scholarly journals A meta-analysis of 2019 novel corona virus patient clinical characteristics and comorbidities

2020 ◽  
Author(s):  
Subodh Sharma Paudel
Keyword(s):  
High Risk ◽  
Clinical Characteristics ◽  
English Language ◽  
Meta Analysis ◽  
Previous History ◽  
Female Ratio ◽  
Number Of Patients ◽  
New Variant ◽  
History Of ◽  
Male To Female

Abstract IntroductionBeing a new variant of coronavirus, detailed information regarding the virulence, its clinical characters, high risk individuals are yet to be defined. This study was done with the objective of finding out clinical features of corona infection and also studies what are the comorbidities that are associated with it.MethodsThis is a single arm meta-analysis in which relevant data were derived from searches in PubMed. It includes study papers which were written in English language and their completely published article is found. Seven articles published from 24th Jan to 16th March, 2020 are included in this study. ResultsThe total number of patients was 1786 with 1044 males and 742 females with male to female ratio of 1.4:1. The median age of patients was 41 years). Fever was present in 88.8% cases. Dry Cough in 68% followed by fatigue in 33%. Hypertension (15.8%) is the most common comorbidity followed by cardio and cerebrovascular condition (11.7%). ConclusionPatients often presented with symptoms of fever, dry cough, lethargy and fatigue, muscle pain, productive cough. Similarly, patients with previous history of HTN, DM, COPD, cardio and cerebrovascular condition, immune-deficient states are at high risk of developing into the severe COVID-19 infection.

scholarly journals What is the risk of recurrent concussion in children and adolescents aged 5–18 years? A systematic review and meta-analysis

2020 ◽  
pp. bjsports-2020-102967
Author(s):  
Jacqueline van Ierssel ◽  
Martin Osmond ◽  
Jemila Hamid ◽  
Margaret Sampson ◽  
Roger Zemek
Keyword(s):  
Systematic Review ◽  
English Language ◽  
Female Athletes ◽  
Meta Analysis ◽  
Previous History ◽  
Return To Sport ◽  
Risk Of Bias ◽  
Eligibility Criteria ◽  
History Of ◽  
Concussion History

ObjectiveWe aimed to examine the risk of concussion in children with a previous history of concussion.DesignSystematic review and meta-analysis. The primary outcome was number of children with and without a previous lifetime history of concussion who sustained a diagnosed concussion within each study period. Risk of bias was assessed using the Newcastle-Ottawa Scale. A random effects model was used to estimate a pooled risk ratio (RR) with corresponding 95% CIs; results were summarised in forest plots.Data sourcesFour electronic databases (MEDLINE, Embase, CINAHL, SPORTDiscus) and selected reference lists were searched (PROSPERO registration No CRD42019135462).Eligibility criteriaOriginal English language peer-reviewed publications that compared concussion risk in children aged 5–18 years with and without a previous concussion history in which risk estimates were reported or able to be calculated.ResultsOf 732 identified studies, 7 studies representing 23 411 children (risk of bias range, 7–9; maximum possible score=9) were included for meta-analysis. Pooled risk of sustaining a concussion was more than three times greater in children with a previous concussion compared with those with no previous concussion (RR=3.64; 95% CI: 2.68 to 4.96; p<0.0001; I2=90.55%). Unreported sex-stratified data precluded direct comparison of concussion risk in male versus female athletes.ConclusionPreviously concussed children have four times the risk of sustaining a concussion compared with those with no previous concussion history. This should be a consideration for clinicians in return to sport decision-making. Future studies examining subsequent recurrent concussion in youth sports must consider sex differences.

scholarly journals Clinical Characteristics of Inpatients with Anaphylaxis in China

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Rui Tang ◽  
Han-Yi Xu ◽  
Ju Cao ◽  
Shi Chen ◽  
Jin-Lu Sun ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Multiple Organ ◽  
Female Ratio ◽  
Multisystem Involvement ◽  
Organ Systems ◽  
Number Of Patients ◽  
Male Patients ◽  
Male To Female

