Circulating microRNAs as promising diagnostic biomarkers for hepatocellular carcinoma: a systematic review and meta-analysis.

Introduction: Hepatocellular carcinoma (HCC), the most common type of liver cancer, is a major global health problem, ranking as the third leading cause of cancer-related death worldwide. Early identification and diagnosis of HCC requires the discovery of reliable biomarkers. Therefore, the study aimed to assess the diagnostic accuracy of miRNAs for HCC. The protocol was registered on PROSPERO website with the registration number CRD42023417494. Method: A literature search was conducted in PubMed, Scopus, Embase, Wiley Online Library, and Science Direct databases to identify pertinent articles published between 2018 and 30 July 2023. Stata 17.0 software was employed to determine the pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic ratio (DOR), and area under the curve (AUC) for evaluating the accuracy of miRNAs in diagnosing HCC. The assessment of heterogeneity among studies involved the use of the Cochran-Q test and I2 statistic tests. Due to the observed significant heterogeneity, the random-effect model was chosen. Subgroup analysis and meta-regression analysis were also undertaken to explore potential sources contributing to heterogeneity. Deeks' funnel plot was used to assess publication bias. In addition, Fagan's nomogram and likelihood ratio scattergram were utilized to assess the clinical validity of miRNAs for HCC. Result: Twenty-four articles were included, involving 1,668 individuals diagnosed with HCC and 1,236 healthy individuals. The findings revealed pooled sensitivity of 0.84 (95% CI: 0.80-0.88), specificity of 0.81 (95% CI: 0.77-0.84), PLR of 4.36 (95% CI: 3.59-5.30), NLR of 0.19 (95% CI: 0.15-0.25), DOR of 22.47 (95% CI: 14.47-32.64), and an AUC of 0.89 (95% CI: 0.86-0.91) for the diagnosis of HCC using miRNAs. Furthermore, results from the subgroup analysis demonstrated that superior diagnostic performance was observed when utilizing plasma miRNAs, a large sample size (≥100), and miRNA panels. Conclusion: Hence, circulating miRNAs demonstrate substantial diagnostic utility for HCC and can serve as effective non-invasive biomarkers for the condition. Additionally, miRNA panels, miRNAs derived from plasma, and miRNAs evaluated in larger sample sizes (≥100) demonstrate enhanced diagnostic efficacy for HCC diagnosis. Nevertheless, a large pool of prospective studies and multi-center research will be required to confirm our findings in the near future.

Prevalence of thyroid dysfunction and associated factors among adult type 2 diabetes mellitus patients, 2000-2022: a systematic review and meta-analysis.

BACKGROUND: Thyroid dysfunction (TD) and type 2 diabetes mellitus (T2DM) frequently co-occur and have overlapping pathologies, and their risk increases with age. Thyroid dysfunction along with T2DM will worsen macro- and microvascular complications, morbidity, and mortality. METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guideline was followed. The databases used were Embase, ScienceDirect, PubMed, and Google Scholar. The Joana Briggs Institute (JBI) scale was used to assess the quality of the included studies. The data was extracted by Microsoft Excel and analyzed through STATA version 14 software. The overall pooled prevalence of TD and its main components were estimated using the random-effects model. The consistency of studies was assessed by I2 test statistics. Pooled meta-logistic regression was used to present the pooled prevalence with a 95% confidence interval (CI). Besides, subgroup and sensitivity analyses were employed. RESULT: Thirty-eight studies were included. The pooled prevalence of TD was 20.24% (95% CI: 17.85, 22.64). The pooled prevalence of subclinical hypothyroidism, hypothyroidism, subclinical hyperthyroidism, and hyperthyroidism was found to be 11.87% (95% CI: 6.90, 16.84), 7.75% (95% CI: 5.71, 9.79), 2.49% (95% CI: 0.73, 4.25), and 2.51% (95% CI: 1.89, 3.13), respectively. Subgroup analysis based on continent revealed a higher prevalence of TD in Asia and Africa. Factors like being female, HbA1c ≥ 7%, DM duration > 5 years, family history of TD, central obesity, smoking, the presence of retinopathy, and neuropathy were found associated with TD. CONCLUSION: The current systematic review and meta-analysis showed that the TD's pooled prevalence was relatively higher than the general population. Therefore, regular screening of TD should be done for T2DM patients.

