scholarly journals Does Er,Cr:YSGG reduce the microleakage of restorations when used for cavity preparation? a systematic review and meta-analysis

2019 ◽  
Author(s):  
Yali Zhang ◽  
Wenfei Chen ◽  
Jinrui Zhang ◽  
Yanhui Li
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Acid Etching ◽  
Cavity Preparation ◽  
Preparation Methods ◽  
Beneficial Effects ◽  
Etch And Rinse ◽  
Significant Difference ◽  
Caries Removal ◽  
Self Etch

Abstract Background: As the member of erbium laser family, Erbium, Chromium: Yttrium Scandium Gallium Garnet (Er,Cr:YSGG) has obtained the approval for caries removal and cavity preparation by Food and Drug Administration (FDA). However, there is still controversy over the beneficial effects of Er,Cr:YSGG preparations on microleakage. The present study is the first systematic review and meta-analysis to compare the microleakage of cavities prepared by Er,Cr:YSGG lasers with that by traditional burs. In addition, the effect of acid etching on the adhesive potential of self-etch and etch-and-rinse adhesives was assessed after laser preparation. Methods: An electronic search was performed in Pubmed, EBSCO, Embase, and the Cochrane Controlled Register of Trials (CENTRAL). Results: Totally, 357 articles were identified. Finally, 13 met the inclusion criteria, of which 11 were selected for meta-analysis. All the included studies exhibited a moderate risk of bias. Based on the meta-analysis, no significant difference was observed between the Er,Cr:YSGG and traditional bur groups in terms of the incidence of microleakage. Self-etch adhesives, in combination with prior acid etching, showed less microleakage than those without acid etching in the laser-prepared cavities. Conclusions: Current studies do not support the beneficial effects of Er,Cr:YSGG preparations on microleakage. Additional acid etching with self-etching adhesives is recommended after Er,Cr:YSGG preparations. Further high-quality studies are needed to draw a convincing conclusion in the future.

scholarly journals Does Er,Cr:YSGG reduce the microleakage of restorations when used for cavity preparation: a systematic review and meta-analysis

2019 ◽  
Author(s):  
Yali Zhang ◽  
Wenfei Chen ◽  
Jinrui Zhang ◽  
Yanhui Li
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Acid Etching ◽  
Cavity Preparation ◽  
Preparation Methods ◽  
Beneficial Effects ◽  
Etch And Rinse ◽  
Significant Difference ◽  
Incident Rate ◽  
Self Etch

Abstract Background: As the member of erbium laser family, Erbium, Chromium: Yttrium Scandium Gallium Garnet (Er,Cr:YSGG) have obtained the approval for caries removal and cavity preparation by Food and Drug Administration (FDA). However, there are still disputes about the beneficial efficacy of Er,Cr:YSGG prepartions on microleakage. This is the first systematic review and meta-analysis to compare the microleakage of cavities prepared by Er,Cr:YSGG lasers with that by traditional burs. We also assess the effect of acid etching on the adhesive potential of self-etch and etch-and-rinse adhesives after laser preparation. Methods: An electronic search was performed in Pubmed, EBSCO, Embase, and the Cochrane Controlled Register of Trials (CENTRAL). Results: 357 articles were identified. Finally, 12 met the inclusion criteria, among which 11 were selected for meta-analysis. All included studies presented a moderate risk of bias. No significant difference was observed between the Er,Cr:YSGG and traditional bur groups in terms of the incident rate of microleakage. Self-etch adhesives in combination with prior acid etching shown less microleakage than those without acid etching in laser-prepared cavities. Conclusions: The current studies did not support the beneficial effects of Er,Cr:YSGG preparations on microleakage. And the additional acid etching is recommended to accompany with self-etching adhesives after Er,Cr:YSGG preparations. More high-quality researches are needed to draw a convincing conclusion in the future.

scholarly journals Does Er,Cr:YSGG reduce the microleakage of restorations when used for cavity preparation? A systematic review and meta-analysis

