Toxicoepidemiology of poisoning exhibited in Indian population from 2010 to 2020: a systematic review and meta-analysis

ObjectiveTo determine the prevalence of pesticide, corrosive, drugs, venom and miscellaneous poisoning in India.SettingSystematic literature search was done in PubMed Central, Cochrane and Google Scholar databases for studies that satisfied the inclusion criteria. Systematic review and meta-analyses of all observational studies published in the English language from January 2010 to May 2020 were included in this review.ParticipantsPatients exposed to poisoning reported to hospitals were included.Primary and secondary outcome measuresThe prevalence of pesticide poisoning was analysed. The prevalence of poisoning due to corrosives, venom, drugs and miscellaneous agents, along with subgroup analysis based on age and region, was also determined. The percentage of persons with poisoning along with 95% CI was analysed.ResultsPooled analysis of studies revealed that pesticides were the main cause of poisoning in adults, with an incidence of 63% (95% CI 63% to 64%), while miscellaneous agents were the main cause of poisoning in children, with an incidence of 45.0% (95% CI 43.1% to 46.9%), among those presenting to hospitals. Pesticide poisoning was the most prevalent in North India (79.1%, 95% CI 78.4% to 79.9%), followed by South (65.9%, 95% CI 65.3% to 66.6%), Central (59.2%, 95% CI 57.9% to 60.4%), West (53.1%, 95% CI 51.9% to 54.2%), North East (46.9%, 95% CI 41.5% to 52.4%) and East (38.5%, 95% CI 37.3% to 39.7%). The second most common cause of poisoning was miscellaneous agents (18%, 95% CI 18% to 19%), followed by drugs (10%, 95% CI 10% to 10%), venoms (6%, 95% CI 6% to 6%) and corrosives (2%, 95% CI 1% to 2%).ConclusionsPesticide poisoning is the most common type of poisoning in adults, while miscellaneous agents remain the main cause of poisoning in children.PROSPERO registration numberCRD42020199427.

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Association between insulin resistance and post-ischaemic stroke outcome in patients without diabetes: protocol for a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2020-044771 ◽

2021 ◽

Vol 11 (3) ◽

pp. e044771

Author(s):

Jeremiah Hadwen ◽

Woojin Kim ◽

Brian Dewar ◽

Tim Ramsay ◽

Alexandra Davis ◽

...

Keyword(s):

Systematic Review ◽

Insulin Resistance ◽

Ischaemic Stroke ◽

Functional Outcome ◽

Recurrent Stroke ◽

Meta Analysis ◽

Secondary Outcome ◽

Stroke Outcome ◽

Post Stroke ◽

Meta Analyses

IntroductionInsulin resistance is an independent risk factor for atherosclerosis, coronary artery disease and ischaemic stroke. Currently, insulin resistance is not usually included in post-stroke risk stratification. This systematic review and meta-analysis intends to determine if available scientific knowledge supports an association between insulin resistance and post-stroke outcomes in patients without diabetes.Methods and analysisThe authors will conduct a literature search in Medline, Embase, Web of Science and Cochrane Central. The review will include studies that assess the association between elevated insulin homeostasis model of insulin resistance (HOMA-IR) and post-stroke outcome (functional outcome and recurrent stroke). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines will be used. The primary outcome will be post-stroke functional outcome (Modified Rankin Scale), and the secondary outcome will be recurrent ischaemic stroke. Comparison of outcome will be made between highest and lowest HOMA-IR range (as defined in each article included in this systematic review). Risk of bias will be assessed qualitatively. Meta-analysis will be performed if sufficient homogeneity exists between studies. Heterogeneity of outcomes will be assessed by I².Ethics and disseminationNo human or animal subjects or samples were/will be used. The results will be published in a peer-reviewed journal, and will be disseminated at local and international neurology conferences.PROSPERO registration numberCRD42020173608.

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Adverse effects of ADT on cognitive function and dementia for men with prostate cancer: A meta-analysis and systematic review.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.6_suppl.150 ◽

2017 ◽

Vol 35 (6_suppl) ◽

pp. 150-150 ◽

Cited By ~ 1

Author(s):

Maxine Sun ◽

Alexander Cole ◽

Nawar Hanna ◽

Adam S. Kibel ◽

Toni K. Choueiri ◽

...

