Efficacy of diathermy on healing power of cesarean section scar: A randomized control trail

Background Over several decades, has come to a dramatic increase In the number of cesarean sections performed across the world, especially in developed country The use of diathermy in the opening of anterior abdominal wall during CS decreases blood loss and operative time. The current study will investigate if diathermy cutting from skin through anterior abdominal is better or the same in cosmoses and post-operative pain Objective To compare the effects of electro-surgery on healing power of CS scar as a primary outcome (from skin to the peritoneum. A randomized controlled trial Data Sources Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2019. Data Extraction If the studies did not fulfill the inclusion criteria, they were excluded. Study quality assessment included whether ethical approval was gained, eligibility criteria specified, appropriate controls, and adequate information and defined assessment measures. Conclusion Our study showed that with the use of diathermy for incising skin during CS is not inferior to the use of scalpel regarding healing power of the scar but also adds benefits of decreasing post-operative pain. Therefore the use of diathermy can be safely recommended for the opening of the skin during cesarean sections as it decrease post-operative pain and blood loss.

Association between hearing loss and frailty: a systematic review and meta-analysis

Background Frailty is associated with poor health outcomes in later life. Recent studies suggested that hearing loss may be a potentially modifiable risk factor associated with frailty. Methods This systematic review and meta-analysis aimed to investigate the association between hearing loss and frailty in observational studies of adults aged 50 years or over. We included observational studies with participants ≥ 50 years old that have clear descriptions of hearing and frailty measurement methods. Meta-analyses were conducted using measurement of risk and 95 % confidence interval of each individual study. Quality assessment, risk of bias, heterogeneity and sensitivity analyses were also conducted. Our study followed PRISMA guidelines. Results Our search identified 4508 manuscripts published in English between 1 and 2000 and 9 February 2021. Sixteen articles reported acceptable measurements of both hearing loss and frailty. Two papers were not suitable for meta-analysis. Twelve sets of cross-sectional data involving 12,313 participants, and three sets of longitudinal data involving 3042 participants were used in the meta-analysis. Hearing loss was associated with an 87 % increase in the risk of frailty among cross-sectional studies (risk ratio [RR] 1.87; 95 %CI 1.63–2.13) and 56 % among longitudinal studies (RR 1.56; 95 %CI 1.29–1.88). There was considerable heterogeneity among studies, but their quality rating, sample size or approach used to assess hearing loss did not change the results substantially. Conclusions The findings of this systematic review and meta-analysis of observational studies suggest that hearing loss increases the risk of frailty in later life. Whether this relationship is causal remains to be determined.

Nutrition Programing of Children at 6-24 Months with Exclusive Breastfeeding : A Literature Review

Masa emas bagi tumbuh kembang anak terjadi 1000 Hari Pertama Kehidupan (HPK), dimulai sejak konsepsi sampai usia 24 bulan. Air Susu Ibu (ASI) mengandung komponen “nutrisi” dan “non-nutrisi” yang dapat mendukung tumbuh-kembang pasca lahir. World Health Organization (WHO) merekomendasikan anak memperoleh ASI ekslusif selama 6 bulan pasca lahir. Kecukupan nutrisi dan pertumbuhan optimal dapat dinilai menggunakan penilaian status gizi. Studi ini bertujuan untuk menganalisa hubungan pemberian ASI eksklusif selama 6 bulan pertama setelah lahir dengan status gizi anak usia 6 -24 bulan. Studi tinjauan pustaka ini menggunakan metode PRISMA, PICO, dan Boolean Operator. Literatur yang relevan diperoleh dari 8 database elektronik dan terbatas pada 10 tahun terakhir. Kualitas literatur dinilai menggunakan Quantitative Study Quality Assessment Tool yang dirilis EPHPP. Hasil penelitian menunjukkan, diperoleh 3 dari 3.218 artikel yang sesuai kata kunci dan 127 yang membahas pertanyaan penulis. Tiga literatur tersebut menggunakan indikator dan standar status gizi, yakni Berat Badan menurut Usia (BB/U), Panjang Badan menurut Usia (PB/U), Berat Badan menurut Panjang Badan (BB/PB), dan Indeks Massa Tubuh untuk Usia (IMT/U). Pada hasil didominasi oleh hubungan yang signifikan. Hasil studi menunjukkan bahwa status gizi BB/U, PB/U, BB/PB, dan IMT/U memiliki hubungan yang signifikan.

