Methotrexate related cutaneous adverse drug reactions: a systematic literature review

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Mohammed Zuber ◽  
Harikrishna ◽  
Vidhyashree ◽  
Manik Chhabra ◽  
Rajesh Venkataraman ◽  
...  
Keyword(s):  
Literature Search ◽  
Data Extraction ◽  
Grey Literature ◽  
Relevant Literature ◽  
Topical Steroids ◽  
Extensive Literature ◽  
Drug Reactions ◽  
Cutaneous Manifestations ◽  
Cutaneous Drug Reactions ◽  
Steven Johnson Syndrome

Abstract Objectives Recently, there is an increased number of reports being published on Methotrexate (MTX) related cutaneous manifestations. We aimed to identify and critically appraise descriptive studies describing the MTX related skin manifestations, treatment approach, and their outcomes. Methodology An extensive literature search was performed in the PubMed, Embase, and Scopus databases from inception to April 2021 without any restrictions along with the bibliographic search of included studies, grey literature search, and a snowball search was performed in Google and Google Scholar to identify the relevant literature. Descriptive studies reporting MTX related cutaneous manifestations were considered for the review. The study selection, data extraction, and quality assessment were conducted by two independent reviewers and any disagreements were settled by consensus with the third reviewer. Results 31 out of 8,365 descriptive studies including 38 patients (22 females and 16 males) aged between 12 and 78 years prescribed for the management of rheumatoid arthritis, ankylosing spondylitis, and psoriasis were included in this review. Toxic epidermal necrolysis (TEN), papular eruption, vasculitis, erosions of psoriasis, ulcerated psoriatic plaques, local reactions, keratinocyte dystrophy, erythema multiforme, drug rash with eosinophilia and systemic symptoms, Steven Johnson syndrome and photosensitive dermatitis were the majority of MTX induced cutaneous reactions. Immediate withdrawal of MTX, providing appropriate care with anti-inflammatory, topical steroids, and supplementation with folic acid were reported to be effective for the management of the MTX related cutaneous manifestations. Conclusions Clinicians and healthcare professionals should be aware of possible acute cutaneous drug reactions induced by MTX to avoid further consequences and fatal conditions. Immediate withdrawal of MTX and supportive care were reported as an efficacious therapeutic management of acute cutaneous drug reactions. PROSPERO Registration number CRD42020220038.

Nanocarriers For Vaginal Drug Delivery

2019 ◽  
Vol 13 (1) ◽  
pp. 3-15 ◽  
Author(s):  
Zeenat Iqbal ◽  
Fahima Dilnawaz
Keyword(s):  
Drug Delivery ◽  
Conventional Treatment ◽  
Literature Search ◽  
Relevant Literature ◽  
Extensive Literature ◽  
Treatment Approaches ◽  
Vaginal Drug Delivery ◽  
Extensive Literature Search ◽  
Cyclic Changes ◽  
Delivery Approach

Background:Vaginal drug delivery approach represents one of the imperative strategies for local and systemic delivery of drugs. The peculiar dense vascular networks, mucus permeability, and range of physiological characteristics of the vaginal cavity have been exploited for therapeutic benefit. Furthermore, the vaginal drug delivery has been curtailed due to the influence of different physiological factors like acidic pH, constant cervical secretion, microflora, cyclic changes during periods along with turnover of mucus of varying thickness.Objective:This review highlights advancement of nanomedicine and its prospective progress towards the clinic.Methods:Relevant literature reports and patents related to topics are retrieved and used. Result: The extensive literature search and patent revealed that nanocarriers are efficacious over conventional treatment approaches.Results:The extensive literature search and patent revealed that nanocarriers are efficacious over conventional treatment approaches.Conclusion:Recently, nanotechnology based drug delivery approach has promised better therapeutic outcomes by providing enhanced permeation and sustained drug release activity. Different nanoplatforms based on drugs, peptides, proteins, antigens, hormones, nucleic material, and microbicides are gaining momentum for vaginal therapeutics.

scholarly journals In Vitro Release of Interferon-Gamma from Peripheral Blood Lymphocytes in Cutaneous Adverse Drug Reactions

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Ilan Goldberg ◽  
Meital Hanson ◽  
Gabriel Chodick ◽  
Idit Shirazi ◽  
Sarah Brenner
Keyword(s):  
Interferon Gamma ◽  
Predictive Value ◽  
Mononuclear Cells ◽  
In Vitro Release ◽  
Drug Reactions ◽  
Vitro Assay ◽  
Cutaneous Manifestations ◽  
Cutaneous Drug Reactions ◽  
Multiple Drugs

