Statin in Combination with Xuezhikang Capsules Get More Lipid-Regulating Effects Than Statin Only: A Systematic Review and Meta-Analysis

Abstract Background To compare the lipid-regulating effects and safety of statin combined with Xuezhikang capsules and statin used alone for hyperlipidemia. Methods CNKI, Wanfang database, VIP Chinese Journals, PubMed, Embase, and Cochrane library were searched to comprehensively collect and screen RCTs of Xuezhikang combined with statin compared with statin used alone for lipid modifying treatment in hyperlipidemia patients from the database built as of September 2021, and the Cochrane 5.1.0 quality evaluation form was used to evaluate the quality of the included literature and The Cochrane 5.1.0 quality assessment form was used to evaluate the quality of the included literature and bias analysis, extract basic study information, primary and secondary outcome indicators, and meta-analysis of the outcome indicators was performed using RevMan 5.3. Results A total of 14 studies with a total of 2042 patients were included, and the quality of the included studies was low to medium. ①Effectiveness rate: OR=3.63,95%CI[2.69,4.90]; Funnel plot: all within the funnel, but not in accordance with the principle of "aggregation at the top and dispersion at the bottom". ②Total cholesterol: MD=-0.61,95%CI[-0.84,-0.39], The forest plots of each subgroup are to the left. ③Triglycerides: MD=-0.30,95%CI[-0.41,-0.19], The forest plots of each subgroup are to the left,. ④ LDL: MD=-0.33,95%CI[-0.46,-0.20], The forest plots of each subgroup are to the left. ⑤ HDL: MD=0.23,95%CI[0.12,0.35], The forest plots of each subgroup are to the right. ⑥Adverse effects: OR=0.32, 95% CI[0.19,0.55]. Conclusion The combination of statin with Xuezhikang capsule has better effect on lipid regulation in patients with hyperlipidemia, and can effectively reduce the incidence of adverse events and has better safety. It is recommended that the treatment of Xuezhikang combined with statin can be used as a safer and more effective treatment for patients with hyperlipidemia.

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Statin in Combined With Xuezhikang Capsules Get More Lipid-Regulating Effective Than Statin Only: A Systematic Review and Meta-Analysis

10.21203/rs.3.rs-965115/v1 ◽

2021 ◽

Author(s):

Dongxiong Chen ◽

Huiyan Feng ◽

Yigen Li ◽

Jinzhu Huang

Keyword(s):

Quality Evaluation ◽

Meta Analysis ◽

Cochrane Library ◽

Secondary Outcome ◽

Bias Analysis ◽

Basic Study ◽

Outcome Indicators ◽

Xuezhikang Capsule ◽

The Right

Abstract Background: To compare the lipid-regulating effects and safety of statin combined with Xuezhikang capsules and statin used alone for hyperlipidemia. Methods: CNKI, Wanfang database, VIP Chinese Journals, PubMed, Embase, and Cochrane library were searched to comprehensively collect and screen RCTs of Xuezhikang combined with statin compared with statin used alone for lipid modifying treatment in hyperlipidemia patients from the database built as of July 2020, and the Cochrane 5.1.0 quality evaluation form was used to evaluate the quality of the included literature and The Cochrane 5.1.0 quality assessment form was used to evaluate the quality of the included literature and bias analysis, extract basic study information, primary and secondary outcome indicators, and meta-analysis of the outcome indicators was performed using RevMan 5.3. Results: A total of 14 studies with a total of 2042 patients were included, and the quality of the included studies was low to medium. ①Effectiveness rate: OR=3.63,95%CI[2.69,4.90],P<0.00001; Funnel plot: all within the funnel, but not in accordance with the principle of "aggregation at the top and dispersion at the bottom". ②Total cholesterol: MD=-0.61,95%CI[-0.84,-0.39],P<0.00001, The forest plots of each subgroup are to the left, P<0.05. ③Triglycerides: MD=-0.30,95%CI[-0.41,-0.19],P<0.00001, The forest plots of each subgroup are to the left, P<0.05. 0.05. ④ LDL: MD=-0.33,95%CI[-0.46,-0.20],P<0.00001, The forest plots of each subgroup are to the left, P<0.05 in atorvastatin and fluvastatin groups, P=0.09 in simvastatin group. ⑤ HDL: MD=0.23, 95%CI [0.12,0.35], P<0.00001, The forest plots of each subgroup are to the right, P<0.05. 6) Adverse effects: OR=0.32, 95% CI[0.19,0.55],P<0.0001. Conclusion: The combination of statin with Xuezhikang capsule has better effect on lipid regulation in patients with hyperlipidemia, and can effectively reduce the incidence of adverse events and has better safety. It is recommended that the treatment of Xuezhikang combined with statin can be used as a safer and more effective treatment for patients with hyperlipidemia.