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Yali Zhang ◽  
Wenfei Chen ◽  
Jinrui Zhang ◽  
Yanhui Li
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Acid Etching ◽  
Cavity Preparation ◽  
Erbium Laser ◽  
Beneficial Effects ◽  
Etch And Rinse ◽  
Significant Difference ◽  
Caries Removal ◽  
Self Etch

Abstract Background As the member of erbium laser family, Erbium, Chromium: Yttrium Scandium Gallium Garnet (Er,Cr:YSGG) has obtained the approval for caries removal and cavity preparation by Food and Drug Administration (FDA). However, there is still controversy over the beneficial effects of Er,Cr:YSGG preparations on microleakage. The present study is the first systematic review and meta-analysis to compare the microleakage of cavities prepared by Er,Cr:YSGG lasers with that by traditional burs. In addition, the effect of acid etching on the adhesive potential of self-etch and etch-and-rinse adhesives was assessed after laser preparation. Methods An electronic search was performed in Pubmed, EBSCO, Embase, and the Cochrane Controlled Register of Trials (CENTRAL). Results Totally, 357 articles were identified. Finally, 13 met the inclusion criteria, of which 11 were selected for meta-analysis. All the included studies exhibited a moderate risk of bias. Based on the meta-analysis, no significant difference was observed between the Er,Cr:YSGG and traditional bur groups in terms of the incidence of microleakage. Self-etch adhesives, in combination with prior acid etching, showed less microleakage than those without acid etching in the laser-prepared cavities. Conclusions Current studies do not support the beneficial effects of Er,Cr:YSGG preparations on microleakage. Additional acid etching with self-etching adhesives is recommended after Er,Cr:YSGG preparations. Further high-quality studies are needed to draw a convincing conclusion in the future.

scholarly journals Using Ketamine and Propofol for Procedural Sedation of Adults in the Emergency Department: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 9 (1) ◽  
pp. 5-11 ◽  
Author(s):  
Morteza Ghojazadeh ◽  
Sarvin Sanaie ◽  
Seyed Pouya Paknezhad ◽  
Sahba-Sadat Faghih ◽  
Hassan Soleimanpour
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Adverse Effects ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Procedural Sedation ◽  
Beneficial Effects ◽  
Advantages And Disadvantages ◽  
Significant Difference ◽  
Study Population

Purpose: Ketamine-propofol combination (ketofol) is being used to provide a safe and effective procedural sedation (PS) in emergency department (ED) and may theoretically have beneficial effects since using lower doses of each drug may result in a reduction of the adverse events of both agents while maintaining optimal conditions for performing procedures. This systematic review was conducted to evaluate the efficacy, advantages and disadvantages of these two drugs for PS. Methods: The PRISMA statement was used for this systematic review. We searched the databases of PubMed, Scopus, ProQuest, Medline (Ovid) from 1990 to August 2017 for randomized clinical trials (RCTs) in which the study population aged ≥18 and was referred to ED. Full-texts of the studies performed in adults that were published in English were reviewed for inclusion. Both authors independently evaluated all studies. Five articles were eligible for the meta-analysis based on their common outcomes. Results: The total number of subjects was 1250, of which 635 were treated with propofol and 615 were treated with ketofol. Although two of the five studies showed a better quality of sedation with ketofol, the other three did not find any significant difference between propofol and ketofol. This systematic review found a lower incidence of respiratory adverse effects in ketofol group than propofol group. Conclusion: Ketamine/propofol mixture (ketofol) has less respiratory adverse effects than propofol alone in ED procedural sedation.

scholarly journals Preparation Methods and Clinical Outcomes of Platelet-Rich Plasma for Intra-articular Hip Disorders: A Systematic Review and Meta-analysis of Randomized Clinical Trials

2020 ◽  
Vol 8 (10) ◽  
pp. 232596712096041
Author(s):  
Flávio Luís Garcia ◽  
Brady T. Williams ◽  
Evan M. Polce ◽  
Daniel B. Heller ◽  
Zachary S. Aman ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Clinical Outcomes ◽  
Randomized Clinical Trials ◽  
Platelet Rich Plasma ◽  
Meta Analysis ◽  
Preparation Methods ◽  
Significant Difference ◽  
Patient Reported

