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1.
Front Endocrinol (Lausanne) ; 12: 691033, 2021.
Article in English | MEDLINE | ID: covidwho-1596864

ABSTRACT

Background: Gestational Diabetes Mellitus (GDM) is defined as the type of hyperglycemia diagnosed for the first-time during pregnancy, presenting with intermediate glucose levels between normal levels for pregnancy and glucose levels diagnostic of diabetes in the non-pregnant state. We aimed to systematically review and meta-analyze studies of prevalence of GDM in European countries at regional and sub-regional levels, according to age, trimester, body weight, and GDM diagnostic criteria. Methods: Systematic search was conducted in five databases to retrieve studies from 2014 to 2019 reporting the prevalence of GDM in Europe. Two authors have independently screened titles and abstracts and full text according to eligibility using Covidence software. A random-effects model was used to quantify weighted GDM prevalence estimates. The National Heart, Lung, and Blood Institute criteria was used to assess the risk of bias. Results: From the searched databases, 133 research reports were deemed eligible and included in the meta-analysis. The research reports yielded 254 GDM-prevalence studies that tested 15,572,847 pregnant women between 2014 and 2019. The 133 research reports were from 24 countries in Northern Europe (44.4%), Southern Europe (27.1%), Western Europe (24.1%), and Eastern Europe (4.5%). The overall weighted GDM prevalence in the 24 European countries was estimated at 10.9% (95% CI: 10.0-11.8, I2 : 100%). The weighted GDM prevalence was highest in the Eastern Europe (31.5%, 95% CI: 19.8-44.6, I2 : 98.9%), followed by in Southern Europe (12.3%, 95% CI: 10.9-13.9, I2 : 99.6%), Western Europe (10.7%, 95% CI: 9.5-12.0, I2 : 99.9%), and Northern Europe (8.9%, 95% CI: 7.9-10.0, I2 : 100). GDM prevalence was 2.14-fold increased in pregnant women with maternal age ≥30 years (versus 15-29 years old), 1.47-fold if the diagnosis was made in the third trimester (versus second trimester), and 6.79- fold in obese and 2.29-fold in overweight women (versus normal weight). Conclusions: In Europe, GDM is significant in pregnant women, around 11%, with the highest prevalence in pregnant women of Eastern European countries (31.5%). Findings have implications to guide vigilant public health awareness campaigns about the risk factors associated with developing GDM. Systematic Review Registration: PROSPERO [https://www.crd.york.ac.uk/PROSPERO/], identifier CRD42020161857.

2.
Clin Endocrinol (Oxf) ; 2021 Nov 14.
Article in English | MEDLINE | ID: covidwho-1518007

ABSTRACT

CONTEXT: Polycystic ovary syndrome (PCOS) is a heterogeneous condition affecting women of reproductive age. It is associated with dyslipidaemia and elevated plasma C-reactive protein (CRP), which increase the risks of cardiovascular disease (CVD). OBJECTIVE: To review the existing evidence on the effects of different pharmacological interventions on lipid profiles and CRP of women with PCOS. DATA SOURCES: We searched PubMed, MEDLINE, Scopus, Embase, Cochrane Library, and Web of Science in April 2020 and updated the results in March 2021. STUDY SELECTION: The study included randomized controlled trials (RCTs) and follows the 2020 Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA). DATA EXTRACTION: Two independent researchers extracted data and assessed for risk of bias using the Cochrane risk of bias tool. Covidence systematic review software were used for blinded screening and study selection. DATA SYNTHESIS: In 29 RCTs, there were significant reductions in triglycerides with atorvastatin versus placebo [mean difference (MD): -0.21 mmol/L; 95% confidence interval (CI): -0.39, -0.03, I2 = 0%, moderate grade evidence]. Significant reductions were seen for low-density lipoprotein cholesterol (LDL-C) with metformin versus placebo [standardized mean difference (SMD): -0.41; 95% CI: -0.85, 0.02, I2 = 59%, low grade evidence]. Significant reductions were also seen for total cholesterol with saxagliptin versus metformin (MD: -0.15 mmol/L; 95% CI: -0.23, -0.08, I2 = 0%, very low grade evidence). Significant reductions in C-reactive protein (CRP) were seen for atorvastatin versus placebo (MD: -1.51 mmol/L; 95% CI: -3.26 to 0.24, I2 = 75%, very low-grade evidence). CONCLUSION: There were significant reductions in the lipid parameters when metformin, atorvastatin, saxagliptin, rosiglitazone and pioglitazone were compared with placebo or other agents. There was also a significant reduction of CRP with atorvastatin.

