scholarly journals Indian scenario of IgA nephropathy: a systematic review and meta-analysis

2021 ◽  
Vol 21 (1) ◽  
pp. 159-65
Author(s):  
Anju Khairwa

Background: IgA nephropathy (IgAN) is most common primary glomerulopathy. There are variations in prevalence of IgAN and its clinical features in different studies from India. Aim: To summarize overall scenario of IgAN in India. Methods: In this systematic review, studies related to IgAN and related renal disease were included. Data searched were PubMed, EMBASE, Google scholar, and Cochrane Database from inception to 31st January 2019. Results: Total 49 studies (N=2480) were included: 21studies (N=2309) of primary IgAN; 19 studies (N=21) of Secondary IgAN; four studies (N=133) of IgA vasculitis nephropathy (IgAVN); and five studies (N=17) of IgA dominant nephropathy (IgADN). Prevalence of IgAN was 16.5% in India. Age of affected persons was ranging from 27.2±16.7 to 48.6±21.3 years . Male female ratio was 1.8:1. Clinical features of Primary IgAN, IgAVN, IgADN & Secondary IgAN were microscopic hematuria (49.6%, 44.4%, 15.6% & 59.5%), macroscopic hematuria (5.1%, 0.4%,40.9%,& 35.7%), Subnephrotic proteinuria (42.1%, 29.4%, 23.2%, & 52.3%), nephrotic proteinuria (16.0%, 4.4%, 76.8%,& 47.6%), and hypertension (25.8%,18.3%, 35.5%,& 47.6%).. The 24 hours proteinuria was ranging from 2.6±1.5 to 4.7±2.3 gm/day and serum creatinine (mg/dl) was ranging from 0.9±0 to 3.5±3.9 mg/dl. Histolomorphologically, all type of IgAN showed mesangial hypercellularity and Immunofluorescence revealed IgA deposition. Conclusion: The overall prevalence of primary IgAN in India was 16.5%. The subnephrotic proteinuria and microscopic hematuria were common clinical features. Keywords: IgA Nephropathy; histomorphology; prevalence; India.

2017 ◽  
pp. 50-55
Author(s):  
Duc Luu Ngo ◽  
Tu The Nguyen ◽  
Manh Hung Ho ◽  
Thanh Thai Le

Background: This study aims to survey some clinical features, indications and results of tracheotomy at Hue Central Hospital and Hue University Hospital. Patients and method: Studying on 77 patients who underwent tracheotomy at all of departments and designed as an prospective, descriptive and interventional study. Results: Male-female ratio was 4/1. Mean age was 49 years. Career: farmer 44.2%, worker 27.2%, officials 14.3%, student 7.8%, other jobs 6.5%. Respiratory condition before tracheotomy: underwent intubation 62.3%, didn’t undergo intubation 37.7%. Period of stay of endotracheal tube: 1-5 days 29.2%, 6-14 days 52.1%, >14 days 18.7%. Levels of dyspnea before tracheotomy: level I 41.4%, level II 48.3%, level III 0%, 10.3% of cases didn’t have dyspnea. Twenty cases (26%) were performed as an emergency while fifty seven (74%) as elective produces. Classic indications (37.7%) and modern indications (62.3%). On the bases of the site, we divided tracheostomy into three groups: high (0%), mid (25.3%) and low (74.7%). During follow-up, 44 complications occurred in 29 patients (37.7%). Tracheobronchitis 14.3%, tube obstruction 13%, subcutaneous empysema 10.4%, hemorrhage 5%, diffcult decannulation 5.2%, tube displacement 3.9%, canule watery past 2.6%, wound infection 1.3%. The final result after tracheotomy 3 months: there are 33 patients (42.9%) were successfully decannulated. In the 33 patients who were successfully decannulated: the duration of tracheotomy ranged from 1 day to 90 days, beautiful scar (51.5%), medium scar (36.4%), bad scar (12.1%). Conclusions: In tracheotomy male were more than female, adult were more than children. The main indication was morden indication. Tracheobronchitis and tube obstruction were more common than other complications. Key words: Tracheotomy


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Yi-jie Gao ◽  
Lei Ye ◽  
Jia-shuo Zhang ◽  
Yang-xue Yin ◽  
Min Liu ◽  
...  

Diagnostics ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 651
Author(s):  
Shih-Yi Lin ◽  
Cherry Yin-Yi Chang ◽  
Cheng-Chieh Lin ◽  
Wu-Huei Hsu ◽  
I.-Wen Liu ◽  
...  

Background: The evidence indicates that the optimal observation period following renal biopsy ranges between 6 and 8 h. This systematic review and meta-analysis explored whether differences exist in the complication rates of renal biopsies performed in outpatient and inpatient settings. Methods: We searched the MEDLINE, EMBASE, and the Cochrane Database of Systematic Reviews from 1985 to February 2020. Two reviewers independently selected studies evaluating the bleeding risk from renal biopsies performed in outpatient and inpatient settings and reviewed their full texts. The primary and secondary outcomes were risks of bleeding and major events (including mortality) following the procedure, respectively. Subgroup analysis was conducted according to the original study design (i.e., prospective or retrospective). Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using a random effect meta-analysis. Heterogeneity was assessed using the I2 test. Results: Data from all 10 eligible studies, which included a total of 1801 patients and 203 bleeding events, were included for analysis. Renal biopsies in outpatient settings were not associated with a higher bleeding risk than those in inpatient settings (OR = 0.81; 95% CI, 0.59–1.11; I2 = 0%). The risk of major events was also comparable across both groups (OR = 0.45; 95% CI, 0.16–1.29; I2 = 4%). Conclusions: Similar rates of bleeding and major events following renal biopsy in outpatient and inpatient settings were observed.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sunny Singhal ◽  
Pramod Kumar ◽  
Sumitabh Singh ◽  
Srishti Saha ◽  
Aparajit Ballav Dey

