Prevalence of restless legs syndrome in adults with epilepsy: A systematic review and meta-analysis of observational studies.

INTRODUCTION: Epilepsy is a common neurological disorder that significantly contributes to the worldwide disease burden. Restless legs syndrome is sleep-related movement disorder that causes uncomfortable sensations in the legs with an irresistible urge to move them. The aim of this study is to comprehensively assess the current evidence to estimate the prevalence of restless legs syndrome (RLS) in adults with epilepsy (AWE) and to compare it to healthy controls. METHODS: PubMed, Medline, Scopus, and Web of Science databases were searched for observational studies reporting the prevalence of RLS in AWE. The modified Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of the studies. Comprehensive Meta-Analysis software (version 3.0) was used to perform data analysis. The heterogeneity of the studies was assessed using the I2 index. The pooled prevalence of RLS in AWE and the odds ratio were calculated based on the random-effect model. Sensitivity analysis was assessed. A funnel plot and Egger's test were used to investigate publication bias. Subgroup analysis and univariate meta-regression analysis were done. RESULTS: Based on the analysis of 17 studies (2262 AWE patients), the prevalence of RLS was 14.9 % (95%CI, 10.4%-21 %). This rate was highest in the Americas (35.3 %; 95 % CI: 19.7-54.9 %) and lowest in Asian countries (11.6 %). The risk of RLS was significantly higher in AWE patients compared to health controls (12 studies, OR = 2.09; 95 % CI: 1.53-2.85, I2 = 91.69 %, P < 0.001). subgroup analysis showed Variations in RLS rates between studies depending on quality scores, methodology, and diagnostic criteria. The funnel plot and Egger's test suggest there was publication bias. Sensitivity analysis showed that none of the studies on their own significantly affected the results. CONCLUSIONS: This meta-analysis provides the first pooled estimate of RLS prevalence in AWE. RLS occurs in 15 out of every 100 AWE patients, and the risk is high compared to healthy controls. However, the findings need to be confirmed in future studies owing to limitations in the analysis and study design.

The Characteristics of COVID-19 Vaccine-Associated Uveitis: A Summative Systematic Review.

Numerous complications following COVID-19 vaccination has been reported in the literature, with an increasing body of evidence reporting vaccination-associated uveitis (VAU). In this systematic review, we searched six electronic databases for articles reporting the occurrence of VAU following COVID-19 vaccination. Data were synthesized with emphasis on patients' characteristics [age, gender], vaccination characteristics [type, dose], and outcome findings [type, nature, laterality, course, location, onset, underlying cause, and associated findings]. Data are presented as numbers (percentages) for categorical data and as mean (standard deviation) for continuous data. Sixty-five studies were finally included [43 case reports, 16 case series, four cohort, one cross-sectional, and one registry-based study]. VAU occurred in 1526 cases, most commonly in females (68.93%) and middle-aged individuals (41-50 years: 19.71%), following the first dose (49.35%) of vaccination, especially in those who received Pfizer (77.90%). VAU occurred acutely (71.77%) as an inflammatory reaction (88.29%) in unilateral eyes (77.69%), particularly in the anterior portion of the uvea (54.13%). Importantly, most cases had a new onset (69.92%) while only a limited portion of cases had a reactivation of previous uveitis condition. In conclusion, although rare, uveitis following COVID-19 vaccination should be considered in new-onset and recurrent cases presenting with either acute or chronic events.

Effects of backward gait training on balance, gross motor function, and gait in children with cerebral palsy: a systematic review.

OBJECTIVE:: To investigate the effects of backward gait training on balance, gross motor function, and gait parameters in children with cerebral palsy. DATA SOURCES:: PubMed, Cochrane Library, Web of Science, Science Direct, Physiotherapy Evidence Database (PEDro), and Google Scholar were searched up to May 2018. REVIEW METHODS:: Randomized controlled trials were included if they involved any form of backward gait training for children with cerebral palsy. Two authors independently screened articles, extracted data and assessed the methodological quality using PEDro scale, with any confliction resolved by the third author. Modified Sackett Scale was used to determine the level of evidence for each outcome. RESULTS:: Out of 1492 papers screened, 7 studies with 172 participants met the inclusion criteria. The duration of treatment ranged from 15 to 25 minutes, three times a week and for 6-12 weeks. The quality of studies ranged from good (two studies) to fair (four studies) and poor (one study), with a mean PEDro score of 4.7 out of 10. All included studies showed positive effects in the measured outcomes. The results showed level 1b evidence for balance when compared to no intervention, and for gross motor function, step length and walking speed when compared to same dose of forward gait training. The clinical heterogeneity of studies makes meta-analysis inappropriate. CONCLUSION:: In children with cerebral palsy, there is moderate evidence that backward gait training improves balance, gross motor function, step length and walking velocity. More high-quality studies are needed.