RESUMO
Chronic rhinosinusitis (CRS) is a prevalent health problem that affects many people around the world and can require surgical intervention if conservative therapy fails. Functional endoscopic sinus surgery (FESS) is a minimally invasive surgical procedure commonly used to manage CRS. The success of FESS depends on various factors, and larger studies are necessary to determine its efficacy in managing CRS in this population. This systematic review and meta-analysis of the available literature aims to provide a comprehensive assessment of the effectiveness of FESS in the Middle East. We followed the standards outlined by PRISMA and the Cochrane Handbook for systematic reviews. The primary outcome of interest was the quality of life (QOL), and the secondary outcome was the recurrence of CRS. This systematic review and meta-analysis was conducted, and sensitivity analysis was performed to examine the robustness of the results. Six studies were included. The review found that the QOL significantly improved (p < 0.001). Two studies reported recurrence of CRS after FESS, and data showed that the recurrence of CRS after surgery was 6%. FESS is an effective intervention for CRS, but further research is needed on recurrence rates.
RESUMO
Urology focuses on the treatment of genitourinary disorders through therapies ranging from lifestyle changes to advanced surgeries; the field has recently incorporated robotic and minimally invasive technologies that have improved patient outcomes and reduced hospital stays and complications. However, these methods still have certain limitations. Regenerative medicine, focusing on natural repair abilities, can be an effective and safer alternative. This review aims to examine the impact of regenerative medicine in urology. We adopted a systematic review design by following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. An exhaustive online literature search involving the databases PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), and Google Scholar was conducted spanning the period between January 2010 and October 2023. Data were extracted from studies on regenerative medicine in urology with a special focus on efficacy and safety. Data from 16 studies were analyzed, which showed that cell therapy, biological materials, and tissue engineering are generally used in the field of urinary diseases. The main applications include the regeneration of urinary tissue, the correction of urinary incontinence, the treatment of erectile dysfunction, the reconstruction of ureteric defects, and the formation of bladder tissue. The study findings generally lack definitive conclusions on effectiveness and safety. While our results indicate that regenerative medicine is successful on a subjective level, more clinical trials are needed to establish its effectiveness and safety.
RESUMO
BACKGROUND: Coronary artery disease (CAD), manifested mainly as acute coronary syndrome (ACS), continues to be a major cause of mortality globally and a significant contributing factor to the global disease burden. Elevation of low-density lipoprotein cholesterol levels attributed to proprotein convertase subtilisin/Kexin type-9 (PCSK9) during and following ACS puts patients at high risk of subsequent adverse events. Evolocumab is a PCSK9 inhibitor that is associated with a significant reduction in low-density lipoprotein cholesterol (LDL-C) levels through PCSK9 inhibition in comparison to traditional statin therapy. METHODS: We conducted a systematic review and meta-analysis of literature addressing the efficacy and safety of evolocumab compared to other lipid-lowering therapies or placebo. An extensive internet-based literature search using pre-determined key phrases supported by medical sub-headings and Boolean operators was performed in October 2022 to identify literature pertinent to the research topic. The search was primarily based on the National Library of Medicine (PubMed and Clinical Trials), MEDLINE, Cochrane, and the Science direct literature databases. Subsequently, the researchers devised PICOs-based screening criteria which had to be met by each identified study for inclusion in the review and meta-analysis. Two independent reviewers conducted data stratification and quality assessment of identified studies. Statistical analysis of the primary and secondary outcomes was conducted on the Cochrane REVMAN 5.4 statistical software for randomized trials. RESULTS: Two thousand five hundred and seventy-six potential studies were identified for inclusion in the systematic review. Data stratification, screening, and quality assessment of these studies based on the eligibility criteria led to the exclusion of two thousand five hundred and sixty-seven studies as they did not meet the standards set. Nine randomized controlled trials progressed to numerical analysis for validity and reliability. Eight studies were included in the meta-analysis. Meta-analytical results showed a significant decrease in LDL-C changes from initiation of evolocumab therapy to 8 weeks following ACS compared to placebo. Similar results were derived in the sub-acute phase of ACS [SMD -1.95 (95% CI -2.29, -1.62)]. The meta-analysis revealed no statistically significant relationship between the risk of adverse effects, serious adverse effects, and major adverse cardiovascular events (MACE) from treatment using evolocumab in comparison to placebo [(relative risk, RR 1.04 (95% CI 0.99, 1.08) (Z = 1.53; p=0.12)]. CONCLUSION: Early evolocumab therapy initiation was associated with a significant decrease in LDL-C levels and was not associated with an increased risk of adverse effects in comparison to placebo.
RESUMO
The Coronavirus Disease 2019 (COVID-19) outbreak caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) resulted in a worldwide pandemic of a highly infectious disease. The difficulty of dealing with COVID-19 is the broad spectrum of clinical manifestations that involves various pathophysiological mechanisms, severities, duration, and complications. This study aims to help emphasize the factors related to the persistence and duration of anosmia (loss of smell) and ageusia (loss of taste) as part of post-acute COVID-19 syndrome in Saudi COVID-19 patients via a retrospective cross-sectional design. Eight hundred and eighty-one participants were recruited between March and April 2021. Those participants were 18 years or older, recovered from the COVID-19 infection, and completed 14 days after the onset of the acute phase of the disease. Among the 881 recruited participants, 808 have submitted eligible responses and were included in data analyses. The most common persistent symptoms in post-acute COVID-19 syndrome were anosmia (33.8%) and ageusia (26.4%). The data also showed a significant association between female sex and the incidence and the persistence of anosmia and ageusia. In multivariable analysis, anosmia during the acute phase was associated with BMI, asthma and shortness of breath, while anosmia during the post-acute phase was associated with sex. Ageusia during the acute phase was associated with sex, myalgia and arthralgia, while ageusia in the post-acute phase was associated with sex.