Background: Despite its increasing use in the management of musculoskeletal conditions, questions remain regarding the preparation methods of platelet-rich plasma (PRP) and its clinical applications for intra-articular hip disorders, including femoroacetabular impingement syndrome (FAIS), labral pathology, and osteoarthritis (OA). Purpose: To systematically review and assess the preparation methods and clinical outcomes from randomized clinical trials (RCTs) on the use of PRP for intra-articular hip disorders. Study Design: Systematic review; Level of evidence, 2. Methods: A systematic review in accordance with the 2009 PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines was performed in September 2019. The Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, PubMed, Ovid Medline, and Embase were queried for studies regarding the use of PRP to treat intra-articular hip disorders. Qualifying articles were English-language RCTs describing the use of PRP for intra-articular hip disorders, either as standalone treatment or surgical augmentation. Two authors independently assessed article eligibility. Data pertaining to patient characteristics, indication for treatment, PRP preparation method, follow-up period, and clinical outcomes were extracted. Study results were qualitatively reported and quantitatively compared using meta-analysis when appropriate. Results: Seven RCTs met inclusion criteria. Four studies described the use of PRP for hip OA and 3 utilized PRP at arthroscopy for FAIS and labral tears. Outcomes after PRP for OA demonstrated improvement in validated patient-reported outcome measures for up to 1 year; however, pooled effect sizes found no statistically significant difference between PRP and hyaluronic acid (HA) regarding pain visual analog scale scores at short-term (≤2 months; P = .27), midterm (4-6 months; P = .85), or long-term (1 year; P = .42) follow-up. When injected at arthroscopy, 1 study reported improved outcomes, 1 reported no difference in outcomes, and 1 reported worse outcomes compared with controls. The meta-analysis demonstrated no statistically significant difference on the modified Harris Hip Score (mHHS) between PRP and control cohorts at a minimum 1-year follow-up. There were considerable deficiencies and heterogeneity in the reporting of PRP preparation methods for both indications. Conclusion: Treatment of OA with PRP demonstrated reductions in pain and improved patient-reported outcomes for up to 1 year. However, there was no statistically significant difference between PRP and HA in pain reduction. Likewise, for FAIS and labral surgery there was no statistically significant difference in mHHS outcomes between patients treated with PRP and controls. Given the limited number of studies and variability in PRP preparations, additional high-quality randomized trials are warranted.

Two Adhesive Systems-effect on Adhesion to Tooth Structure

2019 ◽  
Vol 70 (7) ◽  
pp. 2608-2613
Author(s):  
Larisa Simona Deac ◽  
Kamel Earar ◽  
Adela Loredana Colceriu Burtea ◽  
Alexandra Stefania Berghe ◽  
Aurora Antoniac ◽  
...  
Keyword(s):  
Adhesive Systems ◽  
Hybrid Layer ◽  
Tooth Structure ◽  
Selective Etch ◽  
Etch And Rinse ◽  
Significant Difference ◽  
Wisdom Teeth ◽  
Group 2 ◽  
Self Etch ◽  
Group 1

This study evaluates and compares by dye penetration method and SEM photomicrographs the sealing obtained using two different classes of adhesive systems (etch-and-rinse and self-etch with selective etching) with SDR (Dentsply) bulk fill composite. 84 class V cavities were prepared on oral and vestibular face of 42 intact, freshly extracted wisdom teeth. The cavities were randomly divided in two groups and restored: Group 1 with prime &bond one select (Dentsply) and SDR (Dentsply) and Group 2 with prime&bond one Etch&Rinse (Dentsply) and SDR (Dentsply). Prime&bond one Select (Dentsply) is a single component adhesive and can be used in self etch mode, in selective enamel etch mode, or in etch-and-rinse mode. We chosen for this study the selective etch of the enamel mode. Prime&bond one Etch Rinse (Dentsply) is a universal etch-and-rinse one-bottle dental adhesive, designed to be used in two steps. The bulk fill composites are commonly used in modern dentistry due to their properties of low polymerization shrinkage and curing in layer of 4 mm depth, offering the practitioner a fast clinical procedure with good results. The results showed a good sealing at enamel and dentin margins with no statistically significant difference between adhesives, even though the mean of enamel infiltration was smaller for Group1. Furthermore the results show that there were differences between the two groups, for the infiltrations at the enamel, the values of microleakage being arithmetically higher for Group 1, but with no statistically difference between the two groups.SEM images showed for both groups a good adhesion surface with the tooth, but the hybrid layer of the total-etch adhesives is different from the hybrid layer formed by self etch adhesives, in terms of thickness, uniformity. In conclusion both adhesive systems have equivalent sealing qualities and can be successfully used with SDR.

