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Objective To explore the therapeutic role of corneal cross-linking (CXL) for infectious keratitis. Methods This is an umbrella review of the systematic reviews and meta-analysis concerning the role of corneal CXL in treating infectious keratitis. Appropriate keywords were carefully selected following the identification of PICO (Population: People who have corneal cross-linking for infectious keratitis; Intervention: corneal cross-linking; Comparison: other treatments such as antibiotic therapy; Outcome: Primary outcome was considered as the efficacy of treatment using re-epithelization and heal rate, and secondary outcome was considered need to penetrating keratoplasty (PK)). The electronic search across various databases, including Cochrane, PubMed, MEDLINE, Embase, SCOPUS, CINAHL, Psychoinfo, and ProQuest, was performed until August 2024. Results Five systematic reviews out of 53 identified records are included in the umbrella review. Due to the structure of the included studies, statistical analysis was not possible to be conducted. Four studies were included that mainly evaluated the role of adjuvant corneal CXL in bacterial keratitis, and the other study focused mainly on fungal keratitis. The studies reported heterogeneous results. Two systematic reviews reported a shorter period for corneal epithelium healing in the adjuvant CXL group compared to the standard antibiotic therapy (SAT), especially in fungal keratitis. However, two studies showed no significant change in re-epithelization duration. One meta-analysis reported a reduction in corneal infiltrate size 7 days after adjuvant corneal CXL compared to the SAT. None of the included studies reported a difference in corneal complications, such as perforation and the need for PK in the CXL group compared to SAT. Conclusion The corneal CXL in infectious keratitis has no uniform protocol, especially regarding the de-epithelization procedure before CXL, leading to heterogeneity in the trial results. However, it seems the adjuvant corneal CXL next to SAT is not inferior to the unaccompanied SAT and may be superior in some cases, including fungal etiologies, regarding faster corneal healing. Graphical Abstract

Background: Maternal anxiety has been accompanied by many unfavorable effects on breastfeeding in the postpartum period. We aimed to provide scientific evidence in identifying effective interventions for anxiety and breastfeeding self-efficacy (BSE) in a systematic review and meta-analysis.  Methods: All published studies with inclusion criteria by 2022 were searched in Embase, Cochrane library, Web of Sciences, Google Scholar, PubMed, Scopus, SID and Magiran. The literature search was performed using PRISMA instructions. Further, 20 eligible interventional studies (RCT and pre-posttest) and one case study were included in this systematic review and meta-analysis. Publication bias was checked with Eggers test and funnel plot methods. The collected data were analyzed using stata version16.  Results: It is not possible to provide an explicit and accurate conclusion about the effective intervention method in reducing anxiety and increasing BSE among lactating women during the covid19 pandemic. The results indicated a significant increase in BSE among lactating women after educational and psychological interventions (4.20, 95% CI: 3.61 to 4.80, I2 = 26.38%). Conclusion: It is recommended to conduct further studies with a strong methodology and based on intervention methods during the postpartum period, especially in the first month of birth to reduce the symptoms of stress and anxiety in the mother, establish better mother-child attachment, and improve BSE and maternal performance during the Covid-19 pandemic.  

Ramadan fasting in Muslims may contain several hours of abstaining from food and drinking in any kind. This can potentially increase the risk of urinary stone disease. Current literature on possible effects of Ramadan fasting on urolithiasis is rather limited. Having the gap in scientific background, we decided to evaluate the available comparative information in this systematic review. We included all studies comparing fasting and non-fasting conditions, studies evaluating stone formation and clinical manifestations of kidney stone disease. All the English studies published from January 1980 to the end of 2019 were included. The exclusion criteria were as followed: fasting out of Ramadan, non-comparative studies, animal studies, patients with bladder stones, and studies evaluating conditions that are only indirectly related to the stone formation or clinical manifestations of it. Applying the Joanna Briggs Institute (JBI) methodology for systematic review showed the quality of included studies was not high. Only five studies remained after exclusion. Meta-analysis was not applicable due to the diversity in methods and evaluated population. Main trend of the included studies is toward showing no difference between fasting and non-fasting conditions in terms of renal stone formation. However, generalization of the findings to greater populations should be applied carefully considering the heterogeneity of results and quality of studies.

Preclinical and clinical studies have indicated that combining photobiomodulation (PBM) therapy with other therapeutic approaches may influence the treatment process in a variety of disorders. The purpose of this systematic review was to determine whether PBM-combined therapy provides additional benefits over monotherapies in neurologic and neuropsychiatric disorders. In addition, the review describes the most commonly used methods and PBM parameters in these conjunctional approaches. To accomplish this, a systematic search was conducted in Google Scholar, PubMed, and Scopus databases through January 2024. 95 potentially eligible articles on PBM-combined treatment strategies for neurological and neuropsychological disorders were identified, including 29 preclinical studies and 66 clinical trials. According to the findings, seven major categories of studies were identified based on disease type: neuropsychiatric diseases, neurodegenerative diseases, ischemia, nerve injury, pain, paresis, and neuropathy. These studies looked at the effects of laser therapy in combination with other therapies like pharmacotherapies, physical therapies, exercises, stem cells, and experimental materials on neurological disorders in both animal models and humans. The findings suggested that most combination therapies could produce synergistic effects, leading to better outcomes for treating neurologic and psychiatric disorders and relieving symptoms. These findings indicate that the combination of PBM may be a useful adjunct to conventional and experimental treatments for a variety of neurological and psychological disorders.

