مجله دانشکده پزشکی اصفهان
پیاپی 715 (هفته سوم خرداد 1402)

Diet with regulating inflammation and oxidative stress has an important role in the pathogenesis and development of rheumatoid arthritis (RA). The aim of this study was to investigate the relationship between diet in Kermanshah and the disease activity score of RA.

This cross-sectional study was performed on 184 patients with a definitive diagnosis of RA according to the criteria of the 2010 American College of Rheumatology/ European League against Rheumatism in Kermanshah city. Dietary intakes were determined using a validated 168-item food frequency and disease activity score-28 (DAS-28) based on the number of swollen and sensitive joints, ESR level and self-assessment score of general health. Logistic regression test with adjusting confounders was used to investigate the relationship between diet and DAS-28.

DAS-28 was directly related to total fat intake (β = 0.54) and intake of saturated fatty acids (β = 0.21), and omega 6 fatty acids (β = 0.26), while it was inversely related to protein intake (β = -0.62). In addition, the intake of red meats (β = 0.31) and animal fats (β = 0.24) was directly related to DAS-28 and intake of white meats (β = -0.31), low-fat dairies (β = -0.53), vegetable oils (β = -0.21), fruits (β = -0.19), vegetables (β = -0.25), and spices (β = -0.29) were inversely related.

Adherence to high-protein and low-fat diets from white meats, low-fat dairies, fruits, vegetables, vegetable oils, and spices can be included in the diet therapy of patients with RA.

The impacts of the growth of e-learning technology in medical sciences have been very significant, and it is essential to evaluate the dimensions of the effects of e-learning in medical sciences. The current study aimed to compile and psychometric test of a suitable tool to evaluate the effectiveness of e-learning among students during the COVID-19 pandemic.

This study is part of a larger study which was conducted using a combined consecutive method in 2020. It was designed and psychometrically analyzed in two stages. The literature review was used to design the questionnaire items. Face validity and content validity were evaluated quantitatively and qualitatively, and also construct validity (exploratory factor analysis), internal consistency (Cronbach's alpha), and stability (retest reliability) were evaluated.

The initial questionnaire was designed with 75 questions that after psychometric analyzed was reduced to 60 items with six dimensions. The six dimensions were named as follows: satisfaction, educational content, and materials; learning-teaching activities; feedback and evaluation and flexibility; fitness and workload; infrastructure, technology, and support. The results of total Cronbach's alpha of the tool were 0.95, retest with a correlation coefficient of 0.95 for the whole tool, and P < 0.001 showed that the instrument had desired reliability.

The tool for measuring the effectiveness of e-learning had validity and reliability in the target population of students. Therefore, this tool can be used for research, educational, and practical purposes and to evaluate the effectiveness of e-learning during the outbreak of COVID-19 among students.

Exposure to cadmium is associated with the occurrence of pancreatic cancer. In a situation where the results of previous studies are not consistent, this study, using a systematic review and meta-analysis method investigated the relationship between exposure to cadmium and the risk of pancreatic cancer in order to provide an appropriate conclusion in this regard.

By searching the ISI web of science, Cochrane, Science Direct, Scopus, PubMed and Google Scholar databases and using the keywords (Cadmium, Pancreatic Cancer) and their synonyms, 391 articles were retrieved and considering the inclusion and exclusion criteria, finally 8 articles were included in the present study. Data analysis was done using Stata 15 software. The significance level was considered 0.05.

In this systematic review and meta-analysis study, it was observed that compared to the group without exposure/exposure to the lowest dose of cadmium, the risk of pancreatic cancer in people exposed/exposure to the highest dose of cadmium is equal to 1.62 (95% CI: 1.18-2.21; P ≤ 0.001), this relationship was statistically significant. According to the results of Egger's test (P = 0.100) and Begg's test (P = 0.076); in this study, publication bias was not observed.

According to the results of this Review research, exposure to cadmium leads to a 62% increase in the risk of developing pancreatic cancer. Therefore, it can be said that exposure to cadmium is a risk factor for developing pancreatic cancer and health policies should be aimed at reducing exposure to Cadmium goes forward.