Background. Cutaneous drug reactions are common but diagnostically challenging due to phenotypic heterogeneity and simultaneous exposure to multiple drugs. These limitations prompted the development of diagnostic tests.Aims. To evaluate the performance of an in vitro assay measuring interferon-gamma release from patients’ lymphocytes in the presence of causative drugs for the diagnosis of drug reactions.Methods. Mononuclear cells derived from patients were incubated with and without suspected drugs, and increment of interferon-gamma levels was measured by ELISA. We performed a telephonic survey to evaluate the effect of stopping the drugs incriminated by the assay on cutaneous manifestations.Results. We assessed 272 patients who used 1035 medications. When assessed against the questionnaire data collected at least 6 months after stopping the causative drug, sensitivity was found to be 83.61% and specificity 92.67%. Likelihood ratio for a positive test is 11.40 and for a negative test 0.18. Positive predictive value is 75.37% and negative predictive value is 95.47%. The test was found to perform significantly better in females and in older patients.Conclusions. Interferon-gamma release test is a useful adjunct tool in the diagnosis of cutaneous drug reactions.

scholarly journals Epidemiology of podoconiosis in Ethiopia: a systematic review and meta-analysis protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (1) ◽  
pp. e032850
Author(s):  
Birhan Alemnew ◽  
Alebachew Fasil ◽  
Tesfahun Mulatu ◽  
Nigus Bililign ◽  
Setegn Esthetie ◽  
...  
Keyword(s):  
Systematic Review ◽  
Data Extraction ◽  
Meta Analysis ◽  
Grey Literature ◽  
Relevant Literature ◽  
Forest Plot ◽  
Medical Subject Headings ◽  
Tropical Regions ◽  
Manual Search ◽  
Trim And Fill

IntroductionPodoconiosis is a non-filarial swelling of the lower extremity endemic in tropical regions, North America and India. The aetiology and pathophysiology of the disease remain unknown. We propose conducting a systematic review and meta-analysis to evaluate the burden and risk factors of podoconiosis in Ethiopia reported in studies from 2009 to 2019.Methods and analysisWe will search the following electronic databases: PubMed (MEDLINE), EMBASE, Hinari, Cumulative Index to Nursing and Allied Health Literature, ISI (Web of Science) and Google Scholar. Medical subject headings will be used to extensively search relevant literature on electronic databases using related keywords such as epidemiology or prevalence, magnitude or burden, podoconiosis, and Ethiopia. Grey literature and manual search will also be performed to retrieve unindexed research articles. Two reviewers will screen all retrieved articles, conduct data extraction and then critically appraise all identified studies. We will analyse data using STATA V.14 statistical software. We will demonstrate pooled estimates of podoconiosis and associated factors with effect size and 95% CI. The presence of heterogeneity among studies will be examined by forest plot as well as the I2heterogeneity test. Potential causes of heterogeneity will be explored by carrying out sensitivity and subgroup analyses. The presence of publication bias will also be examined by observing funnel plots and objectively by Egger’s regression test. If the funnel plot is asymmetric and/or Egger’s test was found to be statistically significant (p<0.05), the trim and fill (Duval and Tweedie’s) analysis will be performed.Ethics and disseminationThe study will use publicly available data and will not identify the authors of the publication by name. In light of these and as has been indicated, research ethics clearance is not required for evidence syntheses in such reviews. The results of this study will be published in a peer-reviewed journal and presented at national and international conferences.PROSPERO registration numberCRD42019127459.

scholarly journals Prevalence of Dental Caries among Children of Aged 6-12 Years in Tamilnadu - A Systematic Review

2021 ◽  
Vol 6 (4) ◽  
pp. 177-185
Author(s):  
Suganya. P ◽  
Rajmohan. M ◽  
Bharathwaj. V. V
Keyword(s):  
Systematic Review ◽  
Dental Caries ◽  
Literature Search ◽  
Grey Literature ◽  
Public Health Problem ◽  
Cochrane Library ◽  
Extensive Literature ◽  
High Prevalence ◽  
Newcastle Ottawa Scale ◽  
Ottawa Scale