Copper Concentrations in Breast Cancer: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 27 (37) ◽  
pp. 6373-6383 ◽  
Author(s):  
Leila Jouybari ◽  
Faezeh Kiani ◽  
Farhad Islami ◽  
Akram Sanagoo ◽  
Fatemeh Sayehmiri ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Breast Tissue ◽  
Reference Lists ◽  
Meta Analysis ◽  
Cancer Risks ◽  
Hair Samples ◽  
Significant Difference ◽  
Mean Differences ◽  
Very High

: Breast cancer is the most common neoplasm, comprising 16% of all women's cancers worldwide. Research of Copper (Cu) concentrations in various body specimens have suggested an association between Cu levels and breast cancer risks. This systematic review and meta-analysis summarize the results of published studies and examine this association. We searched the databases PubMed, Scopus, Web of Science, and Google Scholar and the reference lists of relevant publications. The Standardized Mean Differences (SMDs) between Cu levels in cancer cases and controls and corresponding Confidence Intervals (CIs), as well as I2 statistics, were calculated to examine heterogeneity. Following the specimens used in the original studies, the Cu concentrations were examined in three subgroups: serum or plasma, breast tissue, and scalp hair. We identified 1711 relevant studies published from 1984 to 2017. There was no statistically significant difference between breast cancer cases and controls for Cu levels assayed in any studied specimen; the SMD (95% CI) was -0.01 (-1.06 - 1.03; P = 0.98) for blood or serum, 0.51 (-0.70 - 1.73; P = 0.41) for breast tissue, and -0.88 (-3.42 - 1.65; P = 0.50) for hair samples. However, the heterogeneity between studies was very high (P < 0.001) in all subgroups. We did not find evidence for publication bias (P = 0.91). The results of this meta-analysis do not support an association between Cu levels and breast cancer. However, due to high heterogeneity in the results of original studies, this conclusion needs to be confirmed by well-designed prospective studies.

Is there Sex-related Outcome Difference According to oral P2Y12 Inhibitors in Patients with Acute Coronary Syndromes? A Systematic Review and Meta-Analysis of 107,126 Patients

2019 ◽  
Vol 17 (2) ◽  
pp. 191-203
Author(s):  
Oliver Brown ◽  
Jennifer Rossington ◽  
Gill Louise Buchanan ◽  
Giuseppe Patti ◽  
Angela Hoye
Keyword(s):  
Systematic Review ◽  
Acute Coronary Syndromes ◽  
Meta Analysis ◽  
Indirect Comparison ◽  
Bleeding Risk ◽  
Cardiovascular Death ◽  
P2y12 Inhibitors ◽  
Significant Difference ◽  
Coronary Syndromes ◽  
Randomised Controlled

