scholarly journals Black Fungus an Escalating Threat for Covid-19 Patients Calling Out Captivation

2021 ◽  
Vol 4 (2) ◽  
pp. 01-05
Author(s):  
Humaira Zafar ◽  
Irfan Ali Mirza ◽  
Wajid Hussain ◽  
Muhammad Fayyaz
Keyword(s):  
Systematic Review ◽  
Hospital Stay ◽  
Meta Analysis ◽  
Strong Association ◽  
Mortality Rates ◽  
Predisposing Factors ◽  
Management Options ◽  
Reduce Mortality Rate ◽  
Timely Diagnosis ◽  
Prolong Hospital Stay

Background Current year 2021, brought a hope for the world due to availability of various vaccines to prevent COVID 19. Researchers around the Globe, kept working around the clock to dig up various correlations of this infection. So, that morbidity and mortality rates can be reduced. In all this sprint, cases of black fungus came into light in India. The Indian researchers identified strong association of black fungus co infection in COVID patients resulting in high mortality rates. Objectives Therefore, this current systematic review was planned to identify the predisposing factors, clinical presentations and management options for black fungus in COVID 19 patients. Methodology: This ‘systematic review’ was carried out following preferred reporting items for systematic review and meta-analysis (PRISMA) guidelines & various search engines. Total 20(N) articles were selected and included for study. After following PRISMA guidelines and based upon inclusion and exclusion criteria of study, total 05 (N) manuscripts, were included. Results Out of 05(N) selected articles, 80 %( 04) strongly supported strong association of black fungus with COVID 19 patients. The highlighted predisposing factors includes, immunosuppression, anti virals, prolong hospital stay, use of tocilizumab and steroids as management of COVID patients. Timely diagnosis and provision of anti-fungal can be helpful to reduce mortality form this co infection. Conclusion It is concluded that immunosuppression, anti virals, prolong hospital stay, use of tocilizumab and steroids as management of COVID predisposes to black fungus. Timely diagnosis and use of systematic anti fungals can reduce mortality rate form this co infection.

scholarly journals Sofosbuvir with daclatasvir and the outcomes of patients with COVID-19: a systematic review and meta-analysis with GRADE assessment

2021 ◽  
pp. postgradmedj-2021-140287
Author(s):  
Ahmad Fariz Malvi Zamzam Zein ◽  
Catur Setiya Sulistiyana ◽  
Wilson Matthew Raffaello ◽  
Arief Wibowo ◽  
Raymond Pranata
Keyword(s):  
Systematic Review ◽  
Absolute Risk ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Invasive Mechanical Ventilation ◽  
Intervention Group ◽  
Control Group ◽  
Reduce Mortality Rate ◽  
Icu Admission ◽  
Clinical Recovery

PurposeThis systematic review and meta-analysis aimed to evaluate the effect of sofosbuvir/daclatasvir (SOF/DCV) on mortality, the need for intensive care unit (ICU) admission or invasive mechanical ventilation (IMV) and clinical recovery in patients with COVID-19.MethodsWe performed a systematic literature search through the PubMed, Scopus and Embase from the inception of databases until 6 April 2021. The intervention group was SOF/DCV, and the control group was standard of care. The primary outcome was mortality, defined as clinically validated death. The secondary outcomes were (1) the need for ICU admission or IMV and (2) clinical recovery. The pooled effect estimates were reported as risk ratios (RRs).ResultsThere were four studies with a total of 231 patients in this meta-analysis. Three studies were randomised controlled trial, and one study was non-randomised. SOF/DCV was associated with lower mortality (RR: 0.31 (0.12, 0.78); p=0.013; I2: 0%) and reduced need for ICU admission or IMV (RR: 0.35 (0.18, 0.69); p=0.002; I2: 0%). Clinical recovery was achieved more frequently in the SOF/DCV (RR: 1.20 (1.04, 1.37); p=0.011; I2: 21.1%). There was a moderate certainty of evidence for mortality and need for ICU/IMV outcome, and a low certainty of evidence for clinical recovery. The absolute risk reductions were 140 fewer per 1000 for mortality and 186 fewer per 1000 for the need for ICU/IMV. The increase in clinical recovery was 146 more per 1000.ConclusionSOF/DCV may reduce mortality rate and need for ICU/IMV in patients with COVID-19 while increasing the chance for clinical recovery.Protocol registrationPROSPERO: CRD42021247510.

