Evaluating immunochromatographic test kits for diagnosis of acute human leptospirosis: A systematic review.

Background: Leptospirosis, a common zoonotic infection in developing countries, usually progresses to severe conditions and poor outcomes when not detected early. Microscopic agglutination test (MAT) and culture are available but are not accessible in all areas and are usually confined to specialized laboratories. There are several available immunochromatographic test kits (ICT) that offer ease of use, access, and affordability, but diagnostic accuracy is not yet well established. In this paper, we aim to review published literature on the use of ICTs for the detection of leptospirosis and evaluate their diagnostic efficiency. Materials and methods: We systematically searched multiple databases (PubMed, Cochrane Library, and Google Scholar), including gray literature sources for published research articles as of April 13, 2022, on the diagnosis of acute leptospirosis using ICT. We assessed the methodological quality of each article using the revised QUADAS-2. Results: From a total of 41 articles, 30 (73.2%) were identified as potentially relevant after reviewing the title and abstract and eliminating duplicate articles; then, 22 (53.7%) articles were included after scrutinizing and applying the inclusion/exclusion criteria to the full text. Almost all test kits detect IgM antibodies against the Leptospira species except for one which used IgG as a marker for diagnosis of acute leptospirosis. A wide range of sensitivity (15.8%-100.0%) and specificity (37.3%-100.0%) were recorded. Lipopolysaccharide (LPS)-specific Immunochromatographic Lateral Flow Assay presented the highest sensitivity (∼93-100%) and specificity (∼99.19-100%). Conclusion: Rapid diagnosis of acute leptospirosis is highly warranted; however, available test kits present a wide range of diagnostic accuracy. We found that LPS-specific ICT kit has the highest diagnostic efficiency; however, our analysis was limited by the included studies' heterogeneity in design and reporting; thus, we recommend standardization in the conduct and reporting of diagnostic accuracy of test kits as it is vital to evaluate the reliability of the test kit.

Serum ferritin as a candidate diagnostic biomarker of polycystic ovarian syndrome: a meta-analysis.

Objective: In this study, we investigated about the potential of serum ferritin as a complementary diagnostic biomarker of polycystic ovarian syndrome (PCOS) by performing a meta-analysis of existing literature. Materials and methods: Eleven studies written in English were retrieved up to 30 June 2018. Data were extracted from the selected studies by two of the authors and was subjected to statistical analysis. Levels of serum ferritin were compared between women with PCOS and controls using the standardized mean difference (SMD) and 95% confidence interval (CI). Subgroup analysis was also performed and stratified by ethnicity (Asians versus Caucasians). Results: Overall post-outlier outcomes indicated that elevated serum ferritin is strongly associated with PCOS (SMD: 0.52; 95% CI: 0.40-0.64; PA = 10-5). Subgroup analysis by ethnicity showed no significant difference between Asian and Caucasian population. Post-outlier receiving operations characteristics curve were plotted and showed that values for serum ferritin showed good potential in discriminating patients with and without PCOS (AUC = 0.827, p = 0.006). Conclusion: Our findings suggest that high serum ferritin level is significantly associated with PCOS and its potential as a biomarker is evident in its high diagnostic accuracy. However, additional studies are needed to confirm our claims.

G276T polymorphism in the ADIPOQ gene is associated with a reduced risk of polycystic ovarian syndrome: A meta-analysis of Asian population.

OBJECTIVE: The etiology of polycystic ovarian syndrome (PCOS) has not yet been fully explained. Several studies suggested an association between two single nucleotide polymorphisms (T45G and G276T) of the ADIPOQ gene that encodes for the hormone adiponectin and PCOS susceptibility. Hence, we performed a meta-analysis to investigate the relationship of the two further. MATERIALS AND METHODS: Literature search was conducted in PubMed up to June 22, 2018, for related publications written in English. Selected data were extracted from the included studies and was subjected to analysis using Review Manager 5.3. Odds ratios (ORs) and 95% confidence intervals (CIs) were computed and pooled from the resulting studies. Subgroup analysis by ethnicity was also performed. RESULTS: Overall analysis showed that women with the G276T polymorphism have reduced susceptibility to PCOS (OR: 0.68; 95% CI: 0.60-0.78; PA < 0.001). While no significant association was observed for the T45G polymorphism (OR: 1.07; 95% CI: 0.93-1.24; PA = 0.34). Subgroup analysis, on the other hand, showed significant associations among East Asians (OR: 0.69; 95% CI: 0.57-0.82; PA < 0.001) for the G276T association. CONCLUSION: Results of this meta-analysis suggests that women with the G276T polymorphism are less likely to develop PCOS. However, more studies are needed to confirm the claims of this meta-analysis.

Association of maternal iron deficiency anemia with the risk of gestational diabetes mellitus: a meta-analysis.

PURPOSE: The aim of the study was to conduct a meta-analysis investigating the association of maternal iron deficiency anemia (IDA) and risk of gestational diabetes mellitus (GDM). METHODS: Literature search was conducted in various database websites such as PubMed, Cochrane Library, and Web of Science up to 17 June 2018 for related publications written in English. Selected data were extracted from the included studies and were subjected to statistical analysis. Odds ratios (ORs) and 95% confidence intervals (CIs) were computed, pooled, and interpreted. Subgroup analysis by ethnicity (Asians vs. Caucasians) was also performed. RESULTS: Six studies with a total sample size of 15,157 from various countries were included in this meta-analysis. Pooled ORs of all publications included show that pregnant women with IDA have a reduced risk of developing GDM (OR 0.61; 95% CI 0.47-0.80; PA = 0.0003). Subgroup analysis, on the other hand, showed significant associations among Asians (OR 0.60; 95% CI 0.45-0.79; PA = 0.0003) than Caucasians (OR 0.76; 95% CI 0.32-1.76; PA = 0.52). CONCLUSION: Results of this meta-analysis suggests that pregnant women with IDA are 39% less likely to develop GDM. However, more studies are needed to confirm the claims of our results.