Background and Objectives: The majority of patients included in trials of anti-platelet therapy are male. This systematic review and meta-analysis aimed to determine whether, in addition to aspirin, P2Y12 blockade is beneficial in both women and men with acute coronary syndromes. </P><P> Methods: Electronic databases were searched and nine eligible randomised controlled studies were identified that had sex-specific clinical outcomes (n=107,126 patients). Risk Ratios (RR) and 95% Confidence Intervals (CI) were calculated for a composite of cardiovascular death, myocardial infarction or stroke (MACE), and a safety endpoint of major bleeding for each sex. Indirect comparison analysis was performed to statistically compare ticagrelor against prasugrel. </P><P> Results: Compared to aspirin alone, clopidogrel reduced MACE in men (RR, 0.79; 95% CI, 0.68 to 0.92; p=0.003), but was not statistically significant in women (RR, 0.88; 95% CI, 0.75 to 1.02, p=0.08). Clopidogrel therapy significantly increased bleeding in women but not men. Compared to clopidogrel, prasugrel was beneficial in men (RR, 0.84; 95% CI, 0.73 to 0.97; p=0.02) but not statistically significant in women (RR, 0.94; 95% CI, 0.83 to 1.06; p=0.30); ticagrelor reduced MACE in both men (RR, 0.85; 95% CI, 0.77 to 0.94; p=0.001) and women (RR, 0.84; 95% CI, 0.73 to 0.97; p=0.02). Indirect comparison demonstrated no significant difference between ticagrelor and prasugrel in either sex. Compared to clopidogrel, ticagrelor and prasugrel increased bleeding risk in both women and men. </P><P> Conclusion: In summary, in comparison to monotherapy with aspirin, P2Y12 inhibitors reduce MACE in women and men. Ticagrelor was shown to be superior to clopidogrel in both sexes. Prasugrel showed a statistically significant benefit only in men; however indirect comparison did not demonstrate superiority of ticagrelor over prasugrel in women.

scholarly journals Effects of n-3 Polyunsaturated Fatty Acid Supplementation in the Prevention and Treatment of Depressive Disorders—A Systematic Review and Meta-Analysis

Nutrients ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 1070
Author(s):  
Maike Wolters ◽  
Annkathrin von der Haar ◽  
Ann-Kristin Baalmann ◽  
Maike Wellbrock ◽  
Thomas L. Heise ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Treatment Duration ◽  
Depressive Disorders ◽  
Meta Analysis ◽  
Pufa Supplementation ◽  
Depressive Symptomology ◽  
Beneficial Effects ◽  
Randomized Controlled ◽  
Significant Difference

N-3 polyunsaturated fatty acids (PUFAs) have been suggested to affect depressive disorders. This review aims to determine the effect of n-3 PUFAs on depressive symptoms in people with or without diagnosed depression. Medline, PsycINFO, and Cochrane CENTRAL databases were searched for randomized controlled trials (RCTs) assessing the association between n-3 PUFAs and depressive symptoms or disorders as outcomes. A random-effects meta-analysis of standardized mean difference (SMD) with 95% confidence intervals (CI) was performed. Twenty-five studies (7682 participants) were included. Our meta-analysis (20 studies) indicated that n-3 PUFA supplementation lowered depressive symptomology as compared with placebo: SMD = −0.34, 95% CI: −0.55, −0.12, I2 = 86%, n = 5836, but a possible publication bias cannot be ruled out. Subgroup analyses indicated no statistically significant difference by treatment duration of <12 vs. ≥12 weeks, presence of comorbidity, or severity of depressive symptoms. Nevertheless, beneficial effects were seen in the subgroups of studies with longer treatment duration and with no depression and mild to moderate depression. Subgroup analysis by eicosapentaenoic acid (EPA) dosage revealed differences in favor of the lower EPA dosage. Sensitivity analysis including studies with low risk of bias seems to confirm the overall result. Supplementation of n-3 PUFA appears to have a modest beneficial effect on depressive symptomology, although the quality of evidence is still insufficient.

scholarly journals One-Year Clinical Evaluation of the Bonding Effectiveness of a One-Step, Self-Etch Adhesive in Noncarious Cervical Lesion Therapy

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Babacar Faye ◽  
Mouhamed Sarr ◽  
Khaly Bane ◽  
Adjaratou Wakha Aidara ◽  
Seydina Ousmane Niang ◽  
...  
Keyword(s):  
Clinical Performance ◽  
Retention Rate ◽  
Recall Rate ◽  
Acid Etching ◽  
Significant Difference ◽  
Usphs Criteria ◽  
One Step ◽  
One Year ◽  
The One ◽  
Self Etch