scholarly journals 321 Role of Antibiotics in Acute uncomplicated diverticulitis, A Systematic Review and Meta-Analysis

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
A A Tahir ◽  
K M Ali ◽  
A U Khan ◽  
S Kamal ◽  
A Hussain ◽  
...  
Keyword(s):  
Systematic Review ◽  
Statistical Analysis ◽  
Treatment Failure ◽  
Hospital Stay ◽  
Meta Analysis ◽  
Dietary Advice ◽  
Duration Of Hospital Stay ◽  
Uncomplicated Diverticulitis ◽  
Acute Uncomplicated Diverticulitis

Abstract Introduction Diverticular disease is a common health problem with a wide clinical spectrum. About 75% of the patients would have uncomplicated diverticulitis. Cornerstones of treatment are antibiotics, analgesia, and dietary advice. Recent evidence has shown that its treatment is controversial, questioning the use of antibiotics. Aim is to assess the role of antibiotics in the treatment of acute uncomplicated diverticulitis. Method This is a systematic review and Meta-analysis. Literature review of the available studies was conducted using search engines like Pubmed, Medline, Embase, Google Scholar, and Cochrane databases. Statistical analysis was conducted using RevMan5.4. Results Out of 1754 records 1324 were duplicates, 430 studies were screened. 395 were further excluded.35 full text articles were assessed and in the final review 10 studies were included. PRISMA guidelines were used. Pooled OR for recurrence = 0.92 (95% CI = 0.74 to 1.13). Pooled OR for Hospital stay= -0.66 (95% CI= -1.12 to -0.21). Pooled OR for complications = 1.06 (95% CI = 0.69 to 1.64). Pooled OR for treatment failure= 1.24 (95% CI = 0.90-1.69). Conclusions We conclude that from the available evidence antibiotics have no role in reducing recurrence, complications, treatment failure, and duration of hospital stay in acute uncomplicated diverticulitis.

Haemostatic devices in parotid surgery: a systematic review

2021 ◽  
pp. 1-7
Author(s):  
L Allen ◽  
C MacKay ◽  
M H Rigby ◽  
J Trites ◽  
S M Taylor
Keyword(s):  
Systematic Review ◽  
Blood Loss ◽  
Facial Nerve ◽  
Hospital Stay ◽  
Outcome Measures ◽  
Meta Analysis ◽  
Operating Time ◽  
Length Of Hospital Stay ◽  
Operative Blood Loss ◽  
Parotid Surgery

Abstract Objective The Harmonic Scalpel and Ligasure (Covidien) devices are commonly used in head and neck surgery. Parotidectomy is a complex and intricate surgery that requires careful dissection of the facial nerve. This study aimed to compare surgical outcomes in parotidectomy using these haemostatic devices with traditional scalpel and cautery. Method A systematic review of the literature was performed with subsequent meta-analysis of seven studies that compared the use of haemostatic devices to traditional scalpel and cautery in parotidectomy. Outcome measures included: temporary facial paresis, operating time, intra-operative blood loss, post-operative drain output and length of hospital stay. Results A total of 7 studies representing 675 patients were identified: 372 patients were treated with haemostatic devices, and 303 patients were treated with scalpel and cautery. Statistically significant outcomes favouring the use of haemostatic devices included operating time, intra-operative blood loss and post-operative drain output. Outcome measures that did not favour either treatment included facial nerve paresis and length of hospital stay. Conclusion Overall, haemostatic devices were found to reduce operating time, intra-operative blood loss and post-operative drain output.

Incidence and mortality rates of intracranial hemorrhage in hemophilia: a systematic review and meta-analysis

Blood ◽  
2021 ◽  
Author(s):  
Anne-Fleur Zwagemaker ◽  
Samantha C Gouw ◽  
Julie J Jansen ◽  
Caroline Vuong ◽  
Michiel Coppens ◽  
...  
Keyword(s):  
Systematic Review ◽  
Young Adults ◽  
Intracranial Hemorrhage ◽  
Meta Analysis ◽  
Age Groups ◽  
Mortality Rates ◽  
Normal Model ◽  
Live Births ◽  
Incidence And Mortality ◽  
Children And Young Adults

