scholarly journals The Role of L-ornithine-L-aspartate in the Management of Minimal Hepatic Encephalopathy among Patients with Liver cirrhosis: a Systemic review and Meta-analysis

2018 ◽  
Vol 52 (1) ◽  
Author(s):  
Henry Winston C. Li ◽  
Maria Ana Louise M. Naidas ◽  
Karen Anjela M. Mondragon ◽  
Ruter M. Maralit
Keyword(s):  
Liver Cirrhosis ◽  
Hepatic Encephalopathy ◽  
Meta Analysis ◽  
Block Design ◽  
Cochrane Collaboration ◽  
Minimal Hepatic Encephalopathy ◽  
Systemic Review ◽  
Cochrane Library ◽  
P Value ◽  
Picture Completion

Objective. To evaluate the efficacy of L-ornithine-L-aspartate (LOLA) in improving minimal hepatic encephalopathy in adult patients with liver cirrhosis. Methods. A search in PubMed, Cochrane Library, Google Scholar, and Medline was made obtaining four qualified randomized controlled trials. Studies included adult cirrhotic patients with minimal hepatic encephalopathy measured by the number connection test (NCT-A, B), figure connection test (FCT-A, B), picture completion, block design test, and critical flicker frequency (CFF) testing with a cut-off score of <39Hz. Methodologic assessment of studies was performed using Cochrane Collaboration Risk of Bias Tool and Review Manager (RevMan) version 5.3 for statistical analysis. Results. Of the 29 studies identified, 4 fulfilled the inclusion criteria, which entailed analysis of 238 participants (LOLA: 116, Control: 122). Three out of the four studies were used in meta-analysis and one study was analyzed separately due to a difference in the neuropsychometric measure. The metaanalysis favored experimental group (LOLA), with a mean difference of 2.29 (95% CI 0.72 – 3.86), p-value = 0.004, and an I2 of 18%. Conclusion. LOLA provided great potential in managing encephalopathy since treating earlier related to better survival and prevention of disease progression. The results of our study supported such evidence and its use may be encouraged.

scholarly journals Depression and Objectively Measured Physical Activity: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 17 (10) ◽  
pp. 3738 ◽  
Author(s):  
Vincenza Gianfredi ◽  
Lorenzo Blandi ◽  
Stefano Cacitti ◽  
Mirko Minelli ◽  
Carlo Signorelli ◽  
...  
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Meta Analysis ◽  
Cochrane Collaboration ◽  
Protective Role ◽  
Cochrane Library ◽  
P Value ◽  
Meta Analyses ◽  
The Cochrane Collaboration ◽  
Objectively Measured

Depression is a major contributor to the overall global burden of disease, with high prevalence and relapse rate. Several factors have been considered in order to reduce the depression burden. Among them, physical activity (PA) showed a potential protective role. However, evidence is contrasting probably because of the differences in PA measurement. The aim of this systematic review with meta-analysis is to assess the association between objectively measured PA and incident and prevalent depression. The systematic review was conducted according to methods recommended by the Cochrane Collaboration and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Relevant papers published through 31 August 2019 were identified searching through the electronic databases PubMed/MEDLINE, Excerpta Medica dataBASE (Embase), PsycINFO, Scopus, Web of Science (WoS), and the Cochrane Library. All analyses were conducted using ProMeta3. Finally, 42 studies met inclusion criteria. The overall Effect size (ES) of depression for the highest vs. the lowest level of PA was −1.16 [(95% CI = −1.41; −0.91), p-value < 0.001] based on 37,408 participants. The results of the meta-analysis showed a potential protective effect of PA on prevalent and incident depression.

scholarly journals Polyethylene glycol versus lactulose in the treatment of hepatic encephalopathy: a systematic review and meta-analysis

2021 ◽  
Vol 8 (1) ◽  
pp. e000648
Author(s):  
Gilles Jadd Hoilat ◽  
Mohamad Fekredeen Ayas ◽  
Judie Noemie Hoilat ◽  
Ahmed Abu-Zaid ◽  
Ceren Durer ◽  
...  
Keyword(s):  
Polyethylene Glycol ◽  
Hepatic Encephalopathy ◽  
Web Of Science ◽  
Meta Analysis ◽  
Standard Of Care ◽  
Brain Dysfunction ◽  
Cochrane Library ◽  
Continuous Data ◽  
Inverse Variance ◽  
Scoring Algorithm

