BCG vaccination impact on mortality and recovery rates in COVID-19: A meta-analysis

COVID-19 is a pandemic caused by SARS-CoV-2 virus which is a very worrisome public health emergency. In this study, we compared the mortality rate and recovery rate in countries with and without BCG vaccination policy. The data of mortality of COVID-19 was extracted from worldometer (https://www.worldometers.info/coronavirus/) on 26th July 2020. The data of countries where BCG vaccination is being done for all individuals is taken from BCG world atlas (http://www.bcgatlas.org/index.php), updated in 2017. BCG vaccination policy recommended countries are intervention group versus countries without BCG vaccination policies which are regarded as control group. Pooled analysis of countries with and without BCG vaccination policy revealed mortality rate of 1.31% (95%CI – 1.31% to 1.32%; I2 = 100%, p<0.01) and 3.25% (95%CI – 3.23% to 3.26%; I2 = 100%, p<0.01), respectively. The recovery rate in two country groups were found to be 72.60% (95%CI – 72.57% to 72.63%) and 55.94% (95%CI – 55.90% to 55.98%), respectively. 52 individuals need to be BCG vaccinated to prevent one death (NNT = 52). In BCG vaccination program countries, there is statistically and clinically significant less mortality (p-value <0.001) as compared to countries without BCG policy. Our findings corroborate the hypothesis that BCG vaccination may provide protection from COVID-19. High quality evidence from randomised controlled trials are required to establish causality between BCG vaccination and protection from severe COVID-19.

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Mobile Health to Improve Adherence and Patient Experience in Heart Transplantation Recipients: The mHeart Trial

Healthcare ◽

10.3390/healthcare9040463 ◽

2021 ◽

Vol 9 (4) ◽

pp. 463

Author(s):

Mar Gomis-Pastor ◽

Sonia Mirabet Perez ◽

Eulalia Roig Minguell ◽

Vicenç Brossa Loidi ◽

Laura Lopez Lopez ◽

...

Keyword(s):

Heart Transplantation ◽

Patient Experience ◽

Mobile Application ◽

Standard Care ◽

Controlled Trial ◽

Intervention Group ◽

Group Versus ◽

Control Group ◽

P Value ◽

Adherence Score

Non-adherence after heart transplantation (HTx) is a significant problem. The main objective of this study was to evaluate if a mHealth strategy is more effective than standard care in improving adherence and patients’ experience in heart transplant recipients. Methods: This was a single-center, randomized controlled trial (RCT) in adult recipients >1.5 years post-HTx. Participants were randomized to standard care (control group) or to the mHeart Strategy (intervention group). For patients randomized to the mHeart strategy, multifaceted theory-based interventions were provided during the study period to optimize therapy management using the mHeart mobile application. Patient experience regarding their medication regimens were evaluated in a face-to-face interview. Medication adherence was assessed by performing self-reported questionnaires. A composite adherence score that included the SMAQ questionnaire, the coefficient of variation of drug levels and missing visits was also reported. Results: A total of 134 HTx recipients were randomized (intervention N = 71; control N = 63). Mean follow-up was 1.6 (SD 0.6) years. Improvement in adherence from baseline was significantly higher in the intervention group versus the control group according to the SMAQ questionnaire (85% vs. 46%, OR = 6.7 (2.9; 15.8), p-value < 0.001) and the composite score (51% vs. 23%, OR = 0.3 (0.1; 0.6), p-value = 0.001). Patients’ experiences with their drug therapy including knowledge of their medication timing intakes (p-value = 0.019) and the drug indications or uses that they remembered (p-value = 0.003) significantly improved in the intervention versus the control group. Conclusions: In our study, the mHealth-based strategy significantly improved adherence and patient beliefs regarding their medication regimens among the HTx population. The mHeart mobile application was used as a feasible tool for providing long-term, tailor-made interventions to HTx recipients to improve the goals assessed.

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Radiotherapy with radical cystectomy for bladder cancer: A systematic review and meta-analysis

Canadian Urological Association Journal ◽

10.5489/cuaj.5244 ◽

2018 ◽

Vol 12 (10) ◽

Cited By ~ 2

Author(s):

Kristen McAlpine ◽

Dean A. Fergusson ◽

Rodney H. Breau ◽

Luke F. Reynolds ◽

Risa Shorr ◽

...

