Prevalence of EBV infection in 1157 diseased cohorts in Nigeria: A systematic review and meta-analysis

BackgroundEpstein-Barr virus (EBV) is a member of the herpesvirus family that is known to ubiquitously infect people worldwide. However, the actual prevalence of EBV infection in diseased patients in Nigeria, remains unknown. This study was thus conducted to ascertain the true prevalence.MethodsA systematic review and meta-analysis of published data was conducted according to the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Electronic databases including PubMed, Scopus, ScienceDirect, and Google Scholar were searched for studies reporting the occurrence of EBV infection among patients with established diseases. Studies were included if they assessed EBV infection in diseased patients in Nigeria. Data were extracted and subsequently analysed using R software. Funnel plot and Egger's regression test was used to assess publication bias, while JBI prevalence tool was used to assess study quality.ResultsA total of 13 studies covering 228 cases of EBV infection among 1157 diseased patients were included. Summary estimates were computed using random-effects model. The pooled prevalence of EBV infection was 20.3% (95% CI: 10.8–34.9, I² ?= ?92.26, p ?< ?0.001). When stratified according to the type of disease, higher estimates were obtained for patients suffering from Kaposi's sarcoma (98.7%, 95% CI: 82.2–99.9) and Nasopharyngeal malignancy (85.7%, 95% CI: 70.0–93.9). A prevalence of 13.4% (95% CI: 6.0–27.4) and 12.2% (95% CI: 4.8–27.8) was derived for the most reported patient populations, lymphoma and HIV, respectively.ConclusionThis first meta-analysis on the prevalence of EBV among Nigerian patients suffering from various diseases reveals a prevalence that emphasises the need to routinely monitor EBV infection in all EBV-associated diseases in Nigeria.     

Filiform needle acupuncture for allergic rhinitis: A systematic review and meta-analysis

BackgroundFiliform needle acupuncture (FNA), the most classical and widely applied acupuncture method based on traditional Chinese medicine theory, has shown a promising effect in the treatment of allergic rhinitis (AR).ObjectiveTo evaluate the efficacy, safety, cost-effectiveness, and patient preference of FNA in the treatment of AR by comparing FNA with sham acupuncture, no treatment, and conventional medication.Search strategyEight electronic databases were systematically searched from inception to October 14, 2021. Additional studies were acquired from clinical trial registration platforms and reference lists.Inclusion criteriaRandomized controlled trials were included if they compared FNA with either sham acupuncture, no treatment or conventional medication for AR.Data extraction and analysisTwo researchers extracted data independently of each other using a predesigned data acquisition form, and results were cross-checked after completion. The primary outcome was symptom score (Total Nasal Symptom Score or Visual Analogue Scale), and the secondary outcomes were the AR control questionnaire, quality of life (QoL) score (Different versions of Rhinoconjunctivitis Quality of Life Questionnaire), medication score (use of rescue medication), mental health score, total IgE, adverse event rate, clinical economic indicators, and patient satisfaction score. Standardized mean difference (SMD) or mean difference (MD) with 95% confidence interval was used to calculate the effect size for continuous data, while risk ratio with 95% CI was used for dichotomous data.ResultsThirty studies were included in this review. Compared with sham acupuncture, FNA significantly reduced the symptom score (SMD: ?0.29 [?0.43, ?0.15]), AR’s impact on QoL (SMD: ?0.23 [?0.37, ?0.08]) and medication score (SMD: ?0.3 [?0.49, ?0.11]). Compared with no treatment, FNA dramatically reduced the symptom score (SMD: ?0.8 [?1.2, ?0.39]) and AR’s impact on QoL (SMD: ?0.82 [?1.13, ?0.52]). There were no increased rates of adverse events with FNA compared to sham acupuncture and no treatment. FNA increased patient satisfaction and may be cost-effective. Most pieces of evidence from the above two comparisons were of high confidence. Moreover, FNA significantly outperformed conventional medication in reducing the symptom score (SMD: ?0.48 [?0.85, ?0.1]) and displayed a lower rate of adverse events, but the quality of evidence was very low.ConclusionFNA is an effective and safe intervention for AR and can help with symptom relief, QoL improvement, reducing medication usage, and increasing patient satisfaction. Further studies are needed to verify its cost-effectiveness and superiority over conventional medication and the best therapeutic strategies.     