BackgroundHepatic encephalopathy (HE) is defined as brain dysfunction that occurs because of acute liver failure or liver cirrhosis and is associated with significant morbidity and mortality. Lactulose is the standard of care till this date; however, polyethylene glycol (PEG) has gained the attention of multiple investigators.MethodsWe screened five databases namely PubMed, Scopus, Web of Science, Cochrane Library and Embase from inception to 10 February 2021. Dichotomous and continuous data were analysed using the Mantel-Haenszel and inverse variance methods, respectively, which yielded a meta-analysis comparing PEG versus lactulose in the treatment of HE.ResultsFour trials with 229 patients were included. Compared with lactulose, the pooled effect size demonstrated a significantly lower average HE Scoring Algorithm (HESA) Score at 24 hours (Mean difference (MD)=−0.68, 95% CI (−1.05 to –0.31), p<0.001), a higher proportion of patients with reduction of HESA Score by ≥1 grade at 24 hours (risk ratio (RR)=1.40, 95% CI (1.17 to 1.67), p<0.001), a higher proportion of patients with a HESA Score of grade 0 at 24 hours (RR=4.33, 95% CI (2.27 to 8.28), p<0.0010) and a shorter time to resolution of HE group (MD=−1.45, 95% CI (−1.72 to –1.18), p<0.001) in favour of patients treated with PEG.ConclusionPEG leads to a higher drop in the HESA Score and thus leads to a faster resolution of HE compared with lactulose.

Abstract P391: Marine N-3 Fatty Acids Reduce Atherosclerosis Cardiovascular Disease: A Systemic Review and Meta-analysis of Clinical Trials

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Akira Sekikawa ◽  
Nobutake Hirooka ◽  
Abhishek Vishnu ◽  
Vashudha Ahuja ◽  
Emmanuel Sampene ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Fatty Acids ◽  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
Imaging Techniques ◽  
Meta Analysis ◽  
Quantitative Information ◽  
Systemic Review ◽  
Cochrane Library ◽  
Cardiac Imaging Techniques

Introduction: Although marine n-3 fatty acids are believed to be cardioprotective through their anti-arrhythmic, anti-thrombotic, anti-atherogenic and other effects, results from recent meta-analyses of marine n-3 fatty acids on cardiovascular disease (CVD) are controversial. We performed a meta-analysis of marine n-3 fatty acids on CVD outcomes in randomized clinical trials (RCTs) to test the hypothesis that marine n-3 fatty acids are anti-atherogenic. We also tested the hypothesis that such benefit is dose-dependent. Methods: A systematic review of English language articles using PubMed, EMBASE and Cochrane Library through Aug 2012 was performed selecting RCTs evaluating the effect of marine n-3 fatty acids intake for 2 years or more on cardiovascular diseases, coronary disease, arteriosclerosis, cardiac imaging techniques, and carotid artery ultrasound. Descriptive and quantitative information was extracted. Odds ratios were calculated for cardiac event outcome. Correlation coefficients were obtained from studies of which outcome is intima-media thickness (IMT) and coronary lumen diameter (CD). We converted the estimates into a single effect size; the log odds ratio and its corresponding standard error. Results: Of 14,236 citations retrieved, 13 studies were selected, including studies reporting IMT (n=3) and CD (n=2) and major CVD events (n=8). Overall, marine n-3 fatty acids significantly reduced atherosclerotic CVD (RR 0.94: 95%CI 0.90 to 0.99, p<0.05). There was no evidence of heterogeneity (p=0.65) or publication bias (p=0.37, Begg’s test). A sub-analysis among 8 studies of major CVD events showed the similar results (RR 0.94: 95% CI 0.89 to 0.99, p<0.05). Another sub-analysis among 4 studies excluding sudden cardiac death as an outcome showed RR of 0.91 (95% CI 0.82 to 1.02, p=0.097). A meta-regression analysis shows that dose of marine n-3 fatty acids was inversely associated with CVD outcome, although the association was not statistically significant (p=0.06). Conclusions: The result of our meta-analysis supports a modest anti-atherogenic effect of marine n-3 fatty acids. This benefit may be proportional to the amount of marine n-3 fatty acids consumed.