Background: Dental caries is a serious public health problem in developed as well as developing nations, with high prevalence among children around the world. This systematic review of literature was undertaken to document the prevalence of dental caries. Aims and Objectives: This study aims to evaluate the prevalence of dental caries among children of aged 6-12 years in Tamilnadu by conducting a systematic review. Materials and Method: Studies evaluating the prevalence of dental caries among children of aged 6-12 years in the Tamilnadu were investigated. An extensive literature search was done in the following databases: Prospero, Grey literature, Science Direct, Cochrane library, Wiley online library, Lilacs and PubMed. The articles were retrieved from each database based on the MeSH representation. A modified version of the Newcastle-Ottawa Scale for cross-sectional studies was used for assessment of the quality of the studies. A systematic literature search yielded 1034 publications from the various databases searched. According to the Preferred Reporting Items for systematic Reviews and Meta-Analyses and based on the inclusion and exclusion criteria, the final number of included studies was fifteen. Results: Among the included studies, five studies were carried out in the Chennai district. Erode district was found to have the highest prevalence of dental caries at 89.3%. Conclusion: This review has reported a high prevalence of dental caries in Tamilnadu. None of the states reported prevalence below 30%. The government should identify dental caries as a national priority which requires significant attention. Keywords: Dental caries, Prevalence, Tamilnadu, Newcastle-Ottawa Scale.

scholarly journals Facilitators, Barriers, and Strategies for Health-system Guidance Implementation: A Protocol for a Critical Interpretive Synthesis

2020 ◽  
Author(s):  
Qi Wang ◽  
Xiajing Chu ◽  
Ying Zhu ◽  
Mohammad Golam Kibria ◽  
Qiangqiang Guo ◽  
...  
Keyword(s):  
Health System ◽  
Health Systems ◽  
Data Extraction ◽  
Comparative Method ◽  
Grey Literature ◽  
Relevant Literature ◽  
Quality Criteria ◽  
Theoretical Framework ◽  
Implementation Framework ◽  
Critical Interpretive Synthesis

Abstract Background: As systematically developed statements about possible courses of action, health-system guidance (HSG) can assist with making decisions and developing policies to address problems or achieve goals in health systems. However, there are conceptual and methodological challenges related to HSG implementation due to the complexity of health systems and policymaking, the diversity of available evidence, and vast differences in contexts. To address these gaps, we aim to develop a theoretical framework for supporting the implementation of HSG as part of an effort to promote evidence-informed policymaking about health systems. Methods: To develop a theoretical framework about facilitators, barriers, and strategies to the implementation of HSG, we will apply a critical interpretive synthesis (CIS) approach to synthesize the findings from a range of relevant literature. We will search eleven electronic databases and grey literature websites to identify relevant published and grey literature. We will check the references of included studies and papers recommended by experts. Finally, we will conduct purposive searches to identify literature that fills any identified conceptual gaps. We will use relevance and a general five-items quality criteria to assess included papers. A standardized form will be developed for extracting information. We will use an interpretive analytic approach to synthesize the findings from included papers, including the constant comparative method throughout the analysis. The literature screening and relevance assessment will be conducted by two independent reviewers and disagreements will be resolved through discussion. Data extraction and synthesis will be extracted by the principal investigator and the sample of extracted data will be checked by a second reviewer for consistency and accuracy. Discussion: A new theoretical framework about facilitators, barriers, and strategies for HSG implementation will be developed using the CIS approach. The HSG implementation framework could be widely used for different HSG with varied topics and in different contexts (including low-, middle-, high-income countries and settings). In later work we will develop a tool for supporting HSG implementation based on the theoretical framework. Systematic review registration: PROSPERO CRDXXXX (Pending)

scholarly journals Deteriorating Patients and Risk Assessment among Nurses and Junior Doctors: A Review

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Ludin SM ◽  
Ruslan R ◽  
Mat Nor MB
Keyword(s):  
Risk Assessment ◽  
Grey Literature ◽  
Relevant Literature ◽  
General Ward ◽  
Warning Signs ◽  
Junior Doctors ◽  
Extensive Literature ◽  
Professional Journals ◽  
The United Kingdom ◽  
Extensive Literature Search