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Effect of garlic (Allium sativum) extract on salivary streptococcus mutans: a systematic review and meta-analysis

Pharmaceutical Sciences ◽

10.34172/ps.2021.37 ◽

2021 ◽

Author(s):

Mostafa Torbati ◽

Parya Emamverdizadeh ◽

Mohammadalili Torbati ◽

Mahsa Maghalian ◽

Mojgan Mirghafourvand

Keyword(s):

Systematic Review ◽

Streptococcus Mutans ◽

Allium Sativum ◽

Meta Analysis ◽

Garlic Extract ◽

Cochrane Library ◽

Secondary Outcome ◽

Control Group ◽

Dental Diseases

Background: Oral and dental diseases are among the common health conditions which can have different effects on the individuals’ health and quality of life. The objective of this study was to examine the effect of garlic (Allium sativum) extract on saliva Streptococcus mutans (primary outcome) and its side effects (secondary outcome). Methods: In the present systematic review and meta-analysis, English and Persian databases (PubMed, Cochrane Library, Google Scholar, Scopus, Web of Science, SID, and Magiran) were systematically searched until February 25, 2021. The quality of the included studies was examined using Cochrane handbook, and the meta-analysis was carried out using RevMan 5.3. Heterogeneity of the studies was analyzed by index I2. Moreover, the quality of the evidence was assessed through GRADE approach. Results: A total of 93 studies were found on the databases; 89 articles were screened by title and abstract review and were removed as 19 studies were repetitive and 70 studies were unrelated to the subject under study. Ultimately, 4 articles with a sample size of 171 participants were included in this study, and two of the four studies were meta-analyzed. In all the 4 studies, garlic extract was effective in reducing the number of saliva Streptococcus mutans colonies compared to the control group. The results of the meta-analysis showed that using garlic extract mouthwash significantly decreased the average number of saliva Streptococcus mutans colonies (Mean Difference: -3.32; 95%CI: -4.39 to -2.26; P<0.00001). Conclusion: Although this review study indicated the significant effect of garlic extract in reducing saliva Streptococcus mutans, the evidence is not sufficient enough to recommend garlic extract to fight saliva Streptococcus mutans, and more clinical trials with stronger designs and larger sample sizes are needed.

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Effectiveness of Pharmacological Pain Relief Methods on Birth Experience: A Systematic Review and Meta-Analysis

Current Women s Health Reviews ◽

10.2174/1573404817999201230234158 ◽

2020 ◽

Vol 17 ◽

Author(s):

Solmaz Ghanbari-Homayi ◽

Sonia Hasani ◽

Hojjat Pourfathi ◽

Mojgan Mirghafourvand

Keyword(s):

