Prevalence of polymorphisms in thiopurine metabolism and association with adverse outcomes: A south Asian region-specific systematic review and meta-analysis

2021 ◽  
Author(s):  
Anuraag Jena ◽  
Daya Krishna Jha ◽  
Praveen Kumar-M ◽  
Kripa Shanker Kasudhan ◽  
Ankit Kumar ◽  
...  
Keyword(s):  
Systematic Review ◽  
South Asian ◽  
Meta Analysis ◽  
Adverse Outcomes ◽  
Asian Region ◽  
South Asian Region

A systematic review and meta-analysis of screening and diagnostic accuracy for hearing loss among under-five children in South-Asian region

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Ramesh Athe ◽  
Rinshu Dwivedi ◽  
Krushna Chandra Sahoo ◽  
Debdutta Bhattacharya ◽  
Shalu Jain ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
South Asian ◽  
Meta Analysis ◽  
Hearing Screening ◽  
Risk Indicators ◽  
Content Type ◽  
Under Five ◽  
Under Five Children ◽  
Asian Region ◽  
South Asian Region

Purpose Congenital hearing disabilities among children are associated with lifetime discrepancies in the attainment of speech, poor academic-performance, socio-individual isolation and emotional-maladjustments. The present study aims to combine evidence from randomized, controlled trials to assess the accuracy of hearing-screening procedures and relative diagnostic-tests concomitant with partial/permanent hearing loss (HL) among neonatal and under-five children. Design/methodology/approach The steps in this process were conducted according to the PRISMA (Preferred-Reporting-Items-for-Systematic-reviews-and-Meta-Analysis) guidelines. The PubMed, ProQuest, Science-Direct, Cochrane-Library and secondary reference databases were searched. Analyses were carried out by using fixed/random-effects-models for calculating the summary estimates on hearing-screening and test-procedure. Meta-regression-analysis is performed to explore the influence of confounders on the net-pooled effect. Findings A total of 1,656 articles were identified, and 1,575 were excluded as they were not relevant to the purpose of the study. Further, out of 81 studies, 67 were excluded with reasons and 14 were included in the final analysis. Three independent reviewers have assessed the titles/abstracts for their potential relevance. The results from meta-analysis indicate that hearing-screening was significantly higher in the intervention group (n 8,102; OR 0.52, 95% CI 0.34, 0.79; p < 0.00001), as depicted via forest plot. Meta-regression analysis indicates a positive relationship between the age and effect size (regression-coefficient 0.638, 95% CI 0.005, 0.731; p < 0.05). Research limitations/implications The evidence from the present study can be used as reference for identifying the associated risk indicators, improved hearing-screening and reduction of hearing disability among under-five children. Practical implications The results of this review will be used for implementation of a new-born hearing screening, diagnostic accuracy and understanding the risk indicators for HL among under-five children in the South-Asian region. The evidence will be helpful for strategic directions for improved hearing screening and reduction of hearing disability among under-five children. Social implications By understanding the underlying dynamics of hearing-screening procedures, hearing-impairments can be identified at an early stage and required treatment can be provided to the children. Originality/value The findings of this study indicate that early detection, screening and diagnosis of the HL among the children, especially among the infants and new-born (0–2 years of age), will be of utmost importance in reducing the prevalence of HL, especially among the South-Asian region. This study can be used as a reference for other future studies in the area of hearing-screening, diagnostic accuracy and associated risk indicators among children.

scholarly journals COVID-19 in People Living with HIV: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 18 (7) ◽  
pp. 3554
Author(s):  
Kai Wei Lee ◽  
Sook Fan Yap ◽  
Yun Fong Ngeow ◽  
Munn Sann Lye
Keyword(s):  
Systematic Review ◽  
Laboratory Testing ◽  
Meta Analysis ◽  
Clinical Signs ◽  
Adverse Outcomes ◽  
People Living With Hiv ◽  
Common Symptom ◽  
Chest Imaging ◽  
Wide Range ◽  
Epidemiological Characteristics

COVID-19 is a global health emergency. People living with human immunodeficiency virus (PLHIV) have concerns about whether they have a higher risk of getting the infection and suffer worse COVID-19 outcomes. Findings from studies on these questions have largely been inconsistent. We aimed to determine the epidemiological characteristics, clinical signs and symptoms, blood parameters, and clinical outcomes among PLHIV who contracted COVID-19. Relevant studies were identified through Medline, Cinahl, and PubMed databases. A random-effects model was used in meta-analyses with a 95% confidence interval. Eighty-two studies were included in the systematic review and sixty-seven studies for the meta-analysis. The pooled incidence proportion of COVID-19 among PLHIV was 0.9% (95% CI 0.6%, 1.1%) based on the data from seven cohort studies. Overall, 28.4% were hospitalised, of whom, 2.5% was severe-critical cases and 3.5% needed intensive care. The overall mortality rate was 5.3%. Hypertension was the most commonly reported comorbidity (24.0%). Fever (71.1%) was the most common symptom. Chest imaging demonstrated a wide range of abnormal findings encompassing common changes such as ground glass opacities and consolidation as well as a spectrum of less common abnormalities. Laboratory testing of inflammation markers showed that C-reactive protein, ferritin, and interleukin-6 were frequently elevated, albeit to different extents. Clinical features as well as the results of chest imaging and laboratory testing were similar in highly active antiretroviral therapy (HAART)-treated and non-treated patients. PLHIV were not found to be at higher risk for adverse outcomes of COVID-19. Hence, in COVID-19 management, it appears that they can be treated the same way as HIV negative individuals. Nevertheless, as the pandemic situation is rapidly evolving, more evidence may be needed to arrive at definitive recommendations.

scholarly journals Serum albumin concentrations are associated with disease severity and outcomes in coronavirus 19 disease (COVID-19): a systematic review and meta-analysis