Objective.To analyze the clinical characteristics of inpatients with anaphylaxis and the factors that influenced those characteristics.Methods.Using the patient records from 1990 to 2013 from three highly ranked Chinese hospitals, we retrospectively analyzed the characteristics of 108 inpatients with anaphylaxis (not anaphylaxis admitted).Results.The mean patient age was42±20years old and male-to-female ratio was 1 : 1.3. The number of patients with anaphylaxis increased gradually, and cases diagnosed after 2005 accounted for 68.5% of the 108 total cases. The most common trigger was medications. The most common clinical manifestations included cutaneous, nervous, respiratory, circulatory, and digestive signs and symptoms. Male patients were more likely to experience loss of consciousness. Multisystem involvement was more likely to develop in patients with low BP, whereas it was uncommon in those with anaphylaxis induced by antibiotics or anesthetics. Epinephrine was used as the first-line treatment for 56 cases.Conclusions.Inpatient with anaphylaxis was more common in female patients and the number increased gradually during the study period. The most common trigger was medications. Patients with low BP were prone to having multisystem involvement, whereas the cases of anaphylaxis induced by antibiotics and anesthetics were less likely to involve multiple organ systems.

scholarly journals Epidemiological and clinical characteristics of alopecia areata: an observational study from South India

2018 ◽  
Vol 4 (3) ◽  
pp. 313
Author(s):  
Jisy S. Raghavan ◽  
Kunnummal Muhammed ◽  
Sharim Fathima
Keyword(s):  
Alopecia Areata ◽  
Clinical Characteristics ◽  
South India ◽  
Past History ◽  
Indian Subcontinent ◽  
Tertiary Hospital ◽  
Epidemiological Studies ◽  
Female Ratio ◽  
Number Of Patients ◽  
History Of

<p class="abstract"><strong>Background:</strong> Paucity of literature on epidemiological studies of alopecia areata (AA) from Indian subcontinent especially from southern India. The objectives of the study were to study the epidemiological and clinical profile of alopecia areata in a population from northern part of South India.</p><p class="abstract"><strong>Methods:</strong> The epidemiology including pattern, risk factors and associations were evaluated in all newly diagnosed alopecia areata cases seen from January 2017 to December 2017 in a tertiary hospital in South India.<strong></strong></p><p class="abstract"><strong>Results:</strong> The incidence of AA was 2% of total dermatology outpatients. 60 new case referrals of AA were seen from January 2017 to December 2017. Male to female ratio was almost equal. Maximum number of patients with AA belonged to the age group of 21-40 years (50%). Occiput was the commonest site involved in AA (36.8%) followed by vertex (27.6%). 30% of the patients gave a past history of AA and 21.7% gave a family history of AA. 15% of AA patients had history of atopy. Nail changes were found in 30% of patients. 5% of AA patients had associated vitiligo. On microscopic examination of plucked hair early dystrophic anagen hair predominated (70%) as against (16.7%) of dystrophic telogen hair.</p><p class="abstract"><strong>Conclusions:</strong> The clinical characteristics of alopecia areata throws light from a data sparse geographical region but warrants further detailed studies for improved understanding.</p>

The natural history of intracranial cavernous malformations

2011 ◽  
Vol 30 (6) ◽  
pp. E24 ◽  
Author(s):  
Bradley A. Gross ◽  
Ning Lin ◽  
Rose Du ◽  
Arthur L. Day
Keyword(s):  
Risk Factors ◽  
Natural History ◽  
Meta Analysis ◽  
Neurological Deficits ◽  
Cavernous Malformations ◽  
Female Ratio ◽  
Natural History Studies ◽  
Developmental Venous Anomalies ◽  
History Of ◽  
Male To Female

Literature reports on the natural history of cerebral cavernous malformations (CMs) are numerous, with considerable variability in lesion epidemiology, hemorrhage rates, and risk factors for hemorrhage. In this review, the authors performed a meta-analysis of 11 natural history studies. The overall male-to-female ratio was 1:1, and the mean age at presentation was 30.6 years. Overall, 37% of patients presented with seizures, 36% with hemorrhage, 23% with headaches, 22% with focal neurological deficits, and 10% were asymptomatic. Some patients had more than one symptom. Seizure presentation was most prevalent among supratentorial CMs, while focal neurological deficits were common in patients with infratentorial CMs. By location, CMs were in the cerebral hemispheres (66%), brainstem (18%), basal ganglia or thalamus (8%), cerebellum (6%), and other (2.5% [combined supra- and infratentorial, callosal or insular]). Overall, 19% of patients harbored multiple intracranial CMs, and 9% had radiographically apparent associated developmental venous anomalies. An overall annual hemorrhage rate of 2.4% per patient-year (range 1.6%–3.1%) was identified across 3 studies. Prior hemorrhage and female sex were risk factors for bleeding, while CM size and multiplicity did not affect hemorrhage rates. Although not impacting the hemorrhage rate itself, deep location was a risk factor for increased clinical aggressiveness.

scholarly journals P129 The utility of routine operative swab culture in uncomplicated peri-anal abscesses