Intracranial hemorrhage (ICH) is a severe complication that is relatively common among hemophilia patients. This systematic review aimed to obtain more precise estimates of ICH incidence and mortality in hemophilia, which may be important for patients, caregivers, researchers and health policy-makers. PubMed and EMBASE were systematically searched using terms related to "hemophilia" and "intracranial hemorrhage" or "mortality". Studies that allowed calculation of ICH incidence or mortality rates in a hemophilia population of at least 50 patients were included. We summarized evidence on ICH incidence and calculated pooled ICH incidence and mortality in three age groups: (1) persons of all ages with hemophilia, (2) children and young adults below 25 years of age with hemophilia and (3) neonates with hemophilia. Incidence and mortality were pooled with a Poisson-Normal model or a Binomial-Normal model. We included 45 studies that represented 54 470 patients, 809 151 person-years and 5326 live births of hemophilia patients. In persons of all ages, the pooled ICH incidence and mortality rates were 2.3 (95% CI 1.2-4.8) and 0.8 (95% CI 0.5-1.2) per 1000 person-years, respectively. In children and young adults, the pooled ICH incidence and mortality rates were 7.4 (95% CI 4.9-11.1) and 0.5 (95% CI 0.3-0.9) per 1000 person-years, respectively. In neonates, the pooled cumulative ICH incidence was 2.1% (95% CI 1.5-2.8) per 100 live births. ICH was classified as spontaneous in 35-58% of cases. Our findings suggest that ICH is an important problem in hemophilia that occurs among all ages, requiring adequate preventive strategies.

scholarly journals Rates, predictors and mortality of sepsis-associated acute kidney injury: systematic review and meta-analysis

2020 ◽  
Author(s):  
Jie feng Liu ◽  
Hebin Xie ◽  
ziwei ye ◽  
Lesan Wang
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Septic Shock ◽  
Acute Kidney Injury ◽  
Meta Analysis ◽  
Kidney Injury ◽  
Predisposing Factors ◽  
Cochrane Library ◽  
Patient Specific ◽  
Cumulative Number

Abstract Objective:The incidence and mortality of sepsis-induced acute kidney injury is high. Many studies have explored the causes of sepsis-induced acute kidney injury (AKI). However, its predictors are still uncertain; additionally, a complete overview is missing. A systematic review and a meta-analysis were performed to determine the predisposing factors for sepsis-induced AKI. Method: A systematic literature search was performed in the Medline, Embase, Cochrane Library, PubMed and Web of Science databases, with an end date parameter of May 25, 2019. Valid data were retrieved in compliance with the inclusion and exclusion criteria. Result: Forty-seven observational studies were included for analysis. A cumulative number of 55911sepsis patients were evaluated. The incidence of AKI caused by septic shock is the highest. 30 possible risk factors were included in the meta-analysis. The results showed that 20 factors were found to be significant. The odds ratio(OR),95% confidence interval (CI) and Prevalence of the most prevalent predisposing factors for sepsis-induced AKI were as the following: Septic shock[2.88(2.36-3.52), 60.47%], Hypertension[1.43(1.20-1.70),38.39%), Diabetes mellitus[1.59(1.47-1.71),27.57%],Abdominal infection[1.44(1.32-1.58),30.87%], Vasopressors use[2.95(1.67-5.22),64.61%],vasoactive drugs use [3.85(1.89-7.87),63.22%], Mechanical ventilation[1.64(1.24-2.16),68.00%), Positive blood culture[1.60(1.35-1.89), 41.19%], Smoke history[1.60(1.09-2.36),43.09%]. Other risk factors include cardiovascular, coronary artery disease, liver disease, unknow infection, diuretics use, ACEI or ARB, gram-negative bacteria and organ transplant. Conclusion: A large number of factors are associated with AKI development in sepsis patients. Our review can guide risk-reducing interventions, clinical prediction rules, and patient-specific treatment and management strategies for sepsis-induced acute kidney injury.

