Systematic review and meta-analysis of global prevalence of neurotoxic and hemotoxic snakebite envenomation

Background: The World Health Organization estimates that there are approximately 5.4 million snakebites and 1.8–2.7 million cases of envenomation, with 81 410–137 880 deaths each year worldwide. Aims: To estimate the prevalence of neurotoxic and haemotoxic snakebite envenomation through a comprehensive systematic review and meta-analysis. Methods: We searched Medline/PubMed, Scopus and Cochrane Library up to January 2021 using keywords such as snakebite and snake envenomation. Bibliographic and random searches were also performed. Prospective or retrospective observational studies and randomized controlled trials were included for the review. Results: We included 271 of 9711 studies published between 1963 and 2020. The pooled prevalence of snakebite from 188 studies with a total of 207 235 participants showed the highest prevalence in North America (69.20%; 95% confidence interval, CI: 57.06–81.34%) and lowest in Africa (28.10%; 95% CI: 22.22–33.98%). There was a pooled prevalence of 24.94% (95% CI: 22.84–27.03%) for haemotoxicity, with a highest prevalence of coagulopathy (43.76%; 95% CI: 33.15–54.37%). The overall prevalence of neurotoxicity was 38.20% (95% CI: 31.88–44.53%), with a highest prevalence of ptosis (53.57%; 95% CI: 38.51–68.62%). Conclusion: There was a higher prevalence of snakebites in North America. The most prevalent haemotoxicity and neurotoxicity were coagulopathy and ptosis, respectively. The overall quality of evidence was good with a non-significant publication bias.

Analysis of Lead, Cadmium, and Nickel in Blood Donors in Relation to Smoking-A Comparative Study.

Donor blood is usually screened for some risk factors, such as hepatitis, HIV, and malarial parasites, but it is not routinely screened for heavy metals although their adverse effects on the human body have been proved by a number of studies. In this study, an attempt was made to determine the effect of smoking on concentration of cadmium, nickel, and lead in donor blood. A semistructured questionnaire was prepared and given to participants. It showed that 79% (two groups: 65 smokers and 65 nonsmokers) smoked at least one cigarette per day. Collected blood samples were then subjected to atomic absorption spectrometry (AAS). In comparing blood levels between smoking and nonsmoking participants, we noted a high positive correlation between lead and nickel concentrations. There were statistically significant correlations between cadmium, lead, and nickel concentrations in the blood of smokers and nonsmokers. Moreover, because a substantial percentage of blood donors may be smokers and blood donation does not always meet demand, it would be difficult to completely exclude smokers from donating blood. Our findings indicate the need to screen for heavy metals when transfusing blood to the elderly, neonates, and infants, and to avoid transfusion of blood and blood products if levels are in the toxic range.

Impact of pharmacist-led home medicines review services on drug-related problems among the elderly population: a systematic review / 한국역학회지

OBJECTIVES: To address and elucidate the impact of pharmacist-led home medicines review (HMR) services on identifying drug-related problems (DRPs) among the elderly population in home care settings. METHODS: A comprehensive systematic search was performed using electronic scientific databases such as PubMed, Scopus, Embase, and Web of Science for studies published between January 1, 2008 and December 31, 2018, pertaining to HMR services by pharmacists for identifying DRPs. RESULTS: In total, 4,292 studies were retrieved from the searches, of which 24 were excluded as duplicates. Titles and abstracts were screened for the remaining 4,268 studies, of which 4,239 were excluded due to the extraneous nature of the titles and/or abstracts. Subsequently, 29 full-text articles were assessed, and 19 were removed for lacking the outcome of interest and/or not satisfying the study’s inclusion criteria. Finally, 10 studies were included in the review; however, publication bias was not assessed, which is a limitation of this study. In all studies, pharmacists identified a highly significant amount of DRPs through HMR services. The most common types of DRPs were potential drug-drug interactions, serious adverse drug reactions, need for an additional drug, inappropriate medication use, non-adherence, untreated indications, excessive doses, and usage of expired medications. CONCLUSIONS: HMR is a novel extended role played by pharmacists. The efficiency of such programs in identifying and resolving DRPs could minimize patients’ health-related costs and burden, thereby enhancing the quality of life and well-being among the elderly.

Impact of pharmacist-led home medicines review services on drug-related problems among the elderly population: a systematic review / 한국역학회지

OBJECTIVES: To address and elucidate the impact of pharmacist-led home medicines review (HMR) services on identifying drug-related problems (DRPs) among the elderly population in home care settings.METHODS: A comprehensive systematic search was performed using electronic scientific databases such as PubMed, Scopus, Embase, and Web of Science for studies published between January 1, 2008 and December 31, 2018, pertaining to HMR services by pharmacists for identifying DRPs.RESULTS: In total, 4,292 studies were retrieved from the searches, of which 24 were excluded as duplicates. Titles and abstracts were screened for the remaining 4,268 studies, of which 4,239 were excluded due to the extraneous nature of the titles and/or abstracts. Subsequently, 29 full-text articles were assessed, and 19 were removed for lacking the outcome of interest and/or not satisfying the study's inclusion criteria. Finally, 10 studies were included in the review; however, publication bias was not assessed, which is a limitation of this study. In all studies, pharmacists identified a highly significant amount of DRPs through HMR services. The most common types of DRPs were potential drug-drug interactions, serious adverse drug reactions, need for an additional drug, inappropriate medication use, non-adherence, untreated indications, excessive doses, and usage of expired medications.CONCLUSIONS: HMR is a novel extended role played by pharmacists. The efficiency of such programs in identifying and resolving DRPs could minimize patients' health-related costs and burden, thereby enhancing the quality of life and well-being among the elderly.

Impact of pharmacist-led home medicines review services on drug-related problems among the elderly population: a systematic review / 한국역학회지

OBJECTIVES@#To address and elucidate the impact of pharmacist-led home medicines review (HMR) services on identifying drug-related problems (DRPs) among the elderly population in home care settings.@*METHODS@#A comprehensive systematic search was performed using electronic scientific databases such as PubMed, Scopus, Embase, and Web of Science for studies published between January 1, 2008 and December 31, 2018, pertaining to HMR services by pharmacists for identifying DRPs.@*RESULTS@#In total, 4,292 studies were retrieved from the searches, of which 24 were excluded as duplicates. Titles and abstracts were screened for the remaining 4,268 studies, of which 4,239 were excluded due to the extraneous nature of the titles and/or abstracts. Subsequently, 29 full-text articles were assessed, and 19 were removed for lacking the outcome of interest and/or not satisfying the study's inclusion criteria. Finally, 10 studies were included in the review; however, publication bias was not assessed, which is a limitation of this study. In all studies, pharmacists identified a highly significant amount of DRPs through HMR services. The most common types of DRPs were potential drug-drug interactions, serious adverse drug reactions, need for an additional drug, inappropriate medication use, non-adherence, untreated indications, excessive doses, and usage of expired medications.@*CONCLUSIONS@#HMR is a novel extended role played by pharmacists. The efficiency of such programs in identifying and resolving DRPs could minimize patients' health-related costs and burden, thereby enhancing the quality of life and well-being among the elderly.