scholarly journals The Effectiveness of Microneedling Therapy on The Severity of Acne Scars According to Goodman and Baron: A Systematic review and meta-analysis

2022 ◽  
pp. 48
Author(s):  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Control Group ◽  
Skin Damage ◽  
Acne Scar ◽  
Acne Scars ◽  
Significant Difference ◽  
Acne Scarring ◽  
The Mean ◽  
Z Value

Background: The emergence of acne scars due to skin damage in the acne healing process and causes psychological effects. The management of acne scars can be done in several methods. Microneedling is a very simple, safe, effective, and minimally invasive therapeutic technique compared to other therapeutic modalities in acne scars. The resulting wound is micro-sized, and promotes the growth of growth factors and collagen production. We aimed to assess the effectiveness of using microneedling as an acne scar treatment option. A systematic review and meta-analysis were qualitatively and quantitatively conducted from RCTs, assessing the effectiveness of microneedling in reducing the severity of acne scars according to Goodman and Baron in the treatment of acne scars. Methods: Medline Pubmed, PMC, Scopus, Google Scholar, and JDC library, eligible search. Ten studies (n=514) were analyzed qualitatively with 2 studies (n=53 subjects) and quantitatively analyzed by 2 studies (n=90 subjects). Both analyzes were included in the meta-analysis. The mean age of the participants was 40.5 years. The application of microneedling intervention as monotherapy or a combination in patients with acne scarring was followed for at least 16 weeks, the results obtained were the mean reduction in the degree of acne scarring after microneedling. Result: The combination of microneedling treatment obtained a qualitative decrease in the degree of acne scars according to Goodman and Baron with a Z value (-4.299) and P=<0.001 lower than the control (PRP) with a significant difference. The quantitative decrease in the degree of acne scars according to Goodman and Baron obtained a Z value (-4.681) and P=<0.001 lower than the control (PRP) with a significant difference. Quantitative reduction in the degree of acne scars according to Goodman and Baron on single therapy between treatment and control with a value of Z (-3.536) and P=<0.001 lower than control (fractional CO2) with a significant difference. The results of the degree of acne scars in the group treated with microneedling alone or in combination were lower than the control group. The mean before and after therapy compared to the control there was a significant difference. Conclusion. The results of a systematic review, concluded that the group treated with microneedling had a decrease in the degree of acne scarring according to Goodman and Baron with P=<0.001 compared to before treatment. The decrease was shown in the difference in Z values, which was significantly greater than the control given other therapies. Microneedling therapy can be an alternative therapy option for acne scar patients who are unresponsive to previous therapy or in conditions where there are contraindications to other therapies.

scholarly journals Differences in pregnancy and perinatal outcomes among symptomatic versus asymptomatic COVID-19-infected pregnant women: a systematic review and meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Durray Shahwar A. Khan ◽  
La-Raib Hamid ◽  
Anna Ali ◽  
Rehana A. Salam ◽  
Nadeem Zuberi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Pregnant Women ◽  
Low Birthweight ◽  
Meta Analysis ◽  
Perinatal Outcomes ◽  
Respiratory Disorder ◽  
Significant Difference ◽  
The Mean ◽  
In Pregnancy

Abstract Background There is dearth of information on COVID-19’s impact on pregnant women. However, literature reported trends of COVID-19 differ, depending on the presence of clinical features upon presentation. Objective This systematic review aimed to assess differences in risk factors, management, complications, and pregnancy and perinatal outcomes in symptomatic vs. asymptomatic pregnant women with confirmed SARS-CoV-2 infection. Methods A search was run on electronic databases to identify studies reporting COVID-19 in pregnancy. Meta-analysis was performed and odds ratios and mean difference with 95% confidence intervals were calculated using Review Manager 5.4. Review Prospero registration number CRD42020204662. Results We included ten articles reporting data from 3158 pregnancies; with 1900 symptomatic and 1258 asymptomatic pregnant women. There was no significant difference in the mean age, gestational age, and body mass index between the two groups. The meta-analysis suggested that pregnant women who were obese (OR:1.37;95%CI:1.15 to 1.62), hypertensive (OR:2.07;95%CI:1.38 to 3.10) or had a respiratory disorder (OR:1.64;95%CI:1.25 to 2.16), were more likely to be symptomatic when infected with SARS-CoV-2. Pregnant women with Black (OR:1.48;95%CI:1.19 to 1.85) or Asian (OR:1.64;95%CI:1.23 to 2.18) ethnicity were more likely to be symptomatic while those with White ethnicity (OR:0.63;95%CI:0.52 to 0.76) were more likely to be asymptomatic. Cesarean-section delivery (OR:1.40;95%CI:1.17 to 1.67) was more likely amongst symptomatic pregnant women. The mean birthweight(g) (MD:240.51;95%CI:188.42 to 293.51), was significantly lower, while the odds of low birthweight (OR:1.85;95%CI:1.06 to 3.24) and preterm birth (< 37 weeks) (OR:2.10;95%CI:1.04 to 4.23) was higher amongst symptomatic pregnant women. Symptomatic pregnant women had a greater requirement for maternal ICU admission (OR:13.25;95%CI:5.60 to 31.34) and mechanical ventilation (OR:15.56;95%CI:2.96 to 81.70) while their neonates had a higher likelihood for Neonatal Intensive Care Unit admission (OR:1.96;95%CI:1.59 to 2.43). The management strategies in the included studies were poorly discussed, hence could not be analyzed. Conclusion The evidence suggests that the presence of risk factors (co-morbidities and ethnicity) increased the likelihood of pregnant women being symptomatic. Higher odds of complications were also observed amongst symptomatic pregnant women. However, more adequately conducted studies with adjusted analysis and parallel comparison groups are required to reach conclusive findings.