Pain Relief ◽

Meta Analysis ◽

Random Effect ◽

Cochrane Library ◽

Secondary Outcome ◽

Birth Experience ◽

Pharmacological Interventions ◽

Assessment Development ◽

Group Grade

Background:: The use of pharmacological pain relief methods during labour is increasing, however there is no clear evidence that pharmacological interventions can also improve women’s satisfaction with birth experience. Objective:: To assess the effectiveness of pharmacological interventions on women's satisfaction with birth experience (primary outcome) and satisfaction with the received method (secondary outcome). Methods:: We searched databases in English (MEDLINE, Cochrane Library, Embase, ProQuest, Scopus and Web of Science) and Persian languages (SID and Magiran) from inception until April 30, 2018 for clinical trials that pharmacological pain relief methods were compared with standard or routine cares, or non-pharmacological methods. The evaluation of studies in term of risk of bias was conducted using the Cochrane Handbook. Meta-analysis results were reported as OR and 95% confidence interval. In meta-analysis, subgroup analysis was performed based on the type of intervention. Due to the heterogeneity of over 30%, random effect was reported instead of the fixed effect. The heterogeneity was evaluated using I2, T2 and Chi2. The evaluation of the quality of the studies was also examined using the Grading of Recommendation, Assessment, Development and Evaluation Working Group (GRADE) approach. Results:: The results of 7 studies with low-quality in meta-analysis, showed that pharmacological methods significantly improved satisfaction with birth experience (OR = 2.99; 95% CI: 1.37 to 6.52; P = 0.006). However, meta-analysis of subgroups showed that only inhalation of Entonox gas (OR = 6.51; 95% CI: 3.47 to 12.22; P < 0.001), in contrast to epidural analgesia (OR = 1.19; 95% CI: 0.62 to 2.27; P = 0.60) and Hyoscine injection (OR = 2.58; 95% CI: 0.93 to 7.20; P = 0.07) significantly improved satisfaction with birth experience. Conclusion:: Pharmacological interventions such as epidural, although introduced as one of the effective methods for pain relief, may not provide women with satisfaction with birth. However, more studies with precise methodology, high sample size, and standard tools should be performed to more accurately investigate the effect of pharmacological interventions on birth experience.

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Effectiveness of Antalgic Therapies in Patients with Vertebral Bone Metastasis: A Protocol for a Systematic Review and Meta-Analysis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18083991 ◽

2021 ◽

Vol 18 (8) ◽

pp. 3991

Author(s):

Antonio Jose Martin-Perez ◽

María Fernández-González ◽

Paula Postigo-Martin ◽

Marc Sampedro Pilegaard ◽

Carolina Fernández-Lao ◽

...

Keyword(s):

Systematic Review ◽

Bone Metastasis ◽

Data Extraction ◽

Meta Analysis ◽

Risk Of Bias ◽

Cochrane Library ◽

Pharmacological Intervention ◽

Vertebral Metastasis ◽

Randomized Controlled Clinical Trials

There is no systematic review that has identified existing studies evaluating the pharmacological and non-pharmacological intervention for pain management in patients with bone metastasis. To fill this gap in the literature, this systematic review with meta-analysis aims to evaluate the effectiveness of different antalgic therapies (pharmacological and non-pharmacological) in the improvement of pain of these patients. To this end, this protocol has been written according to the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) and registered in PROSPERO (CRD42020135762). A systematic search will be carried out in four international databases: Medline (Via PubMed), Web of Science, Cochrane Library and SCOPUS, to select the randomized controlled clinical trials. The Risk of Bias Tool developed by Cochrane will be used to assess the risk of bias and the quality of the identified studies. A narrative synthesis will be used to describe and compare the studies, and after the data extraction, random effects model and a subgroup analyses will be performed according to the type of intervention, if possible. This protocol aims to generate a systematic review that compiles and synthesizes the best and most recent evidence on the treatment of pain derived from vertebral metastasis.

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A Comparison of Lung Ultrasound and Computed Tomography in the Diagnosis of Patients with COVID-19: A Systematic Review and Meta-Analysis

Diagnostics ◽

10.3390/diagnostics11081351 ◽

2021 ◽

Vol 11 (8) ◽

pp. 1351

Author(s):

Mengshu Wang ◽

Xufei Luo ◽

Ling Wang ◽

Janne Estill ◽

Meng Lv ◽

...