Outcomes After Receipt of Neuraxial or Regional Anesthesia Instead of General Anesthesia for Lower Limb Revascularization Surgery: Protocol for a Systematic Review and Meta-Analysis (Preprint)

2021 ◽  
Author(s):  
Derek Roberts ◽  
Hannah Dreksler ◽  
Sudhir K. Nagpal ◽  
Allen Li ◽  
Jeanna Parsons Leigh ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Outcomes ◽  
Hospital Stay ◽  
General Anesthesia ◽  
Regional Anesthesia ◽  
Lower Limb ◽  
Meta Analysis ◽  
Study Results ◽  
Multicenter Randomized Controlled Trial ◽  
Revascularization Surgery

BACKGROUND Patients undergoing lower limb revascularization surgery for peripheral artery disease (PAD) have a high-risk of perioperative morbidity and mortality and often have long hospital stays. Use of neuraxial or regional anesthesia instead of general anesthesia may represent one approach to improving outcomes and reducing resource use among these patients. OBJECTIVE To conduct a systematic review and meta-analysis to determine whether receipt of neuraxial or regional anesthesia instead of general anesthesia in adults undergoing lower limb revascularization surgery for PAD results in improved health outcomes and costs and a shorter length of hospitalization. METHODS We will search electronic bibliographic databases (MEDLINE, EMBASE, and the seven databases in Evidence-Based Medicine Reviews), review articles identified during the search, and included article bibliographies. We will include randomized and non-randomized studies comparing use of neuraxial or regional anesthesia instead of general anesthesia in adults undergoing lower limb revascularization surgery for PAD. Two investigators will independently evaluate risk of bias. The primary outcome will be short-term mortality (in-hospital or 30-day). Secondary outcomes will include longer-term mortality; major adverse cardiovascular, pulmonary, and renal events; delirium; deep vein thrombosis or pulmonary embolism; major adverse limb events; neuraxial or regional anesthesia-related complications; graft-related outcomes; length of operation and hospital stay; costs; and patient-reported or functional outcomes. We will calculate summary odds ratios and standardized mean differences using random-effects models. Heterogeneity will be explored using stratified meta-analyses and meta-regression. We will assess for publication bias using Begg’s and Egger’s tests and use the trim-and-fill method to estimate the potential influence of this bias on summary estimates. Finally, we will use Grading of Recommendations, Assessment, Development, and Evaluation methodology to make an overall rating of the quality of evidence in our effect estimates. RESULTS The protocol was registered in PROSPERO, the international register of systematic reviews. CONCLUSIONS This study will synthesize existing evidence regarding whether receipt of neuraxial or regional anesthesia instead of general anesthesia in adults undergoing lower limb revascularization surgery for PAD results in improved health outcomes, graft patency, and costs, and a shorter length of hospital stay. Study results will be used to inform practice and future research, including creation of a pilot and then multicenter randomized controlled trial. CLINICALTRIAL PROSPERO CRD42021237060.

Mortality at For-Profit Versus Not-For-Profit Hemodialysis Centers: A Systematic Review and Meta-analysis

2020 ◽  
pp. 002073142098068
Author(s):  
Samuel Dickman ◽  
Reza Mirza ◽  
Maryam Kandi ◽  
Michael A. Incze ◽  
Lorin Dodbiba ◽  
...  
Keyword(s):  
Systematic Review ◽  
Observational Studies ◽  
Meta Analysis ◽  
Mortality Rates ◽  
Clinical Severity ◽  
For Profit ◽  
Not For Profit ◽  
Overlapping Data ◽  
Profit Status ◽  
Dialysis Facilities

We conducted a systematic review and meta-analysis to assess differences in risk-adjusted mortality rates between for-profit (FP) and not-for-profit (NFP) hemodialysis facilities. We searched 10 databases for studies published between January 2001 to December 2019 that compared mortality at private hemodialysis facilities. We included observational studies directly comparing adjusted mortality rates between FP and NFP private hemodialysis providers in any language or country. We excluded evaluations of dialysis facilities that changed their profit status, studies with overlapping data, and studies that failed to adjust for patient age and some measure of clinical severity. Pairs of reviewers independently screened all titles and abstracts and the full text of potentially eligible studies, abstracted data, and assessed risk of bias, resolving disagreement by discussion. We included nine observational studies of hemodialysis facilities representing 1,163,144 patient-years. In pooled random-effects meta-analysis, the odds ratio of mortality in FP relative to NFP facilities was 1.07 (95% CI 1.04–1.11). Patients at FP hemodialysis facilities have 7 percent greater odds of death annually than patients with similar risk profiles at NFP facilities. Approximately 3,800 excess deaths might be averted annually if U.S. FP hemodialysis operators matched NFP mortality rates.