This study evaluated the one-year clinical performance of a one-step, self-etch adhesive (Optibond All-in-One, Kerr, CA, USA) combined with a composite (Herculite XRV Ultra, Kerr Hawe, CA, USA) to restore NCCLs with or without prior acid etching. Restorations performed by the same practitioner were evaluated at baseline and after 3, 6, and 12 months using modified USPHS criteria. At 6 months, the recall rate was 100%. The retention rate was 84.2% for restorations with prior acid etching, but statistically significant differences were observed between baseline and 6 months. Without acid etching, the retention rate was 77%, and no statistically significant difference was noted between 3 and 6 months. Marginal integrity (93.7% with and 87.7% without acid etching) and discoloration (95.3% with and 92.9% without acid etching) were scored as Alpha or Bravo, with better results after acid etching. After one year, the recall rate was 58.06%. Loss of pulp vitality, postoperative sensitivity, or secondary caries were not observed. After one year retention rate was of 90.6% and 76.9% with and without acid conditioning. Optibond All-in-One performs at a satisfactory clinical performance level for restoration of NCCLs after 12 months especially after acid etching.

scholarly journals The high risk of malarial recurrence in patients with Plasmodium-mixed infection after treatment with antimalarial drugs: a systematic review and meta-analysis

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Aongart Mahittikorn ◽  
Frederick Ramirez Masangkay ◽  
Kwuntida Uthaisar Kotepui ◽  
Giovanni De Jesus Milanez ◽  
Manas Kotepui
Keyword(s):  
Systematic Review ◽  
Mixed Infection ◽  
Subgroup Analysis ◽  
Initial Treatment ◽  
Meta Analysis ◽  
Antimalarial Drugs ◽  
Secondary Outcome ◽  
Significant Heterogeneity ◽  
Pooled Prevalence ◽  
Significant Difference

Abstract Background Malaria mixed infections are often unrecognized by microscopists in the hospitals, and a delay or failure to treat Plasmodium-mixed infection may lead to aggravated morbidity and increased mortality. The present study aimed to quantify the pooled proportion and risk of malarial recurrences after the treatment of Plasmodium-mixed infection. The results of the study may provide benefits in the management of Plasmodium-mixed infection in co-endemic regions. Methods This systematic review and meta-analysis searched the international Prospective Register of Systematic Reviews (PROSPERO; ID = CRD42020199709), MEDLINE, Web of Science, and Scopus for potentially relevant studies in any language published between January 1, 1936, and July 20, 2020, assessing drug efficacy in patients with Plasmodium-mixed infection. The primary outcome was the pooled prevalence of Plasmodium parasitemia after initiating antimalarial treatment for Plasmodium-mixed infection. The secondary outcome was the pooled risk ratio (RR) of malarial recurrence in Plasmodium-mixed infection compared with those in Plasmodium falciparum and Plasmodium vivax mono-infection. The pooled analyses were calculated by random-effects meta-analysis. After the initial treatment in different days of recurrences (≤ 28 days or > 28 days), the risk of Plasmodium parasitemia was compared in subgroup analysis. Results Out of 5217 screened studies, 11 were included in the meta-analysis, including 4390 patients from six countries. The pooled prevalence of all recurrences of Plasmodium-mixed parasitemia was 30% (95% confidence interval (CI) 16–43; I2: 99.2%; 11 studies). The RR of malarial recurrence within 28 days after the initial treatment (clinical treatment failure) of Plasmodium-mixed parasitemia compared with the treatment of P. falciparum was 1.22 (p: 0.029; 95% CI 1.02–1.47; Cochran Q: 0.93; I2: 0%; six studies), while there was no significant difference in the risk of recurrence 28 days after initial treatment compared with the treatment of P. falciparum (p: 0.696, RR: 1.14; 95% CI 0.59–2.18; Cochran Q < 0.05; I2: 98.2%; four studies). The subgroup analysis of antimalarial drugs showed that significant malarial recurrence within 28 days was observed in patients treated with artemisinin-based combination therapies (ACTs) with no significant heterogeneity (p: 0.028, RR: 1.31; 95% CI 1.03–1.66; Cochran Q: 0.834; I2: 0%). Conclusions The present findings showed a high prevalence of malarial recurrence after the initial treatment of Plasmodium-mixed infection. Moreover, significant malaria recurrence of mixed infection occurred within 28 days after treatment with ACTs. Graphic Abstract

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