2021 ◽  
Author(s):  
Panagiotis Paliogiannis ◽  
Arduino Aleksander Mangoni ◽  
Michela Cangemi ◽  
Alessandro Giuseppe Fois ◽  
Ciriaco Carru ◽  
...  
Keyword(s):  
Systematic Review ◽  
Serum Albumin ◽  
Disease Severity ◽  
Meta Analysis ◽  
Severe Disease ◽  
Geographic Area ◽  
Adverse Outcomes ◽  
Poor Outcome ◽  
Standard Mean Difference ◽  
Meta Regression Analysis

AbstractCoronavirus disease 2019 (COVID-19), an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is responsible for the most threatening pandemic in modern history. The aim of this systematic review and meta-analysis was to investigate the associations between serum albumin concentrations and COVID-19 disease severity and adverse outcomes. A systematic literature search was conducted in PubMed, from inception to October 30, 2020. Sixty-seven studies in 19,760 COVID-19 patients (6141 with severe disease or poor outcome) were selected for analysis. Pooled results showed that serum albumin concentrations were significantly lower in patients with severe disease or poor outcome (standard mean difference, SMD: − 0.99 g/L; 95% CI, − 1.11 to − 0.88, p < 0.001). In multivariate meta-regression analysis, age (t =  − 2.13, p = 0.043), publication geographic area (t = 2.16, p = 0.040), white blood cell count (t =  − 2.77, p = 0.008) and C-reactive protein (t =  − 2.43, p = 0.019) were significant contributors of between-study variance. Therefore, lower serum albumin concentrations are significantly associated with disease severity and adverse outcomes in COVID-19 patients. The assessment of serum albumin concentrations might assist with early risk stratification and selection of appropriate care pathways in this group.

scholarly journals Children Born with Congenital Heart Defects and Growth Restriction at Birth: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 17 (9) ◽  
pp. 3056 ◽  
Author(s):  
Ali Ghanchi ◽  
Neil Derridj ◽  
Damien Bonnet ◽  
Nathalie Bertille ◽  
Laurent J. Salomon ◽  
...  
Keyword(s):  
Systematic Review ◽  
Congenital Heart Defects ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Congenital Heart ◽  
Heart Defects ◽  
Data Extraction ◽  
Meta Analysis ◽  
Adverse Outcomes ◽  
Growth Restriction

Newborns with congenital heart defects tend to have a higher risk of growth restriction, which can be an independent risk factor for adverse outcomes. To date, a systematic review of the relation between congenital heart defects (CHD) and growth restriction at birth, most commonly estimated by its imperfect proxy small for gestational age (SGA), has not been conducted. Objective: To conduct a systematic review and meta-analysis to estimate the proportion of children born with CHD that are small for gestational age (SGA). Methods: The search was carried out from inception until 31 March 2019 on Pubmed and Embase databases. Studies were screened and selected by two independent reviewers who used a predetermined data extraction form to obtain data from studies. Bias was assessed using the Critical Appraisal Skills Programme (CASP) checklist. The database search identified 1783 potentially relevant publications, of which 38 studies were found to be relevant to the study question. A total of 18 studies contained sufficient data for a meta-analysis, which was done using a random effects model. Results: The pooled proportion of SGA in all CHD was 20% (95% CI 16%–24%) and 14% (95% CI 13%–16%) for isolated CHD. Proportion of SGA varied across different CHD ranging from 30% (95% CI 24%–37%) for Tetralogy of Fallot to 12% (95% CI 7%–18%) for isolated atrial septal defect. The majority of studies included in the meta-analysis were population-based studies published after 2010. Conclusion: The overall proportion of SGA in all CHD was 2-fold higher whereas for isolated CHD, 1.4-fold higher than the expected proportion in the general population. Although few studies have looked at SGA for different subtypes of CHD, the observed variability of SGA by subtypes suggests that growth restriction at birth in CHD may be due to different pathophysiological mechanisms.

scholarly journals Efficacy and safety of instantaneous wave-free ratio in patients undergoing coronary revascularisation: protocol for a systematic review

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e017868
Author(s):  
Joey S.W. Kwong ◽  
Sheyu Li ◽  
Wan-Jie Gu ◽  
Hao Chen ◽  
Chao Zhang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
Adverse Outcomes ◽  
Coronary Revascularisation ◽  
Eligibility Criteria ◽  
Registration Number ◽  
Collection Form ◽  
Randomised Controlled ◽  
Meta Analyses

IntroductionEffective selection of coronary lesions for revascularisation is pivotal in the management of symptoms and adverse outcomes in patients with coronary artery disease. Recently, instantaneous ‘wave-free’ ratio (iFR) has been proposed as a new diagnostic index for assessing the severity of coronary stenoses without the need of pharmacological vasodilation. Evidence of the effectiveness of iFR-guided revascularisation is emerging and a systematic review is warranted.Methods and analysisThis is a protocol for a systematic review of randomised controlled trials and controlled observational studies. Electronic sources including MEDLINE via Ovid, Embase, Cochrane databases and ClinicalTrials.gov will be searched for potentially eligible studies investigating the effects of iFR-guided strategy in patients undergoing coronary revascularisation. Studies will be selected against transparent eligibility criteria and data will be extracted using a prestandardised data collection form by two independent authors. Risk of bias in included studies and overall quality of evidence will be assessed using validated methodological tools. Meta-analysis will be performed using the Review Manager software. Our systematic review will be performed according to the guidance from the Cochrane Handbook for Systematic Reviews of Interventions and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.Ethics and disseminationEthics approval is not required. Results of the systematic review will be disseminated as conference proceedings and peer-reviewed journal publication.Trial registration numberThis protocol is registered in the International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42017065460.

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