POS0716 FACTORS ASSOCIATED WITH FERTILITY OUTCOMES IN WOMEN WITH SYSTEMIC LUPUS ERYTHEMATOSUS: A SYSTEMATIC REVIEW

Background:Fertility is thought to be not reduced in women affected by systemic lupus erythematosus (SLE), however disease-related factors, psychosocial effects of chronic disease as well as medication exposure might impair gonadal function.Objectives:The aim of this systematic review was to explore clinical, hormonal, serological, instrumental and management factors associated with fertility outcomes in women of childbearing age with SLE.Methods:This systematic review was conducted following the Preferred Reporting Items for systematic reviews and Meta-analysis (PRISMA) statement. All articles available in English, published from 1972 to 15th August 2020 in Pubmed, EMBASE, Scopus and Cochrane Library. Study selection and data collection were performed by two independent reviewers. All data were extracted using a standardized template. Risk of bias of the included studies was assessed by using the NIH risk-of-bias tool [1].Results:Of 788 abstracts, we included in the review 45 studies of which 1 systematic literature reviews, 16 cross-sectional studies, 15 cohort studies, 12 observational studies and 1 case-series study, with a total of 4656 patients. The mean age was 33.5 ± 5.4 years, while the mean disease duration was 97.4 ± 65.2 months. Figure 1 illustrates the quality of the included studies. Definitions of fertility/premature ovarian failure (POF) adopted in the studies varied in terms of the number of months of amenorrhea considered. Most studies did not use a hormonally based definition of fertility. Clinical factors associated with the development of POF were older age at the time initiation of therapy and older age at the onset of SLE disease. Cyclophosphamide exposure (CYC) and its cumulative dose influenced gonadal function in SLE women, leading to amenorrhoea and ovarian failure, as reported in 19 studies. Mycophenolate, azathioprine, calcineurin inhibitors and steroids seem to be associated with a lower risk of ovarian failure compared to CYC. 3 studies demonstrated that POF was more frequent in patients treated with CYC not receiving gonadotropin-releasing hormone analogues (GnRH) in comparison to those co-treated with GnRH. 11 studies evaluated the impact of damage and disease activity on ovarian reserve in patients with SLE with conflicting evidence. Finally, 18 studies investigated exposure to hormonal and serological factors able to influence fertility outcomes; among others nor Anti-Müllerian Hormone, neither anti-corpus luteum antibodies were associated with POF.Conclusion:The role of disease activity on fertility in SLE patients is contradictory. Regarding management factors associated with fertility in SLE women of childbearing age, the strongest evidence is about the treatment with CYC and its cumulative dose. Hormonal and serological factors did not impact on fertility outcome but might be used as a surrogate of fertility, especially after treatment with disease-specific drugs.References:[1]Study Quality Assessment Tools NIH. https://www.nhlbi.nih.gov/health-topics/study-quality-assessment-tools.[2]Andreoli L. et al. EULAR recommendations for women’s health and the management of family planning, assisted reproduction, pregnancy and menopause in patients with systemic lupus erythematosus and/or antiphospholipid syndrome. Ann Rheum Dis. 2017; 76: 476–485.Disclosure of Interests:None declared

Urinary placental growth factor as a predictor of complications in hypertensive disorders in pregnancy: a protocol for systematic review and meta-analysis

IntroductionPreeclampsia is an important cause of maternal and fetal morbidity and mortality. Although the diagnostic and prognostic values of circulating placental growth factor (PlGF) have been extensively studied, urinary PlGF represents an excellent alternative to facilitate sample collection in the follow-up of pregnant women. The aim of this study is to determine whether urinary PlGF levels throughout pregnancy can predict severe maternal, fetal/placental and neonatal complications in women with hypertensive disorders in pregnancy.Methods and analysisStudies that evaluated pregnant women with hypertensive disorders and at least one measurement of urinary PlGF will be included. Studies that measure urinary PlGF after the occurrence of the complications will be excluded. The main outcome will consist of severe maternal complications in women with hypertensive disorders in pregnancy. Secondary outcomes will consist of severe fetal/placental and neonatal complications as defined by the International Collaboration to Harmonize Outcomes for Pre-eclampsia. Prospective cohort studies and case–controls studies reporting original data will be included. Studies will be identified by searching MEDLINE and SCOPUS databases. The first literature search was conducted on 2 March 2020, and another search will be performed before analyses. All eligible studies will be assessed for risk of bias with a standardised 10-items study quality assessment tool adapted from the Study Quality Assessment tools developed by the National Institutes of Health (NIH). Summary of ORs and 95% CIs will be reported to evaluate the association between urinary PlGF levels and hypertensive disorders in pregnancy and its complications. A random-effect meta-analysis will also be performed.Ethics and disseminationReview by an ethics committee will not be required for this systematic review. This study will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and will be submitted for publication in a peer-reviewed journal as well as for presentation at conferences targeting different stakeholders, including researchers, physicians and patients.PROSPERO registration numberCRD42020186313.

