Aim: The global outbreak of coronavirus in 2020 was considered as a serious risk for healthcare providers, especially nurses. This study aimed to investigate nurses’ perceptions and experiences of COVID‐19 outbreak in Iran.Design: This thematic analysis study was conducted in March 2020.Method: Semi‐structured interviews were conducted with 24 nurses in Qazvin, Arak, Shiraz and Kashan cities of Iran.Results: It was found out that all the participants had faced a mysterious world created by the virus. No one had clear understanding of the new virus and knew how to tackle with such a virus. In this case, the main experiences were related to defected preparedness, the worst perceived risk, family protection, social stigma and sacrificial commitment. Urgent preparedness of facilities in such outbreaks is inevitable. Accordingly, psycho‐social support of nurses and their families and strengthening their sacrificial commitments are proposed in these conditions.

The current systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to summarize the effect of vitamin D supplementation on biomarkers of inflammation and oxidative stress among women with polycystic ovary syndrome (PCOS). Cochrane library, Embase, PubMed, and Web of Science database were searched to identify related randomized-controlled articles (RCTs) published up to November 2017. Two researchers assessed study eligibility, extracted data, and evaluated risk of bias of included RCTs, independently. To check heterogeneity Q-test and I² statistics were used. Data were pooled by using the random-effect model and standardized mean difference (SMD) was considered as summary effect size. Seven RCTs were included into our meta-analysis. The findings showed that vitamin D supplementation in women with PCOS significantly decreased high-sensitivity C-reactive protein (hs-CRP) (SMD −1.03; 95% CI, −1.58, −0.49; p <0.001) and malondialdehyde (MDA) (SMD −1.64, 95% CI −2.26 to −1.02, p <0.001), and significantly increased total antioxidant capacity (TAC) levels (SMD 0.86, 95% CI 0.08 to 1.64, p=0.03). Vitamin D supplementation had no significant effect on nitric oxide (NO) (SMD 0.11, 95% CI −0.44 to 0.66, p=0.69) and total glutathione (GSH) levels (SMD 0.54, 95% CI −0.20 to 1.28, p=0.15). Overall, the current meta-analysis demonstrated that vitamin D supplementation to women with PCOS resulted in an improvement in hs-CRP, MDA and TAC, but did not affect NO and GSH levels.

Aims: This systematic review and meta-analysis of randomized controlled trials (RCTs) was performed to determine the effect of quercetin administration on lipid profiles and inflammatory markers among patients with metabolic syndrome (MetS) and related disorders. Methods: We searched systematically online databases including Cochrane Library, EMBASE, MEDLINE, and Web of Science to identify the relevant RCTs until November 2018. Q-test and I² statistics were applied to assess heterogeneity among included studies. Data were combined using fixed- or random-effects model and presented as standardized mean difference (SMD) with 95% confidence interval (CI). Results: Out of 591 citations, 16 RCTs were included in the meta-analysis. The pooled findings showed that quercetin consumption significantly decreased total-cholesterol (SMD = −0.98; 95% CI, −1.48, −0.49; p < 0.001; I²: 94.0), LDL-cholesterol (SMD = −0.88; 95% CI, −1.35, −0.41; p < 0.001; I²: 92.7) and C-reactive protein (CRP) levels (−0.64; 95% CI, −1.03, −0.25; p = 0.001; I²: 90.2). While, quercetin supplementation did not significantly affect triglycerides (TG) (SMD = −0.32; 95% CI, −0.68, 0.04; p = 0.08; I²: 84.8), HDL-cholesterol (SMD = 0.20; 95% CI, −0.20, 0.24; p = 0.84; I²: 70.6), interleukin 6 (IL-6) (SMD = −0.69; 95% CI, −1.69, 0.31; p = 0.17; I²: 94.5) and tumor necrosis factor-alpha (TNF-α) levels (SMD = −0.06; 95% CI, −0.25, 0.14; p = 0.58; I²: 35.6) Conclusions: In summary, the current meta-analysis demonstrated that quercetin supplementation significantly reduced total-cholesterol, LDL-cholesterol, and CRP levels, yet did not affect triglycerides, HDL-cholesterol, IL-6 and TNF-α among patients with MetS and related disorders.

Background: Population based studies on prevalence and risk factors of NAFLD in Iranian population are few. The prevalence of NAFLD and non alcoholic steatohepatitis (NASH) in Iranians varies from 2.9% to 7.1% in general population and 55.8% in patients with type 2 diabetes mellitus. Objectives: To determine the prevalence and determinants of non alcoholic fatty liver disease (NAFLD) in a sample of adult Iranian general population. Patients and Methods: This was a cross-sectional study being performed in Shiraz, southern Iran during a 10-month period from November 2010 to September 2011 through cluster random sampling of Iranian general population in Shiraz region. All individuals undergone anthropometric, blood pressure measurements, thorough medical history and physical examinations. Laboratory measurements included fasting blood glucose (FBS), lipid profile, complete blood count (CBC) and liver function tests. NAFLD was diagnosed by transabdominal ultrasonography. Results: 819 subjects were included in this study among which were 340 males (41.5%) and 479 females (58.5%) with the mean age of 43.1 ± 14.1 years. NAFLD was diagnosed in 176 (21.5%) subjects. Patients with NAFLD were significantly older (P < 0.001), had higher proportion of male gender (P = 0.004) and had higher BMI (P < 0.001). They also had higher prevalence of hypertension (P < 0.001), high FBS (P < 0.001), high cholesterol (P = 0.026), high triglyceride (P < 0.001) and high waist circumference (P < 0.001). Taking all these together, patients with NAFLD had significantly higher prevalence of metabolic syndrome when compared to healthy subjects (P < 0.001). Conclusion: The prevalence of NAFLD in this group of Iranian adult general population is 21.5%. NAFLD in Iranian population is associated with male gender, old age, obesity, and features of metabolic syndrome. Keywords: Non alcoholic Fatty Liver Disease; Prevalence; Risk Factors; Metabolic Syndrome; Iran

Background: The prevention and correction of vitamin D deficiency requires a precise depiction of the current situation and identification of risk factors in each region. The present study attempted to determine these entities using a systematic review and meta-analysis in Iran. Methods: Articles published online in Persian and English between 2000 and November 1, 2016, were reviewed. This was carried out using national databases such as SID, IranMedex, Magiran, and IranDoc and international databases such as PubMed, Google Scholar, and Scopus. The heterogeneity index among the studies was determined using the Cochran (Q) and I-2 test. Based on the heterogeneity results, the random-effect model was applied to estimate the prevalence of vitamin D deficiency. In addition, meta-regression analysis was used to determine heterogeneity-suspected factors, and the Egger test was applied to identify publication bias. Results: The meta-analysis of 48 studies identified 18531 individuals with vitamin D deficiency. According to the random-effect model, the prevalence of vitamin D deficiency among male, female, and pregnant women was estimated to be 45.64% (95% CI: 29.63 to 61.65), 61.90% (95% CI: 48.85 to 74.96), and 60.45% (95% CI: 23.73 to 97.16), respectively. The results of the meta-regression analysis indicated that the prevalence of vitamin D deficiency was significantly different in various geographical regions (beta = 4.4; P = 0.023). Conclusion: The results obtained showed a significant prevalence of vitamin D deficiency among the Iranian population, a condition to be addressed by appropriate planning.