Keyword(s):

Prostate Cancer ◽

Systematic Review ◽

Cognitive Function ◽

Cognitive Decline ◽

English Language ◽

Meta Analysis ◽

Pooled Analysis ◽

Cochrane Library ◽

Significant Heterogeneity ◽

The Impact

150 Background: Nearly 50% of men diagnosed with prostate cancer may receive treatment with some form of androgen deprivation therapy (ADT). While some side effects of ADT are well acknowledged, the specific impact of ADT on cognitive function is uncertain. Our objective was to perform a systematic review and meta-analysis assessing the impact of ADT on overall cognitive decline, and the risks of Alzheimers, Parkinson’s disease. Methods: Relevant studies were identified through search of English language articles indexed in PubMed Medline, PsycINFO, Cochrane Library and Web of Knowledge/Science. First, we assessed rates of cognitive decline in five cohorts from three studies. Second, we assessed rates of Alzheimer’s or Parkinson disease using three large retrospective studies. A pooled-analysis was conducted using a meta-analysis. Weighted averages were reported as odds ratios (OR) with 95% confidence intervals (CI) using RevMan and a DerSimonian and Laird random-effects model. The heterogeneity test was measured using the Q-Mantel-Haenszel ( P< 0.10 was considered of significant heterogeneity). Results: With respect to overall cognitive decline (defined as scoring 1.5 standard deviations [SD] in two or more objective cognitive tests), patients receiving ADT had higher odds of overall cognitive decline than patients with prostate cancer not treated with ADT or health controls (OR: 2.03, 95% CI: 1.42–2.90). Furthermore, men with a history of ADT for prostate cancer had higher odds of developing Alzheimer’s and Parkinson dementia compared to men with prostate cancer not treated with ADT (OR: 1.32, 95% CI: 1.27–1.37). Conclusions: Men receiving ADT for prostate cancer performed significantly worse on measures of overall cognitive function. Additionally, results from the three large observational trials included suggest men exposed to ADT for prostate cancer have higher rates of Parkinson/Alzheimer’s compared to men without ADT.

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Smoking and Incidence of Insomnia: a systematic review and meta-analysis of cohort studies

10.21203/rs.3.rs-27889/v3 ◽

2020 ◽

Author(s):

Nan Hu ◽

Chunyi Wang ◽

Yan Liao ◽

Qichen Dai ◽

Shiyi Cao

Keyword(s):

Systematic Review ◽

Cohort Studies ◽

Fixed Effects ◽

Meta Analysis ◽

Significant Risk ◽

Significant Risk Factor ◽

Pooled Analysis ◽

Study Characteristics ◽

Meta Analyses ◽

The Impact

Abstract Background: Both smoking and insomnia are worldwide problems and this study aims to investigate the impact of smoking on the incidence of insomnia. Methods: PubMed, EMBASE and OVID were searched through March, 2020. Cohort studies reporting the effect of smoking on the incidence of insomnia were included. We quantitatively analyzed the basic framework and study characteristics, and then pooled estimate effects with 95% confidence intervals (CIs) of outcomes of each included studies using fixed-effects meta-analyses. Results: This systematic review included six cohort studies involving 12445 participants. Quantitatively summarized results suggested smoking could significantly increase the incidence of insomnia (OR: 1.07, 95%CI: 1.02,1.13). Regular smoking was significantly associated with incidence of insomnia (OR=1.07, 95% CI:1.01,1.13). As for occasional smokers and ex-smokers, the pooled analysis didn’t indicate a significant association (occasional smoker: OR=2.09, 95% CI:0.44,9.95; ex-smoker; OR=1.02, 95% CI:0.67,1.54). Subgroup analysis by age, gender ratio and region showed statistically significant relationship between smoking and incidence of insomnia in specific groups. Conclusions: Integrated longitudinal observational evidence identified smoking as a significant risk factor of insomnia. Considering the limited amount of available studies, more high-quality and prospective cohort studies of large sample sizes are needed to explore details of this association.

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Relationship of prostate cancer topography and tumour conspicuity on multiparametric magnetic resonance imaging: a protocol for a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2021-050376 ◽

2022 ◽

Vol 12 (1) ◽

pp. e050376

Author(s):

Pranav Satish ◽

Alex Freeman ◽

Daniel Kelly ◽

Alex Kirkham ◽

Clement Orczyk ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Prostate Cancer ◽