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Apoorva Khajuria ◽  
Tuba Rahim ◽  
Mariam Baig ◽  
Kai Leong ◽  
Apoorva Khajuria
Keyword(s):  
Inflammatory Bowel Disease ◽  
Perianal Abscess ◽  
Female Ratio ◽  
Incision And Drainage ◽  
Common Presentation ◽  
History Of ◽  
Inflammatory Bowel ◽  
Operative Findings ◽  
The Cost ◽  
Male To Female

Abstract Introduction Despite perianal abscess being a common presentation, certain aspects of its management remain controversial, especially the routine use of intra-operative swab cultures. Methods A retrospective review of patients that underwent incision and drainage procedures for a perianal abscess over a six-month period was undertaken. Results Over 6 months, 50 patients were identified. The male to female ratio was 3:1 and median ASA score was 1. Only 6/50 patients presented with recurrent abscess and 1 patient had history of inflammatory bowel disease. On the basis of operative findings, 39 patients (78%) had uncomplicated abscess (not associated with cellulitis, sinus or fistula); swab cultures were performed in 26 (67%) of these patients. All patients were discharged on the same day; microbiology reports did not impact the treatment and no patients were followed up in clinic post-operatively or presented with recurrence. The number of unnecessary microbiology swabs undertaken in this cohort equates to approximately 52 unnecessary swabs a year. The cost of one swab is £10.10p, which means £520 could potentially be saved annually. Conclusion Routine intra-operative swab cultures do not impact management decisions, add to unnecessary costs and therefore should not be undertaken in uncomplicated or first presentation of peri-anal abscesses.

DEMOGRAPHIC PROFILE OF ACUTE FEBRILE ENCEPHALOPATHY CASES IN PEDIATRIC AGE GROUP PATIENTS: A STUDY FROM WESTERN RAJASTHAN

2021 ◽  
pp. 72-73
Author(s):  
Laxmi Rathore ◽  
P. K. Khatri ◽  
Saroj K. Meena ◽  
Archana Bora ◽  
Suneel Bhooshan
Keyword(s):  
Lower Class ◽  
Mental States ◽  
Clinical Feature ◽  
Female Ratio ◽  
Pediatric Age Group ◽  
History Of ◽  
Laboratory Investigations ◽  
Demographic Distribution ◽  
Viral Etiologies ◽  
Male To Female

Acute Febrile Encephalopathy is a clinical term used to describe patients presenting with short febrile illnesses with altered mental states. Demographic distribution plays an essential role in the diagnosis of viral etiologies. One hundred ve suspected AFE cases were enrolled in the study. A detailed history by predesigned performa and laboratory investigations was obtained for data collection. Viral etiology was diagnosed in 32 (30.48%) cases. The male to female ratio was 1.39:1. Total 56.25% of positive cases were from the lower class, 28.13% from the middle class, and 15.63% from the upper class. 24 (75%) cases from rural, while only 8 (25%) of the urban population showed viral etiologies. In 19 (59.4%) cases were either history of incomplete vaccination or not vaccinated, 13 (40.6%) cases had a history of complete immunization among positive cases. The predominant clinical feature was fever (100%) followed by seizures 66(62.86%), vomiting 37(35.24%), headache 14(13.33%), paresis in 16(15.24%) and altered sensorium in 29(27.62%), respectively. To conclude, the etiologic panorama of AFE varies with several factors such as time and demographical location, age, and immunization status. There is an urgent need to conduct more studies to prole the viral etiologies according to their prevalence in geographical areas so the treatment can be tailored accordingly and prophylaxis treatment or immunization can be boosted in the population at risk of getting the disease.

COMPARISON OF CLINICO-SOCIAL PROFILE OF PULMONARY AND EXTRA PULMONARY TUBERCULOSIS IN TERTIARY CARE HOSPITAL IN A RURALAREA: A RETROSPECTIVE STUDY

2021 ◽  
pp. 70-72
Author(s):  
Gaurav Santosh Nemade ◽  
Sumit Nitin Dhus ◽  
Arushi Ramesh Shetty ◽  
Neha Dhananjay Firake
Keyword(s):  
Tertiary Care ◽  
Care Hospital ◽  
Female Ratio ◽  
Extra Pulmonary Tuberculosis ◽  
Younger Age ◽  
Tobacco Addiction ◽  
History Of ◽  
Early Case ◽  
Male To Female ◽  
Clinical Characteristic