Keyword(s):

Overall Survival ◽

Bladder Cancer ◽

Radical Cystectomy ◽

Meta Analysis ◽

Intervention Group ◽

Pooled Analysis ◽

Secondary Outcome ◽

Control Group ◽

Neoadjuvant Radiotherapy ◽

Treatment Techniques

Introduction: Muscle-invasive bladder cancer (MIBC) is associated with high recurrence and mortality rates. The role of radiotherapy as an adjunct to radical cystectomy is not well-defined. We sought to evaluate the efficacy and safety of radiotherapy preoperatively or postoperatively for patients with MIBC receiving cystectomy compared to cystectomy alone. The primary outcome was overall survival. The secondary outcome was adverse effects.Methods: MEDLINE, EMBASE, and CENTRAL were searched on August 30, 2016 for randomized controlled trials (RCTs) of patients undergoing cystectomy for bladder cancer. A control group receiving cystectomy alone and an intervention group with radiotherapy and cystectomy were required. The Jadad score was used to assess for bias. Fifteen studies representing 10 RCTs met eligibility criteria.Results: A total of 996 patients were randomized in seven trials included in a meta-analysis of neoadjuvant radiotherapy. Insufficient data were available to complete a pooled analysis for adjuvant radiotherapy. There was a non-statistically significant improvement in overall survival for patients who received neoadjuvant radiotherapy and cystectomy. At three years and five years, the odds ratios were 1.23 (95% confidence interval [CI] 0.72–2.09) and 1.26 (95% CI 0.76–2.09), respectively, in favour of neoadjuvant radiotherapy. Subgroup analyses including higher doses of radiotherapy showed greater effect on survival.Conclusions: These data suggest that radiotherapy prior to cystectomy may improve overall survival. This review was limited by old studies, heterogeneous patient populations, and radiotherapy treatment techniques that may not meet current standards. There is a need for current RCTs to further evaluate this effect.

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Effects of music therapy on anxiety and physiologic parameters in angiography: a systematic review and meta-analysis

Journal of NeuroInterventional Surgery ◽

10.1136/neurintsurg-2018-014313 ◽

2018 ◽

Vol 11 (4) ◽

pp. 416-423 ◽

Cited By ~ 1

Author(s):

Adam C Lieber ◽

Javin Bose ◽

Xiangnan Zhang ◽

Hayley Seltzberg ◽

Joanne Loewy ◽

...

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Music Therapy ◽

Case Reports ◽

Meta Analysis ◽

Intervention Group ◽

Group Versus ◽

Control Group ◽

Peripheral Angiography ◽

Anxiety Levels

BackgroundGiven the anxiety patients experience during angiography, evidence supporting the efficacy of music therapy during these angiographic procedures is potentially of clinical value.ObjectiveTo analyze the existing literature forthe use of music therapy during cerebral, coronary, and peripheral angiography to determine whether it improves patient anxiety levels, heart rate, and blood pressure during the procedure.MethodsPubMed, Embase, and Scopus were searched to identify studies of interest. Inclusion criteria included studies reporting using music therapy in either cerebral, coronary, or peripheral angiography. Studies focused on a pediatric population; animal studies and case reports were excluded. Participant demographics, interventions, and outcomes were collected by two study authors. Bias and study quality of randomized controlled trials (RCTs) were assessed using the Cochrane Risk of Bias Tool. Separate meta-analyses of the RCTs were performed to compare State Trait Anxiety Inventory (STAI), heart rate (HR), and systolic and diastolic blood pressure (SBP and DBP) in the music intervention group versus control group. Heterogeneity was determined by calculating I2 values, and a random-effects model was used when heterogeneity exceeded 50%.ResultsThe preprocedure to postprocedure improvement in STAI was significantly greater in the experimental group than the control group (p=0.004), while the decrease in HR, SBP, and DBP was not significant.ConclusionsRecorded music and/or music therapy in angiography significantly decreases patients’ anxiety levels, while it has little to no effect on HR and BP. This meta-analysis is limited by the relatively few RCTs published on this subject.PROSPERO registration numberCRD42018099103

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Efficacy of Physical Therapy Interventions on Quality of Life and Upper Quadrant Pain Severity in Women With Post-Mastectomy Pain Syndrome: A Systematic Review and Meta-Analysis

10.21203/rs.3.rs-354359/v1 ◽

2021 ◽

Author(s):

Priya Kannan ◽

Lam Hiu Ying ◽

Ma Tsz Kiu ◽

Lo Chiu Ngai ◽

Mui Ting Yan ◽

...