Systematic Review ◽

Magnetic Resonance ◽

English Language ◽

Data Extraction ◽

Meta Analysis ◽

Resonance Imaging ◽

Multiparametric Magnetic Resonance Imaging ◽

Meta Analyses

IntroductionMultiparametric magnetic resonance imaging (mpMRI) has improved the triage of men with suspected prostate cancer, through precision prebiopsy identification of clinically significant disease. While multiple important characteristics, including tumour grade and size have been shown to affect conspicuity on mpMRI, tumour location and association with mpMRI visibility is an underexplored facet of this field. Therefore, the objective of this systematic review and meta-analysis is to collate the extant evidence comparing MRI performance between different locations within the prostate in men with existing or suspected prostate cancer. This review will help clarify mechanisms that underpin whether a tumour is visible, and the prognostic implications of our findings.Methods and analysisThe databases MEDLINE, PubMed, Embase and Cochrane will be systematically searched for relevant studies. Eligible studies will be full-text English-language articles that examine the effect of zonal location on mpMRI conspicuity. Two reviewers will perform study selection, data extraction and quality assessment. A third reviewer will be involved if consensus is not achieved. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines will inform the methodology and reporting of the review. Study bias will be assessed using a modified Newcastle-Ottawa scale. A thematic approach will be used to synthesise key location-based factors associated with mpMRI conspicuity. A meta-analysis will be conducted to form a pooled value of the sensitivity and specificity of mpMRI at different tumour locations.Ethics and disseminationEthical approval is not required as it is a protocol for a systematic review. Findings will be disseminated through peer-reviewed publications and conference presentations.PROSPERO registration numberCRD42021228087.

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Treatment of Postural Orthostatic Tachycardia Syndrome With Medication: A Systematic Review

Journal of Child Neurology ◽

10.1177/0883073820948679 ◽

2020 ◽

Vol 35 (14) ◽

pp. 1004-1016 ◽

Cited By ~ 1

Author(s):

Bashar Hasan ◽

Jehad Almasri ◽

Bilal Marwa ◽

Kelsey M. Klaas ◽

Philip R. Fischer

Keyword(s):

Systematic Review ◽

English Language ◽

Selective Serotonin Reuptake Inhibitors ◽

Beta Blockers ◽

Meta Analysis ◽

Quality Data ◽

Favorable Effect ◽

Control Group ◽

Postural Orthostatic Tachycardia Syndrome ◽

Meta Analyses

Purpose: Postural orthostatic tachycardia syndrome has been recognized for decades, but treatment is largely based on anecdotal experience and expert opinion. Pharmacologic treatment is inconsistent and unstandardized. We did a systematic review to identify controlled studies from which informed treatment decisions can be made. Method: Through a standard systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we identified all English-language studies of a medication treatment for postural orthostatic tachycardia syndrome that included a comparison or control group and followed outcomes for at least 1 week of treatment. Results: A total of 626 studies were identified by the search criteria, and 8, involving a total of 499 patients, met the criteria. No studies were adequately similar to allow for meta-analysis. Of the identified 8 studies, 2 were randomized controlled trials and 4 had been subjected to peer review. In individual studies, there was some favorable effect with fludrocortisone, beta blockers, midodrine, and selective serotonin reuptake inhibitors. Conclusion: There is a paucity of high-quality data about effectiveness of medication in the treatment of postural orthostatic tachycardia syndrome. Nonetheless, 2 randomized trials and 6 other reports show some favorable effects of medication.

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A Systematic Review on Natural Medicines for the Prevention and Treatment of Alzheimer's Disease with Meta-Analyses of Intervention Effect of Ginkgo

The American Journal of Chinese Medicine ◽

10.1142/s0192415x14500335 ◽

2014 ◽

Vol 42 (03) ◽

pp. 505-521 ◽

Cited By ~ 26

Author(s):

Mengmeng Yang ◽

Dan Dan Xu ◽

Yan Zhang ◽

Xinyou Liu ◽

Robin Hoeven ◽

...

Keyword(s):

Systematic Review ◽

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

English Language ◽

Meta Analysis ◽

Cochrane Library ◽

Significant Heterogeneity ◽

Meta Analyses ◽

Natural Medicines

We performed a systematic review to evaluate the efficacy of natural medicines for the treatment of Alzheimer's disease (AD) in randomized controlled trials (RCTs). Disease-specific and intervention terms were searched in MEDLINE, EMBASE, the Cochrane Library and PsycINFO to identify RCTs for the AD intervention of natural medicines, and searched for literatures in English language. The RCTs compared natural medicines and either placebo or orthodox medication in AD patients. The quality of literature was evaluated by Jadad's score and the Cochrane assessing tool to reduce the risk of bias. Meta-analysis and the heterogeneity of results across the trials were performed. Out of the literatures, 21 clinical reports were included in this review that satisfied the particular selection criteria. Apart from Ginkgo, other treatments we came across had minimal benefits and/or the methodological quality of the available trials was poor. The meta-analyses showed that Ginkgo had better outcomes than the placebo, with the standardized mean difference (SMD) between Ginkgo and the placebo on cognition being -1.62 (95% CI: -2.69 to -0.56) and on activities of daily living being -1.55 (95% CI: -2.55 to -0.55), with the existence of significant heterogeneity across studies. The meta-analysis for assessing the prevention effect of Ginkgo against AD suggested that risk ratio (RR) is 1.06 (95% CI: 0.92 to 1.22) between Gingko and the placebo, with no significant heterogeneity across studies (test for heterogeneity, p = 0.49). Our results suggest that Ginkgo may help established AD patients with cognitive symptoms but cannot prevent the neurodegenerative progression of the disease.

