Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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J Coll Physicians Surg Pak · Mar 2022
Meta AnalysisIntravenous Alteplase Treatment of Acute Ischemic Stroke Patients Exhibiting Mild Neurological Deficits.
Alteplase is increasingly used for treating ischemic stroke cases with low NIHSS scores, but the guidelines and evidence regarding outcomes are lacking. So, the authors conducted an updated meta-analysis to better understand the effects of alteplase for the treatment of acute mild ischemic stroke. PubMed, Cochrane, EMBASE were systematically explored for all relevant investigations published as in September 2021. ⋯ Subgroup analysis showed that the function outcomes was the best within 3-4.5 hours; and the risk and mortality of sICH were the lowest within 3-4.5 hours. Intravenous rt-PA administration is associated with improved functional outcomes at three months after the stroke in mild ischemic stroke patients. Key Words: Acute ischemic stroke, Mild, Alteplase, Meta-analysis.
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J Coll Physicians Surg Pak · Feb 2022
Meta AnalysisAssociation between Insulin Resistance and Cognitive Impairment.
The objective of the review was to assess the relationship between insulin resistance and cognitive impairment. Medline, Embase, Web of Science and Cochrane Library were searched. Two independent authors selected studies and extracted data. ⋯ The article showed a negative association between insulin resistance and cognition (R = - 0.262; 95% CI-0.309, - 0.215). There is evidence that insulin resistance may be a mechanism of cognitive impairment. Key Words: Insulin resistance, Insulin, Cognition, Cognitive impairment, Systematic review, Alzheimer's disease.
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J Coll Physicians Surg Pak · Jan 2022
Meta AnalysisImpact of Resistance Training on FEV1 and Functional Exercise Capacity among COPD Patients: A Meta-analysis.
Chronic obstructive pulmonary disease (COPD) is the third leading cause of mortality and morbidity across the Globe. A meta-analysis was conducted to determine the effectiveness of different modes of resistance training on FEV1 and functional exercise capacity among COPD patients. Data bases of Cochrane, PEDro, Embase, CINAHL, PubMed and Google Scholar were searched seeking research articles of interest. ⋯ Results of the study demonstrated that resistance training has a mild pool effect in increasing FEV1 with an effect size of (SMD) of 0.160 (95% CI of -0.840 to 0.521) calculated at random effect model, I2 = 62.99% (95% CI of 0.00 to 89.42); whereas, functional exercise capacity demonstrated large pool effect size 0.886 (95% CI of 0.401 to 1.371) with I2 = 0.0 (95% CI of 0.00 to 0.00). The study concludes that there is a small to large impact of resistance exercises in improving functional exercise capacity and forced expiratory volume. Key Words: Resistance training, 6-minute walk test 6MWT, Chronic obstructive pulmonary disease, Functional exercise capacity, Forced expiratory volume.
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J Coll Physicians Surg Pak · Dec 2021
Meta AnalysisThe Efficacy of Bronchoscopy versus Computerised Tomography in Initial Identification of Patients with Hemoptysis.
The effects of bronchoscopy and chest CT on early evaluation of patients with hemoptysis are still controversial. PubMed, EMBASE, and the Cochrane Library databases were systematically searched. Odds ratio (OR) was applied to assess the utility of bronchoscopy for hemoptysis etiology and site in comparison with CT in the various clinical processes. ⋯ In the cases of massive hemoptysis, bronchoscopy and CT had no statistical significance for identifying bleeding (OR=0.27, 95% CI: [0.02, 3.18]). The study suggested that bronchoscopy did not show superior diagnostic accuracy than CT for patients with hemoptysis at the first visit. Key Words: Hemoptysis, Bronchoscopy, CT, Meta-analysis.
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J Coll Physicians Surg Pak · Oct 2021
Meta AnalysisDiagnostic Value of Urinary MicroRNAs for Bladder Cancer in Asia.
This study aimed to explore the diagnostic performance of urinary microRNAs (miRNAs) in bladder cancer (BC) in the Asian population. PubMed, Embase, Web of Science and Cochrane Library were searched for relevant literature on the diagnostic performance of miRNAs for BC in the Asian population. Subsequently, quality assessment on diagnostic accuracy studies-2 (QUADAS-2) was used for evaluating the quality of the included literature, and Stata version 15.0 for statistical analysis. ⋯ Additionally, the area under the curve (AUC) was 0.85 in the summary receiver operating characteristic (SROC) curve, and the diagnostic odds ratio (DOR) was 12.39 (95%CI: 9.00-17.07). In conclusion, urinary miRNAs show good performance in diagnosing BC in Asia, and, therefore, can serve as effective biomarkers for early clinical screening and auxiliary diagnosis of BC. Key Words: MicroRNAs, Bladder cancer, Diagnostic value, Meta-analysis.