醛固酮受体拮抗剂螺内酯治疗难治性高血压疗效和安全性的Meta分析

背景难治性高血压是一种特殊类型的高血压，病因复杂，治疗难度大，更易引起靶器官损害。近年研究发现，在难治性高血压患者三联常用降压药物治疗基础上添加小剂量螺内酯能有效控制血压。但这些研究规模普遍较小，其有效性与安全性尚需进一步验证。目的系统评价螺内酯治疗难治性高血压的疗效及安全性。方法计算机检索PubMed、Web of Science、The Cochrane Library、中国知网、维普网、万方数据知识服务平台，筛选螺内酯治疗难治性高血压的随机对照研究，检索时间为建库至2021-05-03。由2名研究员独立筛选文献、提取资料并评价纳入研究的偏倚风险后，采用RevMan 5.3软件进行Meta分析。结果共纳入20项研究。9项研究未报告随机化分组方法，1项研究按纳入顺序编号奇偶分配（错误的随机化方法），7项研究未描述是否采用盲法，4项研究为开放标签，3项研究描述了分配隐藏，1项研究结果数据不完整、未报告对照组治疗后的安全性指标。Meta分析结果显示，疗效方面：与安慰剂和空白对照相比，螺内酯降低诊室血压、24 h动态血压、日间血压及夜间血压的效果好（P<0.05）；与其他降压药物总体相比，螺内酯降低诊室收缩压、24 h动态血压、日间收缩压、夜间收缩压及家庭自测收缩压的效果好（P<0.05）；与肾脏去交感神经术相比，螺内酯降低日间血压及夜间收缩压的效果好（P<0.05）。安全性方面：与安慰剂相比，应用螺内酯患者的血钾及血肌酐水平高（P<0.05）；与其他降压药物总体相比，应用螺内酯患者的血钾水平升高（P<0.05）；与肾脏去交感神经术相比，应用螺内酯患者的血肌酐水平升高（P<0.05）。结论螺内酯治疗难治性高血压是相对有效及安全的，但受纳入研究数量和质量的限制，该结论尚需更多高质量研究予以证实。     

Effects of blueberry and cranberry on type 2 diabetes parameters in individuals with or without diabetes: A systematic review and meta-analysis of randomized clinical trials

AimsBlueberry and cranberry are rich in polyphenols that are associated with diabetes reduction. This study aimed: 1) to systematically review the literature on the effects of blueberry and cranberry consumption and type 2 diabetes parameters in individuals with or without type 2 diabetes and 2) to quantify these effects by carrying out a meta-analysis.Data synthesisA systematic review and meta-analysis were performed using articles present in seven databases (PubMed, LILACS, Scielo, Scopus, Web of Science, Cochrane, and Embase), including publications until May 2021. We included randomized clinical trials that compared blueberry or cranberry effects on type 2 diabetes parameters, such as fasting blood glucose, insulin resistance, and glycated hemoglobin. Quality of the studies was performed using the Cochrane scale, while the Egger test assessed the publication bias and meta-regression the estimated effect sizes with potential moderator variables. From the 2034 studies identified, 39 were read in full and 22 were included in meta-analysis. In individuals with diabetes, the consumption of blueberry or cranberry significantly reduced fasting blood glucose [MD: ?17.72 mg/dl; 95% CI: ?29.62, ?5.82; p = 0.03; I2 = 57%] and glycated hemoglobin [MD: ?0.32%; 95% CI: ?0.57, ?0.07; p = 0.15; I2 = 39%], whereas for insulin resistance the effects were null. Results were not significant for the general population, except in the sensitivity analysis for fasting blood glucose.ConclusionsThe consumption of blueberry and cranberry significantly reduced fasting blood glucose and glycated hemoglobin levels in individuals with diabetes, with high credibility of the evidence.