BACKGROUND AND OBJECTIVES: The burden of tuberculosis (TB) in India is the highest accounting for 26% of the global incidence. A total of 1.4 million people died from TB in 2019 (including 208 000 people with HIV). India accounts for a fourth of the global burden of TB and 29% of global mortality. Therefore, we carried out this study to compare demographic, lifestyle and clinical characteristic between pulmonary TB (PTB) and extrapulmonary TB (EPTB). MATERIALS AND METHODOLOGY:Aretrospective analysis was carried of 348 patients diagnosed in DOTS centre, Pravara Rural Hospital, Loni. Characteristics of demographic and clinical characteristics were obtained from medical case records. RESULTS:Among the 348 cases, 71.3% were PTB and 28.7% were EPTB including, pleural (36%), meningeal (27%) and lymphatic (20%) cases. The male to female ratio in PTB and EPTB are 1.99 and 1.22 respectively. EPTB was more common at younger age (<25 years). Tobacco addiction (10.9%), diabetes mellitus (4.03%), HIV positivity (12.1%) and history of contact with Tb patients (17.7%) were more likely to be associated with PTB. CONCLUSION:Increased awareness of the risk factors may facilitate early case nding and better management outcomes for these patients.

scholarly journals OUTCOME OF DACRYOCYSTORHINOSTOMY WITH OR WITHOUT SILICON INTUBATION IN PRIMARY NASOLACRIMAL DUCT OBSTRUCTION

1969 ◽  
Vol 1 (2) ◽  
pp. 55-59
Author(s):  
Haroon Rashid ◽  
Faizur Rahman ◽  
Abid Naseem ◽  
Arshad Iqbal.
Keyword(s):  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
Interventional Study ◽  
Female Ratio ◽  
Duct Obstruction ◽  
Number Of Patients ◽  
Silicon Tube ◽  
Complications Rate ◽  
Age Range ◽  
Male To Female

Objectives: The objective of the study was to compare the outcome of Classical Dacrocystorhinostomy(DCR) alone or with Slicon intubation in patients of primary nasolacrimal duct obstruction.Study design: This is a randomized prospective interventional study performed at Saidu Teaching Hospitalform from 1st January'2006 to 31st December 2006.Material and methods: Diagnosis of nasolacrimal duct obstruction was made on basis of history, clinicalexamination, regurgitation test and syringing of the nasolacrimal passage. Patients were selected byconvenient sampling and were randomized to two groups, for DCR with and without Silicon tube. Silicontube was removed after 4 months of surgery. Patients were followed up to 6 months.Results: Total number of patients was one hundred. Fifty (50%) patients were operated with siliconintubation and 50 (50%) without silicon intubation. Male to female ratio was 1:1.27.Age range was 15 yearsto 80 years. Mean, median and mode ages were 42.54, 47 and 30 years respectively. Eleven patients werelost from the study at various stages and were not included in the results of the study. The complicationsnoted were silicon tube loss in 2 cases, silicon tube displacement in 3 cases and DCR failure in 4 cases.Among the failure, 2 cases belonged to each group with and without silicon intubation.Conclusions: We conclude that the complications rate with and without silicon intubation is the same inprimary nasolacrimal duct obstruction. It is therefore, recommended that silicon intubation may not benecessary in such cases.Key words: DCR, Intubation, NLD Obstruction.

P991Predicting arrhythmic risk in dilated cardiomyopathy: a systematic review & meta-analysis of clinical parameters

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
A Sammani ◽  
E Kayvanpour ◽  
L P Bosman ◽  
F Sedaghat-Hamedani ◽  
T Proctor ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
High Risk ◽  
Dilated Cardiomyopathy ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Gadolinium Enhancement ◽  
T Wave ◽  
History Of ◽  
T Wave Alternans

