwide.

Vitamin B12 (VB12) is a water-soluble vitamin, deficiency of which causes an extensive heterogeneous spectrum of neurological symptoms including vision disturbances, paresthesia, tremor, and seizure. The aim of this investigation is to determine the effect of serum VB12 levels on pediatric patients with febrile seizure (FS).

In this meta-analysis, case-control studies that evaluated the effect of serum VB12 levels in pediatric patients with FS were included. Web of Science, PubMed, Scopus, and Google Scholar were searched until August 13, 2024. The PICO criteria for this meta-analysis were as follows: Population/Patients (P: pediatric patients with febrile seizures); Issue of interest (I: serum levels of VB12); Comparison (C: control); Outcome (O: occurrence of febrile seizure). Quality assessment was assessed according to the Newcastle-Ottawa Scale (NOS) tool for case-control studies. The outcome assessment scales, study groups, and serum VB12 levels were extracted.

Of 435 initial articles, eventually 6 studies remained in the meta-analysis. Existing evidence indicated that serum VB12 concentrations were insignificantly lower in FS patients than controls (WMD= -1.09 pg/ml; 95% CI: -2.23, 0.04; P= 0.06), although a significant between-study heterogeneity was observed (I2 = 98.10%, P< 0.001).

The results of our study pointed out that there is low serum VB12 concentrations in FS patients compared with controls. Despite the fact, one of the best ways to prevent FS in children can be VB12 supplementation and proper diet therapy.

Icosapent Ethyl (IPE) is effective and safe in reducing the risk of ischemic cardiovascular disease (CVD). The present study aimed to systematically collect and synthesize available cost-effectiveness studies of IPE in combination with statin therapy for cardiovascular risk reduction in primary and secondary prevention.

Electronic searches on PubMed/MEDLINE, Scopus, Web of Science Core Collection Embase, Cochrane Central Register of Controlled Trials (CENTRAL), NHS Economic Evaluation Database (NHS EED) and the Health Technology Assessment (HTA) database were searched for relevant literature (updated to May 2024). Out of 580 initial studies, 11 studies had the inclusion criteria.

The results show that IPE reduced hospitalization and mortality rates versus standard drugs. The current study showed that IPE has higher QALYs and LYQs than statins. IPE is more expensive than conventional drugs such as statins, for example, the one-year cost of IPE in Australia is $ 3,768 and in the United States is $ 3,497 per patient. The results also show that the threshold for evaluating the effectiveness of IPE varies from $ 50,000 to $ 150,000 in the United States and AUD 50,000 ($ 39,000) in Australia.

According to the current study, IPE is cost-effective and the probability of cost-effectiveness of IPE in patients with secondary prevention is higher than in primary prevention.

 Temporomandibular disorder (TMD) is a cumulative terminology that demonstrates musculoskeletal and neuromuscular disorders. It is of extreme relevance that the number of subjects with TMD-related pain has noticeably increased over the recent years. This could be attributed to the increased stress in lifestyles and use of electronic devices (smartphones/laptops/tablets), altering the posture across the boundaries of age, gender, and geography. Thus, this systematic review and meta-analysis was conducted to derive the prevalence of TMD disorders across the aforementioned boundaries.

 The method used in this study to quantify the prevalence of TMD across the countries and populations was in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. MEDLINE, Scopus, Web of Science, and Google Scholar were systematically searched until July 30, 2024.

 The quality of the prevalence studies was assessed using Critical Appraisal Skills Programme (CASP) Tools. The bias within the study data was evaluated using RevMan software, and the prevalence was calculated as 25.8%. Finally, the forest plot was employed to determine the weightages and risk ratios of the studies.

 Based on the findings, there has been a slow and steady increase in the prevalence of TMD, and thus sustainable measures are imminent for controlling this disorder.

Extracellular vesicles (EVs) are crucial in intercellular signaling pathways. Since cancer has had a significant impact on global health as the second leading cause of death, this study aimed to systematically review the literature on the efficacy and safety of EVs in this setting.

A systematic literature review was performed on MEDLINE, Embase, the Cochrane Library, and ClinicalTrials.gov from database inception until August 10th, 2023. Based on PICOS, the inclusion criteria were: individuals with cancer treated with EVs compared to control among clinical studies.

EVs administered to 46 individuals with cancer. Most studies revealed significant clinical benefits after treatment. Results also demonstrated that EVs are safe without major adverse events (AEs).

The use of EVs may provide potential therapeutic benefits for treating cancer. Further, well-designed randomized clinical trials (RCTs) are needed to provide robust evidence for supporting the clinical use of EVs in this setting.