Keyword(s):

Physical Therapy ◽

Meta Analysis ◽

Intervention Group ◽

Pain Syndrome ◽

Compression Therapy ◽

Pooled Analysis ◽

Pain Severity ◽

Control Group ◽

Myofascial Release ◽

Therapy Interventions

Abstract Purpose: To determine the efficacy of physical therapy interventions on quality of life (QoL) and pain severity in women with post-mastectomy pain syndrome (PMPS).Methods: Multiple databases were searched from database inception-October 2020. Randomized controlled trials comparing physical therapy interventions to control were included. Results: Eighteen trials were included in the review. The pooled analysis of the four exercise trials revealed a statistically significant effect of the intervention on general (p=0.001), physical (p=0.044) and mental health components (p=0.027) of QoL, when compared to the control condition. Pooled analysis of data from six exercise trials revealed a significant effect of exercise interventions compared to control on pain severity (p<0.001). Meta-analysis of data from two myofascial release trials showed a significantly greater reduction in pain severity in the intervention group compared to the control group (p=0.04). The pooled analysis of data from two acupuncture trials revealed a significant reduction in pain severity in the intervention group compared to the control group (p=0.003). Pooled analysis of data from two trials revealed a non-significant effect of compression therapy compared to control on pain severity (p>0.05) Conclusion: This review found that exercise is beneficial for improving QoL and alleviating upper quadrant pain severity in women with PMPS. Myofascial release and acupuncture were more effective than the control condition in reducing the pain severity in PMPS. The effect of compression therapy, complex decongestive therapy and neuromuscular taping on PMPS remains inconclusive, and future research is required to validate the effect of these interventions on PMPS.

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SUPPORTIVE EDUCATIVE SYSTEM DALAM MENINGKATKAN KEMANDIRIAN MERAWAT KAKI PADA PASIEN DIABETES MELLITUS TIPE II

Jurnal Ilmiah Permas: Jurnal Ilmiah STIKES Kendal ◽

10.32583/pskm.9.2.2019.63-72 ◽

2019 ◽

Vol 9 (2) ◽

pp. 63-72

Author(s):

Nova Nurwinda Sari ◽

Herlina Herlina

Keyword(s):

Diabetes Mellitus ◽

Health Center ◽

Intervention Group ◽

T Test ◽

Control Group ◽

P Value ◽

Type Ii ◽

Foot Care ◽

Control Group Design ◽

Patients With Diabetes

Diabetes mellitus dapat menyebabkan cukup banyak komplikasi seperti kelainan mata, kelainan ginjal, kelainan pembuluh darah dan kelainan pada kaki. Penderita diabetes mellitus yang mengalami komplikasi kronis perlu diberikan upaya preventif untuk mencegah komplikasi, salah satunya adalah kemampuan perawatan kaki. Penelitian ini dilakukan untuk menguji efektivitas supportive educative system dalam meningkatkan kemandirian perawatan kaki pada pasien dengan diabetes mellitus Tipe II di Puskesmas Permata Sukarame, Bandar Lampung. Penelitian ini menggunakan metode quasy eksperimen dengan desain pretest-posttest with control group dengan total masing-masing kelompok sebanyak 18 responden. Pengumpulan data dilakukan dengan menyebarkan kuesioner kepada responden yang memenuhi kriteria inklusi penelitian. Penelitian ini diuji menggunakan analisis univariat, bivariat dan uji T-test. Hasil penelitian menunjukkan bahwa terdapat perbedaan rata-rata dalam kemandirian perawatan kaki pada kelompok intervensi dan kelompok kontrol dengan p-value 0,000. Pendidikan dan praktik perawatan kaki harus diberikan sejak dini sebagai upaya pencegahan untuk komplikasi. Kata kunci : Supportive educative system, kemandirian perawatan kaki SUPPORTIVE EDUCATIVE SYSTEM IN IMPROVING INDEPENDENCE OF FOOT CARE IN PATIENTS WITH DIABETES MELLITUS TYPE II ABSTRACT Diabetes mellitus can cause quite a lot of complications such as eye disorders, kidney disorders, vascular disorders and abnormalities in the legs. Patients with diabetes mellitus who have chronic complications need to be given a preventive effort to prevent complications, one of which is foot care ability. This research was conducted to examine the effectiveness of supportive educative systems in increasing the independence of foot care in patients with Type II diabetes mellitus in the Permata Sukarame Health Center Bandar Lampung Working Area. This study used a quasi-experimental method with pretest-posttest with control group design with a total of 18 respondents each. Data collection is done by distributing questionnaires to respondents who meet the research inclusion criteria. This study was tested using univariate, bivariate, T-Test analysis. The results showed that the mean differences in the independence of foot care in the intervention group and the control group in the Permata Sukarame Community Health Center work area with a p-value of 0,000. Education and practice of foot care should be given early as a preventative effort for complications. Keywords: Supportive educative system, independence of foot care