scholarly journals Efficacy Comparison of Intravitreal Anti-VEGF Therapy for Three Subtypes of Neovascular Age-Related Macular Degeneration: A Systematic Review and Meta-Analysis

2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Jianqing Li ◽  
Jiayi Xu ◽  
Yiyi Chen ◽  
Jiaju Zhang ◽  
Yihong Cao ◽  
...  
Keyword(s):  
Systematic Review ◽  
Macular Degeneration ◽  
Meta Analysis ◽  
Age Related Macular Degeneration ◽  
Cochrane Library ◽  
Anti Vegf ◽  
Age Related ◽  
Significant Difference ◽  
The Mean

Purpose. Intravitreal antivascular endothelial growth factor (anti-VEGF) therapy has been widely used for the treatment of neovascularization (NV) secondary to age-related macular degeneration (AMD). This study aimed to compare the efficacy among different subtypes of neovascular age-related macular degeneration (nAMD). Methods. PubMed, Embase, and the Cochrane Library were searched for eligible studies. We performed meta-analysis using Review Manager 5.3 and Stata/SE 12.0. Results. A total of 24 studies met our inclusion criteria and were included in the systematic review. At 3 months, the mean logarithm of the minimum angle of resolution (logMAR) improvements were −0.09, −0.18, and −0.23 for type 1, 2, and 3, respectively, while the mean macular thickness (MT) changes were −104.83, −130.76, and −196.29 μm. At 12 months, the mean changes in Early Treatment of Diabetic Retinopathy Study (ETDRS) letters were 6.38, 8.12, and 9.37, while the MT decrease was 126.51, 126.52, and 139.85 μm, respectively. However, statistically significant difference was only found between type 1 and 3 in vision improvement, both in the short term (p=0.0002) and long term (p=0.01). Conclusions. The reactivity to VEGF inhibitors varied among different subtypes of nAMD. The efficacy of intravitreal anti-VEGF therapy in type 3 nAMD was statistically better than type 1 when considering vision improvement at 3 and 12 months. Thus, the lesion subtype is a predictor for the treatment outcome which can help guide prognosis.

scholarly journals The Role of Mean Platelet Volume as a Predictor of Mortality in Critically Ill Patients: A Systematic Review and Meta-Analysis

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Pattraporn Tajarernmuang ◽  
Arintaya Phrommintikul ◽  
Atikun Limsukon ◽  
Chaicharn Pothirat ◽  
Kaweesak Chittawatanarat
Keyword(s):  
Systematic Review ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Mean Platelet Volume ◽  
Meta Analysis ◽  
Small Sample ◽  
Mean Difference ◽  
Platelet Volume ◽  
Significant Difference ◽  
The Mean