Abstract Background Few studies have focused on exploring the clinical characteristics and outcomes of COVID-19 in older patients. We conducted this systematic review and meta-analysis to have a better understanding of the clinical characteristics of older COVID-19 patients. Methods A systematic search of PubMed and Scopus was performed from December 2019 to May 3rd, 2020. Observational studies including older adults (age ≥ 60 years) with COVID-19 infection and reporting clinical characteristics or outcome were included. Primary outcome was assessing weighted pooled prevalence (WPP) of severity and outcomes. Secondary outcomes were clinical features including comorbidities and need of respiratory support. Result Forty-six studies with 13,624 older patients were included. Severe infection was seen in 51% (95% CI– 36-65%, I2–95%) patients while 22% (95% CI– 16-28%, I2–88%) were critically ill. Overall, 11% (95% CI– 5-21%, I2–98%) patients died. The common comorbidities were hypertension (48, 95% CI– 36-60% I2–92%), diabetes mellitus (22, 95% CI– 13-32%, I2–86%) and cardiovascular disease (19, 95% CI – 11-28%, I2–85%). Common symptoms were fever (83, 95% CI– 66-97%, I2–91%), cough (60, 95% CI– 50-70%, I2–71%) and dyspnoea (42, 95% CI– 19-67%, I2–94%). Overall, 84% (95% CI– 60-100%, I2–81%) required oxygen support and 21% (95% CI– 0-49%, I2–91%) required mechanical ventilation. Majority of studies had medium to high risk of bias and overall quality of evidence was low for all outcomes. Conclusion Approximately half of older patients with COVID-19 have severe infection, one in five are critically ill and one in ten die. More high-quality evidence is needed to study outcomes in this vulnerable patient population and factors affecting these outcomes.


2021 ◽  
Vol 6 (4) ◽  
pp. S163
Author(s):  
Y. Jiang ◽  
J. Zan ◽  
W. Hou ◽  
W. Zhao ◽  
X. Zhou ◽  
...  

2021 ◽  
Vol 33 ◽  
pp. 100771 ◽  
Author(s):  
Mohammad Rashidul Hashan ◽  
Nicolas Smoll ◽  
Catherine King ◽  
Hannah Ockenden-Muldoon ◽  
Jacina Walker ◽  
...  

2020 ◽  
Vol 9 (2) ◽  
pp. 590 ◽  
Author(s):  
Cristina García-Muñoz ◽  
María-Dolores Cortés-Vega ◽  
Alberto Marcos Heredia-Rizo ◽  
Rocío Martín-Valero ◽  
María-Isabel García-Bernal ◽  
...  

Postural instability and dizziness are commonly observed in people with multiple sclerosis (PwMS). The aim of this systematic review was to evaluate the evidence for the use of vestibular rehabilitation, in comparison with other exercise interventions or no intervention, to treat balance impairments and dizziness in PwMS. An electronic search was conducted by two independent reviewers in the following databases: MEDLINE (Pubmed), Scopus, the Physiotherapy Evidence Database (PEDro), Web of Science (WOS), Lilacs, CINHAL and the Cochrane Database of Systematic Reviews (CDSR). A quality assessment was performed using the PEDro scale and the Cochrane Risk of Bias Tool. When possible, the data were pooled in a meta-analysis (95%CI). This systematic review followed the PRISMA guideline statement and was registered in the PROSPERO database (CRD42019134230). Seven studies were included, with a total of 321 participants analysed. Compared with no intervention, vestibular rehabilitation was more effective for balance development (SMD = 2.12; 95% CI = 0.49, 3.75; p = 0.01; I2 = 89%) and dizziness symptoms improvement (SMD = −17.43; 95% CI = −29.99, −4.87; p= 0.007; I2= 66%). Compared with other exercise interventions, improvements in favour of the experimental group were observed, but statistical significance for the differences between groups was not reached.


2014 ◽  
Vol 27 (3) ◽  
pp. 284
Author(s):  
Daniel Caldeira ◽  
António Vaz-Carneiro ◽  
João Costa

<p>Thrombotic and embolic events contribute to the morbidity and mortality associated to Chronic Heart Failure (HF). Differently from patients with atrial fibrillation (AF) and HF, in which the benefit of anticoagulation is well documented, the use of these drugs in those with HF in sinus rhythm (without AF history) is controversial. In this systematic review from the Cochrane Collaboration, the authors evaluated the benefits and risks associated with oral anticoagulation (versus placebo) in this population. Only 2 randomized controlled trials were published (one with open-label design) enrolling a total of 324 patients. The results of the meta-analysis based on the best available evidence do not support the systematic use of oral anticoagulants in patients with HF and sinus rhythm for preventing death (overall or cardiovascular) or non-fatal cardiovascular events. Furthermore the major bleeding risk was significantly increased.<br /><strong>Keywords:</strong> Anticoagulation; Heart Failure; Sinus Rhythm; Systematic Review.</p>


2020 ◽  
Vol 25 ◽  
pp. 100446 ◽  
Author(s):  
Asma Khalil ◽  
Erkan Kalafat ◽  
Can Benlioglu ◽  
Pat O'Brien ◽  
Edward Morris ◽  
...  

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