Prevalence of Diabetes Mellitus, Prediabetes and Its Associated Factors in Dessie Town, Northeast Ethiopia: A Community-Based Study.

BACKGROUND: Diabetes mellitus is becoming an epidemic public health problem in developing countries such as Ethiopia. As the International Diabetes Federation indicates, the number of adults living with diabetes globally has been increasing from time to time. If early screening and follow-up are done, diabetes is a manageable disease. However, diabetes study at the community level in Ethiopia is limited and scarce. Therefore, the present study was conducted to assess the current prevalence of DM, prediabetes and its associated factors in Dessie Town, Northeast Ethiopia. METHODS: A community-based cross-sectional study was conducted from January to March 2019 among people aged 18 years and above in Dessie Town, Northeast Ethiopia. A multistage sampling technique was used to select a total of 587 study participants. Sociodemographic and behavioral characteristic data were collected using a pretested semi-structured questionnaire. Venous blood samples were used to determine the level of blood glucose and lipid profile. Diagnosis and classification of diabetes mellitus and prediabetes were based on the criteria of the American Diabetes Association. RESULTS: The prevalence of diabetes mellitus and prediabetes was 6.8% (95% CI 4.9-9.0) and 15.7% (95% CI 12.9-18.7), respectively. The prevalence of previously undiagnosed diabetes mellitus was 72.5%. Positive family history of diabetes mellitus (AOR: 20.24, 95% CI 4.74-86.43), smoking habit (AOR: 12.12, 95% CI 2.30-63.73), overweight (AOR: 21.95, 95% CI 6.73-71.603), systolic hypertension (AOR: 4.61, 95% CI 1.09-19.50) and hypercholesterolemia (AOR: 8.97, 95% CI 2.05-39.23) were significantly associated with diabetes mellitus. Prediabetes was associated with advanced age (AOR: 3.55, 95% CI 1.16-10.79), marital status (single) (AOR: 3.06, 95% CI 1.40-6.67), educational status (illiterate) (AOR: 2.35, 95% CI 1.04-5.35) and overweight (AOR: 2.11, 95% CI 1.05-4.23). CONCLUSION: There was a higher prevalence of diabetes mellitus and prediabetes. In addition, the prevalence of undiagnosed diabetes mellitus was high in our study area. Therefore, targeting the control and prevention strategy to such modifiable risk factors associated with diabetes and prediabetes may contribute to the reduction of the prevalence and further complications of diabetes mellitus.

Errors in the Total Testing Process in the Clinical Chemistry Laboratory at the University of Gondar Hospital, Northwest Ethiopia.

BACKGROUND: Laboratory services have been described as the major processes contributing to safe patient care in the modern healthcare sector. However, occurrences of errors in the overall testing processes impair the clinical decision-making process. Such errors are supposed to be high in resource-poor countries, like Ethiopia. The objective of this study was to assess errors in the total testing process in the Clinical Chemistry laboratory of the University of Gondar Hospital, Northwest Ethiopia. METHODS: A cross-sectional study was conducted at the University of Gondar Hospital from February to March 2016. All the required data were collected using established quality indicators. Data were analyzed using SPSS version 20. Frequencies and cross-tabulations were used to summarize descriptive statistics. RESULTS: A total of 3259 samples and corresponding laboratory request forms were received for analysis. The analysis of the overall distribution of errors revealed that 89.6% were pre-analytical errors, 2.6% were analytical, and 7.7% were post-analytical errors. Of the pre-analytical errors, incomplete request form filling was the most frequent error observed, followed by sample rejection rate (3.8%). Analytical errors related to internal and external quality control exceeding the target range, (14.4%) and (51.4%) respectively, were reported. Excessive turnaround time and unreported critical value cases were the major defects in the post-analytical phase of quality assurance. CONCLUSION: The present finding showed relatively high frequency of errors, which alarms the importance of quality indicators to assess errors in the total testing process. The University of Gondar Hospital laboratory should improve the quality of healthcare services based on these findings using laboratory standards.