3.
BMJ Open ; 11(10): e052993, 2021 10 07.
Article in English | MEDLINE | ID: covidwho-1462971

ABSTRACT

INTRODUCTION: Sharps injuries, including needlestick injuries and splash exposures, constitute serious occupational health problems for healthcare workers, carrying the risk of bloodborne infections. However, data on such occupational incidents and their risk factors in healthcare settings are scarce and not systematically summarised in the Arab countries.The aim of this study is to conduct a systematic review and meta-analysis to review published literature about sharps injuries and splash exposures of healthcare workers in Arab countries, with the objectives to determine the incidence and/or prevalence of these events, their identified risk factors and the applied preventive and postexposure prophylactic measures. METHODS AND ANALYSIS: The protocol is developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol guidelines. A comprehensive presearch developed in January to March 2021 in the database PubMed will be followed by a systematic search of six, core medical and health science databases: PubMed, EMBASE, Scopus, CINAHL, Web of Science and Africa-Wide Information in May 2021. The search will be performed without any filters or restrictions for publication years. Covidence systematic review tool will be used for document management, blinded screening and study selection. Two reviewers will independently screen the records, extract data and conduct risk of bias assessment. Results will be synthesised narratively in summary tables, and, if findings allow, meta-analysis will be conducted on the incidence and/or prevalence of sharps injuries and splash exposures, and on the effect size of risk factors. ETHICS AND DISSEMINATION: The systematic review methodology does not require ethics approval due to the nature of the study design based only on published studies. The results of the systematic review will be published in a peer-reviewed journal, disseminated to stakeholders and made publicly available. PROSPERO REGISTRATION NUMBER: CRD42021242416.


Subject(s)
Needlestick Injuries , Arabs , Delivery of Health Care , Health Personnel , Humans , Meta-Analysis as Topic , Needlestick Injuries/epidemiology , Research Design , Systematic Reviews as Topic
4.
BMJ Open ; 11(4): e047134, 2021 04 13.
Article in English | MEDLINE | ID: covidwho-1455715

ABSTRACT

BACKGROUND: Cardiac rehabilitation (CR) decreases the morbidity and mortality risk among patients with cardiac diseases; however, the impact of CR on patients with diabetes remains underexplored. This is a protocol for a systematic review and meta-analysis methodology to explore if the effect of CR on mortality and morbidity is the same in patients with type 2 diabetes compared with patients without diabetes. METHODS AND ANALYSIS: Interventional and non-interventional studies comparing the effect of CR, for at least 1 month, on all-cause mortality and cardiovascular outcomes including fatal and non-fatal myocardial infarction, revascularisation and rehospitalisation in adults with cardiac diseases will be deemed eligible for inclusion. Studies published between 1990 and 2020 will be searched in PubMed, Embase, Cochrane, CINAHL, Scopus and in registries for randomised controlled trials. Eligible studies will be selected using the Covidence software, and their salient details regarding the design, population, tested interventions and outcomes of interest will be gathered. The quality of studies to be deemed eligible and reviewed will be assessed using the Cochrane Collaboration and National Heart, Lung, and Blood Institute's tools. The appraisal process will be based on the study design (interventional and non-interventional). In the meta-analysis step, the pooled effect of CR on the outcomes will be estimated. All meta-analyses will be done using the random-effects model approach (inverse-variance method). I 2 and p value of χ2 statistics will guide the heterogeneity assessment. Subgroup analyses will also be performed. The small study effect will be investigated by generating the funnel plots. The symmetry of the latter will be tested by performing Egger's test. ETHICS AND DISSEMINATION: The systematic review will use data from published literature; hence, no ethical approval will be required. Findings of the systematic review and meta-analysis will be published in peer-reviewed international journals and will be disseminated in local and international scientific meetings. PROSPERO REGISTRATION NUMBER: CRD42020148832.


Subject(s)
Cardiac Rehabilitation , Diabetes Mellitus, Type 2 , Myocardial Infarction , Adult , Humans , Meta-Analysis as Topic , Morbidity , Research Design , Systematic Reviews as Topic
5.
BMJ Open ; 11(4): e044456, 2021 04 05.
Article in English | MEDLINE | ID: covidwho-1455710

ABSTRACT

INTRODUCTION: Quad bikes are four-wheeled vehicles, driven off-road on uneven terrains by farmers for work or young adults for leisure. Quad bike accidental crashes result mostly due to the unique ecosystem of uneven terrain, where these unstable vehicles are commonly driven, in addition to numerous distinctive sociodemographic characteristics related to drivers. This is a protocol for a systematic review of observational studies from all geographical regions and demographic groups in the world to summarise the common risk factors relating to quad bike crashes. METHODS AND ANALYSIS: A comprehensive search for the literature on quad bike crashes and related injuries will be conducted in six electronic databases: PubMed, Embase, Scopus, Web of Science, IEEE and PsycINFO. Proquest Dissertation and Thesis, OpenGrey and BASE will be searched for grey literature. Five researchers will be involved in the screening, and the review of full text articles, using the inclusion and exclusion criteria. Disagreements between reviewers will be resolved by discourse. Three researchers will help resolving conflicts that may arise during the screening process and will resolve eventual conflicts identified in the process with the help of the systematic review software 'Covidence' for automatic deduplication and blinded screening. Information on crashes leading to injuries and death, target population characteristics and risk factors involved will be extracted from eligible articles in addition to the assessment of the quality of the researched articles. ETHICS AND DISSEMINATION: Since this is a systematic review of published literature, a formal ethical approval is not needed. Results of the review will be disseminated through peer-reviewed publications, conference presentations and reports to the concerned authorities. PROSPERO REGISTRATION NUMBER: CRD42020170245.