scholarly journals Risk factors of perioperative mortality from complicated peptic ulcer disease in Africa: systematic review and meta-analysis

2020 ◽  
Vol 7 (1) ◽  
pp. e000350
Author(s):  
Sarah Peiffer ◽  
Matthew Pelton ◽  
Laura Keeney ◽  
Eustina G Kwon ◽  
Richard Ofosu-Okromah ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Low Income ◽  
Meta Analysis ◽  
Mortality Rates ◽  
Sub Saharan Africa ◽  
Perioperative Mortality ◽  
Ulcer Disease

IntroductionIn 2013, peptic ulcer disease (PUD) caused over 300 000 deaths globally. Low-income and middle-income countries are disproportionately affected. However, there is limited information regarding risk factors of perioperative mortality rates in these countries.ObjectiveTo assess perioperative mortality rates from complicated PUD in Africa and associated risk factors.DesignWe performed a systematic review and a random-effect meta-analysis of literature describing surgical management of complicated PUD in Africa. We used subgroup analysis and meta-regression analyses to investigate sources of variations in the mortality rates and to assess the risk factors contributing to mortality.ResultsFrom 95 published reports, 10 037 patients underwent surgery for complicated PUD. The majority of the ulcers (78%) were duodenal, followed by gastric (14%). Forty-one per cent of operations were for perforation, 22% for obstruction and 9% for bleeding. The operations consisted of vagotomy (38%), primary repair (34%), resection and reconstruction (12%), and drainage procedures (6%). The overall PUD mortality rate was 6.6% (95% CI 5.4% to 8.1%). It increased to 9.7% (95% CI 7.1 to 13.0) when we limited the analysis to studies published after the year 2000. The correlation was higher between perforated PUD and mortality rates (r=0.41, p<0.0001) than for bleeding PUD and mortality rates (r=0.32, p=0.001). Non-significant differences in mortality rates existed between sub-Saharan Africa (SSA) and North Africa and within SSA.ConclusionPerioperative mortality rates from complicated PUD in Africa are substantially high and could be increasing over time, and there are possible regional differences.

Outcomes of total hip arthroplasty using dualmobility cups for femoral neck fractures: a systematic review and meta-analysis

2020 ◽  
pp. 112070002092665
Author(s):  
Syed H Mufarrih ◽  
Nada Q Qureshi ◽  
Bassam Masri ◽  
Shahryar Noordin
Keyword(s):  
Systematic Review ◽  
Total Hip Arthroplasty ◽  
Femoral Neck ◽  
Hip Arthroplasty ◽  
Meta Analysis ◽  
Mortality Rates ◽  
Femoral Neck Fractures ◽  
Cochrane Library ◽  
Total Hip ◽  
The Mean

Objectives: Femoral neck fractures (FNFs), with up to 15% mortality, are prominent orthopaedic emergencies. After treating FNFs, dislocation is another challenge increasing morbidity, mortality and treatment costs substantially. The emerging dual-mobility cup (DMC) may decrease dislocation rates following total hip arthroplasty (THA) for FNFs. We performed a systematic review of literature reporting dislocation and mortality rates with DMC-THA for the treatment of FNFs. Methods: 2 authors independently searched PubMed (MEDLINE), Google Scholar and Cochrane library for studies reporting dislocation and mortality rates for FNFs treated with DMC-THA since inception up to January 2019. Data on outcomes of interest was extracted from all studies and assessed for eligibility for a meta-analysis. Results: Out of 522 search results, 18 studies were included in the systematic review and 4 in the meta-analysis. The mean rate of dislocation following DMC-THA for FNFs was found to be 1.87% ± 2.11, with a 1-year mortality rate of 14.0% ± 10.55. Results of meta-analysis showed that dislocation and 1-year postoperative mortality rates were significantly lower for DMC-THA with a risk ratio 0.31 (95% CI, 0.16–0.59; I2 = 0%, p  = 0.0003) and 0.55 (0.40, 0.77; I2 = 0%, p = 0.003) respectively when compared to biploar hemiathroplasty (BHA). Conclusions: The mean dislocation and mortality rates in DMC-THA are lower than previously reported rates for THA with single cup and comparable to unipolar and bipolar hemiarthroplasty. Further research involving randomised control trials to assess differences in outcomes, longevity and cost-effectiveness needs to be conducted to make recommendations for the use of DMC in treating FNFs.

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