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RADT-17. RADIOTHERAPY IN THE MANAGEMENT OF OPTIC NERVE SHEATH MENINGIOMAS: AN INTERNATIONAL SYSTEMATIC REVIEW AND META-ANALYSIS OF EIGHTEEN STUDIES

Neuro-Oncology ◽

10.1093/neuonc/noaa215.770 ◽

2020 ◽

Vol 22 (Supplement_2) ◽

pp. ii185-ii185

Author(s):

Yash J Vaishnav ◽

Raj Singh ◽

Prabhanjan Didwania ◽

Eric J Lehrer ◽

Tatiana Bakaeva ◽

...

Keyword(s):

Systematic Review ◽

Optic Nerve ◽

Meta Analysis ◽

Optic Nerve Sheath ◽

Secondary Outcome ◽

Chronic Radiation ◽

Nerve Sheath ◽

Radiation Induced ◽

Meta Analyses

Abstract INTRODUCTION Optic nerve sheath meningiomas (ONSMs) are often managed with radiotherapy (RT) with the goal of achieving radiographic local control (LC) to prevent further decline in visual acuity (VA); however, reports on outcomes are limited to small retrospective series. Thus, we aimed to perform a systematic review and meta-analysis of outcomes for patients with ONSM treated with RT. METHODS A PICOS/PRISMA/MOOSE selection criteria was utilized to identify studies for inclusion. Primary outcomes were stable or improved VA and radiographic LC at last follow-up. The secondary outcome was incidence of radiation-induced retinopathy. Weighted random effects meta-analyses using the DerSimonian and Laird methods were conducted to characterize effect sizes. Mixed effects regression models were used to examine potential correlations between gross tumor volume (GTV) and outcomes. RESULTS In total, 381 patients with ONSM across 18 published studies were included. Of these, 332 and 386 treated ONSMs had information on VA or LC, respectively. Median age was 46.75 (range: 9-87), median/mean GTV was 2.905cc (range: 0.28-26.3), and median follow-up was 51.15 months (range: 1-248.4 months). The estimated LC rate at last follow-up was 100% (95% CI: 98-100%), and the estimated proportion of patients with stable or improved VA at last follow-up was 89% (95% CI: 84-93%). The rate of chronic radiation retinopathy was estimated to be 7% (95% CI: 5-11%). GTV was significantly associated with VA (p=0.014) with estimated VA rates of 96.4%, 91.4%, and 80.5% for GTVs of 2.0, 3.0, and 4.0ccs, respectively. CONCLUSIONS RT was well-tolerated in the treatment of ONSM with excellent LC achieved. Nearly 90% of patients noted either stability or improvement in VA. Larger ONSMs were found to be associated with poorer VA. Incidences of radiation-induced retinopathy were limited and estimated to be less than 10%.

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Racial and Ethnic Differences in Falls Among Older Adults: a Systematic Review and Meta-analysis

Journal of Racial and Ethnic Health Disparities ◽

10.1007/s40615-021-01179-1 ◽

2021 ◽

Author(s):

Natasha Wehner-Hewson ◽

Paul Watts ◽

Richard Buscombe ◽

Nicholas Bourne ◽

David Hewson

Keyword(s):

Systematic Review ◽

Ethnic Groups ◽

English Language ◽

Meta Analysis ◽

Community Dwelling ◽

Racial And Ethnic Differences ◽

Use Of Resources ◽

Language Studies ◽

Risk Of Falls ◽

Meta Analyses

Abstract The aim of this systematic review and meta-analysis was to determine whether differences in reported fall rates exist between different ethnic groups. Searches were carried out on four databases: Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, and Web of Science. Only English language studies with community-dwelling participants aged 60 + years were included. Studies also needed to compare fall prevalence for at least two or more ethnic groups. Two reviewers independently screened all articles and evaluated study quality. Twenty-three articles were included for systematic review, and meta-analyses were carried out on the 16 retrospective studies that reported falls in the previous 12 months. The Asian group demonstrated significantly lower fall prevalence than all other ethnic groups at 13.89% (10.87, 16.91). The Hispanic group had a fall prevalence of 18.54% (12.95, 24.13), closely followed by the Black group at 18.60% (13.27, 23.93). The White group had the highest prevalence at 23.77% (18.66, 28.88). Some studies provided adjusted estimates of effect statistics for the odds/risk of falls, which showed that differences still existed between some ethnic groups even after adjusting for other risk factors. Overall, differences in fall prevalence do appear to exist between different ethnic groups, although the reasons for these differences currently remain undetermined and require further investigation. These findings highlight the need to provide more ethnically tailored responses to public health challenges, which could potentially increase the adherence to prevention interventions, and allow for a more targeted use of resources.

