Journal of Advanced in Medicinal, Pharmaceutical and Biomedical Research (JAMPBR)

Abstract Background: Contrast-enhanced mammography (CEM) is an emerging alternative to breast magnetic resonance imaging (MRI) for detecting breast cancer, offering lower cost and shorter acquisition time. However, comparative diagnostic accuracy remains uncertain.

Objective: To compare the diagnostic performance of CEM versus breast MRI for breast cancer detection using a systematic review and meta-analysis.

Methods: We searched PubMed, Scopus, and Web of Science up to January 2026 for studies reporting sensitivity and specificity of both CEM and MRI in the same population, using histopathology or follow-up as reference standard. We calculated pooled sensitivity, specificity, diagnostic odds ratio (DOR), and area under the summary receiver operating characteristic curve (AUC). Quality was assessed using QUADAS-2.

Results: Fifteen studies (2,148 patients) met inclusion criteria. Pooled sensitivity was 94% (95% CI: 91–96%) for CEM and 96% (95% CI: 93–98%) for MRI (p=0.12). Pooled specificity was 87% (95% CI: 83–90%) for CEM and 84% (95% CI: 80–88%) for MRI (p=0.09). DOR was 118 (95% CI: 72–194) for CEM and 132 (95% CI: 78–223) for MRI. AUC was 0.97 for CEM and 0.98 for MRI. No significant heterogeneity was found (I²<50% for most analyses).

Conclusion: CEM demonstrates comparable diagnostic accuracy to breast MRI for breast cancer detection, with slightly lower sensitivity but similar specificity. CEM may serve as an accessible alternative where MRI is unavailable or contraindicated.

Abstract Background: Dental caries remains the most prevalent chronic disease-affecting children globally, with early childhood caries (ECC) disproportionately impacting underserved populations despite being largely preventable. Caries risk assessment (CRA) tools have developed to stratify patients and guide preventive interventions, yet the evidence base for their predictive validity and the comparative effectiveness of risk-based management protocols remains fragmented.

Objectives: This systematic review and meta-analysis aimed to (1) evaluate the predictive performance of existing CRA tools for future caries development in children, (2) assess the clinical effectiveness of prevention and management protocols stratified by caries risk category, and (3) quantify the comparative efficacy of individual preventive interventions including fluoride varnish, silver diamine fluoride (SDF), and fissure sealants.

Methods: A comprehensive literature search conducted in PubMed, Cochrane Library, Embase, Web of Science, and Scopus from inception to March 2026. Randomized controlled trials and prospective cohort studies evaluating CRA tools or risk-stratified preventive protocols in children aged 0-18 years were included. Risk of bias assessed using the Prediction Model Risk of Bias Assessment Tool (PROBAST) and Cochrane RoB 2.0 tool. Meta-analyses performed using random-effects models.

Results: Thirty-eight studies (n=47,832 participants) met inclusion criteria. Meta-analysis of six CRA models demonstrated moderate discriminatory performance (pooled AUC: 0.79, 95% CI: 0.73-0.84) with significant heterogeneity (I²=78%). All CRA models exhibited high risk of bias per PROBAST criteria. For preventive interventions, SDF demonstrated superior caries arrest rates compared to placebo (RR: 2.34, 95% CI: 1.78-3.08) and fluoride varnish (RR: 1.42, 95% CI: 1.12-1.79). Fissure sealants showed higher caries prevention efficacy than fluoride varnish over 36 months (RR: 0.68, 95% CI: 0.54-0.86).

Conclusions: Current CRA tools show modest predictive accuracy with significant methodological limitations. Risk-stratified protocols incorporating SDF for high-risk children and sealants for permanent molars supported by moderate-quality evidence. Future research must prioritize external validation of prediction models.

Abstract Introduction: Preeclampsia is one of the most important hypertension disorders in pregnancy with adverse consequences and even maternal death. Evaluation of social support and factors related to it can protect women with preeclampsia from adverse mental and physical health outcomes so this study aims to determine factors related to perceived social support in women with preeclampsia referred to a selected hospital in Ilam.

Materials and methods: In this "descriptive-correlation" study, 233 women with preeclampsia referred to the emergency department of Taleghani Hospital in Ilam in 2024 participated by available sampling method. The data collection tool included SPSS 21 software and the data were analyzed based on descriptive and analytical tests (independent T-test and analysis of variance).

Findings: The average score of perceived social support among the studied samples was equal to 71.05±6.04 out of a total of 84 points which indicates a high level of perceived social support among the studied samples. Also between the average score of perceived social support with smoking and tobacco use (P=0.001), history of stillbirth (P=0.02) and type of pregnancy (P=0.04). In the studied samples, a significant relationship was observed.

Conclusion: According to the results of this study, the health officials of pregnant women and nurses working in medical centers should consider the measures and interventions necessary to improve the perceived social support according to individual, social and disease factors in women with preeclampsia.