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The Effectiveness of Using a Mobile Messenger as an Educational Supporting Tool among Nursing Students

Asian Journal of Medicine and Biomedicine ◽

10.37231/ajmb.2020.4.1.333 ◽

2020 ◽

Vol 4 (1) ◽

pp. 67-77

Author(s):

Rohimah Ismail ◽

Chong Mei Chan ◽

Wan Muhammad Azly W. Zulkafli ◽

Hasnah Zani ◽

Zainab Mohd Shafie

Keyword(s):

Nursing Education ◽

Nursing Students ◽

Clinical Decision Making ◽

Intervention Group ◽

Great Influence ◽

Control Group ◽

P Value ◽

Significant Difference ◽

Supporting Tool ◽

Nursing College

The evolution of information technology has exerted great influence on nursing education via new pedagogy of knowledge delivery without time and place restriction. Mobile technology revolutionises nursing education and clinical practice via empowering skills of critical thinking and clinical decision-making through learning. The aim of this study is to evaluate the effectiveness of using mobile messenger (Whatsapp) as an educational supporting tool among nursing students. The study design used is a Cluster Randomized Control Trail. Two nursing colleges were selected. Sample size was 93 participants, 48 from the Kuala Terengganu Nursing College Kuala Terengganu as the intervention group while the control group were recruited among 45 participants from UniSZA Nursing College. There is a significant difference in the level of knowledge between pre and posttest among intervention group (mean difference was -8.70 with a standard deviation 8.42, p-value< 0.001) and 93.8 percent of the respondents perceived the usefulness of using WhatsApp mobile messenger to enhance learning. This demonstrates that learning through mobile messenger (WhatsApp) enhances learning and is well received as a new method of learning by almost all students. Keywords: Mobile learning, WhatsApp messenger, Social Interaction

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Relaksasi Benson Untuk Durasi Tidur Pasien Penyakit Jantung Koroner

Jurnal Endurance ◽

10.22216/jen.v3i3.2788 ◽

2018 ◽

Vol 3 (3) ◽

pp. 556

Author(s):

Mulyanti Roberto Muliantino ◽

Tuti Herawati ◽

Masfuri Masfuri

Keyword(s):

Cardiac Rehabilitation ◽

Sleep Duration ◽

Intervention Group ◽

Self Report ◽

Pharmacological Intervention ◽

Control Group ◽

P Value ◽

Short Sleep Duration ◽

Short Sleep ◽

Coronary Arterial Disease

Coronary Arterial Disease (CAD) is one of cardiovaskular disease that remain leading cause death and disability. Short sleep duration is the major symptoms in patients with CAD, during recovery period after cardiac events and during cardiac rehabilitation. Benson’s relaxation is one of relaxation as modalities therapy to increase sleep duration, however few studies related to this technique in planned intervention. This study was to measured the effectiveness of Benson’s relaxation in short sleep duration of CAD patients during cardiac rehabilitation. It was a quasi experimental pretest posttest control group design. This study included 29 respondens in Dr.M.Djamil Hospital were assigned to intervention group which receiving Benson’s relaxation technique (n=15) and control group with routine care (n=14). Benson’s relaxation technique was administered for 5 days 2 times a day, each 20 minutes to intervention group. Short sleep duration was measured using sleep diary (self report). The result indicated significant increasing in mean of sleep duration before and after Benson’s relaxation in intervention group (p value < 0,001). The study concluded that Benson’s relaxation technique is an effective non-pharmacological intervention to increase sleep duration in CAD patients. Penyakit jantung koroner menjadi masalah kardiovaskular yang mengakibatkan angka mortalitas yang tinggi. Durasi tidur pendek termasuk salah satu keluhan utama pasien penyakit jantung koroner pada masa recovery setelah serangan dan menjalani rehabilitasi fase 2. Relaksasi Benson merupakan teknik relaksasi sebagai terapi modalitas untuk mengurangi keluhan durasi tidur pendek, namum belum banyak penelitian terkait intervensi ini. Penelitian ini bertujuan untuk mengidentifikasi pengaruh relaksasi Benson terhadap durasi tidur pasien penyakit jantung koroner yang menjalani rehabilitasi fase 2. Penelitian ini menggunakan desain Quasi Eksperimen dengan pendekatan control group pretest posttest design pada 29 responden di RSUP. Dr.M.Djamil Padang yang dibagi dalam dua kelompok (kelompok intervensi dan kelompok kontrol). Hasil penelitian menunjukan ada perbedaan rerata durasi tidur yang signifikan antara sebelum dan setelah dilakukan intervensi relaksasi Benson pada kelompok intervensi (p value < 0,001). Simpulan hasil penelitian ini dapat menjadi salah satu terapi modalitas bagi perawat untuk mengatasi masalah durasi tidur pendek pada pasien penyakit jantung koroner.