Sarcopenia predicts minimal hepatic encephalopathy in patients with liver cirrhosis

2017 ◽  
Vol 47 (13) ◽  
pp. 1359-1367 ◽  
Author(s):  
Tatsunori Hanai ◽  
Makoto Shiraki ◽  
Satoshi Watanabe ◽  
Takahiro Kochi ◽  
Kenji Imai ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Hepatic Encephalopathy ◽  
Minimal Hepatic Encephalopathy

scholarly journals Prevalence of pneumonia and its associated factors among under five children in East Africa. Meta-analysis and systemic review

2020 ◽  
Author(s):  
Biruk Beletew Abate ◽  
Melaku Getahun Bimrew ◽  
Ayelign Mengesha Kasie ◽  
Mesfin Kassaw Wudu ◽  
Molla Azmeraw
Keyword(s):  
East Africa ◽  
Associated Factors ◽  
Meta Analysis ◽  
Eastern Africa ◽  
Systemic Review ◽  
Cochrane Library ◽  
Under Five ◽  
Under Five Children ◽  
The Impact ◽  
National Prevalence

Abstract Introduction Pneumonia is defined as an acute inflammation of the Lungs’ parenchymal structure. It is a major public health problem and the leading cause of morbidity and mortality in under-five children especially in developing countries. In 2015, it was estimated that about 102 million cases of pneumonia occurred in under-five children, of which 0.7 million were end up with death. Different primary studies in Eastern Africa showed the burden of pneumonia. However, inconsistency among those studies was seen and no review has been conducted to report the amalgamated magnitude and associated factors. Therefore, this review aimed to estimate the national prevalence and associated factors of neonatal sepsis in Eastern Africa. Objective The aim of this systematic review and meta-analysis was to assess the magnitude of pneumonia and its associated factors among under-five children in East Africa. Methods Using PRISMA guideline, we systematically reviewed and meta-analyzed studies that examined the prevalence and associated factors of pneumonia from PubMed, Cochrane library, and Google Scholar. Heterogeneity across the studies was evaluated using the Q and the I 2 test. A weighted inverse variance random-effects model was applied to estimate the national prevalence and the effect size of associated factors. The subgroup analysis was conducted by country, study design, and year of publication. A funnel plot and Egger’s regression test were used to see publication bias. Sensitivity analysis was also done to identify the impact of studies. Result A total of 34 studies with 87, 984 participants were used for analysis. The pooled prevalence of hypothermia in East Africa was 34% (95%CI; 23.80–44.21). Use of wood as fuel source (AOR= 1.53; 95%CI:1.30-1.77; I 2 = 0.0% ;P=0.465), cook food in living room (AOR= 1.47;95%CI:1.16-1.79; I 2 = 0.0% ;P=0.58), caring of a child on mother during cooking (AOR= 3.26; 95%CI:1.80-4.72; I 2 = 22.5% ;P=0.26), Being unvaccinated (AOR= 2.41; 95%CI:2.00-2.81; I 2 = 51.4% ;P=0.055), Child history of ARTI(AOR= 2.62; 95%CI:1.68-3.56; I 2 = 11.7% ;P=0.337) were identified factors of pneumonia. Conclusions The prevalence of pneumonia in Eastern Africa remains high. This review will help policy-makers and program officers to design pneumonia preventive interventions.

scholarly journals The safety and efficacy of SDLT-2 (Sodium-glucose co-transporter 2) inhibitor versus placebo in the treatment of heart failure in patients with or without T2DM (Type 2 diabetes mellitus): A Systemic Review and Meta-analysis.

2020 ◽  
Author(s):  
Qian Zhang ◽  
Xiaofei Wang ◽  
Peipei Ge ◽  
Aizhen Hu ◽  
Xuexun Li
Keyword(s):  
Diabetes Mellitus ◽  
Heart Failure ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Sglt2 Inhibitor ◽  
Systemic Review ◽  
Cochrane Library ◽  
Volume Depletion ◽  
Patients With Heart Failure ◽  
Safety Outcomes

Abstract Background Sodium-glucose co-transporter 2 (SGLT2) inhibitor which is a type of drug used for the treatment of diabetes mellitus, has been reported by many trials that it could be beneficial for patients with established heart failure. A meta-analysis on this subject could obtain more reliable estimates of the efficacy and safety outcomes. Methods A systematic review and meta-analysis of randomized, placebo-controlled trials of SGLT2 inhibitor in patients with heart failure was conducted. We searched PubMed, Cochrane Library, and Web of Science for trials published from inception to March, 2018. PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) was used to conduct the review. For quality assessment of included studies. The methodological quality of the included trials was assessed using the Cochrane tool for assessing randomized clinical trials (RCT). Efficacy outcomes included hospitalization for heart failure and all-cause death. Safety outcomes consisted of serious adverse event (SAE) and volume depletion. Results We included data from 5 identified studies and 8775 patients (aged 64.9, female 29.8%). A total of 3930 (44.8%) patients were known to have diabetes mellitus. Compared with placebo, SGLT2 inhibitor decrease the incidence of hospitalization for heart failure (RR 0.692; 95%CI, 0.611-0.784 P<0.001), and all-cause death (RR 0.824; 95%CI, 0.736-0.922 P=0.001). The incidence of SAE in patients with a treatment of SGLT2 inhibitor was low (RR 0.869; 95%CI, 0.779-0.970 P=0.012). SGLT2 inhibitor didn’t increase the incidence of volume depletion (RR1.165, 95%CI, 0.977-1.390 P=0.089). Conclusion Our results confirm that SGLT2 inhibitor is effective and safe for patients with heart failure regardless of presence of diabetes mellitus.