Background. An increase in the mean platelet volume (MPV) has been proposed as a novel prognostic indicator in critically ill patients.Objective. We conducted a systematic review and meta-analysis to determine whether there is an association between MPV and mortality in critically ill patients.Methods. We did electronic search in Medline, Scopus, and Embase up to November 2015.Results. Eleven observational studies, involving 3724 patients, were included. The values of initial MPV in nonsurvivors and survivors were not different, with the mean difference with 95% confident interval (95% CI) being 0.17 (95% CI: −0.04, 0.38;p=0.112). However, after small sample studies were excluded in sensitivity analysis, the pooling mean difference of MPV was 0.32 (95% CI: 0.04, 0.60;p=0.03). In addition, the MPV was observed to be significantly higher in nonsurvivor groups after the third day of admission. On the subgroup analysis, although patient types (sepsis or mixed ICU) and study type (prospective or retrospective study) did not show any significant difference between groups, the difference of MPV was significantly difference on the unit which had mortality up to 30%.Conclusions. Initial values of MPV might not be used as a prognostic marker of mortality in critically ill patients. Subsequent values of MPV after the 3rd day and the lower mortality rate unit might be useful. However, the heterogeneity between studies is high.

Diagnostic performance of optical coherence tomography angiography in glaucoma: a systematic review and meta-analysis

2019 ◽  
Vol 103 (11) ◽  
pp. 1677-1684 ◽  
Author(s):  
Ana I M Miguel ◽  
André B Silva ◽  
Luis F Azevedo
Keyword(s):  
Systematic Review ◽  
Optical Coherence Tomography ◽  
Prospective Studies ◽  
Diagnostic Performance ◽  
Optical Coherence Tomography Angiography ◽  
Meta Analysis ◽  
Optical Coherence ◽  
Manual Search ◽  
Significant Difference ◽  
The Mean

BackgroundCompared with current imaging methods, the diagnostic performance and the advantages and limitations of optical coherence tomography angiography (OCTA) remain unclear. We performed a systematic review and meta-analysis of studies investigating vessel density (VD) in patients with glaucoma using OCTA.MethodsWe conducted a literature search on PubMed, Scopus, Web of Science, ISI Conference Proceedings and Google Scholar, along with a manual search, from January 2006 to March 2018. We included prospective studies that used OCTA to compare the VD in glaucomatous eyes with healthy control eyes.ResultsOf 3045 screened articles, 24 were included in a broad characterisation and 18 in the meta-analysis. We observed a statistically significant reduction in the mean peripapillary VD (MPVD) in glaucoma (MPVD: 57.53%, 95% CI 52.60 to 62.46, p< 0.001) compared with controls (MPVD: 65.47%, 95% CI 59.82 to 71.11; standardised mean difference [SMD], –1.41, 95% CI –1.62 to –1.20, p< 0.001) for 888 glaucomatous and 475 healthy eyes, and also in the mean-whole optic nerve image VD (SMD, –9.63, 95% CI –10.22 to –9.03, p<0.001), mean inside-disc VD (SMD, − 9.51, 95% CI –12.66 to –6.36, p<0.05) and mean parafoveal VD (SMD, –3.92, 95% CI –4.73 to –3.12, p<0.001). Subgroup analyses revealed a significant difference in the MPVD across glaucoma subtypes and OCTA devices.ConclusionThis suggests the diagnostic utility of OCTA in detecting glaucomatous eyes; however, further longitudinal prospective studies are welcomed to characterise vascular changes in glaucoma.

scholarly journals Specific immunotherapy in renal cancer: a systematic review

2016 ◽  
Vol 9 (2) ◽  
pp. 45-58 ◽  
Author(s):  
Armin Hirbod-Mobarakeh ◽  
Hesam Addin Gordan ◽  
Zahra Zahiri ◽  
Mohammad Mirshahvalad ◽  
Sima Hosseinverdi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Efficacy ◽  
Specific Immunotherapy ◽  
Meta Analysis ◽  
Cell Cancer ◽  
Control Group ◽  
Autologous Tumor Cell ◽  
Autologous Tumor ◽  
Cik Cells ◽  
Significant Difference