Abstract Background Patients with non-ischemic dilated cardiomyopathy (NIDCM) are at increased risk of ventricular arrhythmias and sudden cardiac death (SCD). However, identifying patients at high risk for life-threatening ventricular arrhythmia (LTVA) who may benefit from an implantable cardioverter defibrillator (ICD) remains challenging. Methods We searched MEDLINE and EMBASE for prognostic studies describing predictors of LTVA (defined as sustained ventricular tachycardia (VT), haemodynamically unstable VT, ventricular fibrillation, (aborted) SCD or appropriate ICD intervention) in patients with NIDCM. We excluded articles with composite heart failure and arrhythmic endpoints but lacking (subgroup) analysis for LTVA. Study quality and risk of bias was assessed using the QUIPS-tool, and articles with high risk of bias in ≥2 areas were excluded from analysis. Univariable hazard ratios of reported predictors were pooled from the remaining studies in a meta-analysis using a random-effects model and presented with 95% confidence interval (CI). Results Out of 1996 unique citations, 51 studies were included comprising 9798 patients with 1493 arrhythmic events. 28 studies were pooled for meta-analysis (mean age 55±4.1 years, 72% male) with a mean follow-up of 3.7±1.9 years. Crude event rate was 4.3% (95% CI 4.02–4.57) per year. From our meta-analysis, hypertension (HR 1.95; CI [1.26–3.00]), history of out of hospital cardiac arrest or sustained VT (HR 4.15; CI [1.32–13.02]), T-wave alternans (HR 6.50; CI [2.46–17.14]), LVEDV per 10ml/m2 increase (HR 1.10; CI [1.10–1.10]), LVESV per 10ml/m2 increase (HR 1.10; CI [1.00–1.22]) and delayed gadolinium enhancement (HR 5.55; CI [4.02–7.67]) were significantly associated with LTVA (figure). The quality of evidence was moderate and there was significant heterogeneity (median i2 57%; IQR 76%) among studies. Additionally from data that could not be pooled, decreased LVEF, history of nsVT and decreased heart rate variability were significantly associated with LTVA. Summary of meta-analysis results Conclusion The risk of LTVA in NIDCM is 4.3% per year and is considerably higher in patients with hypertension, history of LTVA, decreased LVEF, high LVEDV, high LVESV, T-wave alternans, history of nsVT, decreased heart rate variability and delayed gadolinium enhancement. These results may help determine appropriate candidates for ICD implantation. The high heterogeneity in reported results indicate the need for future multicentre studies to further improve risk stratification in NIDCM. Acknowledgement/Funding ERA-CVD JTC2016: DETECTIN-HF, 680969 & Dutch Heart Foundation (2016T096)

Pioglitazone for the Primary and Secondary Prevention of Cardiovascular and Renal Outcomes in Patients with or at High Risk of Type 2 Diabetes Mellitus: A Meta-Analysis

2019 ◽  
Vol 105 (5) ◽  
pp. 1670-1681 ◽  
Author(s):  
Yue Zhou ◽  
Yajing Huang ◽  
Xiaoyun Ji ◽  
Xiang Wang ◽  
Liyan Shen ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Infarction ◽  
Heart Failure ◽  
High Risk ◽  
Meta Analysis ◽  
Cardiovascular Death ◽  
Primary And Secondary Prevention ◽  
All Cause Mortality ◽  
History Of

Abstract Context The goal of the meta-analysis was to evaluate the effect of pioglitazone on the primary and secondary prevention of cardiovascular diseases (CVDs) and renal adverse events in patients with or at high risk of type 2 diabetes mellitus (T2DM). Design Randomized controlled trials (RCTs) comparing pioglitazone with any control were identified through PubMed, Embase, and the Cochrane Library. Cardiovascular outcomes included major adverse cardiovascular events (MACEs, defined as the composite of nonfatal myocardial infarction, nonfatal stroke, and cardiovascular death), hospitalization for heart failure, and all-cause mortality. Renal outcomes included change in urinary albumin to creatinine ratio and 24-hour urinary protein excretion. Weighted mean difference (WMD) and risk ratio (RR) with 95% confidence intervals (CIs) were pooled. Results A total of 26 studies with 19 645 participants were enrolled. Pioglitazone reduced the risk of MACE (RR, 0.8 [95% CI, 0.7–0.9]), with benefit only seen in patients with a history of established CVDs (0.8 [0.7–0.9]) and not in those without (1.0 [0.7–1.3]). Regarding the individual components, pioglitazone reduced the risk of nonfatal myocardial infarction (0.8 [0.6–1.0]) and nonfatal stroke (0.8 [0.7–0.9]), which was confined to patients with a history of established CVDs, whereas no treatment effect was found on cardiovascular death (1.0 [0.7–1.2]) regardless of the presence of established CVDs. Pioglitazone increased the risk of hospitalization for heart failure (1.3 [1.1–1.6]) and had no treatment effect on all-cause mortality (1.0 [0.8–1.1]). Pioglitazone reduced albuminuria by 18.5% (WMD 18.5% [95% CI, 21.1-16.0]), with a similar benefit in patients with different renal function categories. Conclusions Pioglitazone should be considered in patients with or at high risk of T2DM for the prevention of cardiovascular endpoints, especially in those with a history of established CVD who might benefit the most. Robust reductions in progression of renal disease are seen regardless of baseline renal function degree.

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