Keyword(s):

Computed Tomography ◽

Interstitial Pneumonia ◽

Lung Ultrasound ◽

Meta Analysis ◽

Diagnostic Odds Ratio ◽

Receiver Operating Curve ◽

Cochrane Library ◽

Molecular Tests ◽

Specificity And Sensitivity

Background Lung ultrasound (LUS) and computed tomography (CT) can both be used for diagnosis of interstitial pneumonia caused by coronavirus disease 2019 (COVID-19), but the agreement between LUS and CT is unknown. Purpose to compare the agreement of LUS and CT in the diagnosis of interstitial pneumonia caused by COVID-19. Materials and Methods We searched PubMed, Cochrane library, Embase, Chinese Biomedicine Literature, and WHO COVID-19 databases to identify studies that compared LUS with CT in the diagnosis of interstitial pneumonia caused by COVID-19. We calculated the pooled overall, positive and negative percent agreements, diagnostic odds ratio (DOR) and the area under the standard receiver operating curve (SROC) for LUS in the diagnosis of COVID-19 compared with CT. Results We identified 1896 records, of which nine studies involving 531 patients were finally included. The pooled overall, positive and negative percentage agreements of LUS for the diagnosis of interstitial pneumonia caused by COVID-19 compared with CT were 81% (95% confidence interval [CI] 43–99%), 96% (95% CI, 80–99%, I2 = 92.15%) and 80% (95%CI, 60–92%, I2 = 92.85%), respectively. DOR was 37.41 (95% CI, 9.43–148.49, I2 = 63.9%), and the area under the SROC curve was 0.94 (95% CI, 0.92–0.96). The quality of evidence for both specificity and sensitivity was low because of heterogeneity and risk of bias. Conclusion The level of diagnostic agreement between LUS and CT in the diagnosis of interstitial pneumonia caused by COVID-19 is high. LUS can be therefore considered as an equally accurate alternative for CT in situations where molecular tests are not available.

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Lumbar Roll Usage While Sitting Reduces the Forward Head Posture in Healthy Individuals: A Systematic Review with Meta-Analysis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18105171 ◽

2021 ◽

Vol 18 (10) ◽

pp. 5171

Author(s):

Yusuke Handa ◽

Kenya Okada ◽

Hiroshi Takasaki

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Grade System ◽

Cochrane Library ◽

Forward Head Posture ◽

Quality Of Evidence ◽

Head Posture ◽

Head Extension ◽

The Cochrane Library

This systematic review and meta-analysis investigated whether the use of a lumbar roll reduced forward head posture (FHP) while sitting among individuals with or without musculoskeletal disorders. EMBASE, MEDLINE, and the Cochrane Library were systematically searched from their inception to August 2020. The quality of evidence for variables used in the meta-analysis was determined using the GRADE system. Five studies satisfied the criteria for data analysis. All studies included individuals without any spinal symptoms. Data from five studies on neck angle showed a statistically significant (p = 0.02) overall effect (standardized mean difference (SMD) = 0.77), indicating a lesser neck flexion angle while sitting with a lumbar roll than without it. Data from two studies on head angle showed a statistically significant (p = 0.04) overall effect (SMD = 0.47), indicating a lesser head extension angle while sitting with a lumbar roll than without it. In each meta-analysis, the quality of evidence was very low in the GRADE system. The use of a lumbar roll while sitting reduced FHP among individuals without spinal symptoms.

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Association of dyslipidemia with the severity and mortality of coronavirus disease 2019 (COVID-19): a meta-analysis

Virology Journal ◽

10.1186/s12985-021-01604-1 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Yanli Liu ◽

Yilong Pan ◽

Yuyao Yin ◽

Wenhao Chen ◽

Xiaodong Li

Keyword(s):

