Coronavirus disease 2019 (COVID-19) has a wide-ranging spectrum of clinical symptoms, from asymptomatic/mild to severe. Recent research indicates that, among several factors, a low vitamin D level is a modifiable risk factor for COVID-19 patients. This study aims to evaluate the effect of vitamin D on hospital and laboratory outcomes of patients with COVID-19.Five databases (PubMed, Embase, Scopus, Web of Science, and Cochrane Library) and clinicaltrials.gov were searched until July 2022, using relevant keywords/Mesh terms. Only randomized clinical trials (RCTs) that addressed the topic were included. The Cochrane tool was used to assess the studies’ risk of bias, and the data were analyzed using the review manager (RevMan 5.4).We included nine RCTs with 1586 confirmed COVID-19 patients. Vitamin D group showed a significant reduction of intensive care unit (ICU) admission (risk ratio = 0.59, 95% confidence interval (CI) [0.41, 0.84], P = 0.003), and higher change in vitamin D level (standardized mean difference = 2.27, 95% CI [2.08, 2.47], P < 0.00001) compared to the control group. Other studied hospital and laboratory outcomes showed non-significant difference between vitamin D and the control group (P ≥ 0.05).In conclusion, vitamin D reduced the risk of ICU admission and showed superiority in changing vitamin D level compared to the control group. However, other outcomes showed no difference between the two groups. More RCTs are needed to confirm these results.

Choledocholithiasis means the presence of gallstone inside the common bile duct (CBD). Removing the bile duct stones can be done surgically using endoscopic catheters. In this study, we aim to assess the safety and efficacy of basket catheters compared to balloon catheters at bile duct stone clearance. We searched four databases for clinical trial and cohort studies that compare basket catheter and balloon catheter in bile duct stone extraction. We extracted data from the included studies. These data were pooled as mean difference (MD) or risk ratio (RR) with 95% confidence interval (CI) using Review Manager software (version 5.3) and OpenMetaAnalyst software for zero-event outcomes. In a total of 728 patients, we find that the balloon catheter was better than the basket catheter regarding incomplete bile duct stone clearance (RR = 0.91, 95% CI [0.85, 0.98], P = 0.01). Regarding the number of the extracted stones by both catchers, the analysis favored the balloon catheter over the basket for clearance when less than four stones (RR = 0.91, 95% CI [0.85, 0.99], P = 0.02) but no significant difference for more than four stones (RR = 0.77, 95% CI [0.48, 1.24], P = 0.29). There was no significant difference between the two groups. The analysis revealed that the balloon catheter is better than the basket catheter for choledocholithiasis regarding the complete clearance of the stone. However, there was no significant difference regarding the safety outcome.

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Background: Stroke is a major cause of disability and death. Stroke recovery outcomes range from functional impairment to disability. This study was designed to compare the recovery results of stroke patients treated with fluoxetine to those treated with placebo.

Background: Dupilumab is a human monoclonal antibody directed against the alpha subunit of the interleukin-4 receptor and inhibits the signaling of IL-4 and IL-13. It is approved for treating asthma and other type-2 inflammatory diseases. There is a conflict in the literature regarding the safety and efficacy of dupilumab. Thus, we aimed to assess the safety and efficacy of dupilumab in patients with moderate to severe asthma.Methods: Six databases (PubMed, Embase, Scopus, Web of Science, Cochrane library, and clinicaltrials.gov registry) were searched until January 2022. We included randomized controlled trials that compared dupilumab with the placebo in moderate to severe asthma patients. We extracted the data at 12 and 24 weeks and analyzed them using review manager 5.4.Findings: Thirteen trials were included. Dupilumab significantly improved the forced expiratory volume in 1 s, asthma control questionnaire score, the fraction of exhaled nitric oxide level, and immunoglobulin E level at 12 and 24 weeks (p &lt; 0.05). However, it was associated with increased blood eosinophils at 12 and 24 weeks. Dupilumab was generally a safe agent for asthmatic patients. It showed no significant difference compared with the placebo regarding most adverse events.Conclusion: Dupilumab improves pulmonary function and reduces local and systemic inflammatory markers with minimal adverse events in patients with moderate to severe asthma.