Objectives: To investigate the incidence, risk factors, and management of meningitis in cochlear implant (CI )users. Methods:A systematic review was carried out using PubMed, Scopus, Web of Science, and Cochrane Central Register. Articles were considered relevant if reported any data on incidence, clinical presentations, the role of vaccination, management, and outcomes of meningitis after CI.Results: A total of 32 studies including 27358 patients were included, and meningitis was reported in only 202 cases. Meningitis occurred in the period ranging from 1 day to 72 months after CI. A total of 55 patients received the pneumococcal vaccine, while 20 patients received the Haemophilus influenzae type B vaccine. A large number of participants (n=47) had associated anatomical malformations, while 62 Systematic Reviewhad otitis media before meningitis. A total of 24 cases required revision surgery along with medical treatment. Full recovery was the outcome reported by the included studies in 19 patients. Conclusion:Cochlear implant users seem to be at possible risk of bacterial meningitis at any time after implantation, especially in the presence of risk factors, such as otitis media and anatomical malformations of the cochlea.
Hormone replacement therapy (HRT) is defined as a therapy that could allow women to free themselves from the malediction of estrogen loss and conserve their femininity. The study aims to summarize the updated evidence regards types, indication, contraindication, and untoward effects of hormonal replacement therapy among menopausal women. There are several different drug classes comprising estrogens, progestogens, and estrogen + progestogen combinations. Estrogen is the primary active component of HRT, treating menopausal symptoms, particularly vasomotor symptoms. There are several adverse effects of hormone replacement therapy that manifest in many different ways depending on the route of administration, and whether that route has local or systemic effects. Further research is needed to study the risks of menopausal HRT and pharmacological studies are needed to lower these risks and make its use safer with less side effects.
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