scholarly journals Poor glycemic control and associated factors among diabetic patients in Ethiopia; A Systemic review and meta-analysis

2019 ◽  
Author(s):  
Berhane Fseha Teklehaimanot ◽  
Abadi kidanemariam Berhe ◽  
Gebrehiwot Gebremariam Welearegawi
Keyword(s):  
Glycemic Control ◽  
Low Income ◽  
Associated Factors ◽  
Meta Analysis ◽  
Group Analysis ◽  
Poor Glycemic Control ◽  
Systemic Review ◽  
Cochrane Library ◽  
Diabetic Patients ◽  
Optimum Level

AbstractIntroductionThe major global public health problems now days are diabetes especially the burden is high in low income countries including Ethiopia due to the limited resource for screening and early diagnosis of the diabetes. To prevent diabetic complications including organ damage and micro vascular complications blood glucose level should be maintained at an optimum level. However there was no pooled national picture on poor glycemic control and its associated factors.MethodsDifferent data base searching engine including PubMed, Google scholar, the Cochrane library, MEDLINE,, HINARY and African journal online (AJOL) were used. The Joanna Briggs Critical Appraisal Tools and Newcastle Ottawa scale for assessing the quality of cross sectional studies were used for quality assessment. The meta-analysis was conducted using STATA 14 software. I2 statistic and egger weighted regression were used to assess heterogeneity and publication bias.ResultsA total of 134 studies were identified from different database searching engines and other sources. After removing for duplication, absence of abstract and review of the full text 12 studies were including in the meta-analysis. The pooled prevalence of poor glycemic control among diabetic patients in Ethiopia is 64.72% with 95% confidence interval 63.16-66.28%. The sub group analysis of poor glycemic control among diabetic patients in different region of the country shows consistent and high prevalence of poor glycemic control ranging from 62.5% in Tigray region to 65.6% in Oromia region of the country. Residence, dyslipidemia and diet adherence were significantly association with poor glycemic control among diabetic patients in Ethiopia.ConclusionThe prevalence of poor glycemic control among diabetic patients was high in Ethiopia and consistent across different regions of the country. The most important factors associated with poor glycemic factor among diabetic patients were being rural residence, having dyslipidemia and not adhering to dietary plan.

scholarly journals YOGA IN CHRONIC NECK PAIN: AN EFFECTIVE COMPLEMENTARY THERAPEUTIC OPTION - A META - ANALYSIS

2018 ◽  
Vol 7 (2) ◽  
pp. 3-12
Author(s):  
Jaza Rizvi ◽  
Batool Hassan ◽  
Sadia Shafaq
Keyword(s):  
Neck Pain ◽  
Therapeutic Option ◽  
Meta Analysis ◽  
Chronic Neck Pain ◽  
Well Being ◽  
Risk Of Bias ◽  
Adverse Outcomes ◽  
Cochrane Library ◽  
P Value ◽  
Complementary Method

BACKGROUND Neck pain is recognized as the fourth leading cause of disability worldwide. The severity of neck pain may lead to adverse outcomes related to individual’s health and well-being that augment the risk of disability and may severely interfere in activities of daily living (ADL’s) and participation in the society. AIM The aim of the quantitative analysis is to determine the effectiveness of yoga in relieving chronic neck pain and disability. METHODS Databases such as Google scholar, MEDLINE, PEDro, the Cochrane Library and Pub Med were explored from October-November for randomized controlled trials which assessed neck pain and related disability among chronic neck pain individuals. RESULTS Total six studies consisted of 298 participants with chronic neck pain. In risk of bias assessment, all six studies reported low risk of allocation and reporting bias, while one or two study disclosed high or unknown risk of bias in several domains. Moderate to large effect of -0.857 SMD at 95% CI suggest evidence in favor of the effectiveness of yoga; (Q 30.32, df 5, I2 83.51%) on a significant P-value of <0.0001. CONCLUSION The analysis of studies provided robust evidence with pool effect of -0.857 SMD at 95% CI (p<0.0001) concluded that yoga is an effectual and complementary method for the management of chronic or non-specific neck pain. KEYWORDS Yoga, Neck Pain, Cervical, Therapeutic, Prevention, Meditation

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