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Do social relationships mediate or moderate social inequalities in health? A systematic review protocol

10.21203/rs.3.rs-89905/v1 ◽

2020 ◽

Author(s):

Nadia Khaliq ◽

Anne McMunn ◽

Carolina Machuca-Vargas ◽

Anja Heilmann

Keyword(s):

Systematic Review ◽

Health Inequalities ◽

Social Relationships ◽

English Language ◽

Social Inequalities ◽

Data Extraction ◽

Meta Analysis ◽

Database Search ◽

Reference List ◽

Meta Analyses

Abstract IntroductionExplanations for health inequalities include material, behavioural and psychosocial pathways. Social relationships are an important determinant of health, and research has consistently found that a lack of support networks may diminish favourable health outcomes. There is some evidence that social network structures, partly shaped by socioeconomic factors, contribute to health inequalities. This protocol will summarise the systematic review process.Methods and analysesThe Systematic review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. An electronic database search of MEDLINE, Embase Classic + Embase, and PsychINFO using the OvidSP platform will be undertaken. Articles published in the English language that have quantitatively assessed the role of social relationships in mediating or moderating health inequalities will be included and any health outcome (mental/physical) will be considered. The database search will be supplemented by reference list screening of all relevant full-text articles identified through the search. Two independent reviewers will be responsible for screening of articles, data extraction and assessment of bias. Studies will be risk assessed for bias using a modified version of the Newcastle-Ottawa Quality Assessment Scale. It is anticipated that the eligible studies will be highly variable; therefore, a meta-analysis will only be considered if the available data of the selected studies are similar. If the studies are too heterogeneous, a narrative synthesis of the extracted data will be presented. ConclusionThe results of the systematic review will examine the link between social relationships and health inequalities. The findings of the review will identify gaps in knowledge where further research is needed. Systematic review registrationPROSPERO CRD42020181706

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Outcomes and complications of peripartum cardiomyopathy: protocol for a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2021-054994 ◽

2021 ◽

Vol 11 (10) ◽

pp. e054994

Author(s):

Julian Hoevelmann ◽

Elani Muller ◽

Ameer Hohlfeld ◽

Michael Böhm ◽

Karen Sliwa ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Decompensated Heart Failure ◽

Pooled Analysis ◽

Peripartum Cardiomyopathy ◽

Adverse Outcomes ◽

Forest Plot ◽

Cross Sectional ◽

Ebsco Host ◽

Meta Analyses

IntroductionPeripartum cardiomyopathy (PPCM) remains a major contributor to maternal morbidity and mortality worldwide. The disease is associated with various complications, which occur predominantly during the early stages of the disease. Adverse outcomes include decompensated heart failure, thromboembolic complications, arrhythmias and death. We present a protocol for a systematic review and meta-analysis to summarise the available data on the complications and outcomes of women with PPCM.Methods and analysisA comprehensive search of all articles published between 2000 (the year in which the first universal definition of PPCM was used) and 1 June 2021 will be performed on PubMed/MEDLINE, Web of Science, Scopus and EBSCO Host, including Academic Search Premier, Africa-Wide Information, Cumulative Index to Nursing and Allied Health Literature. All cohort and cross-sectional studies, as well as control arms of randomised control trials (RCTs) reporting on the complications and outcomes of PPCM will be included in the review. Methodological quality assessment of included studies will be done by assessing the risk of bias. Heterogeneity of the data will be tested by visual inspection of the forest plot and I2 and χ2 tests. This study will report the burden of complications occurring around the time of diagnosis as well as the 6-month or 12-month outcomes of women with PPCM. A summarised description in form of a pooled analysis of across multiple centres, regions and continents would help us to better understand the estimates of complications and outcomes of women with PPCM.Ethics and disseminationAs this research is a systematic review of published literature, ethical approval is not required. The results will be reported according to the latest guidelines for Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement, and will be submitted to a peer-reviewed journal.PROSPERO registration numberCRD42021255654.

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