The use of medicinal plants in the management of depression, also known as phytotherapy or herbal medicine for depression, is an area of growing interest in the field of mental health and complementary medicine.

This study used a systematic assessment of pertinent literature to assess the effectiveness of medicinal herbs in treating mild to severe depression. A comprehensive literature search was conducted to identify randomized controlled trials (RCTs) that reported data on the intervention, control group, adverse events, outcome measurements, and main findings. A summary and analysis were done on the included research data.

We included 23 RCTs investigating the efficacy of herbal medicines, including Crocus sativus, Lavandula angustifolia, Melissa officinalis, and Echium amoenum, in treating depression. In general, saffron showed encouraging outcomes when used to treat mild to severe depression. With no discernible variations in the reported adverse effects, it proved to be equally efficacious as well-known antidepressants like imipramine and fluoxetine. However, it is noteworthy that not all trials yielded favorable results.

More investigation is required to fully understand the mechanisms of action, ideal dosage schedules, long-term effects, and relative efficacy of medicinal plants in depressive treatment.

The management and approach of dealing with pain after endodontic treatment is one of the most important fields of endodontics, which has received special attention in recent years. The effect of cryotherapy can be achieved by reducing blood flow and metabolic activity by suppressing neurotransmitters and increasing oxygenation in the damaged tissue. We aimed to conduct a systematic review of randomized clinical trials between 2023 and 2024 regarding the effect of cryotherapy in reducing pain after endodontic treatment.

This research is prepared and presented based on PRISMA reporting items. The databases used for this research are PubMed, Scopus and Google Scholar. Gray texts were also done by searching the sources of found articles. The time limitation for the search strategy was set for 2023 and 2024. Inclusion criteria were based on the PICOTS definition. To assess the risk of bias, the ROB2 tool was used.

Based on the search results in databases, 138 articles were found in 2023 and 2024. Finally, 19 studies were included in this review. Finally, five articles had a mild risk of bias, and six studies had a moderate risk of bias. Other studies were also unbiased based on the evaluation. Finally, we included them all in the review study. For each of the studies included in this review, the name of the first author, age of the participants, sample size, population under study, groups under study, outcome, findings and final interpretation were extracted. The tool used to measure pain in 3 articles was the NRS scale; one used VRS, and other studies used VAS. The range of age groups used in all studies was from a minimum 4 of four to a maximum of 60 years. The sample size was in the range of 20 to 152.

It was concluded that cryotherapy can be used as a pain relief method after dental surgery. However, this evidence was accompanied by limitations for the included studies.

Adropin, a peptide hormone has role in various various physiological processes, including metabolic regulation and cardiovascular health. This systematic review aimed to synthesize findings from observational studies on the involvement of adropin in neurological disorders and cognitive performance.

An extensive literature search was conducted across PubMed, Scopus, Web of Science, Embase, CORE, and Google Scholar using terms such as "adropin," "Neurological Disorders," "cognitive function," "Alzheimer's disease," "Parkinson's disease," "cognition," and "brain function." Studies published from 2020 to 2024 were selected and reviewed. The search and selection process adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Out of 127 screened articles, 5 met the inclusion criteria for this review.

The combined research findings suggest a consistent link between decreased adropin levels and a range of neurological disorders and cognitive impairments. In particular, reduced adropin levels were seen in individuals with dementia, cognitive impairment, bipolar disorder, Parkinson's disease, and multiple sclerosis. These findings highlight adropin's potential role in modulating neurological health and cognitive function.

This systematic review underscores the importance of adropin in neurological health and its potential as a therapeutic agent. Based on the observed connections, adropin might serve as a new focus for treating neurological disorders, prompting the need for more research and trials.

Breast cancer is the most common type of cancer and the leading cause of death in women worldwide. Early detection of breast cancer by measuring metabolites that can be easily detected through blood tests will significantly help in time treatment, prevent cancer progression, and reduce the risk of death in breast cancer patients. One of the constant metabolic characteristics of cancer is lipidomic remodeling, which includes changes in fatty acid transport, lipogenesis, lipid storage, and beta-oxidation to supply energy. This review aims to compare lipid changes between women with and without breast cancer.

The systematic review will search and summarize data on observational studies from Medline/PubMed, Scopus, Embase, and Web of Science databases and grey literature published between January 2000 and January 2025. Keywords related to 'breast cancer' and 'lipidomic' will be used to retrieve relevant documents. The PECOS model will be used to include eligible studies. The protocol of this systematic review follows the PRISMA-P statement.

This systematic review will help summarize the existing evidence about the use of blood lipids in breast cancer diagnosis and prognosis and recognize the current gaps in research to design further high-quality studies with the ultimate goal of easy and early detection of breast cancer.