Background: Renal cell cancer (RCC) is the tenth most common malignancy in adults. In recent years, several approaches of active and passive immunotherapy have been studied extensively in clinical trials of patients with RCC. The aim of this systematic review was to assess the clinical efficacy of various approaches of specific immunotherapy in patients with RCC. Methods: We searched Medline, Scopus, CENTRAL, TRIP, DART, OpenGrey and ProQuest without any language filter through to 9 October 2015. One author reviewed search results for irrelevant and duplicate studies and two other authors independently extracted data from the studies. We collated study findings and calculated a weighted treatment effect across studies using Review Manager (version 5.3. Copenhagen: The Nordic Cochrane Centre, the Cochrane Collaboration). Results: We identified 14 controlled studies with 4013 RCC patients after excluding irrelevant and duplicate studies from 11,319 references retrieved from a literature search. Overall, five autologous tumor cell vaccines, one peptide-based vaccine, one virus-based vaccine and one dendritic cell (DC)-based vaccine were studied in nine controlled studies of active specific immunotherapies. A total of three passive immunotherapies including autologous cytokine-induced killer (CIK) cells, auto lymphocyte therapy (ALT) and autologous lymphokine-activated killer (LAK) cells were studied in four controlled studies. The clinical efficacy of tumor lysate-pulsed DCs, with CIK cells was studied in one controlled trial concurrently. The overall quality of studies was fair. Meta-analysis of seven studies showed that patients undergoing specific immunotherapy had significantly higher overall survival (OS) than those in the control group [hazard ratio (HR) = 0.72; 95% confidence interval (CI) = 0.58–0.89, p = 0.003]. In addition, a meta-analysis of four studies showed that there was a significant difference in progression-free survival (PFS) between patients undergoing specific immunotherapy and patients in control groups (HR = 0.86; 95% CI = 0.73–1, p = 0.05). Conclusions: Results of this systematic review suggest that some specific immunotherapies such as Reniale, ACHN-IL-2, Newcastle disease virus (NDV) virus-infected autologous tumor cells, ALT and CIK treatment could be beneficiary for the treatment of patients with RCC.

scholarly journals The relationship between delivery mode and postpartum depression: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Yu-Xin Chen ◽  
Pei Zhao ◽  
ZhuLiduzi Jiesisibieke ◽  
Pei-En Chen ◽  
Tao-Hsin Tung ◽  
...  
Keyword(s):  
Systematic Review ◽  
Postpartum Depression ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Control Group ◽  
Depression Symptoms ◽  
Delivery Mode ◽  
Significant Difference ◽  
The Relationship

Abstract Background: To assess the relationship between delivery mode and postpartum depression and to examine whether cesarean section (CS) has a higher risk of postpartum depression than vaginal delivery (VD). Methods: We searched the Cochrane Library, PubMed, and EMBASE from inception to 30 April 2019 without language limitations. Two authors independently selected studies, assessed the quality of included studies, and extracted data. Any disagreements were resolved by discussion with a third author. We used the Newcastle-Ottawa Scale and GRADE methods to assess the quality of the included studies and evidences. This study had four included cohort studies data and carried out fixed-effect model meta-analysis. Results: The findings demonstrated a significant difference in the risk of postpartum depression between CS and VD. Compared with the control group, the CS group was associated with a higher prevalence of postpartum depression symptoms (Risk Ratio =1.29; 95% CI: 1.11-1.51). Conclusions: The findings supported a relationship between delivery mode and postpartum depression. Particularly, we found that CS is associated with a higher risk of postpartum depression. Therefore, we ought to encourage pregnant women who are without medical indication of CS to select VD.r Trial registration: The protocol of this systematic review was registered in the PROSPERO under the number CRD42019148154.

scholarly journals Repurposing of drugs for Covid-19: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Pinky Kotecha ◽  
Alexander Light ◽  
Enrico Checcucci ◽  
Daniele Amparore ◽  
Cristian Fiori ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Adverse Events ◽  
Clinical Improvement ◽  
Case Reports ◽  
Meta Analysis ◽  
Case Series ◽  
Cochrane Library ◽  
Control Group ◽  
Significant Difference

AbstractObjectiveThe aim of this systematic review is to evaluate the data currently available regarding the repurposing of different drugs for Covid-19 treatment. Participants with suspected or diagnosed Covid-19 will be included. The interventions being considered are drugs being repurposed, and comparators will include standard of care treatment or placebo.MethodsWe searched Ovid-MEDLINE, EMBASE, Cochrane library, clinical trial registration site in the UK(NIHR), Europe (clinicaltrialsregister.eu), US (ClinicalTrials.gov) and internationally (isrctn.com), and reviewed the reference lists of articles for eligible articles published up to April 22, 2020. All studies in English that evaluated the efficacy of the listed drugs were included. Cochrane RoB 2.0 and ROBINS-I tool were used to assess study quality. This systematic review adheres to the PRISMA guidelines. The protocol is available at PROSPERO (CRD42020180915).ResultsFrom 708 identified studies or clinical trials, 16 studies and 16 case reports met our eligibility criteria. Of these, 6 were randomized controlled trials (763 patients), 7 cohort studies (321 patients) and 3 case series (191 patients). Chloroquine (CQ) had a 100% discharge rate compared to 50% with lopinavir-ritonavir at day 14, however a trial has recommended against a high dosage due to cardiotoxic events. Hydroxychloroquine (HCQ) has shown no significant improvement in negative seroconversion rate which is also seen in our meta-analysis (p=0.68). Adverse events with HCQ have a significant difference compared to the control group (p=0.001). Lopinavir-ritonavir has shown no improvement in time to clinical improvement which is seen in our meta-analyses (p=0.1). Remdesivir has shown no significant improvement in time to clinical improvement but this trial had insufficient power.DiscussionDue to the paucity in evidence, it is difficult to establish the efficacy of these drugs in the treatment of Covid-19 as currently there is no significant clinical effectiveness of the repurposed drugs. Further large clinical trials are required to achieve more reliable findings. A risk-benefit analysis is required on an individual basis to weigh out the potential improvement in clinical outcome and viral load reduction compared to the risks of the adverse events. (1-16)