The presence of nurses and junior doctors in the ward environment are crucial, especially in detecting deteriorating patients. However, there is consistent evidence that warning signs may not always be identified or acted upon. This paper aimed to analyse the incidence of deteriorating patients, and the concept of risk assessment of these patients by nurses and junior doctors in general ward, through a review on relevant literature. An extensive literature search was conducted through online research databases, i.e. CINAHL, MEDLINE (Ovid), Science Direct and ProQuest. Professional journals were hand searched for relevant literature based on reference lists and citations made in key publications, and attempts were also made to obtain any relevant grey literature (unpublished materials). A total of eleven papers which focused on patient’s assessment, response to deteriorating patients and knowledge in medication, and a guideline were reviewed. Most of the studies were carried out in the United Kingdom (n=4), followed by Australia (n=2), Sweden (n=2), the Netherlands (n=1) and Taiwan (n=1). Meanwhile, among these studies, the chosen research designs include, qualitative (n=6), quantitative (n=3) and systematic review (n=1). This review concluded that nurses and junior doctors in general ward have a lack of knowledge in risk assessment of deteriorating patients.

Exploring the structure and characteristics of the Anglo-American paramedic system in developed countries: a scoping review

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Timothy Makrides ◽  
Linda Ross ◽  
Cameron Gosling ◽  
Joseph Acker ◽  
Peter O'Meara
Keyword(s):  
Data Extraction ◽  
Grey Literature ◽  
Relevant Literature ◽  
Developed Countries ◽  
Content Type ◽  
Literature Search Strategy ◽  
English Speaking ◽  
Anglo American ◽  
Abstract Screening ◽  
Full Text Screening

PurposeThis study aims to map and examine the existing evidence to provide an overview of what is known about the structure and characteristics of the Anglo-American paramedic system in developed countries.Design/methodology/approachThe review includes results examining the structure and characteristics of the Anglo-American paramedic system in English-speaking developed countries. Databases, including Embase, MEDLINE, Web of Science, EBSCOhost, CINAHL, Google Scholar and Epistemonikos, were searched from the inception of the databases. A grey literature search strategy was conducted to identify non-indexed relevant literature along with forward and backward searching of citations and references of included studies. Two reviewers undertook title and abstract screening, followed by full-text screening. Finally, data extraction was performed using a customised instrument. Included studies were summarised using narrative synthesis structured around broad themes exploring the structure and characteristics of the Anglo-American paramedic system.Findings The synthesis of information shows that varying models (or subsystems) exist within the Anglo-American paramedic system. The use of metaphorical models based on philosophical underpinnings are used to describe two novel subsystems within the Anglo-American paramedic system. These are the professionally autonomous and directive paramedic systems, with the directive model being further categorised into the rescue and hospital-managed submodels.Originality/valueThis study is the first of its kind to explore the modern subcategorisation of the Anglo-American paramedic system using a realist lens as the basis for its approach.

scholarly journals Patient-centred infertility care: a scoping review protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e032266
Author(s):  
Hana Hasan Webair ◽  
Tengku Alina Tengku Ismail ◽  
Shaiful Bahari Ismail ◽  
Norhayati Mohd Noor
Keyword(s):  
Scoping Review ◽  
Literature Search ◽  
Data Extraction ◽  
Grey Literature ◽  
Decision Makers ◽  
Cochrane Library ◽  
Quality Healthcare ◽  
Study Selection ◽  
History Of ◽  
Review Protocol

IntroductionPatient-centred infertility care (PCIC) is one of the quality indicators of effective fertility care. The application of this indicator requires a clear definition from the patient’s perspective. This proposed scoping review aims to explore the extent and nature of published scientific literature on PCIC in the past decade, identify gaps in the literature and define PCIC from infertile patients’ perspectives.Methods and analysisWe will conduct the proposed scoping review following the method of Arksey and O’Malley. The literature search will include studies published from 2009 to 2019, and will be conducted on the MEDLINE, PsycINFO, Scopus, Cochrane Library, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases; reference lists will be mined for literature not contained on these databases. A grey literature search will also be conducted. To be included in the review, studies should have been conducted on people with a history of infertility, with a focus on patient-centred fertility care. Studies that have not been published in full text and studies published in languages other than English will be excluded. After study selection, data will be charted in a prepared form. We will analyse the data using descriptive numerical and qualitative thematic analyses to answer the research questions. NVivo V.12 will be used for data extraction.Ethics and disseminationThis work does not warrant any ethical or safety concerns. This scoping review will synthesise existing literature on PCIC, and the results will be published to be readily available for clinical audiences and policymakers. These findings may support clinicians and decision-makers in applying PCIC, thereby promoting high-quality healthcare in the concerned population.

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