Fixed Effects ◽

Meta Analysis ◽

Cochrane Library ◽

Case Control Studies ◽

Risk Of Death ◽

Potential Association ◽

Increased Risk ◽

Language Restriction ◽

Newcastle Ottawa Scale

Abstract Background The numbers of confirmed cases of coronavirus disease 2019 (COVID-19) and COVID-19 related deaths are still increasing, so it is very important to determine the risk factors of COVID-19. Dyslipidemia is a common complication in patients with COVID-19, but the association of dyslipidemia with the severity and mortality of COVID-19 is still unclear. The aim of this study is to analyze the potential association of dyslipidemia with the severity and mortality of COVID-19. Methods We searched the PubMed, Embase, MEDLINE, and Cochrane Library databases for all relevant studies up to August 24, 2020. All the articles published were retrieved without language restriction. All analysis was performed using Stata 13.1 software and Mantel–Haenszel formula with fixed effects models was used to compare the differences between studies. The Newcastle Ottawa scale was used to assess the quality of the included studies. Results Twenty-eight studies involving 12,995 COVID-19 patients were included in the meta-analysis, which was consisted of 26 cohort studies and 2 case–control studies. Dyslipidemia was associated with the severity of COVID-19 (odds ratio [OR] = 1.27, 95% confidence interval [CI] 1.11–1.44, P = 0.038, I2 = 39.8%). Further, patients with dyslipidemia had a 2.13-fold increased risk of death compared to patients without dyslipidemia (95% CI 1.84–2.47, P = 0.001, I2 = 66.4%). Conclusions The results proved that dyslipidemia is associated with increased severity and mortality of COVID-19. Therefore, we should monitor blood lipids and administer active treatments in COVID-19 patients with dyslipidemia to reduce the severity and mortality.

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The Risk of Gastrointestinal Bleeding between Non-Vitamin K Antagonist Oral Anticoagulants and Vitamin K Antagonists in the Asian Atrial Fibrillation Patients: A Meta-Analysis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18010137 ◽

2020 ◽

Vol 18 (1) ◽

pp. 137

Author(s):

Kuang-Tsu Yang ◽

Wei-Chih Sun ◽

Tzung-Jiun Tsai ◽

Feng-Woei Tsay ◽

Wen-Chi Chen ◽

...

Keyword(s):

Atrial Fibrillation ◽

Gastrointestinal Bleeding ◽

Vitamin K ◽

Meta Analysis ◽

Vitamin K Antagonists ◽

Oral Anticoagulants ◽

Vitamin K Antagonist ◽

Cochrane Library ◽

Secondary Outcome ◽

Optimal Dosage

Background: Non-vitamin K antagonist oral anticoagulants (NOACs) are more commonly used to prevent atrial fibrillation (AF) patients from thromboembolic events than vitamin K antagonists (VKAs). However, the gastrointestinal bleeding (GIB) risk in the Asian AF patients associated with NOACs in comparison with VKAs remained unaddressed. Materials and Methods: A systematic search of studies on NOACs and VKAs in the Asian AF patients was conducted in PubMed, Cochrane Library, and ClinicalTrials.gov. The primary outcome was the hazard ratio (HR) of any GIB associated with NOACs versus VKAs. The secondary outcome was the GIB risks in different kinds of NOACs compared with VKAs. Results: This meta-analysis included two randomized controlled trials (RCTs) and four retrospective studies, comprising at least 200,000 patients in total. A significantly lower HR of GIB risks was found in all kinds of NOACs than VKAs in the Asian AF patients (HR: 0.633; 95% confidence interval: 0.535–0.748; p < 0.001). Additionally, the GIB risks of different NOACs were apixaban (HR: 0.392), edoxaban (HR: 0.603), dabigatran (HR: 0.685), and rivaroxaban (HR: 0.794), respectively. Conclusions: NOACs significantly reduced the risk of GIB in the Asian AF patients compared with VKAs. In the four NOACs compared with VKAs, apixaban probably had a trend of the least GIB risk. We need further head-to-head studies of different NOACs to confirm which NOAC is the most suitable for Asian AF patients and to know the optimal dosage regimen of different NOACs.

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Effects of exercise-based pulmonary rehabilitation on adults with asthma: a systematic review and meta-analysis

Respiratory Research ◽

10.1186/s12931-021-01627-w ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Zhenzhen Feng ◽

Jiajia Wang ◽

Yang Xie ◽

Jiansheng Li

Keyword(s):