scholarly journals Comparative Systematic Review of Fixation Methods of the Coracoid and Conjoined Tendon in the Anterior Glenoid to Treat Anterior Shoulder Instability

2019 ◽  
Vol 7 (1) ◽  
pp. 232596711882053 ◽  
Author(s):  
Jose Carlos Garcia ◽  
Felipe Machado do Amaral ◽  
Renan Juhasz Belchior ◽  
Lucas Queiroz de Carvalho ◽  
Gregory George Markarian ◽  
...  
Keyword(s):  
Systematic Review ◽  
Shoulder Instability ◽  
Meta Analysis ◽  
Japanese Orthopaedic Association ◽  
Coracoid Process ◽  
Latarjet Procedure ◽  
Significant Difference ◽  
Anterior Glenoid ◽  
The Mean ◽  
Process Transfer

Background: Coracoid process transfer for the treatment of recurrent glenohumeral dislocations is a safe and reliable procedure; however, there is no consensus as to which is the best method, the Bristow or Latarjet procedure. Purpose: To analyze the results of coracoid process transfer for the treatment of recurrent glenohumeral dislocations and to compare the results of this transfer between the Bristow and Latarjet techniques. Study Design: Systematic review; Level of evidence, 4. Methods: The databases surveyed for this review included J-STAGE; Cochrane Bone, Joint and Muscle Trauma Group Specialized Register; Cochrane Controlled Register of Trials; MEDLINE; Ovid; Embase; Google Scholar; and CINAHL. Inclusion criteria consisted of (1) studies related to anterior glenohumeral dislocations treated with transfer of the coracoid process to the anterior glenoid rim and (2) studies that could provide data to perform at least 1 meta-analysis or other statistical evaluation. Titles and abstracts were reviewed for inclusion; thereafter, outcomes and the risk of bias were extracted. Statistical analyses were performed according to the nature of the data. When possible, the 95% CI was included. Results: Of the 779 studies found, 63 were able to provide data assessing 3395 shoulders. There were no randomized, blinded, or double-blinded trials. The recurrence of dislocations was assessed in 41 studies that used the Bristow technique (n = 2346 shoulders; percentage redislocations [mean ± SE], 1.00% ± 0.20%) and 18 studies that used the Latarjet technique (n = 930 shoulders; percentage redislocations, 2.13% ± 0.49%) ( P = .04). The mean loss of external rotation was 12.91° for the Bristow procedure (n = 1440 shoulders) and 11.70° for the Latarjet procedure (n = 243 shoulders). The mean quality-of-life outcome scores were as follows for the Bristow and Latarjet procedures, respectively: Rowe score, 92.06 and 89.33; Western Ontario Shoulder Instability Index score, 16.44% and 19.68%; Japanese Orthopaedic Association score, 93.28 and 92.00; and American Shoulder and Elbow Surgeons score, 91.00 and 89.90. Conclusion: Transferring the coracoid to the anteroinferior border of the glenoid through the subscapularis tendon is effective, regardless of the technique. When comparing the Bristow and Latarjet techniques, the recurrence of dislocations was the only outcome that could undergo a meta-analysis, and it presented a statistically significant difference in favor of the Bristow procedure. All other outcomes presented no clinically significant differences between their effect sizes. More studies presenting better methodology are still needed to achieve more robust conclusions.

