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Aim: This meta-analysis's objective was to assess the effectiveness of ursodeoxycholic acid (UDCA) in the management of nonalcoholic fatty liver disease (NAFLD). Methods: Electronic databases like PubMed, Embase, Scopus, and Cochrane Library were thoroughly looked for randomized controlled trials determining ursodeoxycholic acid's (UDCAs) effectiveness on the serum liver function tests in NAFLD patients. After screening, seven randomized controlled trials were incorporated overall. Utilizing a fixed effects model, quantitative data synthesis was performed in R version 4.3.1. Results: The meta-analysis showed significant reductions in alanine transaminase (ALT) (p ≤ 0.0001), aspartate transaminase (p = 0.0009), and gamma-glutamyl transferase (GGT) (p ≤ 0.0001) after UDCA therapy. However, significant reductions in bilirubin (p = 0.6989) and alkaline phosphatase (ALP) (p = 0.1172) levels were not noted. Sensitivity analysis by removing the studies with some concerns of bias was successful in demonstrating a remarkable reduction in heterogeneity for aspartate transaminase and ALP, which was also observed while performing the subgroup analyses via dosage. Conclusion: Ursodeoxycholic acid was beneficial in patients diagnosed with NAFLD as it significantly reduced aspartate transaminase, ALT and GGT levels. However, more randomized controlled trials are required to be conducted in the future to increase the certainty of the evident findings. Clinical significance: This meta-analysis strengthens the evidence about the reductions in AST, ALT, and GGT levels observed with ursodeoxycholic acid therapy in NAFLD patients by pooling the data together from the latest RCTs thus proving its hepatoprotective effects which can be beneficial in preventing the associated complications. How to cite this article: Patel VS, Mahmood SF, Bhatt KH, et al. Ursodeoxycholic Acid's Effectiveness in the Management of Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-analysis. Euroasian J Hepato-Gastroenterol 2024;14(1):92-98.
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Background: Since the coronavirus (COVID-19) pandemic began, several studies were published on the possible prevention and treatment of the disease caused by severe acute respiratory syndrome coronavirus (SARSCoV-2), and its complications. However, one aspect that was overlooked is the impact on the mental health of the caregivers of COVID-19 patients. The current study endeavors to investigate sleep quality disturbances in the caregivers of COVID-19 patients in different countries. Material and Methods: This cross-sectional multi-center study was performed between August 1, 2021, and August 30, 2022, across 11 countries. A total of 2411 responses meeting the inclusion criteria (being a family member or caregiver involved in patient care) were collected. The sleep quality was assessed using the self-reported Pittsburgh Sleep Quality Index (PSQI) 12. Total scores ranged from 0 to 21. A ≥5 indicated poor sleep quality with 89.6% sensitivity and 86.5% specificity. Results: A total of 2411 responses meeting the inclusion criteria showed that mean PSQI scores (P = 0.3604) were higher in caregivers of hospitalized patients than in patients isolated at home. Approximately 62.4% of caregivers reported sleep quality problems while caring for their patients. Conclusion: The results showed that the majority of caregivers of patients with COVID-19 reported disturbances in sleep quality and impaired sleep was more common among caregivers of hospitalized patients, perhaps because hospitalization is associated with a more severe course of the disease. There is a pressing need to take measures to improve the mental health of these caregivers. There should be treatment programs set up to reverse sleep disturbances in this population sufficiently.