The Effect of Alcohol Cue Exposure on Tobacco-Related Cue Reactivity: A Systematic Review

Aims To examine the effect of alcohol cue exposure on tobacco-related cravings, self-administration and other measures of tobacco-related cue reactivity. Methods We searched Medline, PsycINFO, Embase, CINAHL and Scopus from inception to May 2020 for articles reporting on a combination of cue reactivity (and/or cross-cue reactivity), alcohol use and tobacco consumption. A semi-quantitative analysis and study quality assessment were performed for the included articles. Results A total of 37 articles met our inclusion criteria and were included in the systematic review. Most studies (60%) reported that alcohol cue exposure increased tobacco cravings, but only 18% of studies reported that alcohol cue exposure resulted in an increase in ad libitum smoking. There was also substantial heterogeneity between studies due to differences in methodology related to alcohol cue exposure, measures of tobacco cravings, as well as variable participant and study characteristics. Conclusions Alcohol cue exposure can increase cravings for tobacco. This has important implications for individuals who use both substances but are trying to quit one or both.

Bracketless Invisible Orthosis in the Treatment of Children With Malocclusion : A Protocol of Systematic Review

BackgroundMalocclusion is a common oral disorder. Childhood is a critical period for the development of malocclusion. This protocol will explore the clinical efficacy and safety of bracketless invisible orthosis (BIO) in the treatment of children with malocclusion.MethodsThis study will search MEDLINE, PUBMED, Cochrane Library, Web of Science, WANGFANG, VIP, CNKI, and CBM from inception to the present. We will not apply any limitations to the language and publication status. All potential randomized controlled trials (RCTs) on the efficacy of BIO for the treatment of children with malocclusion will be considered for inclusion. Two authors will independently carry out study identification, data extraction, and study quality assessment in each study. Any disagreement will be resolved through discussion with a third author. When a number of included studies are sufficient, we will conduct meta-analysis, as well as subgroup analysis and sensitivity analysis. The certainty of evidence will be appraised using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Outcome of interest will be presented in summary of findings tables, and statistical analysis will be performed utilizing RevMan 5.4 software. DiscussionThis systematic study will summarize all available studies to investigate the clinical efficacy of BIO in treating children with malocclusion. Findings of this study will highlight efficacy and safety of BIO for the treatment of children with malocclusion for both clinical practice and future strategies. Study registrationOSF (https://osf.io/avpmx).

Head and Neck Cancer Literacy in Nigeria: A systematic Review of the Literature

Introduction: Head and neck cancer (HNC), oral cancer inclusive (OC), is one of the major causes of cancer-related deaths globally, especially in Nigeria – a developing African country. Public literacy about HNC plays a very crucial role in HNC prevention. Aim: This study aimed to systematically review existing literature on literacy of HNC in Nigeria. Methods: We searched the PubMed, Google Scholar and AJOL databases for all relevant English articles published on HNC literacy in Nigeria from January 2000 till October 2020. Only relevant articles were included for the study. Quality assessment of the full text of the included articles was done using the Appraisal Tool for Cross-Sectional Studies (AXIS); also, relevant data were extracted from these articles and analyzed thematically. Results: A total of 21 articles (19 surveys and 2 interventional studies), which studied a total population of 7,883 people, were included in the study. All the included articles were rated “excellent” (70 – 100%), regarding quality. The awareness rates of HNC/OC, as documented in the included studies, ranged from 0% to 100%; however, the rate recorded in the majority of these studies was <50%. In-depth knowledge of HNC/OC was found to be generally poor among the surveyed population groups; however, education intervention was found to improve in-depth knowledge of HNC and attitudes toward peer and nonpeer education about HNC among Nigerians. Conclusion: The level of knowledge regarding HNC, in Nigeria, is low. The use of relevant health education programs to boost knowledge about HNC among the Nigerian public is highly recommended.

The Impact of Cardiac Injury on COVID-19 Patients Mortality: A Systematic Review and Meta-Analysis

Background: Cardiovascular system was the second most common organ system affected by COVID-19. Cardiac injury has been reported in many COVID-19 cases. The purpose of this study was to investigate the correlation between cardiac injury with mortality in COVID-19 patients. Methods: We performed a systematic review and meta-analysis study. The relevant studies were identified through scientific electronic databases such as PubMed, Cochrane, and ScienceDirect up to August 2020. The study quality assessment was conducted using the GRADE approach. The pooled odds ratio (OR) and 95% confidence interval (CI) were estimated using the random-effects model. Results: A total of 10 studies involving 2619 patients were included in the meta-analysis. The incidence of cardiac injury in COVID-19 patients was 28.5%. The all-cause mortality was significantly higher in patients with cardiac injury (52.8% vs. 13.1%; OR = 13.78; 95% CI = 7.22-26.32; I 2 = 88%; Z= 7.95; P < 0.00001). Conclusion: Cardiac injury is associated with higher mortality in COVID-19 patients. The cardiac injury should be considered as an important variable in the risk stratification for mortality in COVID-19.