Sildenafil for idiopathic pulmonary fibrosis: A systematic review and meta-analysis

2021 ◽  
Author(s):  
Tyler Pitre ◽  
Muhammad Faran Khalid ◽  
Sonya Cui ◽  
Melanie C. Zhang ◽  
Renata Husnudinov ◽  
...  
Keyword(s):  
Systematic Review ◽  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Meta Analysis ◽  
Rate Of Change ◽  
Point Estimate ◽  
Control Group ◽  
Randomized Controlled Studies ◽  
Significant Difference ◽  
Acute Exacerbations

Abstract Background: Patients with idiopathic pulmonary fibrosis have a poor overall prognosis and there are few evidence based drug therapies that reduce mortality. Objective: This systematic review and meta-analysis aims to assess whether sildenafil reduces mortality, reduces disease progression and the adverse side effects associated with it. Methods: In this review, randomized controlled studies (RCTs) were retrieved from MEDLINE, Cochrane, and EMBASE. The primary outcome was mortality. The secondary outcomes included change in FVC, acute exacerbations and hospitalizations and adverse drug effects leading to discontinuation. We used an inverse variance random effects meta-analysis method to calculate pooled odds ratio (OR) and standardized mean difference (SMD). Results: A total of 4 studies were included. Sildenafil probably reduces mortality when compared to placebo or to standard care, [OR 0.63 (0.38,1.03), I2=0%]. Pooled results showed sildenafil does not alter the rate of change of FVC [SMD 0.02 (-0.14,0.18)], or DLCO [SMR -0.01 (-0.18,0.17)], I2=0]. Pooled results showed sildenafil may not reduce the number of hospitalizations or acute exacerbations, [OR 1.06 (0.67,1.67)], I2= 0]. There was no significant difference in drug discontinuation due to adverse effects when comparing sildenafil to the control group, [OR 0.79 (0.56, 1.11)], I2=0]. Conclusion: Sildenafil probably reduces all-cause mortality in IPF patients. More studies need to be done in order to confirm the magnitude and reliability of the point estimate.

Relationship between Helicobacter pylori and development of hepatocellular carcinoma: A systematic review and meta-analysis.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 4091-4091
Author(s):  
Samragnyi Madala ◽  
Kira MacDougall ◽  
Balarama Krishna Surapaneni ◽  
Robin Park ◽  
Anup Kasi ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Systematic Review ◽  
Helicobacter Pylori ◽  
Causal Relationship ◽  
Subgroup Analysis ◽  
Meta Analysis ◽  
Control Group ◽  
Significant Difference ◽  
H Pylori ◽  
The Relationship

4091 Background: The relationship between Helicobacter pylori (H.pylori) and hepatocellular carcinoma (HCC) was first proposed in 1994. Since then, several studies have been performed to explore the association. The role of Hepatitis C (HCV) viruses coexisting with H.pylori in causing HCC was also studied. With the emergence of data in this regard, a causal relationship has been postulated, but not confirmed, and hence the relationship remains controversial. Our meta-analysis aims to summarize the research on this topic and investigate if there exists a relationship between H. pylori infection and the development of HCC and if the presence of HCV along with H.pylori plays a role in liver carcinogenesis. Methods: Following PRISMA guidelines, we performed a systematic review of all relevant studies published in the literature using keywords “Helicobacter pylori” and “Hepatocellular carcinoma” on major literature databases, including PubMed, EMBASE, Web of Science, and Cochrane controlled trials register. A total of 656 studies were identified between 1994 to March 2020, out of which 26 studies qualified under our selection criteria. Patients positive for HCC are included as cases and patients that did not have HCC under control group. In both groups, H.pylori positive patients and their HCV status, was identified. Results: Out of the 26 studies included in the final analysis, the prevalence of H. pylori infection was 64.78% (561 of 866) amongst HCC cases and 47.92% (1718 of 3585) in the non-HCC control group. The summary odds ratio for the association of H. pylori infection with the risk for HCC using the random-effects model was determined to be 4.75 (95% CI, 3.06-7.37), I²=63%. Subgroup analysis to determine the odds of developing HCC in the presence of H.pylori and HCV coinfection, was 13.97 (95% CI, 3.94-49.61), I²=81%. Whereas, the odds of developing HCC in the presence of only HCV without H.pylori was found to be 2.21 (0.70-6.94), I²=79. Subgroup analysis by study design showed no significant difference between the study groups (P= 0.5705). Conclusions: Our meta-analysis showed a positive association between H. pylori infection and the development of HCC. It showed a significantly higher risk of developing HCC in the presence of HCV infection along with H.pylori. Further prospective cohort studies are needed to prove the causal relationship, especially in cases of Hepatitis B, C coinfection, and cirrhotic patients.[Table: see text]

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