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The Effect of Javanese Language Videos with a Community Based Interactive Approach Method as an Educational Instrument for Knowledge, Perception, and Adherence amongst Tuberculosis Patients

Pharmacy ◽

10.3390/pharmacy9020086 ◽

2021 ◽

Vol 9 (2) ◽

pp. 86

Author(s):

Fauna Herawati ◽

Yuni Megawati ◽

Aslichah ◽

Retnosari Andrajati ◽

Rika Yulia

Keyword(s):

Intervention Group ◽

Personal Control ◽

Control Group ◽

P Value ◽

Interactive Approach ◽

Community Based ◽

Tuberculosis Patients ◽

Level Of Knowledge ◽

The Impact

The long period of tuberculosis treatment causes patients to have a high risk of forgetting or stopping the medication altogether, which increases the risk of oral anti-tuberculosis drug resistance. The patient’s knowledge and perception of the disease affect the patient’s adherence to treatment. This research objective was to determine the impact of educational videos in the local language on the level of knowledge, perception, and adherence of tuberculosis patients in the Regional General Hospital (RSUD) Bangil. This quasi-experimental study design with a one-month follow-up allocated 62 respondents in the intervention group and 60 in the control group. The pre- and post-experiment levels of knowledge and perception were measured with a validated set of questions. Adherence was measured by pill counts. The results showed that the intervention increases the level of knowledge of the intervention group higher than that of the control group (p-value < 0.05) and remained high after one month of follow-up. The perceptions domains that changed after education using Javanese (Ngoko) language videos with the Community Based Interactive Approach (CBIA) method were the timeline, personal control, illness coherence, and emotional representations (p-value < 0.05). More than 95% of respondents in the intervention group take 95% of their pill compared to 58% of respondents in the control group (p-value < 0.05). Utilization of the local languages for design a community-based interactive approach to educate and communicate is important and effective.

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

Postgraduate Medical Journal ◽

10.1136/postgradmedj-2021-140287 ◽

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.

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School-based obesity interventions in the metropolitan area of Rio De Janeiro, Brazil: pooled analysis from five randomised studies

British Journal Of Nutrition ◽

10.1017/s0007114521000076 ◽

2021 ◽

pp. 1-7

Author(s):

Renata da R. M. Rodrigues ◽

Bruna K. Hassan ◽

Michele R. Sgambato ◽

Bárbara da S. N. Souza ◽

Diana B. Cunha ◽

...

Keyword(s):

Eating Habits ◽

Intervention Group ◽

Pooled Analysis ◽

Control Group ◽

Intention To Treat ◽

School Year ◽

School Based ◽

Obesity Interventions ◽

The One ◽

And Control

Abstract School-based studies, despite the large number of studies conducted, have reported inconclusive results on obesity prevention. The sample size is a major constraint in such studies by requiring large samples. This pooled analysis overcomes this problem by analysing 5926 students (mean age 11·5 years) from five randomised school-based interventions. These studies focused on encouraging students to change their drinking and eating habits, and physical activities over the one school year, with monthly 1-h sessions in the classroom; culinary class aimed at developing cooking skills to increase healthy eating and attempts to family engagement. Pooled intention-to-treat analysis using linear mixed models accounted for school clusters. Control and intervention groups were balanced at baseline. The overall result was a non-significant change in BMI after one school year of positive changes in behaviours associated with obesity. Estimated mean BMI changed from 19·02 to 19·22 kg/m2 in the control group and from 19·08 to 19·32 kg/m2 in the intervention group (P value of change over time = 0·09). Subgroup analyses among those overweight or with obesity at baseline also did not show differences between intervention and control groups. The percentage of fat measured by bioimpedance indicated a small reduction in the control compared with intervention (P = 0·05). This large pooled analysis showed no effect on obesity measures, although promising results were observed about modifying behaviours associated with obesity.

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