Introduction and Hypothesis This study was aimed at validating the Persian version of the International Female Coital Incontinence Questionnaire (IFCI-Q). Methods In the current study, 150 sexually active women with complaints of any kind of sexual dysfunction from January 2022 to July 2023, who were referred to urogynecology outpatient clinics, completed the IFCI-Q. Age ≥ 18 years and sexually active women were the inclusion criteria for the study. Quantitative calculations were made to determine the content validity ratio and content validity index. A test–retest procedure was utilized to determine the scale reliability. Results The mean (SD) age of participants was 35.66 (7.03) years. Among a total of 150 women, 21 (14.0%) had coital incontinence (CI), and this disorder happened during penetration in 11 cases (7.3%), orgasm in 9 (6.1%), or both conditions in one woman (0.7%). The intraclass correlation coefficient (95% confidence interval) was 0.79 (0.74, 0.84), and the Cronbach's α coefficient was 0.89. A positive association between the Female Sexual Function Index and the IFCI-Q was also demonstrated by the criteria validity (r = 0. 87 and p  = 0.001). Conclusion Regarding validity and reliability, the Persian version of the IFCI-Q can properly evaluate CI in women with sexual dysfunction or complaining of CI.

This systematic review sought to assess the impact of nicotinamide adenine dinucleotide (NAD + ) precursors on cognitive impairments in several diseases in rat/mouse models. Accumulating evidence suggests that inflammation, apoptosis, oxidative stress responses, and mitochondrial dysfunction are potential factors of cognitive deficits in aging, Alzheimer's disease (AD), diabetes, traumatic brain injury (TBI), vascular dementia (VAD), and schizophrenia. NAD + precursors have received increased interest due to their unique molecular structure targets antioxidant and inflammatory pathways and mitochondrial function. The PubMed, Scopus, Google Scholar, Embase, and Web of Science databases were searched through May 30, 2024. Studies investigating the effect of NAD + precursors on cognitive impairments in rodent models were included. Two reviewers independently extracted and evaluated the data. The PRISMA guidelines for reporting systematic reviews were followed. Thirty preclinical studies were included in the review. Studies have revealed that treatment with NAD + rescues cognitive deficits by inhibiting inflammation, oxidative stress, and apoptosis and improving mitochondrial function . Preclinical evidence has demonstrated that treatment with NAD + precursors may be more effective in learning and memory recovery in AD, TBI, diabetes, aging, VAD, and schizophrenia. The outcomes of this investigation may lead to additional studies on the use of NAD + precursors for treating human cognitive decline.

This study aimed to determine the effects of combined aromatherapy with lavender (Lavandula angustifolia Mill.) essential oil (LEO) and Bergamot (Citrus×bergamia (Risso) Risso & Poit) essential oil (BEO) and/or mindfulness-based therapy (MBT) on menopausal symptoms, sleep quality, and serum cortisol. This factorial randomized controlled trial included 132 postmenopausal 132 postmenopausal women aged 50–60 years with mild to moderate anxiety. The recruited women were divided into four groups receiving: 1) Control: Usual care + placebo, 2) Therapy: MBT + placebo, 3) Aromatherapy: LEO + BEO Aromatherapy + usual care, and 4) Therapy & Aromatherapy: MBT + LEO-BEO aromatherapy. Participants in the aromatherapy and placebo groups were instructed to apply 2–3 drops of the assigned solution to their forearm skin and inhale it three times daily for eight weeks. Weekly MBT sessions were held over two months. After two months, the aromatherapy group showed reduced total scores for menopausal symptoms [adjusted mean difference (aMD) (95 % CI): −5.7 (−9.5 to −1.8)] and anxiety [aMD (95 % CI): −1.9 (−3.4 to −0.4)] compared to the control group. Sleep quality, measured by the Pittsburgh Sleep Quality Index (PSQI), improved in both the therapy [aMD (95 % CI): −2.6 (−4.2 to −1.0)] and aromatherapy [aMD (95 % CI): −1.7 (−3.3 to −0.1)] groups versus controls. However, the combined intervention showed no significant effects compared to control (p > 0.05). Serum cortisol levels did not differ significantly across groups (p > 0.05). MBT and LEO-BEO aromatherapy demonstrated favorable outcomes in managing menopausal symptoms and sleep quality. The combination therapy did not yield additional benefits. The registration number: IRCT20131009014957N8 The registration date: 04/12/2019 •Compared with placebo, Lavender-Bergamot aromatherapy improved menopausal symptoms and anxiety over a two-month intervention.•Compared to placebo, aromatherapy and mindfulness-based intervention improved sleep quality over a two-month intervention.•Mindfulness-based intervention and Lavender-Bergamot aromatherapy had no significant effect on serum cortisol (p < 0.05).