METHODS: Only randomized controlled trials (RCTs) comparing PCABs to PPIs in the maintenance of healing rates of endoscopically proven healed EE and indexed in MEDLINE, EMBASE, and CENTRAL until 3 February 2024, were included. A fixed-effects model meta-analysis was performed to pool primary efficacy outcome (maintenance of healing rates at week 24) and safety data (any treatment-emergent adverse event or TEAE). The risk of bias was assessed using Cochrane's Risk of Bias 2 (RoB2) tool.
RESULTS: Four RCTs with a total of 2554 patients were eligible for inclusion. All trials were of low risk of bias. Compared to lansoprazole 15 mg, the maintenance rates of healed EE at week 24 were significantly higher with vonoprazan 10 mg (RR 1.13; 95% CI 1.07-1.19) and vonoprazan 20 mg (RR 1.15; 95% CI 1.10-1.21). Likewise, compared to lansoprazole 15 mg, any TEAEs were significantly greater with vonoprazan 20 mg (RR 1.10; 95% CI 1.01-1.20) but not vonoprazan 10 mg.
CONCLUSION: Vonoprazan 10 and 20 mg were superior to lansoprazole 15 mg in the maintenance of the healing of EE. Any TEAEs were greater with vonoprazan 20 mg.
METHODS: A systematic search up to July 30, 2023 was completed in Scopus, PubMed, Web of Science, and Embase databases, to identify eligible RCTs. Heterogeneity tests of the selected studies were performed using the I2. Random effects models were assessed and pooled data were determined as standardized mean differences (SMD) with a 95% CI.
RESULTS: The meta-analysis of 23 trials, involving 1,523 patients, demonstrated a significant decrease in TNF-α (SMD: -1.62, 95% CI: -2.89 to -0.35, P= 0.013) and increase in TAC (SMD: 0.92, 95% CI: 0.33 to 1.52, P = 0.002) following ω-3 fatty acids administration. Meanwhile, supplementation did not have beneficial effects on malondialdehyde, C-reactive protein (CRP), superoxide dismutase (SOD), and interlukin-6 levels. The subgroup analysis revealed a significant decrease in CRP levels and an increase in SOD levels in studies with durations of less than 12 weeks.
CONCLUSIONS: We found that ω-3 fatty acid intake can significantly decrease TNF-α and increase TAC levels, but this effect was not observed on other markers. Nevertheless, future well-designed with large sample size and long duration RCT studies with precise ω-3 fatty acids dose and ingredients are required to understand better the effects of these compounds and their constituents on oxidative stress and inflammatory markers in T2DM patients.
MATERIALS AND METHODS: This was a cross sectional study with 64 arms from 32 patients (34 neuropathic, 30 nonneuropathic). Diagnosis was confirmed by nerve conduction study and electromyography. The ulnar nerves were evaluated with 15MHz small footprint linear array transducer. The ulnar nerve CSA was measured at three levels with arm extended: at medial epicondyle (ME), 5cm proximal and 5cm distal to ME. Results from the neuropathic and nonneuropathic arms were compared. Independent T-tests and Pearson correlation tests were used. P value of less than 0.05 was considered significant.
RESULTS: Mean CSA values for the UN at levels 5cm proximal to ME, ME and 5cm distal to ME were 0.055, 0.109, 0.045 cm(2) respectively in the neuropathic group and 0.049, 0.075, 0.042 cm2 respectively in the non-neuropathic group. The CSA of the UN at the ME level was significantly larger in the neuropathic group, with p value of 0.005. However, there was no statistical difference between the groups at 5cm proximal and distal to the ME, with p values of 0.10 and 0.35 respectively.
CONCLUSION: There is significant difference in CSA values of the UN at ME between the neuropathic and non-neuropathic groups with mean CSA value above the predetermined 0.10cm(2) cut-off point. High-resolution ultrasonography is therefore useful to diagnose and follow up cases of elbow UNN.
OBJECTIVES: This is an audit project aiming to evaluate the proportion of misdiagnosis among hospitalised communityacquired pneumonia (CAP) patients in the Respiratory wards of Penang General Hospital based on their initial presentation data, and their associated outcomes.
METHODS: We reviewed the medical notes and initial chest radiographs of 188 CAP patients who were admitted to respiratory wards. Misdiagnosis was defined as cases which lack suggestive clinical features and/or chest radiograph changes. In-hospital mortality and length of stay (LOS) were the outcomes of interest.
RESULTS: The study found that 38.8% (n=73) of the hospitalised CAP patients were misdiagnosed. The most common alternative diagnosis was upper respiratory tract infection (32.8%, n=24). There was no statistical difference between misdiagnosis and CAP patients in the demographic and clinical variables collected. In terms of outcomes, misdiagnosed patients were discharged earlier (mean LOS= 3.5±3.28 days vs. 7.7±15.29 days, p=0.03) but the in-hospital mortality difference was not statistically significant (p=0.07).
CONCLUSIONS: One third of our CAP admissions were misdiagnosed. Although initial misdiagnosis of CAP in our study did not show any increase in mortality or morbidity, a proper diagnosis of CAP will be helpful in preventing inappropriate prescription of antibiotics and unnecessary admission.
MATERIALS AND METHODS: Fourteen HS and 14 TLE patients with age and gender matched underwent resting state functional magnetic resonance imaging (rsfMRI) scanning using a 3-Tesla MRI machine to investigate the EC and percentage of amplitude fluctuation (PerAF) involving SMG and PRE. The rsfMRI data were analysed using Statistical Parametric Mapping (SPM12) and Spectral Dynamic Causal Modelling (spDCM) from which causal models were specified, estimated and inferred.
RESULTS: Model with bidirectional connections between PRE and SMG was chosen as the winning model. The EC from PRE to SMG is positive but the EC from SMG to PRE is negative in both hemispheres and in HS and TLE. Based on the findings from the EC analysis, there is an excitatory effect shown by PRE to SMG connection indicating a dominant role of PRE over SMG in both groups.
CONCLUSION: There is important evidence showing that PRE might also have influence on areas outside resting state network and the influence changes in the presence of brain abnormality.
MATERIALS AND METHODS: This descriptive study utilises a desk review approach and employs the WHO Data Quality Assurance (DQA) Tool to assess data quality of ASDK. The analysis involves measuring eight health indicators from ASDK and Survei Status Gizi Indonesia (SSGI) conducted in 2022. The assessment focuses on various dimensions of data quality, including completeness of variables, consistency over time, consistency between indicators, outliers and external consistency.
RESULTS: Current study shows that routine health data in Indonesia performs high-quality data in terms of completeness and internal consistency. The dimension of data completeness demonstrates high levels of variable completeness with most variables achieving 100% of the completeness.
CONCLUSION: Based on the analysis of eight routine health data variables using five dimensions of data quality namely completeness of variables, consistency over time, consistency between indicators, outliers. and external consistency. It shows that completeness and internal consistency of data in ASDK has demonstrated a high data quality.