Quality Of Life ◽

Pulmonary Rehabilitation ◽

Meta Analysis ◽

Cochrane Library ◽

Control Group ◽

Life Questionnaire ◽

Asthma Control Questionnaire ◽

Clinical Trial Registration ◽

Domain Scores

Abstract Background Pulmonary rehabilitation (PR) has been proposed as an effective method for many respiratory diseases. However, the effects of exercise-based PR on asthma are currently inconclusive. This review aimed to investigate the effects of exercise-based PR on adults with asthma. Methods The PubMed, Embase, Cochrane Library, Web of Science, International Clinical Trials Registry Platform and ClinicalTrials.gov databases were searched from inception to 31 July 2019 without language restriction. Randomized controlled trials (RCTs) investigating the effects of exercise-based PR on adults with asthma were included. Study selection, data extraction and risk of bias assessment were performed by two investigators independently. Meta-analysis was conducted by RevMan software (version 5.3). Evidence quality was rated by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. Results Ten literatures from nine studies (n = 418 patients) were identified. Asthma quality of life questionnaire total scores (MD = 0.39, 95% CI: 0.02 to 0.76) improved significantly in the experimental group compared to control group, including activity domain scores (MD = 0.58, 95% CI: 0.21 to 0.94), symptom domain scores (MD = 0.52, 95% CI: 0.19 to 0.85), emotion domain scores (MD = 0.53, 95% CI: − 0.03 to 1.09) and environment domain scores (MD = 0.56, 95% CI: 0.00 to 1.11). Both the 6-min walk distance (MD = 34.09, 95% CI: 2.51 to 65.66) and maximum oxygen uptake (MD = 4.45, 95% CI: 3.32 to 5.58) significantly improved. However, improvements in asthma control questionnaire scores (MD = − 0.25, 95% CI: − 0.51 to 0.02) and asthma symptom-free days (MD = 3.35, 95% CI: − 0.21 to 6.90) were not significant. Moreover, there was no significant improvement (MD = 0.10, 95% CI: − 0.08 to 0.29) in forced expiratory volume in 1 s. Nonetheless, improvements in forced vital capacity (MD = 0.23, 95% CI: 0.08 to 0.38) and peak expiratory flow (MD = 0.39, 95% CI: 0.21 to 0.57) were significant. Conclusions Exercise-based PR may improve quality of life, exercise tolerance and some aspects of pulmonary function in adults with asthma and can be considered a supplementary therapy. RCTs of high quality and large sample sizes are required. Clinical trial registration: The review was registered with PROSPERO (The website is https://www.crd.york.ac.uk/prospero/, and the ID is CRD42019147107).

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The prevalence of diabetes in Afghanistan: a systematic review and meta-analysis

BMC Public Health ◽

10.1186/s12889-021-10993-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Sohail Akhtar ◽

Jamal Abdul Nasir ◽

Amara Javed ◽

Mariyam Saleem ◽

Sundas Sajjad ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Methodological Quality ◽

Meta Analysis ◽

Population Based ◽

Included Study ◽

Cochrane Library ◽

Or Education ◽

Meta Regression

Abstract Background The aim of this paper is to investigate the prevalence of diabetes and its associated risk factors in Afghanistan through a systematic review and meta–analysis. Methods A comprehensive literature search was conducted using EMBASE, PubMed, Web of Sciences, Google Scholar and the Cochrane library, carried out from inception to April 312,020, without language restriction. Meta–analysis was performed using DerSimonian and Laird random-effects models with inverse variance weighting. The existence of publication bias was initially assessed by visual inspection of a funnel plot and then tested by the Egger regression test. Subgroup analyses and meta-regression were used to explore potential sources of heterogeneity. This systematic review was reported by following the PRISMA guidelines and the methodological quality of each included study was evaluated using the STROBE guidelines. Results Out of 64 potentially relevant studies, only 06 studies fulfilled the inclusion criteria and were considered for meta-analysis. The pooled prevalence of diabetes in the general population based on population-based studies were 12.13% (95% CI: 8.86–16.24%), based on a pooled sample of 7071 individuals. Results of univariate meta-regression analysis revealed that the prevalence of diabetes increased with mean age, hypertension and obesity. There was no significant association between sex (male vs female), smoking, the methodological quality of included articles or education (illiterate vs literate) and the prevalence of diabetes. Conclusions This meta-analysis reports the 12.13% prevalence of diabetes in Afghanistan,with the highest prevalence in Kandahar and the lowest in Balkh province. The main risk factors include increasing age, obesity and hypertension. Community-based care and preventive training programmes are recommended. Trial registration This review was registered on PROSPERO (registration number CRD42020172624).

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