Subject(s)
Bicycling , Ecosystem , Accidents, Traffic , Farmers , Humans , Research Design , Risk Factors , Systematic Reviews as Topic , Young Adult
6.
J Diabetes Metab Disord ; : 1-12, 2021 Mar 31.
Article in English | MEDLINE | ID: covidwho-1169058

ABSTRACT

Background: The coronavirus disease 2019 (COVID-19) patients with diabetes mellitus (DM) are at high risk of fatal outcomes. This meta-analysis quantifies the prevalence of mortality among (1) diabetic and (2) non-diabetic, and (3) the prevalence of DM, in hospitalized COVID-19 patients. Methods: Published studies were retrieved from four electronic databases (PubMed, Embase, Scopus, and medRxiv) and appraised critically utilizing the National Heart, Lung, and Blood Institute's tool. Meta-analyses were performed using the random-effects model. The measures of heterogeneity were ascertained by I- squared (I 2 ) and Chi-squared (Chi 2 ) tests statistics. Predictors of heterogeneity were quantified using meta-regression models. Results: Of the reviewed 475 publications, 22 studies (chiefly case series (59.09 %)), sourcing data of 45,775 hospitalized COVID-19 patients, were deemed eligible. The weighted prevalence of mortality in hospitlized COVID-19 patients with DM (20.0 %, 95 % CI: 15.0-26.0; I 2 , 96.8 %) was 82 % (1.82-time) higher than that in non-DM patients (11.0 %, 95 % CI: 5.0-16.0; I 2 , 99.3 %). The prevalence of mortality among DM patients was highest in Europe (28.0 %; 95 % CI: 14.0-44.0) followed by the United States (20.0 %, 95 % CI: 11.0-32.0) and Asia (17.0 %, 95 % CI: 8.0-28.0). Sample size and severity of the COVID-19 were associated (p < 0.05) with variability in the prevalence of mortality. The weighted prevalence of DM among hospitalized COVID-19 patients was 20 % (95 % confidence interval [CI]: 15-25, I 2 , 99.3 %). Overall, the quality of the studies was fair. Conclusions: Hospitalized COVID-19 patients were appreciably burdened with a high prevalence of DM. DM contributed to the increased risk of mortality among hospitalized COVID-19 patients compared to non-DM patients, particularly among critically ill patients. Registration: PROSPERO (registration no. CRD42020196589). Supplementary Information: The online version contains supplementary material available at 10.1007/s40200-021-00779-2.

7.
PLoS One ; 16(2): e0246903, 2021.
Article in English | MEDLINE | ID: covidwho-1080425

ABSTRACT

The coronavirus disease 2019 (COVID-19) cases could be symptomatic or asymptomatic. We (1) characterized and analyzed data collected from the first cohort of reverse transcriptase polymerase chain reaction (RT-PCR)-confirmed COVID-19 cases reported in the Emirate of Abu Dhabi, United Arab Emirates, according to the symptomatic state, and (2) identified factors associated with the symptomatic state. The association between the symptomatic state and testing positive in three subsequent RT-PCR testing rounds was also quantified. Between February 28 and April 8, 2020, 1,249 cases were reported. Sociodemographic characteristics, working status, travel history, and chronic comorbidities of 791 cases were analyzed according to the symptomatic state (symptomatic or asymptomatic). After the first confirmatory test, the results of three subsequent tests were analyzed. The mean age of the 791 cases was 35.6 ± 12.7 years (range: 1-81). Nearly 57.0% of cases were symptomatic. The two most frequent symptoms were fever (58.0%) and cough (41.0%). Symptomatic cases (mean age 36.3 ± 12.6 years) were significantly older than asymptomatic cases (mean age 34.5 ± 12.7 years). Compared with nonworking populations, working in public places (adjusted odds ratio (aOR), 1.76, 95% confidence interval (95% CI): 1.11-2.80), healthcare settings (aOR, 2.09, 95% CI: 1.01-4.31), or in the aviation and tourism sectors (aOR, 2.24, 95% CI: 1.14-4.40) was independently associated with the symptomatic state. Reporting at least one chronic comorbidity was also associated with symptomatic cases (aOR, 1.76, 95% CI: 1.03-3.01). Compared with asymptomatic cases, symptomatic cases had a prolonged duration of viral shedding and consistent odds of ≥2 positive COVID-19 tests result out of the three subsequent testing rounds. A substantial proportion of the diagnosed COVID-19 cases in the Emirate of Abu Dhabi were asymptomatic. Quarantining asymptomatic cases, implementing prevention measures, and raising awareness among populations working in high-risk settings are warranted.


Subject(s)
COVID-19 Nucleic Acid Testing , COVID-19/diagnosis , COVID-19/epidemiology , Adult , Age Factors , COVID-19/pathology , Carrier State , Humans , Middle Aged , Retrospective Studies , United Arab Emirates/epidemiology
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